'Karma' - what does it mean to you+

Often in life, we find ourselves disillusioned and lost. Life does not seem to be going the way it should- position, money and relationships seem to be going haywire. Sometimes we just don't seem to know the right way to go. The path trodden by others may seem like a maze.Our goals may be set, but the path which we want to take may not seem to materialize. People whom we love and trust may cheat us- knowingly or unknowingly. People we work for may take advantage of us or may not pay us our wages- the laborer must be paid his wages. People who work for us may seem aghast at our actions. Our spouses may mistrust us and our children may question our good motives. We may find our peers and friends palming us the wrong cards: the aces may seem to evade us and the numbers may look irrational. Our moods may reach its nadir, our tempers their worst. Depressions and desperation may follow us as we try to tread the path we have chosen to reach our goals.  The principles that we stood up for all our life may suddenly seem to be wrong in others eyes. We may find our own  past actions  as totally unacceptable. The goals themselves may not look too attractive, the futility of life may set in....

Suddenly we begin to look around, we think, introspect, contemplate and ruminate- thoughts that we once put aside as unreasonable. We start to question- the 'why' of things that happen- why the bad seem to be more successful than the good.... why truth seems to falter in the shadows of lies..... why things happen the way they should not happen... we wonder why most people share their sorrows and not their happiness-es and their profits.... why sellers label their cheating strategies as 'great business'...... why people  who never use a product suddenly advertise them with great gusto...why the rich want to be richer at the cost of making the poor- poorer....... why normal men and women take advantage of the handicapped and the downtrodden....... why like and love is mistaken for lust...... why people who were in love for centuries suddenly hate each other...... Why people feel that they should have expressed their love,  only after their loved ones have left them.... why people build statues in honor of the dead, when in real life they have always belittled them...why politicians forget their promises they once made..... why diseases overcome us and make us suffer beyond our understanding.... why death seem to defeat life-when it is at its best... why relationships must end someday ... why nothing materialistic we experience is eternal......why cricketers like Hansie Cronje must fix overs at the peak of their careers....why Bear Grylls must risk his life every time with death lurking round the corner trying to teach us survival tactics.... why Steve Irwin  had to be stung by a sting ray when he could have used a robotic camera....why innocent men, women and children must become the victims of a war unknown to them.....why the religious suddenly become atheist ....why  some people seek treatment when the disease is beyond control while others like Angelina Jolie must have defective BRCA1 gene and undergo double mastectomies at the peak of her career…Why the forbidden fruit is tasty…. Why familiarity breeds contempt…..the thoughts go on...and on ..

 what should we do?????
Here's where the 'karma' of life sets in.

Karma is a deed or act causing the cycle of cause and effect (or samsara as referred to in ancient India). This concept probably came through observations made by our early ancestors and as time passed by …got incorporated into religions that came into being. All religions believe and end in the principle ‘we reap what we sow’. Whether it be in this present life.. or in rebirth…. the cycles of life …all profess that good deeds must be done. For the atheist, religion and God does not play a role..  Yet most believe in the goodness of life and in doing good deeds and not evil ones… for the people who support ‘’humanity’- to be humane means one has to be good and civilized….history is privy to this,  the good have always overshadowed the bad in the end.  Hitler committed suicide in his bunker after slaughtering millions of innocent souls and Saddam was hung for the same… what we do … will come back to us… the cycles of life will continue.. the sun will go down… the moon will come up….. Seasons will go and come….. we will also be gone someday… and what will remain will be the karma or good that we leave behind…

While karma may be good deeds or bad deeds, when we say 'do your  karma' we mean the good deeds and acts….karma must be unconditional.. only then the results will bear fruit. for if it is conditional, one might stop his karma every time he doubts his goals. Once you follow this principle of karma, your pain and suffering will slowly flow away… for where there is no expectation there can be no pain…in fact the results can only make you ecstatic...we have to do what we have to do.. sounds funny, but that’s the truth. A mother must take care of her baby.. a father his family.. an owner must pay his workers wages and see to their well being… a leader must guide his followers… a doctor must minister to his patients… a priest must lead his believers… a student must concentrate on his studies…a labourer must be true to his profession...

The christian philosophy of 'treating people as we would like them to treat us'  sums up in very simple terms the life we would like to lead. Unless you are a  masochist..enjoying pain,  you will always treat your neighbors with love and compassion. The law of equality must prevail.. fear must go .. hope and trust must develop.. altruism must replace selfishness ...love must replace all.... we must do what we have to do...our responsibilities to our families, friends, relatives, peers, employers, employees, our society, our parishes and our nation must be fulfilled....we cannot let down the people who have placed their trust in us.... our karma of good deeds must go on...the karmic cycle of good will go on.....the hands of time will bring it back to us...

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Skin graft, grafting, Humby knife, Aesculap dermatome, wounds, skin loss, injuries, burns, tumors, cancers, plastic surgery India, cosmetic surgery India, Dr Alexander, Cochin, kerala, medical tourism, India+

Sometimes the skin of our body may be lost or damaged and this may happen due to many causes. Commonly, road traffic accidents are the one which result in skin loss. Skin tumors when removed may lead to loss of skin. When burns occur, the skin may be destroyed and lost. Sometimes infections and conditions like necrotising fasciitis can lead to massive skin and tissue loss.  In all these cases the lost skin will have to be replaced. While skin can be obtained from different sources like cadavers and other living persons, (allograft or homograft), animals like pigs (heterograft or xenograft), or even artificial skin like Integra (bovine collagen and silicone layer), it’s the  individual's own skin that is the best sources and match. The take of this graft (auto graft) is good and the cosmetic and functional results are acceptable as well.

The skin has two layers – dermis the deeper one and epidermis the surface layer. Depending in the thickness of the graft taken, the grafts are named differently. There are two types of skin grafts that are harvested- thick and thin, depending on the requirements in a particular case. Small areas of full thickness grafts can be obtained from behind the ear and that area can be closed primarily. This is done by using a scalpel, cutting the skin out and closing the defect. When a large area of skin is needed, then a partial thickness skin graft is harvested from the thigh or other areas. The first picture seen above, shows how a skin graft can be harvested from our body using a Humby knife. Both the Humby knife and the electric dermatome (Aesculap) is shown in the second picture. Sometimes the area of skin graft required is very big and then we find that our donor skin is limited. The skin grafting mesher allows us to expand the skin by cutting it into a mesh like pattern. This also prevents the blood and serum from collecting under the graft and thereby allows good approximation between the wound bed and the graft itself, so the graft will firmly adhere to the wound bed and will not be rejected. The skin graft must get its nutrition and slowly develop its blood supply from the wound bed. This process takes time and therefore post operative care of the graft is very important. A plaster support or splint will help to immobilize the grafted area and prevent shearing of the graft. Once the graft is well adhered to the wound bed, gentle movements may be allowed – usually about 2 to 3 weeks after surgery. The donor site from where the grafts have been taken takes about 2 to 3 week to heal and thereafter will need some cream applications and moisturizers as well. Avoiding sunlight on the operated areas is important as it can lead to hyperpigmentation +

Vacuum assisted healing, leg injury, foot injury, necrotising fasciitis, fracture bones, skin graft, wounds, accidents, plastic surgery India, cosmetic surgery India, Dr Alexander, plastic surgeon, cosmetic surgeon, Cochin, kerala, before and after , medical tourism kochi +

This unfortunate gentleman had a fracture of his leg bones which were fixed with plates and screws. Thereafter he developed necrotising fasciitis and lost a lot of skin and tissue of his leg thereby exposing the screws that were used to fix his broken bones. His general condition was critical with infection, organ failure and sepsis.Therefore he was subjected to critical care specialist care, antibiotics, debridement and dressings. Vacuum assisted healing (VAC) or negative pressure wound therapy (NPWT) was used in his case- this helped to reduce the infection, increase the granulation tissue, reduction of edema, coverage of the exposed screws and faster healing. A flap coverage would have been ideal, but with the presence of sepsis, possible osteomyelitis and organ failure, minimal intervention with maximal results was the answer. Finally the wounds were covered with skin grafts which were taken from the thighs. Indeed, this was a complex case that was greatly facilitated by vacuum assisted healing +

Breast reduction, ptosis correction, hanging, droopy, sagging breasts, before after pictures, plastic surgery, cosmetic surgery, Dr Alexander, plastic surgeon India, medical tourism, cosmetic surgeon India, cochin, kerala, kochi++

Breast reduction can be a tricky affair. One has to examine the patient to look if ptosis ( droopy or hanging breasts) or other associated abnormalities are present. At the same time one must make sure the breast is free of  disease by doing an Ultrasonography and mammography. Treating an unrecognized cancer postoperatively can be very difficult. Breast reduction is not always done for a cosmetic indication. Sometime breasts like those above can cause pain in the shoulders in addition to other   problems like  hygiene issues. Even finding proper sizes of  undergarments can be a serious issue.  This young lady has  large breasts which were causing severe shoulder pain  in addition to the ptosis. She was also embarrassed by the size of her breasts and was unable to wear the dresses she wished to be seen in. She underwent a breast reduction and ptosis correction and was quite happy with the results+

' The tragedy of love '

This post is a controversial one and out of context, yet it is something that we all ponder on sometime. Love is the extreme of like, an intense manifestation of the affection you feel for someone. It surpasses all boundaries of age, sex, races, and species and surprises both the lover and the loved. One cannot define love; we know it when we experience it.  Love then is a feeling, a physical and mental reaction that we are caught up in. Love is waking up in the morning and looking into her eyes and seeing that little twinkle. Love is that gentle peck on your cheek, the touch of a fingertip, a hand that gently holds and accompanies you through the thick and thin of life. Love is sitting by the seaside, your arms around her shoulder, staring at the moon and the shimmering waves that makes hope a reality. Love is enjoying bread at a table like a king’s banquet, while others dine in fine cuisine and still come out with unfulfilled desires. 

True love is in unconditional giving... receiving is a bonus...

So where did the gifts and the money come in? How did the caveman fall in love?

Did he give his sweetheart a million dollar house, a yacht or a diamond ring? Did he send her expensive gifts and presents?

Well, he never did any of these; he just looked into her eyes and vol la!   they knew love was there.

Times have changed; women have changed, though love has remained the same.

Women now equate love with gifts and money and therein lies 'the tragedy of love'  Express your love without a present or a gift- it will be spurned. Make her happy monetarily and you can fool her into thinking that you love her, thought you might actually hate her. The rich can prove their love easily; the poor must wait for divine intervention. For some men the 'art of gifting' may look alien, though they may be extremely generous on all counts. Its just that they were never brought up on it. 

Yet, love is the only thing that will survive forever. Whether they are rich or poor, men will always fall in love even unto their end of time.........

(PS:  that’s how God made us....)

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