Tuesday, September 11, 2012

No stranger bond - 2

(This is the second part of a short story No stranger bond. You can find the full story here.)

Sharada Subramanyam finished her session and was out of the unit by around 12:30. Madhu came to pick her up in time and drove her to their house which was about ten minutes away.

In the meantime, the old man that was brought in to the unit regained consciousness. He was bewildered. Where am I? He looked around and soon realized he was in a hospital. What is that pain in my thigh? He reached for that stinging pain he felt in his upper thigh. Immediately, a nurse signalled him not to touch his thigh. It was actually a femoral catheter6 used to draw blood for dialysis.

"That is an injection. Please don't touch it. We will remove it very soon."

The old man was trying to recollect how he got there. It was all a blur. All he could remember was that he was reading the newspaper sipping some hot tea. He vaguely remembered reading about some firing. He had become very angry. He tried to strain his memory. Nothing. He fell back asleep.

Sharada had her lunch. She hated every morsel. There was barely any salt7. She said to herself, "Imagine me making such crap!" The only saving grace was the payasam she treated herself to after the meal. Luckily she was not diabetic8. Imagine being diabetic on dialysis, she often thought. After her meal, she took her morning Blood Pressure medications with a sip of water. On dialysis days, she was advised not to take her Blood Pressure medication before dialysis as that could cause the Blood pressure to fall too low in which case removing the excess fluid accumulated between treatments would be difficult.

She went to her room to take a nap. Dialysis left her drained and she needed a good two hour nap to regain some semblance of energy after her sessions.

The old man at the unit was now fully awake. He asked the nurse quite agitatedly what was happening. He wanted to know what happened to him and how he got here. He suddenly noticed a known face enter the dialysis unit. It was his son! "Abbu, how are you feeling now?" asked Masih, the old man's son in Urdu.

"What happened to me? Why am I here?"

"You are fine now Abbu. You had fainted at home this morning and we brought you here. They are doing some treatment and we will go home soon."

The nurse took the young man aside and said, "He cannot go home now. He has to get admitted. His kidneys have a prob - "

Just as she was explaining the situation to Masih, the old man started coughing. The nurse rushed to his side with a small steel stray called a kidney tray to allow him to bring out some sputum. The old man continued to cough and then suddenly threw up. Masih was worried. Kidney problem?

The old man felt horrible. It was like his insides were revolting. The nurse cleaned his mouth with a wet piece of gauze. She said this was normal and there was nothing to worry. This was his first dialysis so this was expected.

"What is his name?"

"Shuja Mohammad"

"Age?"

Masih thought for a bit and said, "About 55".

"Ok, please wait outside. We will call you when the dialysis is completed."

Masih told his father that he was waiting outside and that they would go home soon.

After a while, Dr. Vinay Bhalla came to the unit and came straight to Shuja Mohammad's bed. He looked at his file and then went over to examine the patient. He made some notes in the file and told the nurse to call the patient's family.

Masih was summoned inside. Dr. Bhalla explained to him, "Your father has a kidney problem. He might need some more dialysis. We will also need to do a few tests. You should admit him in the hospital as we need to monitor him closely and diagnose the main problem."

Masih nodded gravely. "Is there anything seriously wrong?"

Oh how I hate that question! Dr. Bhalla thought to himself. What do you answer to such a question? Is it serious enough that the guy will not survive? No! Is it as simple as a cough or a cold which would be treated with some medicines and he would be fine in a week? No! His kidneys are failing and he is likely to be dialysis dependent for the rest of his life unless of course he gets a transplant. Now I don't know whether that can be classified as 'serious'.

"No, not serious. Don't worry", Dr. Bhalla said as he walked out of the unit.

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6 - Femoral catheter is a thin catheter inserted into a vein in the upper thigh. Femoral catheters are typically used for dialysis to draw out blood from the patient and send it to a dialysis machine to clean it of toxins and excess fluid. Femoral catheters are typically used for short durations, from one day to a few days until a permanent mechanism to perform dialysis like an AV Fistula is ready.

7 - Salt is one of the toxins kidneys remove. Though salt is essential for the human body to function, excess salt can be very harmful for the body. Since the kidneys are not functioning salt can accumulate in the body and cause things like high blood pressure and excess thirst. Dialysis patients are asked to eat very little salt - sometimes as little as 4 grams per day. Most healthy people eat more than 8 grams of salt per day.

8 - Diabetes is the biggest cause of kidney failure. Many dialysis patients are diabetic. The problem is having kidney failure has one set of diet restrictions while being diabetic imposes another set of restrictions. That is why, diabetics on dialysis have it really hard as they need to follow both sets of restrictions!

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