Monday, July 30, 2012


Our cruise ship was from Vancouver to Alaska. Alaska is a breathtakingly beautiful place. It is the largest state in the US. We made three stops at land in Alaska. We also went right up to the Hubbard Glacier!

Whenever a cruise ship either docks or is tethered at land, the passengers generally get off the ship and do various fun things at the port. These are called shore excursions. You can book for these excursions either through the cruise line itself (usually turns out more expensive) or book through websites on the internet (you can usually get good deals like this). Despite having Dinesh with us, we did not manage to book in advance and had to pay the full cruise line fare!

Our first stop was called Icy Strait Point and was located off Hoonah, a fishing village in Alaska. The weather was quite cold. My buddies tried to convince me to agree to go on the Zip line ride where you are on a small seat without any base that goes at a height of several hundred feet across a rope from one hill to another hill. I refused. I was sure I would have a cardiac arrest and die if I did that! We finally went on a kayaking tour which was great fun! Two on each kayak, we paddled in the ocean itself close to the shore. the entire trip lasted about three hours.

Dinesh and I after the kayaking trip

The next day the ship was to go to the Hubbard Glacier. As we neared the glacier, the weather became colder and colder. On the way to the glacier, we started seeing many chunks of ice floating on the water.

When we reached the glacier, almost everyone on board gathered on the various decks to get a glimpse of the magnificent glacier. We were all on the upper decks getting pictures and taking in the beauty of the whole scene.

The captain came on to the PA system and told us some interesting facts about the glacier. We also saw parts of the ice breaking away and collapsing. They took three 360 degree turns at this point to enable everyone on the ship to get a good view of the glacier and get as many pictures as they pleased. Once everyone had had their fill, the ship was steered in the opposite direction away from the glacier. It truly was an amazing day!

The next stop was Juneau, the capital of Alaska. The weather was awesome here and we decided to to see the Mendenhall Glacier and then do a river rafting trip down the Mendenhall river. We were given special gear that would prevent us from getting wet in the icy cold water. We got into the rafts. There was a guide with us who helped steer the raft while some of us paddled. We first went up to the Mendenhall Glacier, got a better look and then headed down the Mendenhall river which is basically formed by the melting ice from the Mendenhall glacier. The river had rapids of Levels 2 and 3. We had a really good time rafting and did get our fair share of thrills. The river ran through areas which were inhabited and there were some really beautiful houses on both sides. At the end, we were given some warm Apple Cider with cheeses and crackers. We were all also given a "I shot the Mendenhall" badge!

After rafting, some of us took the tram ride atop Mount Roberts in Juneau. The view from the tram is just amazing.

The last stop was Ketchikan where we did not do any excursion but went about the town and got a cup of steaming hot coffee. It was drizzling and it was great to get good coffee in that weather.

Alaska is probably the most beautiful place I have seen. The weather, the natural beauty and the great maintenance by the authorities make it a must-see destination. What more could I ask for than to see Alaska as part of the cruise?

Sunday, July 29, 2012

The cruise

The ship started around 4:30 in the evening on Sunday, the 15th of July. We sailed towards Alaska from Vancouver. The cruise ship was very luxurious. Here is a pic of the ship from outside:

And here are some pics from the inside:

A bar where there is live music being played

My room

A theatre where they had Broadway-style shows every evening

We sailed for the whole of Sunday evening, Monday, Wednesday and Saturday. The rest of the days were either completely at land or part at land and rest at sea. When we were at sea, we enjoyed the amenities the ship offered like the swimming pool, the jacuzzi, the many restaurants they had and the events they had at the theatre. We also spent a lot of time with each other as well. It was fifteen years after all of us met together!

We would chat late into the night over a few drinks (I did not drink, of course!) and have a lot of fun. We also had a couple of sessions of singing and antakshari!

Just sitting on one of the many decks on the ship and staring into the vastness of the ocean was a delight in itself.

The food was very elaborate. You had multiple options. You could either go to a buffet that had a whole lot of options or you could go to a restaurant where they had gourmet meals that were served. All meals were on the house. We did both a few times. 

The shows that were there were really good with some very good comics, magicians and other performers performing every night at two slots so that you could catch the show even if you have missed the first slot for some reason.

The staff on the ship were extremely courteous and would do everything to accommodate your every little request. 

On the day before we were scheduled to get back to Vancouver, the view from the decks was especially amazing.

This week on the ship on the cruise was one of the best weeks I have ever had in my life. I fulfilled my dream of going on a cruise ship. I couldn't have asked for a better ship. I couldn't have asked for a better destination (Alaska, more on this in a later post). And finally, I couldn't have asked for better company!

Getting on board the Celebrity Century

I was in Dinesh's car along with his wife, Yogita and their kids. We were having a nice time singing songs and chatting along. We stopped for a bit to fill some fuel and got some coffee. I took a little into a separate glass for myself and really enjoyed sipping it in the cold weather that was there at that time amidst the serene, green hills.

We started off again. Suddenly, Yogita realised that they had not got their kids' passports! We had driven about two hours from their house. It was 12 noon. If they went back, it would take them four hours just to get to the point we were currently at and then another hour or so to get to the point where we would board the cruise ship.

There was panic all round. I got into Kamal Kumar's car and Dinesh and Yogita headed back. There was no way Canadian immigration would allow the kids in without passports! They got in touch with their sister who also stays in Seattle and asked them to break in to their house, pick up the passports and then meet somewhere in between! Dinesh's sister got hold of a locksmith and drove to their house and removed the lock, collected the passports and then met Dinesh somewhere in between Seattle and Vancouver. Dinesh collected the passports and zipped back towards Vancouver!

In the meantime, we checked in to the cruise and got on board. We ourselves were late by about half an hour at least. I had given up hope of Dinesh catching the cruise in time. As we boarded, we were asked to attend an emergency drill where we were taught how to wear the life jackets and were told about other mandatory procedures. Chetan had stayed back on the dock to talk to the cruise officials about holding on until Dinesh and his family got there.

The Cruise Terminal at Vancouver

After the demo, I went to my room and took my luggage inside. I was told that the ship had just started. I was afraid Dinesh might not have made it. I went out of my room and towards the elevators. I suddenly saw Dinesh along with one of his kids. I ran up to him and hugged him tight! I couldn't believe he made it in time!

Just as the ship sailed

We all then went up to the main deck where almost the whole ship had gathered and there was loud live music playing. The ship had started. We were all so thrilled. Finally what we had all panned for and dreamed about for the last so many months was happening!

Tuesday, July 24, 2012

Seattle Diary

I got into the British Airways flight to London enroute to Seattle at about 6:50 in the morning on Thursday the 12th of July. It was a very comfortable flight. I did not sleep much. They served elaborate three course meals. The entertainment was kind-of limited but not too bad. The only Hindi movies they had were 'The Dirty Picture' and 'Ladies versus Ricky Behl'. When the former was released, I had, for no particular reason decided never to watch it. I changed my mind during this flight. It wasn't bad. I also watched some Olympic Games (being held in London from the 27th of July) related stuff which was really nice.


We reached London at about 12:45 in the afternoon local time after about ten and half hours of flying. I went to the British Airways lounge and had a shower and a light snack. I also sent out an  email to my folks at home. The flight to Seattle was to start at about 3:30 in the afternoon. I had to take a train to another terminal and then boarded the plane. This plane was much better than the one to London. It seemed that the earlier aircraft was older and more rickety than this one.

I managed to sleep quite a bit on this flight - probably because it was night time in India, my native time zone. I reached Seattle quite fresh and relaxed.

Clean, green and very beautiful

Dinesh came and picked me up at Seattles's Tacoma airport. My first impression of the city was that it was very green. There were lovely evergreen trees all around. The roads were very clean.

That evening my other two friends, Chetan and Kamal Kumar also got to Dinesh's home. We had dinner and spent the next few hours chatting and catching up on old times!

Dinesh's wife Yogita made some renal friendly food for me. For the first time, in many years, I would need to follow the renal diet and watch my fluid intake!

Contrary to expectations, I slept very well. No jet lag at all.

Dialysis slot mess up

I had initially planned to get two sessions at Seattle, on Friday and Saturday evening. On Friday morning,  I called the center I was booked with in Seattle to confirm that my slot was confirmed. Suddenly I was told that they do not have an evening shift there! I got in touch with the lady I was co-ordinating with when I was in India. She made a few calls but called back to say she could not help. So then, I went for the afternoon shift. I was also told that on Saturdays they don't even do the afternoon shift. They do only the morning shift and I would have to to go in by 6:45 in the morning the next day.

The dialysis session went off very well. I had put on about 3 liters in about 48 hours and pulling it off wasn't difficult. At home I run at a blood flow rate of 250 ml/min because I do about seven hours. Here, I ran at 300ml/min because it was my first session. I would need to go to 350 or 400 to get good clearances with the shorter run time.

Taking charge

Bill Peckham had said in a reply to a post I put up on the 'I hate dialysis' forums asking for tips on dialysis in the US that if you cannulate yourself, the centers generally respect you and allow you to have more say in your treatment parameters. I found this to be very true.

I had taken my buttonhole needles and realized that I was very lucky to have done that. I initially wasn't planning to take them but my mother advised me to carry them. When the staff at the center learnt that I use buttonholes and can cannulate myself, they also allowed me to set all my other parameters which gave me a lot of comfort since I was worried about how I would be able to tolerate the much harsher treatments patients in the US are used to.

At the Davita Everett Center in Seattle

Lake Washington

One thing I loved about Seattle was that apart from downtown, most buildings had only the ground floor. This, added to the greenery and cleanliness, gave it a very nice overall feel. It was as if we are at a hill station with a small and simple population.

On Saturday evening, we went to Lake Washington where Dinesh had hired a speed boat for two hours. We were on or own. We drove the boat quite fast in the lake which was very huge. This was great fun!

In Lake Washingon

Departure to Vancouver

On Sunday morning, the weather was excellent! There was a slight drizzle and it was colder that the previous two days. We headed out in three cars for Vancouver. We would try to reach by around 3 p.m. after accounting for lunch in between.

This journey should ordinarily have been fairly uneventful. But it was not to be. In keeping with the theme of 'everything that can go wrong will' on this trip, this journey proved to be the most 'edge of the seat' for all of us!

Wednesday, July 11, 2012

Dialysis away from home - I am scared!

For the last few years I have been dialyzing at home. Apart from the fact that this trip (which begins in less then 24 hours) is going to be my first out of the country, this is also the first time I will be doing conventional thrice weekly, four hour dialysis sessions in-center for such a long time. I have done one such session at a time when I travelled to Goa twice in the last few years. Never more than that.

Now, for the next three weeks, I will be undergoing this modality. I am honestly quite scared. For one, I will have to restrict my fluid intake and watch what I eat as well. I will also be subjected to high blood flow and dialysate flow rates. When you're undergoing nocturnal dialysis, it is ok to run the dialysis at low blood flows which causes the whole dialysis to be gentler and less strenuous. When you do four hour sessions, you need to clean the blood at a much faster rate and this causes the 'drained' feeling that is associated with dialysis.

My trip is divided into four parts really. The first leg when I get to Seattle and I get two continuous days of four hour sessions - so that will give me good dialysis. Then comes the cruise itself - I am hoping I will be so busy having fun on the cruise with my buddies and the shore excursions and stuff that I will not have time to even think about the dialysis. Then comes the California leg - Los Angeles and San Jose - where I have three alternate night nocturnal sessions which will give me very good dialysis. These should be fairly easy. Last is the Las Vegas, Toronto and New Jersey leg. Here I have one session each. So, not too bad all in all!

It will be interesting to see how dialysis is done in other countries as well and compare it to how it is done here in India. I will getting all my dialysis sessions in Davita centers except in Toronto where I will be going to a private center - the only center that offers dialysis to international visitors. Initially I had tried to book all nocturnal sessions but surprisingly, very few centers had this facility!

Here's hoping my trip goes off well!

Saturday, July 7, 2012

I'm off in 5 days!

You're not going to believe what else happened after I last updated you about my trip! Two of the three friends who are joining me on the cruise along with their families stay in the US and as you know, the cruise starts from Vancouver in Canada. So, they both needed a Canadian visa as well.

They applied for their visas about a month back. As we were getting dangerously close to the start date of the cruise, we got increasingly worried as they hadn't received their visas. This was a couple of days back. Dinesh visited the Canadian consulate in Seattle where he stays. No luck. They said there was no way they could find out except by sending an email or a fax. They did both. No response.

We immediately got onto a call and started planning for the worst case that they did not receive their visas in time. Chetan found out that they could actually fly in to the place where the ship would dock on the first stop which was in the US so they would not need Canadian visas and they would also disembark at the last stop before getting back to Vancouver. The downside - they would be able to be on the ship for only about three and half days! This would also cost each family about $1,600 more for the flights. But what could we do? We had no choice. 

We decided to wait until Monday and then they would book the tickets.

What I construed as the universe's whispering had by then turned into a full-blown loud message! What was this? The Canadian government's way of telling us we're not welcome? Right from the beginning of this plan, things did not go smoothly. Everything that could go wrong did go wrong! However, the one thing that was positive was that in the end, things always turned out fine. Like with my friends' Canadian visas.

This morning I received an email from Dinesh that read:

The visas are approved!
I have Yogita's and my passports in hand. Chetan's and Pavithra's passports are in Express mail expected to arrive at my house tomorrow. We are now unblocked to do next level planning of how we will ENJOY the freakin' vacation.

Seriously guys, thanks for all the help.

PS: And a note to myself about starting earlier moving forward.

I leave on Thursday.

Wednesday, July 4, 2012

Mahabubnagar Diary

One Friday morning I found myself on the Bangalore Highway on the way to Mahabubnagar. NephroPlus has a dialysis center there. This was the district's first dialysis center providing free dialysis through the government's Aarogyasri scheme. Many patients travelled about 100 km each way twice a week just to get dialysis until then!

The road is excellent. Once you take the left fork at Jadcherla and then take the right that goes into the district, the area is especially picturesque and very green. Our center is at the SVS Hospital that is at the mouth of the district.

I complained that I had no shoes until...

At our unit, I chatted with the team and the guests (NephroPlus jargon for patient). It struck me how little some of them had access to. I saw this lady, probably around 65 who had very thin veins. The technicians struggled to cannulate her. She did not utter one word. She did not even complain about the pain which I could sense was immense from the repeated attempts at pricking. She stoically looked on, waiting for it to finish. The technicians gave up in the end as there seemed to be some stenosis (blockage) due to which the minimum flow of the blood was also not achieved. They advised her to go to Hyderabad and get her fistula checked and revised.

I felt really bad for her. Now, she and whoever was looking after her would have to catch some conveyance to Hyderabad (about 100km) and then meet a vascular surgeon who would then advise them what to do. And then they would have to get it done. The surgical procedure was just a small part of the suffering. That the whole effort of getting something as basic as a fistula revision involved so much more trouble seemed quite unfair. I felt my heart become very heavy when I looked at the lady thinking about this.

Truly, I was very fortunate to have the access to medical care I currently have.


Mahabubnagar is famous for many reasons. One of the less talked about these days though is the Banyan Tree called Pillalamarri which is supposed to be about 800 years old. Some people say that it is impossible to tell which is the main tree as there are many 'children' of the tree that have grown around it. Beneath the tree is supposed to be the tomb of a Muslim saint. 

We visited the site a few trips back. It was totally deserted barring the one old man who manned the ticket collection room with a single window through which he would issue the tickets to the enclosure. We took our tickets and went in. It was a maze of trunks. The funny thing was until someone tells you that the trunk of the original was not identifiable, you don't think about it! One thing was for sure, the tree was really old.

Telangana Agitation

Mahabubnagar is represented in Parliament by K Chandrashekhar Rao, the president of the Telangana Rashtra Samithi, the party that is at the forefront of the agitation for a separate state of Telangana. The area is a hotbed of activity related to this agitation. Most bandhs called in support of this cause are successful. During the setting up of our unit, the agitation was totally alive and kicking because of which we did have a few days of disruption - government officials would not attend duty, doctors would stay away from work etc. These days however, it looks like things are more peaceful. We've not had such problems for a while. Once the Presidential elections are completed, however, people expect some move on this front. No one is really sure about which direction the movement will take from then on. Fingers crossed!

Avanthi Udupi Hotel

I went over to the main town to have lunch at the usual Avanthi Udupi Hotel. The place serves simple South Indian meals. Nothing very fancy. But still very tasty. It is the typical South Indian Meals place complete with the sweets counter near the billing desk, a small air-conditioned section, a small Family section, the outer area for the rest of the customers and the huge weighing machine outside that has all the lights and fancy colors, into which you insert a one rupee coin and it throws out a small card with the weight printed on it!