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Dr. Rahul Baxi Profile picture
@baxirahul
May 31, 2023 • 20 tweets • 15 min read • Read on X
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So here’s the detailed day by day itinerary of my recent Sikkim trip. So much to explore in this beautiful state. We covered Gangtok, Lachung and Pelling. Day trips from each place. Also visited Darjeeling mainly for the heritage train and the zoo. It was an awesome trip and… twitter.com/i/web/status/1…
So we had a flight from Mumbai to Bagdogra (West Bengal) which is the nearest airport. I took an early morning flight (about 3 hrs duration) as the road journey to Gangtok is about 4-5 hours and we wanted to reach by evening latest. We had lunch on the way. After settling in the… twitter.com/i/web/status/1…
Next morning we were planned for local Gangtok sightseeing. Bakthang waterfalls, Institute of Tibetology, Chorten stupa. Some local fruits🍍 on the way too!

#Gangtok

3/n twitter.com/i/web/status/1…
Also visited Gunjan monastery

#Sikkim
#Gangtok

4/n twitter.com/i/web/status/1…
Then we went to the Hanuman Tok. Beautiful temple and we had clouds welcoming us. The temple is maintained by the Indian army. There’s a nice stall near the parking selling tea and some snacks too.

#Hanumanji

5/n twitter.com/i/web/status/1…
Next morning we started for the Nathula pass. A permit is required 1-2 days prior which is arranged by the local agents arranging the taxi. Have a look at the discipline on the roads! It was snowing at the pass and we weren’t able to see much of China border. But a wonderful… twitter.com/i/web/status/1…
On the way back we halted at the Baba Harbhajan Singh Memorial and then the Tsomgo Lake, also known as Changgu Lake. Picturesque. There are Yak rides available there and also a ropeway, which we skipped as it was raining.

#Tsomgolake
#ChangguLake

7/n twitter.com/i/web/status/1…
Next day we left for North Sikkim (Lachung), halting at some beautiful waterfalls and a dam on the way.

#Sikkim
#Shotoniphone

8/n twitter.com/i/web/status/1…
And now you enter a place with the most successful ban on plastic bottles in 🇮🇳

#Sikkim
#PlasticBan

9/n
Next morning was a visit to the Yumthang valley. We didn’t get to see the famous rhododendron flowers due to extended winters. Still very beautiful with the river passing by the valley. There were yaks strolling around too!

#Sikkim
#Yumthangvalley

10/n twitter.com/i/web/status/1…
Then we went further up to the zero point, it was pretty cold and windy there with some hint of a snowfall.

#Sikkim
#Zeropoint

11/n twitter.com/i/web/status/1…
Then after lunch in hotel, we started back to Gangtok. We skipped the famous Gurudongmar lake as we had our little one and were told less than 8-10 years will not get the permit. It requires another day to visit. Reached Gangtok at night, had a walk next morning in the streets of… twitter.com/i/web/status/1…
Then after lunch in hotel, we started back to Gangtok. We skipped the famous Gurudongmar lake as we had our little one and were told less than 8-10 years will not get the permit. It requires another day to visit. Reached Gangtok at night, had a walk next morning in the streets of… twitter.com/i/web/status/1…
We reached Pelling in the afternoon and there were the beautiful snow clad Kanchenjunga mountains welcoming us. And yes, dal-chawal after a long journey! Three was an option of going to Namchi en route, which we skipped.

#Pelling
#shotoniphone

13/n twitter.com/i/web/status/1…
Next morning we started with the Shingsore bridge.

#Pelling
#Shingshorebridge

14/n twitter.com/i/web/status/1…
Then on to the Pemayangtse Monastery. There is also a well maintained bird park on the way which kids can enjoy.

#Pelling

15/n ImageImageImageImage
Then we visited the glass skywalk and the Chenrezig statue.

#Skywalk
#Pelling

16/n twitter.com/i/web/status/1…
Then we visited the orange 🍊 garden- no oranges but a beautiful river with chilled waters to relax your feet in. Next morning we left for Darjeeling for a short visit and our Sikkim leg of the tour was complete. There is lot of driving involved and a good car and driver is… twitter.com/i/web/status/1…
This is what my little one had to say about Sikkim. Do share the thread if you like it! Thanks 💐

#Sikkim
#IncredibleIndia

18/18
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More from @baxirahul

Dr. Rahul Baxi Profile picture
Mar 1, 2023
Came across an interesting article by John P Higgins.

“Ten Traits of Great Physicians”

Beautifully described by quotes. Summarising in the below thread. Much of it would be true for other professions too. Do read.

🧵

#Medtwitter

1/n
Be a Detective like Sherlock

“When you have eliminated the impossible, whatever remains, however improbable, must be the truth.”— Arthur Conan Doyle, The Case-Book of Sherlock Holmes

2/n
Get Healthy and Relax

“Intelligence and skill can only function at the peak of their capacity when the body is healthy and strong.” —John F. Kennedy.

3/n
Read 12 tweets
Dr. Rahul Baxi Profile picture
Jan 17, 2022
“Doctor, what should be my targets for Hba1c, Fasting and Post meal (PP) glucose?”

Many of our friends with Diabetes have this question. I will try to explain in the thread below.

#Diabetes #GlycemicTargets #HbA1c (1/n)
HbA1c should be done at least 2 times a year if goals are met and glucose control is stable,

Done more often if goals not met or there is change in the medicines.

A1c goal for many non pregnant adults is < 7% without any significant hypoglycaemia.

#Diabetes #HbA1c (2/n)
Tighter HbA1c goals ( less than 7%) may be considered in some.

Less stringent goals (less than 8%) may be appropriate in pts with limited life expectancy or side effect of drugs.

Individualisation of glycemic targets is a must. It’s not a one size fits all criteria.

(3/n)
Read 11 tweets
Dr. Rahul Baxi Profile picture
Dec 14, 2021
What all steps can our friends with Diabetes take to keep their feet healthy?

Always remember, Prevention is better, cheaper and safer than cure.

Few pointers about footcare for patients with Diabetes. A thread 🧵

Do read and share.

#Diabetes #Footcare (1/n)
Diabetes can be dangerous to your feet🦶

Even a small cut can have serious consequences.

It can affect blood flow to the lower limbs, affecting healing and making prone to infection.

It can affect nerves leading to reduced sensation including pain. #Diabetes #Footcare (2/n)
If you have diabetes & develop a blister or cut or a sore, it could lead to a non healing wound that could progress & some cases requiring surgeries & even amputation. We see many cases in late stages, hence requires intervention. Many are PREVENTABLE. #Diabetes #Footcare (3/n)
Read 18 tweets
Dr. Rahul Baxi Profile picture
Aug 22, 2021
Yoga doesn't work, Anulom Vilom Pranayama doesn't work, Cardiac coherence breathing does #Yoga #CardiacCoherenceBreathing (1)
This article by @AskDrShashank et al sheds light on role of yoga based lifestyle modifications in Type 2 Diabetes and associated factors #Diabetes #Yoga (2) ncbi.nlm.nih.gov/pmc/articles/P…
This editorial in @j_metb talks about evidence for effect of yoga in #Diabetes and #Prediabetes #Yoga (3)

ncbi.nlm.nih.gov/pmc/articles/P…
Read 9 tweets
Dr. Rahul Baxi Profile picture
May 23, 2021
In the sea of tweets about high glucose levels, let’s not forget something which can be equally important and more dangerous. Hypoglycaemia (low glucose levels). Below are some of the symptoms which can be due to low glucose levels #Diabetes #COVID19 #Steroids (1/n)
Many patients who are on steroids may be on medications for hyperglycemia(tablets as well as Insulin). Once steroid dose is gradually reduced, the glucose levels will tend to improve. Some may have low glucose levels in morning too #Diabetes #Hypoglycemia #COVID19 (2/n)
As steroids r reduced & stopped, its important to continue monitor glucose levels & consult ur Dr so the diabetes medicines can be adjustd accordingly. I have seen few cases who continued diabetes medicines & had weakness but didn’t check glucose levels regularly #diabetes (3/n)
Read 5 tweets
Dr. Rahul Baxi Profile picture
Apr 14, 2021
This chat with wife of one of my #Diabetes patients adm with #Covid19

1. Please trust the Doctors taking care of you. They know best at that point of time.

2. Steroids may be one of the drugs used for treatment especially when oxygen saturation low (1/n)
3.Steroids can significantly affect glucose levels.They can typically cause rise in after meal glucose levels during the day & morning fasting glucose levels are better

4.Some oral agents (tablets) for Diabetes may need to be stopped on admission(2/n)

#Diabetes #COVID19India
5. Insulin will be required in most patients on steroids. Please allow your Doctors to use this drug to control your glucose levels.

6. You may see glucose levels u have never seen or heard all your life. Levels of upto 300-400 mg% are likely to be seen(3/n)

#Diabetes #COVID19
Read 8 tweets

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