Monday, April 2, 2007

Dont CRI

Hey Don't Cri !
"Usually I creep into the poor guys neck first and he calls me the pain in the neck.

How superficial? I think when he speaks to friends like that.

He usually helps me by working more and caring less about the problems I cause, for God has not given him time, he says. (I tend to agree with him, it must be God's will, for how else can God create me without offering me a means of survival.)

The humans have not yet recognized me. But let it be. It is said that they want to find only viruses and bacteria or now a days genes. (Yes of course, hats off to our great new age leaders like HIV and our old and awe-inspiring fighter, in fact our role model when young, the TB) How funny?

Ya ya, It is said that I am the offspring of many years of constant prayer by our race, the Diseases, to beat the man at their own game. This is our time. When we beat them at their technology or through their technology? Their Computers? The blasted things, which are helping them to think and work against us. Now you see why I am a hero. I beat them in their own game.

You know how long I had to lie dormant? There was great hope around 200 years before when they started their so-called industries (We, the elite of the Diseases, call it our restaurants and Resorts). But soon somebody found us out and reported. They made life so difficult to us by working in proper conditions and soon you see we are available in good fertile countries like India only.

Ya, you want to know how I do it? It is my secret. Still for somebody like you I shall open my mind. Computers are my vectors. You know vectors. Like my uncle the Malaria and cousin Dengue, they use mosquitoes as vectors & I use computers. Yes, you see I use them to pass me on and I seep into anybody looking at the computers.

No they can't find me. No microscope can do it. As long as they don't look into themselves I am fine. You see. I am they and they are me. Does it not sound like "Aham Brahmasmi".

See him. That guy over the corner. He is the best fodder for me around. See how keenly he is looking into the computers. How important he thinks his work is or rather he is. How much he wants to be the performer. (Growls) Ya, I will show him in just 365 days. If he is cooperating that is. I can make him sit back at home looking at the sky with enough drugs from a shrink to help him out of his depression because of his lost job. You Bet.

NO NO, not the neck alone. I get in through where I like. Neck, wrists, head, eyes, ears, low back, legs. You name it I can get in through there.

Yaaaa, I also help my old folks who are my relatives like Diabetes, Blood Pressure, Heart problems. But you see many a times we work together. Then it is great fun. We make the guy run around different specialists and really we go touring. In these tours we also meet different preys (read humans) who are suitable for any one of us. You see, on one such travel I really fell in love with a beautiful secretary of a doctor instantly. It is a shame in our community to fall in love with one of our preys. But I could not help it. She had beautiful eyes and long hair and most important she had my dearest friend the computer in front of her. She was but short and had high heels and a most uncomfortable chair. I must really thank the good doctor for being so mean. I immediately started working and worked up from her hip. No, No, not lured by her hip hugging dress of course but by her way of sitting in front of the computer which made it very suitable for me (A suitable woman, she is). Now she regularly takes me to the orthopedician and gynecologist and she is worried about why she is not getting pregnant. Ya, in a way, I also help in bringing down the population of these human creatures.

Probably. Even if I am in love with her I cannot forget the duty to my race.

No my life is not confined to computer professionals alone. Really I was named RSI (Repetitive Strain Injuries) and I can live in many groups of people who work in improper working conditions for long periods or maintain improper positions and postures or out of size instruments or gadgets or furniture. Infact I thrive in all of them. You can find my divine (his words) presence in as I said Office Secretaries to CEOs. From Bank employees to Accountants in local grocery stores. I am everywhere. But people working on Computers are my all time favorites. And then some humans started calling me CRI. (Computer Related Injuries). I liked it. It was cool. I felt it sounded like what I was doing to my preys. Making them CRY. You noticed the similarity. CRI. CRY. CRY CRI. Fry. Fried CRIs. Crying CRIs. Fried Crying CRIs. (The fellow got hysterical at this stage and continued for long with his gibberish and the author had to offer him a piece of his own neck to nibble before he calmed down. The mentioning of his strange ornaments also brought him back to a state of normalcy)

These? Do you like them? Ya, I shall tell you in brief about my signs and symptoms which are my ornaments. Carpel Tunnel Syndrome? You have heard about it in connection with me? But in fact CTS is only a small and dangerous percentage of typing injuries which I cause. Tendinitis, Bursitis, Tenosynovitis, DeQuervain's Syndrome , Thoracic Outlet Syndrome, Trigger Finger/Thumb , Myofascial Pain Syndrome, Cubital Tunnel Syndrome and several others are also there in my treasure box. All of these are serious and in advanced cases can cause great pain and permanent disability……………………………………"

(The above was a piece of dialogue by Mr CRI (alias RSI) who the author has met on several occasions when he paid a visit at the authors clinic with several of his clients)

Life , Health , Happiness, Comfort and all the works of God ………so beautiful. It is a mystery how the Computer Professionals of our times, the news kings and queens of the world forget that a there is a life beyond the depth of the internet or the life in the computer.

Aged no more than 2 decades the health problems generated by the computer industry is comparable to the same created by the industrial revolution in the late 18th century in its social magnitude, severity, diversity and financial implications to the members of this grand profession. In spite of the huge profits generated by the industry, the lords of the same turning a blind eye towards the indicators of this problem, fast attaining epidemic proportions, has not helped much in properly understanding or preventing CRI.

Data collected from the more than 2000 computer professionals afflicted with CRI, who had sought help from Sanjeevani in Bangalore and Trivandrum, on analysis proves that maximum number of people have developed some or other kind of diseases related to the vertebral column (often presented to the doctor as neck pain or stiffness, vertigo or dizziness, low back pain and pain or numbness radiating into the legs) followed by head ache, sinusitis, too frequently recurring cold and running nose and digestive problems including excessive gas formation - flatulence- and pain in the eye or problems of vision as the third. More than 75% of them have complained of very high mental stress, sleeplessness and excessive fatigue. In comparison with the normal population, computer professionals are highly prone to High blood pressure and diabetes, as a group, especially comprising of maximum number of youth. Fertility and marital bliss are also evading this supposed to be rich population at an alarming rate.

Studies suggest that 20 percent to 25 percent of computer users worldwide, both vocational and recreational, have symptoms related to their computer activities. The first CRI "epidemic" was noticed in Australia 15 years ago and then emerged in many other industrialized countries.

There is a great need for spreading the awareness about CRI because it is devastating not only for the injured party but it also affects the company he works for. It accounted for 66% of work related illnesses in the US, in 1999. The estimated costs in lost productivity and compensation due to it are in the region of $60-100 billion annually. No one is immune to CRI, and it can seriously disrupt work and domestic life. About 20-25 % of all computer users worldwide are estimated to have it, which is why it is essential to raise public awareness as quickly as possible before a new generation of computer users is exposed to the risks.

Due to lack of awareness about CRI, Computer users tend to ignore its initial symptoms. A survey of 500 software professionals at Hyderabad (in 2000) established that 50% had symptoms of established CRI. Preliminary results of an ongoing survey among over 400 IT professionals in projects it as high as 75%.

The pattern and nature of CRI in India is significantly different from that in the west. There may be significant anthropological differences in body shape and dimensions work practices and furniture design that only a comprehensive study can unearth. As these problems are unique to our country, so should the solutions.

In India, thanks to the lack of adequate laws and procedures, employers don't have any obligation to compensate for the problems accrued by the employees in long run. Government laws and regulations on employee welfare and safety do not show any concern for the provision of ergonomically designed office products, tools and work environment.

As more and more work, education and recreation involves computers, everyone needs to be aware of the hazard of Repetitive Strain Injuries (Cumulative Trauma Disorder). i.e. to the hands and arms resulting from the use of computer keyboards and mice. This can be a serious and very painful condition that is far easier to prevent than to cure once contracted, and can occur even in young physically fit individuals. It is not uncommon for people to have to leave computer-dependent careers as a result, or even to be permanently disabled and unable to perform tasks such as driving or dressing themselves.
What are the Symptoms?
ü Tightness, discomfort, stiffness, soreness or burning in the hands, wrists, fingers, forearms, or elbows

ü Tingling, coldness, or numbness in the hands

ü Clumsiness or loss of strength and coordination in the hands

ü Pain that wakes you up at night

ü Feeling a need to massage your hands, wrists, and arms

ü Pain in the upper back, shoulders, or neck associated with using the computer.

WHO IS AT RISK?

Any computer keyboard user, including pre-school children, who uses the computer 2 or more hours a day, is at high risk for CRI. They are in the 20-40 year age group, which is the most productive one. It is estimated that a large proportion of the software professionals, students and other computer users (e.g. secretaries, clerks, cashiers, etc) in India would soon develop CRI, if the current situation prevails.

As with other things in life, too much of anything is dangerous. But that doesn't mean that one should avoid using computers or alter the duration of computing sessions. A judicious mix of working habits, proper ergonomic infrastructure support and medical support & care can prevent the development of most of the symptoms.

As you know, prevention is better than cure. Some prevention tips have been given which is sure to make you feel computing a safe & healthy experience.

MUSCULOSKELETAL PROBLEMS:

Common causes of musculoskeletal problems include poor workstation design, bad posture and sitting down for extended periods of time. The vertebrae of the spine are arranged in a loose 'S', with a slight curve in the lower back. The typical office chair offers little support and actually encourages poor posture by forcing you to round out your lower back and hunch your shoulders. Symptoms of musculoskeletal problems include:

§ Sore muscles, particularly the shoulders and upper back
§ Stiffness
§ Headache
§ Backache.

Prevention tips:

Suggestions to reduce the risk of musculoskeletal problems include:

§ Correct posture at the desk: A monitor position lower and farther away may be better. The chair and keyboard are to be set so that the thighs and forearms are level (or sloping slightly down away from the body), and that the wrists are straight and level - not bent far down or way back.

§ Position your keyboard at a height that allows your elbows to rest comfortably at your side, roughly parallel with the floor and level with your keyboard. While you are actually typing your wrists should not rest on anything, and should not be bent up, down, or to the side. Your arms should move your hands around instead of resting your wrists and stretching to hit keys with the fingers. (palm rests give you a place to rest your hands only when pausing from typing, not while you are typing.) When you stop typing for a while, rest your hands in your lap and/or on their sides instead of leaving them on the keyboard.

§ Wrists also should not be bent to the side, . . .

. . . but instead your fingers should be in a straight line with your forearm as viewed from above.

(All of the above is easier to do if you tilt the back edge of your keyboard down, away from you. Put a prop an inch or two thick under the edge of the keyboard closest to you, but make sure the whole thing is still low enough so you aren't reaching up.)

§ Take frequent short breaks and go for a walk or perform stretching exercises at your desk. Stand often. Take lots of breaks to stretch and relax. This means both momentary breaks every few minutes and longer breaks every hour or so.

§ Adjust your chair so that your feet rest flat on the floor & Switch to an ergonomic chair, which helps your spine to naturally hold its 'S' curve while sitting.

§ Use a footstool (if your feet do not rest on the floor when the chair is adjusted to have the arms in a good posture).

Ayurvedic prevention tips:

Massaging daily with oils such as Dhanwantaram OR Shashtikadi lepa tailam in a specific manner so as to loosen and strengthen the constantly injured muscles can be one of the best prevention for many who is prone to CRI. As CRI is a repetitive strain Injury, repetitive and regular support through medicines is found to be very effective in the prevention and management of this problem. The self-massaging skills can be developed with proper guidance from a doctor. Also getting massaged through the Sulochana techniques is equally effective in warding of CRI.

Ayurvedic cure:

Includes specialized external manipulation of muscles and bones and judicious internal medication. Medicines such as Narayana Tailam, and treatment procedures like Sulochana, Rookshaswedam, Pizhichil etc administered under proper supervision of expert doctors and internal medicines like kashayam and grithams administered timely proves very fruitful in helping people to come out of the problems of CRI.
OVERUSE INJURIES:

Muscles and tendons can become irritated and inflamed by repetitive movements and awkward postures. This is known as 'overuse injury'. Carpal tunnel syndrome is a common example of an overuse injury associated with computer work. This painful disorder of the hand is caused by pressure on the main nerve that runs through the wrist. The fingers are also prone to overuse injury, particularly the finger that clicks the mouse buttons. Symptoms of an overuse injury include:

§ Pain
§ Swelling
§ Restricted mobility of the joint
§ Weakness
§ Numbness.
Prevention tips:

Suggestions to reduce the risk of overuse injuries include:

§ Keep your mouse at the same height as your correctly positioned keyboard.

§ Position the mouse as close as possible to the side of the keyboard.

§ Use your whole arm, not just your wrist, when using the mouse.

§ Hold the mouse lightly, don't grip it hard or squeeze it. Place the pointing device where you don't have to reach up or over very far to use it; close to the keyboard is best. Better yet: learn and use keyboard equivalent commands, whenever possible, as no pointing device is risk-free. Even trackballs have injured users.

§ Type lightly & gently & don't pound on the keys, use a light touch.
§ Keep your arms & hands warm. Cold muscles & tendons are at much greater risk for overuse injuries, and many offices are over-air-conditioned.

§ Eliminate unnecessary computer usage. No amount of ergonomic changes, fancy keyboards, or exercises is going to help if you are simply typing more than your body can handle. Don't try to be the fastest, most powerful hacker around - the cost is too high. Also: is there recreational computer use you can reduce? Can some of your electronic mail messages be replaced by telephone calls or conversations in person? And lose the computer/video games . . ., which often involve long, unbroken sessions of very tense keyboard or controller use. If nothing else, PAUSE the game every 3 - 4 minutes. Don't sacrifice your hands to a game!

§ Mix your tasks to avoid long, uninterrupted stretches of typing. Use two hands to perform double key operations like ctrl-c or Alt-c instead of twisting one hand to do it.

§ Remove the hands from the keyboard when not actively typing, to allow the arms to relax.

Ayurvedic care & cure:

Ayurveda offers treatments including external relaxation and muscle & joint soothening manipulations and marma (vital points) revitalizing treatments like Sulochana, Elakkizhi, and Abhyangam etc and these medications when administered by trained hands are the best available preventive methods available for the Overuse injuries.

These include specialized external applications of oils and herbal pastes and along with internal medication, shall bring down the inflammation and pain. Medicines such as Jadamayadi lepa choornam, Nagaradi lepa choornam and treatment procedures like Elakkizhi, Njavara Kizhi etc and internal medicines like kashayam and Arishtams are very effective, in fact more preferable to any anti-inflammatory analgesics of our time, which themselves proclaim to gift lots of complications on long term use.

VISION SYNDROME:

Concentrated tasks can cause tired eyes and blurred vision. Using a computer does not cause any permanent damage to your eyes. However, working on a computer is a demanding visual task that can cause eye discomfort. If you have an uncorrected vision it can make computer use uncomfortable and can lead to blurred vision and eyestrain. Focusing your eyes at the same distance & point for extended periods of time causes fatigue. Ayurveda specifically mentions about continuous eye fatigue leading to damage to the eyesight. The human eye structurally prefers to look at objects further than six meters away, so any work-performed close-up places extra demands on the tiny muscles. The illuminated computer screen can also contribute to eye fatigue.

Symptoms include:
§ Blurred vision
§ Temporary inability to focus on faraway objects
§ Headache.

In case of vision problems, though the monitors are themselves not a culprit, the way they are utilized creates the problems. The problems like long working hours without break, glare and improper lighting can be easily eliminated by good working habits such as resting periodically and refocusing eyes on objects at different distances, overhead lighting and appropriate placement of monitor. Placing monitor at right angle from brightly lit windows can reduce screen glare.

Moreover there are exercises to keep the eyes healthy. Changing the eyes focus can relax the ciliary muscles of the eyes. Blinking can moisten the eyes and stimulates tear production that can wash away the pollutants.

Ayurvedic Care and cure:

According to Ayurveda, for prevention the best medication would be to consume Tribhala choornam, specially prepared, daily with milk or with plain water. Washing eyes twice daily with special eye care herbal medicines and doing eye exercises is a very effective way to prevent potential eye disorders and fatigue. These medications not only keep the eye non-strained and cool but can also prevent even retinal damages owing to constant strain. For cure of eye disorders Ayurveda offers very particular internal medicines and also treatments like Tarpanam, Nasyam etc along with internal medicines like Jeevaneeya Gana Gritam. Special procedures like "Sudarsana" gives one of the best available preventive and curative care for the eye, be it simple eye strain or retinal disorders.

Prevention tips:

Suggestions to reduce the risk of eyestrain include:

Ø Make sure your primary light source (such as a window) isn't shining into your face or directly onto the monitor.

Ø Tilt the monitor slightly to eliminate reflections or glare.

Ø Make sure your computer screen isn't too close to your face.

Ø Position the screen so that it is either at eye level, or slightly lower.

Ø Reduce the contrast and brightness of your screen by adjusting the controls on the monitor & also consider using colour schemes that are easier on the eyes, particularly shades of gray for text documents.

Ø Increase your font sizes.

Ø Frequently look away from the screen and focus on faraway objects.

Ø Have regular eye examinations to check that blurring, headaches and other associated problems aren't caused by any underlying disorders.

STRESS:

The heavy demand of work thrust upon the employees creates a level of stress that makes injury more likely. Whenever a user feels anxiety, the muscle automatically tightens up and it increases the likelihood of getting a computer related injury. Here it is worthwhile to mention the problems and excess stress faced by the call center employees. The excess stress of changing their circadian rhythm once in 30 or 40 days is the most major stress factor faced by them. Loss of sleep or disturbed sleep is a very common symptom among them as is mouth ulcers and digestive problems and headaches.

Ayurvedic Prevention and Care:

Yoga and special kinds of medicines along with mediation shall be the best combination to tackle this, other than the realization and attitude change of people towards causes of stresses. More than these techniques, treatments with internal medicines like Manasa mitra vatakom, Saraswata Gritam, Saraswatarishtam etc and treatment procedures like Takra dhara , Ksheera dhara and Taila dhara including relaxation massages are very good for overcoming mental stress. Food stuffs like drum sticks included in the menu would be good for call center employees which shall help them to stay awake at night without much strain. Also food like Milk and snake gourd and drum stick leaves at night, Ash gourd juice daily morning (before sleep- specific only for call center employees), Butter milk with a lot with curry leaves ground and mixed with it at noon, tender coconut water etc can be very effective in managing mental and physical stress. Also it is better to avoid curd & fish at night.
OTHER SUGGESTIONS:

v Evaluate other activities. Problems may be caused or aggravated by other things you do frequently. Sports, carrying children, hobbies requiring intense small work (like knitting), and excess effort/tension in other daily things may have enormous impact too. So avoid these activities, which may trigger the problems to more severe intensity.
v Don't tuck the telephone between your shoulder and ear

v Consider voice recognition.

General suggestions:

Other ways to reduce the risk of computer related injuries include:

v Make sure your work space is well ventilated

v Maintain equipment, such as laser printers and photocopiers, to reduce emissions.

CHILDREN AND COMPUTERS:

Kids are at risk too with increasing hours in front of the computer at home and school, using equipment that rarely is set up correctly for people their size. Parents can reduce the risk of children developing computer related injuries in additional ways, including:

ü Set up the computer, desk, chair and keyboard to suit your child

ü Install a smaller mouse that contours to the child's hand

ü Show your child how to use the keyboard and mouse properly and safely

ü Encourage frequent breaks

ü Reasonably limit your child's game-playing time

ü Make sure your child has enough time for other activities, such as sport.

Ayurvedic prevention and care:

Children should be helped with dietary supplements (like Flowers of Sesbania grandiflora, drum stick leaves, carrots and Grapes) and massages so that the formative muscles and bones do not get bad as it is the stage where maximum damage can occur and also preventive and curative efforts can be the most effective.

What If I Have Symptoms of RSI?

We all have occasional aches and pains that go away in a day or two, especially when we overdo anything. But if you have the symptoms listed above regularly when you are using the computer, run; do not walk to your doctor or health care provider RIGHT AWAY. Dealing with this early is critical to limiting the damage, and to spare you a world of hurt, trouble, and frustration. You are not overreacting: by the time you have symptoms there has already been some damage done, and if you try to ignore the pain you may sustain a serious injury. If your doctor doesn't seem to know much about RSI, find one who does. When you find one, listen to them and check with them about any changes you intend to make or therapy you want to try.

Remember that "RSI" is a mechanism of injury, not a diagnosis. Where or how seriously you are injured, and how best to treat it, varies immensely from person to person. Also, many systemic disorders such as diabetes can mimic or exacerbate RSI, and these can be ruled out by medical tests, so don't go chasing a treatment you may have heard about UNTIL YOU'VE SEEN A DOCTOR.

Last but not the least, PAY ATTENTION TO YOUR BODY. Pain is your body yelling that it is in big trouble but learning what is comfortable or awkward for your body before you are in pain may prevent injury.

Look to nature - it adopts. So can you.

About the Author

****************************************************************************************** An article by Dr. G. Geetha Krishnan MD, Chief Physician, Sanjeevani Holistic Health Care Services (P) Ltd, Singasandra Post, Hosur Main Road, Bangalore 68 Karnataka India Ayurvedic Department, Mahabodhi Mallige Hospital, Siddhapura Bangalore Sanjeevani Center, J P Nagar 1st Phase, Bangalore. Shradha Sanjeevani Ayurvedic Center, Koramangala I Block. Shradha Sanjeevani Ayurvedic Center, Koramangala VIII Block. Shradha Sanjeevani Ayurvedic Center, Tavarakare Tel: 91 080 5731505, 5731506, 51119911, 56907096, 6632441 e-mail: drgk2000@yahoo.com Compiled and edited by Jayachandran.R. freelance content writer who also owns http://www.aayurmart.comFor more details mailto:ayurmart@gmail.com **********************************************************************************************


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