Saturday, May 28, 2011

Abhi tak hum zinda hain!

Yes, I am still alive. And kicking! No posting from a few days, yes. But that's because I've been a little busy.

I have been mostly busy with the automation project of the Jain Dialysis Trust. The coupon distribution that happens every last Sunday of the month was becoming very chaotic and difficult to manage. So, Shri Inderchand Jain asked me if it could be automated. I said, "Sure!" And got started with this project. I couldn't contribute financially to this extremely noble cause. This was the least I could do. So, with the help of my dear friends, A Srinivas, Ankurpreet Singh and PVK Ramesh, I embarked on an enterprise of honorable, dangerous consequence. Honorable because the cause was so good and dangerous because failure would be disastrous!

After much of going back and forth on the technology, we got the application complete. We have the hosting figured out too. Now only the testing and deployment remains! Wait a minute! Did I say 'only'? No way. Testing and Deployment can be major, major headaches. Let's hope the project gets done soon and well.

On the medical side, my hemoglobin went down to 9.9! Well, it was 13+ at one point. In an extraordinary act of courage, my neph decided to reduce my Erythropoietin to 2,000 units a week. Within weeks, the hemoglobin plummeted to 9.9. My neph blamed me for not checking my Hemoglobin often enough! I have been accused of many things in life. But not this. Never have I been accused of not doing blood tests often enough. I check it once a month at least! Not enough, he said. Once in fifteen days it is, now! So 9.9 leaves you with not too much energy at the end of the day. I am now on 4,000 thrice a week. It has bounced back to 11.4! If the blood tests are right, that is!

All this low hemoglobin has not reduced my swimming though. I am gradually increasing the amount of swimming I am doing. I changed the pool I swim in recently. And I am doing more than my last pool. The motivation for increasing the swimming was mainly the increased weight which was probably due to the relaxed diet (sweets and fried stuff) I was indulging in. So, I now have given up sweets and fried food (chocolates exempted from the ban).

I am still unable to give up the ghee on idlis though. Right in the midst of this austerity drive, I went to Poorna Tiffins one Sunday morning, firm in my mind, that I would have the idlis without ghee. I successfully managed that too. But it wasn't the same. My day felt incomplete. Dry. Something was missing. I had to go back on the Wednesday following that Sunday and have my usual idlis laced with ghee. I think the weight loss will have to come from more swimming!

Monday, May 23, 2011

Unexplained problems of dialysis patients

I often have problems that bother me for a few days and ask my doctor about on my next visit. Sometimes he knows what to do. Sometimes he just ignores it or gives me some vague answer and asks me not to do anything about it. I get irritated.

At NephroPlus, I meet all patients that come for dialysis whenever I am at a center and chat with them about how they're doing. I tell them how I am doing. We share our problems and solutions. Often they talk about some problem that I have never had. I have no clue on what they could try. I tell them as much. I tell them to talk to their doctor. They most likely have already done that and have not received any advice.

Well, that is the nature of the human body. Medicine has so much yet to be discovered. What has been unravelled is but a tiny part of this very complex system. Just think about the way the parathyroid glands control the level of Calcium in the body (see this link) and you will begin to appreciate this almost magical system called the human body. At lower levels, when I read about the way the complement system works (especially interesting to me because of my primary disease) and the mind-boggling number of chemicals involved released and absorbed by various tissues, I see why medicine has not been able to solve so many problems related to disease. Still, the progress made is stupendous by any standards.

Given such a complex system, it is impossible, at least at this stage, for doctors to be able to figure out every small problem patients have. Patients must understand this. At the same time, it is important not to ignore certain things. Things that could be signs of a serious condition. So, we, as patients, must watch out for every symptom that is out of the ordinary.

We must talk about every problem with our doctors. If they don't know about it or ignore it, we must not get irritated. We must understand the limitations of medical science. Especially if the symptom is something transient, lasts only a few days. On the other hand, if there is something that is persistent, something that is recurrent or something that is paining or bothering you, then do not ignore it. Talk to your doctor. If he is not able to help, talk to another doctor. Or look up the symptom on the internet. There are plenty of support groups online. Ask there. The I Hate Dialysis suport group has hundreds of members and will very likely give you some answers.

Saturday, May 21, 2011

Bread maker on the way

I love good bread. Freshly baked, warm bread is the ultimate morning experience if you don't count Darjeeling tea. Geetha Aunty of Boston is famous for her bread. My mother stayed with her a few years back on her trip to the US. At that time she had baked some bread flavored with orange rinds. My mother couldn't stop talking about how she left the bread to bake in the night and in the morning the entire house was filled with the aroma of fresh bread!

This kind of imagery usually has me hooked. Ever since then I have dreamed of waking like that at my house too. Now, finally, that wish will come true. My parents who were in Boston a couple of days back bought a bread maker recommended by Geetha Aunty. I am more excited about the bread maker coming home than them!

Bread though is a very individual thing. There are many people who cannot stand it while there are others who swear by it. My uncle, for example, has this hatred for bread that is difficult to describe. He feels bread is for the poor and not for people who can afford better food! This is probably a relic of the times when bread was always made with refined flour (maida) rather than whole wheat. It came really cheap.

These days, however, you get bread made with a variety of flours and can cost quite a fortune. Walk into a Bread Talk (one is inside Q Mart at Banjara Hills) and you can see the different kinds of bread at prices that will put the Alphonso mango to shame. Gone are the days of bread only being a cheap, poor man's food!

I am not a regular cook. But I like to dabble once in a way. One of the things I have tried my hand is bread. It has never come right. I sure hope that changes in the coming days!

Wednesday, May 18, 2011

WebObjects: Clean your project if you have modified any resources

I was working on a WebObjects project that needed some reports for which I was using ReportMill. Now the ReportMill templates are to be kept in the Resources folder of the WOLips project (I use Eclipse/WOLips/Project Wonder - is there any WO developer out there that does not use this combo? Please send me an email!!!).

First cut at the reports - obviously it wouldn't work. I thought I had figured out the problem (the object that you actually pass to the report wasn't bound correctly to the table in the template) and fixed it. Tried it again. No luck. Made some more changes. Nope. Started the template from scratch. Nothing.

Then I don't know what struck me. I cleaned the project. Voila! It worked. I had forgotten an important WOLips (Eclipse?) rule. Clean your project when you modify your resources. The build system figures out whenever you have changed your java files and auto-compiles and uses the latest. Not so for the resources. It does not by default check if the resources are modified and includes them afresh. You need to clean the project and then the new files will be picked up.

I am sure there must be a simpler way to get the latest resources to be picked up every time! Anybody?

Tuesday, May 17, 2011

My Nano caught fire

I had heard a few instances of Nanos catching fire. But this happened to me.

First of all, for the past few months, the Nano has been giving us a lot of problems. It stopped right in the middle fot he road on two occasions and just wouldn't start. My dad was driving it both times. He had it pushed to the side of he road and then we called the workshop and they had to tow the vehicle to their place. Both times they said some part had to be changed which they did and brought it back.

About a week back, I was in the Nano and my driver was driving it. Suddenly, in the middle of thick traffic, there was fire below the hand brake and smoke around. We were shocked. My driver immediately switched off the car and steered to the side of the road. We both got out of the car and then had it pushed to my brother's house which was close by.

We called the workshop again and they towed it away again.

I talked to the manager and asked them to take the car back and give me a refund. They say they will check the problem and let me know.

Monday, May 16, 2011

Is it wrong for kids to enjoy?

On Saturday, we had dinner at my uncle's house. It was a big family dinner. The occasion was his son's wedding anniversary and their daughter-in-law was in town though they stay in the US.

I, as usual, reached early. Well, their house is in between my office and home. So, instead of going home and coming back half way, I thought might as well go there straightaway. To kill time till the rest of the family strutted in, I took my iPad with me. I was checking my email on it when my cousin sisters' kids came there. Two cousin sisters. Four kids. All from out of town. In the age group of probably 6 to 10.

They asked me in the cutest possible tone, "Aa shoo chhe?" (What is this?) I told them it is called "iPad". I then did a quick demo of the Photos app. They were all floored. They all sat in a line next to me and one by one took the iPad in their hand and played with the Photos app. Zoom in, zoom out, pan, rotate. I also showed them some pics of some of them from a few years back. Squeals of laughter and delight!

By then their mothers had sensed that they were playing with a fancy device. They quickly warned them and me to be careful.

Next were a few simple games I have on my iPad. One by one they would take shots at the games and play for a few minutes each. "Next its my turn". "Then mine". "Then mine". They were clearly having a ball!

I then showed them the Piano and played a couple of popular tunes and then opened Penultimate. This was a huge hit. This is an app that allows you to write or draw with your finger. There are some fancy features like an eraser, adjusting the color and size of the pen etc. They were on a roll. One by one, they took the iPad and let their drawing skills loose. Mountains, the sun, birds, the ocean, fish.

After a while, the adults went berserk. They asked the kids to stop it at once. They asked me to put the iPad in. I didn't quite understand what the fuss was about. It was not as if they were fighting over it. They were drawing one by one in an extremely orderly manner, clearly fascinated by this new little gadget.

But the adults didn't care. It had to stop. They would 'spoil' something. This was an expensive device. Not to be fooled around with by a bunch of unruly kids!

The kids gave up. I put the iPad in.

After all, I couldn't stand up against the collective might of the maternal oligarchy of the Parekh kutumb!

Sunday, May 15, 2011

What a dearth of choices

There has been so much that has been said about the 2G scam and the corruption in India that I don't think I can add anything of value on the subject.

However, I was just thinking about the recently concluded Assembly elections in Tamil Nadu. People are very gung-ho about the way the DMK government has been booted out and the very low number of seats they have won this time. Yes. Totally agree. Good that they were booted out. They deserve this. Probably more.

But think for a moment. Who has come in the DMK's place? Jayalalitha, the mother of corruption. And she has the gall to actually say that the mandate was not only against the DMK but decisively for the AIADMK. Apparently she is going to foist more corruption cases on the Karunanidhi family.

The people of Tamil Nadu always give a decisive mandate in favor of one party. So, turn by turn these two people come to power, loot the state and its people and then lose power, smug in the belief that they will get their chance after five years.

Talk about being having to chose between the devil and the deep sea!

Thursday, May 12, 2011

Differences in spoken language between migrants and the natives

I caught up with a few cousins this Sunday for breakfast at an aunt's house. (Yes, I missed my weekend rendezvous with Poorna Tiffins. I made up for it by going mid-week in the evening though!) We discussed a host of stuff. One of them was how the same language, Gujarati, is spoken so differently by us, who have been out of Gujarat forever and people who have been in Gujarat all their lives.

The Gujaratis who stay in Gujarat use very pure Gujarati, unpolluted by English or Hindi words. An example my sister gave - "Jo ben tamari seeti boli" evoked laughter among all of us. We were more used to "Jo seeti vaagi"! Another example she gave was - "Aatlu motu vahan nathi dekhaatu?" "Vahan"? We forgot that word long back!

I remember Dinesh growling, many years back, at the chaste Tamil being used by a group of students from Chennai who were going back to Chennai from Hyderabad on the same train as us. One of the students asked him in Tamil if the TT had come and gone. Dinesh spoilt his face after the guy went! Dinesh wasn't used to such pure Tamil!

Another thing that I noticed was people who are away from the state generally have a purer dialect than people in the state. The people in the state acquire the dialect of the region. People away from the state generally speak the 'official dialect', if there is such a thing! Again this is true mostly for people who haven't stayed for long in their native states.

The language of the people of a state who stay in other parts of the country slowly gets mixed with other languages. More importantly, they also get more attached to the culture and traditions of the place than their native states. For example, Sankranthi appeals to me more for the Pongal than the kites!

Wednesday, May 11, 2011

Well, you can't give up dialysis just yet!

There's a lot of exciting stuff happening on human organs and newer, more compact dialysis delivery mechanisms. In the first issue of the HKF newsletter, we had given some details about the Wearable Artificial Kidney. We also mentioned that this was at least a few years away. However, the excitement of getting dialysis where you want and when you want got some people carried away and we started getting calls from hopeful dialysis patients asking for one!

Well, sorry to spoil your party but it will be at least another ten years till people like you and me can have access to this machine.

There is a lot of research and promising stuff on the horizon. Take a look at this link sent by Karthik that talks about growing kidneys among other organs in the lab. They talk about using organs from brain dead people and then washing off or dissolving all the tissues to get the 'scaffold' and then putting cells from our own body on the scaffold to form an organ that will not be rejected by the human body. The program itself says this is decades away.

You know what - sometimes I honestly feel that I should have been born about 25 years later. That way I would have had access to the NxStage System One in India and may be even got a shot at some of these fancy new devices.

All these new devices may just be a little too late for me.

Feedback from patients - a double edged sword

At NephroPlus, one of my responsibilities is to get feedback from all patients once in two months. It is an interesting exercise. You get to talk to patients in a non-dialysis unit setting. At times, when I am introducing myself to them, I feel like I am a call center executive calling to sell a credit card or an insurance plan. The same lines over and over again to an irritated listener. Mostly though, they are all very good and complimenting!

They have never had this experience though. Someone from a dialysis unit calling and enquiring about whether the service has been good and if there are any complaints is very unusual. Some of them are so not used to it that as soon as I call they say I am coming tomorrow at 8 for my session without waiting for me to even ask my questions!

The patients in a dialysis unit are a small replica of the world. You have the Ph. D.s  and you have the uneducated. You have the extremely rich and the not so rich. You have cheerful folks and you have grumpy people. Each of them reacts to the questions in a different way.

There is one patient that I particularly dread calling. The patient is mostly grumpy. She talks only to one nurse in the dialysis unit. She doesn't even come on the phone. Its mostly her family. And they are equally grumpy. I usually save her call for the last. I try to avoid it too. But in the end, the empty cell next to her name in my Feedback Excel forces me to dial the number!

Most calls are usually very easy to do. "Excellent service", "No problems at all", "Staff is very good", "Nice of you to call"!

Tuesday, May 10, 2011

Why do we kill our daughters?

The recent census states that India's child sex ratio (number of girls per 1000 boys in the age group of 0 to 6) has fallen to 914 from 927 in the 2001 census! This shows that all efforts by the government and various other organizations is simply not bearing fruit. Why are Indians still killing their daughters?

The answer lies in our basic thinking. Even in very educated families, women still don't have the same rights as men. Boys are given many liberties denied to girls. In my own family, I can see a number of examples where this discrimination is very evident. Adjust for the level of education and financial status and you will figure out why the girl child is often not even allowed to be born and if she succeeds, condemned to a life of being discriminated against or worse, tortured.

In this article on the Wall Street Journal, the writer asks, "Is it poverty, deep-rooted cultural conditioning or our ignorance about what it means to be a woman?" I strongly feel it is the 'deep-rooted cultural conditioning'. We are all brought up that way. Me, too!

Only now do I see the gross injustice meted out to women in India. Women are discriminated against at every level in Indian society. It is only the magnitude that differs. At higher levels, you will find 'not-so-serious' things like men always eating first at a family gathering. At lower levels you will find things like female foeticide.

There is a new initiative being started by an NGO called SIAAP. They are starting a program called "Reducing the Gender Divide by promoting acceptance and enhancing agency of the girl child in 13 districts of Tamil Nadu". The specific problems have been identified and objectives with measurable expected outputs have been set. It is not a generic 'benefits-all' kind of a program. It is being done in a very structured and systematic manner.

Please contact SIAAP at for more details. You can also click here for a Concept Note that details the program.

Wednesday, May 4, 2011

Choice of technology

I have been tasked with the development of a web based application for a non-profit organization. The application is not very complex but will solve many problems in their operations. I have been pondering about which technology to use for the application.

My first instinct, of course, was to use WebObjects (WO), my first love. However the thought of not having too many people to support the technology came to mind and I promptly dropped the thought. Then I thought about PHP. The people I knew who knew PHP were taking a break so that didn't work out either.

I then thought about J2EE / Java Frameworks. I got a couple of friends to commit to some time and started off. I prepared a detailed Functional Design document and some complicated project plans and got started. The only problem was none of us was full time on this. Plus J2EE projects need tremendous amounts of discipline and patience. For example, you might need to refer to up to like a million XML based configuration files and another couple of million of other files - all this just to figure out the flow for the Login use case!!

Give me WO any day!

I have, for the time being, decided to use WO. Let the first phase be completed. Let us get the ball rolling. Once we have a working application being used, we can slowly start building the complete application using a technology that has more people to support it.

Unfortunately, in the software world, more developers = better technology! 


This evening brought some horrible news. I got an SMS from the son of one of NephroPlus' PD patients. His mother passed away this morning. She had battled various complications for the last couple of weeks and this morning had a cardiac arrest and passed away.

This serves as a reminder (again) about how unpredictable life is. I had met her a couple of months ago to get her started on NephroPlus' PD program. She seemed a strong woman, well educated, aware of her condition and proactive. She seemed to be doing very well indeed. I could never imagined that this would come so fast.

Life is so, so uncertain. You never know what's going to happen the next moment. More so for people like me. After joining NephroPlus, I have had to face this harsh reality more often. It is very unnerving to think about this. When I heard about this today, my heart became really heavy for a while. I froze for a few seconds.

When I think about this, I am appalled at the directionless way I am living my life. Reckless and intemperate. I must ask myself this question: If death were to come face to face with me and give me a few seconds to think, what would my thoughts be? Would I say - "I have lived a good life, I am not scared" or would I be so shocked and regretful about the life that I have lived that my face would blanch with fear?

Tuesday, May 3, 2011

Cheese slice cravings

I sometimes crave really badly for simple things. When I was on dialysis at Kamineni Hospital, one day I started craving for watermelons. From the next dialysis onwards, I would have a big bowl of watermelon during the first hour of dialysis. The nurses would remove that much extra fluid off!

A couple of days before my transplant in 1998, again in Kamineni Hospital, while I was actually on the dialysis machine, I had an unbearable craving for Apple Milk Shake. My parents were at home and no one was with me. I called my dad and said I simply had to have Apple Milk Shake. Promptly, Apple Milk Shake was made at home and sent with my uncle! I had such a loving family. They would do anything for me. And it was just a couple of days before my transplant!

At one point, when I was on PD, I read an article about the Darjeeling Toy Train by Mark Tully in which he mentioned that he had a cup of Darjeeling Tea every morning. That was it. I suddenly started craving uncontrollably for Darjeeling Tea. A tea-hater became a tea-addict!

This afternoon, I suddenly started craving cheese slices. I could think only about cheese slices. So, when I wound up work, I rushed to the super market and picked up a packet of whole wheat bread and cheese slices. I went home, toasted the bread, cut a few slices of tomatoes. I took one slice of cheese and put it on the hot toasted bread. I then put the slices of tomatoes on the cheese, showered a little basil and oregano and took a bite. Yummmmmy! This was so good!

As I believe, some of the best things in life are the simplest!