Saturday, July 25, 2009

Battle at Poorna Tiffins

Thrinath, a former colleague and a dear friend challenged me to a competition a few days back."Who can eat more idlis?" Wow, I thought. Who could eat more idlis than me? This was going to be easy. I agreed. The bet was that the loser would pay the bill. Simple enough. The date and time were fixed. Saturday, 25th July, 8:30 a.m. at Poorna Tiffins (where you get arguably the best idlis in town).

I added a caveat. The idlis had to be with ghee. Thrinath preferred idlis with ghee too.

So, the stage was set. Saturday it was.

To be honest, I was pretty confident of winning. I'm going to let you into a little secret. But promise me you won't tell anyone. I eat a minimum of 16 every Sunday morning when I go to Poorna Tiffins. On occasion I have also touched 24. 20 is the average. Who could eat that many? People who have accompanied me have rarely eaten more than half of what I usually do.

Thrinath also roped in Santosh Ramakrishnan, another former colleague into the bet. It was going to be a threesome. The bet was modified so that the person in 3rd place would pay two-thirds of the bill while the first runner up would pay a third.

I was all charged up. Saturday morning came. When I got up, I actually debated whether I should have my daily cup of Darjeeling Tea. If I did not have it, I could probably eat a couple of Idlis more. But I told you I was quite cocky about this whole thing. There was no way I could lose. I went ahead and had the tea.

I then left for Poorna. Thrinath and a few other former colleagues were already there by then. Santosh arrived a while later. We started the competition.

Each of us took 8 idlis to start with. They were heavenly as usual. Soaked in ghee with the spicy chutney. Thrinath was slow. Santosh and I gobbled them up quickly. The only person I was scared of was Santosh. There was a lot of real estate there that could be put to good use in competitions such as this!

All of us took another eight. Thrinath was still quite slow. Santosh had also slowed down by then. I thought both were struggling. I comfortably finished them. I took another four. I had finished 20 and was totally full. I waited while my other two competitors took another 4 each. I was quite surprised and disappointed too. At the end of this round, all of us would be at 20. A three way tie, I thought?

To my utter shock and horror, Thrinath asked for four more and Santosh asked for two. The waiter, by then had figured out we were in a bet and he put two in my plate too. I struggled to finish them. Thrinath and Santosh slowly finished their four and two respectively. There was no way I could have had any more. I got up and went to wash my hands. Just then I heard Thrinath ask for two more! I could hardly believe my ears! Santosh ordered a Poori bhaji. I almost fainted. It was too much for me to take.

The prime consumer of idlis had just been defeated fair and square. The king tuned out to be a mere pretender to the throne. Thrinath was the new king. Santosh and I split the bill because we came a joint second. The poori bhaji did not entitle him a sole second place. This competition was about idlis after all!

At the end of the day, I was lesser by about Rs. Three hundred and thirty and a lot of ego.

Thrinath, finishing his 26th idli

Santosh, enjoying the poori bhaji - after 22 idlis

Friday, July 24, 2009

Phosphorus continues to baffle

Day before yesterday I started adding a phosphate solution to my dialysate so that too much Phosphorus is not removed from my blood during dialysis. The normal range for Phosphorus is 2.5 to 4.5 mg/dl. Mine has been between 1 and 2 mg/dl post dialysis.

I have been taking a phosphorus supplement called Neutraphos but it has not been helping too much because the removal of Phosphorus during dialysis was a lot.

Yesterday, post dialysis, my Phosphorus was only 1.1 mg/dl. This, after adding the phosphate solution to the dialysate. Yesterday, I had two packets of Neutraphos before dialysis. This morning it was 1.7 mg/dl.

I'm wondering if it is safe to increase the amount of phosphate solution further in the dialysate.

Thursday, July 23, 2009

Way to go, Justices!

The Andhra Pradesh High Court directed the state government to stop funding religious pilgrimages. This was the judgement in two Public Interest Litigations filed against the Andhra Pradesh government's decision to fund pilgrimages of Christians to Bethlehem and other religious places. This judgement apparently also covers the subsidy to Haj pilgrimages.

This judgement must be welcomed by all.

What business does the government have funding religious pilgrimages? Isn't this a blatant example of minority appeasement by the politicians of the country? Why are only Muslim and Christian pilgrimages subsidized? Now, I am not, for a moment, suggesting funding Hindu pilgrimages at all. No religious pilgrimages must be funded by the state. Period.

Clearly, the government has got its priorities all wrong. Every year around Rs. 400 crore is spent on the Haj subsidy. Add to this the amount proposed to be spent on the Christian pilgrimage subsidy. Just imagine how much can be done with this money!

I did a quick calculation and realized that a shocking 28,000 people can be given free dialysis for a year at a corporate hospital in India with that money!!!

This is just one example. But it goes to show how wasteful that expenditure is. What has the government got to do with religion? Especially when we claim that we are a secular nation.

The judiciary has once again proved that it is capable of rational thinking. The judges must be complimented for this. I suspect, however, that the government will find a way to wriggle out of the embarrassing situation it finds itself in. But these kinds of judgements are welcome. Hats off, Justices!

Wednesday, July 22, 2009

An enterprise of honorable, dangerous consequence

I can't get over Shakespeare, can I?

Well, the title is only partly true. It is more an enterprise of healthy or dangerous consequence! Only one of the two really. Let me explain.

As you probably know, I undergo daily nocturnal dialysis. Which means that I get considerably more dialysis than your average Joe who usually gets about 12 hours a week. I get around 42. There is a downside to this.

For most dialyzors, Phosphorus is not adequately removed during dialysis due to the infrequent and relatively short sessions they get. They need to take Phosphate binders that remove the excess Phosphorus from their blood.

I get so much dialysis that excess Phosphorus is actually removed from my blood. So much that my Phosphorus is - hold your breath - below normal!

I have been taking Neutraphos, a Phosphorus supplement. This is one of the ways to treat this but not ideal. My Phosphorus probably goes below normal towards the last 2-3 hours of my dialysis. Then I take the supplement after a couple of hours of this. So, for a long time, my Phosphorus is below normal.

The amazing Dr. John Agar suggested in a webinar on Home Dialysis Central that a phosphate additive be added to the dialysate so that too much phosphorus is not removed in the first place. They add a phosphate solution (I am leaving out more details on purpose. You don't want to know. Trust me) to the dialysate for most nocturnal dialysis patients in Australia.

A similar solution is available in India too but the composition is slightly different. So, though the dosage is standardized in Australia, I am going to have to do a little bit of trial and error to arrive at what will work for me.

The consequences can't be too bad however, given that I am going to start with a low dose, measure my post-dialysis Phosphorus and then keep tweaking it till I get a good post-dialysis Phosphorus.

My Class 12 Chemistry has really helped me in this endeavor!

I start trials today. Wish me luck!

Monday, July 20, 2009

What's happening in the Afzal Guru case?

So today Ajmal Kasab finally confessed. Let us see how the trial now proceeds. Hopefully, it should be brought to an early end.

This brings me to Afzal Guru. The Supreme Court pronounced him guilty in the attack on Parliament and upheld the death sentence that was announced earlier. He filed a mercy petition before the President who forwarded it to the Central Government. The last I heard about this was that the Central Government had sent it to the Delhi Government headed by Sheila Dixit for advice. This was several months back.

The Delhi Government was apparently too busy with elections to take a decision on the matter. That is a ridiculous excuse. But let us accept that reasoning for a moment. The elections are now completed. It should be business as usual by now. What is stopping the Government from taking a decision on the matter?

No less an authority than the Supreme Court found enough evidence of his involvement in the attack on the seat of democracy in this country - symbol of national pride and honor. What is there to decide?

Why did the petition have to be sent to the Delhi Government in the first place? Why is the Delhi Government taking so long to decide on what should be an open and shut issue?

Why is nobody raising these questions?

Sunday, July 19, 2009

Why the BIG project failed - Earthy Mistakes

(This is a work of fiction. Resemblance to any company, project or people is unintentional.)

Grey Matter was sold to the NEW company. The BIG project was supposed to be a major reason for this sale. The NEW company believed it had the ability to bring the project back on track and they had good reason to do so. They were expecting "many more similar sized projects" if this went well. Ah, the lure of more work! This has done so many people in.

The NEW company did what it could do best. Throw highly qualified and experienced people at the project. And expect it to be done. Unfortunately, that did not work.

Introducing Mr. Smart Alec. He thought he could solve all the world's software problems. This should be a piece of cake. Accompanied by Mr. Jack-of-all-trades who was the NEW company's handy boy. He looked after everything from database design to uncomfortable chairs. Ouch!

Together they brought on chaos. The developers were already fatigued with all the hullabaloo over the acquisition and the concomitant unkept promises. The dynamic duo had to instill enthusiasm into the team. They threatened them instead. Tch tch. Didn't work.

To add to the confusion, the NEW company added more heavyweights to the team thinking that they could solve all the problems. What was needed was more hands-on people. What they added was a bunch of managers. What are managers? Managers, as an old saying goes, is a bunch of people who cannot do anything, but they keep meeting and decide that nothing can be done! So it was with the BIG project.

Where do I fit in in all this?

Well, I was involved with the BIG project for a few months too. This was just before the company was sold. So, I am also equally responsible for the failure of the project. I should have done more. Used more common sense. There was this sense however to not go against the tide. This is a major problem with me as a person. I don't always go against the tide. I am more comfortable agreeing with everyone - supposedly more knowledgeable and experienced than me. I must learn not to do this. I must ask myself - what I think should really be done. And then listen to the answer.

Saturday, July 18, 2009

Why the BIG project failed - Efficient and Intelligent Mistakes

(This is a work of fiction. Resemblance to any company, project or people is unintentional.)

The BIG project (BIGP) was the promise of liberation for Grey Matter. It was supposed to be a two year, multi-million dollar project. With "many more similar sized projects" if this went well.

An entire army of big guns were poached from software majors. Folks who had executed similar projects and come out with flying colors. Or so they said.

Today, about three years since the project was started, the curtains have come down - officially.

What went wrong?

Many things.

To start with, the project was highly over-architected. When I first saw the architecture diagram, I thought it was a huge club sandwich. There were about ten layers. Ten layers? That's a lot. When you have ten layers in your architecture, you know you have a problem. Mr. Architect-in-Chief just loved complicated architectures. "Come on guys, this is a huge project. How can it have a simple architecture? Three layers is for wimps. The more (layers) the merrier. How about 10?"

"Makes sense", all his cronies nodded in agreement.

In any software project, there is one cardinal rule that must be followed: Keep it simple. When you have a project with such complicated functionality, you have to keep the design simple.

This brings me to the next problem with the BIGP. Multiple locations with no single anchor. The project was executed from three locations. There was no single person responsible for the project. People in all three locations had heavyweights who took no personal responsibility for the overall delivery of the project. They had a fancily named Project Management Office (PMO) which was supposed to be jointly responsible for the project. Joint responsibility - another red flag. There is no such thing as joint responsibility. There has to be one person responsible for a project. Nobody could be held accountable. Not Mr. Bald Eagle, not Mr. Bong Babu. Certainly not Mr. Spineless in San Jose.

In going with the fancy sounding names, the Agile methodology was adopted. Apart from sounding sexy - "We're using Agile" - it looked good on a resume. Well, there is nothing wrong with the Agile methodology. The only caveat is you have to follow it completely. Here, Agile was used in parts. For example, requirements freezing for a sprint, the foundation of an Agile sprint was never done. As a result, features kept getting added on the last day of a sprint! A sure recipe for disaster.

A major problem with the project was nobody from the PMO had their ears to the ground. The developers on the project, the foot soldiers, had predicted this outcome six months into the project. Nobody listened. They raised red flags again and again. Still nobody listened. The number of bugs kept getting bigger and bigger. Stability plummeted. Still nobody listened. If the customer was happy, why bother.

That was a huge problem in itself. Mr. Chief Architect knew how to please customers. Unfortunately he did not realize that you can fool some people some times, but you can definitely not fool all people all the time. Sooner or later the customer would wake up. When he did, all hell broke loose. But by then it was too late.

Friday, July 17, 2009

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.

Thursday, July 16, 2009

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.

Wednesday, July 15, 2009

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.

Wednesday, July 8, 2009

I love you Prateeka!

Prateeka 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 Prateeka!

Sunday, July 5, 2009

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.

Saturday, July 4, 2009

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?)