Tuesdays with Chandra: A Voodoo Doll for Seven Days

A week has elapsed after surgery and there is still pain and fatigue lingering, but that has not prevented the new crop of hair from popping out of my skin, I look like a man-sized cactus. Every time I adjust my dhothi and shirt, it feels like pulling piece of cloth entangled over bush of thorns. For a change I am thorny!

The idea of having someone help you scrub your back and douse you with mugs of water and wipe you (while you are in an adulthood) can sound “Guzzarish” but having none besides me was more like “bizarrish”. For the first time in a week I managed to give myself a bath without any help, though mom prepared the water with some antiseptic solution, and placed the bar of fragranced soap near the bucket and left the towel in the rack. The last time she had prepared something like this was when I had measles (25 years ago).

The endurance and fitness that I built through 12 years of disciplined routine won some admirers and appreciations evening the hospital but seem to all have vanished for now. Every action had to be slow and almost hitting the pause button for a few seconds, and anytime I tried to increase the pace of the activity my body reacts very differently. The surgeons had corrected the direction of blood flow in my heart but bouts of palpitations, lumps in my throat and sweat beads in my head was a testimony to unhappy and angered heart. How do I placate him?

Starring at the mirror and wiping my body after bath, I examined the wound and ran my fingers on it to register the contours and marks left behind by the serrated surgical knife. While I was wearing my Hawaiian print shirt I noticed 4 attempts made by the medical community to get a Central line in place for loads of Heparin to be pumped into the system. The needle marks from the two peripheral lines used to pump antibiotics and two arterial lines for collecting blood samples in either hands was still visible. I realize I was a voodoo doll for seven days punctured by needles, lying in a maze of colorful tubes taking and bringing fluids into my body and in the spell of doctors.

Finally when I sat down this morning after prayers, I felt like I have some conserved energy from not socializing to be used towards recording and sharing my seven day experiences (Resurrection?)

Day d-2: Bags were packed, itouch, gas tanks, car tires and snack bags were filled to the capacity for the journey, doesn’t it sound like a family trip? With my brother in the driving seat, me in the front passenger seat, while mom in the rear seat, the car cruised on NH 4 at averaging at 70km/hour. In 5 hours we reached the Silicon Valley of India. The first day was spent pretty much unpacking and giving my brother, mother an orientation of the neighborhood and discussing hospital roles and responsibilities with my friend over for dinner.

Day d-1: We waited for Rahu’s time to get over, the Mumbai Stock Market to open and a few minutes after nine am we left the service apartment. With brother driving mom and me with a packed bags and dropping us at the curb made it appear like some vacation. Before proceeding towards the admission area I took them on a hospital tour to help them familiarize with the place. At quarter to Eleven before I was given the keys to my private room on the eleventh floor, the doctors called me and my family in for a meeting to all risks related to the surgery and ask us to sign the consent forms and protect themselves and the hospital from any possible lawsuit. To live, everyone needs some immunity in this world in the name of consent. There were no surprises or chaos and everything in the hospital seems to follow a logical process.

11:00 AM: I was escorted by a hospital staff to my private room: a large room with huge windows overseeing the old airport. Atleast a hospital room with a view if not an office with a view.

The welcome kit had a booklet with all instructions for the patient’s attendant and the bed had a towel and hospital wear. Within minutes the nurse collected my earlier medical records and asked me to change to hospital gear; while she arranged the set up to measure my height, weight and other vital parameters. Soon the hospital staff parked a wheel chair outside my door to transport me to the Echo and X-ray labs. Looking at the staff I was not sure if she would be able to cart me around and moreover I was healthy to walk. 

12:30 Noon: Walked over from the Echo lab to the blood bank to find out if my donors had turned up without fail. There was one no-show, but I had a Plan B! I was getting close to my lunch time and was getting tired and irritated with delays at the Echo Lab.

3.45 PM: Shortly after the lab visits the barber arrived to prepare my body for the surgery. The razor sharp blade harvested almost a kilogram of hair from all over my body and for the first time I saw my real skin hidden beneath the hair; it was wheatish and healthy. Post shave, the nurse handed over a bottle of Betadine solution and gauze to scrub my body. A few drop of Betadine was enough turn the bucket of water bloody, a 100 ml of it turned the bucket deep red and frothy.

4:45 PM: Hardly a few minutes after the wash and scrub the surgeon arrived with his junior opened up my shirt, starred at my clean, bacterial and fungal free chest and briefed me about the next day’s procedure, duration, etc. The doctor and his team seemed calm, comfortable and confident and asked me if I had any questions about the procedure. He asked me if I had some auspicious time during which I need to be wheeled into the theatre. So his last word was, “All the best and let’s see you on the table tomorrow.”

I was surrounded by friends and family and it was a good hour to gossip, discuss politics, make vacation plans and here and there make references to next day’s procedure. I was not sure who brought in anxiety into the room and it was hiding in the corner waiting for the rest to leave.

6.45 PM: The last medical staff to visit me that evening was the Anesthetist. The poker faced women in a surgical garb ran through a printed sheet of questions noting down my medicine allergies, etc. finally she noted down my weight to calculate the amount of sedation required for the surgery. I looked at lurking anxiety in the corner and expressed the need for an anxiety medication for the night and the plan for pain management post surgery. she said I was going to be on Fentanyl (100 more potent than Morphine)

7.30 PM: Visitor hours was over and all my friends had to leave. I was left in the room with my mother and anxiety. Nurse came to remind me that I should finish my dinner by 10 pm and not take any fluids after 11 pm.

9.30 PM – The dinner was so unappetizing that I made my mother eat the dinner and While enjoyed a full bowl of cereals. The Nurse walked in while to check if I had finished my dinner. She handed over two pills and gave me a run-down of activities for the next morning. She collected a few more films and reports to be made available for the surgeons in the OT. I reminded that the Anesthetist consent was yet to be signed by my family.

From dawn to dusk I was physically and mentally busy preparing for the surgery. I was only hoping to have a restful sleep. Did the anxiety medication work or make it worse?

D-day:

5.30 AM: The Nurse knocks on the door and I answer it. Before she hands over the bottle of Betadine scrub, a set of new clothes and a towel, she verifies the last time I consumed fluids. I asked her if she heard back from the doctor on the surgery time. She said she was awaiting a response.

6.00 AM: I came out fresh and clean from the toilet and sit on the freshly made bed. I complained to my mother that I hardly slept after having taken over by anxiety and nightmares. I cursed the poker faced anesthetist and I hoped her cocktail to work today. But then I had to be positive

7.00 AM: A few doctor friends of mine arrive; we read the newspaper and exchange some banter and gossip from the newspaper. I switch off my mobile phone.

9.00 AM: My stomach starts to growl and I walk up to the nurse station to check on the surgery timings. I wish they had let me sleep a little longer. Anand’s mobile burps, my friend Stephanie sends a message to check if the procedure had started.

10:00 AM: Nurse comes over and announces the earlier surgery has run into complications and is taking time to wheel me in. I complain that I’m thirsty and hungry. I know how much ever I complain I would never ever get to see water. To stop me hunting for a waterhole the Nurse starts me on intravenous. I remind her that a consent signature is due on the Anesthesia form.

10.45 PM: I was tired of handling the anxiety and wait though I know I was going to transition them to my friends and family as soon as I enter the operation theatre. But for now I was restless and wanted to be rushed into the theatre. The junior surgeon in surgical attire, shows up to check on my condition and says I will be wheeled in at noon.

12 noon: Finally the much awaited stretcher arrives, the room turns quiet and family and friends stand up to give me a fitting farewell. It almost feels like I’m headed to the execution chamber. I asked the nurse if she would allow me to walk to the theatre, but she insisted that I should lie down on the stretcher. L I still don’t feel like a patient! The old patient identification tag is now replaced with the broader tag that gives more details (blood group, type of surgery, doctor’s name, etc.)

12.10 PM: We are still on the 11^th floor waiting for the elevator. I put my head up from the stretcher, while rest of them stand away from me. I keep smiling while the rest and stare at me as though I’m some museum piece.

12.20 PM: I being pushed in the OT area and for the last time I wave back to my followers. I enter the theatre complex and the anesthetist asks me a few basic questions to ensure that I am the right patient. He realizes that a consent signature is missing and calls for my family again. Who would turn up? Will it be my mother, brother or close friend?

12:25 PM: My doctor friend shows up and swears he is my cousin and signs the consent form. He walks upto me and says a final bye. Then the theatre staff asks me to scoot over from one stretcher to another. 

12.30 PM: The stretcher makes a left turn and I notice the first theater to my left was busy and a bright red bulb indicated the same. To my right I see a bunch of doctors enjoying their cups of coffee after the surgery. None of them were smiling, but I wanted to wave at them. We skipped the second and then enter the next theater.

12.31 PM: The anesthetist walked ahead of me and gave me a warm reception. I surveyed the surgery room and it was in no way close what we see in the movies. I was well lit, clean, spacious, mobile shelf packed with surgical instruments, while those to be used for today was sterilized and packed in a green cloth and kept ready. I was once again asked to scoot over from the stretcher to the operation table.

12.32 PM: The table was not very spacious and the doctor asked me move up a little more. They gave me a little head rest that was no very comfortable. I was sure I was going to sprain my neck from using the head rest. The chief surgeon was yet to arrive.

12.33 PM: Anesthetist stood to my right and briefed about the procedure for a few seconds. He said he would inject a mild sleeping drug for me fall asleep. I looked up at the clock again while the drug was injected through the arterial line. The assistant held the oxygen mask at a distance and before the LCD display moved to the next minute I was knocked out.

Did I wake up in the middle? How long did the surgery last? Was it a simple surgery? Come back soon for more updates.

Tuesday with Chandra: The Story of US!

It is “us” time and here is an anecdote from last afternoon that precipitated the emotion in me and propelled me to write about our discovery and recovery. We were at “Rolls United” over at the first block in Koramangala for lunch. Nothing fancy for lunch, just rolls from all different cuisines in the world. We dropped the conversation abruptly and sifted menu card hoping to find what we wanted after an earlier disappointment from looking at the list of crappy movies playing in the city. I flipped the pages and fervently looked through from cover to cover only to find a nice salad, but to my disappointment it was parked under Monday’s special.

Hardly had the chalk dust settled down on the floor or the manager had come closer to the take the order, but my friend instantly ordered “Moroccan Eggplant Salad” while the manager was still filling up the empty space under the “Today’s special” column. We both came back to the menu, scanned through the remaining items and found our eyes transfixed on the same item and that is when she looked at me and said “they are going to think you are my husband” and I said “just because you know I was going to order some homemade lemonade and I know you would order Moroccan Eggplant Salad”. Some serious giggles were a part of our starter menu until the aromatic and intoxicating tomato basil soup and bouquet of Goodmorning Vietnam - shredded carrots and beetroot wrapped in rice paper and garnished with peanut sauce arrived.

When I moved to Bangalore she had just moved in and was still living a hotel room. Everything about the city was still new and unsure, but what made our lives easier was the friendship and stories we shared at the end of each working week. There was more than the lemonade and eggplant salad to make it all look scandalous. We made sure the new living room furniture went well with her existing furniture; we lay down besides each other and tested the comfort of the mattress while we recalled Charlotte and her partner testing the mattress in of the SATC episodes, and we sat in the dining chairs to ensure they were strong, comfortable and entertainable. Every trip of ours to the shopping mall or to the movie theatre was fun filled..

Two friends leaving their family behind, boldly embracing changes in their lives, moving into the new city with hope, helping each other settle down, and courageously facing challenges thrown by life isn’t new and caring about each other’s small comfort and happiness in many ways, sound scandalous, huh?

When I had to go through my extended diagnosis and tests in Bangalore she offered to take time off and stay besides me during the tests and send her car to take me back and forth from the hospital. With mom completely busy with dad’s broken hip in a different city, I thought my friend would be around me on the day of surgery. But all that changed when I received her sms last Friday afternoon, but that didn’t change our Saturday meeting. Our Saturday meetings were fixed – it was lunch at a nice restaurant, maybe a movie, but definitely a coffee shop followed by some errands and prepare for the week. This Saturday was no different, and we both had something in common and something soon coming up and we were out together checking each other’s to-do list.

Even before her SMS arrived on that fateful Friday afternoon, our plan to spend the last weekend together before my surgery was all fixed. But SMS made our Saturday meeting absolutely mandatory. When I mentioned the contents of the SMS to a colleague cum friend at work she was afraid to call her my friend and was ready to relinquish our friendship!

With my dad breaking his hip and giving me a stiff competition for surgery, my friend’s SMS only turned the surgical race more nervous and nail-biting. I couldn’t digest the fact that our surgeries would be just 24 hours apart. I was expecting to see her when the effect of anesthesia wanes out but now we were going to spend our days in different hospitals. But still we plan to keep texting each other from respective hospital beds complaining about nurses, doctors and our pain!

During the lunch break at Rolls United she mentioned about signing another year’s apartment lease during the week. A year was almost over and we were still shopping for some more furniture for her house. Thanks to my dad’s fall, it helped me come to speed on the hip stuff and now I was a self taught expert and ready to help my dear friend on a different kind of shopping trip. The ritual was still the same, we tested to ensure the chair was comfortable, the potty seat extension was safe, the walking aid was sturdy and we all ensured that all these were home when she returned from the hospital. There were a few things that I had to go around and check before she goes under the knife, while she had a check-list for me. We even checked on each other will – life support system, property, etc. Sounds like a friendship in geriatric years?

My friend had been suffering from a bad hip and a replacement surgery was imminent. In our earlier Saturday meeting I asked her to schedule the procedure after I had fully recovered so that I could be around her. But the Friday consultation with the doctor revealed that her hip needed immediate surgery and medical attention. Though we couldn’t be in the same hospital or be besides each other during hospitalization, but we have decided to join each other in recovery. As of now we would come home the same day and the spare bed in the other room was ready for me. Over a piece of cheese cake and coffee that evening I was telling her how we could spend time sculpting the head of her femur, while she was making ideas to stitch frock and make a finger puppet out of it, and do shadow plays. Then we discussed how to make SOS calls between two rooms, and how we can watch all episodes of SATC and Desperate Housewives back to back! Food was always a part of our conversation and she said she had a copy of the menu from Rolls United and they did a home delivery. In pain, pleasure, party and in recovery we are together as friends!

You can’t choose your family or relatives, but you can choose your friends. And I have had friends  with whom I had studied, shopped, partied, toured, but not the ones who would go together for a surgery. Sounds weird, huh? Every dot that appeared on our pages of life, we were connecting them and coloring them with hope, happiness and trying to discovery new meaning very often. It was not fun, but we made it fun and next few weeks will be the Koramangala  way - The Rolls will be united in recovery! Thanks Bangalore! We were making more than lemonade from lemons! And that is the story of US!

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.