Saturday, January 26, 2013

Things I hate about the big, fat Indian wedding

We have one going on in our family. My dear cousin Malay is getting married. The trouble is almost everyone realizes that there are things about the wedding that are antediluvian but nobody feels like changing anything.

Take the gifts given by the two sides to each other. There are gifts not only for the bride and the groom but also a lot of 'important' people on either side. The gifts are not so much out of love as they are about 'looking good'. The most ridiculous part about gift giving is that the gifts are all displayed for everyone to see and then - hold your breath - the list is announced in front of the elders of the society! How pathetic is that? Why make a public spectacle of this?

Another thing that is evident in most traditional marriages is the absolute supremacy of the 'boy's side'. India is a hopelessly male-dominated society. Marriages make for one of the most vulgar displays of this domination. The 'girl's side' is supposed to behave in a completely servile fashion. Every wish of anyone in the 'boy's side' is supposed to be their command! Though, in some families, the extent of servitude is decreasing, the mindsets are still the same.

One of the most disgusting aspects of weddings is the tendency to show-off. 'X spent this much on a wedding, so I must spend at least twice that much!" or "Y brought the baraatis by a chartered flight. I must do so too!" This kind of competitive celebration is really sad and totally unnecessary.

Relationships have become so commercial. I often wonder how a husband and wife can live happily together and with true love for each other after the shameless and utterly disgusting negotiations that go on in the name of 'dowry'. And it is shocking that in this day and age, so many educated people still practise this horrendous tradition. It had all become so institutionalized that the woman, who has been through so much at the time of her 'dowry' negotiation would not hesitate to do the same to another woman when she has a son and it is time for him to get married!

Thankfully, in our community, the practise of 'dowry' has been entirely done away with. But it is really high time the other antiquated traditions are also abolished.

Thursday, January 24, 2013

Some basic professional behavior

However intelligent you are, however efficient you are, I believe that you must have some basic professionalism in your day to day work. Without this, a lot of people could be put off and your unprofessional behavior may overshadow your intellectual genius.

When I look around me, I find these are some of the things I expect while working with people:

- Punctuality: Basic punctuality is one of the mot important attributes of professional behavior according to me. If you have agreed to be somewhere at a particular time, you bloody well be there at that time. Most of the time at least. All of us get delayed once in a while. There're a lot of things that could cause this - traffic, oversleeping, getting delayed at an earlier meeting etc. However, there is a big difference between once-in-a-way delays and regular, consistent delays.

On those rare occasions when you do get justifiably delayed, I consider it important to let the person or people you are going to meet know with a brief apology. Not doing this, in my humble opinion, is the pinnacle of unprofessionalism.

- Responding to email: Email is something that is meant to be responded to within a reasonable amount of time. You don't have to respond immediately but you should really respond within probably 24 hours unless it is a holiday. Not responding to email could mean so many things. You don't consider the topic important enough or worse you don't consider the person important enough.

Not responding to email can leave many things hanging in the air. To make sure I respond as soon as possible to email, I follow a simple rule. I keep the email in my Inbox until it has been 'dealt with', which means I either respond to it or make an Action Item and put it on my To-do list or both. It then goes into a folder meant for emails related to the topic. That way, anything in my Inbox means I have things to take care of. If the number of emails in my Inbox goes beyond what fits in one screen without scrolling, I become very uncomfortable and restless!

- Phone calls: We all get calls when we cannot take them. What do you do in that case? Ignore them? Call back? It is ok not to take calls when you are in a meeting. It is actually very unprofessional to take calls during meetings unless it is really urgent! Texting, equally so. What about the call itself? If the call is from a person I know, I would definitely call back once I am done with the meeting. If it is an unknown number as well, most of the time I call back unless it is from a number that looks like a tele-caller's!

I find that basic professional behavior goes a long way in making work much smoother and a pleasure. Some unprofessional people can completely ruin your day and make delays in getting things done very frustrating. It is never too late to change. All it takes is intent.

Wednesday, January 23, 2013

A good strategy to manage fluid intake

For me, the biggest problem while being on dialysis was the fluid restriction. Typically, people on dialysis need to restrict their fluid intake to a liter. This includes water, tea, coffee, curd, dal, rasam, ice cream etc. Anything that is fluid at room temperature is counted as fluid. All told, the fluid intake should typically not cross a liter. For people who pass urine, this could be higher.

I find that having a plan on the fluid helps a lot. Rather than drinking at any time, having a plan on when to drink what and how much helps manage this much better. One thing which is commonly recommended is to measure out your allowed quantity of water in a bottle and drink only from that. When you drink something other than water, discard an equal amount from the bottle. Plan your day so that the bottle lasts you till you go to sleep.

Another good way is to write out your fluid plan for each day. Think about what's important for you. Let's say, it is important for you to have 3 small cups of tea - one early in the morning, one at around 11:30 and another cup in the evening, write these three things down. This could probably come to about 300 ml. Put in about 100 ml of water after every meal. The total comes to 600 ml. You still have 400 ml to play with for different things. The key is to fix up the time, the quantity and what exactly you would like to have and write this down and follow it as much as possible.

By doing this, you have no surprises. In case you feel like having a gulp of cola at dinner, you can skip one round of tea. I believe very few things are entirely out of bounds for people who get thrice weekly dialysis. You can have everything in limited quantities provided you plan it well.

If there is something you really relish which is high in potassium, ask your doctor if you can have a small quantity during the first half an hour of dialysis. If you are otherwise compliant and dialyze regularly without skipping the prescribed sessions, you can afford to take some liberties during the first half an hour of dialysis since the dialysis will remove the excess potassium during the treatment. Of course, every individual is different. So, please check with your nephrologist or dietician before doing anything out of the ordinary!

Tuesday, January 22, 2013

Indian dialyzors have problems more serious than adequacy

On the internet, when you browse forums related to dialysis, you see a lot of emphasis on trying to increase frequency and duration of dialysis. When you talk to many patients in India, you realize that the issues are very different. Considering that a majority of dialysis patients do not have access to dialysis treatments, you begin to realize the seriousness of the problem.

Very few people can afford to pay close to Rs. 20,000 for medical treatment. What generally happens is if you are lucky enough to be able to get diagnosed in the first place (yes, a large number of people don't even get diagnosed, they simply die of some 'unknown illness'), you start getting dialysis. You soon realize that this is eating away the entire family's resources. The rest of the family also sees this. The patient starts feeling guilty of this. What will happen to the rest of the family? And it is not like a few dialysis sessions would cure the patient. This punishing disease can only be managed, not cured!

The patient and the family often decide that they cannot continue this forever. They are only being practical. The dialysis treatment is stopped. In a few days to a few weeks, the patient passes.

For those that can afford the treatment, everyday problems like paying for the expensive erythropoietin injections, dealing with the co-morbidities, managing doctor visits, the inevitable hospitalizations once in a way take up so much of the patient's and the family's time and energy, that there is barely any bandwidth for other things.

When I talk to people about doing daily dialysis or nocturnal dialysis, it is as if I am talking nonsense. These things for many are things they don't even want to begin considering. It is too far fetched and impractical. Their immediate problems are more existential, much more fundamental.

It is a pity really. When I get on to dialysis sometimes, in the comfort of my home, I feel so grateful (not to God), just generally grateful that I could get access to this wonderful modality that enables me to lead a close-to-normal life, I feel simultaneously sad that more people are not able to do this. When there is something that can take away a lot of the pain and frustration that dialysis is generally associated with, it is really unfortunate that more people cannot try it.

It is not due to money alone. I know many people who can easily afford the expenses. My monthly medical expenses come to the same as someone who is on thrice weekly dialysis! And I am getting about 40+ hours compared to their 12 hours. It has more to do with the leap of faith in dialyzing at home. For those who have the gumption to do this, often, financial constraints come in the way.

Wednesday, January 2, 2013


Yes, I have not posted for really long. I have been very busy with work lately. I am also working on another short story which should be done soon. I have not been well for the last few days. Nothing too bad. We had a get together of technicians at my house on Sunday and that night I had body aches and a slight fever. The next day I was feeling bad so I took the day off.

New Year's eve, we had a family event at home. I was a part of it but did not do a whole lot. I also skipped dialysis that night. The next day I went to work but worked from home in the afternoon since I felt sick towards the afternoon. I got back and took a Zofer which helped.

I got a good 7.5 hour session last night and I am feeling much better now.

Here's wishing you a very Happy New Year!