Inhuman doctors

I was recently contacted by a fellow dialyzor from India. He has been on dialysis for more than 15 years now. He has had some tough times. I was appalled however to read about the attitude of his doctors. He has got no support from them.

Doctors have a special responsibility. They are not dealing with machines. They are not even dealing with human beings who have had a normal life. People with chronic conditions go through a huge amount of mental stress and depression. They deserve a lot of compassion. Who knows this better than a doctor?

Doctors know exactly what a patient goes through. They know the symptoms, the pain and suffering. They know the side effects and all the co-morbidities that people on dialysis have to deal with. How can some of them then be so indifferent to the plight of their patients?

Again, all doctors are not like that. I have, for the most part, had doctors that were extremely considerate. They would happily engage in a discussion about my condition. They would answer all my questions very satisfactorily. Sadly, all of them are not like that.

The person in question has been threatened with discontinuation of his dialysis if a particular wish of his doctor was not fulfilled. (I am intentionally leaving out the details because I don't want to compromise his position.) This kind of blackmail is downright evil. It is against the basic tenets of humanity, let alone the medical profession.

The techs in his unit are hardly qualified. He is not answered properly when he asks questions regarding his dialysis. I can tell that he wants to know. Which is a very good thing. He browses the internet looking for answers his doctor should be giving him.

This is really bad. We really need a support system for people on dialysis in India. Where people can go to when they are faced with problems like this. Some doctors can be quite vindictive if they realize you are taking action against them. We need a system by which patients can be educated on their options and how to get the answers they want without compromising their treatment due to the offended sensibilities of their doctors.

Merely blogging about this is not enough.

To start or not to start - that is the question

This incident really brought back all the questions I have always had about my home hemodialysis and more importantly, whether I should start the treatment myself or not.

Whatever you say, there is an element of risk involved. But then, you can argue, isn't life itself full of risks? There are tons of people doing home hemo all over the world. Many people do it alone at home without anyone to call out to for help in case of an emergency.

There is one important difference between their situation and mine. Training. Everyone I know on home hemo has undergone four to six weeks of formal training. They are taught what to do in case of an emergency. What to do when something goes wrong. How to recover quickly from an error.

We are humans, after all. We are bound to make a mistake once in a way. The important thing is to recover from the mistake, take corrective action and get on with the treatment. That is one thing that I sorely lack. The ability to get out of a mess caused by a mistake.

Even techs or nurses in a hospital or dialysis center setting make mistakes. I have lost a circuit of blood once many years back. But since they have the infrastructure and the training to deal with them, it is is usually not a problem.

Also, since I am undergoing dialysis daily, the process is in itself, much gentler compared to conventional in-center hemodialysis. So, the chances of anything wrong happening during the treatment itself is much lower. The risk is of human error while starting and closing dialysis.

Yes, a checklist will help. I must try this. The only thing is, once you use the checklist for a few days, you tend to get complacent and not go through the list. Anyway, for a few days atleast, I am not going to start treatment on my own. Or at best, will start only when the tech is present.

A really scary incident

Yesterday, my dialysis tech was going to be late. He's going through some pretty tough times professionally. He came early, primed the dialyser and tubes and got everything ready and left. I was to cannulate and start the treatment myself.

By the time I got back from work, he had already left. He was to return a few hours later and did not want to delay my dialysis session. I had dinner and then started the process.

I first cannulated myself. No problems. I was anyway doing this even when he was there. Then came the part where I connect the needles to the tubes. I connected the arterial tube and then realized that that the dialysate flow was off. This is usually done when there was a long gap between the time you primed and the time you started the session.

I quickly started the flow. But the conductivity takes time to come to the normal level once you start the flow. By the time the blood had reached the end of the line, the conductivity had not yet reached the normal level and gave an alarm. I connected the venous line and thought I would have to "reset" a few times for it to settle down.

For some reason the Trans Membrane Pressure (TMP) shot up to its maximum level and so did the venous pressure. I was surprised. This had never happened before. I tried resetting a few times. No change. Then suddenly, blood started coming out from the dialyser's two ends. I started to panic. I noticed that the tubes were not screwed tightly enough. I tightened both ends. The blood stopped leaking. The alarm however did not stop. The TMP and venous pressure continued to be at their maximum levels. Dialysis was not happening.

Blood had also gone through the venous line into the protector. The venous chamber was also full.

I shouted out to my mother and asked her to call the tech and put the phone to my ear. I got him on the line and explained the situation. By then the blood in the tube had become quite dark and was almost black. He asked me to check if the clamps on the tube and the needles were open. That was it. The venous clamp was closed on the tube at the point of connecting to the needles. I opened it immediately.

The alarms still did not stop. The TMP and venous pressure were still at their maximum levels. I removed the venous chamber from the Air Bubble Detector and also removed the venous line from the protector. To no avail.

The tech then said he was on his way. He sent his brother, also a dialysis tech who arrived in about 10 minutes. All this while, I had the venous chamber in my right hand and was resetting the machine with the left. The blood was regaining its natural color. But the alarms were not letting up.

He asked me to lie on my bed. I did. He then put the venous chamber back. With a syringe he cleared the protector of the blood and reduced the level of blood in the venous chamber. The alarms finally abated.

The brother of the tech wanted to leave as they were all having dinner out. My mother would have none of it. She said there had to be one person during my dialysis session. The tech came about an hour later and his brother then left.

The one mistake of not opening the clamp caused all this. I was quite shaken.

I love you Pratheeka!

Pratheeka who?

The host (RJ) of Full2Bindaas.

What Full2Bindaas?

A show on 93.5 SFM.

What 93.5 SFM?

A radio station in Hyderabad.

When does it air?

Every evening 6 to 7 in the evening.

Why all the luv-shuv?

Well, she is really funny. In a different way. Very silly. Despite that, can make you laugh uncontrollably! She speaks in a mixture of Telugu, Hindi and English, plays Hindi and Telugu songs. Is famous for "cutting" people. Totally insulting them (in a funny way). Some people find it "faltu". It is meant to be. I like "faltu" stuff sometimes!

Every day, she chooses some question. People have to call in to a number and tell her the answer to the question. You can also SMS your answer to the question. She reads a few of the SMSes on the show too. Simple questions. For example, how would you spend Rs 10? Or on a rainy day, what would you really like to eat or drink and where? Who would you take with you to the moon? For the last question, she added, "Now don't say boyfriend/girlfriend!"

It is usually on on my way back from work. It is the perfect way to relax after a tiring day.

Keep going Pratheeka!

Mayawati's monument mania

Aren't statues of only dead people erected? Not any longer.

Mayawati has taken Indian politics to a new low by spending around Rs. 1,000 crores on building mammoth monuments that has statues of Ambedkar, Kanshi Ram and herself apart from hundreds of huge elephants, her party's symbol. This is really ridiculous. Never before in the country's history have we heard people erecting their own statues. When she got to know that the Supreme Court was going to hear a PIL regarding this, she advanced the inauguration of these monuments.

The court has given her four weeks to respond on this.

Mayawati's actions have been the most blatant example of self-aggrandizement we have seen in recent times. The levels of corruption in Uttar Pradesh, one of the poorest states in the country have risen dramatically. There are fixed rates for government contracts. Everyone knows about this. Nobody can do anything about it.

The self-proclaimed messiah of the dalits could have spent this money for their upliftment instead of pandering to her own ego. Imagine how much can be done with this money! Yet, despite all this, she continues to be regarded as the hope of the dalits by many.

These are instances where I feel the judiciary needs to act more strongly and proactively. There should be more stringent action and punishment. People like Mayawati need to be taught a lesson they will not forget. They need to told, in no uncertain terms, that they cannot take the country for a ride.

Dear Nicky

First of all, thanks for awarding me on your blog! I am so excited! Wow, the "Most Thoughtful Posts which also make the reader think award". Sounds quite good. I never realized my posts were thoughtful. I consider my blog to be very mundane, about the simple things in life. Swimming, idlis, dialysis etc.

Anyway, I am writing this to you to let you (and through the blog others) know how much I appreciate you and your blog. Girls like you are very hard to come across. Fearless, frank, WYSIWYG.

I have for the longest time appreciated girls who are of the traditional kind. Home makers, shy, not too ambitious. Well, yes, I know you are going to hate me for this. But, hang on, I have changed over time. No, seriously!

One complaint I have though - some readers of my blog have followed the links to your blog on your comments to my posts and have become fans of your blog. So much so, they are now more regular readers of your blog than mine!!

Thanks again Nicky for the award. It means a lot to me!

(P.S. Those who haven't read Nicky's blog, please do so. It is freakin' awesome. It is called BitchSena. Need I say more?)

Did you attend the asyw agm? Shit, I missed it too!

In fact a whole lot of people missed it. In fact just about 28 people attended. The 28 members.

Recently my Facebook home page was flooded with messages about the asyw agm. WTF was that I wondered? I first thought it was some auto show which the whole of Hyderabad was attending. Then I wondered why there would be an "AGM" for an auto show. I took the trouble of clicking on the asyw that was helpfully linked in the messages.

You know what it turned out to be? Agarwal Samaj Youth Wing. You have never heard of this? Come one, ASYM - Agarwal Samaj Youth Wing - the second most important institution in the world - after the UN. Like, everyone just had to know what it stood for. They had their Annual General body Meeting (AGM) recently. Billions of blue blistering barnacles! What a hue and cry! And how many members does it have? All of twenty eight! Why call a meeting of 28 people an AGM? Heck, our family get to-gethers have more people!

Well, I am just kidding. In all likelihood, the group in question probably does a lot for charity. Once a year, they probably have their fun in a five star hotel. Nothing wrong with that.

This goes to show however what Facebook can be. A few years back, one would have thought what was the use of anyone knowing what they were up to? For example, why would I be bothered if Akbar saw a sandwich called The Obama or if Rishit breathed a sigh of relief and it is Dot Net (ugh!)for Rajesh. And no I am not interested in which Simpson's character you are like or which color defines you. No, I couldn't care less about when you will find true love. The quizzes really get to me. And people take them like their life depended on it.

In spite of all this (or is it because of all this?), I check Facebook religiously thrice a day and many times on my phone in between. I am totally addicted to it!