Life lesson from my dad’s passing

Its been a month since my dad’s passing and as mom and I continue to reminisce about his life and reconcile with his loss, I am realizing that life has taught me an important lesson.

Both Dad and his younger brother were tall and heavy and both had acid reflux issues (thanks to their maternal genes). But how their health unraveled took two contrasting roads.

1. Extreme acid reflux can simulate cardiac issues and this happened for both. Cardiologists did angioplasty on uncle but treating arterial blocks do not stop acid reflux. Uncle lost faith in treatment. Bypass surgery was recommended for dad after 20 days so I figured if he can survive for 20 days, his health can be managed without surgery.

2. Both developed swelling on their hands and feet. Uncle’s condition was apparently not treated. Dad’s cardiologist kept asking about his bypass surgery and ignoring the swelling. So I googled to find out why the swelling was happening. Any issue that affects the working of the heart reduces blood flow to other parts of the body. When kidneys receive lesser amount of blood the body assumes there is not enough water so kidneys start accumulating water, first on the feet and then on the hands. The condition is called edema. Finally when water enters the lungs it becomes pulmonary edema. Then the only treatment left is bypass surgery. Dad’s cardiologist was trying to force bypass surgery on him by leaving the swelling untreated. I immediately changed the cardiologist and consulted a nephrologist who prescribed a diuretic which forces water in the swelled up areas to be released from the body through urination. Uncle refused bypass surgery, water had to be pulled out of his lungs, he developed paralytic stroke and eventually passed away.

3. Dad reduced salt intake drastically after misunderstanding cardiologist’s instruction. I was unfamiliar with the ensuing condition but realized something was wrong with him. Took him to hospital for checkup and found his sodium level freefalling. In another two days he would have had ended up in coma.

4. Dad’s new cardiologist advised me to treat acid reflux at home and not to take him to hospital as acid reflux bouts can seem like cardiac issue and he would end up in the hands of cardiologists.

For the past 10 years, I have been mostly at home and especially in the last 6 years, largely due to market conditions. This gave me the opportunity to try doing different things which led to starting a home based cloud kitchen and in a way fulfill dad’s lifelong ambition to start a restaurant. I forced dad to go to the gym which improved his health drastically. When he suffered stroke like symptoms I chose to take him to a physician nearby who checked him and told me his nerve functions were fine and he was suffering from weakness due to muscle loss caused by protein deficiency. Though he fell a couple of times nothing happened to him and mom and I ensured he never fell down again especially in the bathroom. Broken bones never heal completely in old age, restrict movements which reduces immunity and makes body vulnerable to other diseases. Dad had normal blood sugar and I ensured all his body organs were working well and his blood pressure, essential elements like sodium, potassium and magnesium and vitamin levels were normal. Circumstances prevented me from pursuing a career in medicine but my fundamentals in biology and human anatomy are strong and I read a lot on both.

I did not earn a lot of money in the past 10 years but I was able to save a lot of money on dad’s treatment. If I hadn’t been at home. he may have underwent bypass surgery which could have ruined his health. Most importantly, he was able to live a disease free life, eat and do everything he wanted to and go peacefully. I could not have bought him this with all the money in the world. Is it possible to become successful without having a lot of money and everything that comes with it? I guess it is.

The sinking ark of faith in doctors

There is a group of fellow beings amongst us who are considered the avatars of the Almighty. Endowed with the knowledge and the skills to heal us, it is to them that we reserve our greatest respect among our own. We call them doctors. They say there is more faith in the prayers at hospital wards than at the church altar, but ironically, we still pray for the safety of our loved ones rather than pray to God to guide the doctors who are waging the battle on our behalf. But what if the doctors themselves fall from grace and put their fame and prosperity ahead of the people’s wellbeing? This is what is happening now all around us and especially in India.

A case in point is my dad. Much before the cardiac arrest he had exactly to the day last year, he started getting slight swelling on his feet, hands and cheeks. He did show a physician and took some medicines, but nothing came out of it and he ignored it. Then he hit a rough mental patch which I guess most old people go through when they feel more disappointed than contended about their lives. The addiction to caffeine and nicotine went a couple of levels higher and he didn’t pay heed to my warnings. So when the storm came, I was ready for it mentally. After being saved by the full power of a defibrilator, he was back on his feet the same day which really took me by surprise even though I knew he was physically very strong. I shooed away his cardiologist’s recommendation for a bypass surgery because his arterial blocks are only marginal, he has a small variation in his BP and he is not a diabetic. I believed I could get him to back to his best with a strict life and clean food, but then two incidents happened and the second one was a killer blow on my confidence in his doctor and doctors in general.

Last year, he was adviced to follow a salt restricted diet. He misconstrued it as a ban on salt and slowly I started observing radical changes in his behaviour. Unable to figure out, I called up his doctor and he pacified me saying nothing is wrong but I insisted on taking dad for a checkup. Turned out that his sodium level was fast decreasing and in another couple of days, he may have ended up in coma. Through all this time, the swelling in his body remained. When someone goes through something as big as a cardiac arrest, most of the parameters of vital statistics will show elevated values and I thought things would improve with medication and time. But in spite of all the medication, he kept complaining that for some reason, he was not regaining his health and he was feeling tired all the time. The value of creatinine, the prime indicator of kidney’s health was consistently a shade higher than normal value. A couple of days back, the swellings started increasing on his hands and feet and that is when I started my own investigations on the internet.

Turned out that a cardiac condition would result in decreased output of blood to the kidneys and thinking that the body is losing blood or generating less blood, the kidneys would start retaining water. Because of the false alarm, the water starts getting accumulated first on the hands and feet resulting in what is called edema. It was then that I checked dad’s medicines thorougly and found out that the medicine for edema, called diuretics which forces the excess water out of the body was not prescribed to him in the last one year. If left untreated, the body would have started storing water in his lungs ultimately. The doctor never even referred dad to a nephrologist to get his kidneys checked. This is what came as a shocker to me because it was so evident yet he chose to be so callous about it. Our kidneys grow weaker as we grow older and only God knows what would have had happened to dad if this had been left untreated. I immediately consulted another cardiologist, he referred dad to a nephrologist and dad was immediately put on a course of diuretics. The swelling on his hands has gone down in a day.

I am writing this blog because I have been wondering how we are at the mercy of the doctors we consult. From time immemorial, knowledge of medicine has been the privy of a privileged few and we have been blindly believing them and following their words to the tee without once questioning because we never had the knowledge. But in the modern age, their benelovance towards us has increasingly changed to arrogance and they have started treating people as illiterates in the matters of medicine. I will not claim this about every doctor and doctors abroad, but in India it is prevalent to large extents. When I rejected the bypass surgery for dad, the doctor never told me its full implications and what impact it could have on other organs in the short and long term because he saw me as a “medicine illiterate”, chose to share very little information with me and spoke to me in layman’s language, not knowing that my understanding of biology is excellent. When I asked the nephrologist about prescribing diuretics for dad, he immediately understood that I had done my research and I would understand his diagnosis. I noticed that he was slowly slipping into the doctor’s lingo which I took as a token of appreciation for my knowledge and understanding of medicine.

We did not have any options till some time back, but now Internet can tell us anything we want to know. It is high time everyone started researching on the Internet in such cases, creating self awareness and spreading knowledge among family and friends, so that when our loved ones are down, we know exactly what is wrong, what treatment is being administered and what can be done to make the treatment better. In India, everyone learns biology till high school and other than those people who aspire a career in medicine, everyone else says farewell to biology. It is time we realised that giving up on our understanding and knowledge of our own body will come back to haunt us someday.