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Glimpses into our bright lighted individual worlds: Heart process and Hospital

Glimpses into our bright lighted individual worlds

In the very early morning, I woke up with clear glimpses into our bright lighted individual worlds, Mitthu smiling and confident, Ruku mature, responsible..

The life-threating breakdown on a sidewalk

On 18th Jan about a month back, I had a major breakdown while returning home. At 11 am, with a lot of excitement I started for Howrah station and finally could capture my desired photo of a table between two facing rows of seats in a chair car of an Indian railways train coach.

I started from home with fruits breakfast, went on from Howrah station to Burrabazar in search of Trikatu original materials for making Trikatu churna in my heavy stone mortar and pestle, bought the raw materials of medicinal black pepper, dry ginger and long mirch not only for me but also for my close friend.

I was feeling a bit tired by then after I chattered on happily about the reasons behind these apparently incomprehensible actions of mine to my ever-curious niece in Dubai. I was wearing her warm pullover, showed it to her earlier when I could get a good selfie of mine in Howrah station using the free resource of a curious railway security man.

After Burrabazar and a second all-fruits light lunch, I took the Metro train from Mahatma Gandhi Metro station. While walking even the short stretch from the main road to the station, my backpack felt heavy and I dragged my feet slowly. At 6 pm I got down at the Jatin Das Metro station. As I reached the street level from the womb of the underground station, the place suddenly reminded me of the one and only Ujjwala's chanachur we used to enjoy when living in Alipur. So I had to buy a half kg of the fresh warm crunchy inimitable chanachur and put it into my large backpack.

Total weight crossed possibly 4.5 kgs and just as I took a few steps forward my pulse beats started their mad race. All energy left my body. I sat down on a roadside stool with my left hand on the right wrist pulse, taking deep breaths and trying to slow down my racing pulse. After half an hour, it slowed down enough so that I could get up. I found myself into my second most weakest state. Taking a single step forward was nearly impossible. I called a cab, somehow crossed the street like a drunk, the drizzling rains coursing down, and dragged my body inside the cab. I told the driver, 'Today you saved my life.'

I played the waiting game of self-testing and didn't inform anyone about the details of my breakdown

Mitthu and Ruku returned from Purulia after two days that was previously scheduled. I told them only a brief toned down outline of the breakdown. After a few days of self-test, I had to call my cardiac doctor who had put on the stent on my LAD attack 22 years ago.  I visited him just a few weeks ago on my yearly check-up. All was well then.

Now the doctor promptly put me on to a four-day long single sensor Vigo Holter monitor. It recorded my heart beats continuously and transmitted the result to the app running in my mobile over Bluetooth. The four-day period ended around noon and within an hour, the soft copy of the report reached me and my doctor simultaneously. I promptly shared the report in my close ones' network. Doctor called me at 2 pm. There apparently is something important to discuss.

The cardiac doctor committed himself to the major decision

I and Mitthu visited him on 31st Jan. By the time we reached the Cath lab, he finished writing my prescription. His coordinator explained to us. Two tests, Angiogram and mini-EP were prescribed along with recommendation of ICD implant if needed. Coming down to ground floor, we finally submitted our request for Mediclaim pre-approval to the hospital TPA, the Mediclaim intermediary.

Next morning on 1st of Feb, anxiously I called up the TPA desk and someone told me, my application for pre-approval has been submitted only this morning. I was beyond anger. My Mediclaim agency takes half an hour to give me their pre-approval. The hospital TPA was at grave fault. It showed the nature of the owners and crumbling admin. I told the girl at the other end, 'At last I am sure that my ghost exists.' 

Still I didn't reject the hospital. Noon came and passed. I called the coordinator. At around 6 pm a message from my Mediclaim agency pinged.

First part of the message showed that the hospital TPA sent my pre-approval request taking more than 24 hours.This was the Rough Edge that helped me reject this hospital with bad administration.

In the second part my Mediclaim agency expressed, 'We are sorry for the delay.' I called the lady coordinator. She didn't respond as expected.

That was the principle of hidden opportunity in action: Now I can reject both the doctor and the dubious hospital

That settled the deal as we call it. I have a lot of patience, but it is not infinite. My Rough Edge Rejection Method roared in its full force. Too many rough edges here. Promptly I told Ruku to cancel my request for pre-approval. He sent the cancellation mail to my Mediclaim agency immediately. And just then the pre-approval message for more than Rs.6 lakhs pinged in.

At 8.03 pm, in my cardiac doctor's calling window, I called the doctor. Next 15 minutes hot lava flowed along the ether, both shouting. The parting was in peace, him repeatedly emphasizing the need of my taking the two tests, me agreeing and suggesting him to take very good care of himself. I didn't know then, this was the second time the Principle of hidden opportunity came alive (subsequent events gave me the best results possible in Kolkata).

The period of deep confusion started, but every tunnel ends

That started a tumultuous period of confusion, intense anxiety, hard medical decision making, intense bursts of my anger associated with severe pulse beat drops and finally all my counsellors agreed to the choice of the new doctor and the new Hospital. I visited the new doctor on 6th of Feb with Ruku accompanying me. Ruku is 31 years old, a Permaculturist practising Forest farming and I am 72 still trying to convince the world that I can do anything. The doctor prescribed Angiogram and a full EPS. I took time to get admission as I was bent upon attending my friend Amit's daughter's wedding reception on the 10th.

We were deeply impressed by the large heart specialized hospital and the professional businesslike but wise demeanor of my new cardiac doctor. Through the mishap and confusion during thde last few days, my heart has found a great home.

The wedding ceremony was a grand success lifting moods of all

I thought Amazon delivery can never fail. But this crucial time on the 10th, the  delivery of the Sony sound recorder was delayed by a day. I had to go out to the ceremony by 4 pm and I must get the sound recorder before that. I had to record the singing of Somnath. I promised him and myself. So Amazon delivery needed a hard push. After a bit of hard pushing of Amazon through chat, my over-delayed Sony sound recorder finally arrived at 2.50 pm noon. Another barrier crossed.

I went out to get a specially tuned flower bouquet from a nearby flower shop on my way to Vivanta, the venue of the ceremony. Two flower shops ditched me, but I could manage to make a bouquet to my satisfaction in the third shop in New Alipur. I have a quiet pride of taking the most beautiful bouquet among all in any gathering I went.

Somnath's wiry tall 72 year old frame stood erect on the podium with his lips hardly parting. He was singing with a band as a part of the evening ceremony. All in the hall were dancing, such was the beauty of his music. And I was intently recording.

That was a fabulous evening. Amit excitedly chatted with me till late in the night.

As prescribed, now is hospital admission time

After a day's gap Ruku accompanied me to R N Tagore heart speciality hospital to get me admitted on 12th. In between the paper procedure, we always enjoyed our burgers and coffee. I found my three-bedded room very nice, clean and bright. My mind was vibrating at a high pitch, I was feeling sleepy, very sensitive in mind and body and with a deep apprehension of the coming procedures.

On the 13th, Mitthu in her jeans and smart dress accompanied Ruku with his casuals and thick black beard. I was shoved into the OT waving my hands weakly to them.

After the two major tests, I was told briefly that I have developed a second major artery block and will also need an ICD implant that is a very sophisticated version of a pacemaker.

Now at last I am properly and truly a patient with all restrictions of not getting down from the bed without assistance. What a predicament!

A rest day to relax and be creative - who knew a hospital room can be so comfortable

14th was a rest day I spent reading Amitav Ghosh's Smoke and Ashes, writing my new pieces for my website and finally managing to complete the draft of the first new post for my website after two years by just before 5 pm, the start of the visiting time.

First came up Mitthu. She looked beautiful and calm, a charming young lady. Excitedly I explained to her the niceties of my stay, the stories of my roommates who had become friends by then. Her eyes sparkled after a long long time. Her lips smiled with assurance and confidence. Only in the morning she explained over phone, the details of my condition that was explained to Ruku and her by the doctor but not to me.

She soothed my frayed nerves, 'First it would be implant of ICD that would protect you from a possible uncontrollable heart condition and then after 10 days gap, the second stent would be implanted. You will be free to move in your wanderings of forests and hills and we would be free of intense anxiety we were suffering all along.' I introduced her to Azad, my roommate of 54 years of age with unfortunate kidney condition. He was deeply disturbed, naturally.

The math olympiad question solution got enriched

After Mitthu, Somnath came up. By then I have just finished the draft post of my solution of a Math Olympiad question in my mathematical reasoning approach. I offered Somnath the problem for solution and he solved it in 3 minutes flat using just a few steps of factor analysis. I had solved the problem step by step slowly, focusing on the solution, eliminating other possibilities by mathematical reasoning and basic concepts, but not using factor analysis. It took me 7 minutes.

I have now two approaches of solution by two different kinds of mind. His mind moves faster and with wisdom and knowledge. My mind moves slower, step by small but assured step. Soon after the visiting period was over I finalized my new post and for the first time posted it in my website using my mobile phone. All the work I did earlier using my laptop. Finally, I sent him the link. He also sounded a bit happier from his usual unflappable demeanor.

The Mediclaim pre-approval took time but was not overly delayed

During noon Ruku sorted out the uncertainty of pre-approval of my mediclaim. It took hours of waiting. In between I could manage to bring him up to visit me. Sitting calmly on the only chair specially provided for me for my writing, he was advising Azad on how to improve his kidney condition. Ruku knows a lot. Azad was very impressed by him.

Azad made the same delightful mistake as others made before him

Late in the evening Azad made a surprise remark, 'Dada, was that your daughter?' He addresses me as Dada, elder brother. The lady he was referring to was none other than my dearest companion for forty three years, mother of Ruku and his elder brother Rubai, an accomplished singer and a literattiuer. Her Bengali translation of My Autobiography of Charlie Chaplin was sold more than a dozen copies in the last year's Kolkata Book fair. With short well styled hair and jeans she looked beautiful and young. With twinkling eyes I told Azad, 'In the past also, she was often mistaken as my daughter.'

Now is my alone time for delving deep into my quests - in a hospital room

Then I became very absorbed in my delving into deep discussions with AI Bing on a number of unusual questions haunting me over the years.

By dinnertime I felt ravenous hungry. Both I and Azad enjoyed our dinner hugely. After dinner I was still on my makeshift desk in my hospital room when sleep overtook me and I had to retire for the night at about 11 pm.

At 3.50 am I woke up all alert. No further sleep possible. Everyone sleeping, but not my mind. Today at 4 pm my ICD implant will be done. But this alone time, beautiful time belongs to me.

Terminologies and briefs

LAD infarction: Cleveland Clinic: A widowmaker heart attack happens when you have a blockage in the biggest artery in your heart. That means blood can’t move through your left anterior descending (LAD) artery, which provides 50% of your heart muscle’s blood supply. Immediate treatment is crucial for a chance at survival.

Angioplasty and Stent placement for the heart: John Hopkin's Medicine: Angioplasty is a procedure used to open blocked coronary arteries caused by coronary artery disease. It restores blood flow to the heart muscle without open-heart surgery. Angioplasty can be done in an emergency setting such as a heart attack. Or it can be done as elective surgery if your healthcare provider strongly suspects you have heart disease. Angioplasty is also called percutaneous coronary intervention (PCI).

Implantable Cardioverter Defibrillator (ICD): American heart association:

ICDs are useful in preventing sudden death in people who have a high risk of a life-threatening arrhythmia. These include ventricular tachycardia (VT) or ventricular fibrillation (VF).

Most ICDs, called transvenous ICDs, have a dual function and also serve as a pacemaker.

In VF heart pressure  drops to zero. It is filled with blood but in spite of high beat rate stopped pumping. The organs do not get blood supply and death happens shortly. Such cardiac deaths usually occur during sleep.

The second function of ICD is to limit heart pressure and beats within safe values. When such limits are crossed the ICD generates electrical impulses to shock the heart into normalcy.

For patients with VF, ICD is the only solution and EP or Electrophysiological Process can only identify the extent of VT or VF, while Angiogram identifies a block in the arteries because of malfunction of blood circulatory system.