At Dr. Ratnaparkhi's Clinic

So after the appointment that Dr. Rao fixed on my behalf with Dr. Ratnaparkhi, we went to his clinic at 5:30 for a 6:00 pm appointment.
Mom and I went with Aadu and my Papa was to join us there directly from his office in Navi Mumbai. My aunt and her son stayed home.
Once we were at the clinic, they asked me for Aadu's particulars, then weighed him and noted his height. As we sat down, a nurse/attendant came and asked me to bring Aadu to a nearby cabin, I went in and there she gave me 4 ml. of a medicine that would make Aadu sleepy, so that we could do the 2-D echo without any disturbance. I gave him the medication, only after making sure with her of any side-effects. There were none.
We waited for almost an hour and still Aadu was not sleepy, infact he had grown restless and wanted to go out and play. It was also raining a lot that evening.
As our turn came, the nurse asked me if we wanted to wait for some more time for the medication to take effect....I said 'no' and assured her that as long as I was with Aadu while the test was being done he would not cause any disturbance.
So...we walked in to the diagnostic cabin, there was a tread-mill there and a bed and the 2-d Echo cardiogram machine stood besides it.
Then entered Dr. Ratnaparkhi, from his adjacent cabin, to me he appeared to be calm and confident (just what I wanted), and after pleasantries he asked me to sit cross-legged on the bed with Aadu on my lap. We did as told, removed Aadu's shirt...and then the doctor smeared some jelly on Aadu's chest...it was cold and Aadu made a face...I comforted him..then he was OK.
Aadu leaned over my knee to watch the proceedings on the monitor...to his little innocent mind it was a computer which showed some pictures !!
The test began...it is just like our routine sonographies that we do during pregnancies...I mean the jelly smearing and the apparatus that they move across our tummy...what is it called....hmmm..well never mind..lets call it a probe.
So basically the doctor smeared jelly on Aadu's chest and moved the probe over it and then the images appeared on his screen....I could make out the outline of his heart, and then the four chambers etc...
Then he switched the view so that we could see red and blue...red for the pure blood and blue for the impure blood being sent to the heart.
During this viewing I noticed that in the upper chamber of the heart the blue and the red were mixing...I knew that was not how it should be...right...we learnt in our school biology that the pure and impure blood stays in separate chambers of the heart...and here in front of me I could see that they were mixing...so I knew something was not correct...what exactly was wrong I did not know...and of course the doctor was going to tell me.
Dr. Ratnaparkhi or his assistant did not say anything at that point and he just asked us to follow him to his cabin.
We followed...and sat down ...his face same...calm and confident...I did not know what to expect.
Then came the moment of his talking....he said there was definitely a problem with Aadu's heart. The wall (septal) separating the upper chambers (atrium) of his heart was not fully formed and thus there was a 14-15 mm hole. This was causing the pure blood from the left to mix with the impure blood in the right side chamber...thus putting a lot of strain on the heart, and the result was weak lungs which had to re-purify some already pure blood which was mixing with the impure blood due to the hole. The technical diagnosis was: Large Atrial Septal Defect. 14-15mm in size. Shunt = left to right.
'Shunt' refers to the movement/flow of the blood in the upper to chambers due to this defect.

By the time this bit of news fell on my ears I crumbled and tears that were confined were let out...I just could not help it...normally I do not cry in front of strangers, but this time I just could not care ...

Thankfully my mother was much more stable than me and discussed the options with the doctor. He said considering that Aadu is not even 3 years we could wait for him to turn 4 and then think of surgery. But surgery was the only option and that the chances of the septal defect rectifying itself naturally was very small.

We left the doctors office with heavy hearts and me crying but trying to look strong coz I was carrying Aadu. Once we stepped out of the doctor's clinic, I stood and cried with Aadu in my arms.....my baby then lifted my face with is hands and said 'mumma....it's OK....me aahey na....me strong boy ahe na...' (which translates to...mumma it's OK...I am there with you...I am a strong boy'....
In that moment, I said to Aadu 'tu theek kar...karshaal na?' (you make it alright....you will won't you?) and he said 'yes mumma....me theek karto na...' (yes mumma I will make it alright)

As we were going down the stairs, my Papa walked up with an umbrella in hand (it had been raining very heavily and he thought we should not get wet while reaching the car). As soon as I saw Papa I cried again, fell in his arms and told him what had happened....he said 'don't worry beta...everything will be alright..'
We rushed in the rain to the car, and headed home in silence.....when we reached home...my brother was home and I told him and Papa everything that the doctor had said and we went through the reports together...
We all sat together and said we will do everything to ensure that Aadu gets the best treatment.
We told each other that we still had to go to Dr. Dalvi's clinic on the 15th so maybe he has a different diagnosis or treatment etc....we were hoping against hope so that our little angel would not have to face surgery...but God had other plans for us all.

9th July 2008

As mentioned in the last post, Aaditya had mild fever running for almost 1 week, so finally I decided to head to Dr. Daftary.
At the clinic, Dr. Atul checked Aadi, then he called over Dr. Daftary to check Aadi, This had never happened before, Dr. Atul had never asked Dr. Daftary to check Aadi ever!!
At that moment I knew something was wrong, but thought that it would be related to the fever.

Then Dr. Atul told me that there were something wrong about his systolic heartbeat, and that we should get it checked by a 2-D Echo Cardiogram.
I had never heard of a 2-D Echo before this, I was very confused.

They gave me numbers to Dr. Bharat Dalvi's clinic in Matunga, telling me that he is the best when it comes to childhood heart ailments.

When I heard that....my head was in a tizzy, I tried my very best to concentrate on what the doctors were saying.

Dr. Daftary said there was no need to be alarmed, we just want to rule out the possibility of a heart ailment hence the 2-D Echo.

I kept that in mind and headed home.

I called Dr. Bharat Dalvi's clinic upon reaching home, and got an appointment only for the 15th of July, and I was not willing to wait till then; because in my mind I thought that we have to just get it checked once and get over with it, so the sooner we check the better.

So the next morning, I went to our family doctor, Dr. Rao in Andheri and he suggested another Cardiologist in Andheri, Dr. Ratnaparkhi. He told me that this cardiologist is well known, and was a good friend oh his. Dr. Rao even called him in my presence and fixed up an appointment for the same evening.

While at Dr. Rao's he checked Aaditya and told me that according to his diagnosis there was no problem, but all rests in God's hands (I remember he pointed to a picture of Lord Ganesha behind him).

By this time, I was tensed and it showed. My mom tried very hard to divert my attention, but the worry just kept eating bits of my heart.

I also remember that while washing some glasses, I actually broke one. Now I am not an overtly superstitious person, but I don't know there was something about that day and when that glass broke I knew I would face some bad news.

In all this time, I had not told my brother about this. I think he was going through a very busy patch at work and hence me and mom decided to keep him out of this, since we had to just get the 2-D echo done to rule out any problem.

This was another mistake I made, because for me my brother is my pillar of strength, my rock solid support. Without him by my side I was just not stable.

The Journey to India

After the second episode of Febrile Seizure, we were very careful with Aadi's fever or any health related issue. Luckily there were none until I decided to go to India to visit family.

In May 2008 I went home for a 2 month vacation. On 30th May Aaditya and I left for Mumbai, we were really happy to go home as it was our trip after almost 1.5 years.

As I was packing, Amol was telling me how I should be careful with the water that Aadi drinks, the rains - he must not get wet, he is not used to it. He must not play in the mud, he could get sick.....and the list went on. I knew Amol was worried for Aadu and since he himself was not going to be there during this trip to India, he was making sure he voiced his concerns....but the truth I think is that he was trying to mask his sadness of having to part with his little soldier for that long a period.

Anyways, we landed in Mumbai, the family was there to receive me, and actually I had not told my mum that I was coming; so the trip was actually a surprise for her, and also a sort of birthday gift for her 1st June birthday!!

During the next month, Aadu was healthy, and did not even as much catch a cold. I was feeling very relieved that he did not have any health complaints with the change in weather etc.
We did go out to the park in Juhu (opposite Sahakari Bhandar..now Reliance Fresh) and he would run around the jogging/walking track. He would actually take one and a half round jogging, and that was great according to me coz I never saw a child his age run that much. He would then play on the swings, play in the sand, run after butterflies. He would get exhausted after that; and here I used to think that after all that play it is natural for a child his age to fall asleep.

I really had little or no way of comparing Aadu's stamina to other children. During this trip however, my aunt and her little son also came down; he was just around 2 years of age. So I had just him to compare with.

He (my aunts son Atharva) is always jumping around, and never sat still for more than 5 minutes. But he would hate to run or walk in the park, and would insist that my aunt carry him.
Compared to him, Aaditya would play at home; but could sit and watch cartoons or even a movie continuously without getting bored. At the same time, once he is out of the house and in the open there is no stopping him and his running around.

So here also I really saw no "red flags".

Early July, Aadu had a mild fever, and I gave him Panadol Syrup, to counter it. This worked well. But the fever continued for about a week and then I decided to take him to Mrs. Daftary (his Pediatrician since birth)

What proceeded next I shall write in my next post.

8 ways to avoid medical mistakes - Dr. Oz's Smart Patient Checklist

Chances are you or your loved ones will need to be hospitalized at some point. Reduce the chances of a medical mistake by following Dr. Oz's eight steps.








This is Dr. Oz, he is a regular at the Oprah Show, and I follow his site RealAge very closely for any medical or health related information.

These following steps will ensure that you or your loved one will be well taken care of while in Hospital and also will get the best treatment available.

Step 1: Prevent infection.

Dr. Oz says there's a straightforward advantage to staying infection-free in a hospital. "You're in an environment that has sick people in it who have infections themselves," he says. "It's so easy to spread to you."

• Ask people to wash their hands before touching you.
• Keep hand sanitizer by your bed.
• Try to avoid bacteria-promoting items, like flowers and jewelry.
• Ask doctors to clean their stethoscopes. "Did you ever think where the stethoscope was before he examined you?" Dr. Oz says. "It was on someone else's chest, and that same bacteria gets carried to you."
• Clean television remotes.
• Ask a doctor to remove his tie, or else tuck it into his shirt. "How many men here have ever washed their tie?" Dr. Oz says. "Nobody. No one washes a tie. Doctors don't either.

Step 2: Avoid wrong-site surgery
When Dr. Oz's wife, Lisa, went in for corrective eye surgery, he says she was the victim of a medical error. "They set the device for her right eye and put it on her left eye," he says. "[It] almost blinded her."

One way a patient can prevent this kind of "wrong-site surgery" error is a simple as writing a note. "If you're going to have surgery on your left arm, write 'Operate on this arm' [on your left arm]," Dr. Oz says.

Step 3: No chitchat

Hospitals can be very hectic places, and small talk could distract your doctor. "I know you're trying to be polite, and they're trying to be polite talking back to you," Dr. Oz says. "But let them do their job."

Step 4: Find a high-tech hospital
For instance, if a hospital in your area uses bar code technology to organize treatment and medication, go to that hospital. "You will dramatically reduce the risks," Dr. Oz says.

Step 5: Find a hospital that uses a care checklist

Dr. Oz says this is like the preflight list pilots use before takeoff to prevent simple, preventable mistakes. "It turns out that if you have a simple checklist—like use a sterile cloth or drape if you're going to put a catheter in some patient—you can reduce the infection rates about 85 percent. That probably saved in the last 18 months 1,500 lives," he says.

Step 6: Use an accredited hospital

Dr. Oz recommends researching your hospital using resources from the Joint Commission, a health safety watchdog organization. By going to a high-ranked hospital, Dr. Oz says you are rewarding excellence and forcing other hospitals to improve themselves. "Pick the places you want to get the care you desire," he says. "Those places will thrive, and other hospitals want to be like them."

Step 7: Get to know your hospitalist
Your regular doctor is your go-to gal for for the coordination of all your illnesses and treatments. But, they aren't around when you're in the hospital. That's where a hospitalist steps in.
"They know all the programs and the protocols. They're going to work closely with you to make sure you get what you need done," Dr. Oz says. "Find that person, learn who they are and work with them. That's the person that's going to help you get out of there quickly."

Step 8: Be a smart patient

The key to being a smart patient is being proactive about your care, Dr. Oz says. If you hear a doctor say something that doesn't sound right to you, speak up. "If you're on medications, know what they are so you can say: 'Wait a minute. I'm supposed to get four; you just gave me a fifth one. What's going on here?'"

The second Febrile Seizure

After the first episode of the Febrile Seizure he had another one in the month of April 2008.
This one also happened very suddenly. He was not sick, no fever, not even a cold. We went to bed as usual on the 7th night, and all through the night I felt feverish, and had body ache.
I had no clue that Aadi was also feverish, and was making 'aah' sounds as he tried to sleep. I was overcome by the agony of my own fever.
We woke up around 6:30 AM and saw that Aadi was very hot and did not look well at all, I knew the fever was high, so I rushed to the kitchen to get the suppository from the fridge, while I was on my way back, Amol asked me to hurry up as Aadi was having a seizure. As I ran into the room, I saw the same repetition of the previous episode, only this time around the major difference was that he did NOT turn blue.
I administered the suppository and within minutes the fever was down.

We decided to take him to Pantai none the less to see Dr. Azam.

After the suppository, the fever never came back, and Aadi was playing around as though nothing had happened. He was not sick at all.

At Dr. Azam's clinic also he was playful, and chatted with the doctor. Again Dr. Azam asked us to be watchful for the next 24 hours, as the fever may return and thus a seizure could happen again.

Thank fully though the fever dd not show up.

But my fever turned out to be a viral one and I was stuck to the bed for a few days.

Drained

Sorry folks for not writing .... I was/am emotionally drained after re-visiting those memories and I realised how the memories can still torture ....so please give me some time to get back my emotional strength to write again....

Some Red Flags - October 2007

Febrile Seizure

It was the last week of October, 2007; we had just shifted to KL from SG. Aadu was running a mild fever, and I got busy with the unpacking, in the middle of this Aadu wanted to sleep so I made the arrangements, without giving him medicine, thinking that it would recede on its own. This was a huge mistake.
When I went to check on Aadu, I realized that his fever had gone up, and I went and got some plain water and a napkin to sponge his forehead, palms, and feet. While I was doing this he woke up and I sponged him for a few more minutes. I kept talking to him, and I said that 'I'll get the medicine from the cupboard, and then he will feel better'. While I was saying this he tried to get up, and I saw that he had started shivering....he then lay on his back and what transpired in the next 6-8 seconds was horrific. He turned blue. His hands and feet were shaking, his eyes were rolled up, there was froth coming from his mouth.

I had never witnessed such horror before, and I did not know what it was. I was feeling helpless as the land line was still not up, and my handphone was not functioning. So there was no way I could call for help from my house.

In this situation, I had remembered something that I had read in one of the child-care books, that when a child (or anyone) is having a convulsion, we must put something in the mouth so that they don't swallow or bite their own tongue. I put some cloth (I think it was his read vest) in his mouth, wrapped him in a baby blanket and rushed out of the house, shouting and banging on my neighbours doors. This was my first day in KL, and I did not know anyone in my condo. But I kept shouting and finally some neighbours came running and I managed to place a call to Amol who started for the Hospital, and then Veena in her calm voice asked me to come into her house while she administered a suppository to Aadu. I had not known of a suppository for children till that day. She also put a fever-patch on his forehead, then took me down to the parking where Seema was waiting in her car ready to rush me to Pantai Medical Center. I had insisted on Pantai as I used to go there when I was pregnant and knew that it was the best place for Aaditya.

Once we were there, we were taken to the ER (Emergency Room). Thankfully Amol had reached before us, and had done all the paperwork. The doctor there asked me what had happened, and I told her all that took place and also of the suppository that was given to Aadu.
They put on a pulse monitor on his finger, and checked his fever; which had (thanks to the suppository) come down to normal.
It was here that I got to know what had actually happened to my little boy: it was a Febrile Seizure or convulsion. It happens, when the immature, still developing brain of a child cannot make sense of the high fever. This phenomenon can occur till the child is 5-6 years of age. This has no side effects on the other development of the child.

We decided to admit him for a day, just to monitor him and because the doctor said that the chances of a re-occurrence are highest in the next 24 hours. During that hospital stay he required the suppository three times. The next day also showed some ups and downs with his fever, so we stayed on in the Hospital. Meanwhile my brother had also come down from Mumbai after a shock-stricken phone call that I made while sitting in the ER.

On the next day, after the doctor made his rounds, he said we could go home.

Points to remember:

• When going to a new place, always have the names, phone numbers of hospitals, nearest to your home.
• Always have one working phone line. Move in only when the land line is installed or then keep your earlier mobile line in roaming while your current mobile line is getting arranged.
• Always travel with the basic medicines that your child needs.
• Never wait for the fever to go down on its own. Always administer medication ASAP.
• Get a health insurance for your entire family immediately when you relocate.
• Check health insurance for hospital coverage; as hospital stay can get expensive.
• The health insurance package will give a list of affiliated clinics, hospitals etc and the emergency health line. Keep this handy at all times.
• Make a list of emergency phone numbers of the new city ASAP and paste a copy near your phone.
  
• Maintain all health records of each family member in separate folders. Keep this updated.
  
• When at a hospital or clinic, never hesitate to ask all the questions that you have. No question is a 'stupid question'; if you don't know the answer to a question, you have to ask.
• The doctor may look rushed to you, and you may think that probably you will ask him later...there is no later. It is the doctor's duty to answer all your questions.
• It is completely OK to check the credentials of the attending doctor. If you know any other doctor in that hospital do not hesitate to ask for him.