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Dr Sudhir Kumar MD DM

@hyderabaddoctor

Jan 1

Short Story of a minor Struggle and Successfully overcoming it
May 2024
Flare up of ankylosing spondylitis (AS), caused pain in multiple joints, tendons and ligaments.
Sudden break on running after three and half years.
Even walking was difficult- every step was painful.
1/n

Waited for a day or two for pain to reduce/subside; as that was the norm earlier (during the past 34 years, after the most severe relapse in 1990, when I was hospitalized for more than three weeks at CMC Vellore).
Pain did not reduce, instead, it became more severe.
2/n

Consulted a rheumatologist and an orthopedic surgeon;
Investigations confirmed a relapse of AS (enthesopathy, tendinopathy, joint inflammation, etc)
Was suggested complete rest; pain-relief medications and specific medications (biologicals) for AS.
This appeared depressing..
3/n

Read 12 tweets

Dr Sudhir Kumar MD DM

@hyderabaddoctor

Jul 31, 2024

Running as a form of aerobic exercise increases longevity, but there are other factors to consider too.

The news of Jogi ji's passing away due to cardiac arrest during sleep is shocking. Our heartfelt condolences🙏

1. Joginder Chandna ji was extremely fit and had amazing statistics for a long-distance runner. His PB for 5k, 10k, HM and FM were 23 min, 46 min, 1:39 hours and 3:40 hours.

2. He had an amazing control over heart rate while running long distances. His latest long run (23 Km) was on Sunday, 28th July (2 days before we lost him). An AHR of 127 bpm (and a max HR of 139 bpm) for a pace of 6:50 min/Km is amazing.

3. His running mileage was not excessive. If we look at his last 12 months, his monthly running mileage ranged from 170-240 Km (which translates to 6-8 km per day, or 50-60 Km per week). This is within the safe zone as per research.

Read 7 tweets

Dr Sudhir Kumar MD DM

@hyderabaddoctor

Jan 30, 2024

By the time diabetes mellitus is diagnosed, it is already too late.

Take control when insulin resistance sets in. Or may be even before that.

Low carbohydrate diet and regular exercise are the keys to prevent insulin resistance, prediabetes and type 2 diabetes.

Ref: (1/n)doi.org/10.3390/antiox…

Lifestyle tips to manage insulin resistance

1. Lose excess weight (especially abdominal and visceral fat),
2. Engage in regular physical activity,
3. Sleep well,
4. Minimize stress,
5. Reduce carbohydrate intake,
6. Quit smoking.
(2/n)

Insulin resistance-related diseases in humans
(3/n)

Read 5 tweets

Dr Sudhir Kumar MD DM

@hyderabaddoctor

Jan 26, 2024

Running and heart diseases
Learning points from the past 30 years of published research

1. Runners have a lower risk of heart attack, as compared to people leading sedentary lifestyles,

2. Runners are 45% less likely to die from heart disease than non-runners,

3. The benefit starts with as little as 10 minutes of running per day, and increases with increasing running duration up to 60 minutes. There is no additional mortality benefit from running beyond 60 minutes per day (or beyond 7 hours per week),

4. In terms of distance, the benefit starts with 1 mile (1.6 km) of running and increases with greater running mileage. There is no established upper limit beyond which running is detrimental to heart health, however, benefits may plateau beyond 80 km of running per week,

5. Runners have a lower resting heart rate. Lower resting HR is associated with greater longevity,

6. Running has a favourable effect on risk factors for heart attack. Running is associated with higher HDL-cholesterol, lower LDL-cholesterol, lower triglyceride, lowering of BP, improved insulin sensitivity, lower HbA1C level and lower body mass index,

7. Sudden cardiac arrest during long distance running is rare. The incidence is 0.8 per 100,000. The fatality due to sudden cardiac arrest during running is 0.4 per 100,000,

8. Majority of cardiac arrests occur while a person is sleeping, sitting or standing; only a miniscule of them occur while a person is running or doing some form of exercise,
9. Sudden cardiac arrests that occur during marathons make it to the headlines, as they are dramatic, unexpected and those affected are younger and fitter,

10. Marathoners have a greater chance of surviving a cardiac arrest, as compared to non-runners,

11. Sudden cardiac arrest during running is more common among men as compared to women,

12. Sudden cardiac arrest during running is most often NOT caused by running. However, running may precipitate sudden cardiac arrest among people with pre-existing cardiac diseases,

13. The commonest cause of sudden cardiac arrest in people aged 35 or less is hypertrophic obstructive cardiomyopathy,

14. The commonest cause of sudden cardiac arrest among people above 35 is coronary artery disease (due to blockage of artery supplying blood to the heart muscles),

15. The ideal average heart rate while running is 180 minus age (ref: MAF method). This ensures better recovery between runs, reduces the risk of injuries, and allows adaptation of the heart for better pace during races,

16. A good night sleep (7-8 hours) before a long run is of paramount importance,

17. Periodic hydration/nutrition breaks during a long run is also important. Dehydration, exhaustion, fatigue, and heat stroke can lead to a runner collapsing during a marathon,

18. If the body gives signals, such as dizziness, breathing difficulty, chest pain, tightness in chest, severe fatigue, or light-headedness, during a run; withdraw from the run and seek immediate medical help,

19. Do not start a run with a pre-meditated pace or finishing time. Alter thepace (increase or decrease) based on the route, elevation, temperature, how you feel and other race-day factors,

20. Long distance running is not a competition to be ahead of others. It is a passion to be enjoyed and cherished. Enjoy the entire run and not just the chip time.

Dr Sudhir Kumar MD DM 26-01-2024

There are various causes for cardiac arrest among runners and they differ based on the runner's age. Survival depends on the underlying cause of cardiac arrest; prompt performance of CPR (by the bystander) and use of defibrillator (on site).

Majority of cardiac arrests among marathon and half marathon runners occur during the last qartile of the run (after 26th mile in marathon, and after 10th mild in half marathon, until completion).

Read 6 tweets

Dr Sudhir Kumar MD DM

@hyderabaddoctor

Dec 17, 2023

Why are teenagers (adolescents) getting affected by heart attacks?

1. Heart attacks commonly affect older people. However, we have seen a recent increase in number of young people and even teenagers getting affected. What are the underlying reasons?

2. It is easy to put the entire blame on Covid 19 illness & covid vaccines, but that won't do proper justice (to our youth). There are several other possible reasons that have increased the risk of heart attacks in younger population, including adolescents. Let us look at them:

3. High prevalence of depression, anxiety & stress (DAS) among school-going children.
In a survey done among school going adolescents, the prevalence of depression, anxiety and stress was found to be 65%, 81% and 47%, respectively.
DAS increase the risk of heart attack.

Read 12 tweets

Dr Sudhir Kumar MD DM

@hyderabaddoctor

Aug 6, 2023

twitter.com/i/web/status/1…

Tips for NMDC Hyderabad Half Marathon

Hyderabad marathon is scheduled on August 27th (3 weeks from now). It is one of the most popular marathons in the country and many of you may be planning to run here. I have done two half marathons on this route.
Sharing my experience
1/n https://t.co/0XGzatZkIatwitter.com/i/web/status/1…

The HM flag off time is 6 AM. Location is near Necklace road (Hussain Sagar lake, Secunderabad). Since one needs to assemble by 5 AM, it would be wiser to stay closer to this location, or make advance transport arrangements accordingly. Ample parking space is available.
(2/n)

Crowding at start:
Thousands of people participate and you would find difficult to run fast during the first 500 meters. Take it easy, as the rest of the route is un-crowded and you would enjoy running.
(3/n)

Read 7 tweets

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