Dr harold Gunatillake

Have you checked your Blood Pressure recently? – Good advice by Dr. Harold

You get high blood pressure as you get older. Being a slow process of increase, you may not have any prodromal signs, until one day you feel dizzy. Blood pressure is cause by pushing the blood from the left lower chamber of your heart against the walls of the arteries that develops a resistance due to thickening (arteriosclerosis). As you know, your doctor will give you two readings when he checks your BP: upper pressure represents the pressure caused by the contraction of the left lower chamber of the heart (ejection pressure), and the lower reading represents the diastolic pressure due to the pressure in the arteries as the heart dilates.

In healthy active situation the best readings of your BP should be-systolic 120mm and your diastolic below 80 mm. High blood pressure (hypertension) is now defined as systolic pressure more than 130mm. and your diastolic pressure is more than 80mm. When your BP is over 180/120 you might go into a crisis and end up in the ICU.

If your home reading is over 140/80 you need to see your doctor soon to take measures to bring down the values to normal range.

The danger of having a sustained high systolic pressure is that the situation strains the heart due to the increased systolic pressure and may lead to heart muscle thickening (hypertrophy) and if neglected leading to heart failure which may be irreversible.

Further, symptoms with neglected high BP could be severe headaches, fatigue and tiredness at rest, vision blurring, chest pain, breathing problems, irregular pulse rates, blood in the urine, and pounding in the chest (palpitations), neck and ears.

Remember with continued high BP, you damage your arterial walls, risk heart disease, chronic kidney disease and may get a stroke.
If you are a diabetic, your chances of getting high blood pressure are high and you need to check your BP more frequently.
There are factors that can increase your BP, and you should attempt to eradicate them:

Smoking, Over-weight and obesity, lack of physical exercise, too much salt with your food, over-indulgence in alcohol consumption, aging, family history and genetics, stress at work, chronic kidney disease, and sleep apnea.

Conclusions: Please check your BP at least once in six months. Eradicate all risk factors. Your doctor will give you medication for hypertension, if it cannot be brought down by correcting the factors that’s causing it.

There are three kinds of medication you may get with persistent high BP. (1) Release the pressure on the heart muscle by giving calcium channel blockers to slow the heart. (2) Dilate the peripheral arteries by giving dilators. (3) control rapid heart rate by giving beta-blockers.
For older people, your doctor will prescribe medication to counteract the pressure caused by a hormone secreted in the kidneys called ‘angiotensin’. Angiotensin causes contraction of blood vessels, a natural mechanism in the body to compensate blood loss resulting in low BP (hypotension). These drugs are called ACE inhibitors, (angiotensin converting enzymes), and ARB drugs (angiotensin receptor blockers). Your doctor may prescribe a diuretic to pass more urine.

This is a brief account to make you understand the significance of untreated hypertension and the classification of medications you will be prescribed for hypertension.

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Recurrent nonspecific backaches – Good advice from Dr. harold

This applies to situations, quit commonly found among active people, getting neck aches and lower backaches with no specific condition affecting the spine, confirmed by CT scans and other tests.

These aches are due to muscle sprains and ligament strains found on either side of the spine, and most days you experience a sudden crooked spine with aches on one side of your back. You could use the term ‘Lumbago’ for this condition.

Simplest remedy is when you have your morning shower, make the water as hot and comfortable as possible. Whilst the hot water is hitting your back, bend down slowly and touch your toes a few times. Then, do a side bend to the right and then to the left. Do other movements to improve the mobility of the spine, a few times.

This alone may temporise your back problem for the rest of your day.

Sitting with your neck bent forward, or hunched as we call it, facing your computer can give you a neck-ache. This posture tends to flatten the natural curve of your spine and damage the cushioning discs between vertebrae and cause early arthritis.

Keep your PC screen at eye level; straighten your back whilst being seated. Gently stretch and move your head a few times to prevent strains, at regular intervals. Some blame the mattress for a crooked spine. The ideal mattress should be firm, and if the springs of your bed are worn out, sleeping on the mattress on the floor would be the answer.

If you are a back sleeper inserting a rolled towel under your knees will keep the natural curve of your back, and this may prevent the back ache.
Best position to sleep.

Do not sleep on your belly if you have a back problem. In any case it would bring back the ache if you sleep in this position.
Side sleeping would be the best position to sleep if you have a backache. Placing a pillow between your thighs would release the pressure on your hips and also relax your spine.

Exercising is very important whilst you have a backache. I find going on a treadmill at slow speed gives instant relief. Other low impact exercises like walking, biking and swimming strengthen your stomach and spine muscles which protect your discs in your spine.

You will notice that when get up from the seated position after sitting for a long time may experience backache. Just a bit of walking gives instant relief.
If you suffer from this malady, do not overeat and put on pounds. Extra pounds strain your bones and muscles of your back. Protruding belly due to overeating can hurt the lumbar spine very badly.

Those who use backpacks should not overload them. Your child’s backpack should not weigh more than 20% of their body weight.

Ladies wearing very high heels can strain their calf muscles, Achilles tendons and indirectly their lower spine. On returning home after work and removing high heels and getting into slippers may exacerbate the aches.

Doing slow yoga movements can help relieve low back pain. Over-doing it may hurt your back muscles.

Local spraying of anti-inflammatory sprays like voltaren seems to give temporary relief.

Certain spinal exercises done daily after a hot shower would be another way of getting relief. Any physiotherapist will demonstrate those exercises.

The author experiences lot of back pain after sitting in front of the computer long hours, and that has inspired him to write this brief article.

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A diet that makes you slim Written by Dr Harold Gunatillake: Health writer

Some of my readers have asked me to suggest the best diet for slimming. There are many diets described, each has its merits and demerits, but I find the ketogenic diet is one of the most practical and rewarding diets if you desire to slim. It is more a further extension of the popular Atkin diet with more restriction of carbs and added more fats, and is easy to follow.

We need carbohydrates, fats and proteins to provide energy for survival. In the normal traditional staple diet we consume carbs as the main calorie producing ingredient (60%), and about 30% of fats, which includes about 10% of saturated fat and 20% of unsaturated fat. Proteins are the bricks of your building structure and you need about 10%.

One could bring down the carb consumption to about 20% and increase the fats to provide nearly 80 per cent of the daily required calories In the traditional low carb diet protein content is increased whilst in keto diet the fat content is increased.

Why is it called the keto diet?
When your carb consumption is very low, the body turns round to the stored fats for energy. When fats are broken down the liver produces ketones to be used as energy. This is a natural survival kit in our bodies, to produce ketone bodies when we are deprived of energy producing carbs. WE are not really starving ourselves in this diet but only reducing the main energy producing carbs.
Fats being the main source of energy in keto diet, let’s discuss what fats should we consume to lean ourselves. You do not target the foods in the deep freezers in supermarkets for such required fatty food consumption. Such food contains trans-fat added to the foods to increase their shelf life. They increase a person’s cholesterol levels and increase inflammation in the body. These trans-fats are manufactured from vegetable oils and they go through about ten processes and hydrogen fumes are added on. So, they are also called hydrogenated fats, like margarine.

So, please avoid fatty foods containing hydrogenated fats when starting on a ketogenic diet. Those friendly saturated fats in a ketogenic diet are: coconut oil, grass-fed beef, butter from grass-fed cows: and whole milk and whole milk dairy foods.

Include more polyunsaturated oils in the cooking process, such as almond oil, flaxseeds, olive oil, and canola oil, corn oil and so on.
Eat plenty of oily fish and nuts in a keto diet. You could eat two eggs a day without fear of increasing your blood cholesterol level. 

The keto diet is not a high protein diet. They are not used to provide energy. As such you could eat the normal amount of protein foods daily, such as grass-fed meat products, nuts, seeds and eggs, among others

What carbs do you reduce to restrict carb intake. Keto diet recommends vegetables of the non-starchy varieties, and avoids potatoes, and other ground roots. Vegetables included are: artichoke, asparagus, baby corn, broccoli, Brussels sprouts, and eggplant, green beans, okra, onions, tomatoes, salad greens, spinach, arugula and so on. Carbs like pasta, noodles, bread and rice are not included in the keto diet. Fruits are also not included in the keto diet. The diet does restrict starchy foods but you may consume in very small quantities adding up to 20 per cent of your calories.
Coffee and tea are allowed without sugar. Sodas are not included due to the high sugar content.

Condiments such as yellow mustard, mayonnaise and hot sauces are okay provided you chose the ones without sugar. You could add the Asian spices, pepper chili, basil, and cilantro ad lib on a keto diet. 

Keto diet not only reduces your weight but also ideal diet for diabetics. You may not have to take any anti-diabetic medication, and control your blood sugar by choosing the right carbs. For instance, the Vegans find it easy to control their blood sugar levels. 

Seizures in epileptics
This diet reduces the seizure rate among epileptics. According to the Epilepsy Foundation in US, an estimated 50 per cent of children reduced fits by half on the ketogenic diet. Keto diet promotes heart health in addition to losing weight

Side effects
There are a few side effects with keto diet. Constipation could be one problem. High fibre greens and drinking lot of water may be the solution. It is not recommended for young people as it may retard growth. Formation of kidney stones is a possibility. Doctors do not recommend this diet for those having chronic kidney disease and gout. If you suffer from any chronic disease, you must talk with your doctor before beginning any new diet.

Conclusions: In this diet you transfer the main energy requirements to the stored fats in the body through a process of ketone bodies production in the liver for energy, depriving intake of carbs to produce energy. It is mainly a high fat diet.

(Some reference to the article on the same subject written by Rachel Nall, RN) New research Latest finding is that when it comes to shedding pounds, there is little difference between a low carb diet or a low fat diet. That conclusion comes from the tracking of roughly 600 adults who had been between 15 and 100 pounds overweight when they embarked on either a low-fat or low-carb supervised diet for a year. (ref: Medicine.Net)

Dr Gunatillake-Health editor is a member of the Academy of Medicine, Singapore. Member of the Australian Association of Cosmetic Surgery.
Fellow of the Royal College of Surgeons (UK), Corresponding Fellow of the American Academy of Cosmetic Surgery, Member of the
International Societies of Cosmetic surgery, Fellow of the International College of Surgery (US), Australian diplomat for the International
Society of Plastic, Aesthetic & Reconstructive Surgery, Board member of the International Society of Aesthetic Surgery, Member of the
American Academy of Aesthetic & restorative Surgery, Life Member of the College of Surgeons, Sri Lanka, Bachelor of Medicine & Surgery
(Cey), Government scholar to UK for higher studies and Fellowship.

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Health Benefits of Garden Parsley – By Dr Harold Gunatillake

We have a balcony garden, growing many herbs, spinach, basil, chillies of various lengths, mukunu anna and so on. It is a great comforting feeling to see these plants grow in pots, watering daily, and the satisfaction is beyond imagination. We live in Sutherland, Sydney.


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Chillie by Dr Harold Gunatillake

Chillies have health benefits: you can lose weight, increase your metabolism, boost your immune system, has many vitamins and micro-nutrients, repairs your skin, blood vessels and tissues through the production of collagen and many other health benefits. Filmed by Dr Harold Gunatillake



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Mukunuwenna film – Dr Harold Gunatillake

Health benefits of Mukunuwenna is discussed. Filming was done by Dr Harold Gunatillake on his own balcony garden where this herb has grown wild. It has more dietary fibre than most other veggies and eating frequently is good for your -heart, bone and blood health.


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Most People Are Dehydrated Without Knowing – By Dr. Harold Gunatillake

Most people do not know to recognize when dehydration sets in and they go on with their normal work as usual. Some complain that they do not pass enough urine, or may feel not right without realizing that dehydration is the simplest cause.

By definition dehydration means that one hasn’t got sufficient water in the body for its normal metabolic requirements. You lose water when you breathe out in the exhaled air. You will sweat when warm to cool your body. You need to pass urine to get rid of waste products like creatinine, urea and other detoxified breakdown products. You do pass a small amount of water in your faeces daily, and more when having loose motions.

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A better way to check your diabetes : Written by Dr harold Gunatillake FRCS-Health writer

Most Sri Lankans do ignore a simple test to check for diabetes when required after the age of 40, as they do not realise the serious issues of the disease and the ability to control better when detected early. Those who have a family history of diabetes do check to find out whether they have got high blood sugar levels.

To check for fasting blood sugar finger prick test would do. If you have your own glucose testing monitor, you could check it at home when required. In a normal non-diabetic person the reading would be about 90mg/dl. (6 mmol/l). When it reaches 126mg/dl (6.9mmol/l) you would be considered a pre-diabetic. The complications with pre-diabetes and full blown diabetes are similar. So, it is important at the pre-diabetes stage to nip in the bud by eating low GI foods and exercise daily.

There are other tests recommended like ‘Glucose tolerance tests’ among others to diagnose and confirm diabetes.

Today there is a better test to control blood sugar levels and reduce the long term risks of heart attacks, stroke, blindness and kidney failure associated with diabetes.

One such test is the HbA1c or in short A1c test. This term refers to glycated haemoglobin a protein within each red cell that carries oxygen throughout the body. The glucose that enters your blood stream joins with the oxygen in the haemoglobin to become glycated.

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