End of the South Indian Sojourn

Leaving Bangalore after the end of my fellowship turned out to be quite an emotional affair. This was the first time I was away from home for so long and my seniors and colleagues in the department made me feel quite comfortable during the tenure of my course.

Working with each one of them turned out to be an amazing experience in which I learned the necessary skills in the best possible atmosphere and I am definitely going to miss all of them in the future.

Now looking forward to my next stint in America. 🙂

image

With Dr. Anthony - one of the best surgeons I have worked under...cool, calm and composed

image

With Dr. Archana - who was always willing to teach and help

image

Meera ma'am - who was an important link between the doctors and the patients. Learnt a lot about life from her.

image

Breast care nurses - the most dedicated lot I have seen. They were responsible for the seamless functioning of the unit.

Advertisements

39 fibroadenomas removed using just two incisions!!

Yesterday, we performed a marathon fibroadenoma surgery, where we removed 39 fibroadenomas from both the breasts (19 from the right breast and 20 from the left) just by making one incision in each breast. We used a crescent incision in both the breasts and comfortably removed fibroadenomas measuring as big as 5-6 cms through that incision. The entire procedure lasted 2 hours and the patient was discharged the same day.

Although the smaller fibroadenomas could have been left behind (because they are not malignant) but the patient was very apprehensive about them and wanted all of them removed. The importance of the single incision (periareolar crescent) is that it makes the end cosmetic result quite good. I am sharing some intra-operative pictures in this post. Will update the post-operative and follow-up pictures soon.

Marking of the crescent incision.

Marking of the crescent incision.

 Fibroadenomas marked along with the incision. Smaller lesions were not marked.


Fibroadenomas marked along with the incision. Smaller lesions were not marked.

 

6x7 cm fibroadenoma removed through the incision

6×7 cm fibroadenoma removed through the incision

 

5x5 cm lesion removed through the left breast

5×5 cm lesion removed through the left breast

 

Starting the closure. Will share the post-op and follow up pictures soon

Starting the closure. Will share the post-op and follow up pictures soon

Mobile Mammography Units

On the occasion of World Cancer Day, a new mobile mammography unit was launched in Bangalore. This is a joint venture between Narayana Hospitals and is partly supported by the Nilekani family.  This is the second functional unit in the city and it will help in spreading Breast Cancer Awareness. Similar units are functional in Delhi, Mumbai, Goa and UP.

DSC04050

 

 

These units not only help in conducting mammograms, which help in early detection of lesions but also create awareness regarding breast cancer by distributing educational material and training women to carry out breast self examination. With the increasing incidence of breast cancer, more mobile units are required in the country to reach out to the masses.

IT city (Bangalore) is also India’s Breast Cancer Capital

Bangalore is India’s breast cancer capital – Dr. Anita Khokhar’s Blog

Bangalore now has the dubious distinction of being India’s Breast Cancer Capital. In a recently concluded population based study, the IT city has registered the highest incidence of Breast Cancer cases in the country (36.6 new cases for every one lakh population). (Source: PBCR data)

This data compiled from 11 cities across India revealed Thiruvananthapuram to have the second highest incidence of Breast Cancer at 35.1 followed by Chennai (32.6) and Nagpur (32.5).

Although the study has revealed these numbers, the actual incidence of Breast Cancer in these cities is much higher. This is due to the fact that many cases go un-reported.

The reasons for such a high incidence of breast cancer in Bangalore are quite obvious:

  • Increased incidence of smoking and alcohol consumption among women
  • Early menarche (age at which menstrual periods start) due to obesity and Western lifestyle habits
  • Late marriages and children
  • Lack of breastfeeding
  • Increased use of estrogen based contraceptives
  • Late menopause and the use of hormone replacement therapy following menopause

All these factors are known risk factors for breast cancer and are quite prevalent in Bangalore.

This study should serve as an eye opener for women not only in Bangalore but also other metropolitan cities of the country.

 

Web of life (and death)

Web of life (and death)

Web of life (and death)

I was surprised to see this extensive web, day before yesterday evening. Initially, I thought of clicking a picture with my DSLR the next day but my instincts pushed me to click a picture with my digital camera at that moment. In retrospect, it was a great decision because the web got washed away in the rain that night. This incident reminded me of this quote:

The amount of good luck coming your way depends on your willingness to act.

– Barbara Sher


Smile language

All-people-smile-in-the-same-language

I recently started working at a Cancer center in Bangalore and I am not fluent in Kannada (the local language). This poses a challenge when I am communicating with my patients. In the OPD my colleagues help me out but during the morning rounds there is a problem as most of the nurses (being Malyali), don’t understand Kannada very well either.

Although I have always used “smile language” with my patients in the past but over the last few days I seem to be using it more frequently and effectively. Every morning I greet the patients with a smile and get a lot of information about their condition without speaking a word. Rest of the conversation takes place in ‘sign’ language (another universal language) and broken Kannada. Patients also respond in the same language and a patient’s smile can answer many questions without a word being spoken.

This approach not only provides key information about the patient’s condition but also helps in making a rapport with the patient and is an integral part of the doctor-patient relationship.

Everyone (specially doctors) should follow this universal language, when interacting with people!! 🙂 🙂

Patience pays off

Rohan_046

Clicked this picture during a recent thunderstorm in Bangalore. Got a decent picture after multiple attempts but my patience (and continuous clicking 🙂 ) finally paid off. The incident reminded me of these words (golden worlds for a doctor) :

“Learn the art of patience. Apply discipline to your thoughts when they become anxious over the outcome of a goal. Impatience breeds anxiety, fear, discouragement and failure. Patience creates confidence, decisiveness, and a rational outlook, which eventually leads to success.” – Brian Adams

This picture has recently been published in one of the leading newspapers of India : http://www.deccanherald.com/photo.php?id=12994