Wednesday, February 26, 2014

Bone pain returns

I have grappled time and again with bone pain. The worst episode lasted almost a year around 2010 and I found the answer after numerous trials and errors, seeing multiple specialists and a lot of frustration. The balance between drugs and the Calcium level in the dialysate is very delicate and I have never quite found the right answer.

For the last month or so, I have felt the pain return. The signs were familiar. The back first started to hurt. Then a shoulder. Now the feet. The increase was gradual. A month back, I found that my PTH had plummeted to 30 pg/ml (it should be around 250). I immediately stopped the Calcitriol and Cinacalcet (after confirming with my nephrologist). However, the pain continued to increase.
From this Sunday, however, things became quite severe. I am now walking with a limp.

I checked my PTH again to see if I was on track. 150 pg/ml. Ok, I was on the right track. Not there yet but getting there hopefully.

But then, why did the pain worsen?

Currently, my right shoulder aches unbearably during the last hour or so of dialysis. It returns in bursts during the day causing a lot of discomfort. And my left foot continuously pains. I am actually wondering if there is a tear or a small fracture of some sort!

My Calcium and Phosphorus levels are normal. So, is my Vitamin D.

I have scheduled an appointment with my nephrologist tomorrow. I hope he has some answers. 

Wednesday, February 19, 2014

NephroPlus introduces Hello Kidney, a dialysis podcast!

I interviewed Samiir Halady for the first episode of Hello Kidney, a podcast from NephroPlus. In the interview, Samiir talks about how he finds the energy to trek despite being on dialysis. This interview is inspiring not only for those on dialysis but also people with healthy kidneys.

It is a great example of how kidney disease need not restrict you from doing what you truly love. Nothing is impossible!

You can listen to the podcast by clicking here.

Tuesday, February 18, 2014

Rishikesh Diary

One of the items in my bucket list was to raft and swim in the Ganga. So, when I learnt that Rishikesh, which is situated on the banks of the Ganga, is only an hour's drive from Dehradun where NephroPlus had two dialysis centres, I got all excited. I finally got a chance to visit Dehradun this month during my trip to North India.

I finished off all my work in Dehradun by Saturday night and took a cab to Rishikesh on Sunday morning. I had already talked to a company called Paddle India that had very good reviews on Trip Advisor. They seemed to be very professional and had an excellent safety record. I asked to be booked on a rafting trip that had Grade 1 and 2 rapids and nothing more! I really wasn't sure if I would be able to handle anything more than that. I had not done a whole lot of rafting before and wanted to go easy the first time.

The River Ganga

I reached the appointed place on time and they gave me a suite and a jacket that would keep the water out. Once I had changed, we drove to a place called Brahmapuri. I got my first view of the Ganga on the way and it was completely mesmerising. We got off at one point and trekked downhill to a very serene place on the banks of the pristine, yet mighty river and had to wait till the raft arrived. The Ganga was really beautiful with a light green hue that calmed the eyes. Very clean, very pure.

Here ia short video of the flowing river:

When the raft came, I was given some instructions by Shiv, our guide for the day. There was an American couple already on the raft. We headed out. Shiv was very cognisant of the fact that city dwellers are not always in the best of fitness! He would goad us to paddle a little and give us a break. It was a fantastic experience! There was a calmness in the waters that is impossible to describe.

At one point, I asked Shiv if I could swim in the river. He stopped the raft and asked me to take off my shoes and go in. I excitedly removed my shoes and socks and just jumped into the water! The first touch of the river was awesome! The cold water against my body was a different experience altogether. The cold was somewhat reduced because of the suit I was wearing. I started floating thanks to the life jacket and the flow of the river took me along with it. I swam a little and floated a little, feeling the cold water and relishing every moment. There was a rescue kayak with an expert, Darshan, that was always around to handle any untoward event.

I continued to swim along the flow of the magical river while the others rafted behind me. After about  half an hour, I started to feel really cold and asked to go back into the raft. Shiv, expertly pulled me back into the raft. I had really enjoyed the swim!

The rapids during the rest of the journey were fairly exciting. Nothing heart-stopping but fun nevertheless. I had what I could probably call, one of the best couple of hours of my life!

Sunday, February 16, 2014

Delhi Diary

This trip was the longest I have done in India after I got diagnosed with kidney disease. I had to go to Delhi for a meeting and decided to visit Agra (for some work) and Dehradun (since I had never been to the NephroPlus centres there). At the end of the limited planning I did, it turned out to be a 9 day trip! And also one of the best ever!

Paranthewali Galli

I had heard about the Paranthewali Galli from my parents when I was a kid. They said it was a lane in old Delhi which had a bunch of shops selling piping hot paranthas. They however said that it used to be very good long back but they hadn't been there in a long while and were not sure any more of how good it was now.

On a flight stop at Delhi en route to Lucknow a couple of months back, the air hostess of the Indigo flight we were on advised people getting off at Delhi to try the paranthas at Paranthewali Galli which, she said, were served with yoghurt and pickles. My mouth started to water. I could not do anything about it though since we were on our way to Lucknow!

So, this time, I made it a point to visit the place. I was all by myself. Once I was done with my work on my last day in Delhi, I took an auto to the famous galli. The auto driver stopped in the middle of a crowded street in old Delhi and pointed to a lane and said that was it. I got off, paid him and walked into the lane.

All I could see was jewellery shops and a couple of shops that sold chaat and jalebis. No paranthas. I kept walking forever. I realised that I was on the wrong way. I asked someone about the galli and he pointed me in the right direction! After about fifteen minutes more of walking, I finally saw 3-4 run down shops with the names that had "Paranthewala" suffixed. I walked in to one that seemed crowded and sat down. I ordered a Paneer Parantha, a Dal Parantha and a Lassi. I was served in a few minutes.

I took a bite of the Paneer Parantha. It was out of the world! Crisp outside, soft within, the flavours taking over your entire being in seconds! The Dal Parantha was no less delicious. The Lassi was also fantastic! The Indigo air hostess, however, was probably reciting from a script written by a completely uninitiated person. The paranthas are not served with yoghurt or pickles! They are served with a tangy banana chutney and some other curries. Another thing I figured was that the paranthas were actually fried! This made them even tastier!

After I was done, I paid up and then walked out of the galli only to be greeted by a halwai selling hot jalebis. I couldn't resist the temptation. I ordered a plate of jalebis. They were unlike anything I had ever eaten before. Crisp, sweet and very, very tasty. I had undone many hours of swimming in one evening. But, what the heck? It was more than worth it! After all, what is life without a little good food?

Sunday, February 2, 2014

Rajahmundry & Kakinada Diary

I don't know when I developed this fascination for rivers. For a few years now, I have had swimming in a natural river on my wish list. The problem of course, was dialysis. I could only go to places by rivers that had a good dialysis centre. That automatically ruled out a large number of places. The Godavari was one of them. I wanted badly to go to this river. I have no idea why. I remember checking with the tech that came to my house until a couple of years back - Jayaram Reddy about dialysis centres in Rajahmundry. He said there were centres but of very poor quality.

So, when we opened a centre at Rajahmundry some time back, I was really excited. I would finally be able to take a dip in the Godavari. Things did not materialise until a few days back when Venkatraman, my colleague at NephroPlus and I finally booked tickets on the Goutami Express from Secunderabad to Rajahmundry.

At dawn, we awoke and were sitting by the window when we were treated to our first glimpse of the river. The sheer size of the river left me overawed. It was like this huge mass of water flowing slowly on its journey towards the Bay of Bengal. The stretch at Rajahmundry is only a few kilometres from the sea.

Dialysis at NephroPlus

I head the Quality team at NephroPlus. So, I was completely sure of the quality at our dialysis centre in Rajahmundry. We monitor all the critical parameters on a continuous basis and there are rarely any surprises. My dialysis session passed off very well. When I talked to some of the patients who were there, they were all very happy that we were providing such high quality dialysis in their city. Some patients and their family came and met me and chatted with me during my session.

Meeting patients who really benefit from the quality we offer is heartening. It makes all the effort we put in very worthwhile. When you see the gratitude in their eyes, you mentally decide that you would go to any lengths to keep a smile on their faces forever!

The dip in the river

Once we were done with our work, we checked with the team there on where we could go and swim in the river. At first they suggested a swimming pool. I told them that I wanted to swim in the river. They found this idea most amusing. Why would "Kamal sir" want to swim in the river? There was a scurry and muted discussions among them and they zeroed in on a particular spot which they felt would be good to actually take a dip. We got on to their bikes and made our way to the spot. There were a bunch of kids there having a whale of a time.

I had not got my swimming trunks with me. I honestly never thought we would actually be able to swim in the river. But here I was, on the river banks, a series of temples and ashrams flanking me. I was in a T shirt and shorts. I decided to take the plunge. I slowly stepped into the river making sure the moss covered steps do not make me fall. The cool water was exhilarating!

My wish of many years was finally fulfilled!

Rose milk

We took a boat ride in the river on a speed boat and then decided we were hungry. I asked our Rajahmundry team (Shiva, John and Prasad) where we could eat or drink something nice. The consensus was rose milk. We heeded to the main market of Rajahmundry where there was a small little shop. The shop had no name. It was apparently called Rose Milk itself. Legend has it that the family that owned the place and ran it for the past 60 years had this secret recipe for the rose flavour that goes into the making of the rose milk. The rose milk was not the best thing I have ever had but it wasn't bad either.


The next morning we headed for Kakinada. It was about an hour's drive. The team there was also very welcoming. I got done with my dialysis and other work that was scheduled. Towards late evening, we headed out towards the beach. Kiran and Shekhar from the Kakinada team took us around. We wanted to hire a speed boat into the ocean but we were a little late for that.

We ended up going to a park that had a lake within and took a small speed boat ride there.

Subbaiah Hotel

Kiran then took us to the Subbaiah Hotel. This place is steeped in tradition. There is a large hall with single tables and chairs. They serve you on a plantain leaf. The order of the food is fixed. They try to convince you to taste everything. They also force you to eat more in the traditional style! Everything is unlimited.

The food was really very good. There are a large number of items, all very simple, very tasty.

We topped off the heavy meal with a pan.

Simplicity is the key

When you visit places like these, you find that most people here are very down to earth, deriving joy from the simple things in life. A glass of rose milk, a dip in the river, a satisfying meal are all enough to keep them happy. In the city, while we need something much fancier to give us our kick, people in smaller towns seem much more contented with simpler things.

As we got into the train on our way back to Hyderabad, I couldn't help marvel at our teams in Rajahmundry and Kakinada. They were genuinely committed and passionate about our cause. They treated the patients like family. Patients also loved them back. Despite not seeing the founding team or any of the management too often, these people went about their work with a zeal that is truly exemplary.

This perhaps ties in with the inherent simplicity of the people in these parts.