COVID-19 and beyond: One frontline warrior reveals all about medicare

By Zahid H Javali

Dr Oliver E Rodrigues is a frontline warrior for the underprivileged in Bangalore. After graduating in medicine (MBBS) from St John’s Medical College, Bangalore, he completed his post graduation in family medicine from CMC, Vellore. He has been in rural private practice since 2006. Besides, he takes care of patients in orphanages and homes for the elderly. When he’s not prescribing medicines both online and at his Bellandur facility (Scorpion Clinic), he is seen dancing, listening to music, reading books, and gaming on his playstation.

Being a general practitioner, he gets more patients than the specialists. To the untrained person, this might not be too appealing. However, Dr Rodrigues knows the pulse of the public like no other due to the great volume of patients he gets to meet. Therefore, we asked him everything that you might want to ask a conscientious and experienced doctor about medicare, illnesses, medications, tests, and tackling pandemics. It’s a must-read if you want to stay safe and healthy all your life.

“Careless attitude is causing the COVID-19 cases to rise”

The best way is, as it has always been, social distancing, wearing a mask while going out, and avoiding any social gatherings. Also, frequent hand washing. While many do scoff at this being repeated, let me point out that most of us doctors who are currently practicing and seeing fever patients are doing nothing more than just that. The single most important reason why people are being infected by corona is because they are being careless or have a lax attitude. We have many elderly people who get infected despite staying indoors because of their family members being careless.

“Over-dosing on vitamins can be toxic”

Anyone can have allergic reactions to a medication, and that includes vitamin tablets, which may contain chemicals that a person may be allergic to. Over-dosing yourself with any medication, vitamins included, will lead to health issues, especially with medications like Vitamin D which when taken in excess will definitely cause toxic issues. So please consult a doctor before taking any medications.

If you are a healthy person, you don’t need to take multivitamins throughout your life. The best way to live life is to be happy with what you have, eat healthy, exercise, and always keep aside some time every day for fun. Do not miss life for the sake of work. Vitamins have their role, but every person has to make an effort to stay healthy.

“Deworming every year is a must”

It would be good if doctors would recommend deworming tablets. But then again, as most practitioners are specialists who do not see patients on a regular basis as a family physician does, this tends to get ignored. Deworming once a year would be more than adequate.

“Annual health checks are a must for people above 35 years”

Executive health tests are important because they help us identify diseases that pose significant health risks by having no symptoms. Also, I want to add that not all labs are reliable. Just because one lab has 115 tests doesn’t mean that it is a better package than one that has 95 tests. It’s not quantity, but quality. So before blindly going the “online discount” way, please consult your doctor.

“Control your eating habits”

Over-eating, eating out regularly, overindulging in high fat, spicy, and oily foods contribute to an overall detrimental effect on health. Instead, home-cooked foods on a daily basis, consisting of reduced carbohydrates and increased proteins, with daily intake of fruits, water and juices are quite beneficial. 

“Vitamin supplements are useful for those who are deficient in them”

Those deficient in specific vitamins, be it B12, D3 or others, will benefit from taking those vitamin supplements specifically. That being said, beyond the age of 45, regular B-complex and calcium supplements are recommended. Long-standing fatigues have been relieved by B12 supplements. Similarly, chronic back aches were eased by vitamin D3. But these are individual cases. Chronic fatigue can also be due to myriad causes, ranging from simple dehydration to undetected cancers. Similarly, back aches can be anything from repetitive stress injuries to spinal TB. So while vitamin supplements have definitely cured a patient of long-standing illnesses, that may not always be the case.

“The importance of a balanced diet and exercise cannot be underestimated”

Eating healthy is not an impossible task. Most people are married or have families or have cooks. So ensuring that you have a diet which has a good amount of proteins in terms of meat and vegetables, avoiding carbs by substituting chapatis instead of rice, and ensuring that you have fruits like two oranges or apples after dinner isn’t that much of a herculean task. Also, keeping dry fruits such as almonds and walnuts to snack on when hungry is a good idea. Walking everywhere is also a good way to stay fit. Stop using vehicles to go grocery-shopping. If it’s a ten-minute walk, go for it. Avoid lifts. Use the stairs. If you live on the 8th floor, take the elevator to the 4th floor, and then walk up. It takes a bit of effort and force of will, but it isn’t impossible, and worth it.

“Stay away from unproven products”

I do not subscribe to supplements like Boost or Horlicks for any age group. If you eat a proper diet and have an active lifestyle, that should hold you in good stead. My most aggravating problem is with patients who are concerned with the side-effects of medicines prescribed by the doctor. While they do not have a problem with consuming medications given by a pharmacist with no working knowledge of human pharmacology or the harm of drinking alcohol, smoking, eating unhygienically, they do have a problem with taking medications prescribed by a doctor. The other myth is ‘milk is good for you’. Our bodies are designed to get what we need from a good diet. So milk is in no way a ‘super food’ that gives you any added benefit.

“Seek a second opinion when your third consultation fails to give results”

I always urge my patients to return to me if they aren’t improving. However, if by the third consultation, I see no change, then I ask for help from my circle of doctors who support me in my practice. If by the third consult, you find no improvement, then maybe a second opinion would be prudent.

“Rush to the hospital if the pain is uncontrollable”

If you are having pain in the night, take a pain killer like paracetamol, aceclofenac or diclofenac, and consult your doctor when available. However, if the pain is extreme, then the best thing would be to head to the emergency department of a nearby hospital. That is why hospitals work 24/7.                                                                                               

“Tests are important to diagnose the ailment”

There are times when we cannot diagnose based on the patient’s history and physical examination. In such a case, a battery of tests may be required. However, if you have a diagnosis or a hunch in mind, then targeted tests can be done to confirm your diagnosis. I simply take a proper history, conduct an examination, explain to the patient about my diagnosis and why I have ordered for the tests.

“Papaya extract tablets cause more harm than good”

The papaya extract tablets prescribed for dengue patients have no clearance by any medical council. They have no documented benefit, but they do cause side-effects, such as severe acidity, that worsens the patient’s condition.

“Trust your instinct while choosing a doctor”

If you feel something isn’t right with a doctor, follow your instinct. If you have been referred to the practitioner by someone, allay your fears by speaking to the person who recommended him or her.

“I treat the patient, not the disease”

My rule in treatments are the same that I advise my junior doctors. First: treat a patient, not a disease and second: have the humility and bravery to say, “I don’t know.” If you do not know what is wrong with your patient, admit it, and refer to someone who can help the patient rather than cause harm by refusing to admit to it.

“Doctors are also human”

While doctors are expected to treat their patients, their service gets confused with servitude. So I humbly implore everyone to keep this in mind. All doctors are humans. We have our families, problems and stresses. There are times that a doctor may not be as welcoming as you may expect or may not be available when you want. Kindly give the doctor the benefit of the doubt. Support your doctor. A simple “Please stay safe doctor” really gives us the much-needed emotional hug.