It was a day in my life........

A few weeks ago I found myself testing the US medical system-- again. It had been seven years since I underwent quadruple bypass surgery at the best heart center in the US. Unfortunately that experience had left me with an ejection fraction of 15% barely adequate to pump the heart. During the past seven years, three doctors had managed to skillfully redesign my life to a relative health. But now I was back again having fallen off the strict regime which had upset the chemical balance of my body.

One of the prime culprits was a new drug called Lyrica. NowI love my doctor-he is kind, considerate and so far his judgements (I have had him now for 25 years) and advice have been sound. But....once in a while his judgement slips. Unfortunately it happened last week...He had prescribed Lyrica, a brand new drug, a month ago to alleviate my phn pain a result of a bout of shingles the prievous year. But he had not taken into account it's possible side effects! Apparently lyrica had built up in my body raising both the creatinine and bun levels beyond the danger levels. Alarmed at the new levels he now recommended a right heart  catherization and an iv drip. Except that I had become so weak as a result of lyrica, I felt that the procedure may be danger to my life. So I refused the procedure then, only to reap the fruits of my delaying and leading to the emergency trip to the hospital! 

The new hospital system-- and it's old habits. I entered the hospital and soon enough found myself engulfed with various experts.

The perils of specialization and coordination: The  tale of three experts. -- during my seven days scores of experts visited my bedside but three standout each of whom predicted my demise with different degrees of subtlety. One prognosed that the only solution to my condition was a heart transplant. But a few years earlier, John Hopkins, after a detailed assesment had declined to place me on the list because of old age of 70. Another suggested an LVD but in the present condition it was not possible. A third prognosed that dialysis was only a temporary fix --in short I should get my affairs in order ( and this in presence of my daughter who was understandably distraught). Another suggested I focus on Gita . In short all of them saw but a limited lifespan left for me....fortunately my old cardiologist was there to provide a common sense path forward.

The hospital had now a new set of gadgets:

There was a 3 lb heart monitor

There was more paperwork- more computers but less efficiency

There was a new bed which moved every few seconds- modern but uncomfortable.

Among these shiny gadgets old fashioned commode stood out in discomfort and oddity

Lessons old and new

Doctors don't know everything --As Jerome Groopman wrote on average, a physician will interrupt a patient describing her symptoms within eighteen seconds. In that short time, many doctors decide on the likely diagnosis and best treatment. Often, decisions made this way are correct, but at crucial moments they can also be wrong Ð with catastrophic consequences.

Nurses are grossly under appreciated. Constant attention by a good nurse may be just as important as a major operation by a surgeon.  ~Dag Hammarskjold . Nurses dispense comfort, compassion, and caring without even a prescription.

Your family is everything. During the entire period my family stood like a rock beside me-my daughter took leave to spend nights massaging my back, my son flew back from Vietnam to reinforce her ministrations and my wife was an ever present presence in the room. Without them it is unlikely that I would be writing this blog!

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