Hello Doctor: Connecting Readers with India's Leading Medical Specialists
Welcome to another edition of Hello, Doctor – the exclusive series that bridges the gap between India's foremost medical experts and readers seeking reliable health information. Each week, subscribers submit their personal health concerns, our editors select the most pertinent questions, and top clinicians provide clear, evidence-based responses written in accessible, everyday language.
The mission remains unchanged: to cut through the noise of generic wellness advice and online misinformation, connecting readers directly with trusted, experienced medical voices. These are not abstract discussions but real questions from real people, answered with precision, context, and genuine care.
Meet Our Distinguished Medical Panel
Our panel brings together some of India's most respected specialists across multiple disciplines:
- Dr Kumar Narayanan – Cardiology
- Dr Anoop Misra – Diabetology
- Dr Sujeet Rajan – Pulmonology
- Dr Nita Nair – Oncology
- Dr Kiran Coelho – Gynaecology & Obstetrics
- Dr Shaunak Ajinkya – Psychiatry
- Dr Tushar Parikh – Paediatrics & Neonatology
- Dr Lalit Panchal – Orthopaedics
- Dr Soumyan Dey – Urology
- Dr Anita Mathew – Internal Medicine
- Dr Jawaharlal Mansukhani – Dermatology
- Dr Jignesh Gandhi – General Surgery
We are also pleased to welcome Dr Shama Kovale, Consultant ENT Surgeon and Voice & Swallowing Specialist, to our expanding panel. In an era where health anxieties are deeply personal and misinformation spreads rapidly, Hello, Doctor aims to restore clarity, confidence, and trust in medical guidance.
This Week's Questions and Expert Answers
Question 1: Sudden Hearing Loss and Positional Changes
Vishal Mehra, TOI+ Subscriber: "I've been experiencing sudden hearing loss in my right ear for the past 10 days. My hearing significantly worsens when standing, walking, or sitting but improves when lying down after about 20 minutes, often with clanking or popping sounds. An ENT specialist prescribed ear drops for wax, followed by suction cleaning, then a nasal spray (Flomist F) for three weeks with no improvement yet. Why does my hearing improve when lying down? Could this be Eustachian tube dysfunction? Is my treatment appropriate, or do I need further evaluation?"
Answer from Dr Shama Kovale, Consultant ENT Surgeon and Voice & Swallowing Specialist, Kokilaben Dhirubhai Ambani Hospital:
I understand your concern – blocked ears can be very disturbing. The most common cause for muffled or decreased hearing is Eustachian tube blockage, which can sometimes cause popping or clunking sounds. A probable explanation for improved hearing when lying down could be venous congestion, temporary improvement in tube patency, or if there's middle ear fluid secondary to Eustachian tube dysfunction that improves in that position.
You mentioned sudden hearing loss for 10 days, but sudden hearing loss can only be diagnosed through pure tone audiometry. To diagnose Eustachian tube dysfunction or middle ear fluid, we need a tympanogram or impedance audiometry. Sudden sensorineural hearing loss cannot be positional.
For Eustachian tube improvement, it could take another 10-15 days or longer. It's too early to judge your response to Flomist F. You can also perform gentle valsalva maneuvers and take antihistamines if you have a cold.
I believe you're more or less on the right treatment, but it's incomplete. I recommend getting a pure tone audiometry and tympanogram done. This will determine whether it's conductive hearing loss or sensorineural hearing loss, and treatment can be specified accordingly. Seek re-evaluation with your doctor to check tympanic membrane mobility, assess for fluid, and conduct a tuning fork test. If audiometry shows sensorineural hearing loss, you might require prompt treatment like steroids. If it's persistent conductive loss, we'll need to diagnose if there's an issue in your nasopharynx.
Question 2: Maintaining Long-Term Heart Health
Nimish Patel, TOI+ Subscriber: "I'm seeking advice for a 53-year-old man. What are the best ways to maintain a healthy heart in the long term?"
Answer from Dr Kumar Narayanan, Senior Consultant Cardiologist & Electrophysiologist, Medicover Hospitals, Hyderabad:
To keep the heart healthy, the most important measure is adopting a heart-healthy lifestyle. The main pillars are eating healthy and keeping oneself physically and mentally fit.
- Eating Healthy: Predominantly home-cooked meals rich in vegetables and fiber, low in saturated fats, with calories appropriate for body habits and physical activity level.
- Physical Fitness: Aerobic exercise for at least 150 minutes every week plus simple muscle-strengthening exercises twice weekly.
- Mental Fitness: Appropriate stress management and mind nourishment through meditation or other relaxation techniques.
It's also advisable to have a basic heart check-up annually focused on early identification of risk factors like blood pressure, diabetes, or high cholesterol.
Question 3: Complex Regional Pain Syndrome Management
Anonymous TOI+ Subscriber: "I'm a 34-year-old woman diagnosed with Complex Regional Pain Syndrome in my leg, affecting my hip, starting after a fall three years ago. I continue to have severe pain, sensitivity, skin color changes, tingling, twitching, and walking difficulty. I've tried pain medications and a nerve block with only brief relief. What are the best long-term treatment options to control this condition and improve mobility and quality of life?"
Answer from Dr Lalit Panchal, Senior Consultant Orthopaedic Surgeon, S.L. Raheja Hospital, Mumbai:
Chronic nerve-related pain requires a multidisciplinary, structured approach. Pain rehabilitation includes:
- Graded Motor Imagery
- Mirror Therapy
- Desensitization
These techniques help the brain "retrain" itself and gradually decrease pain perception over time.
Medications also contribute to successful management. Gabapentin (Neurontin), pregabalin (Lyrica), and duloxetine (Cymbalta) help stabilize nerve signals and benefit persistent pain when conventional analgesia isn't effective.
For patients with ongoing symptoms after these techniques, advanced pain management options include spinal cord stimulation, dorsal root ganglion stimulation, ketamine infusions, or specialized nerve blocks to control pain signal transmission.
Gentle, regular movement under physiotherapist guidance is crucial for restoring function without aggravating symptoms. Additionally, psychotherapy (Cognitive Behavioral Therapy) vastly improves coping ability with chronic pain, decreases stress-induced pain triggers, and enhances overall quality of life.
Question 4: Focusing on What's Within Your Control
Chandan Kumar, TOI+ Subscriber: "How can I focus more on what is within my control rather than worrying about things beyond it?"
Answer from Dr Shaunak Ajinkya, Consultant Psychiatrist, Kokilaben Dhirubhai Ambani Hospital, Mumbai:
The most significant source of human suffering isn't the presence of problems but the misallocation of mental energy. We often treat our circle of concern (everything we care about) as identical to our circle of influence (everything we can actually change). Worrying about uncontrollables – global shifts, others' opinions, or the distant future – keeps your brain in hypervigilance, which is exhausting.
To reclaim focus, move from anxious contemplation to action:
- Psychological Audit: When worry hits, perform cognitive triage. Draw two columns: Column A for Uncontrollables (weather, stock market, boss's mood – focus on acceptance); Column B for Controllables (your effort, boundaries, routine, self-talk – focus on action).
- Shift from 'What If' to 'What Is': Practice grounding. When caught in "What if" spirals, say aloud: "Right now, I am safe. Right now, I have this in front of me. Right now, I choose one deep breath." This activates the prefrontal cortex instead of fight-flight mode.
- 15-Minute Worry Window: Schedule a daily worry appointment. Write down all Uncontrollables during this time. If worries pop up earlier, tell yourself: "I see you, but your appointment isn't until later."
- Develop Internal Locus of Control: Focus on process, not outcome. You can't control getting a job (outcome), but you can control application quality and interview practice (process).
- Three-Choice Framework: In overwhelming situations, you always have three choices: Change it (if in your influence), Leave it (if toxic and uncontrollable), or Accept it (to preserve sanity).
Practice stress management techniques like yoga, deep breathing, and meditation daily. Develop good eating and sleep habits, and avoid substance addictions. Peace comes not from a problem-free life but from confidence in handling what's in your hands.
Keep sending your health questions to: hellodoctor@timesofindia.com
