A FREEZING CHALLENGE

Most of us have been in the ICU of hospitals at some time or the other. An intensive care unit (ICU), also known as a critical care unit (CCU), intensive therapy unit or intensive treatment unit (ITU) is a special department of a hospital or health care facility that provides intensive care medicine. These Units cater to patients  who suffer from life threatening illnesses and/or injuries and when the condition warrants  close monitoring and support from specialist equipment and medication in order to improve the patient’s condition. The ICU is supposedly manned by  highly trained doctors and critical care nurses who have been trained  in caring for seriously ill patients.

If you are admitted in a comatose or even semi comatose condition, it really does not matter what happens around you.  But when you are not all that ill, have your mental faculties intact, and have had the misfortune to be kept in the ICU, just “for observation” for the night or the next day as I was on two occasions, the miseries are manifold.

Firstly, you are moved from the emergency to the ICU and instructions go back and forth between the ward boys and the nurses over your head and you sigh in relief as you are wheeled into a refrigerator. Ah yes, you have to wear the hospital gown. Gone are the comforts of thick cotton gowns with tapes at the back. The ones you are given are paper thin, translucent, and you guessed it, eco friendly and disposable without the headaches of laundering. They are fastened with Velcro at the back, which hurt as you lie flat, and with maneuvering and twisting like I do, the fastening comes off. Fortunately or unfortunately you are surrounded by co-patients who don’t have the energy to ogle, or see you in a half clothed state. Uniformity persists and at times difficult to tell a male from a female, so you are cloaked in anonymity. It is easy to contact pneumonia in these surroundings!

Lowered on to a waiting bed,  the monitors and tubes are all in place as your progresess is recorded and your fate described electronically. There is a file on you, and interns and young doctors enquire politely how you are, and  ask what exactly is the problem. The problems? “Innumerable”, I want to say, as I clench my teeth in an effort to keep them from chattering. “It is i..i.cyc..c..cold”, I venture. My toes generally go into a cramp if they are chilled, and dash it I forgot to bring those warm woolen socks knitted for me by Sue, my sister-in-law, who believes that woolen socks should be part of ones wardrobe and her insight is to be lauded. They bring you blankets, cotton blankets, one at first. When I still chatter, they place another one on me. “She must have fever,” say the nurses and check my temperature which is absolutely normal.

Since I was conscious and mobile I did not want a bedpan. I was however assisted by a kindly nurse, and I felt a rush of cold air behind, and realized the back was fully open. Giving up futile attempts to cover my behind, I shuffle to the loo which has bedpans, urine bottles, beakers and other stuff.I asked if I could read, and in a moment of weakness the sister gives me the newspaper which I could not enjoy, as the light was dull and the headlines screamed murder most foul, theft, and other heinous crimes including rape. Enough to depress even the most cheerful person around.

When the Chief comes on his rounds, there is a bustle of activity as files are updated and every comment of the Doctor is recorded and hopefully carried out. Your fate (read stay in the ICU)rests with the good doctor.

End of the day but the ICU is  forever night with artificial lights, and you lose sense of time though aware that it moves ever so slowly. You welcome the night, as the end of it you will see the day, and that means discharge or at least a move to a ward where you see life around you. But you are not prepared for the night and the surprises it brings.

The handing  over begins as the shift changes. The nurse-in-charge loudly tells her takeover counterpart every single detail of the patient, his or her physical condition, through the well worn file. By now you know your entire history by heart. Lights are dimmed and you are gently asked to sleep.

That’s when the fun and games begins. I thought ICUs would be silent zones where soft footed medical staff would be Florence Nightingales .Not so in your wildest imagination. Cries of “Narayana, kadavale!” rent the air, as one male patient believes he is being assaulted. “Thatha, don’t shout”, says the young nurse as she runs to placate him. Two beds away another man who has been relieved of his tubes sleeps but lets out the strangest of noises and loud snores oh so familiar. It makes me terribly homesick.

The interns and nurses discuss their day with gusto. They talk about in-laws, out-laws, the state of economy in the country, the corruption, politics and various other subjects… and the emphasis with which the discussion goes, pales  drawing room conversation  into insignificance.  They joke and laugh loudly and in my disturbed dream, I imagine glasses clinking and people laughing in a half drunken state. I sit up in bed, call a nurse to my bedside who “Ennama”s me, and I tell her in no uncertain terms what discourtesy it is to such sick patients, and that I would write about the attitudes here and complain. Very deflated the matter is reported to the doctor, and silence persists for sometime before the cacophony begins again.

The next day I am cheerfully told I could “go” and I feel that I have been released from jail.Though moving to the ward is another process which you suffer  there is the promise of your own gown, and the warmth of family attenders and then home. The ICU is the loneliest place in hospital hell, where you lie removed from family and contend with tortuous thoughts. Recovery when you are not so seriously ill, is faster in your own home, with nursing staff and the comfort of familiarity. Ah for midway nursing homes  where you could just lie back and allow yourself the luxury of relaxing, without the endless disturbance of hospital routine!

Driving Miss Daisy

My driver, let’s call him Sam… doesn’t drive Miss Daisy, he drives me… crazy.  And yet we can’t do without him. Sam doesn’t drink. Or smoke. He is a skillful driver and used to traffic gridlocks weaving in and out of heavy traffic without a scratch on the car. A good psychologist he knows when someone is overtaking him on the left and when pedestrians are about to cross the road. He doesn’t swear at rule breakers except to say  “Dai Somberi” a catchy phrase picked up from his employer. No litany of abuses thank heaven.

My husband and I having been driving for decades.. When we realized that driving through Chennai traffic requires uncanny skill, and nerves of steel, we decided to hire a full time driver. A painful decision for my husband  aman reluctant to share his well and maintained vehicle with anyone save  his wife..

Good at handling personnel, or rather my diminishing domestic staff, I was still perplexed as to  how I would handle this new entrant. I decided that Sam would be in my huband’s domain. “But I hired him just for you,” was his  remark, and I did have a sneaky feeling he was trying to pass the buck. I rushed to my library and scoured the shelves for self-help books to see if there was a chapter on “ How to Handle your New Driver.”   It was a futile exercise and putting on my sternest countenance I decided to meet the challenge head on.

The salary was fixed, though we both knew that we were overpaying. I told Sam that there was not much of driving, but he had to do all the odd jobs like the vegetable market and the groceries. And of course the bank, repair shops, collecting the laundry etc. Every month he would have to cobweb the place, clean the fans  and the lofts occasionally and garden help. Sam nodded his head very emphatically. I always look for chinks in the armour, and years of experience have taught me not to swallow the too-good-to-be-true situation.

Soon enough we found several chinks. Sam’s mobile is his lifeline, he receives more calls than we ever do. When we are ready to go home, we call his mobile and find it is “busy”. We have learnt to say a prayer and hope he will answer our call. Sam is a sneezy wizard. He sneezes if there is dust, he sneezes during every cleaning job we give him. He is allergic to the AC. You will never find him idling the time sitting in air conditioned comfort in the car, with the music in full blast. He will stay outside despite the sweltering heat, communicating with his buddies on the phone or outside.  When we travel long distance by car, he begs for spells of non AC, will lower the front window and stick his head out like a puppy. A  teatotaller he will never stop for cups of tea or coffee.

Sam is a pro when it comes to the Disappearing Act. He has this uncanny knack of scooting as soon as we reach our destination. He finds a friend everywhere he goes, and when he does, he leaves the mobile in the car. We stand outside and cool our heels, rave and rant about his inconsistencies till he spies us long distance, and runs like the wind to reach us.

Sam is clueless about punctuality. Getting a watch for him did not help. He leaves it at home. When we have an appointment in the morning, we cry ourselves hoarse on his reaching us in time and making calls to his home is useless as the mobile is never picked up.

Plus points? Plenty. He has the kind of social networking which will put Facebook to shame. Even in absentia  he will know where we went and how long we stayed. Recently we went  to the hospital to run tests and hired a call driver as Sam let us down. The moment he reported for work he said he knew how many hours we spent at the hospital and thatthe dadipayan(fat slob) we hired slept peacefully in the car with the aircon on, and  a lullaby from the sound system.

Anyone wanting a good driver and Sam will get one for you. Looking for domestic help? Someone will report for work, irrespective of whether they will stay on for a day  or a week. He will explore their background and give you the relevant details. He will never let anyone of us go unescorted to a shop, restaurant, or the market. He will offer his arm whether taken or not, when we have to negotiate over broken pavements, and steep steps without a hand rail. If anyone of us is sick, he will  press his chest to control his so called palpitations while his eyes would fill with tears.If there is a street fight or a small accident he will have no qualms of abandoning me to run  to the scene of crime, and participate actively..  I resolved to take a spare car key so I can drive off and leave Sam to his belligerent activities.

I cannot conclude without a small anecdote.. Every Thursday Sam drives my husband to the Gymkhana Club.. Originally Sam sulked at the late nights since the week could have other activities like plays, the occasional movie and weddings. Never mind the extra tip, he liked to be with his family. I  was surprised to see a gleam in his eye and an energized Sam take off with my husband every Thursday to MGC. As it happened one day my husband decided not to go. Thinking I would take his help for other chores I looked for him.

“Where’s Sam?”

“ Oh he’s gone to the Gymkhana Club,” said my husband, most matter-of-fact-ly.

“WHAT? Without you?”

Sam had taken a local train, visited the Club and returned after meeting his weekly buddies for a while. “They would be heartbroken if I didn’t turn up…” he explained.

A mini Club for drivers at MGC?  What fun!

The Horror of Rape

THE HORROR OF RAPE

With stories of rape coming in from very quarter, every one of us need to protest and raise our collective consciousness.  Rapists seem to stalk our everyday life. No one is really spared, the middle aged, the young and even toddlers. When Nirbhaya, a young woman died in Singapore of rape, of brutal assault, and grevious injuries, the nation  went beserk. Moving her to Singapore in her condition was a political decision. A 1000 crore Nirbhaya fund was announced in the Budget for the safety of women. Is it functional yet or is the Government still dragging its feet?Soon after, several rape cases from across the country were reported, many of them gang rapes.

When five year olds and two year olds were raped, sodomised, injured and tortured, our insides burned. The sadistic and horrific sexual assault on a five-year-old in East Delhi  in April, shook the nation and  I could hardly read the reports as my eyes were constantly blurred with tears. Death sentences are too mild for perverted rapists like these. What then is the solution? Are we getting more aggressive and perverted? Is it the rise in the rural- turned- urban population which escalates this figure ? Or, is the media uncovering every one of these heinous crimes, shocking us as never before? Were these incidents very much there in the old days, but covered with a veneer of respectably, while the skeletons of child abuse rattled in the cupboard?

While we are merely addressing the symptoms of this rape epidemic in our country, we are not sufficiently probing into the actual cause of  the persistent disease which has to be stricken from its very roots. I see pornography as one of  the causes, raising the male libido to a great level. Where  porn was available in the form of blue films officially banned but nevertheless surreptiously watched, today it is a free for all, porn sites are there in plenty accessible to young children and teenagers. Some of our movies are violent, holding up killing and aggression as heroics.  And last of all though I might sound very old fashioned or prudish our young girls today, even in a conservative city like Chennai wear shockingly revealing clothes. Mini shorts or skirts, spaghetti tops, low cut blouses  to reveal  the cleavage are just some of the modern attire.

I frequently tell the young girls in my family that they have to be careful what they wear when they are using public transport or walking on the road. You cannot afford to be provocative.  Men of a different class view the girl who is scantily dressed as one who is inviting a sexual dalliance, as they are not used to seeing women dressed immodestly. This does not rule out men of a  higher class who views the modern woman as one who is sending out subliminal cues through her dressing like “Look at me. Catch me if you can.”

The dressing down craze is creeping into the minds of young maids. Nobody wants to look outdated, so they switch to the ubiquitous salwar kameez which proclaims modernity, but covers the body. Now the necklines have started plunging and “low backs” are a must. My maid who is extremely fashionable, laments the fact that I wear high necked blouses and brushes off my age as something insignificant. Her back neckline plunges so low that only two inches of blouse are seen and oodles of flesh revealed…. thankfully restricted to her back. I insist she drapes her pallu over her back if she is walking home unescorted.

There is something graphically wrong with a society which cannot guarantee the safety of its women and children. Our tourism will ultimately get sorely affected when people realize that India is not a safe place for women as in the recent past, foreigners have been at the mercy of rapists.  We have unfortunately a broken system where the initial horror and public outrage converges into a placidity and drawing room conversations before dissipating totally.

You don’t have to look carefully to find that the law and order system, beginning with the judiciary and filtering to the police, is quite flawed. The Government needs to take up some responsibility and introduce fundamental reforms which will include counseling, delinquent homes, psychiatry and stringent laws to enforce discipline. Legalising prostitution with protection for the sex workers may be another solution where lust can be vented.

Sociologist Manas Ray from the  Centre of Social Studies Kolkatta says the rise in rape can be partly interpreted as the anger of the urban poor where women and children become easy targets. “It is more a power issue than sexual gratification”, says psychiatrist Aniruddha Deb of Kolkata.

What can the common man do? Protect your children and women. Don’t invite trouble, we can’t afford not to be too careful.  Protest in any form that you know. Bring to the attention of the media/ police/government any cases that you personally know. Don’t adopt the “nothing works” attitude. Let your voice be heard.

By safeguarding your women and children you are safeguarding the nation.

What's left is memories

I wrote this when I lost our daughter in 2001. She was only 34, and left two lovely little girls aged 6 and
 2 1/2....

It always happens to someone else or so you think. The tragedy of death. You commiserate with those who face the irreparable loss and your heart is squeezed. Nevertheless somewhere inside is the relief that it had not happened to you, and you float on the feeling of being forever protected. Alas no one is really protected from life’s strange vicissitudes….

Without warning, in one fell swoop, the inexorable axe of death separates you from the one you love more than life itself. A slow numbness spreads starting from your brain to the rest of your body. In an incomprehensible waking dream , you are as it were, insulated from reality. You go through the motions mechanically, the last rituals, looking at the stream of people, coming over to condole you, and you listen to clichés which you expect they will mouth, and staring at them with disbelief when they don’t.  “ You have to be brave,”  “Time is the best healer.” “ If there is anything you need we are there for you.”

One part of you is touched by their kindness and caring. Another part screams hurt when people lack sensitivity. When they ask probing questions. What  really happened? How did you let her go? You who are educated and know so much? Couldn’t  the medical care have been better? How is so and so taking it? It is the Indian way of showing concern. You cannot blame them. They all mean well, every single one of them.

Every single detail that led to the ultimate end is etched so finely in your mind. What you talked about. The dreams and the future. The smiles and the tears. How you tried to keep the visitors at bay. How they would sneak into the ICU for a seemingly last look. How your insides burned to have them view the spectacle of your loved one with tubes all over her body. Did it provide them satisfaction to have a look? Was it the sight that they hankered for?  “Well meaning” relatives who had the “right” to look in, could never be put off, however much you pleaded for privacy.  However much you pleaded that in the battle for life she be left with some shreds of dignity.

Shock and disbelief surge through your being, when you are told she is gone. You can’t even cry, because it did not happen. Someone else is laid out, someone else is cremated, the loved one is there in another room, sure to come out smiling, and soon…people come in droves or so it seems.

No room  is large enough. Did one really know so many people, or are they all strangers, acting out a part in a movie? You cringe as the blackness takes over. There is no day or no night. They silently file past, and say the right things to you, as you hang your head, ashamed for being alive, for being hungry, for wanting to sleep and to go through all the motions  of life in a search for normalcy.

You freeze as they wrest the physical body from your tender clasp, and agonise to hear that her ashes are scattered over the holy rivers, into water she was always a part of, into the outdoors where she really belonged. You search desperately for her astral body. And then you break down. Your cry from the depths of your soul is never heard. Because it is soundless. Enough, enough, please don’t speak to me, let me lay my head down, let me die, let me go.

Never mind if you go in and out of hospital. You need to get back into the mainstream of life for the living. The dead are gone, it is a tribute to the living to help them get on with their lives. The  living need you. Please hang in there. Look at so and so. Her tragedy is worse than yours she how she manages. I couldn’t care less about so and so. Your grief is unique to you and you alone, and it is your pain that you care about.  How you will address it, how you will work your way through it.  Why me? You ask yourself. Why not you? Pat comes the answer. Look  around you. People have lost their entire families. What about the earthquake in Bhuj so recent? How about 9/11?

And then start the sleepless nights. If only, you tell yourself, she were here. If only we had done this. If only we had done that. If only we were there early enough. The saddest two words and the most painful…”if only”. Regret, bitterness and guilt. The emotions cascade over you like waves. Grief stabs your body in hot pain. The dam bursts. You cry till you have no tears to shed. You go through desolation and black depression. You cannot focus on things which were dear to you just months ago.

Nothing matters anymore. There is no meaning to life. You go through the motions of daily living with mechanical rigidity. The spark of life which people found so attractive to you has gone maybe forever. You lose interest in the home, in how you look or how you dress. The long line of visitors dwindle, and there is a strange emptiness, for they too have been part of your daily routine. You are finally left alone with your thoughts, and your desolation and you plod one, wondering if there is any light at the end of the tunnel.

Somewhere out of the blue you hear a voice, “ I am just here with you, though you cannot see me. I love you and want you to carry on as you always have. I am watching over you…..” You hear it again and again. The tide turns. You see the familiar smile, the mannerisms and her voice in the children, and you know it is a miracle, and it is a message from her….Petal fresh memories linger with their own brand of fragrance, of happy times. You learn to shape your lips into a smile.

Before you realize it you are looking at the first anniversary. Friends and loved ones call, write or visit you, to say they remember. Flowers fill the house. You cry unabashedly at every single memory that unfolds. Anything triggers it… a particular piece of music, a smell or evern a colour. You lean heavily on people who have been there for you, consistently, through the year. Those who have nurtured you,  tenderly, helping you hold your head aloft, motivating you  to live and not sink into abysmal gloom.

After the enormous tidal wave, calm sets in, very slowly. Not an uneasy calm but a resigned peace thanks to meditation, the solace of spirituality and submission to the inevitable. Knowing that your loved one was halted at a time when she was beautiful, robust with health and youth, and realizing she will be so eternally, at least in your memory. A calm is born out of knowledge that she is at peace and that her karma in this life is fulfilled and that she responded to a higher calling. Knowing that she is there for you , to be summoned at will, and that she continues to live in her children and the ones who loved her. The voice sounds again, this time more gentle, more persuasive.

“Move on, as you always have. Don’t let this stop you. I am there if you have eyes to see. Look upon this as one more challenge met, one more lesson to be learnt. Look after the family I have left behind. Love them as you loved me. They are in your trust. Move on…..amma.”

And yes, you move on. But you wipe your tears first, as otherwise your path is blurred.

Givers and Takers

GIVERS AND TAKERS

There is a nip in the air, as I write this, a great Chennai experience… imagine dipping to 19 degrees at night!! It reminds us that we are into the “ winter” season.. Despite  the cheer it is a long run of heavy expenses, buying sweets, clothes, household gadgets what with the offer of great discounts and the buying of gifts for loved ones, from the very top of the rung to those right at the bottom, not forgetting the annual bonuses for our workers. Which brings me to the topic of the month!

Gift giving has been a staple of human society for centuries. Tribal leaders would give one another gifts in exchange for peace, protection and food. The Romans exchanged gifts during  celebrations held during the Winter Solstice which was on  January 1st. The gifts were originally evergreen branches, and later they moved to cakes, to symbolize prosperity and sweetness in the coming year.

The culture of gift giving was so different at one time. When we were invited for dinner or lunch we would just go along, enjoy the meal and return satiated. Likewise when we returned the gesture we welcomed our friends or relatives and laid out sumptuous fare. Alas, the unwritten law today is that you cannot  make a casual visit to a person’s home without taking some gift in the form of sweets, fruit or some  token. When I make a note in my diary of the date of an invitation  I put in a reminder note for buying “something” to take along. like edibles. Edibles meant something overly sweet, but the more prudent of folks today, assailed by threats of diabetes, cardiac diseases, hypertension or high cholesterol, now sensibly bring fruit, or nuts which are clearly more welcome.

We live in an era of excesses. When I encountered what my children faced in sending their kids off to birthday parties I was  appalled. The gifts were as expensive as the wedding gifts we bought for a bridal couple. As if this was not enough the persons who hosted these parties had to dole out return gifts to each of the little invitees and they had to be of a certain accepted standard. This kind of barter leaves me cold. We did give small take home gifts at the parties we held for our children, but they were just tokens and not necessarily high value items. We shopped excitedly for pencil boxes,   hair clips, crayons,  small note pads etc. My son-in-law thoughtfully gave as return gifts, small potted plants, and for the next birthday the return gifts he arranged for were a few fish in a small glass bowl. I wonder how much these unusual gifts were appreciated, and whether the plants or the fish were tended to lovingly, or just dumped.

We as children treasured the few things our parents gave us and preserved them for years. Nowadays children have so much of everything that it is difficult to decide what they would like so it’s best to give them cash. We attend innumerable weddings and unless the family is very close to us, giving a present is meaningless,  lost as it would be in the sea of gifts and not really appreciated. I have seen huge bouquets of expensive flowers dumped in the wedding hall for takers! I admire the couples who request in their invitation that donations instead of gifts are welcome for a specified charity.

One good idea is giving of coupons from a favourite shop.Instead of throwing lavish parties for ones birthday it makes sense to contribute money to the underprivileged or buying food for the destitute children or adults. It gives more satisfaction than anything else.

Gifting has lost its meaning. Come birthdays and you receive such personal gifts which are rarely  to your taste. Face creams which you would not use, artifacts for your home when you have no place to put in a pin, saris you would not be seen dead in, handbags which you consider flashy, a box of expensive chocolates when you are planning to diet…the list is endless. People are becoming smart and have learnt the art of recycling unwanted gifts. So have I. I have a shelf full of these things. Someone’s birthday was coming up and we were invited at the last minute. I opened my gift shelf and found something which the lady would use and it went well with her personality.  In a very magnanimous flourish  as it was an expensive thingy, I handed it over telling her that she would love it. She opened the gift in my presence, and exclaimed with such vehemence,  “My dear, it is the same thing that I gave for your birthday six months ago!”

To avoid such acute embarrassment you have to learn to be more organized. Label everything, as to who gave what, and for what occasion. Date it, as everything has an expiry date. And for God’s sake if the gift is mere junk, just trash it and don’t ever think of recycling otherwise your reputation is at stake.

A Miracle at Krishnagiri

Do you believe in miracles? Or the power of prayer? I do. I also believe in good vibrations and thoughts and positive thinking which wards off ill effects even though we might not be able to vanquish them entirely. Before you think this is going to be a treatise on “how to live your life”, let me tell you a small story to illustrate my belief…

My husband is a bridge enthusiast, and playing bridge at Gymkhana Club is a passion with him. Every year he garners other bridge buddies and goes on a short trip to Coonoor where bridge tournaments are held. This year it was no different. My husband along with Major Lakshman also a Gym Club member and three other friends decided to hit the road early morning.  Call it intuition, or what, my husband was bugged with my questions. Who will drive the car?  Is he a good driver? Is he used to hill driving? Call me from time to time! Thinking it was rather unusual of me to ply him with queries, he just brushed them  aside with his usual broad smile and the men set out on the journey like excited school boys. I kept praying off and on that they should be safe as I could not dispense with the strange uneasiness that I usually did not feel.

The Krishnagiri route is usually very good, with the dual carriageway and a scenic beauty of its own. You look at the hills in the distance and the ambundance of verdant greenery on the side that we always took this route to Bangalore and enjoyed the drive. Very typical of our civil engineers, the route on that fateful day was speckled with diversions and dug up at various places, and sand and stones were  everywhere on the road.  The Scorpio at a particular juncturent skidded on a patch of sand, and the Major lost control of the car, which nose dived in slow motion into a 8 ½ foot deep trench, and turned turtle. The seat was hurled forward and my husband’s hand got embedded underneath  it. Help came in the form of many young men who broke open the glass to extricate the passengers. By God’s grace, no one was greviously hurt and got off with small bruises, except my hero who broke his forearm and suffered  huge blackish bruises on his shoulder and back and some on his face.

The ambulance arrived in 3 minutes flat and all who could leave were taken to Krishnagiri for first aid, and my husband was sent in the same ambulance to Chennai where he got admitted to the hospital in Porur. He had his surgery after a few days of checking all the vital parameters. We had to cool our heels for five full days before the surgery was undertaken. As I write this he is safely at home looking over my shoulder!

 On hindsight, why couldn’t this road be blocked as it was so dangerous for driving? Why didn’t the passengers fasten their seat belts? It is not enough if the front seat passengers have their seat belts on. If only the belts were used in the rear seat as well, the injuries would have been minimal. It was horrific to see the picture of the car…which was reduced to metal scrap the roof and the sides dented, and the mess was lifted by crane. People who looked at the car wondered how there were survivors….I was told that the car took the impact and saved the passengers.This then is the blessing of a higher power and the protection given…otherwise I cannot think of any logical reason. It was a real miracle. The gift of life is the best gift I could hope for this Deepavalli, we don’t need anything more.

People were quick to point out that it would not have happened this way in a foreign country. No one would have been allowed to use the road.. I do remember on our last visit to the US, my friend implored me not to trip over and fall as I have an uncanny knack of doing this. “ You could sue me for a huge amount if you fell in my house,” she said with a chuckle. I was imagining, given the present situation,  suing the corporation for negligence, not posting enough warnings and plus  suing them for a large amount for the mental trauma caused, and for hospital expenses which cost us a pretty packet. Alas, as true blooded Indians we “accept” and call it our karma and inevitably thank God for small mercies. The younger generation is more belligerent and believe in fighting for their rights and oppose the scant concern for human life. A good thing if I may say so and, without doubt we need more Kejriwals!

Hope for Diabetics

India houses over 61 million diabetics and a forecast that diabetics will cross 100 million by 2030. China today is the world capital for diabetes with India following as a close second. And Chennai is the diabetes capital of the country! 

Diabetes Mellitus a Latin term meaning ‘honeyed urine’ was well known to ancient Indian Physicians, from 400 B.C. “More than 70% of middle aged Indians, will suffer with non-insulin dependent diabetes during their lifetime.  Results of a ten year analysis from Southern India (1994 - 2004) reveal a trend towards increasing prevalence in both urban and rural population and more number of younger persons, particularly women,  afflicted with diabetes. “Though diabetes is caused by a complex interaction of genetic  and lifestyle factors, the most obvious reason for this increase in the number of young diabetics is their frenetic  lifestyle”, says Dr. Rajesh Shah, Consulting Physician and Cardiologist,  Better Health Foundation.

In layman terms, diabetes is a metabolic disorder in which the body is unable to control the amount of sugar in the blood, because the body either does not produce enough insulin or there is resistance to the action of insulin. “Diabetes is one of the diseases that affects the endocrine system. The pancreas produces a hormone, insulin. In type 1 diabetes, the insulin producing cells in the pancreas are destroyed. In type 2 diabetes, insulin is still produced but the body becomes resistant to it.” Says Dr.M. Ravi Kiran Endocrinologist, Agada Health Care. “We as endocrinologists can help you manage your diabetes, by prescribing insulins and/or medications, and offering diet plans .”

“Diabetes may damage almost every tissue and organ of the body, the kidney being one of them”, says Dr. Soundarajan, Head of the Department of  Nephrology SRMC.  “Neglected, one could go into diabetic nephropathy. Once a month albumin in the urine, blood urea, and creatinine levels should be checked. Diabetics should avoid painkillers.. One should watch out for swelling of the feet, extreme fatigue, weakness and breathlessness. Obese children should also be screened for diabetes.”

“A person afflicted diabetes needs to take utmost care of his or her feet”, says Dr.V.Ramnarayan, Consultant Orthopaedic Surgeon SRMC. “Watch out for numbness, foot ulcers and carefully examine spaces between the toes and the soles of the feet.. Socks should be washed regularly and changed everyday and one should use footwear preferably with ankle support. Nails should not be cut short and sharp edges should be filed. Lack of trained professionals in diabetes foot care in India and podiatry as a profession being non- existent in India compound the problem further.” Patients with neuropathy who visit religious places during summer months when the day temperature varies from 40 to 45 degrees celsius, develop severe thermal injuries as they have to walk barefoot.“Trivial foot lesions precede 85% of leg amputations in India. Almost 75 percent of amputations are carried out in neuropathic feet with secondary infection, which are potentially preventable.”

“When diabetes is diagnosed the patient needs to go in for regular eye check ups,” says Dr. Amar Agarwal Chairman and Managing Director, Agarwal’s Eye Hospital. “The retina gets affected, and the blood vessels in the eye start leaking blood. Fluorescein angiography is performed to trace the leakage, and laser surgery performed to stop the leakage. Diabetes also produces early cataract. In extreme cases where diabetes is neglected the patient can lose his or her eyesight.”

“There is a strong relationship between depression and diabetes”, says Dr. Thara, Psychiatrist and Director, SCARF... Research studies have also demonstrated that the chances of developing diabetes within two years was increased for persons with current depressive and/or anxiety disorders. “Some of the newer drugs used in the treatment of mental disorders might increase blood sugar levels. It is now important to monitor all patients on such  drugs for their blood sugar levels.”.

“Diabetes is a generalized micro and macro vascular disease, affecting various organs” says Dr. S. Thanikachalam, Chairman & Director of Cardiac Care Centre, Prof. &Emeritus, Sri Ramachandra University. “It is the prime responsibility from those involved in Cardio Vascular Disease Management to address the evolution manifestation to quell the cardiovascular disease in diabetics as they have 2 – 4 fold higher risk of CVD as compared to normal. The cluster which harbours  hyperglycemia, high BP, altered lipid profile, smoking, high body fat content and sedentary habits needs appropriate intervention to prevent emerging epidemic of sub clinical and manifesting CVD. A concerted attempt to identify the pre-diabetics and intervene to reverse the metabolic abnormality will prevent further increase in the prevalence of diabetes, with its inherent complications.”

According to Dr. M.Thanikachalam, Cardiac Surgeon, (American Board of Thoracic Surgery) preventive health check up and a year-round management of health and wellness customized to one’s health profile and screening are absolutely essential. This led him to follow his dream project Agada a one stop institute for comprehensive therapy with the focus on preventive treatment, and established in association with the world leader in Diabetes Prevention Management and Care, Joslin Diabetes Centre, Harvard Medical School, Boston USA. “We believe in empowering you with skills to take ownership and manage your health optimally”, says he.

The future is not as bleak as it was, and with tri annual checks and regular physician consultation diabetes can be kept under control without the feeling of despair that it usually evokes. See box below

BOX

·         Under normal circumstances the blood glucose level does not rise above 160 mg/dl even after food

·         Normally the kidney does not allow any glucose to be lost and hence the urine is sugar free. However if the blood glucose level rises above 180 mg/dl, sugar "spills over" into the urine.

·         Symptoms could be excessive thirst, excessive appetite and excessive urination and swelling of feet. Delayed wound healing, frequent infections, nausea, vomiting and weight loss may be other symptoms.

·         Neglected, diabetes will affect the heart, eyes, kidneys and all major organs

·         With proper treatment, counseling and personal management,  diabetes can be controlled.

Sabita Radhakrishna   (sabi.kittu@outlook.com)