Tuck in bed

 One of my patients has severe dementia and needs total assist with all mobility in bed. She cant walk. She needs 2 people to help her sit by edge of bed or to change her incontionence pads or to move her in bed. She is blessed with a son who is so loving and caring that everynight he tucks her in bed and says that ' u tucked me in bed when I was young, now its my turn to tuck u in bed. Everyday instances like these makes my hope in humanity and love stronger. 

The day my Father-in-law passed away

July 18th :
Yesterday was the most horrifying and sad day of my life. In the morning after talking to dad who was home with the doc I left for work. Conversation with dad was limited that the meds are started and that he will rest at home till he recovers from his pneumonia and then he will be back to work. I saw Sam's and Avni's missed call. I called Sam and he said dad was in hospital. It was a matter of 4 hrs since I talked to dad. Ashish Bhai joined line and said that v guys should come soon but he did not say anything else. I knew it was serious but that thought did not strike me. I called Amit and he just said that  dr said he is no more. Still in shock stage mind was not ready to believe and I felt there may be some hope...prayed real hard to god that " please just 1 last chance"...please...pleaded and pleaded....however with life there is no 2nd chance... Nobody will say that he is ok and alive.. Those are the only words I was looking for. Right now I am writing from London airport... Only things which come to mind is how beautiful life was and suddenly a storm comes and shatters the house...we have to build our house back up...

Arya and Reyna were talking to dad this morning Arya is told that dada is in hospital and mom and dad went to c him.. Her next question is. "Why"?

The biggest loss is for my daughters who are devoid of their dada's pure unconditional and unmatched love and pampering... And for my bau( niece) who did not get to see her dada..

I want to tell you all on how great a person he was. I can writes pages and pages on how he loved and celebrated life... And how his teachings will show us path on how to love and live.

He was a true family man.... He never missed any opportunity to be there when his family needed him. in fact he made sure he was there with us whenever it was possible for him. He told me that every summer vacation either I come to US or u send kids to India...Amit just received his US citizenship and we were planning to call them permanently so that they can stay with us forever. One thing we are truly blessed is that we got to spend so much time with him every year that he was pretty much involved in each and ever aspect of our lives.
All incidences are striking in my brain like a storm. .I want to write down each and everything to keep him alive in our lives but most importantly to keep his memories for my kids and for them to know that " their granddad was the best granddad in the whole universe"""....he was present at all their birthdays if possible... always asked us to celebrate them in a way that we will remember for life....so far we have done well and made each birthday a special one with him in just being present in all of them...he loved food...he traveled the whole world and always wanted us to see the whole world...he loved America and not because we lived here but because he found it to be a place where people are just and he wanted to have his kids and grandkids have a quality life. He did not tell us like all other parents in India who selfishly wish that their kids return back home. He was not a conventional dad at all...that is what made him so great...we visited many places together and he enjoyed the beauty of every place and found immense peace and pleasure in nature. In the morning after he drinks his tea he used to read books in our backyard.....he hears the noise of birds chirping/ water running through a small stream and said" ketlu saaru lage che.. which in Gujarati means' This feels so nice, this is heaven"....
On Halloween: he got a scary mask so that he can have fun on that day...he goes out for trick or treating with kids...him being another kid...he once also went to downtown to see how people dressed....he enjoyed all minute things in life which needed to be enjoyed. 
He could spend hours in library....
He was like a kid...loved to go to park every evening with Arya and Reyna, ate lots of chocolates,  hid some in secret containers in house to hide it from me...if I found one box and threw it in trash after few days a new one pops up from somewhere.
He wad my best buddy. First thing in the morning which wakes us up is his facetime/ google hangout to see Reyna brushing her teeth while he will be in his office...she will talk some and we hang up again...after shower Reyna goes to dining table to drink milk and as always dada counts till 10, or play chal chal chal mere haathi... or lakdi ki kaathi...songs and Reyna finishes hot milk...we talk some and get a super head start to the day. Last call happens in evening when he calls again after he wakes up and is having his tea/ breakfast.  We talk about routine things/ discuss politics/ movie/ talk about my patients ( he loved to hear my patient stories) ironically the few days before he died he told me " Shweta you are blessed to encounter such unique experiences which not many get to experience....you need to write it down. if u don't have time just get a recorder and record them...I will write when I come there or u can hire somebody later to make a book out if this. Please continue and I will regularly keep pushing u to do that." He found the stories of the elderly patients who had so much gong in in their life still in the face of difficulty and  how they cope up with everything, very inspiring. He loved to hear my patient stories on how the bond of love grew stronger as years passes in elderly folks. He told me once ' I feel that in spite of my difference with your mom, I love her the most and feel that the bond is getting stronger everyday now.'
My trip to India after my father-in-law passed was the worst trip of my life. we were on plane and there was an Iranian old lady sitting next to me. Seeing me crying and in pain she was concerned and offered me some paper napkin and asked what happened. After I told her what happened she told me ' WE do not have a choice... we don't we wish we had one but we don't. We have to accept it.'' after saying that she was almost in tears and told me that she lost her 10 year old grandson to cancer. She feels that the worst thing that can ever happen to anybody is to lose their grandkids. She felt that losing parents is difficult but losing your kids and even worse grandkids is the most painful experience in life.. however Life goes on. She remembers him  each and every moment of her life. she showed me his picture on her cell phone screen.
spending 9 hours in London was tough. I started writing few thoughts coming to my mind. Couldn't think of anything except how things would have been different if we were there with him. This will be the biggest regret of my life and will remain the biggest regret of my life forever. All along the way we were thinking of mom as well. Dad loved life and my mom so much that he would want mom to be happy always. We decided that no matter what Mom will not change anything in her life. She will continue to enjoy life like Dad did and would have wanted her to do. We will travel with her, she can wear clothes she like, she can buy anything she wants and enjoy life the same way. Because Dad kept her happy and would want her to stay the same. 

'Nobody can take place of MOM'

 I admire and respect this mom who is truly a supermom!

35 yr old patient of mine with multiple sclerosis who is wheelchair bound and needs assistance with everything. Patient has a 5 year old daughter. husband was hopeful about her recovery and tagged along all these years but knowing the severity and course of this progressive condition he started loosing hope. Disability can put strain to strong relationships as well given how selfish today's generation is getting. They are in a  process of getting divorce. I can't image the physical and mental strength, both patient and her mother has.

 Patient's mother had her own medical problems. She had colon cancer , for which she needed surgery. She had bells palsy which left one side of her face paralyzed and on top of that she developed as chronic back pain while taking care of her daughter by lifting and transferring her. On asking how she is coping with all this she was in tears and said' I am not going to lie or sugar coat it, I have my plate full and it's hard to take care of my daughter, grand daughter and take care of house'.

Patient has stopped walking 3 years ago. Her goal is to get back to walking again. After few exercises, and with the help of a walker we made patient take few steps with mom carrying wheelchair behind us so that the patient doesn't fall. She was ecstatic seeing her daughter start walking again... Oh what a joy!! and at the end she patted patient's back, rubbed her shoulder and gave a big hug to her daughter. She said that' This is the best mother's day gift you gave me!!' knowing that Mother's day is round the corner this Sunday.

Seeing this made my day today.

Motivated and Doting Mom in Wheelchair

A 32 year old female wheelchair bound patient of mine who has a rare condition of spinal muscular atrophy which has paralyzed both her legs to the extend that she can stand with assistance no more than a minute now. When I arrived at her house I see a handsome 3 year old son and a cute chubby 8 month old daughter. This condition has a 25% chance of manifesting in a person if both mother and father are a carrier. Both her kids are normal for now and she being a staunch christian prays to god that none of her kids gets the disease. She met her husband in college of natural medicine. Having like interests both fell in love and got married. Patient was walking with help of walker for short distance then, however main struggle started when she got pregnant. Although they were ecstatic that they were going to have a baby, she did not want to harm baby in any way so she stopped walking as she did not want to fall.  pregnancy went well and they were blessed with a beautiful baby boy. They wanted to have one more kid and soon after the older one turned 2 they planned for another one. God blessed them with a sweet little angel. Along with 2 kids came responsibilities. Patient got busy in taking care of kids and did not get to spend time to take care of herself. She stopped walking altogether. Now that her daughter is 8 months old her only concern is that she will start rolling soon and she may not be able to save her from rolling off bed. She is not keeping her on floor till evening as she can't pick her up and put her back to bed. Never thought that these kind of simple things can hold such high importance to some of them. Patient has started walking now  with walker once therapy started. The 2nd day she walked from front door of the house till bedroom and back. It took a while but she did it. Her son was so so amazed to see her mom walk. He said' Mommy you are doing an awesome job'... My patient was thrilled listening this. She responded ' Oh that is the best motivation I can have. I will walk everyday if that makes you so happy'. My day was made just listening to those 2 sentences. Small things in life can bring such great pleasures! 

July 15th-2014

Medical Dilemma: Mrs. X lives alone and has a 24 hour CG who lives with her to assist with her daily activities. Her son is her power of attorney. I arrived at the patient's home in the morning and saw patient making her own coffee. when asked why she is doing that, patient said that her CG was not there all night and she was alone. After some time CG arrived and said that patient has memory issues and thinks that nobody was there. It was hard for me to know the real truth. If I give the CG a benefit of doubt, then I am placing patient at a risk. If I assume that patient is telling truth then I don't know if I am blaming a sincere CG for something she hasn't done. I finally called son and asked him to install camera in house to be fair both to patient and the CG

9 to 5 job for my 89 year old:
Met this lovely gentleman who tells me that his Full time job at his age goes as follows:
To give you the background, patient's wife lives in an assisted living facility 5 mins away from patient's apartment. she was moved there 1 year ago as she needed a lot of assistance due to medical problems and patient was unable to take care of her. Patient wakes up in the morning, has his breakfast and is there to see her at 10 am. They spend some time in activity center, takes her to dining room for lunch. Since he cant eat there everyday, he drives around and gets a quick lunch from a fast food place for himself, comes back to her. Both of them rest in her room and take a short nap till 3:30 pm. after which it's time to wake up, take medications and get ready for dinner. He stays with her till she gets dinner. takes her back to her room. the caregivers get Mrs. A ready and he gives her good night kiss and he leaves after she sleeps. After leaving from the facility, he picks up his own dinner or eats outside, get back home, finish few home chores and goes to bed. Next morning same routine starts. He has been doing this for 1 year and wish to continue till he or she passes away as he told me. Patient had medical problem in his rt forearm and was hospitalized for 3 days. After being back home, he was not able to drive. He was sad that he hasn't seen his wife for a week now and is eagerly waiting for his hand to heal so that he can start driving and go back to his much awaited 'full time job'.

'My 6 year old must be an angel'
A patient of mine with multiple sclerosis. Lives alone and has some care giver who helps him. It was going to be my daughter's 6th birthday party, as I mentioned that he had a big smile on his face and said' she sure must be an angel, Have fun at the party'. He couldn't stop talking about his 5.5 yr old son with cerebral palsy who died after struggling from multiple medical complications. Because of a disabled kid at home, wife turned to drugs and they ended up divorced. He paid a substantial amount to get custody of his 2 kids. after the divorce, his younger son died. He took care of his only son and raised him alone. While talking this story his words which hurt me most was' The pain of losing a kid is the greatest. The pain I am going through right now is nothing compared to that'. I had to struggle to stop tears coming to my eyes, coz I was sure that it would make him sad as well. Now I know why he said ' that my 6 year old must be an angel".

Quote from one of my patients: ' Who said that life will be easy? But it's worthwhile to have challenges'. This patient of mine has severe arthritis and is progressively becoming so weak due to pain that she is becoming dependent with transfers and is getting wheelchair dependent. We are trying hard to keep her mobile. sometimes she loses hope and said' sometimes I feel that if God loves me then Why does he give me so much pain?" but then she repeats the above quote. Today morning she was weak and could hardly move in bed, few words of encouragement made her walk 50 feet... She definitely won today's race. She will see what tomorrow has in stored for her.

#2: patient who was as independent as any of us was made WC bound when he had his hip fractured. He needed 2 people assist to move him. We started working on him,, taking each day as it comes. in 1 week he progressed well and is now walking with assistance. He was ecstatic as he never thought he will walk again. Had a good feeling on my way home thinking about different challenges people face everyday.