It's Never too late Ladies

 

My dear friend Renu wrote this after watching my TV interview ( in Kannada Language) after I created a World record of being the Oldest Woman to have climbed the 8th highest and 4th dangerous mountain of the world, Manaslu which is a 8163 metres peak in Nepal.

https://youtu.be/uoSZsRNgTh0?si=3AGhVOmBlGscTGUE

Dear Usha.....

After your interview to media , my views.

The moral of your journey is...."" IT'S NEVER TOO LATE ""

Defying age - related stereotypes, women are living life on their own terms.Be it embracing hobbies, pursuing higher education, entrepreneurship, entering politics, social work, solo adventures , mountaineering , whatever.... they are exploring opportunities in a world of ever evolving possibilities.

Women can always dream, their aspirations need not dim with time.Despite life's challenges, let us have the courage to pursue dreams , defying age constraints, for it's never too late to make our aspirations a reality.

Ageing is an undeniable journey,path we all have to tread , yet growing old remains an irreversible truth. As time marches on, dreams that once shined brightly in our eyes, often dim with the passing of years.we watch as time slips through our fingers, and that it is too late cliche echoes in our minds.The notion of acting at the right time becomes deeply ingrained, stealing away our hopes and aspirations.

For all those brave explorers, age is never a barrier. Fulfilling dreams isn't always about grand achievement , it's breathing life into the smallest of aspirations.Its about defying the conventions of age and stepping boldly into a world of opportunities. 

 Many women have embarked on this journey of renewal, and they will tell you unwavering conviction: that it's NEVER TOO LATE. 

  I believe in narishakti , women embody the boundless potential within.we should refuse to let societal stereotypes about ageing defining us.

My own experience during COVID.....No where to go and doing the monotonous household chores with nobody to help....i thought of doing something to beat this... As I was browsing YouTube , i found one channel ,lady doing cement fountains, I was attracted by the sound of water falls. why not this ? To my luck all materials needed for this were lying in my car garage. I immediately jumped over this idea and could do not one but 4 concrete fountains which are in working conditions even now. What i learnt from this is ... little bit of civil engineering.

Having learnt this , I wanted to learn something different again, browsed again, colours attracted me .... Bought some painting brushes and colours which i had never touched and started to play with the colours on the canvas. 

 Question is.... why I am telling this beautiful experience is.....

Nowadays, e- learning has removed age as a barrier.All it takes is optimism and adaptability - to learn, adjust and realize that it's NEVER TOO LATE.

 As the age - old saying goes, there is no age limit to learning.Many women are now taking online courses to acquire new skills, switch career paths, or even navigate through midlife crisis.

 Having learnt this , I wanted to learn something different again, browsed again, colours attracted me .... Bought some painting brushes and colours which i had never touched and started to play with the colours on the canvas. 

 Question is.... why I am telling this beautiful experience is.....

  Nowadays, e- learning has removed age as a barrier.All it takes is optimism and adaptability - to learn, adjust and realize that it's NEVER TOO LATE.

 As the age - old saying goes, there is no age limit to learning.Many women are now taking online

Thank  courses to acquire new skills, switch career paths, or even navigate through midlife crisis.

"Torn between” Lines from a Working Mom’s Dairy

 “Torn between” Lines from a Working Mom’s Dairy by Dr Shylasree Surappa

I was always in a state of dream during my teens and childhood,

went skipping to school without comparing my life with others.

The only dilemma in those days was to buy a flowery frock or a stripy one.

Sometimes I rebelled to have a fringe cut, but it was always bob cut!

I ate everything my mother cooked, most delicious and healthy food

Dad put in the culture of learning something new all the time.

We swam and climbed trees against norms of those days.

I even rode a scooter and typed on a noisy Remington at lightning speed,

devoured everything my teachers taught, some stern and some soft, but all kind and loving.

The only thing I complained in those days was mosquitoes singing in my ears

and there were many of them in my town.

After graduating to be a doctor, choices I made were not great master plans.

They were random heady thoughts and whispers from my heart,

some strong and some not so but no obsessions or compulsions.

Personal and professional spaces were separate and synched without complaints

like neatly stacked books in a library with a color code.

Time appeared unlimited, I never once looked at my watch, with cool breeze touching the cheeks on sunset walks and starry nights.

Finally, managed to find love, maybe confused under the spell of hypothalamic–pituitary–ovarian axis!

Finding wallpapers and cushions for the nest sounded fun, despite my partner’s bored looks in shopping malls.

Two adults shared personal and professional space without short-circuiting each other, life sounded like frills without fuss.

Then, I ventured into an all-important journey without a map, decided to take a well-trodden path all animal kingdom takes, “having babies!”

Nobody ever explained to me that this path was like walking in the snowy alps without a warm hoody or in a jungle without footwear.

Pregnancy kicks from inside the tummy were meant to be enjoyed, but the tiny soft feet were getting bony and bigger by the weeks.

I slept on a king-size bed crosswise as little aliens with stinky diapers climbed on it in the middle of the night from nowhere.

Dinner time was a long-drawn process of preparing foods of various consistencies and ended in pasta and curry days, only cake days, and just

take away chips!

Juggling ten thousand tiny jobs, my circadian rhythm would have suited planets with longer than 24 hours to call it a day!

Life which was like classical physics once, nice and predictable, became quantum science, with chaos and random tantrums, not to be confused with premenstrual mood swings.

Everyone reassured that the results of such a journey are holistic and rewarding!!

At this stage, overwhelming thoughts entered my life which were not published in any journal medical or otherwise.

I confess, I had no guidelines with levels of evidence to clarify such thoughts.

Only soft conversations and deep breaths with women like me when I met them hurriedly in the lift or car parks.

Hence, sharing hypothesis generating dilemmas and thought bubbles for future research!

• Do I breast feed long or just as long as maternity leave goes? Immunity was not perfect science!

• Do I drive early to work before kids woke up or kiss them looking into eyes full of love? Emotions of guilt are deep seated!

• Do I look after my sick child or my ill patients? Duties have no boundaries!

• Do I write a scientific paper or paint with my toddler what looked like modern art? Expression has no limits!

• Do I go part-time and exercise or work and earn security for my kids? Time and retirement age are finite on earth!

• Do I attend a parent–teacher meeting or teach communication skills to my medical students? Charity begins at

home!

Such dilemmas and many more went on and on for nearly two decades of my life!!

I was left with a sea of choices and no perfect answer.

My head argued and heart tugged all the time, playing musical chair.

It was not “midlife crisis” or “burnout syndrome” reported in psychology.

No one had given a name to this universal feeling, which I constantly felt during the prime of my womanhood and I called it “torn between,”a chronic blissful state of tiredness and confusion.

Dr. Shylasree FRCOG

Consultant Gynecological Oncosurgeon

 Department of Gynaecology Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Indian Journal of Medical and Paediatric Oncology Vol. 43 No. 1/2022 © 2022. Indian Society of Medical and Paediatric Oncology.

Ps: sharing this article by my  sister Dr. Shylasree published in the Medical Journal on my blog as I feel it reflects what most of us, career women are going through. 

 

Cesarean Delivery

In general 20 % pregnancies end up in a cesarean delivery for various reasons. Some of these reasons might be predictable before hand leading to a planned or elective cesarean section where as some can happen as an emergency.

Elective cesarean decision although can be disappointing, is atleast planned and gives you time to think and plan the procedure.

However, if you end up having an emergency Cesarean, it can be quite upsetting, as there is not much time to absorb and think about the decision.

So what is a Cesarean Section?

A Cesarean section (also known as C-section or cesarean birth) is a surgical procedure that involves making abdominal and uterine incisions to deliver a baby. Cesarean sections are typically avoided before 39 weeks of pregnancy to allow the child to develop properly in the womb. However, if complications arise, a cesarean section is done before 39 weeks.

When is Cesarean Section Recommended?

A C-section may be recommended if:

• You've had a more than one C-section before

• The mother has infections such as HIV and active herpes

• The placenta is obstructing your cervix.

• The placenta separates from the uterus

• Multiple pregnancies may necessitate a C-section.

• Your baby is too big or in an awkward position for successful vaginal delivery.

• Your baby has birth defects that necessitate a C-section

• When complications arise during vaginal birth

• Labor stops progressing

• The baby shows signs of distress

How Long Does a Cesarean Section Surgery Take?

In general, the entire cesarean section surgery roughly takes 20 to 40 minutes. In certain situations, like in an emergency C-section, the cesarean birth will be quite speedy, with the baby arriving in less than 5 minutes.

How Do You Prepare for Cesarean Section?

When a caesarean section is recommended, your doctor will provide you with detailed instructions on how to minimize the risk of complications during a cesarean delivery. Your doctor will tell you to:

• Avoid solid foods eight hours prior to the C-section

• Bathe or shower using a special soap to reduce the possibility of infection following the procedure

• Avoid shaving your pubic area or stomach to lower the risk of infection after delivery

There are a variety of options available for pain management following surgery, these include IV drugs delivered continuously through a pump or as scheduled dosages, or medication administered by an epidural catheter or spinal.

What Happens During a Cesarean Section?

Before the surgery, your doctor will clean your abdomen and prepare you to receive IV fluids into your arm. This enables doctors to deliver fluids and medications as needed. A catheter will also be inserted to ensure your bladder stays empty during the procedure.

Different types of anesthesia are offered to expectant mothers:

Epidural: an epidural is common for both cesarean and vaginal deliveries. It is administered into the lower back outside the spinal cord sac

General anesthesia: a type of anesthesia that induces a painless sleep. It is typically reserved for emergency situations.

Spinal block: this type of anaesthesia is directly injected into the sac surrounding your spinal cord, to numb the lower section of your body.

Once you have been appropriately medicated and numbed, the surgery can begin. The area of the surgery will be covered throughout the procedure. The first incision will be made just above the pubic hairline. Typically, this is done horizontally across the pelvis, but for emergency situations, a vertical incision may be necessary. Once the incision is made and the uterus is revealed, another incision will be made into the uterus.

Following the second incision, your newborn will be delivered from your uterus. The doctor will first attend to your newborn by removing fluids from their nose and mouth, as well as clamping and separating the umbilical cord. 

At this point, the baby will  be handed over to hospital personnel, who will ensure that he or she is breathing normally and will prepare your baby for placement in your arms. Your uterus will then be restored using dissolving stitches, and your abdominal incision will be closed with sutures.

Recovering from a Cesarean Section

After the procedure, you will most likely be hospitalized for two to three days. The first few weeks following the surgery will be quite painful. Coughing, sneezing, or even laughing may be uncomfortable. Your pain management options will be discussed with you by your doctor.

You'll be advised to stay hydrated and walk after the effects of your anaesthetic wear off. This aids in the prevention of deep vein thrombosis and constipation. Your doctor will keep an eye on your wound for symptoms of infection. The bladder catheter will be removed as quickly as possible

You can begin breast-feeding your new-born as soon as you are ready. Your nurse will show you how to support your baby and position yourself so you're both comfortable. 

When you get home, take it easy and prioritize rest. You should also avoid sex for at least 6 weeks. If you experience symptoms such as overwhelming fatigue or severe mood swings, pain when urinating, signs of infection, foul-smelling vaginal discharge, breast pain accompanied by fever, or bleeding with large clots, consult your doctor.

What are the Risks of Cesarean Section?

The major risks involved with a cesarean section include

• Risks from anesthesia

• Excessive blood loss requiring blood transfusion

• Infection

• Bladder or bowel injury

• A blood clot may break off and make its way into the bloodstream

• Fetal injury rarely

Conclusion

Regardless of the type of birth you're hoping or planning for, a Cesarean section should not be completely ruled out. With adequate preparation, a C-section doesn’t have to be a negative experience.

Dr. Usha Kiran FRCOG

Consultant OBGY

Prime Hospital

Whatsapp no +91 90043 38835

PMSing or Attention seeking??

Unlike what some might believe, PMS is not a myth.

In fact, If you do a little Math you’ll find out that it touches a quarter of the world’s population at some time in their life. That’s over one billion girl/woman!!

But what is PMS, really? Is it severe enough to halt and disturb a woman’s life and performance? Well, here is a simple ID of PMS:

Name: Premenstrual Syndrome (PMS)
Ages of sufferers: between 12 and 50 years of age
Places it affects: The entire body and mind
Time of trigger: After ovulation and before menstrual cycle begins
Symptoms: bloating, headaches, mood swings, cravings for certain types of food…
Consequences: Tiredness, irritability…well, not the best feeling you can have!!               

This combination of physical and emotional symptoms that a substantial number of women get is due to a hormonal change when estrogen and progesterone levels begin falling dramatically if one is not pregnant.

So it is good, right? That is, if you are not ready to go into motherhood yet!

Sadly, people around you are not aware that you are going through that phase, and hence may not be understanding enough!

You could be accused of being lazy, or simply seeking attention, which definitely is not the case.

So can we say that women should bear their discomfort quietly and not remedy to it?

Not in the 21st century, you don’t!!

Here are some tips you can try to alleviate the pain and make this period as smooth as possible:

1. Yes, get some pain killers (Ibuprofen, Aspirin, simple over-the-counter medicine that can lessen headaches, cramps…). No need to be a masochist at this point, it is ‘dépassé’ and so 19th century!!
2. Homeopathy can help too (no need to burn sage yet!!) with a nice warm herbal brew prepared by your mom/partner. Peppermint, Fennel and aniseed are very efficient, plus the mere aroma of those teas can have a relaxing effect on the mind.
3. Adopt a healthy lifestyle throughout the month (eat healthy food, exercise regularly, meditate, get enough sleep…) for this will help lessen the pain and discomfort when PMS hits.
4. Talk to friends you feel comfortable with. There is no shame in letting people know you are at that critical time of the month as they can understand and sympathize with you.

Remember, PMS is NOT a disease, neither a situation you need to shun away from but if you feel taking a day off can help, why not?! The world will understand.

Dr. Usha Kiran FRCOG

Consultant OBGY

Prime Hospital

Whatsapp no +91 90043 38835

Why do i want to blog?

People often ask me why wanted to blog when there  is already an overwhelming amount of online information and I have a chance for one to one communication with my patients. 

Well, there are two main reasons for my desire to  blog. 

I believe that  communication is the key to success in any venture and all the more so in healthcare. 

Knowledge is power which takes away the fear of unknown and  empowers one to take charge of the situation. 

I have been in this specialty for more than 25 years and  I have worked in some of the best hospitals in India, the UK, and the UAE.

A common desire of patients, irrespective of nationality, culture, and religion, is to get uncomplicated and accurate solutions that cut through medical jargon. Many of my patients tell me that  online formation is not individualistic and many times makes them more anxious instead of allying their fears. The reason probably is cos most of the blogs are by non medical writers as doctors are too busy to pen down their thoughts. 

 My patients feel that my simple, sincere, and straightforward way of communication relieves them of their anxiety and helps them to cope with their situation better. 

 I specialize in High risk pregnancy care and Minimal access  (Laparoscopic & Hysteroscopic) surgeries. 

Communicating with patients in these situations is time consuming and  despite effective communication, it is difficult for patients to retain all that is said to them in one sitting. Many women, including those who are not my patients also have similar common queries. 

For instance, one of the recurring queries from women is on fasting in pregnancy during Ramadan. So, instead of answering each woman separately, I decided to blog to make the information accessible to all women, including those unknown to me.

 My blog is a bridge to reach out to not just my patients but to the women of this world. It aims to help them navigate the challenging journey of womanhood with straightforward answers to their health-related questions.

My blogs reflect my learning as a woman who has been through all phases of womanhood from puberty to pregnancy, motherhood and finally, menopause. Each stage is a milestone and has a distinctive mood. I feel grateful that I can draw upon my experiences to offer a perspective to the many concerns women face, medical and individual.

I feel privileged to be on this journey with them.

Nightmares of Breastfeeding

Whoever said ‘breastfeeding is a natural instinct?' Maybe in the animal kingdom, not for humans anymore.  

Maybe our ancestral women had more time on their hands, had more children and learnt more from their mothers and relatives about breastfeeding.  

But in this modern era where we women are always multitasking, breastfeeding is weighing heavy on our hearts and minds as neither does it come naturally nor is it easy to learn. 

Some fortunate ones do it very easily and spontaneously. However, not everyone is that lucky. 

After my own experience and seeing some of my patients go through this with a considerable amount of confusion and stress, I decided to write about the difficulties that women face rather than the benefits of breastfeeding (which I do not dispute).  

For those who have  or are experiencing difficulties, I would like to reassure and say 'Do not feel guilty, you are not alone.'  

1. Soon after the delivery, I was expecting to feel an intense desire to feed the baby, but I do not, Am I normal?  

We are often given the impression that as soon as you give birth, you will experience this overwhelming motherly love and wanting to feed the baby.  

Believe me, it is not so, and a majority of the women will agree with me on this. I looked at  my baby and all I could think of was 'how am I going to feel anything for this blob covered in liquor and blood.'  

That was 15 years ago, and today, words are not enough to express what I feel for my children.  So give it time. I am not saying 15 years! But alteast 15 minutes or a couple of hours.   
The feeling of bonding is the result of a hormonal milieu created by various hormones in the brain  such as Oxytocin, Dopamine, etc.;  Research has shown that 30% of women do experience delayed bonding which might be due exhaustion, pain or any other factor. 

 It is proven that if enough Oxytocin is injected, you can bond with anyone not just your baby! 

So do not despair, it will kick in, and you will feel the 'tug,' Just hang on.  

2. I have very small breasts, do you think I will be able to breastfeed? 

Do not worry, the size of the breasts does not make any difference. Size varies depending on the fat content in the breast and fat is not what is producing the milk for your baby.   

3. There is very little milk is coming; I don’t think this is enough for my baby as he/she is hungry all the time and keeps waking up every 10 minutes to feed.

 This is a  common problem faced by first-time parents. The anxiety that your baby is not getting enough milk is normal. But believe me, the baby doesn’t need a lot of milk in the first two days. 

In addition to this, the size of a newborn stomach is really tiny and can hold only a teaspoon full of milk at a time which means it can feed only a tiny quantity at a time.

  

However, by day 3 or 4, this capacity increases by four times and that is when you start noticing that you baby is sleeping a bit more between feeds. 

 By this time the baby's suckling reflexes also get better with practice.   

4.       Is it wrong to bottle feed my baby? 

There is nothing wrong or right about this. If for some reason, you are unable to breastfeed, there is nothing wrong with bottle feeding your baby. You can't let the baby starve, Can you ?! 

However, before you decide to bottle feed, you need to be aware of a few things. 

a.  Bottle feeding doesn’t always equate to formula feeding. You can bottle feed your baby with expressed breast milk (especially in premature babies who can't suck and are in neonatal intensive care).  This will provide all the benefits of breastfeeding. However, expression of breast milk either manual or by pump is not as stimulating as a baby suckling at your breast. So the establishment of milk production and maintenance is not effortless. So unless you did not have a choice (as in preterm or ill baby), it might be easier to breastfeed than bottle feed after the initial teething difficulties are overcome.   
b. Bottle feeding with formula feeds although might be less tiring and troublesome and makes you feel like a normal sane person, doesn’t have all the benefits of breastfeeding (such as ideal composition for baby's needs, gentle on the stomach, antibodies, less chance of infection plus lower risk of breast cancer for yourself to name a few )   
 

5.  My baby keeps vomiting and passing stools as soon as I finish feeding.   

This again is quite normal. As soon as the milk enters the stomach, there is a reflex which makes the baby pass stools. As long as the stools are not greenish and the baby is passing enough urine and feeding and playing well, you needn't worry.  Vomiting or regurgitation is more common in babies who are bottle fed as the baby ingests air while sucking through a bottle which is lesser while breastfeeding. It is important to keep the baby in upright position for a while or until it burps to prevent this.  

 6.  I was told not to feed the baby lying down, but my stitches in the perineum hurt.  

There is nothing wrong with feeding a baby lying down as long as your position is correct. The reason mothers are advised not to do so is because of the risk of suffocation if the mother goes off to sleep while doing so. So be careful that you do not fall asleep while doing so and hence definitely do not feed lying down in the night.   
 

7.  Can I take medicines to produce more milk?  

There is really no need for it. The main stimulus comes from the baby suckling. So if you want to increase your breast milk, just feed the baby more frequently. Drink lots of water and fluids (such as juice and milk which have the nutrients).  

Consult your doctor if you are not getting enough milk despite this.   
 

8.  I feel like a failure as my baby doesn’t want to feed from me as it feeds well from the bottle but cries when I try to breastfeed. 

Babies do not have any such feelings towards you. They are just doing what is easy for them. Milk flows more easily from the bottle, but baby needs to do a work out to get it out of your breast. So once they know this trick they just cry until they get the bottle.   

9.  Am I a bad mother if I do not want to breastfeed my baby?  

Despite everything you have heard and read, some of you might just not want to breastfeed at all. 

Honestly, that is ok.  No need to beat yourselves for it.   Like everything else you do in life, you do have a choice despite what everyone around you says. So do not feel guilty about it.   

10.  Will my baby bond with me if I do not  breastfeed? 

Fathers do not breastfeed! 

Breastfeeding is not the only way to bond with your baby.There are many more ways of bonding with your baby. Your baby will bond and love you as much even if you do not breastfeed.  

Bonding is not a one-time event anyway; it is a lifetime process.   
Good luck whether you decide to breastfeed or not.   

Dr. Usha Kiran FRCOG

Consultant Obstetrician and Gynaecologist

Specialises in Minimal Access surgery/Urogynaecology/High Risk Obstetrics 

Prime Hospital

Airport Road, Al Garhoud

Dubai

whatsapp no 00917208012411

Blog: drushakiran.blogspot.ae

You Tube channel: Dr Usha Kiran