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Dr K K Aggarwal

Addiction Terms

By Dr K K Aggarwal
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(Harvard): People sometimes confuse the words tolerance, physical dependence and withdrawal. Although related, these terms are not interchangeable.

  • Tolerance means that, over time, a person will need larger doses to get the same effect first experienced with smaller doses. Because tolerance to some side effects does not occur, people with tolerance often face worsening side effects as they take larger and larger doses.
  • Physical dependence means that the body gets used to having the substance or activity and “misses it” if its taken away. People with physical dependence who stop using their object of dependence or who decrease their dose might develop uncomfortable withdrawal symptoms.
  • Withdrawal refers to a range of typical symptoms that vary depending on the substance or activity in question, but they often reflect the opposite of the high. How long withdrawal symptoms last and how severe they are depends on which substance (or activity) a person uses, at what dose, and for how long. The fear of withdrawal symptoms sometimes makes people nervous about stopping or lowering their dose. Thats sometimes true even for people who no longer derive pleasure from their object of addiction.

Spiritual Prescriptions – Controlling the Inner Noise

By Dr K K Aggarwal
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Yoga Sutras of Patanjali define yoga as restraint of the mental states (Chapter 1.2). In the state of total restraint, the mind is devoid of any external object and is in its true self or the consciousness. Many Vedic scholars have given their own formulae to control the mind. Being in touch with one’s own consciousness requires restraining of the mind, intellect and ego on one hand and the triad of rajas, tamas and satwa on the other hand. Every action leads to a memory, which in turn leads to a desire and with this a vicious cycle starts.

The mental turmoil of thoughts can be equated to the internal noise and the external desires and objects to an external noise.

The process of withdrawing from the external noise with an aim to start a journey inwards the silent field of awareness bypassing the internal noise is called pratihara by Yoga Sutras of Patanjali. It involves living in a satwik atmosphere based on the dos and don’ts learnt over a period of time or as told by the scriptures. To control inner noise-based thoughts, we either need to neutralize negative thoughts by cultivating opposite thoughts or kill the origin of negative thoughts.

Not allowing thoughts to occur has been one of the strategies mentioned by the scholars. One of them has been neti–neti by Yagnayakya.

The other method is to pass through these inner thoughts and not get disturbed by it and that is what the process of meditation is. This can be equated to a situation where two people are talking in an atmosphere of loud external noise. For proper communication one will have to concentrate on each other’s voice for long till the external noise ceases to disturb. In meditation, one concentrates on the object of concentration to such an extent that the noisy thoughts cease to bother or exist.

One of the ways mentioned by Adi Shankaracharya in Bhaja Govindam and by Yoga Sutras of Patanjali (Chapter 2.35) is that whenever one is surrounded by evil or negative thoughts, one should meditate open the contrary thoughts. For example, if one is feeling greedy, one can think of donating something to somebody. Deepak Chopra in his book Seven Laws of Spiritual Success talks in detail about the importance of giving and sharing. He says you should never visit friends or relatives empty handed. You should always carry some gift of nature, which if nothing is available can be a simple smile, compliment or a flower. By repeatedly indulging into positive behavior and thoughts, you can reduce the internal noise, which helps in making the process of meditation or conscious living a simpler one.

Washing out negative thoughts is another way mentioned by many Vedic scholars. Writing for 3 min is one such exercise which anybody can do. Just before sleeping, take 3 min and write down all your emotions and then discard the paper. Another exercise is to reward or punish oneself at bed time for the activities done during the day by either patting or slapping yourself.

In Paralysis, Act Fast

By Dr K K Aggarwal
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Brain attack should be tackled like a heart attack. As time is brain, a patient with suspected paralysis/stroke or brain attack should be shifted to hospital at the earliest and given a clot dissolving therapy if the CT scan is negative for brain hemorrhage. Prevention for paralysis is the same as prevention for heart attack. All patients with paralysis should be investigated for underlying heart disease and all patients with heart diseases should undergo testing to detect blockages in the neck artery, which can cause future paralysis.

Facts

  • Brain haemorrhage should be ruled out as soon as possible.
  • Obtain emergent brain imaging (with CT or MRI) and other important laboratory studies, including cardiac monitoring during the first 24 hours after the onset of ischemic stroke.
  • Check glucose and correct high or low sugar. If the blood sugar is over 180 mg/dL, start insulin.
  • Maintain normothermia for at least the first several days after an acute stroke.
  • For patients with acute ischemic stroke who are not treated with thrombolytic therapy, treat high blood pressure only if the hypertension is extreme (systolic blood pressure >220 mmHg or diastolic blood pressure >120 mmHg), or if the patient has another clear indication (active ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, acute renal failure, or pre–eclampsia/eclampsia).
  • For patients with acute ischemic stroke who will receive thrombolytic therapy, antihypertensive treatment is recommended so that systolic blood pressure is 185 mmHg and diastolic blood pressure is 110 mmHg.
  • Antithrombotic therapy should be initiated within 48 hours of stroke onset.
  • For patients receiving statin therapy prior to stroke onset, it should be continued.

You Cannot Hate Strangers

By Dr K K Aggarwal
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You can only hate somebody whom you have loved. Hatred, therefore, is withdrawal of love.

Love is the opposite of fear and not hate. Most of us assume that love and hatred are opposite to each other but hatred is withdrawal of love and manifestation of fear; it’s not opposite.

In spirituality, you cannot have love and fear together. Love means being in touch with your consciousness. Love is total absence of fear.

As per mythology, there are only two emotions and they are emotions of love and emotions of fear. All other emotions are their sub-categories. For example, love can be categorized into joy, peacefulness, happiness, forgiveness. Fear, on the other hand, can give rise to hatred, depression, guilt, inadequacy, discontentment, prejudice, anger, etc.

In Ayurveda, fear is linked with Vata disorder, Pitta with anger and Kapha with attachment and possessiveness.

Again, as per Ayurveda, fear is linked with large intestine, pitta with small intestine and kapha with stomach and upper GI systems.

Fear in Vedic sciences is linked with Mooldhara Chakra, the first chakra with the sound LUM and love is linked to the Heart, the fourth Heart Anhata Chakra with its sound Yum. In terms of Vedic sciences, in Chakra meditation, Mooldhara chakra has the opposite characteristics of Anhata or Heart Chakra. Therefore, the sounds LUM and YUM are often chanted together.

Fear and love have different chemistry. Fear is based on adrenaline and love is based on endorphins. Fear is related to adrenaline based fight and flight.

The most important fear in body is fear of death. If that fear goes, one attains spirituality.

In the Sikh prayer “Ik Onkaar Sat Naam Kartaa Purakh Nirbh-a-o Nirvair Akaal Moorat Ajoonee Saibhn Gur Parsaad Jap…………”

‘Nirbhay’ means free of fear. Once one is in touch with consciousness, the fear goes away.

When there is fear, there is no love and when there is no love, there is fear. Fear and love cannot be experienced at the same time.

Nail Hygiene

By Dr K K Aggarwal
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  • Nails can harbor dirt and germs and contribute to the spread of many infections.
  • Keep nails short.
  • Trim nails often.
  • Scrub the underside of nails with soap or water each time you wash your hands.
  • Clean any nail grooming tools before use.
  • Nail grooming tools should be sterilized before use in saloon.
  • Avoid biting and chewing nails.
  • Avoid cutting cuticles as they act as barriers to prevent infection.
  • Never rip or bite a hang nail, instead clip it with a clear sterilized nail trimmer (a hang nail is small torn piece of skin next to finger nail or toe nail).
  • Infections of the finger nails or toe nails are often characterized by swelling of the skin or thickening of the nail. In some cases these infections may be serious and need to be treated by a doctor.

Managing grief by free expressive writing

By Dr K K Aggarwal
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The loss of a loved one is often painful. The resultant grief makes it hard to eat, sleep and leads to loss of interest in routine life, affecting behavior and judgment.

Some can feel agitated or exhausted, to sob unexpectedly, or to withdraw from the world and others may find themselves struggling with feelings of sorrow, numbness, anger, guilt, despair, irritability, relief, or anxiety.

It is well known that disclosing deep emotions through writing can boost immune function as well as mood and well-being. Conversely, the stress of holding in strong feelings can ratchet up blood pressure and heart rate and increase muscle tension.

One can write on a piece of paper, in your personal book, on the open website with nick name or keep it in the mind. One doesn’t have to preserve the emotions and can throw away the writings.

In the absence of deeply troubling situations, such as suicide or a violent death which are best explored with the help of an experienced therapist, one can choose writing as a way to express out the grief.

  • Start writing for 15 to 30 minutes a day for three to four days.
  • Continue up to a week if it is helping.
  • Continue writing for 15 to 30 minutes once a week for a month.
  • Writing has stronger effects when it extends over more days.
  • Remember writing about grief and loss can trigger strong emotions (one may cry or feel deeply upset).
  • Many people find journal writing valuable and meaningful and report feeling better afterward.
  • Don’t worry about grammar or sentence structure.
  • Truly let go. Write down how you feel and why you feel that way. You’re writing for yourself, not others.

Eating foods in their natural form is always better

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An elephant is obese, eats sugarcane and yet does not develop diabetes. I am sure if he were given 10% sugar drinks everyday or made to eat sweets containing 30% sugar, he would end up with diabetes.

The natural form of sugarcane is eating sugarcane in its raw form, the second form is sugarcane juice, third is gur (jaggery), fourth is shakkar and fifth is white sugar.

The more you eat foods in their natural form, more the health benefits you will get from that food.

Food is Brahmin and contains the same consciousness as you have. Refined foods lose their consciousness and are not beneficial to the health.

Similarly, wheat flour with bran is better than flour without bran, which is better than suji, which is better than maida (refined flour), which is the final product. If refined flour is taken every day, it can cause heart disease, diabetes and high blood pressure.

I am the Best

By Dr K K Aggarwal
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People who lack self-confidence and self-esteem face recurrent episodes of depression. They suffer from inferiority complex, as all the time they compare themselves with others.

It’s a common saying that “everyone likes someone else’s wife, money and their own buddhi or intelligence”.

An organization is good or bad is decided by its people. If the people are good, the organization is good and if the people are bad, the organization is bad. An organization without people is only a building made up of bricks.

Imagine a situation where two students of a school are asked “how is your school”. The first student answers: “My school is the best” and the second one says: “My school is not the best”. The teacher’s reply to both the students is the same: “It has to be because students like you are there in this school. It’s you who will make the school best or not the best.”

Whichever organization you work for, it has to be the best, because you are working there and because you are the best. If it was not the best, you would not have been there. The mantra of success lies in the self affirmation of “I am the best.”

Everybody is born with a hidden talent. One should only look for positive things in oneself and others. One should never compare oneself with others, as one does not know how many bad things they might be harboring in them.

You have to be the best as God selected you as a human being. Remember, a human being is born passing through 84 lakhs of different kinds of living species.

The Eastern scripture explains that in this world, there are approximately 84 lakh species of living beings which include 3 million species of plant life; 2 million 7,00,000 species of insects; 1 million 4,00,000 kinds of birds; 9,00,000 kinds of water animals and 4,00,000 kinds of land animals, including men.

One, therefore, should not only look at oneself through the eyes of flesh but also through the eyes of mind and soul. One should not only analyze one’s physical profile but also the ego and soul profile.

External beauty is important but is incomplete without the beauty of the mind and of the soul. Ashtawakra Gita was a dialogue between the sage Ashtawakra and Raja Janaka. Ashtawakra was a person with eight curves in the physical body. But his soul profile was unmatchable.

Walking Tips

By Dr K K Aggarwal
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  • Walking requires no special clothes or equipment, and it’s free.
  • Make walking fun by going to places you enjoy, like a shopping center or park.
  • Bring along someone to chat with, or listen to some of your favorite music (but keep the volume low enough to hear the sounds around you).
  • Think about safety as you plan when and where to walk.
  • Walk with others when possible, and take a phone and ID with you.
  • Let someone know your walking time and route.
  • If it’s dark outside, wear a reflective vest or brightly colored clothing.
  • And always be aware of your surroundings.

Definition of Health

By Dr K K Aggarwal
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Health is not mere absence of disease, it is a state of physical, mental, social, spiritual, environmental and financial well-being. All aspects of health are not defined in allopathy.

During MBBS, medical students are taught more about the physical health. Social and mental health are covered only in few lectures. Community health is a separate subject but never given its due importance. Spiritual health is not defined at all and financial health is hardly covered.

Yet, in day-to-day practice it is the social, financial, spiritual and community health, which are most important during patient-doctor communication. It is incorporated in the four basic purposes: dharma, artha, kama and moksha.

Dharma and artha together form the basis of karma, which is righteous earning. You are what your deep rooted desires are. Most of the diseases today can be traced to a particular emotion, positive or negative. Anger and jealousy are related with heart attack, fear with blood pressure, greed and possessiveness with heart failure. Unless the mind is healthy, one cannot be free of diseases.

The best description of health comes from Ayurveda. In Sanskrit, health means swasthya, which means establishment in the self. One is established in the self when there is a union of mind, body and soul. Most symbols of health are established around a shaft with two snakes and two wings. The shaft represents the body, two snakes represent the duality of mind and the two wings represent the freedom of soul.

Sushrut Samhita, in Chapter 15 Shloka 10, defines the Ayurvedic person as under:

Samadosha, samagnischa,

Samadhatumalkriyah,

Prasannatmendriyamanah,

Swastha iti abhidhiyate.

From an Ayurvedic point of view, for a person to be healthy, he/she must have balanced doshas, balanced agni, balanced dhatus, normal functioning of malkriyas and mind, body, spirit and indriya full of bliss and happiness.

Human body is made up of structures (Kapha), which have two basic functions to perform; metabolism (pitta) and movement (vata). Vata, pitta and kapha are called doshas in Ayurveda. Samana dosha means balance of structures, metabolism and movement functions in the body. Agni in Ayurveda is said to be in balance when a person has normal tejas and a good appetite.

Ayurveda describes seven dhatus: rasa, rakta, mamsa, medha, asthi, majja, shukra and they are required to be in balance. They are equivalent to various tissues in the human body.

Ayurveda necessitates proper functioning of natural urges like urination, stool, sweating and breathing and that is what balance in malakriya means.

Ayurveda says, for a person to be healthy, he/she has to be mentally and spiritually healthy, which will only happen when his or her indriyas are cheerful, full of bliss and devoid of any negativities. For indriyas to be in balance, one has to learn to control over the lust cum desires, greed and ego. This can be done by learning regular pranayama, learning the do’s and don’ts in life, living in a disciplined atmosphere and learning to live in the present.Regular pranayama shifts one from sympathetic to parasympathetic mode, balances the mind and thoughts and helps in removing negative thoughts from the mind. One can follow the yama and niyama of yoga sutras of Patanjali or do’s and don’ts taught by various religious gurus, leaders and principles of naturopathy. Living in the present means conscious or meditative living. This involves either learning meditation 20 min twice a day or learning subtle mental exercises like mind–body relaxation, yogic shavasana, self–hypnotic exercises, etc.

According to Yoga Sutras of Patanjali, a person who eats thrice a day is a rogi, twice a day is a bhogi and once a day is yogi. The take home message is: To live more, one has to eat less.

Swar yoga defines the importance of respiration and longevity. According to this yoga shastra, everybody has a fixed number of breaths to be taken during the life span.

Lesser the number a person takes in a minute more is the life. It also forms the basis of pranayama which is nothing but longer and deeper breathing with reduced respiratory rate. To be healthy, one can remember to follow the principle of moderation and variety in diet and exercise, regular pranayama and meditation and positive thinking.

Mindfulness meditation

By Dr K K Aggarwal
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  • Sit on a straight–backed chair or cross–legged on the floor.
  • Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.
  • Once youve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas.
  • Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again

Keeping blood pressure in the safe zone

By Dr K K Aggarwal
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Keeping your BP below 120/80 is the ideal goal to avoid a host of afflictions, including heart disease, kidney failure and erectile dysfunction. When lifestyle changes fail to fix the problem, doctors tend to reach for the prescription pad and add medication.

  • Reduce sodium intake. DASH diet keeps sodium to 2,300 mg per day (about one teaspoon of salt). Cutting it to 1,500—not easy, but doable—works even better. The DASH diet can lower your systolic pressure (upper number) by 10 points or more.
  • Monitor your pressure at home. This can give you instant feedback on the benefits of diet and exercise and give you and your doctor a more accurate picture of your blood pressure. This is valuable, because some people experience “white coat hypertension,” in which blood pressure spikes higher than normal when measured at the doctor’s office.
  • Limit your alcohol intake. For men, the suggested limit is 1 to 2 alcoholic drinks per day, defined as 1.5 ounces (1 shot glass) of 80–proof spirits, a 5–ounce serving of wine, or a 12–ounce serving of beer. (For women it’s no more than one drink a day.)
  • Take more meds if you need to—but take the right ones.

(Healthbeat)

Do Your Duty with Discipline and Devotion

By Dr K K Aggarwal
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“Vasudhaiva kutumbakam” (the whole world is one family) and “Ekam Sat Viprah Bahudavanti” (truth is one but the wise call it by various names) are two basic statements, which come from the ancient Rig Veda and form the fundamentals of Vedic philosophy.

One should do one’s duty with devotion and discipline. This principle can be remembered as the principle of three Ds.

In daily routine ‘one should remember the purpose for which one is born, which to fulfill Dharma (duty), Artha (wealth), Kama (desire) and Moksha (liberation). To achieve them, one needs to follow the four Fs: (i) Follow the teacher (ii) Face the negative devils of the mind (iii) Fight till the end and (iv) Finish at the goal.

The essence of Bhagwad Gita can be summarized in one shloka (Chapter 2.48) where Krishna says to Arjuna “yogastha kuru karmani”, which means ‘concentrate on actions’ (do all actions while remaining in yoga). He further says that one should take success and failure in the same stride. (yogastha = steadfast in yoga, kuru = perform, karmani = duties or action).

To acquire spiritual health, one should follow three Ss which are: (i) Satsang (company of good people) (ii) Sadhana (hard work), and (iii) Sanskar (good deeds). Adi Shankaracharya in Bhaj Govindam describes them as Satnam or Simran (bhakti, or reciting the name of their God), Satsang (company of good people) and Seva (good karmas).

Before doing any work, one should follow the principles of three Hs: (i) listen with the Head (ii) follow the Heart to choose one of the choices and (iii) order the Hands to take an action.

The ABCs of a good professional are Availability, Behavior and Competence. Competence comes last; the first is the availability of the professional.

An action should be based on Truth; it should be coming from consciousness and should end in internal bliss. Various Vedic literatures have termed this triad by different names like satha, chitha, ananda, and satyam, shivam sundaram.

Do not heat leafy vegetables twice

By Dr K K Aggarwal
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Nitrates in foods such as spinach, beet root and lettuce stimulate the production of nitric oxide in the body. Nitric oxide relaxes blood vessels. Ingested nitrate is reduced by oral, commensal, bacteria to nitrite, which can further be reduced to nitric oxide.

Vegetables are a major source of dietary nitrate. Green leafy and root vegetables, such as spinach and carrots, provide more than 85% of dietary nitrate. Foods in which nitrite are present are bacon, fermented sausage, hot dogs, bologna, salami, corned beef, ham and other products such as smoked or cured meat, fish and poultry. The conversion of dietary nitrate to nitrite has antimicrobial benefits in the mouth and stomach. Some epidemiological studies show a reduced rate of gastric and intestinal cancer in groups with a high vegetable-based nitrate intake.

Nitrate is totally harmless; however, it can be converted to nitrite and some portion of nitrite to nitrosamines, some of which are known to be carcinogenic. Heating increases the conversion rate. The longer the heat treatment, the more nitrosamines will be formed. Hence, the recommendation not to heat leafy vegetables twice.

Adding lemon juice to vegetables will reduce the formation of nitrosamines. It contains vitamin C, which also reacts with nitrite, thereby preventing the nitrosamine formation.

Spiritual prescriptions learnt from patients

By Dr K K Aggarwal
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As doctors, we are witnesses to human suffering. When we were young in medical college, we were quite disturbed seeing the sufferings of the people. But, in our practice, we have learnt many spiritual prescriptions from our patients. These have not only helped us to heal our patients but also changed our perception to health and sickness.

I recall, Swami Bodhanand, a disciple of Swami Chinmayananda, was once hospitalized under our care. When I asked him to give me a spiritual message, he said only two words “Detached Attachment”. He said, “As a doctor you should behave like a lotus leaf. It is wet as long as there is a drop of water on it, but once the drop is out, the leaf is as dry as if the water was never there.” The message was that “we should be attached to our patients as long as they are with us. The day they die, we should be completely detached from them or else we will not be able to treat other patients”.

I saw another spiritual guru through our Chief Anesthetist. The fee he paid me was a spiritual message “Suno Samjho Jano Karo – Hear Understand Wisdom and Do”. He said that hearing is different from listening, listening is different from wisdom and wisdom is different from doing. Unless you hear, understand what you have heard and implement, the learning has no value.

One of my Buddhist patients gave me a spiritual learning, which has helped me a lot in my routine clinical practice. He taught me the basic Buddhist message that there is suffering all over, there is a reason for every suffering and it is possible to maintain sufferings. This message fits into the main message of Hinduism and also the main teaching from Garud Purana.

In Hinduism, we know that the very fact that we are born in this life means that in our last life, we could not get liberation, as Hinduism believes that after liberation you are not reborn. Not getting liberated in the last birth means that some sufferings were left in our life. The basic purpose of this birth, therefore, is to face sufferings. When the basic purpose of our birth is to face sufferings, then why suffer from these sufferings. Every time we suffer, we should thank God that he has reduced one more. The period in between two sufferings is called a happy period (Sukh). In fact that period is nothing but a period of rest given by God to us to prepare the body for next suffering. This, as a concept of counselling, helps my patients in managing most of their mental disturbances.

Not telling a patient that he is suffering from terminal cancer sometimes works. One of my patient’s father aged 83 years was found to have extensive cancer of the prostate. Medically, we all gave him three months to live. My patient did not have the courage to tell his father or the family members that he (the father) had extensive cancer. He took me into confidence and played a game with the family. We gathered all the family members and told them that with the surgery this cancer had been cured. A party was organized in the evening to celebrate the cure. The magic happened; he lived almost a symptom-free life for the next 9 years. I have tried this on many of my patients thereafter and it works. The probable explanation was loss of fear of death, a confidence in his doctor and faith in himself.

The way to live up to the age of hundred is to go on working in life. My great grand–father–in–law was 75 years old, when I got married. That year, he gathered all family members from across the world and said that his purpose of life was over and he would like a collective family photograph and like to quit the world. Nothing happened for a year and he did this again next year. The entire family from across the world gathered but he remained alive for another year. This went on for three years. Suddenly, we played a spiritual trick on him and told everyone to convince him that he is going to live for 100 years as he has many more works of the family to be done. Every year, we gave him law students from within the family to be taught (he was a lawyer himself), or gave him the responsibility of finding a boy for some eligible girl in the family. We made him teach and search for suitable bride/bridegrooms for years together and he actually died at the age of 100 years. This is the beauty of positive attitude in life.