Sunday, July 24, 2016

How a ten minute meditation routine every morning helped me

I have been traditionally wary of meditation. I have participated in a few meditation sessions where a guide would ask you to focus on the breath for a long, long time and I would just not be able to do it.

A few months back, however, I chanced upon an article that talked about a ten minute meditation routine every morning  using an app called Headspace. The author said that he benefited immensely from it. I decided to give it a try. The thing I found attractive was that it was only a ten minute routine.

So, I downloaded the app and tried the ten day free pack they offered. I started to like it. The best part was it was only ten minutes. This did not make it difficult. You can sit comfortably on a chair. The sessions are guided. The guide understands that the mind can wander and says that it is only natural for this to happen. All you need to do when you realise your mind has wandered is to gently bring it back to the exercise.

Another good thing about the app is that it has different parts to it. It is not just about focussing on the breath. There are things like visualisations, introspections and other techniques which make the different sessions interesting and not at all boring.

The key aspect in these sessions is being aware of things and noticing what the mind is thinking and how it behaves. It's almost like you detach yourself from your mind and watch it in third person! This makes a dramatic difference to the way you think.

I have been taking the monthly subscription for four months now and have experienced some of the most profound changes ever in my way of thinking. I know this may sound unrealistic. I could of course say that these changes have nothing to do with the meditation and it is mere coincidence that they have happened around the same time. But I don't think that is true. It cannot be a coincidence. The fact that these happened after about a month of doing this and continue to happen has to have to do with this new change in my routine.

I am planning to continue doing this for now. I have my morning cup of black Darjeeling tea when I wake up and then do the ten minute meditation and then go about the rest of my day. 

Sunday, July 17, 2016

Handling a fistula rupture

For those on dialysis, an AV Fistula is a lifeline. We must protect it at all times. When a fistula is created, we are given guidelines like the following to protect and maintain them:

  • Don't allow Blood Pressure to be measured on that hand
  • Don't allow any injections to be administered on that hand
  • Don't carry heavy weights with that hand
  • Don't sleep on that side
I am quite scared of a fistula rupture. Most people on dialysis have some aneurysms (bloated or bulging veins) on the fistula hand. These are the things which healthy people find scary, weird or ghastly depending on how well they know you! :-)

Many experts have warned me of a rupture. I cannot change my fistula because the number of possible access sites left in my body are low. With nineteen years on dialysis behind me and hoping to continue for a long, long time (unless of course I get a transplant), I need to preserve my fistula for long.

I read this and this article on the blog Big D and me which I found very useful to handle fistula ruptures. The key point is this:

"Press down with your finger and Lift your arm above your head!"

All dialysis patients with an AV Fistula need to memorize this like a mantra and repeat it every day so that we never forget and are ready if and when this happens.

Thursday, July 14, 2016

19 down, many more to go!

Today, I successfully complete 19 years on dialysis! Of these, there have been some years on hospital hemodialysis, some years on PD and most years on Daily Nocturnal Home Hemodialysis. And yes, 11 days on a transplant! Looking back, I haven't done too badly for myself!

Here's to my 20th!

Saturday, July 9, 2016

The National Dialysis Program takes off - surprisingly early!

In this year's budget, Finance Minister, Arun Jaitley had announced the National Dialysis Program which aims to have a dialysis centre in every district of the country under the PPP model. I was skeptical initially on the contours of this program and how it would be implemented. I was also concerned with how long it would take for the program to actually be rolled out.

Surprisingly, many states have already jumped onto the bandwagon and are in various stages of starting the program using the PPP route. The Andhra Pradesh government was the first to do so and has already completed the tendering process for the 13 districts of the state.

This is really a welcome change from the slow manner in which government projects are generally rolled out. Various other states are in the process of rolling this program out.

Some good aspects of the guidelines of the National Dialysis Program:

  • Quality makes an appearance, well, not in the most perfect manner but definitely in a non-insignificant manner! The program talks about staff ratios, separate machines for positive cases, Kt/V targets etc.
  • There is a facility for Above Poverty Line patients to avail dialysis at these centres by paying what the government is paying the providers.
  • There is a requirement for a double RO treatment plant which means even if one plant breaks down, dialysis will not stop
  • There is a schedule of investigations to be performed for the patients and this includes viral markers, iPTH apart from the anemia management and biochemistry related parameters

I am still a little worried about how all this is going to be monitored and compliance ensured. But I have been surprised with the initial pace at which this has happened. Hopefully, I will be surprised in the future as well!

Sunday, July 3, 2016

Aakar Patel's attack on vegetarianism - flawed reasoning, superfluous and badly written

Aakar Patel writes in today's Times of India on "10 reasons why DiCaprio shouldn't preach vegetarianism to desis". The article is about a forthcoming visit to London by RSS chief Mohan Bhagwat for an event of some Sangh group in the UK. Some celebrities like Leonardo DiCaprio and Richard Attenborough are expected at the event to talk about the benefits of vegetarianism.

Before I go any further, I would like to state that I am neither a member nor a supporter of the Sangh Parivar. I am a vegetarian by birth and now by choice.

Patel, for some reason, includes vegetarianism in a purported "war being forced on a majority by Hindutva".

Patel's first reason is that the word 'non-veg' is a word that only Indians use. How that implies that DiCaprio should not talk about vegetarianism is lost on me!

Reasons 2 and 3 contradict each other. First he says that 70% of Indians are meat eaters. Then he says vegetarianism hasn't helped Indians as our life expectancy is low and that our incidence of diabetes and cardiovascular diseases is high. Isn't Patel implying the opposite of what he's setting out to prove?

It is true that Indians have the highest incidence of diabetes but that is due to historical reasons (many, many years of famines where the Indian genes have adapted to store fat and carbs).

In #4, he says vegetarianism does not represent some higher achievement. Okay. So what? The reason many vegetarians are vegetarians is that eating meat seems very cruel. Especially the modern abattoirs which adopt some horrible methods to produce meat cause many meat-eaters to give up meat as well.

In #5, he says Patels are the only low-caste folks that do not eat meat and that is because of Hindutva. This may be true. But that does not mean DiCaprio should not speak about the benefits of vegetarianism! What is the connection between the two? Is there some link between him being a Patel and this point?

In #6, he says meat-eating is a very low-caste thing and vegetarianism is considered a high-caste thing. This could be true for some vegetarians but this is definitely not the case for all!

He then goes on to make a point about Gandhiji's position on meat eating and milk. Again, no connection to the topic at hand.

Point #8 is a repetition of Point #5. In the next point, he talks about eateries that have caste related names. Again, Mr. Patel, this is true for only a handful of eateries! Please do not generalise. I honestly have no clue about what #10, a self-confessed digression, has to do with this topic.

Many vegetarians in India would say that eating any meat is wrong because of the cruelty involved. Killing and eating a cow is as wrong as killing and eating a chicken. Both are life forms. Both experience the same amount of pain and suffering. No one can justify eating a chicken or a goat if they do not eat cows.

Granted, as Patel says, there is bigotry in India. But to make the case for meat eating using this is not fair. Fight bigotry for bigotry's sake. Fight the way some Hindus use caste and the 'holy cow' to attack others. Don't use these to fight vegetarians.

There could be some vegetarians who are like what Patel describes. However, make no mistake, there are many who are vegetarian not because they want to be high-caste, not because they want to be pure, not because Gandhiji told them, but because they genuinely want to avoid cruelty to animals.

One swallow does not a summer make!

Money, power or fame - what gets you high?

I think most people measure success in terms of their acquiring one or more of these three things - money, power or fame.

For a vast majority of people, I am guessing, it would be money. The more money they make, the more successful they consider themselves. They would also look at others and consider them successful if they've made a lot of money.

For people in politics, people in the government, people deciding national and state policies, I would think power would get them high. The power to influence people, the power to change things, the power to change an entire country's future would all be measures of success for them.

For some people, fame would be important. They like to know that people are talking about them. They like to see their name published in the newspapers. They like to know that people appreciate their work. Scientists, researchers, writers might probably come in this category.

There would be many people for whom a combination of these would work. Our Prime Minister Modi, for example, I think would be driven by power and fame. For corrupt politicians, it might be money and power. For businessmen like the Ambanis, it could be money and fame.

There possibly is a fourth thing that drives some people - the genuine, selfless desire to touch people's lives. The people who serve the poor, the suffering without expecting anything in return would come under this category.

I know some people who are like this. Many of the trustees of the Hyderabad based Jain Dialysis Trust (Bhagwan Mahavir Jain Relief Foundation Trust) are like this. I know one of them - Mr. Inderchand Jain personally. I see no clamouring for fame or power in this man. I only see a genuine, selfless desire to serve poor dialysis patients. Even a 2 minute conversation with him leaves you feeling warm and nice. In this world driven by greed, it is people like him who make you feel that humanity still exists. There is still hope.

I, personally, still aspire for one of the original three. I am not going to reveal which! Those who know me well would know. I wish I could be like Mr. Jain however. If I genuinely, selflessly touch even 1% of the lives he has touched, I would consider my life a great success.

Saturday, July 2, 2016

Karnataka government likely to enable free healthcare for all cancer and dialysis patients

The Karnataka State Government is likely to enable all cancer and dialysis patients to get free health care similar to the current facilities available for those below the poverty line. Recognizing that these two diseases eat into the family's life's savings, former Health Minister U T Khader said: "Many patients have been pushed into poverty as they cannot afford the treatment. The move will mitigate their financial problems to an extent."

This is a welcome step. It is a pleasant surprise that a government is thinking on these lines. Both cancer and dialysis render hundreds of families penniless without any guaranteed cure or relief. People who are poor often give up and let the patient die. The middle class are often made poor due to the severe strain the treatments put on the family's finances.

The government must also simultaneously ensure that adequate infrastructure is setup to cater to the increased population that will now avail the treatments. The availability of good quality dialysis centres would be the first requirement for at least the dialysis part. I am sure similar facilities (chemotherapy centres?) would be needed for cancer treatment.

Any number of companies would be interested in partnering with the state government to set up dialysis centres using the PPP route. The government needs to ensure that these centres meet quality standards and are not focussed on making a quick buck.

This year has been good for health care, especially dialysis! For the first time, we hear governments talking about this massive problem. Only about 10% of people who need dialysis get dialysis in India. This can only be changed by government intervention.