Renu's Week

Saturday, August 28, 2021

Report of 28 Aug 2021

 Good evening!

We are enjoying watching the Paralympics - such fortitude, skill, joy!

We are well and hope the same with you.  My telemedicine practice had a lady with chronic kidney disease.  She had become a bit frustrated with the dietary restrictions and wanted to eat a piece of fish occasionally.  I do not manage kidney disease, leaving it to the nephrologists, so I consulted a neph friend of mine and my sister-in-law, a nutritionist.  Both had lots of good input and I felt prepared to consult with this lady.  The appointment went very well; the patient is older, in her 80's, and I love the older patient populace.  We had a genial visit, and I mentioned to her caregiver niece that a small piece of fish perhaps once a week was okay, keeping the balance of the kidney disease and the patient's food likes in mind.  

My healthy weight practice is also fine.  Small clientele, but usually motivated to listen to advice and increase intake of millets and raw vegetables.  The weight comes off slowly, but that's how I want it.

We listened to a very good talk by a neurologist friend, Dr. Prithika Chary, on the aging brain.  It's nice to listen to useful educational info.  A well-meaning friend suggested I learn to design my website myself; I sat to do that one day, but quickly realised that I like soaking up medical info and not website-design instructions.  So, the trusty husband, Scott, to the rescue.  The results are at https://bit.ly/doctalk-rw.  I also finished the foundation course by the Telemedicine Society of India and it is useful in this new era of tele-this and -that.  

Scott and I went to Mysore last week, after my sister-in-law made the same train journey without having to provide a negative RT-PCR test.  It was good to see my aunt, my mother's younger sister.  We had a meal with her, with lots of laughter and chatter.  We saw some other relatives, too, and returned invigorated.  My former Banyan colleague, Mr. V, now runs a taxi service and he picked us up from the station; it was good to support a former colleague and truly splendid to get home without having to haggle with a cab driver.  

Scott and I spoke to our respective parents, and that was enjoyable, as usual.    

I am in a bad mood today, but it has lessened after this writing.  I hope all of you are well and safe.

Unw -

R  

Sunday, August 08, 2021

Report of 8 Aug 2021

 Good evening!

This has been a splendid Olympics, hasn't it.  Scott is an ex-athlete and sports buff, thus I have got excellent tech details on the various sports plus fun trivia on the various athletes.  No offence, the coverage here has been balanced; I understand the broadcaster has not done a good job in the U.S.  

So now the young husband has turned cricket on.  Not for me just yet.  I loved watching the other sports: we even invested in a TV for that reason.  It has been joyous.  What could not be watched on TV, we watched on computers, sometimes on 2 computers.  Yes, the pandemic continues to rage, but it has been most therapeutic for the soul to watch the grace and class and ability of the athletes.

I have a telemedicine practice now - https://bit.ly/doctalk-rw.  The healthy weight program has attracted some patients and some success - yay!  There was also an enquiry about an older patient who has had leg swelling; as I pondered over the multiple causes, her son mentioned that her cardiologist stopped one of her medicines.  My, yes!  Some medicines can certainly cause leg swelling and it was very good to be reminded of it, as I was focusing more on the organic causes.  "Listen to the patient (or family member) - (s)he will give you the diagnosis."  Slight adaptation of Osler's quote.    

COVID continues to do the rounds here and - I hear - elsewhere.  There is an able administrator in charge in our state, Tamil Nadu, so we no longer have to man the volunteer network and scour for beds or oxygen.  It is quite a nice state of being.

We talked to the children yesterday and it was the massive fun fest it always is.  It is a privilege to be connected to family.

Stay safe and well.  I mean that sincerely.

Unw -

R

Saturday, July 17, 2021

Report of 17 July 2021

 Good evening!

The monsoon is here.  This is the time the other founder of the Banyan, Vaishnavi, usually wanders around in a vehicle, rescuing marooned folks and ensuring that they have shelter for the foreseeable future.  She does all this quietly and unexcitedly; it is quite remarkable to work with her.  

We are well and hope the same with all of you.  I have started a healthy weight and fitness initiative and it is going well enough.  As a physician, I am unfailingly concerned when I see an overweight or obese person; not for the aesthetics, but for the sheer adverse impact that extra weight can have on the entire human body.  Not 1 organ system is spared by overweight; the body was not intended to be thusly impacted.  The service is slow to take off, but the patients that I do have are motivated and are getting excellent results.  

I had to make a short trip to Bangalore.  A cousin younger than I, was going for bypass surgery and I went; I wanted to show moral support to my cousin and wished to speak to the surgeon to see what she/he found.  It was a good trip; my cousin was happy and the surgery went well, thank goodness.  I returned to Chennai a few hours after the surgery.  It is splendid to live in a city with an airport and good to travel to a city with an airport.  

We went to Vellore last Sunday.  My sister-in-law, Susan, was there to visit my niece, Sanjana, who has recently finished med school in the very prestigious Christian Medical College.  Susan asked if the Chennai-ites could come down for a visit, and we went.  With the recent lifting of the lockdown, travel has resumed and there was heavy traffic on the highway, with regretfully very rash driving.  Our vandi (vehicle) was sideswiped by another car and I was dismayed.  It was not a massive hit, and more cosmetic; we managed to get to Vellore.  We had a good visit with Susan and Sanjana, and an outdoor lunch, as Scott was not allowed into the women's hostel.  We returned to Chennai the same day, with similar rash driving encountered on the return, and were very happy to get home.  

Vellore is known for good quality and inexpensive fruit and we returned with 3 bags of fruit.  My motor does not run if there is no fruit in the house and I was happy to buy fruit.  

We spoke to our children on my return from Bangalore and that was wonderful.  With the time difference (we are 9-1/2 hours ahead of them), it is not always feasible to chat, but we manage.  

I updated my aunts and other relatives on our cousin in Bangalore.  As I age, I find it important to be in touch with relatives and am unfailingly grateful to be on good terms.  

The pandemic continues to rage here, with daily cases and deaths.  The variants appear to affect even the vaccinated.  

Stay safe and well.

Unw -

R

Saturday, June 19, 2021

Report of 19 June 2021

 Hello and happy day before Father's Day!

We are well and hope the same with you.  I am occasionally bored witless.  We are under a lockdown and I cannot see patients in the flesh.  Thankfully, I started a telemedicine service and that is keeping me engaged; I give talks for now and enjoy giving them.  A little education goes a long way, we hope.  

Scott is engaged with the consultancy service that he and a friend run.  Scott is a patient and intelligent sort, thus does the work and waits.  I publicise something and expect 50 patients to sign up the same day.  

On the medical side, ye olde husband developed a rash on both legs and it appeared to be due to socks.  It was in precisely that distribution on his legs and did not respond to steroid ointment or moisturizers.  Finally, I put him on a small dose of a steroid tablet and voila, things have cleared up!  I sometimes wonder when treatment I give actually works.  

I spoke to my Dad last week and urged at least minimum exercise.  One of the folks who works for him says he is wary of criticism from his kids, so I tried to keep the advice gentle.  "Frailty" is a thing, I discovered at the most recent conference of the American College of Physicians.  I will speak to him again tomorrow.  

Naren and Nat are well, and we spoke to them last week.  It is always nice to see them; we discussed basketball and farming and work.  

We hope all of you continue to stay well and safe.

Unw -

R  

Sunday, May 30, 2021

Report of 30 May 2021

 Good evening!

There are no lights on the Muttukadu bridge: the lockdown is here and has been extended by another week.  Scott and I have food in the fridge and freezer, and a fridge shelf full of mangoes, so clearly we are set.  Scott is talking to his mother on a free Whatsapp call and I have just finished talking to my father, who is well by the grace of God, as he would say.

We are well and hope the same with you.  I turned 58 last week and the day was merry: chat with our children, a couple of sweet food treats and a day of work.  The day after that, calls to our COVID helpline started decreasing: our state's new administration has been quick to rope in fine talent from the Indian Administrative Service (IAS) and put in place all manner of measures to ease the situation.  Beds and oxygen are available in Chennai and more and more available in other areas.  I am immensely hopeful that this is the case in other states.  

The volunteers on the COVID helpline have a proven track record: at times of the tsunami or the floods in 2015, these folks came to the fore and put in place systems to aid.  No different this time, and it is a privilege to work alongside and triage.  The early days were a bit difficult, and we had our share of heartbreaks with not being able to reach people in time, but the days are better now.  It is a tremendous joy to work alongside such visionary, committed, intelligent folks.  

Scott's consulting continues from home and he is happy to be doing it.  Truly, Internet has become as necessary as food and shelter.  When we were in Madurai last week, we used our phones' data and that was fine for that situation; it is nice to have Internet for our laptops, too.  

I saw a spectacular movie on Netflix today - "Inside Man," from a few years ago.  It is nice to watch a good movie.  We have a son in that industry and were firm fans before he got in the industry.  Our daughter is a farmer, and we have new respect for that industry as we bite into our cold mango.  

We hope you stay well and safe.  I remain very grateful for your presence in my life.

Unw -

R  

Sunday, May 23, 2021

Report of 24 May 2021

 Good morning!

Our washing machine is whirring, a handsome husband is on the sofa reading today's paper, some millets (a hardy, hearty grain) are cooking on the stove and we are back.  

We arrived less than 3 weeks ago, I started working with the COVID helpline organised by the Very Visionary Vaishnavi 3 days after arrival and it has been nonstop.  The crew is Vintage Volunteer, used to focusing on pressing causes with no thought for remuneration, and has a solid track record.  Vaish (with Vandana) founded the B 28 years ago, has since achieved wonders with the Disability Rights Alliance - in a country where disabled are invisible and thought not to exist - and has likely done much, much more than I am aware of.  The crew assisting on the helpline is from around the world - all committed, all diligent, articulate, communicative, keenly aware of the mission.  Most communication is through text, and is unfailingly succinct and professional.  This is a joy!  Sometimes, I veer off into a personal few words - which I am trying to rein in - and they are tolerated.  

The group is called "Chennai Cares," and we were focusing on Chennai, but now have calls from around the state.  According to other writeups in the paper, there are groups such as ours in many other states.  A 16 year old in another state said something to the effect of, "If the Government denies us basic health care, we have to step up."  I love the zeal that tough situations create in the young.  

My father tested positive for COVID last week and I got the phone call from the family that helps care for him.  After that, I had to triage a call here at work and nothing moved for me, even speech - no cognition, clear thinking, reasoning, basic gathering of info - nothing.  As much as I think we can prepare ourselves for such news, we truly cannot.  I told my work crew that I had a medical emergency and had to step away.  Our vehicle had not had the servicing necessary to keep it running and the lockdown had closed workshops, too, so we had no wheels.  We booked by air and flew to Madurai.  I love the Madurai flight - folks are dressed in their best, everything is festive and excited, no one is jaded by flying; it's like a school "excursion" and I fully expect someone to pass out tamarind rice packets.  Anyway, we got to Madurai, got a cab and headed home.  My father was seated at the dining table, waiting for us.  The help had made a spectacular lunch, we ate, assessed my father and then rested.  More of the same in the evening, except a quick run to the medical shop to get some extra supplies - 1 corner of the shop also has groceries.  We returned home and repeated the routine the next day.  On day 3, we invested in a pulse oximeter and saw that my Dad's oxygenation was good - thanks, God.  Towards the end of day 3, a more stringent lockdown was announced and we mulled over returning to Chennai; we discussed it with my Dad and he approved, so we booked tickets to travel to Chennai.  My father has had the full vaccination, thus his infection is a "breakthrough infection."  Thankfully, symptoms are usually mild and it was the same with my Dad.  Ideally, we would have preferred his isolation, etc., but logistical challenges existed.  

We managed to talk to both children on a video call from Madurai.  All parties - grandparent, parents, children - were happy to see each other and my Dad chuckled at a few things the children said.  His entire demeanor perked up while talking to them; I guess this is the joy of grandkids, eh.  

A beloved former colleague now runs a taxi service and he picked us up at Chennai airport.  Being with Velan is like salve; his speech is measured and matter of fact and warm.  His goodwill is apparent.  We stopped at a couple of grocery stores en route - some had been wiped clean, but our local little grocer had lots of veges.  We bought, and headed home.  We invited Velan in for a cup of tea but he declined; he said, "If your children have any program, I can help."  I told him neither child looked close to marrying, and thanked him.  Scott handed over the couple of things we had bought for Velan at the store; it was nice to see the expression of surprise on Velan's face.  It was a delightful way to get home.  

Chennai was overcast and Scott and I capitalised on it (otherwise, the heat is stupefying) to walk to the store next door - almost next door.  It is a "supermarket" and they had all sorts of goodies: produce, toned milk (does not have to be refrigerated until opened), nice cheese and exemplary service.  We let the manager know of our joy and left with our bags of merchandise.  We stopped for a tender coconut.  The seller said, "Wow, it's been so long since I have seen you!," and in the course of conversation, "Have you been to Madurai recently?"  So, she did remember us, it was not a fake attempt at geniality and we enjoyed the chat.  The last time I saw her, there was a bouncing baby boy crawling around the shop; I said, "How is your son?" and she said, "He is in the third standard (grade)."  After my being recovered from that news, we chatted, and had coconut.  She cut 3 for the 2 of us as I was after the harder variety of coconut, not the tender, slippery kind.  She charged us for 2, we paid a little extra and left.  It was nice to walk everywhere.  

We got home to find that the lady who helps take care of the house had arrived with her daughter and they were busy cleaning.  I thought this extraordinarily considerate: a lockdown was to arrive on 24 May, and the ladies came speedily over on 23 May and cleaned our house.  We had not told them of our return from Madurai, and had not expected to see them for a few days.  It was a treat to see both - they are fine, good and loving people - and we had a nice evening.  We gave them some treats ("foreign chocolate" - always a novelty) and some money that our children had sent for them, and I know for a fact that blessings from this family will go to mine.  

I am back at work this morning.  My friend, Fanny, had graciously passed on some clothes to me and I am in a thin cotton dress from that gift; it has stick figures of women frolicking and dancing, and I love it.  The dress stops well above my knees and I would not wear it outside the house here.  It is lightweight and well-made, and suits the climate here.  We are triaging calls and reassuring anxious relatives.  It is nice work.  I have also eaten a cold Imam Pasand mango and that always helps the morning.  

We talked to Naren this morning and talked to Nat last week.  It is nice to talk to children.  

Our blessings are many, many.  We hope yours are, too.  Thank you, God.  

Unw -

R

Sunday, May 16, 2021

Report of 16 May 2021

 Good evening - 

Blue sea, handsome husband - new goatee and all - nearby, a slight break from the COVID helpline and I will quickly blog plus try to do some CME (continuing medical education).  One day, I started CME at 8 AM and finished the 45-minute lecture at 5.45 PM - helpline activities predominated.  

So, the whole funda (fundamental) is that Vaishnavi, one of the 2 founders of the Banyan, put together a volunteer group to do what the Govt cannot - match COVID patients to beds.  We triage, and either keep patients at home or find oxygen/beds for them.  It is nice work - stupefyingly busy.  I don't usually see my husband the whole day and both of us work from home.  

The days of sitting in our pretty Muncie apartment, looking out of the window at the pond (I love water - ponds, lakes, rivers, seas) and eating oatmeal loaded with raisins and nuts and banana, seem so idyllic now.  Work is great, of course, and it is nice to be a small part of the solution.

So, for those of you who have heard how devastating COVID has been in India, it is true.  Please know there are also hordes of good people springing to the solution here.  And it is wonderful to work with them.  

N and N and we got to speak on Mother's Day.  That was very nice.  I got a list of 30 ways I was a good mother; it was sweet.  

Unw -

R