living bridge

Saturday, April 8, 2017

Thank you my Tennis elbow

Once day morning  when I tried to lift a jug of water from the dining table, I suddenly felt a twitch in my right elbow ,and ouch was my response when my wife  - what happened ? then I have to explain my tennis elbow. Tennis elbow! How come I have never seen you lift a tennis racket !!  Well I grabbed the  chance  to show case my anatomical knowledge- studied in 1955 under Pro.Cooper,Pro.Askar Ali, Pro. Ramanathan  and others- that it is the pain you feel at the lateral bony part of elbow { lateral epicondyle}. Where the extensor of the wrist-{Extensor Carpi Radialis longus and brevis } take origin and is inserted at the base of metacarpal bone at the wrist and they act to extend the wrist. Whenever this muscle is stretched and over used a sharp pain is felt at the lateral side of the elbow. It is also called “ Washer women’s elbow” since the washer women pronates { palm facing downwards] and continuously extend and flex the elbow and wrist  for a long time  then  the tennis elbow pain is felt.  O.K But then why it is called tennis elbow and not Washer women elbow ? The tennis player who repeatedly uses backhand return, or the famous wristy cricketer Mr. Azarudin , again  the said muscle is put at stretch causing pain. You call it as you like was my reply. But why you,who  has neither   played tennis,nor cricket  or washed cloths ? That is it ,it can happen to any one who overused  the said muscles ,I, daily do some basic stretching to keep my joints mobile and flexible, may be I overdid it. If my memory is correct Sachin Tedulkar had tennis elbow  but neither christened as Sachin elbow or cricket elbow.

She elbowed me out of the kitchen –  see a good doctor and come back when you are fit to lift a cooker . I have no choice except to listen to the home doctor and thus set foot to consult an orthopaedic surgeon.After listening to my story , when he palpated my lateral condyle,ouch my my response.Will you give me a local steroid – No was his emphatic reply. You take Ultra sound massage for few days,which he assured will relieve the pain.can you tolerate NSAD { NON STERIODAL ANTI INFLAMMATORY } No thank you was my quick response. O.K then you have ultra sound at the site of pain. As a faithful patient I agreed.

I was directed to a good Physiotherapist , he examined me gently,diligently,and saying the trigger point is usually the extensor muscles,with that he massaged the muscle with some pressure ,rolling the extensor , for nearly 10 mins which gave me  pain at that site but the  pain at  the lateral epicondyle-tennis elbow point-was relieved to a some extent. Latter he gave Ultra sound at the tennis point for about 5mins .When I came back  the pain bounced back.I attended his therapy daily for a few days but without any significant improvement. He advised me to wear  tennis elbow guard over the extensor muscles,which I did for five days but no good.

Back I came to home doctor and she made a poultice with egg white,asafoetida,turmeric powder and applied it over the extensor,let it dry for half hour and washout with warm  water. It didn’t help me but since it is cumbersome and sticky I gave it up after a four application—but didn’t let my home doctor ,saying it has done some improvement.

My son a dentist by profession wishing to play his role as caretaker of father wanted me to apply a pain relieving plaster which he brought with him after his holidays at Indonesia  I politely accepted his compassionate suggestion and faithfully applied for three days.But none of the home remedies helped me.May be I didn’t give afull trial I admit. But it didn’t give me an iota of benefit I apologetically with held the home remedies

I have been contemplating as to why I didn’t improve in spite of  Ultra sound, home treatment—it is then I realised that I have been driving for at least for one hour a day with out giving adequate rest to my elbow – even though I have for the time withheld my stretching exercises.
O.K I said to myself to ensure rest to my elbow as much as I can.But how to go about it.Next morning when I got to brush my teeth I said to myself change hands and use my left hand. It is funny the tooth paste got all over my lips and chin rather over the teeth,slowly I could maneuver the brush around my teeth but when I tried to swing my hand to the left and right I was astonished to see in the mirror that I was moving my face to the left and right and not my left hand holding the brush which made me blush at the screwed face at the mirror. While I concentrated with my brushing ,suddenly I realised that my right hand-the tennis elbow hand—started screwing behind my back like ERB’S palsy, probably angry with me for sidelined him after having held the brush for donkey’s years. As a compromise I told my right hand O.K you hold me steady from falling by grabbing the towel rod as your brother left hand is trying to brush which I have reprogrammed my brain

Latter when I tried to shave I couldn't apply the foam with my left finger as easily as  with right finger much worse when I tried to hold the Gillette razor in the left hand the cartridge couldn't be applied to  properly-flush with the skin, especially when I was looking into the mirror to position the cartridge- without looking into the mirror I was able to apply the cartridge on the cheek with the correct side, but drawing the cartridge up and down the cheek ,looking in the mirror was like the Gillette screwing his face like BOBO. This time my face wore the mask of a Bells Palsy ,alternating right and left side as the Gillette razed down my cheek
Normally when I brush my teeth or shave, my thoughts are about my program for the day like,corresponding by phone or mail,tax return, instruction to secretary. Updating the details of residents and their needs for the day at the retirement home I manage.With the tennis elbow and my mind reprogramming my upper arm movements, I was totally with what I was doing at that moment,brushing,or shaving thoroughly enjoying what I was doing. Even though my razor split my skin it didn’t hurt,but I could see myself smiling  in the mirror. This  is living in the now,no thoughts of the past,your plans for the day,your appointments. Early morning ordeal which has been a mundane procedure became a challenging task,which I thoroughly enjoyed,said to myself, this is living the moment and not just existing. Latter I changed the water mug to smaller size,and when I tried to pour water over the body,I have to bend back to pour the water properly and even with that bent posture I spilled water into my left ear and once banged my head with the water mug. However I enjoyed my bath and felt refreshed. Brushing my teeth,shaving,bathing  have been a challenge,accepted and faced it with optimism,and congratulated myself for my heroism and self approval has been a great  motivation for me to persevere with my efforts. When a hurdle is overcome with optimism and perseverance is a new experience,and every experience is climbing the learning ladder. Now I look forward to daily sun rise and a new experience
Accepting the challenge and to take it forward I decided to do most of my work if not all  with my left hand,wearing my watch and ring in the left hand,eating with left hand,sometimes with a spoon in the left hand,using key board,mouse with my non dominant left hand. Writing with the left hand is the most difficult I find, just started scribbling drawing straight lines,curves,doodling, opening the door with key,peeling the banana,cleaning my table,telephone dialing etc. Am I trying to become ambidextrous –not really but accepting the challenge and enjoying whatever I do. Is it hobby  ! I guess so, for if I AM ENJOYING WHATEVER I do, it is hobby ,Is it not ?!! THANK YOU TENNIS ELBOW for the opportunity.

I t is three weeks now,75% better with rest as much as possible, without any medicament,and my left hand accepting the challenge, and my right hand grateful for the well deserved rest,let me see how far I can take it forward.

Wednesday, January 4, 2017

Diamond jubilee Alumni meet


                                        Madras Medical College 1957 Batch Alumni meet

We had wonderful,joyous Alumni get together at Intercontinental resort at Mahapalipuram,from 28th Dec for two days. Only 25 colleagues could join with their spouses and family the Alumni meet.Our batch  doctors almost all of them had P.G qualification, and three of them has been awarded PadmaShri,among them Dr.Chandrasekar ,well known Rheumatologist and Dr.Velmurugendarn distiquished neuro phsician ,Dr Badrinath internationaly recognised opthalmic surgeon[ who couldn't participate due other official engagement}  participated in the Alumni meet. It was very heart touching to see Dr.Rajkumar Pandian attended the meet even though for a short time in spite of his ill health.That is the spirit of friendship.We had three colleagues from U.S attended the meet.Respected Sri Nalli Kuppuswamy chettiar was the chef guest and he recalled the steps trodden in building his textile empire in Tamil nadu.He congratulated all of us and presented an award.

I was the only member attended the Alumni meet as a great grand father with one great grand son and one great grand daughter. All my children had a fabulous time building a sand castle

Mrs.Abirami Gugan, Mrs.Sakthi Gowthami,Dr.Suguna Priya,selvi Netraa,baby Sangavi,and master Pranav

In the evening we were entertained with a Thabala dance by local citizens

Latter we visited the Shell Museum one of the best in India with a collection of 40000 shells with 2500 varieties  from around the world collected by one family of Raja Mohamed meticulously displayed and only museum in the world with smallest shells about the size of kaduku

                 Latter we visited the Five Rathas built in Pallava times


Next day in the evening we visited the Dakshin Chitra a heritage museum displaying old traditional  life style and houses of Tamil Nadu,Andhra, Kerala,Karnataka

Dr.Velmurugendaran Neuro Physicican with his pains taking power point presentation took us back to the initiation Madras Medical College and its progress to renowned Medical College of international repute 

All is well that ends well with my children having gained new comrade re irrespective age  and gender and an opportunity for ageing senior colleagues  to travel down the memory lane 

Adieu till we all me meet .Thank the Almighty for his benevolence for our health and friendship  

Wednesday, March 2, 2016


Life is a sexually transmitted disease and the mortality is one hundred percent.    R.D.Laing


Yes a blunt truth very succinctly  worded.But when I  deeply dwell  for a minute  I am  a little puzzled by branding life as disease since its birth by sexual transmission. Life has began nearly 3-4 million years ago in the form of single celled oraganism-Arachea  and has evolved    through various stages to the present state .Life has no mortality. Death is only is to the vehicle which carries the life in its journey. The vehicle may be human,plants,animals,insects or  any living organism in the planet.The vehicle may in its journey may die during the course of its journey by some form of disease or due to aging process. So where is this life after the death of vehicle? It is a million dollar question, discussed,critically analyzed ,various hypothesis put  forth  but without any consensus opinion. As an illiterate on this subject I remain in awe without offering any answer. However I disagree in branding life as disease even though life is sexually transmitted

Further Disease -{DIS-EASE}- means a state of being unwell either physically,mentally which is unlikely in all cases right from birth, so branding life as a disease is not correct 

LIFE: L- Living ,I-In the,F-Flow of,E-Enegry
Living  In The  Flow of Energy

Life is living, being alive, being energized towards ,growing,maturing,learning the art of survival while the nucleus in the hypothalamus through secretion of various hormones  takes care of energy  homeostasis so that the energy produced by food intake and the energy utilized are balanced. Energy is utilized in the perception of sight,smell,taste,sound,touch so that it is identified and properly interpreted  such that the body can suitable respond. This sense of perceptibility is present in animals,insects and in some plants e.g Mimosa  Pudica a sensitive plant which when touched fold and drop to defend themselves and open again after a few minutes. We humans are blessed with the ability to think of any relevant subject, critically analyze and take suitable action. Thought is the grass root of our imagination, innovation ,creation,and implementation of ideas for practical applicability. More energy is utilized for this purpose. This creative  energy is always on the flow and so long it is positively directed we are happy and contended which is the sole purpose in life.