"WHY PEOPLE COME BACK TO YOU" A TESTIMONIAL TO ANURAG HOSPITAL,COIMBATORE

' WHY PEOPLE COME BACK TO YOU'

A TESTIMONIAL TO ANURAG HOSPITAL, COIMBATORE

Sometimes one wonders what is the point of becoming a doctor .... and a surgeon at that. What you set out to be at 15 years of age when you start training, goes on all your life time , even decades later!

It is really and most certainly worth it , when you receive a note of appreciation - rather a testimony- of what your services offer and what you mean as a physician / surgeon to the person who receives your professional attention.

It is said,
                " Not everything that counts can be counted,
                           Not everything that is counted truly counts" 

This letter received from a patient who recently underwent surgery at ANURAG HOSPITAL, COIMBATORE means a lot not only to the team who treated her, but also to the person who wrote it!

The patient has kindly permitted to have this as a blog. The writer's name is erased to maintain confidentiality.

Why people come back to you 

I was first introduced to DR. John AC Thanakumar when I was referred to him by our family doctor Dr. V.Chandra of Kovaipudur. It was in the year 2006 and I had gone to her for a consultation on feeling a cyst in my right chest. My family and friends strongly advised that this should not be brushed aside nor postponed. 

My husband and I waited outside the consulting room of Dr. John in Kovai Medical college and Hospital ( KMCH) with a lot of trepidation. KMCH had lot of memories to provide . My daughter was born here in 2000 – happy days which we would always cherish . But more were the days spent here in 2001 when my late mother was frequently in and out of KMCH due to her prolonged illness which lasted for nearly a year after which she breathed her last . Hence both sweet and sad memories – similar to life .

We were meeting Dr. John for the first time and we had come there only on the assurance given by Dr. Chandra that he was one of the leading surgeons in town . On going through the reports , the doctor was very quick in his decision- that a surgery was needed, giving us no room for fear or sentiments .We guess that was what gave us the confidence – when he nailed the fact that the cysts has to be removed immediately instead of needling and sending it for biopsy . Having a 6 year old daughter at home , my fear knew no bounds hearing the doctors words .what seemed to be a mountain dwindled in to a mole on hearing the doctors clear and patient explanation . He concluded that as such he was available in the city for a couple of days and was ready to do the surgery on the same day or the very next day . we headed back home, pondered on the doctors words and came to the conclusion that I needed to go ahead with the surgery. 

Our next meeting with the doctor was during my first and final review after a couple of weeks ( I don’t remember recognising him in the operation theatre as there were a few of them – all masked in their professional attire ). The doctor was full of energy and cheer . The way he removed the band aid was so abrupt and rapid that it still flashes in my memory – for a second it was unbearable pain. He explained that if done in a slow manner the pain would have been double fold during the whole process . By now , it was clear that he was quite proficient in his profession . He was citing some examples of few surgeries he had performed on some models which did not even leave a scar . I was then not in a mental status of appreciating the scarless surgery as I was worried about what the reports would say . My joy knew no bounds when he confirmed that it was just fibrodenomas . Hence I returned to my normal routine life .

We moved to Chennai a couple of years later .Months turned to years . The surgery was done so efficiently that there was not even a slight prick or a pain in the area to remind me of the same and it did not leave a scar too . Being a Banker , when I listen to clients appreciating a doctor’s work or when I interact with clients who are doctors , I would remember with gratitude a humane , dynamic and a skilled surgeon of Coimbatore whom I had failed to appreciate for the scarless surgery .

Twelve years later , on feeling some discomfort in the left axilla , I had a scan in which again 2 cysts were noticed in the right chest . I recollected that Dr. John had hinted earlier that my body did have a tendency to develop fibrodenomas and also that I may get it say, after 10 or 15 years . 

The start of another tension filled period began – family and friends insisting to go for another consultation . My husband was on travel, overseas , on job and my daughter was taking up her boards which made my presence at home mandatory . As the consultation was kept on the back burner, the fear slowly started to creep in . I was heading our Adayar Branch and then subsequently our Mylapore Branch .We were staying at Mylapore , Chennai . Hence we had doctors and hospitals at every nook and corner . But the speculation that I might have to undergo yet another surgery triggered the recollection of an efficient Surgeon of Coimbatore . My husband and I then decided that it would be the best to go back to him given his pin point diagnosis in the past. 

I was informed by the receptionist of KMCH that Dr. John was no longer with KMCH . I googled to find out that he was now practicing in the hospital he has founded : “ Anurag Hospital “ . We did not have any second thoughts . We reached “ Anurag Hospital “ at Sowripalayam , Coimbatore on the 5^thof Sept 2018. We waited in the neat reception hall of the hospital which brought back the memories of us waiting in the lobby of KMCH. During the wait , we noticed that the hospital team was lead by Dr. John and his family – wife , son and daughter in law – a family of doctors . It is undoubtedly , the dedication and sincerity he has towards his profession which must have made him reach here . It is a very neatly maintained hospital with all the amenities especially the friendly staff . Being a busy doctor with innumerable patients , he did not remember us but he was more or less the same person whom we had met 12 years before . The stay in the hospital was just for two days after surgery during which we understood that the doctor and team also gave back to the community in various ways like free treatment for the poor , conducting free medical camps etc.. The surgery reports were luckily diagonised again as fibrodenomas .

On our journey back home which was 25 km away from the hospital , it dawned on us that when people come back to you inspite of the innumerable choices that they have , it is just not the skill and efficiency but the trust and confidence which is instilled in them . It is the kind and sincere gesture the person shows at the time of need . This applies to all professions , be it banking , teaching , sales etc . There may be 100’s of Doctors like Dr. John but there would certainly be 1000s of patients who are thankful to such doctors as the old saying goes “ Doctors are next to Gods “

May the Lord Almighty shower his blessings on the Team of Doctors and staff of “ Anurag Hospital 

Appreciating the sincere efforts of the entire team of “ Anurag Hospital “
J.....  ..
( Patient ) "

HOW TO AVOID STAGE FRIGHT IN STRING PLAYING!



When string players perform in public or at an audition, many suffer from stage fright. Performance is around 80% of what one achieves in practice.

It is due to the adrenaline effect which is responsible for the ‘ fright or flight’ body hormone coming into play. Effects include tremors, inability to do long bowing, good tone, inability to focus on the repertoire at hand, fear of making mistakes, inability to recover from mistakes, worrying about mistakes which result in more mishaps, shallow breathing, sweating and many more effects.

Anxiety is apparent more during a solo performance than playing in a group.

This blog is written to help the string players who have suffered from the above symptoms of nervousness and the inability to perform to the full capacity as in practice.

Here are some of the steps to avoid stage fright; some may overlap the steps to prepare for concert also:

1. PRACTICE PERFECT PRACTICE

Practice regularly and thoroughly. First practice the technique namely the intonation, the bowing, the timing and the fingering – slowly at first.

Remember, playing fast is impossible if it cannot be played slowly!

Perfect Practice means that the difficult passages have to be identified, and practice slowly with the above principles, and again practice in context with the preceding and succeeding passages before bringing it up to speed.

2. BE OVER PREPARED

Nervousness on stage costs approximately 20% from many players . So practicing the repertoire slowly at first, then at the correct speed and finally 20% faster than the actual speed helps.

3. PRACTICE WITH ACCOMPANIMENT AS MUCH AS POSSIBLE

Reading the music at first the accompaniment helps in understanding the phrasing. It is important to practice with the piano accompanist repeatedly both the easy and the difficult parts with reference to the intonation and timing is vital to achieve a perfect , tension free performance. More the practice with the accompaniment, less the tension

4. ADEQUATE REST THE WHOLE DAY

Certainly no alcohol. Maybe a beta blocker to ally anxiety.

5. ATTAIRE

External appearance matters starting with the choice of shirts, coats in men and dress in women not to mention the shoes. All these may help to allay undue anxiety.

6. LEARN YOGA




Yoga helps to make to control your breathing and improve blood supply to brain.

7. MEDITATION


Meditation helps concentration and improves focus. Hence less tension.

8. PUBLIC PERFORMANCES


Playing in front of your friends, grand parents, cousins, church congregation and other students builds up confidence. Get as many public performances of this sort under your belt , prior to an audition or a major performance.

9. STRETCH

Stretching exercises while waiting to perform helps to relax the muscles aound the shoulder, arm, wrist and back.

10. BOWING

Playing slow bows either as open strings or as scales to get a pure tone and good intonation prior to going to perform helps one to relax and warm up.

11. CONTOLLED BREATHING

In general deep breaths prior to getting on to the stage help to regulate your low heart rate and also steady your nerves by keeping your fight or flight ( sympathetic tone of the nervous system) down as much as possible.

12. POSTURE

While waiting in the hall, keep a positive confident posture and the rest the violin fully tuned with the scroll up. Check your tuning with the pianist before you begin.

13. FOCUS



With all the above, learn to focus on the piece at hand to be played. The audience should not be a distraction. Playing for relatives, hospital patients and friends will prepare you for the presence of the audience.

14. FOOD

Not a heavy meal, but 1 to 2 bananas may help taken half hour before performance. These have a high energy content, high level of potassium and beta blockers. Top performers in sports and music are known to consume bananas just prior to the event.

15. TALISMAN

Some believe in talisman such as particular socks, or shirt, etc for performances. These are of psychological boosts. Anything to elevate your morale!

And good luck!



ANURAG HOSPITAL NEWSLETTER, April 2014

ANURAG HOSPITAL SURGICAL NEWS , April 2014.

ANURAG HOSPITAL

8 Krishna Nagar

Sowripalayam Main Road

Coimbatore 641028

Tel:0422-6587871

Email: anuraghospitalcoimbatore@gmail.com

Dear Friends,

We are pleased to share the news that at ANURAG HOSPITAL we have completed the first year and celebrated the First Year Anniversary by a Prayer Meeting with message from Bishop of Coimbatore Diocese Rt Rev Timothy Ravinder.

Bishop Rt Rev TIMOTHY RAVINDER         INAUGURATION OF OPD ROOM

                 

ANURAG HOSPITAL is surgical hospital with modern facilities for ambulatory surgery which is the way of doing surgery early and discharge in a short time from the hospital. This is helped by modern 2 operation theatres with laminar flow and 0.3 microns Heba filters for doing no infection surgery. We specialize in Advanced Laparoscopic Surgery of Gastro intestinal tract and Obesity Surgery.


DEDICATION of NEW EQUIPMENT         DEDICATION of NEW ICU EQUIPMENT

                                    

We have completed laparoscopic surgery for gall stones, appendix, hernias, uterus removal as well as Bariatric Surgery for control of Obesity. We have had international patients as well as patients from all the corners of India like Mumbai to Mizoram. We have also carried out successfully cancer and tumor surgery of the gullet, pancreas and liver. ENT, Gynecological and Urology operations are also commonly performed.

Our charitable activities include visits to CSI Hospital, Dharapuram every Tuesday afternoon and Mission Hospital in Kerala to perform surgery. We conduct along with Rotary club of Coimbatore Texcity Free Diabetic Camp; BP camps every second Saturday where patients are examined, tested and treated free of cost.

We welcome Dr Prabavathy for physiotherapy, Dr Rajendran for orthopedic surgery and Dr
Gurumoorthy for diabetology.

Kindly continue to support us with your good wishes, prayers and referrals so that we can continue and serve with the motto ‘COMMITTED TO CARE’.

Dr Pravin Hector John MS, Dr Twinkle Sharmila MBBS,(DGO)
Dr Neena John MBBS, DCH,  Dr John Thanakumar MS, MNAMS, FRCS, FRCS, DIP MIS (Fr)
Past President OF IAGES 2012-14.

APPENDIX ABSCESS –LAPAROSCOPIC RETROGRADE APPENDECTOMY

Sites of Appendicular abscess           Divide Base 1st & then Vessels

                 

Retrograde Appenectomy

24 year old came with umbilical pain with shift right iliac fossa sic days ago with high fever 101-102.
Ultra sound had revealed acute appendicitis. He was tender in right iliac fossa on examination.
An urgent laparoscopy revealed appendicular abscess with foul smelling pus which was walled off by
omentum, terminal ileum and caecum.. Appendix was necrotic in the distal 4/5ths and was frible. Stump of the appendix was ligated with vicryl and laparoscopic retrograde appendectomy was carried out by removing the necrotic appendix in pieces. A wash out was used. No drain was used. Patient improved with antibiotics and well healed wound.

TOTAL LAPAROSCOPIC HYSTERECTOMY

REMOVED UTERUS WITH OVARY

TOTAL LAPAROSCOPIC HYSTERECTOMY

47 year old diabetic, post cardiac stented ,obese patient with BMI of 37 presented with heavy bleeding .
She had fibroid uterus measuring 6x6cm with a history of 2 previous caesarian sections. She underwent
total laparoscopic hysterectomy with bilateral salpingo oophorectomy and was discharged in 48 hours.
Removal of uterus is commonly done for excessive bleeding , fibroids and for suspicion of cancer.
Total Laparoscopic Hysterectomy is dissection of the uterus, division of the uterine vessels, vaginal vault opening using totally laparoscopic technique with resultant delivery of the uterus via the vagina and closure of the vaginal vault using intra corporeal laparoscopic suturing.

Advantages include no urinary catheter, ambulation the same day, no NG tube, less pain, more comfort
and discharge within 24 hours after surgery.

Assisted Laproscopic Hysterectomy usually is the dissection of the uterus using the laparoscope till the
uternine vessles. Then per vaginal dissection pushing the urinary bladder above and ligation of the
uterine vessels from vaginal aspect, before delivering the uterus per vaginum. Patient requires an
indwelling cather and the pain is considerably more than total laparoscopic hysterectomy.

LIVER RESECTION IN 7 YEAR OLD

LIVER MASS- 7 YR CHILD                                                     LIVER RESECTION SURGERY

                         
                                

Liver masses sometimes require to be resected. 7 year old girl was referred with mass in the left lobe of

liver for resection. This was successfully done under general anesthesia using hypotensive anesthesia.

Blood loss was less than 150 ml. No blood was transfused and she was discharged on the 7th day from

hospital.

RESECTED LIVER MASS                                            CHILD IN POST OPERATIVE ICU

                              

SPECIALITIES  & FACILITIES         

Advanced Laparoscopic Surgery
Bariatric Surgery
Gynecology
Pediatrics
Gastroenterology
ENT
Emergency medicine
General Surgery & Medicine
Diabetic Care
Oncology and Cancer
Digital Xrays, Ultrasound, ECG
Twin operating theaters, ICU
Urology
Hematology ,Biochemistry Lab
24 Hour Pharmacy
Master Health Check ups

Map of ANURAG HOSPITAL

( We are on google- so use GPS for navigation while driving to ANURAG HOSPITAL)

You can contact us through Tel/Email

Tel No. : 0422 – 6587871
Mobile No. : 9443709158, 9566070818
E-mail : anuraghospitalcoimbatore@gmail.com

HOW DO YOU PRACTICE TO BECOME AN EXPERT?

HOW DO YOU PRACTICE TO BECOME AN EXPERT?

• Does increased practice improve  your performance?

• Does Practice make you Perfect?

• So, how much do you practice to be an expert?

• What makes you different from the world class performer?

Does increased activity as practice improve  your performance?

School Annual day,V Class

I have  played violin since the age of 5 years and now I am a laparoscopic surgeon. Both the vocations demand a lot of practice and dexterity of hands. 

As a kid, my dad always taught me,”Practice makes perfect”. 

As a senior surgeon training other young surgeons, I feel that training  of both surgeons and violinists have a lot in common.

Performing or playing violin is a skill – World class professionals have fined tuned this to an art. 

Surgeons differ in caliber and skill levels. 

This blog  hopefully will benefit all the above as well as those who wish to improve performance at work like writing skills, drawing, computers, etc. 

When the professionals play tennis , martial arts, golf or cricket, these too become an art.

You watch the expert violinist perform in a symphony effortlessly, and yet, when you attempt, it is a flop. You may practice very hard for hours, days or months. 

Finally  you realize that 'this is not for me!' 

You think that the performer has some magic quality which is missing in you.... not true! 

If this is indeed how you feel at the end of it all, then this article is for you!

Does Practice make you Perfect?

“Practice makes perfect” - This is a myth!

I have always wondered as a violinist if I was practicing enough per day. 

After all, practice makes perfect… 

Using this logic, the more you practice, the better  you should become. Is it true? …. it is not.

Mindless practice without reflecting is dull, makes you less confident , consolidates your mistakes and a general waste of time.

Listen to the expert violinist- Jascha Heifitz the best violinist of the last century  the excess practice is as bad as too little practice; he practiced for 3 hours per day and not on Sundays.  

What is the best time for practice according to psychologists?

Best timing is when mind is rested after a nap , always in the mornings and before a meal. 

Duration of practice matters to about 1.3 to 4 hours everyday. 

Between the good and the average students, the duration is not as really different as shown in the graph.

It is the 'Deliberate Practice' that counts!

           

                                       K A Ericsson et al Psychological Review 1993

So  how long should you practice to be an expert?

The answer is 

• 10000 total hours, or 

• 3 hours a day for the next 10 years, or

• 20 hours per week  for the next 10 years.

'Deliberate Practice' (DP) is the acquisition of expert performance with improved potential with extreme environmental adaptation and learning for 10 years.

K A Ericsson et al Psychological Review 1993

Deliberate Practice is scientific activity, slow and involves small and specific skill areas to be improved.

A violinist for instance will break down a difficult section of music to phrases and solitary notes and analyze for a better effect.

Deliberate Practice also is bent on feed back in the form of audio (music) or video (surgery, sports) performance- always looking for ways to analyze and improve the effects.

What makes you different from the world class performer?

1.Focus

Duration of focus in an adult is usually for about an hour; less so in a child. 

You take a break between practices. 

Short Breaks keep your mind clear. 

Aptitude is everything in life.

Continued focus is the key.

2.Timing of practice

‘Early to bed and early to rise’. 

Mornings are good time to practice or before meals. 

A good  sleep is useful according to the experts as this clears  your mind.

3.Keep Written Records

Clear written down goals keep you on the way to fame. 

For instance I need to sharpen my ‘trills with the double stoppings’. 

If you learn a new technique while planning and trying out, by all means keep track of it and publish it for everyone to benefit.

4.Work Smart, not Work Hard

Mindless practice without aim is not kosher. 

One needs to break down the stance in golf or the grip of the club rather than keep swinging mindlessly. 

Serious planning by looking at the hot spots, identification of the problem, looking at the alternatives of solution and choosing the one that fits you…. Now that is smart!

5.Motivated Practice

Once you have perfected your solution, you still need to practice a lot till you perfect each technique. 

A ‘presto’ of demi semi quavers has to be played rapidly and you will spend motivated time till you get it right. 

At surgery, each operation is different. 

If a new technique is going to be adopted, one has to work at it many times in mind and on simulators to make it fluent at the final surgery.

Nothing like 'hard work' once you sort out the strategy.

6.Assessment Internally & Externally

All of us have blind spots. It requires one expert to recognize the faults of another.

Coach is a good idea, who will note your good and bad. He will shape you by observing you.

In addition to above, one should never forget the feed back, audio or video replay to get your act together perfect.

Atul  Gawande, a surgeon wrote about getting a senior surgeon as coach for improving his surgery just as Eric Schmidt, Chairman of Google  to improve his administrative ability. 

And this is in tune with ‘humility’; there is always room for improvement in all of us!

WHAT DO YOU DO WHEN YOU CELEBRATE BIRTHDAYS?

WHAT DO YOU DO WHEN YOU CELEBRATE BIRTHDAYS?

For everything, there is a season

And a time for every matter under heaven:

… A time to weep, a time to laugh

A time to mourn, and a time to dance..”

Ecclesiastes 3:1-8

This birthday is special to my batchmates and me. We are the batch of 1970 - medical students of CMC Vellore.

Everyone is asking, each other, ”How did you celebrate your special birthday?”

This question got me wondering what is great about birthday or better still why celebrate it all. Is it just the parties , which our parents arranged when we were kids, which our spouses did to gather friends and later the children do for us?

Birth is the beginning of life, and to enjoy the fruits of life, it is good to celebrate the tree event which bore the fruit namely the birth itself. This is the reason for celebrating the birthday.

All of us are thankful to the almighty, God, the force, mother nature that we are safe and sound one more year… ; for all the things we have in life so far. So birthday is yet another reason for saying to say,” Thank you” to the bigger force in life before we return to the earth.

My dad used to visit orphanages to feed during his birthday and my children do the same.

Friends of mine feed the poor by the roadside and do not wait for birthdays to do so- Rotary Texcity of Coimbatore!

What do you do when you celebrate?

In the younger years, one decides to be the best, competes and sets special goals in the occupation. Nothing wrong with this.

But after decades pass by, it is time to wonder if life is going the way you planned……. Are your goals in profession and life being achieved?

In my batch of classmates, most guys are now changing directions- in jobs, locations, habits. I did this a year ago.

It is time to decide if you want to change the direction of your life and the goals for the future. I see an occasional younger colleague changing  more quickly and earlier if this is indeed warranted . Good for him as normally wisdom only comes with age. You live only once and you must be what you want to be!

On this special birthday for my batch, the families gather around and arrange special surprise parties.  One spouse arranged a surprise overseas trip for the husband and the family.

I left the corporate practice, after 24 years for setting up my own ambulatory surgical centre for advanced laparoscopy and bariatrics, with the family.

I now serve the prince and the pauper…. Right  from ‘Redo Bariatric Surgery‘ on overseas patients to doing ‘Whipple’s radical pancreatectomy for cancer of the pancreas’ in the poorest of the poor. There is no need to turn away anyone who cannot afford, as we can always make provisions for most who need surgery, under this roof using the most modern equipment.

I continued with my surgical work on my birthday, as surgery is what I wish to do in my life. This is my forte!

I feel at last that I am doing justice to “ Not to be ministered unto, but to minister” the motto of my alma mater.

I also finish my 2 years of tenure of heading the professional body of laparoscopic surgeons of India; as a team, we have done a lot of good to a lot of surgeons and the feeling is mutually satisfactory.

So it comes to what do you do on your birthday…

• DO SOMETHING GOOD
• DO SOMETHING GOOD YOU NORMALLY DID NOT DO THE DAY BEFORE
• DO SOMETHING NO ONE IS COMPELLING YOU TO DO
• DO SOMETHING OUT OF THE  KINDNESS OF YOUR HEART
• DO SOMETHING TO EXPRESS HUMAN KINDNESS AND NOT FOR PROFIT IN RETURN