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Switch off, literally
In the past six months, Sunil Mistry has taken three long breaks in Pattaya, Goa and Lavasa. The chartered accountant’s phone stayed off during the trips and even after he’s back he doesn’t answer calls from clients or check emails after 7pm.
It is not that Mistry, 33, has suddenly become unprofessional or lost all ambition. The Mumbaikar has just been following doctor’s orders — to switch off, literally, as often as possible.
Instead of heading to a doctor who would treat him symptomatically, Mistry has opted for what is known as ‘lifestyle medicine’ to ensure he leads a healthy and productive life. Last November, he had been warned that he would suffer a heart attack in the next five years if he didn’t bring his stress levels down. After all, Mistry used to work long hours, had not taken leave for three years and was constantly irritable. He would get furious if his employee or wife took an five extra minutes to complete a task. All this had started taking a toll on his body. “All medical tests were normal but I would get exhausted even if I climbed one floor. My wife, too, felt my behaviour had changed a lot so I decided to take stock of my life,” he says.
Mistry is not alone. A growing number of busy executives are heading to lifestyle medicine (LM) clinics that have sprouted in the metros in recent years. Instead of just doling out drugs or giving vague recommendations about sleep and exercise, these clinics aim to make targeted interventions to cure faulty lifestyles so that their clients don’t develop chronic conditions like diabetes, obesity or hypertension. With close to 51 million diabetics, India is the diabetes capital of the world and may soon become the heart attack capital, too. Heart disease is the single largest cause of death in India.
Considering today’s fast-paced lifestyle, it is no surprise that LM is emerging as an important medical specialty and that there are many takers. The LM clinic set up last June at Mumbai’s Hinduja Hospital gets several new patients every week and 270 individuals have enrolled at Dr Dhiraj Abhyankar’s LM centre in Hyderabad since it opened eleven months ago.
TOO BUSY FOR THE SICKBED
A significant number of patients at these clinics are professionals who are “too busy to fall sick”, say doctors. “Lifestyle management is in because people can’t afford to be sick and miss work. They are ready to correct their lifestyle to avoid being laid up in bed,” says Dr SK Sharma, who offers LM consultation at his clinic in South Delhi’s Green Park.
While many individuals opt for LM because they suffer ‘mild problems’ — slightly high blood sugar, cholesterol, constant backache or fatigue — and want to bring them under control without medicines, perfectly healthy people are also adopting lifestyle changes as a preventive strategy. “These days people are more aware about their health so they know the importance of lifestyle correction,” says Dr Zinobia Madan, who heads the LM unit launched at Jaslok Hospital, Mumbai, in February. The Jaslok unit and the holistic medicine department at Gurgaon’s Artemis Hospital treat many IT professionals and BPO employees who suffer from insomnia due to stress. Patients of diabetes, coronary artery disease and other chronic conditions also go for LM as an adjuvant (along with medicines) therapy.
LM experts are also sought after by corporates. Dr Sivaramakrishnan S, the lifestyle medicine consultant at Hinduja Hospital, has been roped in as advisor for SAP India, a leading software firm, which had lost its CEO and MD, Ranjan Das — one of the youngest CEOs at 42 — to a massive cardiac arrest last year. “I help the employees strike the right work-life balance,” says Sivaramakrishnan.
Though it’s not an anti-medication movement, LM experts recommend various lifestyle modifications as the focus is prevention. The changes include an appropriate diet, exercise programmes ranging from a salsa class to meditation as well as behaviour changes. So, don’t be surprised if the prescription reads: “Three portions of green veggies”, “10 minutes of deep breathing” and “compulsory cuddling with wife.”
An LM consultation costs anywhere between Rs 500 and Rs 3,000 and the follow-ups, usually once every fortnight for several months, cost Rs 300 to 1,000 each. Doctors, however, point out that lifestyle therapy is not just for the proverbial ‘money-rich and time-poor’. Abhyankar set up his first LM clinic at Chandrapur, a small town in Maharashtra, three years ago and also consults at three hospitals in Nagpur, albeit for a lesser fee. “Lifestyle diseases have cut across class barriers. Even Class 4 labourers have big paunches these days,” says Abhyankar who went from cancer specialist to LM expert because he wanted to help people prevent lifestyle diseases. “Lifestyle management can help one prevent cancer and reverse heart disease,” he says, adding that Bill Clinton’s physician had successfully used LM to reduce artery blockages significantly.
STRESS ON PERSONALITY
The clinics prescribe lifestyle changes based on a comprehensive analysis of one’s personality, stress level and routine. At Hinduja Hospital, Sivaramakrishnan puts his patients through a ‘stress audit’ which involves answering a set of 80 to 100 questions such as ‘Do you get irritated if you have to stand in a long queue for a ticket?’, ‘Do you have trouble sleeping?’ and ‘Do you eat more when a deadline is coming up?’ The answers help the doctor identify the risk factors that are associated with various medical conditions. Moreover, they also help determine the patient’s personality type. People with Type A personality, for example, are ambitious, perfectionists and multi-taskers who try to race against time. “Corporates call them performers and these are the guys who are promoted in offices. But research has shown they are also future candidates for heart attacks,” says Sivaramakrishnan.
Abhyankar does not administer questionnaires; he prefers having long chats with his clients before he arrives at a new ‘life plan’ for them. Sivaramakrishnan also asks patients to select what they want to modify and sign a commitment sheet. “My job is to motivate the patient to implement these changes,” he adds.
COMMON SENSE OR ESSENTIAL GUIDANCE?
While critics of new-age specialties like LM dub it as ‘packaged common sense’, its practitioners retort that it is the underlying scientific approach and motivation which make lifestyle interventions effective.
“Every mother and grandmother can tell us to eat right and go for walks. But we understand the root cause of the problem and help the patient deal with it,” says Abhyankar, who also employs alternative techniques like hypnotherapy to motivate patients to make required lifestyle changes. The fact that he has doctors as his patients proves that the mainstream medicine community is opening up to this new discipline. “I knew most of what the doctor told me but we all need some pushing,” says Dr Prasad Potdukhe, a Chandrapur-based cardiologist, who enrolled for LM a year ago because he was obese and suffered from mild hypertension. Other patients agree. “I am glad I went for lifestyle medicine. I dread to think of what would have happened if I had not changed my ways. It could have been too late,” says Mistry, who is also planning to start a family as per his doctor’s prescription.
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