Tuesday with Chandra: Father’s day out and day!

Where do I start this week’s blog? Do I start with the unanswered question from last week’s blog? So, who goes first? Almost sounds like a race huh? Well when compete with Chennai motorist sitting in an ambulance you will answer this question right away.

I was back at Chennai on a Friday morning and dad had to be taken to the hospital for an x-ray and review. Since the previous night I was thinking about how we could bring down a 6 foot man on a stretcher through a narrow stairway. We need a Hanuman to lift this Sanjeevi. When we called in for anambulance in the morning I explained his injury and they promised to send a stretcher that could be folded into a chair.  

The paramedics showed up on-time but brought along a plain stretcher instead of the one that could fold into a chair. We had to send them back and make another request for a multipurpose stretcher. The clock was soon approaching “Rahu Kalam” and mom was all tensed and not happy making the trip to the hospital at that time.

And finally when the guys arrived it was close to 11 am. The stretcher neatly folded into a chair and dad managed to sit up. Like a temple Utsavamurthy on a palanquin he came out of his room and there was no Nacchiyar accompanying him on this trip. He quickly passed through the living room, foyer and finally descended two floors, thanks to Johnson Lifts. Before my dad could reach the ground floor all his belongings were loaded in the ambulance. Mom had packed his neivedhiyam, medicines and medical history. Well it was Daddy’s day out!  

I had my fourth ride besides dad in the ambulance. There was a sense of calm on his face and he fell asleep on the way to the hospital. Chennai motorists drive around as though they are driving emergency vehicles. They seldom obey traffic rules and are always in a hurry. It suddenly comes to the forefront when you travel in an ambulance and when every second is precious and crucial. Though we were in an ambulance but there was no emergency this time around. I must tell you that ambulances are equipped with pretty good medical instruments (defib, ecg, oxygen cylinders – not sure if they work) and copious medical supplies. More importantly contents of each of the cupboards were listed on the doors.

On reaching the hospital we went into emergency, but there was no anxiety since it was a regular check-up. The doctors ordered an x-ray and were planning to remove the pin traction (Bohler Braun Traction) if healing was on track and if the femur had descended. While the x-ray was being processed the doctor grinned when they heard my dad insisting on the use a local anesthetic during the removal of the pin traction. Doctors know the anatomy and seldom do they know or feel the pain of a patient. Xylocaine was my father’s trusted friend for the moment and it made traction removal smooth and painless. Finally with the help of doctors for the first time in 24 days his feet touch the ground. More than pain there was a sense of fear on my dad's face.

During my school days I remember my father being summoned twice to have a conversation with my teacher on my progress report. And I now had an opportunity to avenge. Doctors called me in and put up the X-ray film in front of the light source and explained the healing that was in progress around the femur and pelvic joint. Dad was lying besides the doctor intently listening to every bit of detailed shared by the doctor. But doctors needed him to wait for another 3 weeks before they could decide on his surgery.

Soon after our conversation was over dad started a discussion with the doctor over choosing his trusted companion. It was not a Ferrari and we didn’t have to argue if we should go for a petrol or diesel version and fight over mileage. Nevertheless it was going to make him independent, mobile and more confident. Shortly after the decision was made over the model, I brought out the neivedhiyam and medicines while my brother was  arranging for the ambulance to bring him back home.

After father’s day out, more peace and calm seemed to have descended on our house.  And that made me realize that the upcoming weekend was Father’s day. The next morning mom, my nephew and I went to the surgical store in the neighborhood to get home is trusted companion and a toilet throne - just in-time for Father’s day.

Later in the evening when physiotherapist came home and when he made dad walk a little with the walker, my nephew put his hands together and celebrated my dad's baby steps. Anybody who came home that weekend had to hear my 4 year old nephew narrate a story about my dad walking again. What a grandson!

It is not a easy feeling when you are asked to pee into a bed pan or let an attendant clean up your ass. The power was back in my father hand and he was on the seat of power! A new piece of furniture was added to our living room, a walker, and dad’s toilet had a new addition too, a raised throne to potty.

Suddenly everyone’s spirits at home were on a high, not high enough to fly, but atleast walk around with a smile. So this was our Father’s day!

Mom has always been the first person to wake up and the last one to sleep in the house and I am not even sure if she is sleeping well these days. There was a sign of relief on my mother’s face today and importantly the Rahu Kalam didn't trouble her for once. If I could gift her something priceless today, it would be some peace, sleep and lots of rest.

In three weeks we will have to repeat the x-ray and hopefully the cartilage and bones would have turned cosier and healthy. At the moment dad is bonding well with his new companions and hopping around the house.  As they say, one step at a time.....

Tuesdays with Chandra: Hip but not hip hop!

In 2009 December dad underwent a heart ablation procedure (to remove the scars in his heart from earlier heart attacks and reduce the recurrence of arrhythmia) and this was the last procedure to reduce the recurrence after having implanted a defibrillator. We were kind of satisfied after having done everything medically possible and there was nothing more from science. Having gone through 6 consecutive years of frequent hospitalizations, we were optimistic that the tough phase of life was over. But life always has surprises around the corner. After having mastered the heart, it was time for us to graduate to the next body part.

When I answered call on my mobile phone it was 11.30 am and it was mom on the other end. She said that dad had a fall in the toilet and he broke his hip and was in an ambulance on his way to the hospital. It took a minute to react to the news and I had a freeze in my throat. The next thing that came to my mind was medical insurance and savings in the bank to meet out the medical expenses. An old Tamil saying goes like this, “those who don’t have money have no place on the earth and those who don’t have grace have no place in heaven”.

While I was thinking about something different my mother was processing different set of emotions on the ground. Who gets to stay with dad in the hospital? Who gets to run the home and manage the 4 year old toddler? How long will he be in the hospital?  Well we were experienced managing home and hospital after having gone through such harrowing summers year after year. We all waited for him to reach the hospital and have doctors examine him. In the meantime I called up my cousin to go to the hospital and another cousin to head home and stay with mom. Sometimes, staying away from the epicenter helps, it gives you time to think about the next steps – emotionally, physically, and financially without being affected by the incidents on the ground and make better decisions.

Ever since doctors discovered the anomaly in my heart and the need for surgery I decided to educate myself. I spent my evenings watching videos on You Tube and reading medical journals on the latest procedures, etc. And when I got to bed my head would replay the images and text from the journals will scroll at the bottom. After 7 weeks of running the same images and text, my head finally got a break and another set of images and text to process and beam. And this time it was the anatomy of pelvis , not Elvis! It was hip and not hip hop!

Next morning I was at the breakfast table fishing for blueberries in my cereal bowl. The berries had settled to the bottom and I was trying hard to finish the milk with a little spoon and I know I had berries to look forward to. At the moment, life seemed so full like the milk in the bowl but I was not sure if there were wild and sweet berries waiting at the bottom. For the first time it occurred to me that my father was competing with me to get operated.

Towards that evening my brother called and briefed me on the procedure dad had undergone. Doctor put a pin below his knees and connected that to a tuning fork kind of a set up. Weights were suspended from that assembly to gradually help the femur descend from the fractured acetabulam cup. The low ejection fraction in the electrically wired heart prevented the orthopedic from administering any aggressive treatment on my father. For next three weeks dad would in bed and any update on the next course of treatment would be announced based on the x-ray doctors had scheduled after three weeks.

The first storm arrived on April 5 and the next one on May 31 and washed away all my plans for a family vacation. It was almost 20 years since we had gone on a family vacation. My dad was doing okay health-wise and my sister and her son were also planning to come to Chennai for a vacation and I felt this was an opportune moment. But then life has its own priorities. 

Fifteen days back, I was busy putting together a transition plan and organizing my hand over documents at work, while I was also making plans to make my surgical experience pleasurable and memorable, not just for me but also for people around me. I had an excel sheet with to-do list before and after the surgery. I had drawn a list of blood donors and I wanted to give them hand written thank-you notes and gift certificates. I wanted to fill the refrigerator with healthy stuff that my family can eat while I make them go through additional stress. I wanted to mark the right side of my chest with a big X mark and an arrow pointing to my left side, a small reminder to redirect them incase they were looking in the wrong side. I had also requested a doctor friend of mine to be in the theatre to ensure no surgical cutlery; gauze or cotton gets left behind in my chest. I had stacked lose fitting beach shirts to wear while I lie on the shore recovery intoxicated with pain-killers. I made a list of songs that I wanted to hear on my way to the operation theatre and again when I woke up and when tubes took over my body. Curious to know who all got on to my play list? Not now, but later.

I had planned the run-up to the surgery with lots of enthusiasm and I was afraid that everything was going to be postponed. Now suddenly I didn’t know if it was wise to go ahead with my surgery. With two people in the hospital and in two different cities, it would be a tough choice for my mother and family to pick who they would want to be with – my father or me. My leave plan was approved at work, my boss had broadcasted the plan far and wide, and I had finished the transition walk through and hand over. The surgeon’s calendar was blocked and the run-upto to the event was almost done. Life has its own choice.

When I arrived back in Chennai later that week dad was already home. My 4 year old nephew came running and explained in his little voice about what happened to grandfather. I left my luggage, picked up him and then walked towards my dad’s room. The double bed in the room was moved out and now there was a single bed in the center of the room and he was facing the door. He welcomed me and there was a male nurse seated at an arm’s length from him and his bedside table was filled with medicines and appeared like a mini pharmacy. Like a child he explained me what happened and my nephew butted in to give his version. The 6 feet tall man with broad shoulders was helplessly in bed and I was reminded of Shivaji Ganesan in the movie Karnan. Nothing else comes with you in the end, it is just your actions!

Ok I need to take a break. Here is some homework for you.

1. Make sure elders at home have a decent medical insurance and coverage (5 Lakhs each). Here is a link that can help you do comparison and buy one soon.
2. A simple two day hospitalization can run upto a lakh and if there is a surgery involved hospitals can dry up your insurance coverage in a few days. Ensure your insurance covers home hospitalizations expenses.
3. There is also critical illness insurance that gives you a lump sum payment after the diagnosis of the illness. You can purchase that as add on to your existing policy.
4. Make sure you have one year worth living expense available in your savings bank account and 5 Lakh cash towards emergency.

The race is on and I will see you next week with an answer to the question - who goes first? 

TWC: Filled upto my gills

It is Tuesday and I know you must be anticipating my next blog update. I will not disappoint you. Well almighty doesn’t seem to have any scheduling issues delivering my karma week after week and I don’t seem to find a better and cheaper way of therapy! So are you ready for this week?

I know I am not swimming on Dead Sea to expect to stay afloat all life, but sadly every time I come up to the surface to fill my lungs I get pushed down mercilessly. Not sure if it is gravity of the situation or density of the ocean, but to survive I have to evolve and I need to have gills. And this phase of life is all about evolving and developing gills.

Breaking news (definitely not the kind that you see scrolling at the bottom of your TV screens) about my heart condition to mom wasn’t that difficult. Though mother’s can be reactive, emotional, but they reconcile and cool down fast. Mothers remind me of dark colors that absorb heat quickly and at the same time cool fast. Fathers are like light colors, they react slowly, take time to warm up and take time to cool down.

For six weeks until I got all the tests done, results verified, doctors consulted, surgeons and hospitals narrowed down for my surgery I kept things under wrap and out of my father’s ear. I would call home to share updates with mom and brother, and we would refrain from discussing if my father was around. I was cautious from sharing the news to the outside world and didn’t want any Wikileaks finding its way home. It was collusion and stealth between the mother and sons.

That Saturday night, dinner was over peace seemed to be all pervasive in our mind, stomach and in the house. Dad was peeling and popping his medicines one by one and that is when I interrupted and with a silly smile on my face. I was not scared or ashamed and this was as simple as bringing out my report card and putting it under his nose and asking him to sign. We belong to a family were we have issues with both Math and matters of the heart. So I thought he would not fuss or fume.

And finally when I broke the news to my dad, he was speechless and his face turned pale and his head dropped down in disappointment. He knew I had no issues with either Math or matters of the heart and sudden disclosure was pushing him into denial. Barrage of questions followed on the discovery, diagnosis, treatment and next steps. His complaint was that why wasn’t I part of this discovery? And he hauled us over the coals for holding the news back.

I had no intentions of keeping him out of the discovery, but I wasn’t sure how he would react given his heart conditions and complications. Ever since he turned 56, we’ve had our yearly summer vacation in the hospital. And this summer seemed no different for the family. It was not an easy revelation to be digested and I expected him to go through the cycle of denial and acceptance. I gave him a copy of the reports incase he decides to consult another cardiac specialist.

The moment news reached to the extended family they had their own way of reacting, researching and interpreting the congenital defect. Sadly among Hindu families’ people find peace blaming karma for all ailments, congenital issues, etc. rather than understanding the science and biology behind flesh and bones and that we are all breakable, mend able and mortals. Their interpretations were freely floating in the market like pirated CDs. Their unasked sympathy and stupid logic didn’t mean anything to me.

To deal with people at work was a little different. They understood congenital defect as it and were kind enough not overlap other frames to make their judgments. I briefed my boss on my health condition and explained the need for time-off. The next day from people across our offices in India pinged me expressing their grief and sympathy. I felt like I was on the obituary column. I became food for the idle tongues and hungry mouths.

I didn’t worry what people spoke/discussed and I spent the next weeks trying to prepare for the surgery. As a first step I put together transition plan to hand over responsibilities at work, and on the personal front I was counting every penny in the bank account and trying to simulate my total savings account balance on the day of my surgery. Since the surgery was planned in Bangalore I had to make logistics arrangements for my family to come stay near the hospital. Doesn’t this sound like a vacation plan? As a family we’ve done a lot of medical tourism both within the country and outside the country. Dad went for his by-pass to US in early 80s, in 2005 he was admitted in Thanjavur hospital when suffered an arrhythmia and in 2009 he went to Hyderabad to undergo RF ablation to remove scars inside his heart.

The most difficult part was to put together a transition plan. I felt more difficult to put together the plan than my will. I loved my job so much and I was not ready to part with it. But then transition is the only way forward if I had to take time off from work.

I was in Mumbai last week to begin my transition and set the stage for my absence and surgery. When I booked my tickets last week I thought I would work the whole week from Mumbai office and hang out with my friends than head back immediately after transition. One week in Mumbai sounded like a usual annual vacation week. And to be with friends before I go on with my surgery felt assuaging. Thought it will be a regular work week, change of work place and scene made it feel like a vacation. Interestingly there is also a film festival that is opening that week and I thought I will catch a few of them while in Mumbai.

Everything seemed right and okay when I landed in Mumbai on Monday morning. There were no surprises with the hotel room, cab or at work. Seldom did I realize that this was the calm before the storm. Tuesday morning I received a call from home. It was my mother at the other end and she was in tears. I have received 3 such calls in the past decade and they were only serious. She would call me only if she couldn’t handle the situation. Mom had just gone for a routine health check-up the earlier week and the results were due today. I was not sure if they found anything in her health examination.

Now I was transitioning her tears, anxieties and worries. With four year old grandson on a vacation in Chennai, my mother’s hands were full and she sounded helpless. Interestingly this grandson was always around during my dad’s earlier hospitalization episodes. May be he brought dad back home? If you ask him about his grandparents his standard reply would be, “they’ve gone to the hospital to see the doctor”. Even to this toddler hospital sounded like an exotic vacation spot or an expensive cruise!

Till almighty is around and I am alive there will be posts on this blog. For now I am filled up to my gills, come back next weekfor more.

PS: Life gives a little reason to smile now and then, check out http://dipasub.blogspot.com/2011/05/lasting-impression.html

Tuesdays with Chandra: Secret….Sin…..Stones

Some call it sins of the gene, while some call it the secrets of the gene. The former sounds both clichéd and scary while, the latter can sound esoteric. Let us not forget that the world was born from a sin (Adam and Eve eating an apple) and not from a secret. So come on let us discover!


There are two sets professionals who can scare you by sharing personal information - your secrets and sins. One looks at your blood reports, x-rays and scans and the other ones look at the 12 squares and planetary movements to predict your future health. What the astrologers usually call it a sin, the doctors call it the secret of the gene. And today I was not sure if I will come out sin-free or with more secrets and sadness.

After 3 weeks of grueling medical tests in 2 metros and 5 cardiologists’ consultations across 3 continents and discovering the secrets in my gene, there was another rigmarole that I had to go through the analysis of my karma quotient. I had to fast prior to discovering the secrets in my gene, but for the sins of the gene I could go in with a full stomach. That was the only consolation!

Word of mouth had landed us in a densely populated lane in Mylapore. And for the first time my family accompanied me to a consultation, rather I had no choice but to go along with my mother for the karma consultation. Wouldn’t it be easier and logical to locate astrologers in the hospitals and let them do the first reading prior to consultation?

It was 4.00 pm on Saturday evening and when we entered the 2 bedroom apartment, the perimeter along the living room was punctuated with chairs and there was just one vacant chair left and it was far away from the blades of the fan sweeping air across the room. Two fans were sweeping air across the room, but sweltering heat from the setting sun was unquenchable.

An elderly gentleman directed me to take a token and that is when I realized there were 11 people ahead of me in the queue. I asked my mother take the last available seat and surveyed the waiting crowd. Most of them in the room were couples and each of them had a file hidden in a plastic bag and guarded it like a treasure chest. Does it sound like a fertility clinic? Lol! Well all had come to check if they had a fertile future. It was more about destiny than progeny.

People who gathered to discover the sins and secrets of their gene behaved the same way. None in the room exchanged pleasantries or any conversation and yesterday’s news in today’s newspaper seemed more interesting than sins of secrets of fellow humans in the room. To be honest each of them appeared to be carrying a cross in their back. Karma cross? The door to my right opened every ten minutes, a wave of cool air from the air-conditioned swept across and before I could catch a glimpse of man behind the desk who robbed smiles of couples faces and turned them pensive, the next in-line entered and the door closed. Sounds furtive and like Abottabad, huh?

Finally I entered the room and sat for the first time since I got out of the car an hour ago. I shared the piece of paper with 24 squares and gave him a few minutes to read and ruminate on the planetary positions. I am used to people throwing the cheesiest pick-up line “do I know you from somewhere” on me, while this man confirmed that it was my first visit and he had never seen me before. Should I take it as a sign of relief or mark of honesty? Will he display the same honesty when it comes to predicting my future? I was only hoping this man would not celebrate like the radiologist.

Not sure what he said/read came true or not, yet I had to go through this 12 square check without any intense breathing or fasting. May be fasting comes after the discovery of the sin?

It looked like his viva-voce when I was asked to shoot the questions. I didn’t have too many questions, but just one. I wanted him to pick a few favorable dates for a surgery in July. He starred at me as though I was out of my mind and asked me more details. I shared the secrets from the chambers of my heart. After thoroughly analyzing the horoscope (it took 3mins to stare at the 24 square boxes) and he said my horoscope showed no signs of any heart surgery. If at all I had a surgery it could be something simple like stone removal from my kidney or gall bladder. He swore that I could challenge the doctors and avoid the heart surgery and I would still be around to celebrate my 82 birthday. I wish I had come here first to discover the sins of my gene than go for secrets of the gene. I would have saved some money and not developed dark circles around my eyes.

Was it sin vs. secret or astrology vs. cardiology? I was not willingly to argue on the astrological front, but would rather make him understand the seriousness of the heart anomaly. I took a piece of paper and diagrammatically represented the anatomy of the eloped pulmonary vein, but he was far from accepting and the planetary combinations proved no chances for elopement. He looked at the piece of paper that I gave him and started to apply the principles of astrology to disprove science of heart. He was not jubilant like the Radiologist who spotted the eloping vein, but he was more confident and convinced with his science of planet (aspect, position and combination), while I was in no mood to take his side.

He tried to convince me by sharing an anecdote from three decades ago and how the guy is still alive and fit after skipping the cardiac surgery based on his advice. I once again reminded him that I was here to mark the dates for my surgery, and he also realized that I was far from being convinced and he had 12 more waiting in his living room to consult him. He picked a few dates in July and I walked out of the room with not sin, but a new secret and stone to deal with. For now life is all about the S-word.

May be I will come back to him if at I get a chance to mother stones in my kidney or gall bladder. But for now it is Jul 5! Until then let the stones remain stones and be unturned.

Tuesdays with Chandra: Pulmonary vein elopes

The hospital staff was pushing the stretcher and there I was lying in a loose fitting hospital garb. I saw two of my friends and then my parents following me. Sometimes I would lose sight of them in the crowd, and then I would slowly lift my head to get a glance. I had no clue where my brother vanished, he was not someone small, but nevertheless he was missing. An inch long vibuthi adorned the center of my forehead with a tiny mark of kumkum could not hide the anxiety of my face. And the only ones who were cool and calm were the hospital staff who pushed the stretcher.

I had to leave everything and everyone behind and it all started with shaving my chest in the morning and soaking every pore with Betadine. The razor could clean everything on my chest and the solution could only clean my outer skin, but the memories of loved ones and family was intact. For the last time I said bye to my parents and it felt like my first day ever in school, my eyes brimming with tears and over-sized heart filled with memories. I really wanted to hold their hands, just like a new-born does out of insecurity. When I was a new born my five fingers would have curled up around their one finger, but today they were faraway though I could clasp all their fingers with mine.

I was whisked into the theatre area and I was made to wait in the runway for my chance. For one last time I begged the hospital staff to show me my parents and friends. I looked at the glass opening in the door and I couldn’t see any of my dear ones peeping through. I told him I don’t mind getting of the stretcher and walking out to see them for one last time. I didn’t have any money on me to bribe him and all I could do was convince him with my tone and tears. I know my request sounded hideous, but the guy understood my state of mind and obliged to call them in. Two of my friends came in, but my parents had gone down to the waiting area. I held their hands, not sure whose hands were colder, mine or theirs. When I woke up it was 3.30 pm in the afternoon and all this was happening eight weeks before the surgery.

That morning of April 18 after the round of extended tests, I sat with my doctor friend at the lunch table to understand the real issue in my heart. He took the paper napkin started to sketch the anatomy of heart and my anomaly. Should I call it storyboarding? None of the medical terms like “Partial anomalous pulmonary venous return” (PAPVR) made any sense to me. I was still in a state of disbelief sitting in front of him and none of what he said entered my ears and registered in my cortex.

In simple Bollywood parlance, of the four Pulmonary veins that carries oxygenated blood from the lungs to the left side of the heart, one of them had grown tall and eloped and joined the bridging vein aka innominate vein (carries deoxygenated blood) and drains into the right atrium. And to me this news sounded like an inter-caste marriage, a marriage between the oxygenated vein and deoxygenated vein and my heart was harboring the matrimonial secret for 35 years and unwilling to part with it. Was it really a marriage or an affair? It could be whatever, but doctors were now planning to open my chest, separate the vein and put it back in the right chamber. And it is going to be a tough fight, and there would be surgical weapons and some blood shed. Will the left side of my heart accept the new tenant? We have to wait and watch!

My first two questions to the doctor were very basic, how could it happen to me and how come it went undetected for 35 years? I felt fit all through my life, there was breathless only when I pushed my lungs to its limits and that is common among athletes. I have lifted weights for the past 11 years, practiced yoga regularly, actively involved in sports of every kind and even ascended 4 of the 6 sacred peaks in Himalayas. And his answers were plain and simple. PAPVR is congenital; it is asymptomatic and usually revealed on an x-ray only when dilatation of heart happens or later on in life (late 50s) when people are diagnosed with arrhythmias.

What is PAPVR?

Partial Anomalous pulmonary venous return (PAPVR) is a rare heart defect that occurs when the pulmonary veins fail to form normally while the baby is in the mother’s womb. It comprises <1% of all congenital heart defects. The cause of the problem is not known.

In the normal heart, there are four pulmonary veins that bring red blood back from the lungs to the heart’s left upper chamber (the left atrium). Two of the veins bring red blood from the right lung and two bring red blood from the left lung. In a baby with anomalous pulmonary venous return, one or more of the pulmonary veins returns to the right atrium instead of the left atrium.

As a result of this draining, there was volume overload on the right side of the heart (this explained the dilatation) and the lung (luckily, pulmonary hypertension had not set in) was purifying the same blood again. And my body managed to grow this big with a little less pure blood.

With every spoon of rice going down my gullet, I had a question to ask, I know it sounds like a reflux. To my friend it reminded him of his a viva-voce sessions in the medical school.

So what would happen if we leave the condition untreated?

The right side heart muscles will be irreversibly stretched and damaged; pulmonary hypertension (high blood pressure in the arteries of lungs) will overwork the right side of the heart and eventually lead to heart failure. And it can also give rise to atrial fibrillation (abnormal cardiac rhythm in the right side of the heart).

Surgery was imminent and the eloped vein had to be brought back home to save my life. Bringing home may sound simple, but the procedure involves breaking the sternum or moving around the ribs. And I would have mark(s) of a warrior at the end of the surgery.

How soon should the surgery be performed?

Sooner the better was the answer from the medical fraternity. I had no cholesterol, pressure and diabetes and that significantly decreased the risks in the surgery and recovery time post-surgery. Leaving the right side muscles of the heart dilated for a long time may cause an irreversible damage (stretched beyond Young’s modulus).

The bus ride back home that afternoon was scarier than the afternoon dream last weekend. There was some plumbing and tailoring job to be done in my heart. How do I convey this to my parents? The bus was crowded, but still I felt I like I was the only one there, and route that was punctuated with building every inch seemed deserted. There was a tug-of-war between belief and denial. I was just 35 and my chest bone had to split open? "Why me" was the most difficult question hanging in front of my eyes?

Come back next week to find out how I am coping up with this, and how my near and dear ones are reacting to this news.

Tuesdays with Chandra: Culprit intercepted

It would be a lie if I said it was yet another morning, because it was not. This has been my fourth morning in a week and I have been making these trips with an empty stomach to places with a strong stench of phenol. Trust me it is not the most scenic place or appetizing smell on earth. My intestines were already missing the “Cranberry cereal” and it made me a little grumpy and impatient to get done with the procedure.

I was not Kanimozhi going for a trial and didn't have a retinue of minister accompany me to the trial room. Having no family around made all through this journey made it easier because I had to just deal with my emotions and not theirs. It is no fun anxiously waiting outside when a loved one is going through test, trials and tribulations.

I arrived at the lab and it seemed a lot busier than the railway station, does it surprise you? With 1.2 billion people in the country, every place indoors and outdoors is crowded and Bangalore is extra cozier. Awaiting the radiologist’s call, I scanned the waist size of people around me. It was like India map, broadest in the middle. And at the head there was a lot going on like Kashmir. True patriotism, isn’t it? But I must tell one thing about this country amazes me, we are educated, we hold respectable jobs, but we don’t know how to stand in a queue. There was a mob that swarmed the cashier from all sides to pay for their tests. To me it looked like pack of hyenas bullying their prey. A National Geographic moment, but not rare!

There are a few other things that amaze me about the Indian gene. We have no guilt when it comes to littering or defecating in public places and we always look at the easiest way to get things done, even if it means paying bribe. Should we include this in our constitution?

And finally I got my call and before the radiologist let me in the room, he was curious to know if I have been fasting since last night. And he asked me for a copy of my urine test results to ensure that my urea and creatinine levels were normal and my kidneys had the gall to host and eject the spy they were planning to inject into my system.

The CT Angio room looked more or less like a recording studio with the radiologist on the other side of the glass partition starring at the monitor. His objective was to record the anatomy of my heart and scan for anomalies. He explained the procedure, belted me on to the mobile platform and connected the ECG leads to my chest. He belched a few rounds of breathing commands to ensure that I understand and followed the procedure. His voice reminded me of my NCC unit commander in school, strict and Stoic. Very soon intravenous cannula pricked my right wrist and the radio contrast was injected into my body.

While the radio contrast it was doing its round in my body, my mind was making a ticketless travel from Chennai to Bangalore. It had been ten months since I moved to Bangalore and more than 7 years since I lived away from home. When I had to make the decision to move to Bangalore, my mother was finding it difficult to accept my choice, but she cared about my health and happiness and blessed my move. Will the test results make her happy, proud and continue to smile?

The mobile platform soon moved into the annular space and I as the dye travelled through my body, there was no fear or anxiety, and I was going through without a hiss or hesitation. With no family around I realize I was experiencing the unexpected in the new city. A few more lessons were going to be added to the pages of my life today. I had no choice but to accept, and make the experience enjoyable and get through wearing a smile.

Very soon I heard the radiologist talk me over the audio system. This position I was in was very similar to Savasana and he passed on the same instructions my yoga sir would do. With lungs filled with fresh air, dye going around the body, my heart and anatomy around it was pictured. And after every shoot the lungs were let deflate, relax and rest. A warm sensation traveled through my body, but I was not sure if it was from the impinging x-rays or traversing dye or psychological or physiological reaction. I knew the doctors were far from giving up and were in full throttle to carry out exploration mission to nab, nail and noose the eluding culprit hiding my heart.

A few more rounds of inhalation and exhalation and it were all over. Finally the Radiologist walked out of the glass enclosure and walked towards the machine to set me free from action pit. He quickly took my doctor friend into the room and while they scanned through the images on the screen, while I slipped back into my shirt. Except for the cannula prick, the procedure was painless and but will the results be painful?

As I walked out of the CT room, the radiologist exited from the other door. And before I could ask him for the results, he greeted me with his beaming smile and shook hands with me. I couldn’t understand the meaning behind the beaming smile and the handshake. I received his smile and handshake like an award and returned with courtesies without any less respect. He said something that I couldn't hear or understand and towards the end he  threw me a freebie: offered to do an MRI of my heart. My anomaly was celebrated and rewarded! Should I term their celebration as “dutiful and diligent or simply insolent and sickening?

I was not moved by his generosity and at the same time I was not hit by the gravity of the situation. What kept the cardiologists guessing for 10 days was finally solved. As we walked to the MRI room I converesed with my doctor friend on the diagnosis. Was it an arterial septal defect (ASD), or issues with the tricuspid or pulmonary valve or partial anomalous venous return? My throat had gone completely dry by then, but hearing was sharp and I was prepared to hear the bad news. My friend promised to walk me through the results once we get out of the MRI lab.

After a long wait I was invited into the chamber. If the CT Angio lab looked like a recording theatre, this one looked like an execution chamber. I had to again lie down on a moving platform, the process was almost similar except that I was made to go through a claustrophobic cylindrical opening that was more than 6 feet long.

When I first entered the scan cylinder, my heart and lung almost stopped from lack of space and a sense of fear engulfed me for the first time in 10 days. A wollen blanket covered my feet and cold air was blowing over my face. There was just 6 inch space between my nose and the inside of the cylinder. Even if I lifted I could not see my toes or the open space behind my head. I had a headset with a microphone to exchange conversations with the radiologist seated in the glass room. While everyone could see me, I could only see the sheet of fiber 6 inches away of my nose. Starring at the piece of fiber for even a few seconds gave me a headache and I had no option but to close my eyes and inflate, hold and deflated my lungs.

It took 5 minutes for me to get adjusted to the ambience inside and I was hoping the procedure be as brief as CT Angio. I had to divert my mind that was ready to abort the mission and jump out. I felt worse than an airport baggage going through numerous scans. I temporarily fantasized I had escaped earth’s gravity and was floating in the outer space in a NASA aircraft to escape the feeling of claustrophobia. My NASA hallucination soon crashed with my pulse dropping and now the radiologist from the adjacent room reached my ear drums, “sir, breath-in, hold but the exhale command came only after an minute. My like patience my lung capacity to hold air was enormous.

Was the pulse drop due to lack of oxygen, or claustrophobic atmosphere or extended starving? I was not interested in finding answers, but just wanted to break open the machine and walk out like a new born chicken.

After 90 excruciating minutes, I started beating my legs to show my like to get out and pleaded with the radiologist to let me out. I have never done such a thing since my childhood, and to the radilogist i must have looked like a toddler throwing a tantrum. When I came out of the chamber I realized what it is to be trapped in a mine or what is to be born again, but immediately let my lungs swallow all the oxygen in the room. The radiologist applauded my lung power and explained why I was kept longer. I was in no mood to listen to him and I felt like throwing the oversized radiologist into the machine and give him a taste of his extended scanning and his oversized waist.

For the first time I imagined the pangs of staying in my mother womb. I was reminded of Garbha Upanishad.There is so much of love on the outside, yet the chamber inside is filled with fluid, devoid of oxygen and light. If I can stay there for 10 whole months, why is this 90 minutes so treacherous? Not the diagnosis, but just this experience compelled me not to desire another birth cycle.

The search operation was not in the caves of Tora Bora, but in the right chambers of my heart and the culprit was intercepted and caught on camera. But you need to come back next Tuesday to know more on the diagnosis and next steps.

Tuesdays with Chandra: A treasure chest of secrets

Not everybody born on this earth is worthy enough to carry secrets. Is it because they can’t be trusted with secrets? I am not sure! Even some of those who carry the secrets are often unaware till the end. Is it because the secrets they carry are not worthy enough? What about those who get to secrets they carry? Does it mean the secrets are worthy or the agents carrying them are worthy? To find out secrets in my treasured chest and it’s worth you needn’t travel to a land beyond mountains and oceans as described in fairy tales, but just come along with me on these hospital trips. You don't need to be sterile or anesthesized.

I never knew my body was a treasure chest concealing secrets for 35 years. A secret that was elusive to the stethoscope of pediatricians, to the mathematical calculations of astrologers, concealed from my creators (parents) and even today it is still elusive to the cardiologists. Is it really a treasure chest, a ticking time-bomb or both?

I showed up the next morning and this time it was for a TransEsophagealEcho.

The ratio of anxiousness to my usual happy self seemed insignificant. The computer was booted and the doctor ordered the technician to get the meter long probe.

While rest of them in the room respectfully awaited the arrival of the probe, I was asked to slowly swallow a bottle of highly viscous liquid (oral local anesthetic), Lidocaine. The wait for the probe felt like a wait for the noose to adorn my neck, it coming soon for the next few minutes. I knew this was not going to go down my throat so easily and I was not PC Sorcar’s to let the sword down without any struggle.

The oral anesthetic liquid was heavy, odorless, transparent, funny tasting (slightly sweet) and gooey liquid that seemed to defy gravity. I needed extra energy to push the topical anesthetic down my throat. My throat felt funny, heavy and I almost felt like I had an internal goiter. For a second I imagined how Lord Shiva must have felt when he gulped the poison that emerged during the churning of the ocean. That was Neelkant, but what would this be?

I needed no Parvati to keep Lidocaine from going down my throat. The viscosity of Lidocaine was Parvati enough to resist the flow down my gullet and stayed suspended in my throat. Am I Lidokant? And when it lost to gravity my lips, tongue and esophagus turned lazy and sloppy, while my stomach turned heavy and slimy. To give a break to the serious mood in the room, I borrowed a pen from the doctor and scribbled in my palm. “If you had mentioned the thickness of the probe, I could have practiced with a stick of the same size”. The doctor was flummoxed with the secrets in my heart and this unexpected comment only made him chuckle in disgust.

Needles have punctured my epidermis and hungry syringes have intoxicated themselves by lodging into my veins, but never a foreign object gone down my esophageal to picture my internal organs. The Senior doctor took a minute to explain the procedure and finally the meter long probe arrived and skewed the ratio of anxiousness to happiness from insignificant to highly significant. The procedure sounded like a periscope being lowered down my throat while the sonar waves were picturing my heart, veins, valves, etc. The organs didn’t need a screen test, make-up to cover up deficiencies or dialogues to be prompted when the lights and camera were turned on. And when the technician arrived with a long black probe, he almost looked like Yama with the lasso.

I was made to lay down on my left side and the doctor shoved a spacer in my mouth to keep my jaw open and prevent my teeth from clenching the probe during the procedure. I was a little nervous and between the winks of an eye the doctor shoved the probe down my throat. Lidocaine worked, but couldn’t prevent the reflux reaction as the probe lowered down my esophagus. I helplessly watched the monitor in front of me, while the doctors around me were calling out the morphology of my internal organs and as time elapsed they started asking for different views. They were on their journey of discovery.

Everytime they asked for a different view, the probe was turned around I felt a screw driver move in my esophagus. The probe was not hairy, but the motion and movement was similar to cleaning a bottle with a hairy brush. They scanned the walls of the hearts, valves in the heart, crazy veins that routinely couriered blood from my lungs to heart and those wide ones (like outer ring road) that ran from the upper and lower part of the body to the heart directly. Not sure if my heart felt shy and naked, from all the viewing, but it simply refrained from sharing the secrets.

After 15 minutes the effect of Lidocaine started to die down and if they needed to continue their exploration journey I would have needed more anesthetic. With no conclusive evidence the team of doctors finally called off the search operation. The probe was finally pulled out and my esophagus collapsed back to its original size, but my heart resisted to altering its dimension.

Here is the procedure for your viewing - http://www.youtube.com/watch?v=9Us9mXXILSk&NR=1

Not sure if the sign of relief from my heart caught on to the doctors, but I found no feeling of disappointment from failing to unlock and unravel the secret in the treasure chest. I realized that day that our bodies are as much secretive as sacred and you need the right keys to unlock the chambers of the heart.

So did the doctors lack search skills or did conclude my heart to be “tight lipped” and give up on search operation? Will they take up the challenge and find new ways to unlock the chambers of my heart? Come back next Tuesday.

Try to include oats, tomato, apple, avocado in your diet. These lower your LDL cholesterol and keep your artery from clogging.