Energy Rhythms in Women


Intricate part of our well being.

We need energy to be productive – to work around the house, to perform at our jobs outside the house, to deal with other people (you can easily notice this by creating an awareness of how you feel after interacting with another person – some people bring a lot of positive energy into your life whilst others bring negative energy and these energies in turn have significant impact on our mood, how we feel and subsequently how we perform for that day – another conversation in itself which we’ll leave for another day:) and most of all to deal with ourselves – few will disagree that it takes some energy to stay focused on eating well, exercising regularly and yes it takes energy to relax.

It would be so nice if we could stay energetic most of the time. Bounce around with a positive buzz – bring positivity through this energy into our own life and then start spilling it into the lives of those we come into contact with!

Doesn’t happen that way all the time though. The positive buzz can easily transform into drop dead fatigue for most us and it can do so quite rapidly and unexpectedly – leaving us feeling tired, exhausted, not having enough strength left in us to stay on track with self care and subsequent care for others.

Remember the mantra that you can never expect to give any energy and positivity to others if you have not first allocated some to yourself. Only once you’re saturated with this positivity do you have enough to give to others. Thats why self care is so important.

Even if you’re other centered and you believe your primary duty lies in pleasing others, taking care of your children, family, profession, vocation or a larger philanthropic work, you still need to start with yourself. The universe works that way. Energy can neither be created nor destroyed – it can only be transferred. If you’re full of positive energy, you’ll transfer the positivity around and the vice versa is certainly very true.

So what to do if you feel you’re always running on an empty tank?

Well, fatigue is common. Its more common at certain life stages.

Young mums, those juggling multiple things such as work/family/multiple dependents such as children who require special attention, looking after elderly parents or a sick partner are definitely at higher risk of fatigue. And for a good reason. They can’t really change much about the other end of the equation which are their care duties. So they need to address this end of the equation, which is how much they invest in looking after themselves. They need to have more awareness about eating well, taking some time to exercise and to relax regularly. They need to take stock of their social situations to see what support network they can call upon to make these things work e.g. enlisting help of a family member on regular basis to get some down time themselves, making arrangements with a friend where they can share their duties e.g. baby sitting for each other etc.

As simple a situation as having a child and navigating through infancy and preschool years can take efficiency, planning and execution of a CEO running a company. The only difference is that profit in this case is measured not in monetary terms but in how much happiness and fulfilment fills your life. How much energy you’re left with at the end of the day.

So hats off to all those who do it day in and day out and are building up on the little savings of energy they make every day and pass on these positive spills to those around them.

And even bigger kudos to those too that are not quite achieving it every day but continue to strive every day.  Every day is a new day for these courageous women.


So what about the rest of us though? Those who are not particularly facing any exhaustion prone life stages but are still experiencing fatigue on daily basis.

Its quite important to have a general check with your health professional to ascertain that its not a physical cause such as iron deficiency, thyroid dysfunction, trouble with sugar metabolism, vitamin b12 deficiency etc.

Another thing that your health professional might need to look at is the quality of your sleep as well as your mood as both can be tied in quite intricately with your energy levels.

On top of all of this, your hormone levels can also affect your energy levels.

You may have noted that you have far more energy at certain times of the day – some of us are morning sunshines whereas others start slow in the morning and pick up speed as the day goes on whereas yet another type of people are full of beans at the end of the day.

Its quite important to not to try too hard to fight these natural patterns in ourselves but to work around them. Plan your most demanding tasks and meaningful tasks around your “high energy hours” and you may find them becoming less of a chore or a drag.

From a medical perspective, we do have a peak of hormones in the morning which is perhaps tied in with our evolution. We are meant to be physically active, gathering food in the first half of the day and that’s when the hormones peak to give us more energy. These hormones then start going down as our bodies get ready to slow down and switch off for the night.

Having said that, its still quite important to be in tune with your own energy rhythm and it is still best practice to listen to your body to a large extent.

As well as the daily ups and downs of the hormones, we also undergo a monthly up and down of the hormones. Haven’t we all noticed how certain days of the month we are full of energy, happy, brimming with enthusiasm and nothing seems too much – all things fall into line and we are on top. I’ll call these our Estrogen days – the days of our menstrual cycle when this hormone is predominant. Its a natural boost to us and in a typical cycle it peaks around mid cycle, having started a gradual pick up from about second week after the periods. So if you’re planning big and important events then it makes sense to plan them around the time of the month when you’re more likely to handle it well and without undue stress.

And haven’t we all noted those days when we are just drained. Tired. Loss of motivation. Everything is a drag. Its like someone has pulled the plug out of the socket or turned a switch off. I’ll call these our Progesterone days – these are the days when progesterone is predominant in our body and its a naturally depressive and draining hormone. It starts to pick up around the third week of the cycle and goes on into the first days of the period, contributing to the pesky Premenstrual Syndrome and Premenstrual Dysphoric Disorder. Tiredness can a hallmark of this phase of our cycles.

So you can well see that we are constantly going through theses hormone driven changes on daily as well as monthly basis. We do need all these hormones for our body to function well. So the smart thing is to have an awareness of our energy levels on daily as well as monthly basis and to use it our advantage. Plan your tasks around energy levels and plan your relaxation around the downer phases as much as possible.

Some days it may well be the case that you just have to push through the low energy days. Energy is a balancing act. Focus more on the things that give you energy such as eating nutritious foods, exercising and spending time with family and friends.

But if these measures are not helping then its quite important to validate this. If severe symptoms are happening to you on daily basis, then it is happening, its valid and its real and it deserves attention.

Then it may be a good idea to have a chat with your health care provider as hormone therapies such pill or HRT, if you are in perimenopausal or menopausal stages, can be helpful. In some cases mood stabilising therapy can be used to try and bring some harmony into the fluctuating hormone and the resultant fluctuating mood and energy states.


The key message is to hear the beat of your internal rhythms.

Ride the waves of high energy and plan for the calmer waters ahead.






The Present

As I think of what

to get you on your birthday

As I think of what

will make a perfect present

on this special day


I thought as I sat

Oh what it ought!

That proves to be a marvel caught!


I remember buying you a car

it exhilarated you!

..but only for month or two.


Then I bought a watch

..but then it got boring too.


So I sat and thought of the past

what had ever made a present last?


..and then it dawned

-simple & unhoned!


I decided to gift you

-my eye

the eye that sees the sparkle in you

when you see darkness around you.


I decided to gift you

-the love for you

the love that sees the beauty

that lies inside of you

the love that loves the person

that is you!


I also gift you

-the wings you gave me

the wings that let me fly


And with these wings I also gift you

-the branch that is you

the branch that I find most relying

to rest when I’m done flying


..& the branch that’s always nearby

for the mornings when I forget how to fly.


My gift to you

is that you may feel for yourself

the love that I feel for you.


I gift you

-the cheer

that you give me

when I feel low & drear.


Have yourself a glorious day

on your birthday.


May your day be good & true

..almost as good & true as you!






X mas story

It was the night before Xmas

Sue decorated the house and bought everyone presents

Sue cooked for everyone

On Xmas day everyone came to Sue’s party

They opened presents, enjoyed the food, laughed a lot & then they all left

Sue felt tired

Sue felt annoyed

Sue felt irritated

She felt she did all the cooking, spent so much money buying expensive presents


Everyone just came, ate, took the presents

And left

All she got was a bunch of flowers and a couple of hand made cards saying how lovely she is

Then Sue sat down to think

What present would have made Sue the happiest?

Expensive watch? Designer dress?

What is it that she was really expecting

Sue thought some more…

What is my happiness?

Sue decided her happiness was:

Being appreciated & loved

⁃ she looked around and the flowers were there to show how well people thought of her. Sue considered that flowers represent natural beauty & grace – she liked the idea of being thought like that by the person who bought the flowers.

Sue cheered up a little.

⁃ She looked at the hand made cards – one said she was the most amazing person in the giver’s life and another said that she made the giver’s world a happier place simply by being in it.

Sue felt bit more happy.

She then looked at the dirty dishes and mess left behind.

She again felt irritated.

Sue felt tired. Her back ached.

Then she noted that all the food she had cooked had been devoured by everyone who all kept going on about how much they enjoyed the meal.

Then she remembered one of the comments that they would rather eat this food than at a fancy restaurant

Sue felt her food and her cooking was appreciated.

Wasn’t this what she had set out to achieve when she invited people for dinner?

Sue decided that surely this is a sign of successful dinner get together

Sue felt successful

Sue felt cheerful

Sue felt little bit less tired and her back didn’t hurt so much now

Then Sue remembered that one of her dear friends had mentioned that instead of getting her a present that Xmas they had donated to a charity that Sue supported

As Sue allowed herself to sit, think, reminisce & reflect, Sue realised that she actually got all her heart’s desires on this x mas day!

As Sue sipped her tea, Sue wondered about the change in her mood and contemplated the reason for her feeling annoyed and irritated just a few minutes ago

Sue realised that the annoyance was merely a negative feeling – a feeling that came from being tired & feeling overwhelmed by the task of dirty house and dishes after her guests left

The negative feeling invited the pack of negative thoughts and she felt angry, upset, dissatisfied

Once she took some time out and sorted her thoughts out, Sue shut the door on the negative thoughts

She opened her eyes to so many positives in the same situations which had just annoyed her so

Sue liked herself for allowing herself to be happy instead of being angry and quarrelsome

Sue felt happy

Sue felt light

Sue decided to allow herself some rest, told herself that the tidying up can wait

Sue reminder herself that the only reality in the world is the relationships she has built in her life.

Rest is all distractions.

Chores are chores.

Chores can’t take place of real things.

So why was she willing to give more importance to chores over the beautiful relationships that her friends brought into her house that day?

Would her friends have cared if her house was bit messier?

She decided that they would’ve been the same.

The judgement was from herself.

She stressed and put the pressure on herself.

But now it was all over.

She congratulated herself for having had a brilliant day and allowed herself a well deserved rest.

Sue woke up happy and fresh on Boxing Day

The chores which had seemed mountainous the night before were finished within an hour

Sue put on her favourite dress to tackle the Boxing Day sales

Sue opened the door and left home with spring in her step and a song in her heart

Sue didn’t feel tired and her back didn’t hurt anymore

Sue had a good Boxing Day.

Sue brought happiness into her life.

Life lessons and traffic

Life experiences.


Life lessons.


They help make us a better person.


They come from either our own experiences or those of others.


They do not necessarily have to be gained by big events or big journeys. In fact, the best lessons come from seemingly mundane and day to day occurrences.


Routine daily life makes for great insights and experiences.


Take, for instance, traffic. Not the best feeling invoked by the mention of it?


Can be a great teacher in character building and learning about life.




Let’s break it up.

A great day on the way to work (or another destination) is when there is no traffic.

A bad day is when there’s queuing traffic with no exits in sight.


The former can make us feel really great – that we chose the best route, the correct lane to be in and what’s more, left home in just the right time to hit the road in perfect time.


The latter can really frustrate us – frustrated with others on the road (who seem to be doing all the wrong things like lane hopping, going too slow or too fast – you name a wrong thing to do and someone is doing it); and frustrated with ourselves for choosing that route, not leaving home in good time and so on.


Now if you really think about it, how different are these traffic experiences from the ones which concern seemingly bigger things in life – when things work out for us and when they don’t?


The feelings they invoke are quite similar.


We are happy with ourselves when things work out and happily take the credit for it and enjoy the positive feelings invoked by the experience.

We are frustrated and angry when things do not work out.


But the thing to remember is that a queuing traffic is generally made worse by the circumstances that are not entirely in our hands – there’s simply too many cars and motors on the road, lights not working, road works, accident, police checks and so on – getting frustrated in not likely to help.


Best solution is to keep calm, look at alternate routes, think about calling ahead wherever you are heading so there is some future planning set in place. Fuming at the road or at the fellow drivers is unlikely to make matters better.


Similarly, in a life adversity, don’t blame the situation or those around you.

Keep calm and think about what can be done to improve a bad day.

  • Bring yourself to be completely present in your current moment. This means forgetting about what could have been, what should have been, how it should have been. Just deal with how it is now.


  • Weigh the actual problem. What is the problem here?


  • Think about the possible solution.


  • Weigh how much of that solution is in your hands.


  • Should you decide that you can’t actually solve this problem as it’s out of your scope or its out of your hands then think about what you can do to ease the burden of that problem. There’s always something that can be done. 


Similarly, the day the traffic is good, remember that a lot of things have to line up to give you a good day – green lights, no road works, no accidents etc.


So a good run on the road is not really entirely one person’s doing but an alignment of lots of out of control elements.


Keeping this simile in mind for the good days in life helps us keep grounded.

The good times are not just a one man job and we would be wise to not take all credit to ourselves as good circumstances are often a happy result of a number of things lining up in our favour.


We are but a small part of something big – our universe-  and we will do well to keep that awareness and have tolerance for others and abundance of patience for ourselves.


I don’t own all the good days, hence I don’t own all the bad days.


I think about the good days and strive to do more of what role I played in making it good and I think about the bad days and strive to do less of what made the day bad.


But I share my days with the universe – with those around and our experiences together connect us and help “I” feel less lonely – a curse of our present day generation.


Be one with you but remember to be one with your surroundings too.


Its an illusion of ours to think that we are separate and we can do and achieve things on our own. We are part of universe and part of that universe is within us. Once we understand this, it helps us develop more understanding and tolerance for ourselves and  the fellows.


The path to discovering self, the greatest of all quests, is to look within.

Its to know self.

To know self is Ego.

Ego is good.

Ego is positive.

Ego connects.


The path to loosing self is to be full of self.

To be full of self is Egoism.

Egoism is negative.

Egoism disconnects.


To feel the connection with the universe around is a big step close to achieving the idyllic content state of being – Nirvana.


So when on the road tomorrow, let your Ego rule, not the Egoism.


Feel that you’re part of the universe and not alone in your good fortune or your suffering.


Reflect and analyse what can be done to improve your situation but stay patient with those around you – most are in same boat as you, they just seem different as some are more gracious in adversity, others less so.


You stay true to yourself, don’t let your behaviour be guided or influenced by others.


Stay true to yourself and add a grain of glitter to the universe for everyone.


So much learning – from the traffic jam!!


Bless the jam!


Think traffic.

Think meditate.

Think reflect.

Reach nirvana.


I guess the person who came up with the great saying – when life gives you lemons, make lemonade – thought somewhat along the same lines:)


In present day though, it can be adapted thus:

When roads give you traffic, practice Ego and not Egoism.


I’m already relaxed.


Bring on the traffic, there’s a great deal more reflection to be done!




My present to me on my birthday

As I celebrate my fortieth birthday,

I look back at the years gone by.


Seems like I am halfway through the journey of life,

do I celebrate this achievement or do I get myself into a strife?


Life has been kind,

so I ask myself, ” being the big four oh, do I really mind?”


Reaching here was a mix of joy sadness ecstasy hard work and some trudge,

so why should I this beautiful journey begrudge?


I am who I am regardless of how old,

this thought feels happy and good as gold.


With this thought I accept I am happy to be forty,

so what should I gift myself to celebrate this party?


As I look around I realise and accept,

that it’s actually quite easy finding the best present.


My present station in life is good and simple and my own,

why spoil it with goods bought from a shop made by unknown for someone unknown?


I accept my present – my this day,

as my best present for my special birthday.


But then a thought comes to my mind,

what makes my life so kind?


Hasn’t life thrown bad times and challenges my way,

hasn’t it made me cry and despair and want to run away?


Yes it did all that,

but it also gave me the resilience to be phat.


It taught me some useful lessons as years went by,

the lessons that helped me to face the challenges thrown my way.


When I felt envious and jealous and self centred,

life taught me to be kind,

to not have vile thoughts in my mind.


When I struggled and experienced impatience,

life taught me resilience.


It said to carry on no matter how hard things seemed,

and indeed when I did that things turned out much easier than they deemed.


When I dreamt big and reached for a star,

and a little voice inside said it was much too far,

life told me to put my heart and soul into my dream,

and told me to reach for my star no matter how far it may seem.



But then it also showed me that we are limited to a degree,

there’s a power that is stronger and with that I agree.


We all get our dues,

fighting the destiny is of no use.


Acceptance of our station is essential,

adapting and moving on is prudential.


Life also made me cry,

when it made me try and try,

and still left me all empty and dry.


It then came to my rescue with a lesson,

it whispered well done for the effort but nudged me to move on.


Life showed me that when you follow and follow your ambition with heart,

all things in the universe line up to give you the start.


My mother said this when I was little,

it annoyed me then and made me whittle.

She said if a job needs doing,

and doing it is worth your while,

you might as well do it with a smile.


Life taught me not to judge,

to not to look at others and fudge.


It showed me that anyone can have addictions,

its just that some are obvious,

whereas others are deceptions.


I am addicted to my work game,

which may seem noble,

but an affliction all the same.


Life has slowly even painfully,

taught me to love self fully.


Other’s pictures may seem prettier,

and the lights may even make them seem glitterier.


But here’s the key,

the everlasting arrow in your bow –

a possession more precious than you’ll ever know.


And with you it’ll always stay,

as long as you don’t loose its sight and push it away.


That priceless possession is true,

it’ll always be with vous – because it’s you.






The lifecycle of anxiety

When you have the good fortune that I do of being allowed quite intimate glimpses into the lives, minds and psyches of so many different people, you can not help but be amazed and awed by the extraordinary range of human emotions, tenacious ability to cope and adapt. People constantly work towards what they believe will make their lives better. But does the end always meet the expectations? Do we always nail the idea of what happiness is? Does the journey take the toll if we don’t recognise the true meaning of personal happiness and unconsciously keep carrying the burden of generations before us?

Here’s a story that evoked these thoughts in my mind. Will be interesting to see what your analysis of this family’s story will be.

Alex was born in a large family. His father George was a decorated war hero and had returned home after serving in the Great War with pride but also carrying the hardness instilled by the cruel experiences of the war. The already tough farm life was further hardened by the distant and detached behaviour of the father who believed that children should be disciplined and love is an emotion to be felt and now shown, in fact any show of loving emotions weakens the children. Quite early in his life Alex got used to being at the receiving end of George’s thrashings, verbal jibes and berating as Alex was somewhat creatively inclined and this frustrated his father no end as this was very distant from his idea of the son he wanted. George often told Alex’s mother that he needs strong sons to work on his farm, not singers who are not men enough. This instilled a deep sense of not being enough in Alex’s mind. The life at farm suffocated him and soon as he was able to, he ran away from home and one way or the other found himself on a boat to America – the land of promise. Alex told himself constantly through the hardships of journey that soon as he put foot on American soil things will be different – he will be happy again.

The instant happiness didn’t show up but as Alex started grappling the realities of starting a new life in a foreign land, he met a girl, Barbara, and both set up a home for themselves. To meet the dreams of owning their own house and settling up lives of their three children they worked four jobs between themselves. Life soon settled into the routine of working, paying bills, putting kids through school and generally getting through life.

Anna was the youngest of the three kids and just like her older siblings she was also brought up in a strict household which laid emphasis on results where success was measured in achievements – an important thing for the migrant family trying to make its place in the foreign land – full of opportunities but also quick to remind them in subtle ways that they were still outsiders.

Alex and his kids didn’t see eye to eye on the matter as the kids, having been born in America couldn’t understand why dad still compared life here and “back home” – for the kids this was home but dad clearly didn’t agree and this created a deep sense of confusion in their young minds.

Alex, on the other hand, felt cheated out of a chance to enjoy prosperity in own homeland as he felt sure that given half a chance he could have built this kind of life back home and infact would have been better off.

He constantly felt dissatisfied with his station in life. His dream had been to own a home and car but his eventual achievements in the new land – a home, car and then even another car, were never satisfactory. He continued to experience a subconscious sense of needing to prove himself and feeling he was not good enough – a sense that had been instilled in his younger years when he was but a child, by his father.

This combination of hard work, a raw instinct typical to first generation migrants to survive, do well and look out for themselves and the eventual lack of satisfaction made him quite grumpy and he frequently took his frustration out on his kids, drunk a lot and didn’t think twice about hitting his wife. He had seen his father hit others when they annoyed him so why should it be different for him?

Anna saw all this. And in a simple clear way that is only given to children she understood that this is not a happy life. She made up her mind to find a way to get out of the house as soon as she could. She took this decision years before she had gained the maturity to tackle the gravity of the decision. This overwhelmed her little inner environment and this manifested outwardly in impatient and restless temperament. She was quick to get angry and had little patience for anyone. Through all this she managed to finish her course in book keeping, met a lovely young man Peter and went on to get married and have two lovely girls – Alanna and Ariel.

After the birth of girls life got busier and Anna struggled to adjust. She found herself getting annoyed quite easily, felt stressed and tired all the time. She also didn’t enjoy engaging in any hobbies any more. Her sleep started being disturbed and her appetite wasn’t the same – she was either following fad/restricted diets or simply not caring. She tried talking to Barbara about this but her mother, hardened by own life experiences, recounted to Anna how hard her own life had been and how she had coped so she couldn’t understand why Anna wasn’t able to cope even though she had far better life than her own. Peter was sympathetic but just advised Anna to relax more and just be more happy.

This annoyed Anna even more as she knew all this but she just couldn’t seem to be able to do it. The frustration of being judged and patronised irritated Anna and made her situation more despairing.

She instead started focusing on raising her two girls. The control Anna lost over her own life, she gained it in being able to control the lives of the two little girls. Being in control gave her some stability.

She made rigid routines for the girls and every single moment of girls’ lives was controlled by the seemingly devoted mum. But the reality was that Anna was subconsciously putting all her efforts in raising her kids perfectly as the control was the only thing that provided some respite from the the mental anguish she experienced otherwise. This controlled upbringing raised two girls who were not wanting for anything, felt quite entitled but were weak at recognising their own emotions and managing them as they had been told from young age, every step of the way, by their mum how they should be feeling, how they should be behaving. In return for all the efforts Anna put in raising the girls, she demanded them to be orderly, well behaved, be at the top of class in school, do well at ballet and gymnastics. When the kids didn’t achieve something to her expectations, Anna was quick to reproach them. The memories of childhood were filled with more irritating rants and shouting from mother with hardly any quiet words of encouragement.

Ariel was the younger and more sensitive of the two girls and from quite a young age she developed a sense of being judged in all her actions. She developed a sense that people are watching and their approval is very important. The repeated sounds of Anna hissing through her gritted teeth at supermarket were instilled in her mind “people are watching! what will they say!”

Ariel didn’t quite understand how she was going to earn everyone’s approval and in her young mind she decided that if she can have others’ attention then that might be good enough. She didn’t really care how she got the attention. She learnt very quickly that fighting, pushing and shoving others at school got her the attention quite quickly and her immature mind adapted this to being an acceptable way to get the result she so craved. She started being reprimanded by teachers and her parents for her behaviours.

When she was in her classroom she felt as if the kids were looking at her and laughing at her. She felt very lonely and unhappy. She made up her mind to not to be nice to others anymore because if she didn’t try to be nice to them then she doesn’t have to worry about  them laughing at her. Slowly Ariel picked up the reputation off being inattentive in class, poor learner, unfriendly and a bully in nature.

On her own Ariel felt very lonely and rejected. She constantly felt that she didn’t live unto the expectations put on her by her mother at a very young age as she was always being told off for one thing or the other. She learnt slowly not to like herself much and lost any confidence in herself.

She found it very hard to adjust to any changes in her routines, couldn’t cope with small discomforts such as minor injuries or ailments – infact she played on them as much as possible as that was the only occasion she got attention from her parents. She found it hard to regulate her emotions and got angry quickly and lost her temper with fairly everyone.

Ariel finished the school with difficulty and enrolled herself into a course which she didn’t really enjoy but felt this will earn her parents’ approval . She found it hard to cope with the stresses of her studies and soon started smoking and drinking.

Life had come full circle. The post traumatic stress disorder that went unrecognised and untreated appropriately in the great grandfather eventually culminated in the discovery of twenty year old Ariel’s body in a cheap motel with syringe marks on arms indicating accidental drug overdose.

The anxiety that passed from one generation to the other, the learned behaviours of anxiety that defined each person’s character, the feelings of low self esteem, self doubt and emotional lability that got passed into each generation at a very tender age had finally claimed its final victim.

As Alanna looked at her younger sister’s lifeless body she made up her mind to break the cycle. Right then and there.

Goodbye, Pap smear! Hello, Cervical screening test!

I’ve been meaning to write about this for a while but things keep coming up!

Enjoying a few days in the country side and have some much needed time on my hands. There’s something in the country air which is immensely relaxing and calming, which puts things in perspective a bit, makes you realise there’s more to life than reaching daily goalposts, getting to places and meeting deadlines. Quiet clean air, birds chirping, leaves rustling in the soft warm wind of the summer, water flowing gently in the river …. ahhh bliss!

Anyway, back to the equally calming (not!) topic of the Pap smears. So, Australian health system has decided to bid adieu to the good old Pap smears.

All of you will know that Pap smear has been the universally accepted method of screening for cervical cancer in women and has been around for ages, since WW II to be precise.  An interesting fact about this test is that its named after it’s inventor, a Greek American pathologist, Dr George Nicholas Papanikolaou, who started his research in the area of trying to find a non invasive test to diagnose uterine cancer through sweeping some cells from neck of the womb. He started working on this around 1923 and it wasn’t until 1943 that he was able to publish the groundbreaking work ” diagnosis of uterine cancer by the vaginal smear” which made his work known far and wide and the method became universally acceptable.  So for over 20 years of his life this pioneer worked on methods to describe the cell changes that occur in the cells of cervix in cancer, how to prepare the slides to collect a good sample etc. All through these years he apparently fought the scepticism of medical fraternity which initially rejected the idea as being ludicrous! History states that one of the most crucial contributors in his work were his patients with uterine cancer who allowed him to experiment by taking samples from their cervix and study. None of the scientific work we do, the big discoveries that are made will ever be possible without the contribution from the patients themselves. So anytime a patient asks me about my opinion about participating in a scientific study I’m encouraging about them being an invaluable part of a possible life changing experiment for millions, for many generations to come, as we have seen in the case of Pap test.

Pap test has been based on the principle of taking a sample of cells from the cervix(neck of the womb) by the health care professional trained in doing this procedure and preparing a slide from it. The slide then makes its journey to the lab where the pathologists study it for any changes that are a deviation from the normal cells. If there are no changes then its obviously a normal study but if there are any changes then they are further put into various categories, ranging from possible small changes to highly abnormal, suggesting the ultimate bad guy, cervical cancer.

It’s now well known that all of these changes, whether small or more significant, occur due to a virus named HPV – Human Papilloma Virus.

So the key change that is happening in replacing Pap smear with cervical screening test (CST) is that Pap smears used to rely on picking up the cell changes that had already occurred ( the effect of the virus) and the new cervical screening test relies on picking up the virus itself ( the cause of all cell changes in the cervix).

This has changed the landscape of the screening test as we are no longer waiting to check  and assess the extent of the damage done by the virus but we are targeting the virus itself.

This makes CST a far superior test as its picking up the problem (virus) before it has become a problem (cell changes).

This is where the beauty of this test comes in,  which I am sure will appeal to almost all women : due to its superiority in picking up the pathogen itself, a negative test means that you don’t have to have another screening test for five years!

The reasoning behind this is cervical cancer is a pretty slow growing cancer. I remember being taught at med school that for a nasty subtype of virus to make home in the cervix and for it to grow to full blown cancer, it can take unto ten years – this is the theory behind the safety in leaving these long periods in women who don’t have the virus.

So, lets say you have a normal CST and get an all clear for 5 years, then you get exposed to the virus unbeknownst to you and you remain without any symptoms then the virus wouldn’t have had enough time to cause any serious damage by the time you have the next test.

But if on the other hand, you do start having any symptoms such as irregular vaginal bleeding, particularly in between periods or after intercourse, then you should see your doctor, regardless of the last test being negative, as then your doctor may decide to undertake some further tests.

Coming back to the root cause of all this problem and the conversation about cervical cancer and the need for a robust screening program – HPV. Its not a single virus but a whole family – with about 170 known members so far. Not much unlike our human families! Some members of the family are quite benign and cause no symptoms and resolve by themselves without needing any intervention, some are pesky and linger for a bit and can cause warts or precancerous changes which can then lead to cancerous changes. Nearly all cancerous changes are due to 2 subtypes, HPV16 and HPV18 which account for about 70% of all cases. CST can’t pick up all the virus members but looks for the problem ones, which tend to be the troublemakers and are our concern anyway.

The other difference with the new screening test is the age. Previously it was 20 yrs to 70 yrs of age whereas now it starts at 25 and goes upto 74 yrs.

The start age for the screening may seem somewhat late from what to used to be but like most other scientifically backed programs, that has logical reasoning too. And the reasons are:

a) HPV vaccination has changed the landscape a lot. It’s able to provide significant protection, provided its administered prior to the onset of sexual activity. Hence the drive to vaccinate young people whilst they are still at school – it sets them up with the best possible protection for the rest of their lives;

b) Younger people have sturdy immunity and most youngsters are able to clear the virus by themselves without needing any intervention.

But what about people who are in the age group 20-25 yrs and had already started the Pap smears under the old screening program? Well, if their last smear test was normal they will get notification from National Cervical Screening Registry when their first CST should be done to get them integrated into the new screening program. If there last Pap smear was abnormal then they should continue to follow the advice they received from their doctor regarding follow up intervals.

Lots of information here! Please remember this is quite general advice and your circumstances may be different based on your own health, lifestyle etc. So make sure you take the opportunity to have a discussion with your health care professional about your screening test as they’ll be best placed to guide you in the right direction.

Happy screening!


Kamini : Opioid marketed under the guise of Ayurvedic preparation

Having grown up around the Indian culture and having had the privilege of studying the ancient language of Sanskrit, I have known and understood Ayurveda to be a traditional, herb based, non chemical, healing remedies derived from mother nature. The words that come to mind when I think Ayurveda are: tradition, wisdom, natural, safe.

So when I recently started work with people who are struggling with drug addiction and recurrent mention came up of this ‘Ayurvedic medicine’ Indian men are taking and which they have got dependent on, to the point of requiring assistance from specialist that provides assistance with heroin addiction, it caught me by surprise and intrigue.

Until a few weeks ago I had not heard or read anything about it. And suddenly I am seeing a whole lot of young migrant Indian men who are addicted to the drug. So much so that they are not able to function. They have given up their studies, work and their families are falling apart so what’s going on here?

This ‘Ayurvedic medicine’ is called Kamini. It’s available online and also under the counter at a few Indian food and grocery stores and is marketed as an aphrodisiac.

The label information reads as such:

Kamini vidrawan ras is one of the safest ayurvedic medicine with potent herbs and minerals, constituting a herbo-mineral ayurvedic drug having aphrodisiac effects on human health. It is available in the form of Tablets and also known as Kamini Tablets. It has excitement stimulating effects and properties, that is how Kamini vidrawan ras is helpful in improving sexual vigour,  cures erectile dysfunction and premature ejaculation. “(

The catch is that when people start talking this ‘safe Ayurvedic medicine’ they report development of dependence quite quickly and it is similar to the pattern seen in heroin dependence.

And this is how easy it is to buy it:

I just hopped to the website whilst writing this and it took me less than a minute to get to this:

Shopping Cart



Subtotal (1 item): $52.75


 2 clicks is all that it took and I could have placed the order from the convenience of my home. Or as my patients have advised me, I could try my local grocery store and make some discrete enquiries and can get a bottle for about 100 AUD.
This is very concerning.
It somehow gives the air that because its Ayurvedic medicine and is relatively easy to acquire it is safe which is absolutely not the case when you deal with people who have developed dependence after tasking these tablets.
I am using this platform to share information about this drug and its ill effects with a hope to raise as much awareness as possible. I have mentioned only Indian migrant men as main users but that is because I am an Indian medical professional who speaks a few dialects so attract these subgroups but there are other users as well – Australians, other Asian groups, women…
Drug dependence ruins lives – of users and of their loved ones. But fortunately an even stronger drug exists and that is the basic nature of us humans to never give up on each other. And on ourselves. And this quality will help us all to keep on our fight against illicit drugs, in our own special little ways –  creating more awareness and tolerance, one addict and one addiction at a time.

Short story: The answers

A short piece I wrote, loosely based on the story of a remarkable woman I had the privilege of knowing many moons ago. She led me to reflect on the intricacy and incredulity of our emotions and the effect they have in shaping our relation with self and with others. And a valuable lesson- about developing the beautiful ability to let go.                                                  As she lay on the bed, she drifted in and out of consciousness. She could hear the beeps of machines on the background of constant humming sound. What was this sound? Suddenly she was back in her childhood, and the humming sound was made by the drone flying out in the otherwise quiet and dark skies. Four people were sitting in the darkened basement awaiting sudden spray of bullets that had become the norm now that the Great War was drawing close to its end and just like a beast doing a final heart wrenching roar before its imminent demise, the war seemed to have become more deadly as it drew closer to its long awaited end.Even at the tender age, when the hardest task a child should be having to comprehend is how to read alphabets and count basic numbers, she understood that there were bad things happening around her and she could understand that these things should normally not happen. Otherwise why would mother keep cursing the wretched war and bemoaning her bad luck to be stuck with a husband at the war front and three young children to look after all on her own. She thought it was awfully nice of uncle Jack to be looking after their mum and comfort her when she was tired and sad. Just as the war had become a familiar noise and chaos in the background, having uncle Jack around the house became a way of life.

She couldn’t be too sure when uncle Jack metamorphed into dad but it remained a blur throughout the times when she was growing up. The toddler had craved a father so much that it was finally nice to have one and it didn’t really matter who or where he came from . She grew up to be a young lady and then a doting wife and then a proud mum and then a loving grandmother. She had a clean and comfortable town house with well-tended gardens and had her tea parties in the garden. She became a part of her local community, doing regular work as lollipop lady for the local school and also volunteering as part time canteen worker there. She loved being at school partly because, amongst many other things missed by her peers, regular school was a luxury denied to her generation. She would have loved to be a librarian but that would have required her to read fluently and it would have shamed her deeply if others could see that behind her carefully kept exterior she was just an illiterate person. She took great pride in her children’s literacy achievements and made it a point to display each and every certificate on display cupboard.

But then as her own old age crept on her, she found her mind playing games with her. Where was her real dad? Why did he never come back home? Had he died or had he simply abandoned her as it was the easier thing to do? Or perhaps the war messed his brain up and he couldn’t remember that he even had a family and especially a little girl who really wanted him to come back? Maybe he lived for many years trying to remember through the war riddled haze in his brain and had died, having met an agonizing end, tormented by these unanswered questions? Would things have been different if she had made some effort to connect with him? And then why had mother never spoken about this? Was she ashamed to have her little kids on her own? Was she not enough for her? Why did uncle Jack have to come into their lives and then become dad which he really wasn’t? She suddenly started feeling increasing more resentment towards her mother for putting her through this agony in her own old age and also rage against her father for not coming back home and not making any efforts to find her and explain things to her.

Day after day, simple things in life, which she took for granted like getting up in the morning, taking a shower, dressing up, preparing food, cleaning the house, became increasingly difficult. Her husband started showing concerns that she has become more forgetful and seems weak and tired all the time. Slowly she started losing the joy she found in loving her family and tending to the well-kept home she had created. As the layers of her comfort fell away, she became increasingly withdrawn and the demons in her head kept soaring higher and higher asking the same questions until she could actually see these horrible thoughts in shapes of monsters sitting by her bedside and mocking her.

As she tried to fight them with words and her feeble body, her family decided that she she was going mad and tried to make her comfortable by doing things for her and asking her not to move as she was making herself prone to falls with sudden lunging movements as if in the motion of hitting or pushing someone away. These restrictions made her more uncomfortable because now these demonous thoughts, which had by now taken familiar shapes and facial expressions, could just get their own way of laughing in her face, making fun of seemingly full life she created for herself but which in fact was hollow because the very creator of her person had chosen to abandon her and the other one had kept her in dark without any explanation as to why this had happened. She felt inexplicable pain and agitation that they could just make these judgements about her and brush her whole life away as if she was inconsequential all along. She felt outraged that they could just mock her whole life as if it was all make believe act that she lived throughout her life to mask the hollowness of her existence.

Any further attempts on her part to fight these demons were met by the assessments done by cold stethoscopes and blood tests by her family doctor and giving her some sedatives to calm her down. Could they not see that there was no calming for her now that demons had taken hold of her and were mocking her whole life? As she made final attempt to fight these, the family decided that mum was too sick and bundled her to the big hospital in ambulance. She was too weak to protest. Her attempts to communicate her position in her fight with the demons of the past were labelled delirious babble by her loved ones as well as by the authoritative figures at hospital in their white coats.

And then her family was told that she had a rare brain condition which had caused her to have a stroke and hence this delirium. As she lay there with her eyes closed and her chest rising and falling in shallow tired breaths, she finally understood that there are are some questions in life which are beyond our comprehension and sometimes we don’t get answers even where they are well deserved. She understood now that as a two year old little girl she had no control over the decisions her father or mother made and she could finally see the difficulties her mother went through to raise her and the siblings in those hard times and she could comprehend the fright his father must have felt fighting from a disease and dead bodies ridden trench. She could finally forgive them. She could finally see that she actually had a very full life with a loving husband who stood by her through thick and thin and together they had beautiful children who still rallied around her and loved her for what she was and not for what she had been or where she came from. Her past was not shameful anymore. She could see the happy faces of all the little children of neighbourhood she had helped on the crossing and in the canteen and the lack of any judgement in their joyful faces. She could hear the laughter in her tea parties. There was joy and contentment all around and she had created that by being who she was. She understood that life is very complicated and yet very simple because you don’t need to have all the questions answered and things don’t always have to be correct. As long as you have joy, love and peacefulness around you, it’s enough. As if in a movie, she saw all the demons fall in front of her and then evaporate in thin smoke to be gone forever and she felt lighter and free. She longed more than ever to share this contentment with her husband and family. It was at this point that nurse in charge of ward noted that beeping sound on bed 5 had stopped and she said a silent prayer for bed 5 as she made emergency call for cardiac arrest team to attend.

Lifestyle choices: Happiness or Fulfillment

The most common causes of illness in modern age are diabetes, high blood pressure, heart disease, cancer, mental health. Almost all the research into these ailments points towards lifestyle as being a significant contributor. Lifestyle is a choice we make. So does this mean at times we are choosing illness?

It’s an unpleasant thought but worth pondering over.

The recommended lifestyle choices for health and wellness are:

  1. Eat healthy – daily portion of fruits and veggies, lots of water, reduced amounts of processed and sugar rich foods, consuming most of the diet in the first three-quarters of the day, avoiding eating large portions of meals and avoiding eating after 6pm, avoiding smoking and excess amounts of caffeine, alcohol or drugs.
  2. Regular exercise – recommended regime is moderate intensity exercise 4-5 times per week for 30-40 minutes.
  3. Relaxation – all work and no play makes Jack a dull boy – the proverb has been around since 1600s so no new brainwave here but the hectic lifestyle of modern days makes it all the more relevant. If we are not actively practicing it then it can be quite easy not to switch off at all in today’s whirlwind pace. De-stressing, mindfulness, yoga, pursuing favourite hobby – these are all the ways to practice it.

The general lifestyle choices we do make are:

  1. Eating – diet is rich in processed foods, based more on comfort, driven by busy lifestyles. We have become so busy creating “the lifestyle” that the very basis of a healthy lifestyle i.e. a good diet is the first casualty. Its much easier to find the exotic flowers or bushes in our boutique gardens than the basics of kitchen herbs as it’s not that much of a thing anymore.
  2. Exercise – the organs to get the most exercise in today’s world are the eyes, followed by the fingers as we spend a significant amount of times in front of our social media connector devices.
  3. Relaxation – well, all I can comment here is that this is a rarity nowadays. If you ever find yourself truly relaxed, cherish and relish the moment as it has perhaps become the most difficult to achieve out of all the lifestyle choices.

So this is a quick snapshot of what we need to be doing and what we are actually doing. Why this imbalance?

Surely we are smarter than the last generations and have more intelligence and knowledge than our predecessors so logically should have figured it all by now about the lifestyle choices thing but it’s clearly become our biggest problem so what’s gone wrong?

What drives our lifestyle choices? I like to think that positive drivers by far outweigh the negative drivers.

The biggest positive drivers of lifestyle choices are happiness and fulfilment.

At first glance both seem to indicate the one and the same thing but they are actually very different. Happiness is an instant emotion – of momentary gratification. Eating a chocolate makes me happy but does this fulfil my life? Eating healthy for the whole day, exercising adequately and finding time to relax makes me feel fulfilled but doesn’t necessarily make me happy – I can’t remember feeling the same happiness whilst eating berries as that felt whilst tucking into an ice cream Sunday!

So what is more important – happiness or fulfilment?

I’m sure I’m not the first to stumble upon this philosophical thought. Lifestyle is a choice. A choice driven by our quest for happiness and fulfilment. Whichever emotion is more important to us will dictate what lifestyle choices we make. And our lifestyle choices have a significant bearing on the state of our health and wellness. Choose well.