Saturday, December 30, 2017

A dream comes true: NephroPlus arrives in Goa

When we started NephroPlus, I always dreamt that we would have a dialysis centre one day in Goa. I had gone to Goa a few times after getting on to Home hemo and got dialysis in different centres there. I was not at all happy with most of them. I had also read about a dialysis centre in Australia that overlooked the Great Barrier Reef and had glass walls from ceiling to floor where the dialysis stations faced the ocean. I could not let go of that image and thought Goa would be an ideal place to set up such a centre in India. 

Eight years after starting NephroPlus, that dream is one step closer to reality. We still do not have a centre overlooking the ocean but have setup our first centre in Goa. The centre is inside Victor Hospital in Margao. I had undergone dialysis in this centre on one of my trips to Goa much before NephroPlus was born. I visited the new centre during my recent Goa trip. What a beautiful centre this has turned out to be!

Here is a video of me speaking during my visit to the centre:



I have always believed in the magic of taking a holiday for those on dialysis. A break from the routine can be welcome for anyone; more so if you’re on dialysis. That is why we were all excited about the Holiday Dialysis program in the company. Till date, several patients from all over the country and indeed the world over have utilised this program to enjoy a relaxing vacation while not having to worry about the quality of dialysis they would get while away from their base location. 

With comfortable weather, a host of fun things to do and excellent beaches, Goa is the ideal getaway destination for dialysis patients. Merely driving through sleepy Goan towns with lush greenery all around can be such a pleasure.

So, I would encourage all dialysis patients looking for a holiday to consider Goa the next time they want a break.

You can email holidaydialysis@nephroplus.com or call +91-40-6000-7200 to find out more.

Friday, December 29, 2017

Please change the spelling of the word ‘opportunity’, someone


In India, the word ‘opportunity’ is probably the most mispronounced English word. Every second person I hear says it like it is spelt. The second syllable is pronounced by them to rhyme with the first. ‘Or’ is such a common word that when these two letters appear in the word ‘opportunity’, they pronounce it like they would pronounce ‘or’. How can you blame them?

English pronunciation has been the topic of many essays. The lack of consistency in pronouncing similarly spelt words has flummoxed many. This is also the topic of a legendary dialogue of the great Indian actor Amitabh Bachchan in the film ‘Namak Halal’.

Wouldn’t English be much simpler if it were pronounced the way it was written or written the way it was pronounced? It would save so many people their blushes. I don’t claim to have perfect pronunciation myself. I have been caught on the wrong foot many times with some words. Yet, my mistakes are most often with less common words.

English would be much simpler, agreed. But would it be as beautiful? I doubt it. The beauty of the language lies in its idiosyncrasies. It deserves a little effort to learn. It takes some practice as well.

For the time being however, those who pronounce opportunity as ‘opp - or - tunity’ would do well to use ‘opp - ur - tunity’. But is that good enough? What’s to prevent someone from pronouncing the ‘ur’ as ‘oor’ or worse?

I guess some things are best left untouched. Robert Benchley would agree, “Drawing on my fine command of the English language, I said nothing.”

Friday, December 15, 2017

Off to Goa



I’m off to Goa today. I will be there until Sunday. I am meeting my college friends there. The last time we met, we had gone to stay at Oceanside in California, US. The previous time was the Alaskan Cruise  I really enjoy the time I spend with them. These are friendships that have stood the test of time. We love to become the kids we were during our college days and do stuff that we enjoyed back then.

Goa is a great place for a holiday for those on dialysis. It is of course, a great place to relax and also has some very good dialysis centres (NephroPlus recently started a centre there).

I have been to Goa so many times now that my brother calls it my second home. Quite ironic considering the fact that half my blood is Goan.

As it turns out though, given a choice I would rather go off to a place like Rishikesh or Coonoor  I honestly am not much of a beach guy. I also absolutely abhor the salty sea water and would much prefer rafting in the Ganga. But Goa is only a flight away and is considered the ultimate party destination in the country so I keep ending up there most of the time.

Looking forward to the trip!


keep ending up there most of the time.

Wednesday, December 13, 2017

How stopping a Proton Pump Inhibitor changed my life



As I wrote here recently, I was asked to stop a drug, Cintodac (a Proton Pump Inhibitor  because it did not allow another drug I was prescribed, to act. As I mentioned, stopping the drug and being put on a milder alternative that came under the class of H2 receptor blockers reduced my appetite and the fluid weight gain between dialysis sessions.

I have lost almost 7 kg of dry weight since I have stopped Cintodac. What’s more important for me is that my fluid weight gains between sessions are now within human limits. Earlier they used to be in the elephantine range.

Having low fluid weight gains provides a lot of benefits. I am not referring to the obvious clinical benefits such as less stress on the heart but of other simpler things. For example, I can now afford to miss dialysis twice a week with ease. I keep changing my number of dialysis sessions per week like nobody’s business. Just recently I had switched to missing two night in a week and blogged about it  But yes, I was back to missing once a week in a few days because the fluid restrictions I had to put myself on were quite onerous. 

Many people could not understand how on earth I could drink so much fluid? Well, neither could I. But now, it all falls in place. It was due to Cintodac. I remember reading on a dialysis blog that if you ate less, you could drink more. The Cintodac increased my appetite so much that I put on a lot of fluid weight due to eating too much. So, not only did I put on dry weight, I also put on a lot of fluid weight.

I was so embarrassed by my fluid weight gain that whenever I was asked what my average fluid weight gain between sessions was, I would always say 2 kgs or some such ridiculously low figure. And imagine my horror when people would be surprised that I even put on that much. I would squirm in my seat thinking about how they would have reacted had I told them my actual average.

But thankfully, that’s more or less settled. Blame it on Cintodac and not on non-compliance. My course of medication completes in about a month. At this point, I do not plan to resume Cintodac.

Saturday, December 9, 2017

Why home hemodialysis?



Many people ask me why I choose to do home hemodialysis. To me the answer is quite simple. The main reason I do home hemodialysis is that it makes it easy for me to do daily nocturnal dialysis. This begs the question, why daily nocturnal?

I’m going to let you into a secret here. 

Many people do daily nocturnal hemodialysis because they say the outcomes rival those of a deceased donor transplant (cadaver transplant). They say the risks of organ stunning, damage to the heart and many other co-morbidities associated with long term kidney failure (and hence dialysis) are much lower with daily nocturnal hemodialysis than the regular thrice a week modality.

Honestly, for me all that does not matter much. I do daily nocturnal only for one reason - no diet and fluid restrictions. I eat and drink pretty much what I want and how much I want. I don’t stop to think whether something is high potassium or high phosphorous. I don’t stop to think how much I have drunk today before sipping on a cola. 

This freedom to eat and drink without any restriction is the main reason I do home hemo. 

That said, there are other things that are good about this modality:

- Flexibility to do dialysis when you want to. You can skip when you choose not to do dialysis. You can choose to do dialysis if you feel like it.

- Flexibility on the time of dialysis. I got late at a party? No problem. Dialysis will begin late and will be only 6 hours instead of the 7 1/2. 

- Full control over dialysis parameters. I can play around with the dialysate temperature and sodium level based on how I feel and what I have read helps.

All this is good. But the main reason is no diet and fluid restrictions. Period.