Online portals like RxOcean let patients seek second opinion from home

n the month of September 2010, Bhagwan Devi Munjal faced a decision between two types of follow-up treatments for her broken shoulder bone: the standard, six to eight week-long normal therapy which lets the bone join on its own, or surgery to join the bone and get cured within 2 weeks. Although cost wasn’t a concern but her age was. Although the orthopedician consulted had assured that the age is not a concern and surgery would be a better option as the person would be able to recover fast in case of surgery but family physician had her own doubts about the case and she wanted to seek second opinion from other specialist orthopedicians to ensure that surgery would be beneficial.

But Bhagwan Devi, 85, decided not to travel to Delhi or any other place from her current native place. Instead her family discovered that by submitting her medical records through a service available on www.RxOcean.com, she could obtain a second opinion from a top specialist without leaving home.

“It would have been very cost-prohibitive and tiresome for me to travel to couple of hospitals in different cities. I accomplished the same thing without that expense,” she says.

Online second-opinion services offer patients consultations from specialists based on the medical records that they fax, mail or send via the Internet. The average cost, payable upfront via credit card or online transfer to the bank accounts of the organization cost anywhere between INR 150 to INR 500, depending on the number and type of specialists one wants to consult. Patients then receive online access to a second opinion in about a day or two again depending upon the case. In cause of an emergency, RxOcean claims to make these services available within couple of hours thus helping the patients when they need the help most.

Since www.RxOcean.com went online in early 2010, about 100 patients have already taken advantage of the service in last six months, says Dr Kirti Soota, co-founder of the web services company. Some of the patients were not satisfied with the treatment that they were undergoing, some just wanted to ensure that treatment is ok, some people who approached us didnt understand what their doctor wanted to tell them as a result they wanted to have a word with another doctor and a few wanted to discuss issues over the phone related to their sex problems and marital problems for which they didnt want to see a doctor face to face. Many a times these problems just need counseling patients and some OTC drugs are advised. In case we feel the case is serious or diagnosis is wrong then either request the patients to get some more tests done or consult another doctor face 2 face. As was the case with Mrs Bhagwan Devi wherein 2 orthopedists on our panel independently suggested that surgery shouldnt be done coz at this age bones become very fragile.

But such cases are rare may be to the tune of around 5-10%. What we are able to do is give patients more treatment options and hopefully give the patient more peace of mind. Today, Mrs Bhagwan Devi is doing well, and her family speaks highly of their experience with a remote second opinion: “We were lucky to have landed in right hands at the right time but most of the people are not even aware of the services like Second Opinion over the web. We would like more and more people to be aware of this option.”. Dr Soota ends the discussion by saying that we want to popularize this service only by word of mouth as we cant afford to spend a lot on our marketing and advertising and end up increasing our rates which would defeat the whole purpose of formation or RxOcean to reach the masses and be able to provide quality health care services at a very nominal price.

Neck & Shoulder Pain – IT / ITES Workers

My neck has been troubling me for almost a month now. It makes a crackling sound when I rotate it and always gets stiff. At times it gets so lifeless that I feel I am carrying dead weight of my head on my Neck. Along with that my shoulders get swelled and at times eyes and head also pain making me feel what the hell is going on. I somehow knew at the back of my mind that my profession is the problem. Being in IT Industry has its own merits and de-merits.

Merits which generally people from other industry find and also crib about include work schedule flexibility and working from home. We hardly realise that these merits actually become demerits in a very short span of time. You would be wondering how that could be possible. Simple reason being we get glued to our laptops / computers for longer duration in comparison to normal office hours. The usual breaks that one takes in office be it tea break or some chit chat with colleagues also go for a toss at home making us “may be” a bit more productive but at the cost of our health.

I think this is what has been taking its toll on my health – my neck, my eyes and my shoulders have been paining like anything since last month. Anyway, my orthopedician doctor confirmed the same today – he said jokingly it is IT Industry syndrome and if you want to get rid of this issue forever you should leave your job. Not sure if it would be restricted to IT industry in future as all the work in service industry even our books, newspaper, etc are moving to e-paper. Anyway, according to my doctor this continuous working infront of computers leaves one with stressed muscles and hence the swelling and other issues that I have been suffering from.

What I was suggested some simple exercises which need to be done religiously to help improve strength of neck muscles. Also I was advised to take rest breaks and close eyes after every hr and put the head on the backrest of the chair for couple of minutes along with improving the ergnonomics. Ideally Eyes should be at the level of your computer screen so that one doesn’t have to look down or bend his/her neck to work, which rarely happens as when working on desktops only our chairs are adjustable and not our desks. So if you are lucky enough to have normal height then your body would be positioned ergonomically else not. Anyway there are a number of tips for IT workers to sit properly and do some normal things to improve their posture so that they dont face all these issues and it is not that this blog is the first time you are reading about those but certainly we fail to implement those in our normal life and remember those only when we fall sick.

I will keep writing about various issues or health hazards that IT professionals suffer from so that we IT community at large can benefit from it.

Medical Records and Importance of Data / preserving prescriptions

Who is responsible for Data? Are we responsible for maintaining our personal medical records or the hospital or nearby Doctor that we visit us?

More often than not the prescriptions that are given to us by doctors end up in the waste bin after couple days or weeks or years as we think that we have been fully cured and we don’t really require those prescriptions. Do we ever realize how important those prescriptions are even after we get cured. We can do a lot of analysis and unearth answers to some of the questions like

• How many times in a year did I fall ill
• Whether the treatment went as per the plan
• Whether my body reacted badly to certain drugs
• Whether my body responded faster to certain kinds of drugs and slower to certain
• Is there some pattern in illness – monthly, weekly, quarterly
• Is the whole family falling ill in a pattern – be it season change or one particular month.

Apart from the normal questions like above – We should also be able to analyse as to whether some of hereditary diseases that our parents used to suffer from have been passed on to us and whether our children are likely to suffer from those in future. All the above can be answered if prescriptions that we dump in our dustbin are stored properly. Infact every member of the family should maintain his/ her file of records.
Answers to some of the queries can not only help us take preventive action in case we see similar circumstances and patterns emerging but also help us raise the standards of our healthcare sector. Imagine if the same data is collated at the community level a number of problems can be forecasted (outbreak of diseases in certain areas and how it is spreading) and action can be taken in time.

Is it possible to keep all the records in safe custody and do all analysis? Yes, but it would be easier if online medium is used to store personal records. In fact web portals like www.RxOcean.com offer these solutions for free. Users can store their medical records, consult online dietitians and doctors. One can also seek second opinion from various super specialists available on the portal. Also Doctors and Dietitians together analyze your family’s health records and can help you and your family follow healthy and nutritious diet plans. Although benefits are tremendous but what is required is some sort of discipline in filing our records properly as they are too important for us and for the community at large.

IT workers and Eye Strain, Dry Eyes

With the growing number of people glued to their computers/ Laptops/ Mobile Phones 24X7 in India, Computer eye strain or computer vision syndrome is bound to affect majority of the population. This group of users are not only IT/ITES workers but also workers from other industries as Computer has become a mainstay in a number of industries.

Initially it was thought that eye strain and other symptoms of computer vision syndrome (CVS) occur in adults only but a recent study shows that many children who are exposed to computers either at home or in school suffer from similar issues. With even books being phased out by ebook readers the problem is bound to increase. Following are some of the symptoms of Computer Vision Syndrome:

• Headache
• Loss of focus
• Burning eyes
• Tired eyes
• Double vision
• Blurred vision
• Neck and shoulder pain

What causes it ?

Computer eye strain and computer vision syndrome are caused by our eyes and brain reacting differently to characters on a computer screen than they do to printed characters. Our eyes have little problem focusing on printed material that has dense black characters with well-defined edges. But characters on a computer screen don’t have the same degree of contrast and definition.

Words on a computer screen are created by combination’s of tiny points of light (pixels), which are brightest at the center and diminish in intensity toward their edges. This makes it more difficult for our eyes to maintain focus on these images. Instead, our eyes want to drift to a reduced level of focusing called the “resting point of accommodation” or RPA. Our eyes involuntarily move to the RPA and then strain to regain focus on the screen. This continuous flexing of the eyes’ focusing muscles creates the fatigue and eye strain that commonly occur during and after computer use.

What can be done to reduce stress to eyes ?

1) Doctors recommend anti-glare glasses to reduce the strain on eyes
2) Eye-lubricants are advised for workers who work long durations in front of computers. These eye-lubricants are easily available as OTC drugs and don’t need prescription from the doctor.
3) Simple eye exercises should be done along with improvement in diet so as to get normal dose of vitamin A for healthy eyes
4) Doctors also recommend anti-glare filters.
5) Improvement of ergonomics while using computer can go a long way in helping reduce stress on eyes and other body parts. It should be ensures that computer screen is positioned at a proper height.
6) It is also advised that people shouldn’t continuously stare at computer monitors instead focus on other things which are far off thus giving frequent breaks to eyes.

Dont ignore that pain – Talk to a Doctor – Seek Second Opinion

Recently a very close relative in our family passed away cause of multiple organ failure. Deceased was extremely young ( in his early 30s) which showcases the things that we ignore at times shouldn’t be ignored. Any signal that the body gives should be taken seriously and listened to. Body is like a machine with many parts operating in sync with each other. Even when one of the parts malfunction some sort of screaching sound or some sort of pain is experienced in one part or the other part.

This young man had been complaining of some minor pain just above his waist for past couple of months but no one knew what is happening inside his body and the pain was not that severe. As a result family ignored the same until when the signals became stronger and he started having fever. Even later when he fell ill – for 10 continuous days he was treated with medicines for various ailments that are seasonal like flu, viral or even dengue and malaria. Doctor in his town wasn’t able to diagnose the problem in his body. Fever was coming on and off for at-least couple of weeks.

Finally someone impressed upon the family that a second opinion is required and the patient was rushed to another specialist in Chandigarh where he was asked to get a number of tests done to diagnose the root cause of his illness. Upon looking at the reports doctor immediately asked the patient to get admitted in emergency ward of a major hospital in Chandigarh. But things had gotten out of control by the time he was admitted to critical care.

This extensive suffering could have been avoided if the local emergency department and family physicians, instead of assuming his symptoms to be typical of the viral or dengue from which he was suffering, had stopped to ask ‘what else could this be?’ He was later diagnosed to be suffering from well-described complications of kidney and liver. By the time he was admitted to the hospital his intestine had ruptured as it had lots of toxins in it and lever and kidneys had stopped functioning. Even after doing dialysis on every alternate day, doctors couldn’t revive any of his organs.

I am not saying that this is the case of a wrong diagnosis and blaming the doctor but such lives can be saved easily if we are a little bit careful with our bodies. Even OTC drug abuse ( Paracetamol ) has been known to affect liver. What does it take to talk to a doctor or take professional help. Now that things have become so advanced that you can talk to a professional doctor or even see a doctor and doctor can hear your heart beat through phone then what stops people from consulting that doctor. Moreover with every passing day technological advances in medical technology are letting doctors diagnose better and some doctors by virtue of their location are better informed about the changes in medicine then others.

RxOcean, www.rxocean.com is an initiative of doctors and other members of the community to help those patients whose lives have been impacted by missed or delayed diagnosis, to help clinicians around the world do the best job for their patients. RxOcean helps people take second opinion over the web and that too at a very nominal cost.