Saturday, March 30, 2013

Disconnect from your phone at least when you're sleeping!

What is the first thing you do when you wake up in the morning?

If you're like me, you reach out for your phone to see what email you have received! This is really pathetic. Till about a year or so back, I did not have a data plan on my phone. I rarely used my phone for email even when I was in a Wifi network at home or office. Life was much more peaceful then. Ever since I got data on my phone, I am living life always on tenterhooks.

When I wake up in the morning, I need to see my email. When I am having lunch, if the email alert beeps, I need to immediately read the email and worse, respond right then. Even when I am in a meeting, I need to check and respond to the email I received in between. Never mind if what I was responding to was far less important than the meeting itself.

This whole 'always connected' syndrome is ruining me. It does not let me participate and enjoy the present moment. I am never living in the moment.



This affects my personal life for sure. It also affects my effectiveness at work. I feel it is very important for us to be fully involved in what we're doing at any given point in time. If I am eating, I should focus on eating. If I am sleeping, I must try to get a full, sound sleep. If I am in a meeting, I must be 100% in the meeting. Only then am I going to be effective!

But my cell phone will not let me. And a lot of the times, the emails are not that urgent requiring an instant reply! Heck, if it was that important, they would have called!

From today, I am planning to turn off email on my phone at least when I am about to go to bed and turn it on after I have woken up completely and settled into my day. Depending on how it goes, eventually I plan to turn off email on my phone completely unless in an emergency!

Sunday, March 24, 2013

The culinary delights of summer

Summer is my worst season. I really hate the heat. Indian summers, especially can be punishing. Right from Sankranthi in January when the cold starts reducing to Mahashivarathri when the cold is long gone and the heat really begins to settle in to Holi when the summer has fully and surely begun, Indian summers are not for the weak-hearted.

Many times, when I am outdoors, I decide that I am going to move to a hill-station. Sometimes, I zero in on Darjeeling (the tea would be a bonus!). At other times, I think Kodaikanal or Coonoor would be a better bet (I would get my fix of Idlis too!). But somehow, the whole move seems to big, too 'undoable'.

There are some good things about the summer as well. Swimming, for instance. Swimming has this ethereal property of making you cool enough to face every rigor of the heat. Until, mid April at least. That's when the children finish their exams and flood the pools in hordes. Thousands of them. Of all shapes and sizes. And they bring with them into the pools the dirt, the grime and other unprintable mess. Before this, you can see the other end of the pool from one end. After this, you are barely able to see your own hand inside the water!

Until mid June. Then the schools start again. The children go back to class leaving the pools to us. Slowly the water clears up.

For me the best part about summer is the food.

I love watermelons. But eating a cold slice of watermelon when it is 45 degrees celsius outside is something else. I still remember eating slice after slice of this delicious fruit many years back with a bunch of cousins in the peak of summer at Kalambole, a place close to Mumbai!



Summer also brings with it the king of fruits - the mango!

Breathes there an Indian with soul so dead who ne'er to himself hath said - heck, I love mangoes?

(Apologies to Sir Walter Scott!)



Mangoes take meals to an entirely new level. Lunches at our house are transformed. It first starts with the katki keri - diced raw mango topped with a little salt and red chilli powder. This adds a delicious, tangy flavor to the lunch! Once the bowl of aam ras makes it appearance, there is no question of a lunch without it until the entire season is over! It can be that addictive!



Kachhi households take this to another level. They relish the much-maligned karela 'like anything' along with the mango. The bitter gourd takes on myriad shapes, sizes and flavors in the quest for adding flavor to the meal - karela chips, bharela karela, karela pakodas and what-have-you!

The Ugadi Pachadi is another summer attraction! This delightful concoction of five different primary ingredients representing the five chief flavors is a mirror to what life eventually is -  a mix of different flavors! It is truly amazing how our ancestors thought!



So, as we get into another hot and torturous summer, let us savor the culinary delights summer brings with it. Hopefully our tongues will make the skin's job a tad easier!

Wednesday, March 20, 2013

With a true friend, there are no expectations

I have a few friends who I am very close to. I meet them rarely. I don't even talk to them regularly. But I know for sure that if I get into any trouble and I call them, I can count on them. These are people who genuinely care for me. The important thing is that there are no expectations. I don't expect them to do anything to know that they care for me. I know that they do.

I find that the younger you are when you form these friendships, the more genuine they are. As you grow older, friendships become more out of need than genuine bonding. I remember my friend Chetan's dad telling me after we had graduated out of engineering college, "Friendships you made during these days are those that will last you forever because these are made without any motive!" So true!

As we grow older, we lose our innocence and friendship becomes another commodity. When we are kids, we make friends because we truly enjoy being in their company.

When friendships are genuine, there are no expectations. I wouldn't be upset if my close friends don't wish me for my birthday. I would be happy if they did but I wouldn't hold it against them if they didn't. That is the beauty of it all. When you expect something from your friends, its simply that they're not close enough!

Wednesday, March 13, 2013

Have a heart for your kidneys!

Tomorrow is World Kidney Day!

On this occasion, let us all take a pledge to take small, simple steps to protect our kidneys. It really isn't that difficult. The trouble is it is really important. Here are some simple things you can do to protect your kidneys:

- Keep your blood sugar and blood pressure under control: Diabetes and Hypertension are the leading causes of kidney disease. It is very important to keep these under control.

- Stay fit - do some exercise regularly. We tend to get so caught up in our work that we keep postponing this. Remember, all you need is 30 minutes. Can't we even pull out 30 minutes from our work for exercise? Especially if it going to give us many healthy years?

- Drink only moderately if you must. Never binge. Never overdo it.

- Don't smoke. No concessions here. There are absolutely no benefits. Only very disastrous consequences.

- Drink plenty of water - the elixir of life! I wish someone would tell me to do this. You can. So drink all you can!

- Don't self-medicate - Painkillers and antibiotics must be taken with extreme caution. This year's World Kidney Day focus is Acute Kidney Injury, one of the causes of which is this. They might give you relief but the long term consequences are dangerous.

- Get a medical check-up regularly - especially if you are at risk. Once a year, a complete medical check up can't be that big a problem, right?

We all get busy with work. But think about what can happen if you don't take this seriously. We live life like there is no tomorrow. Lightning can strike at any time. It struck me when I was 21. I had no control. You are lucky that you do. If you still do not choose to exercise it, it is really up to you!

Happy World Kidney Day!

Friday, March 8, 2013

Is a bacterial sore throat an Indian thing?

I posted a couple of days back about whether to take antibiotics or not when I get a cough. Someone, presumably a doctor, commented, "Most Upper Respiratory tract Infections are viral in nature and they usually run a self limited course and there is no role of antibiotics." I had heard that in the past and when I saw this comment, decided to dig deeper.

I found reputed websites support this claim. In fact, millions of dollars worth antibiotics are prescribed in the US every year to treat these infections where they do not have any role in their treatment in reality.

When I look back at the episodes of cough that I have had in the past, I distinctly remember that I would get the cough and no matter what I did, the symptoms would abate only when I started antibiotics. Why was that the case?

I checked with a few friends about this. They seemed to concur. "My cough starts getting better only when I take antibiotics!"

Surely, so many people could not be wrong!

Could it be then that there is an Indian context to bacterial coughs? That Indians are more predisposed to getting coughs that can be successfully treated with antibiotics than people from the US, for example?

A lot of information on medical websites and medical information on Wikipedia is authored by people from the US. Could it be possible that this information is keeping that gene pool in mind?

I don't know, I'm asking.

Wednesday, March 6, 2013

The Antibiotics Question

I tend to get a sore throat and cough on and off, every few months. The signs are familiar. It will start with a slight sore, keep going and coming and then eventually turn into a full blown sore or cough. I try a lot of home remedies - hot water gargles, steam inhalations, drinking hot water mixed with turmeric (haldi), salt and ghee.

But most of the time, there is no sign of the infection abating. It becomes worse until a point where I conclude that this cough is made of sterner stuff. Then I go to a doctor who would prescribe an antibiotic and within a few days I would be totally all right.

This makes me tempted to wonder why I cannot start the antibiotic right away, when the cough just begins to rear its head? The trouble is antibiotics and their usage have been the target of a lot of criticism especially the way they're abused in India.

I am really not sure about what is true and how much is true in that whole campaign. All I know is that when I take an antibiotic, it helps me greatly. Yes, they could have deleterious effects. But they help me!

Last few times, I have not been trying the home remedies for too long! I try them the first day or so and then request my doctor to prescribe an antibiotic!

Of course, I do not recommend this to you at all. I am just describing my own experience. Any drug must be taken with extreme caution and only if nothing else works. What happens in my case is very different because I have a compromised immune system - my body's ability to fight infection is not as strong as a person with healthy kidneys. So, trying home remedies might help in only the most trivial of infections. I would need the help of an antibiotic to feel better.

I have no clue on what other harm these potent medicines are causing. For now, I am looking forward to the antibiotics that I started last night for my developing sore to help me feel better in time for Saturday morning when I go out on a weekend break!

Sunday, March 3, 2013

The needle pricks kill a part of you every session

When I meet people on dialysis, I sometimes ask them what the worst thing about dialysis is. 'Fluid restrictions', some say. 'Can't eat fruit', say some others. 'Going to hospital thrice a week'. 'Needle pricks'.

All of them are bad. But in my humble opinion, if there was a way to remove the needle pricks during dialysis, life on dialysis would have been a much pleasanter experience. You start dreading the pain as soon as you think about the next session. By the time you are on the bed, you are a bundle of nerves. You are hoping you get the tech or the nurse who does a good job. (Of course you can't ask for him or her; you don't want to piss the others off - they will be cannulating you some day!)

I feel a little lidocaine to numb the area before cannulation may not be so bad after all. Yes, it does cause hardening of the tissue in the area but for me, it works well to reduce the pain dramatically. Of course, you have a funny situation because the lidocaine itself is painful! Delicious irony of life! But in my experience, the sum of both pains is less with lidocaine than without.

Yesterday, I was at a dialysis unit. There was an old lady ready for dialysis. A few minutes later, I heard her cry out in pain. My gut wrenched. Somehow, I can't take old ladies having pain. I just feel it is not fair at all. She had just been cannulated. I heard the techs reassuringly tell her, "Its over, its over"! She looked at them with a frown. It is often not the tech's fault. Cannulating with such a thick needle is bound to pain a bit however experienced or good you are.

The pain lasts only a few seconds, half a minute at most unless something is wrong. Some of you might wonder why such a big fuss for a few moments of pain? All I can say is experience it before you comment. The needles really kill a part of you every session.

There is a way to get dialysis without the pain. A permcath. Unfortunately, a permcath is prone to getting infected and it lasts only for a year or so. A fistula lasts decades but with a fistula, the pain comes free. Why couldn't it have been the other way round?

Friday, March 1, 2013

You helped me when I needed you most!

Yesterday, after closing dialysis, during the Hot Disinfection cycle, the dialysis machine gave a Flow Alarm a couple of times. Naidu, the tech that was there asked me to call the machine technicians and simultaneously, he removed the inlet water filter and soaked it in bleach.

I called Nambi, one of the leads from the Fresenius team and requested him to have someone take a look. Later in the morning, Chary, the Fresenius engineer came and checked everything. He did not find any issues. He asked us to put the inlet water filter back just before starting dialysis and everything would be fine.

Last evening, Zia, the tech who came to help with my dialysis put the filter back but when he put the machine on testing mode, the machine test failed and three important tests were failing. We tried running the tests again. No luck.

Luckily I had not cannulated myself. I called Nambi again and told him the problem. He said he would send someone asap. It was about 11 in the night by then.

Chary reached my house by about 11:30. He checked everything and found that a valve inside the machine was giving a problem. Within an hour he fixed the problem. By about 1 a.m., we started dialysis.

The machine is almost seven years old now. So, small problems from time to time are only to be expected. What I was moved by, however, was the superb responsiveness of the Fresenius team. Any other company would have pleaded helplessness and said they would send someone the next morning. But not Nambi, Zahid and Chary of Fresenius. Their total commitment to patient care and genuine willingness to help stood out in this incident! They went beyond their call of duty to make sure that I was able to dialyze last night.

It is really heartening to see that such gems still exist in an industry that has been overtaken almost completely by greed. Many people in the healthcare industry forget that this is supposed to be a different kind of job. This is not entirely about the money.

Once again, I would like to thank Nambi, Zahid and Chary for helping me in my hour of crisis! I will never forget this!