Sunday, May 29, 2005

THE ORDEAL Mount Abu

Takayasu arteritis

The final diagnosis showed Liz had contracted the dreaded Takayasu arteritis. I knew we were in for something horrible, how horrible only time would tell. Abu is cold in the winter, the night temperatures dip to around 0 to -5 C. This cold climate and the fact that Liz was in real misery did not help us in any way. Intense pain was experienced by Liz. The pain would begin around midnight and drain her very soul till early parts of the morning, the painkillers only worked for a short spell. I found that If I stayed awake reading or doing some work on the computer it kind of helped her to drop off into an undisturbed sleep. Her pain seemed to haunt her between midnight and 2 a.m. I found that staying awake around this time seemed to help, so this became a regular feature for me for months to come. In the beginning, I thought it was a psychological factor that was causing Liz this extreme bout of pain, but it was far from the truth. The pain was genuine and it began to manifest in its true and ugly form. Her little toe, the one she had banged had turned blue-black, the excruciating pain now was becoming intolerable. I was at a total loss, physically and mentally drained, I knew something had to be done and done fast as this situation could not go on forever. Dr.Sharma who was monitoring the situation on a day-to-day basis said that she was heading for gangrene. "GANGRENE" On hearing this word my very being froze. It's like telling a patient that he has cancer. How was I to break the news to Liz, and break the news soon was imperative, because any delay now would be curtains for Liz. With a heavy heart, I approached her bed and was on the verge of telling her that her condition had gone from bad to worse when my mobile rang and I heard Dr.Sharma's voice. He told me an extremely competent surgeon, Dr Anand. Subbarayan was down from the Maldives on a holiday, here in Abu and was a close associate, and he had agreed to see Liz on Dr Sharma's request. I went to Dr.Anand's residence immediately and picked him up. On the way, I told him the story of Liz, and what hell we folks were going through.
�Dr Anand Subbarayan Liz's Mentor

Saturday, May 28, 2005

Ahmedabad Sal Hospital

Takayasu arteritis is a complex and challenging condition

Sorry could not upload the snaps of the angiography, they are extremely good!
snapshots of the angiography performed by Dr Dhani on 8th Dec 2003 at 8pm. What followed next was a chain of events that will haunt me for the rest of my life. While the operation was on I was in touch with my family doctor back home, during the course of my conversation he suddenly asked me to hand the mobile to Dr.Apurva. He instructed Dr Apurve to run an investigation on Liz to determine whether she had Takayasu arteritis, this was a new word that I had never heard of and from Dr.Apurva's facial expressions, I kind of guessed it was something not of the ordinary, made a mental note of it and decided I would get in touch with my doctor after the operation.
From the results of the angiography, it was confirmed that the artery carrying blood to the foot had a blockage in it and that the blockage was in the ankle. Conclusion An immediate operation of microscopic proportions would have to be performed and that too with abs no guarantee that it could be pulled off. The other option was an injection, (ST.PASE INJ ), so Heparin was stated for 2 days then Liz was diagnosed with thrombolysis with SK for 48 hr.T these 48 hours were a nerve-racking period, for both Liz and myself. I phoned my doctor next and asked him what was Takayasu arthritis, and he told me ran my blood cold. I walked to the nearest cyber cafe to surf the internet to glean what I could about this dreaded disease. I was numb and I felt a vice-like dread gripping my very being, the more I read the more I was convinced there was very little hope to hold on to. I returned to the hospital with a heavy heart and a dread of impending doom.
The staff at the Sal Hospital were very cordial, the interims, and the doctors were considerate and made the patients at the hospital feel comfortable, there was an air of trust that the doctors instilled into the patients. Liz had been monitored around the clock by a batch of competent nurses and young interim doctors who were ever ready with a smile and an encouraging word. Liz's condition was stable there was a slight improvement in the temperature of her foot, but the pain persisted and she was put on heavy painkillers. The doctors speculated as to what action should be taken, should they go in for an amputation of the foot, if so how much of the leg should be amputated, since the blockage was in the ankle should they amputate just above the ankle leaving most of the leg intact. The very fact of having a part of her leg amputated sends shivers down my spine. Liz was devastated, she asked me to take her home and to let providence play its part. I approached Dr Apurva the chief surgeon and told him of our decision. He was very considerate and only wished us the very best, before parting he advised us to see that under no condition was Liz to hurt that foot or even get it scraped as it would never heal. He also assured us should we ever need his services in the future he would be there for us. With a heavy heart, and dreading what was going to happen in the near future I packed our stuff got a cab and left Sal Hospital on the 13th Dec 2003 for our Abode in Mount Abu.

Christina liz's elder daughter

Christian agreed to give her moral support by standing by her side in the operation theatre. Dr Dhani one of the leading cardiologists of India was to do the angiography on her right leg. As per the schedule, everything went off well except for a small diversion that took place. I was watching the angiography along with Dr Apurva, Dr Dushient the lab technician when suddenly one of the assistants burst out of the operation theatre for help. Christina had fainted at the sight of the blood.

ELIZABETH MY BITTER HALF Mount Abu

Keith Grandson of Elizabeth

Keith

Liz, while playing with her grandson Keith, banged her small toe on her right foot; she paid no heed to the bang, thinking it would in time right itself. This little bang aggravated the situation even more. Midway through October, the pain in her leg was driving her crazy. She would for hours soak her legs in hot and then cold water to relieve the pain. She would get her legs massaged with oils and creams to ease the pain. By mid-November, the pain was even more intense, the painkillers, the massages, nothing seemed to work. And by the end of November 2003, the pain had become unbearable. Dr Sharma gave her a dose of shorts to relieve her of her excruciating pain. A few days later, I found her looking very flushed, so I encouraged her to come out with me for a short walk down the road to our friend’s place, Mike.

Mike

Mike knew I had bought Liz over so we could take her BP. After three attempts on the BP machine, Mike got a little worried. It seemed the machine had gone berserk; it kept throwing up error after error. After a few minor adjustments, we tried again and the shock we were in for was too much. I immediately rushed her home and called the doctor. Her BP had gone to 180+stolic and 110 diastolic. After giving her sedatives and medication doctor was also worried. Something seemed to worry him, as just plain arthritis did not fit into her pattern. There had to be something else that he had missed in his diagnosis. Liz went into a deep sleep and I really became paranoid the next day when she showed no sign of stirring, anyway I let her sleep that whole day. When she came to, she realized she had lost a day in her life.

The final countdown to her real misery and grief for a long, long time to come began on “Feast of Christ The King”. The agonizing pain had taken on the tune of the fury of a storm of gale proportions of force eight. Dr. Sharma felt her feet and found out that her right foot was abnormally cold. The sensation of coldness in her foot sent alarm bells ringing. He immediately phoned his colleagues in Ahmedabad Sal Hospital and said he was sending them a personal patient for a battery of tests. He advised both of us not to delay and to head for Ahmedabad as soon as possible. She was to undergo a Doppler test and a host of other tests.

I wonder if we would have had different results if we left right away instead of delaying for our students' exams. Arthritis has all these symptoms. Who could have guessed what lay in store for Liz? Not even my family doctor had an inkling till the very end of what she was in for, more when I come to it. We kept Liz on a barrage of painkillers and other medication till we finally left for Ahmedabad on the 5th of December 2003.

On reaching SAL Hospital, a team of wonderful and dedicated doctors attended to us. After checking in, they immediately gave her a battery of tests recommended by Dr Sharma. Her blood tests were above normal or, as Dr Apurva (the surgeon) aptly commented, excellent. I wish I had an HDL profile like hers, way out.

The abnormalities in her right leg's Doppler test led to the doctors performing an angiography to identify the cause of her condition. It devastated her To hear she needed an angiography after going through so much pain and psychological stress. She refused point blank and was on the verge of packing up and getting the hell out of there. I had to cajole her and psychologically get her ready to undergo the angiography for her own good. Being the mettle she's made of, she finally got down to agreeing with the angiography.

The team of doctors at Sal scheduled the angiography for the 8th Dec at around 8 pm. Her elder daughter Christina also was present for the angiography.

Mount Abu Dr.A.K.SHARMA our family doctor "THE ALL ROUNDER"THE WRITER,THE POET,THE ATHIEST,THE DRAMATIST,& THE HEALER

Our family doctor, Dr. A.K. Sharma gave her the recommended treatment. She had been on his therapy for almost a year and a half. Then in October 2003 while running after her grandson.

Head to my next post for more on Liz my bitter half.

To learn more about this astonishing doctor Click the link

Dr A.K.Sharma a man for all seasons Mount Abu

ELIZABETH MY BITTER HALF Mount Abu

MY ORDEAL OF WATCHING MY BITTER HALF'S AGONY & LIVING WITH IT
My bitter half Elizabeth had been suffering on and off for quite some time with symptoms of presumably acute arthritis syndrome. Our family doctor DR.A.K.SHARMA