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Saturday, July 25, 2009

Recovery From Cardiac Bypass Surgery: Day 5

I made it to hospital early in the morning on Saturday with my brother. My brother was leaving for the airport from the hospital, so he stayed only for a few minutes. I was alone with my parents after that, and started learning from my mother how to help out with various activities. Essentially, my father needed help with activities like sitting up, walking to the bathroom, eating his meals, etc. And all these activities had to be done without straining specific parts of his body (for instance, my father was not allowed to put any weight on his hands even to move himself up in bed, or while trying to sit up or get off the bed).

The big event of the day was supposed to be the EEG that had been prescribed the previous day.

The appointment for the EEG was originally for 10 in the morning. The main problem with the EEG was that it had to be performed in a separate facility across a busy thoroughfare from the hospital itself. Yes, this fact is prone to induce some disbelief, but that is the way this hospital has evolved. The hospital owned land in separate parcels bisected by the They have a separate facility for all kinds of major outpatient diagnostic tests like EEG. These are tests which are not routinely needed for surgical patients. Tests which surgical patients need, such as X-rays, ECG, etc., are done inside the hospital proper.

In any case, because of where the EEG had to be performed, it required that an ambulance be arranged for transporting my father to the diagnostic facility. 10 AM came and went and nobody came to take my father for the test. 11 AM came and went, and still nothing. Finally at 11:45, two orderlies came with a stretcher and transferred my father from his bed onto the stretcher. The stretcher was then wheeled out all the way to the front of the hospital where the ambulance was parked. The hospital did not have a special receiving dock for ambulances like they do in the US. It was quite hot outside, so it was a little uncomfortable for the few minutes it took to load the stretcher into the ambulance (the stretcher's legs had to be collapsed manually to get it inside the ambulance and then the flattened stretcher had to be locked in place using a couple of latches to keep it from moving once inside the ambulance).

The ambulance itself was air-conditioned and seemed to have a full complement of emergency equipment including a defibrillator, intubation kits, etc. The ambulance ride took about 10 minutes, and then the procedure of loading him into the ambulance had to be repeated in reverse. He was then wheeled into one of a number of small rooms each devoted to different kinds of diagnostic procedures. Once inside the room my father had to be transferred bodily off the stretcher onto the bed inside the room because the metallic parts of the stretcher might interfere with the EEG procedure.

The EEG technician then put a harness around my father's head and started attaching a spiderweb of leads to various points in the harness. The leads were attached to a console which was hooked up to a computer. The technician then began the test by starting up the appropriate program on the PC and entering the parameters required. The signals from the leads showed up on the monitor as wavy lines. Based on what she saw on the monitor, the technician then began the process of adjusting and fine-tuning the positions of the leads in the harness around my father's head.

When she was satisfied with everything, she instructed my father to lie still, without moving his head or mouth, close his eyes and breathe normally. She started recording the wave patterns using the computer program. After about 10 minutes, she positioned a strobe light over my father's closed eyes and instructed him to continue keeping his eyes closed. The strobe started out flashing about once every few seconds, then slowly increased in frequency until it was flashing on and off about 10 or 20 times a second. The entire procedure took about half an hour. The technician told me the results would be ready by 5:30 PM.

At 1 PM the orderlies again transferred my father from the EEG bed to the stretcher, loaded the stretcher into the ambulance and we began the drive back to the hospital. At the hospital, we unloaded the stretcher wheeled him back to the room, and transferred him to his bed. We then paid the orderlies some baksheesh, and they left.

After that, we had lunch and my father rested. Later in the evening, a dietician came and wrote down detailed instructions about what my father could/should eat and what he should avoid for the next few days, few weeks, few months, etc. He also had recommendations for the ideal weight he had to maintain, how much and what exercises he should do and so on. What surprised me somewhat was that there were some fruits included in the to-be-avoided list along with oils and other fats, coconuts, peanuts, and some root vegetables like potatoes.

After that, I opened up my laptop and worked on my travel log. I also put together a blog post about my experience traveling back home in a text editor. I had not had any internet access since I left on my trip. The internet connection at home was out because of some problem, so I still had not checked my email or done anything else on the internet. The lack of internet access continued as the hospital did not have wi-fi or any other way to access the internet. I am not exactly addicted to the internet, but the internet is my main source of information and news since I don't watch TV or subscribe to newspapers when I am in the US. Being cut off from it was like being in an information void. And, of course, I was getting antsy about what emails were waiting in my inbox for my attention too. But that problem was going to take some more time to resolve.

Right after 5:30 PM, we confirmed that my father's EEG results were available to be picked up (the results do not go directly to the doctor who prescribed the procedure. It is the patient's responsibility to pick the results up and give them the doctor). I dodged my way through the peak-hour traffic (which appeared as if it was in brownian motion, with no apparent movement with any purpose), and picked up the report from the same room my father had had the procedure in earlier in the day. The report was about 15 pages thick, but there was writing only on the front page. The rest of the pages were filled with the wavy lines that I had seen recorded on the computer during the procedure. The front page was quite cryptic in terms of content apart from the details of the patient, the time when the procedure was performed and other details about the procedure itself. The conclusion of the doctor who interpreted the EEG was that there was no apparent epileptiform activity in the brain (which was what we had been worried about). The report did mention possible slow wave dysfunction, whatever that meant.

I gave the report to the nurses attending on my father to convey to the neurologist. One of them came back and said the neurologist had been read the report over the phone. He did not think there was anything in the report that required immediate attention, so he was going to be back to see my father only on Monday. We took that as an indication that everything was fine and there was no cause for any concern.

One of the reasons why my brother decided to stay back until after my father's surgery and then leave me in charge of the recovery, rather than the other way around had to do with logistics. I never learnt to drive back home and my entire driving experience is restricted to the US. My brother has lived here for much longer than I have, and at one point owned his own car and drove around here. Driving here requires some special skills because to call the traffic here chaotic would be to put it insultingly mildly! During this trip, my brother had full use of his father-in-law's car and that made it easy for him to shuttle back and forth between home and the hospital. The hospital was about an hour from home by public transportation and I have no access to private transportation of my own.

I hate traveling outside of home when I visit back home because of the various problems that come along with it. Public transportation is crowded, slow and subject to frequent unannounced changes. For-hire transportation consists mostly of 3-wheeled auto-rickshaws that are notorious for rash driving. Moreover, even though they are supposed to use a meter to charge passengers for transportation, such a concept would be laughed at by the drivers of these vehicles. So, all charges have to be negotiated between the passenger and driver before-hand. The drivers will usually start the bargaining by asking for an amount approximately double or triple what it normally costs and it is upto the passenger to hardball that down to something reasonable. I hate such bargaining, which makes for-hire transportation as unpleasant to me as public transportation when I visit back home.

The hope had been that by the time it was time for him to leave and for me to take over, my father would have mostly completed his stay at the hospital and I would not need to commute between home and hospital too many times by myself. Unfortunately, because the surgery had been postponed by 3 days, my father's return back home was also delayed by at least 3 days.

What had originally been planned as just a couple of days of me managing using public or for-hire transportation was now going to be at least 5 or 6 days of my doing so. It was not something I was looking forward to. Luckily, a cousin of mine lives about 15 minutes from the hospital. I am pretty close to this cousin and he has always been very helpful and friendly. He had enquired about how the logistics were going to work, and once he realized that things were going to be quite a hardship for me, he immediately offered to put me up at his home for the nights so that I would have a much easier commute to the hospital. In fact, during the weekend, he could drop me off at the hospital and pick me up in his own car. But he was going out of town on Sunday night, so I would have to manage on my own during the week, but the much shorter commute would certainly be a big help to me. It was therefore decided that rather than commuting between home and the hospital, I would stay at my cousin's home as long as my father was in the hospital.

My father was also having problems with the quality of the hospital food, especially at lunch time. The food provided had initially been too spicy for my father. Once my mother requested the staff to tone it down a little bit, the food became too bland. Either way, my father was not happy with it, leading to poor appetite and intake. Everyone, including my father, realized that good nutrition was key to his quick recovery, so my cousin's wife also offered to send my parents home-cooked food, at least for lunch. And my commuting from my cousin's place to the hospital would make the couriering of the food convenient too.

At about 7 PM, my cousin and his wife showed up and spent some time with my parents and me. After that, I took leave of my parents and left with my cousin for his home. My cousin lives in a 3-bedroom apartment with his two children (he has a college-aged daughter and a son in high school) and his mother. My cousin and his wife are jovial characters, always making jokes and pulling each others' and everyone else's legs. His children are wonderful, smart and well-behaved kids who have inherited their parents' sense of humor. His mother has always been fond of me since the day I was born. I have stayed with this cousin several times when I was younger, so I was quite comfortable in his company and that of his family.

Once I reached his place, we had dinner, chatted and watched some TV. My cousin's computer was hooked up to the internet, so I spent some time making sure there were no important emails in my inbox (I did not actually read any of them, I just skimmed through the subject lines). After that, I posted the blog post I had worked on at the hospital. Then I spent some more time chatting with everyone before going to bed at around 11 PM.

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