Laughter, the best medicine

Staying positive during a chronic disease helps the family manage the illness and also speeds up the healing process  for the patient

How can I think positive when my life is falling apart? What have I done to deserve this? Why me?” These were Rakesh Sharma’s thoughts when he found out that he needed an angioplasty. Seven years back, he had a bypass surgery after a severe heart attack. Being Christmas, the doctor who conducted the surgery wasn’t the renowned cardiologist Rakesh would have liked. Six months later, when he came to Mumbai to visit his family, the 40-year-old NRI was rushed to the hospital with chest pain. The electrocardiogram (ECG) showed unusual activity and his cardiologist suggested the possibility of an angioplasty. A second — and third — opinion revealed the same thing: His cardiogram showed a flaw in the bypass — one artery had not been operated upon and this was now showing a blockage.

Disturbed and disillusioned, Rakesh put his foot down: “There’s no way I’m getting this procedure done. I can’t afford to get my heart operated upon every six months. I’d rather die, if I’m fated to.” His cardiologist spent an hour explaining why he was lucky to know what the problem was and that he still had a chance: An angioplasty is safe and will definitely improve things, he said. But it was his mother who managed to convince him: “This is what God wants. It’s for your own good.” So after numerous tests and consultations, Rakesh agreed. Last year, when he came to India, he paid his doctor a visit. “Doc, the positive discussions that I had with you and my mother really helped me,” he said. “I’ve had a completely asymptomatic five years. And when I think back to those conversations, I still feel motivated. It still helps me control my diet and lifestyle.”

Like Rakesh, a number of people who suffer from chronic diseases — like cancer, hypertension, diabetes and AIDS — believe that approaching the doctor with an open mind and staying positive throughout the treatment has helped them get better faster. “If one stays positive, vital physiological parameters stay normal,” says Dr Ramakant
Deshpande, surgical oncologist at Lilavati Hospital.

Doctors agree that staying optimistic is important for the patient, family and the doctor.
“Sometimes, patients with chronic diseases feel that they are hooked on to the treatment for life. This can be a depressing thought,” says Dr Jatin Kothari, nephrologist at the PD Hinduja Hospital. High cost of treatment, constant vigilance and the time consumed by procedures such as chemotherapy and dialysis, can take its toll on the entire family.

“If patients stay positive, they are more likely that they will follow up with their treatment. This improves recovery,” adds Dr Dehpande. “We have seen that patients who get depressed and lose the will to live can develop complications.” It is important for the doctor to spend some time with the patient and the family to explain the procedure. “The doctor should make sure that there is no fear that can lead to negativity,” says Dr Siddharth Dagli, consultant cardiologist. “Medicine does not adequately describe this, but it has been seen that attitude plays an important role in recovery.”

And this is entirely scientific. “Staying optimistic releases neurotransmitters — chemicals that conduct electrical impulses in the brain — that liberate endorphins in the body.
These endorphins are natural pain and stress relievers and enhance the healing process by improving the body’s immune response,” explains Dr Dagli. Exercise, agree doctors, plays an important role in releasing these endorphins. Various studies have shown that exercise after chemotherapy boosts the activity of infection-fighting T-cells. It also improves physical functions, such as endurance, body strength and volume of oxygen intake. Whether it is cancer, AIDS or heart disease, exercise reduces weakness, muscle cramps and fatigue, say doctors.

The knowledge a patient has on his/her illness is also dependent on the attitude. “A person reads up on the disease and prepares himself to deal with the pain and cost of the treatment,” says Dr Deshpande. Instead of brooding, if the patient considers the short-term effects of the illness, it becomes easier to take it one day at a time, says Dr Kothari.

Like Samiir Halady, who has to undergo dialysis twice a week, every week, for the rest of his life. Diagnosed in 2002 with Membranoproliferative Glomerulonephritis (MPGN), the 35-year-old MBA read up about the disease on the internet and decided that since he had to live with failed kidneys, he might as well get used to the idea. “I realised that I shouldn’t be comparing my problems with those of others,” he says. “I didn’t let myself get into the mould of ‘why me’ because I knew that I had to get emotional strength from myself, not from others. So I live the way I want to, and take my illness one day at a time. I’ve told myself that everyone lives with problems… and this is mine.”

For both Samiir and Rakesh, and most patients suffering from cancer, diabetes and other diseases, the family plays a very important role in helping the patient stay optimistic and happy. Support groups for cancer, Alzheimer’s, autism and AIDS, among other illnesses, play a tremendous role too. “Knowing that someone else is dealing with the same, or similar problem as you, makes it easier to stay happy and move ahead with treatment,” says Dr Deshpande. Sometimes, there are religious groups and individuals that step up to help bring in this positive attitude. “At the end of the day, whether it’s the family, a priest or the doctor, what is important is that the patient remains happy and optimistic about his/her chances,” adds Dr Dagli.  
j_geetanjali@dnaindia.net