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Dr Sudhir Kumar MD DM🇮🇳 Profile picture
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Jan 4 • 9 tweets • 3 min read
6-yr old to me: "Doctor, I have grade 4 cancer and will live only for 6 more months, don't tell my parents about this"
1. It was another busy OPD, when a young couple walked in. They had a request "Manu is waiting outside. He has cancer, but we haven't disclosed that to him+
2. Please see him and advise your treatment, and don't share the diagnosis to him". I nodded my head, accepting their request.
Manu, on a wheelchair, was brought in. He was referred by his #oncologist for management of seizures.
He had a smile, appeared confident & smart.
3. On reviewing history and medical records- Manu had been diagnosed with glioblastoma multiforme grade 4 in left side of brain, due to which he had paralysis of right hand and leg. He had been operated, and was on chemotherapy. Seizures were due to brain cancer.
#MedTwitter
4. I discussed the medical treatment with parents and answered a few queries. They were about to leave, when Manu requested his parents to allow him to talk to me in private. Parents accepted his request.
#Cancer #seizure #Children
5. After parents left the room to wait outside, Manu said- "Dr, I have read all about the disease on iPad and I am aware that I will live only for 6 more months but I haven't shared this with my parents, as they would get upset. They love me a lot. Please don't share with them"
6. I was shocked and couldn't speak for a few moments. I gathered myself- "sure, I will take care of what you said".
I called his parents and requested them to speak to me after making Manu wait outside.
I shared the entire conversation that transpired between Manu and me.
7. I couldn't keep the promise to Manu, as it was important to bring family on the same page on this sensitive issue. It was vital that the family enjoyed together, whatever time was left. More so, as Manu knew about his illness. Whether he understood the gravity, I am unsure.
8. Parents were in tears but they were still thankful and left OPD with a heavy heart.
I had almost forgotten this incident, when about 9 months later, the couple returned to see me. I recognized them at once and enquired about Manu's health.
9. "Doctor, we had a great time with Manu after we met you. He wanted to visit Disneyland and we went with him. We took temporary leave from job and spent quality time with Manu."
"We lost him a month back. Today's visit is to just thank you for giving us those best 8 months."

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More from @hyderabaddoctor

Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 4
Taking 6000-9000 steps/day reduces the risk of cardiovascular disease (CVD) in older adults aged 60 or more

1. In a recent study, taking 6000 to 9000 steps per day was associated with a 40% to 50% lower risk of CVD, compared with taking 2000 steps per day.
#walking #Medtwitter
2. There was a dose response noted between CVD risk and number of steps per day.
As the number of steps per day increased, the risk of CVD too decreased.
3. Compared with those who got the fewest steps/d (median 1811), the risk of CVD was 20% lower in those in quartile 2 (median of 3823 steps/day); 38% lower in quartile 3 (median of 5520 steps per day) and 49% lower in quartile 4 who walked the most ( median of 9259 steps/day).
Read 4 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 3
Are "diet" soft drinks healthy?

1. People are opting for diet soft drinks in place of regular soft drinks, assuming that they are free of sugar, contain zero calories and hence are healthier & safer. But research shows evidence to the contrary.
#MedTwitter #HealthyFood
2a. In two studies conducted in US & Europe, individuals who consumed diet soft drinks had higher prevalence of metabolic syndrome than non-consumers.
Diet soft drink intake positively correlated with waist circumference and fasting plasma glucose in both studies.
2b.
Reference: doi.org/10.3390/nu7053…
Read 14 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Jan 1
Sharing experiences of my #fitness journey
Could be of help to those who have planned to start theirs in 2023
1. My earlier self:Weighed 100 kg, could walk 5 km with great difficulty
Negatives: Worked 16-17 hours/day; slept 4-5 hours; overeating, indulged in junk food and sweets
2. Fitness journey started on Nov 6th 2020. Initially walked 5 km, gradually increased to 10 km over 4-6 weeks, then, slow jogged and finally started running. Focused on distance and time on feet and not pace. Also wanted to keep HR low and feel comfortable.
#running #Health
3. Running stats:
2021- Avg running 15 km/day, 339 runs of 10 k or more, 69 half marathons (HMs) and 1 full marathon.
2022- Avg running 12.6 km/day; 304 runs of 10 k or more, 43 HMs
Finished Ladakh marathon in 2:24 hours
Best timings: 10 Km in 51:11 min; HM in 2 hours
Read 10 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 30, 2022
#Kiwifruit found effective in #constipation
1. Constipation is a common problem and drug treatments do not work in many.
In a recent trial, efficacy of kiwifruit was tested in patients with functional constipation (FC) & constipation-predominant irritable bowel syndrome (IBS-C)
2. Participants were randomly assigned to consume either two ripe green kiwifruit without the skins, or 7.5 g of #psyllium per day for 4 weeks.
Psyllium (OTC) is considered a first-line treatment for both the constipation conditions with which participants were diagnosed.
3. At the end of the 4-week treatment periods, the people with functional constipation who ate kiwifruit demonstrated an average increase of 1.53 bowel movements per week, a statistically significant increase.

Those with IBS-C demonstrated an increase of 1.73 bowel movements.
Read 8 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 29, 2022
A teenager whose unusual #disease forced him to live a #lonely life

1. Sam was a bubbly kid until the age of 8, when his parents noted that he would blink his eyes on an off. This did not trouble Sam, however, he was taken for an eye check up, which didn't show any abnormality.
2. Two years later, he started shrugging his shoulder and would occasionally hop on one leg. This would repeat 5-6 times in a day. Sam had no control on these movements. Again, this did not bother Sam but his parents were perturbed. They thought Sam is being naughty.
#MedTwitter
3. By age 12, Sam started to make some unusual sounds, as if he is clearing his throat or grunting. Sam had no control on these sounds too.
His friends had started making fun of him. He could suppress them for a few minutes, however, after that, movements & sounds would return.
Read 11 tweets
Dr Sudhir Kumar MD DM🇮🇳 Profile picture
Dec 29, 2022
#music improves quality of life for people with #Dementia

1. Dementia caused by #Alzheimers disease is a relentlessly progressive #brain disease. Sufferers have #memory loss and impaired cognitive functions. Many require assistance for carrying out daily living activities.
2. People with dementia are often depressed and have poor quality of life.
Immediate recall and recent memory are the most affected in dementia, whereas remote memory is preserved until later stages.
Memory of music (especially their favorite ones) is also retained in many.
3. In a study, effects of music on #mood and quality of life of seniors suffering from dementia were assessed.
Over a period of 6 weeks, the seniors listened to their favorite music via headphones and an MP3 player for 20 minutes at a time three or four times a week.
Read 6 tweets

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