How does it sound when a healthy ageing adult wishes for assisted-suicide as his/her birthday gift? Terrifying? Haunting? Sad? But this is the reality in today’s world where many old-age couples wish to end their lives while they are still happy and healthy as they fear loneliness or terminal illnesses that might strike them anytime.
Euthanasia is helping a terminally sick person to end his/her life to relieve him/her of suffering. This is a critical issue that garners extremely different views from people worldwide as every person’s view on life is different. A controversial and emotive topic, passive euthanasia (2 types exist) is legalized in India since March 2018 under rigid guidelines only when the patient is terminally ill or in a vegetative state. Let’s assume that your family doctor knows you for years together, has witnessed your physical/mental deterioration as you age and feel pitiable for your living. At this juncture, if this physician prescribes terminal illness drugs that are in practice not needed for your comfort (for example, sedative overdose or muscle relaxant) but prescribed with the only aim of ending your life, it is euthanasia, active euthanasia. But if the same doctor assists you in committing suicide or encourages you to commit suicide at your request, it is assisted suicide. It might even be your friend who purchases strong sedatives to help you end your life at your request. He/she is assisting you in your suicide venture and this too falls under the same category.
Sometimes, people withhold or withdraw treatments needed for maintaining life which can result in death of the patient and this is called as passive euthanasia. Patients themselves most of the times feel like giving up on living and wish for a peaceful death. In such cases, they request for voluntary euthanasia. Some other times, it is the family members of terminally-ill or ‘vegetative state’ patients who request for mercy killing as defined as involuntary euthanasia.
Parents who introduce us to this world become dependent on us for life as they age. They are left to plead and seek mercy from their sons, daughters, sons-in-law and daughters-in-law to be spared to live. Thalaikoothal is the illegal and traditional process of geronticide or involuntary euthanasia forced by family members over their elderly relatives which is commonly practiced in some parts of southern districts of Tamil Nadu. While reasons cited by the person performing the euthanasia is generally terminal illness, suffering or physical pain, the process is performed even due to greed of money, dispute between siblings for acquisition of will and many things more.
Motivating Factors for Euthanasia
While extreme pain is the first reason that strikes us when someone prefers euthanasia, there are other reasons that serve as equal contributing factors. Terminal illness that robs a person of his/her quality living due to conditions such as nausea, incontinence, vomiting, paralysis or swallowing difficulties and psychological factors such as depression, loss of control or dignity, feeling a burden or uninterest in leading life as a dependent are other strong factors that motivate a person to seek euthanasia.
Assisted suicide is legal in Switzerland, Germany, Japan, South Korea and in the US states of Washington, Oregon, Colorado, Hawaii, Vermont, Montana, Washington DC and California. Society today forces both parents to work in order to match expenses and the elderly people are left at the mercy of domestic aids or worse, themselves, for food and attention. This has pushed many healthy ageing couples to come forward and seek permission for assisted suicide to end their lives gracefully without much pain. Some other elderly people are tired of living, have lost the desire to explore life or feel it a pain to even do their daily chores and hence, choose such dying options. An Australian scientist, David Goodall, travelled to Switzerland to end his life via assisted suicide at the age of 104. Though not terminally ill, he was left with limited mobility, failing eye sight and had no desire to live anymore. Illegalization of euthanasia in countries force such citizens to undergo the pain of travel to end their lives!
A couple in Mumbai, India have sent a petition to the President of our country seeking permission for assisted suicide despite the absence of terminal illness or pain in either of them. The couple wish for this as they are satisfied of leading a fulfilled life and fear that either of them might pass away which would lead to mental agony, pain and dependency for the other. Is life so simple that we want to end it for such trivial reasons or are we the ones complicating it by forcing people to live without any interest in life? Situations might differ, opinions might vary and the reactions could be harsh, but the reality now is that more and more people wish for assisted suicide in all parts of the world!
Arguments For & Against Euthanasia & Assisted Suicide
Each of us have an opinion and like to raise our views/concerns on general subjects. What are the various reasons quoted by people for supporting or disapproving assisted suicide?
Coughing occasionally during winter, after getting drenched in the rain or affected by common cold are common causes of coughing and no one cares! Let the cough last for more than a week and you start taking some medication or trying home remedies as treatment. When the same cough remains for more than 3-4 weeks, it becomes a matter of concern and panic arises in the individual. Nowadays chronic coughing makes the individual worry about heart disease and cancer!
A cough can be a reflux one, consciously done or a voluntary act that starts with a gasp that sucks air into the lungs. Is there anyone who has never coughed? There can be none at all! Everyone coughs and none of us bother about it until it is an occasional one caused due to acute illnesses such as hay fever, common cold, bronchitis or pneumonia which resolve in a couple of days. On the contrary, a chronic cough lasts for few weeks, months or even years together.
Coughing is as common as sun and moon, but chronic cough interrupts our daily activities, sleep, causes fatigue, affects job performance and we lose the ability to focus on the work at hand. We live in an era of scary viruses and social interactions become greatly affected due to persistent coughing. Moreover, coughing affects a person physically too in the form of urinary incontinence, fainting and broken ribs. Severe chronic cause can even cause vomiting, lightheadedness and rib fractures sometimes. But the entire episode of chronic coughing vanishes away once the underlying problem is diagnosed properly. Chronic cough can occur along with other symptoms such as runny nose, a sensation of liquid running down the back of your throat (postnasal drip), frequent sore throat, wheezing, breathlessness, heartburn, sour taste in the mouth and rarely, coughing up blood too happens.
Common Causes of a Chronic Cough
Any physician would spontaneously quote smoking as the leading cause for chronic cough. It starts as a simple chronic cough but can lead to far serious conditions such as bronchitis, emphysema, pneumonia and lung cancer which becomes a matter of concern for chain smokers. While there are numerous conditions that can cause a chronic cough, five conditions top the list and include:
A chronic cough isn’t all that serious until you experience symptoms such as fever (consistently high or prolonged), shortness of breath, weight loss, night sweats, wheezing, weakness, fatigue, chest pain that’s not due to the cough itself, coughing up blood, copious sputum production and loss of appetite which immediately calls for a physician’s attention.
Although not dangerous mostly, when you cough persistently it can land you in various problems including disturbed sleep, dizziness, excessive sweating, fractured ribs, urinary incontinence and passing out too!
A cough might be ‘dry’ or ‘wet’. A dry cough does not produce mucus and is predominantly visible in people who smoke and use ACE inhibitors whereas a wet cough produces mucus or sputum and is visible amongst people using a postnasal drip or having cystic fibrosis.
Diagnosis & Treatment
The doctor begins the diagnosis by questioning on the patient’s initial symptoms, time of appearance of the cough, what makes the cough better or worse and also about the patient’s history and lifestyle habits (mainly for smoking). Sometimes, the doctor suggests the patient to go for a bronchoscopy (lung view to check for irritation or disease), imaging scan or sputum sample test to check for any complications.
Treatment depends on the underlying cause. Doctor suggests decongestants or antihistamines for treating postnasal drip, lifestyle changes for GERD that include going to bed two hours post-meal, eating several small meals and sleeping with your head in a raised position, antibiotics, cough suppressants, inhaled-asthma drugs and acid blockers.
Home remedies that can be easily practiced by most people include sucking on cough drops, using a vaporizer to steam and drinking warm liquids such as warm water, tea, coffee or hot soup.
Gone are the days when our mommies and daddies went to the market early in the morning and purchased the required produce for the day’s meals. Such freshly purchased veggies and fruits not only taste great but also save time and effort consumed in storing them. Ironically, these days people don’t even go to market to buy vegetables but order everything online, right from your greens, herbs and spices to the daily produce required for cooking. Even on occasional visits to the farmer’s market or vegetable shop (which is mostly during the weekends) they purchase produce that lasts for more than a week! So, is there an option to keep them fresh or at least prevent them from rotting away inside the comfort of the refrigerators?
The vegetable/fruit vendor is always the scape goat who gets blamed for rotten produce that stales away inside our refrigerators before we get a chance to use them. What we miss out is that, every fruit or vegetable has its own qualities. Some fruits give off ethylene gas that can make the other produce ripen and rot faster than it can be consumed. Apricots, avocados, papayas, nectarines, tomatoes, banana, cantaloupe, mango, honeydew melons, peaches, pears, plums, tomatoes and kiwis are the most-common ethylene-producing fruits that must be kept far away from ethylene-sensitive produce such as apples, asparagus, green beans, cucumbers, broccoli, carrots, eggplants, lettuce, potatoes, summer squash and watermelons. Mostly, it is due to improper storage techniques that produce rot away rapidly. Each produce must be stored in a different manner to retain its authentic nutrient qualities. Such careful storage techniques become even more critical when we try to store multiple produce together in the refrigerator.
Be the Perfect Host to Your Produce
Generally, produce can either be stored on the counter, inside the refrigerator at 40° F or placed on the counter to ripen and then stored inside the refrigerator. Few common mistakes or issues that can affect freshness quotient of produce include:
At room temperature: Bananas, basil, cucumber, eggplant, grapefruit, Beans, potatoes, oranges, lemons, sweet potatoes, Watermelon, tomatoes, zucchini
At room temperature but move to the fridge once ripe: Apricots, avocados, papayas, peaches, pears, nectarines, melons, kiwi, mangoes, pineapples, plums
Refrigerate: Apples, asparagus, blueberries, corn on the cob, cauliflower, cherries, cilantro, Broccoli, Brussels sprouts, carrots, Dark leafy greens, grapes, leeks, peas, parsley, lettuce, pomegranate, strawberries
The job doesn’t end here and we need to clearly understand ‘how’ to store produce as well. In general, remember to store high-ethylene-emitting fruits away from other produce. But, the same set of fruits can also become advantageous when we wish to ripen certain produce faster. For example, if you want to ripen your avocados, you can place them inside a paper bag and keep them right next to the bananas. You would be amazed to find ripe avocados sitting right next to the bananas ready to be used in your smoothies, as a spread or to make some yummy dessert. So, ‘how’ to store your favorite produce?
Garlic & Onion: Garlic and onions gel well and bond together as they are both part of the allium family. There is no harm in storing them right next to each other in open containers in a cool, dry and dark space.
Mushrooms & Okra: Keep them unwashed in paper bags inside refrigerators as moisture makes them slimy and rot away.
Tomatoes: Most of us are inclined to pack any produce into the refrigerator and tomato too faces the same challenge. It is advisable to store them at room temperature (in a bowl away from heat and light) away from the cooling air inside the fridge to prevent quick rotting of the produce. It is even better to keep the stem side down as this prevents moisture from accumulating around the stem and spoiling the entire tomato.
Potatoes: These stay happy at room temperature. Place potatoes in a cool, dry space in your kitchen but far away from onions or apples (any fruit that emits ethylene) as this can make them wilt and sprout quickly. You can surely grow your own potato garden with the small sprouts that appear on these root veggies if they stay together with onions, even by mistake!
Carrots: These have a longer shelf life and can stay fresh up to 2 weeks when placed in an unsealed zip-lock bag in the crisper drawer of the fridge.
Peas: Store them in plastic bags
Cucumbers: Avoid storing them in fridge but if the need arises never refrigerate them beyond three days. Place them in the front portion of the shelf wrapped in paper towels (you can keep these wrapped ones inside a plastic bag) where the temperature is pretty warm.
Leafy greens: Firstly, remove any rotten leaf from the greens before storing and place different greens in different bags. Wrap the leafy greens in paper towels and put them into plastic bags.
Banana: You can place them on the counter or use banana hangers to prevent the fruit from ripening too much
Berries, cherries and grapes: Any of these fruits must never be washed until you find it essential to use them. Keep them dry in covered containers inside the refrigerator.
Citrus fruits: All kinds of citrus fruits can be stored in the crisper drawer or in a mesh bag in the refrigerator.
Stone fruits: Plums, peaches and nectarines must be placed in a paper bag on the counter until they ripen and then stored inside the refrigerator.
Melons: Watermelons must be stored outside in a cool, dry place. Cantaloupes and honeydews can also be kept outside until they are cut.
Herbs: Herbs can be preserved just like flowers, keeping them in a vase filled with water. Before doing that, you can wash them, dry them and cut off the ends. You can even cover the top portion of the herbs with a plastic bag or a damp paper towel as this absorbs moisture.
Washing your produce is an art that needs to be mastered. This helps to get rid of as much pesticides and dirt as possible. You can get a list of the top 10 dirtiest and cleanest produce from the website www.firsteatright.com. So, store your produce the right way and wash them properly to enjoy a hearty meal with the essence of fresh and healthy ingredients. This is economical and saves your time too!
None would be unaware of the infamous story ‘The King & The Spider’ where a spider’s perseverance taught a much-needed lesson for the king. Such famous are these arthropods that there are more than 40,000 species of spiders identified worldwide and real numbers are estimated to be 4 times more than this number presented here. All of these are predators that feed on insects and other tiny animals. Spiders are air-breathing arthropods (largest species collection) that are diversely found ranking seventh in total species diversity.
Just like lizards and cockroaches, many of us are scared of these eight-legged creatures but spiders rarely harm humans or bite them unless threatened. No spider attacks a human for some reason, all the more bite someone. They inflict pain only when an individual accidentally harm it or when the spider misinterprets the person’s movement with that of a prey. History shows that there is only one aggressive spider till date, the funnel-web in Australia, which attacks humans without any reason or provocation.
Each of us would have come across or been victims of spider bites sometime in our life. Most of these bites are harmless, many of them blamed on spiders seem to have been inflicted by other bugs and sometimes, skin infections have also been mistaken for spider bites. Tiny might be the species, but its bite can rarely be extremely dangerous and damaging. Spiders have hollow tusk-like jaws connected at the base with poison glands that produce toxins delivered by the jaws. Amongst the 40,000+ species, few of them can penetrate human skin and even if they do so, most of these possess toxins that have little or no effect on humans. Rarest of the rare species have both the abilities-penetrating through the human skin and disposing toxic venom-together that can cause serious human disease. The severity of reaction to spider venom depends on numerous factors such as the quantity of the venom injected, site of bite, duration, age and health conditions.
Victims of spider bite experience pain and swelling in the site of biting, necrosis, respiratory distress, kidney dysfunction, hypertension and death. Some of the world’s most poisonous spiders and the available treatments are discussed here:
Brown Recluse Spider
Characterized by a violin-shaped marking on its back, this spider is a nocturnal creature that rests mostly during the daytime. Individuals wearing clothes or shoes displaying spiders are bitten. The bite is painless, but the degree of pain increases in a couple of hours manifesting as inflammatory, hemorrhagic and painful lesions. Antivenoms dispensed decrease the size of the necrotic area and faster they are dispensed, minimal is their manifestation. Recommendations are to dispense these antivenoms within first 4 hours of the bite, but certain investigations seem to find them useful even after 12 hours.
The spiders are names so because they like to hide away in undisturbed areas and prefer to live indoors, for instance, amongst the clutter of basement or attics, behind bookshelves and dresses and in unused/rarely used cupboards. Outside, they choose their quiet spot underneath rocks or tree stumps.
Black Widow Spider
One amongst the famous venomous spiders, black widow spider has a black hairless body and commonly found in North America and Australia. The entire body is pitch black with the exception of a red marking, in the shape of an hourglass, on the abdomen. The bite hurts minimally, similar to a pinprick. This spider bites during the warm summer months and mortality rates are as low as 1%. But rarely, especially in children, the bite of a dark widow or brown recluse spider results in death.
Symptoms include abdominal cramping, sweating profusely, fever, chills and body aches. Rarely the cramps can be such intense that they are mistaken for appendicitis or a ruptured appendix. Sometimes, the central portion of the bite turns dark blue or purple and emerge as an open sore (ulcer) that grows in size as the surrounding skin dies. The ulcer growth stops within 10 days after the bite, but complete healing takes months together and high degree of severity might result in grafting the affected site. Treatment consists of using muscle relaxants, narcotics, analgesics and antivenom.
The most dangerous spider in the world, this spider is aggressive even in the absence of provocation. The web formed by this spider is funnel-shaped and hence the name. Pain, hives, diaphoresis and piloerection are local symptoms. A funnel-web bite can cause drooping eyelids, double vision, swallowing difficulty, rapid heart rate, breathing difficulty, joint pain, muscle spasms, shivering, headache, coma, diarrhea, nausea and vomiting. Hives can irritate a person due to itching and also sting them. Read more on hives, their causes and treatments at www.firsteatright.com.
Treatment includes bandaging for blocking lymph nodes, limb immobilization and taking the affected person to the hospital as fast as possible. Antivenom must be given immediately after hospitalization along with other measures such as ventilatory support and tetanus vaccination.
A spider bite might produce a reaction similar to that of a bee sting and result in redness, pain and swelling. Treat spider bite by:
AVOID FRAUD. EAT SMART.
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Dietitian & Nutritionist Dr. Nafeesa Imteyaz.