ELIZABETH MY BITTER HALF PART II Mt.ABU

Liz's ordeal with "Takayasu arteritis" 

As promised, I am here to continue my story concerning my bitter half. After the removal of her small toe, I brought Liz home to Abu. It was bitterly cold as it was the month of January. To keep Liz warm I made sure the room’s temperature never fell below 22 C, mentally and physically worn out. Her ordeal had just begun. Her life changed with Takayasu arteritis, but she was fortunate it only affected her ankle as it can be terminal if it affects the heart. The nights were terrifying as she went through agonizing pain; even powerful painkillers had little effect on her. Her toes turned black and began to resemble something from a horror movie as blood flow decreased. Dry Gangrene had set in.

I called Dr. Anandan in the Maldives and inquired how much longer Liz would have to bear this bombardment. He responded calmly, saying they needed to wait and see how much damage there was before deciding on amputation. I am a complete cynic; his soothing remarks left me shattered. Liz, on the other hand, had complete trust in her mentor's prognosis; she endured the pain with dignity and awaited his return from the Maldives.

Dr. Anandan couldn't make it on his scheduled dates, which made me worried. Liz seemed a bit anxious, something I hadn't seen before.. Her big and second toes were gone to charcoal, shrivelled, and were not a pleasing sight to behold.

A lot has happened since I posted my last blog on her. Today I am in a better frame of mind and do not have the proverbial ‘sword of Damocles’ hanging over my head. After the removal of the small toe, the other toes followed suit. Here are some photographs taken by my web camera of her foot to forward to Dr.Anand.

Dr. Anandan who was one of the chief physicians to the President of the Maldives and had to be away for long breaks, kept in touch with me via e-mail. Here is one such extract.
Dr. Anand.
M.S., M.N.A.M.S., F.I.C.S.,
Dip. Laparoscopy (Germany),
Consultant surgeon,
E-Mail - dranand108@yahoo.com
Dear SIR, NICE to get your mail. You can continue to use the ointment for the foot and request Dr Sharma to have a look periodically to see the foot to decide whether further disarticulation of the toes is needed. Since they have requested me to visit another hospital to take care of a few more surgical cases, I may have to delay my return to Mt Abu. I will try to come as soon as possible. Meanwhile please send me mail often
Anand---

Ainsley wrote:

> Good Day Dr Anand,

How are you? Here is a report as to the progress of my better half, Elizabeth. Although she's improving, there's a minor problem - her skin opens up and there's a reddish and yellowish fluid coming out of her foot when she walks. The third toe at the joint is pink, but the rest has turned black, she has stopped taking painkillers and does not experience the pain that she had previously felt. Also between her toes, she has some raw skin which is difficult to clean. Should we use some medicated cream to keep these parts moist as the climate has turned very dry and the skin also has turned dry?

Do you believe in miracles? I do not, but what I have witnessed is certainly a miracle, the miracle of wonder drugs that have made the impossible possible. Sal Hospital doctors suggested that amputating Liz's leg above the ankle was the best solution to save her life. They did the angiography in 2003 in the month of December, it’s now five years and the team of doctors who had attended to Liz still cannot believe that this adorable woman is still alive and kicking. She’s still on medication, moves around and is in good health. Her foot does give her trouble, especially in the winters, so each winter we leave our Abode in the Mount and head like migratory birds for warmer destinations; Goa, Madras, Ahmadabad and Bombay have been a few of our winter destinations these last few years.
The tide that had taken a turn for the worse in our lives with Liz’s ordeal has helped us to come out of it with a better understanding of what life is all about. We know we are not yet out of the woods, but are thankful that we still have each other to tide us over if the next tsunami hits. Her foot has healed but she has to be very cautious and careful that she never hurts her foot accidentally, as it would take ages to heal. This is a snapshot of her foot as of today.

To have a better idea of this rare disease "Takayasu arteritis" click on the links below

http://vasculitis.med.jhu.edu/typesof/takayasu.html

http://en.wikipedia.org/wiki/Takayasu

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