“Beta (Son), I am going away” I was woken up from my deep sleep, my heart was beating rapidly. It was three in the morning; I tip toed my way in the bedroom to check on my mother. She was fast asleep; it was just a bad dream.
Maa had been unwell again; Dr. Manas was outstation and wouldn’t be able to pay a visit for the next few days. The oximeter saturation was fluctuating between 87 to 92 and her pulse was precariously near 100.
“Doctor, we are planning to do some blood tests (CBC, etc.), Maa was saying her urine output seems low, should we do anything specific?” I inquired with Dr. Manas on call.
“Check her Creatinine, and along with that urine routine and culture,” he replied while driving. “If the urine output is low, there is a possibility her kidneys could have been impacted,” he added.
“Hmm, I have asked her to drink more water,” I replied while pacing myself back and forth in the house.
“Don’t worry Harry, all will be well, we will wait for the lab results, but we have started nebulization and other antibiotics.”
Next day morning, the lab technician took the blood sample, and we waited patiently for the report to come. The results came after couple of days; one of the values in the report was alarmingly on the lower side.
HEMOGLOBIN 8.0
“Harry, this is the reason why the pulse oximeter is not catching SPO2 properly, because of low Hemoglobin, Auntyji’s hands and fingers are cold,” explained Dr. Manas, “we will add a medicine to stabilize the hemoglobin.
“Doctor, can we do an ABG, just to be doubly sure?” I requested in a calm tone but with my heart racing.
“I am back in Mumbai now, we will do it tomorrow morning,” Dr. Manas concurred.
We did an ABG test next day morning and the SPO2 value was 95, which was good as it was normal. The only thing to wait for now was the culture report which was expected anytime soon.
“The Urine culture shows a large colony of bacterial infection, we might need to hospitalize Auntyji as she needs intravenous medication,” cautioned Dr. Manas while speaking to me on the phone.
“Now what doctor, its peak COVID, hospitalization could be a bigger risk, what should we do?”
“I will work something out Harry, you order the medication for seven days, I will WhatsApp it you,”
ERTAPENEM IV INJECTION – 7 Days
For the next seven days, Dr. Manas arranged for a Nurse who would come home every evening around 6 pm and give Maa the IV injection.
After few days, Maa started to feel better, the SPO2 was stabilizing at 90 – 91. We felt a slight sense of relief, but on a precautionary level we also decided to consult Dr. Karve.
I went with all of Maa’s reports to Dr. Karve, who inquired “Has any doctor checked Auntyji in person?”.
I explained to Dr. Karve who was wearing a full PPE kit, that Dr. Manas visited Maa couple of days ago. Dr. Karve decided to speak with Dr. Manas on the phone and suggested “Give Auntyji this medicine.”
WYSOLONE (10) 10 Days
I looked at the name and curiously questioned, “Steroid?”
“Yes,” he nodded “it will help Auntijy recover faster.”
We started the dose of steroids and after another few days Maa’s Oxygen Saturation was touching the normal range of 96-97 while her pulse was settling around 85; overall we felt relieved.
“Wake Up,” my sister awaked me in the middle of the night.
“What happened?” I asked my sister in an alarming tone.
“It’s Maa, she is having severe backpain and she is unable to bear it,” my sister replied with tears rolling down her eyes.
It was about 3:00 AM, I immediately called Dr. Manas and he mentioned “It’s mostly because of her hunchback Harry, give her a pain killer and continue the Bi-Pap full night.”
The pain subsided in another few hours, my sister took Maa’s reports and visited an orthopedic who suggested few more medications.
“How many medications will I take, I am tired of taking so many medicines,” exclaimed Maa just looking at the crowd medication strips kept in front of her.
I tried to comfort her and mentioned, “I will speak with Dr. Manas, and check if we can reduce some medicines, Maa.”
After consulting Dr. Manas, we reduced some medications, but she was continuing to get backpain while sleeping in the night. Above all, once the effect of the steroid started to wear off her oxygen saturation was dropping again, even if she walked a few steps in the house. After further consultation with Dr. Manas and Dr Karve, we started her on another short course of steroids, her vitals settled post few days. But, once again as the effect of the steroid started to wear off Maa’s SPO2 started to dip, and her pulse started to shoot upwards.
“Harry, its imperative we get a CT done for Auntyji” informed Dr. Manas, “take her to ‘Adonis Hospital’ and get the Scan done,” he recommended.
I discussed the same with my sister who called an Ambulance and we reached Adonis in an hour and awaited our turn for the CT-Scan.
My sister kept asking Maa every ten minutes “Maa, you are feeling all right?” and Maa would just nod her head in silence, comforting my sister.
Our turn came for the CT-Scan, but the technician was unable to do the scan. Maa was not able to fit in the machine due to her hunchback which over the years had aggravated.
I consulted Dr. Manas who recommended, “Do a Chest X-Ray.”
We got the X-Ray done which was easier to accomplish compared to the CT-Scan. I asked the technician if he could email the film to Dr. Manas and without any hesitation he complied.
“Harry, we need to admit Auntyji, the X-Ray shows water in both lungs, she needs the big machine, NIV (Non-Invasive Ventilator)” explained Dr. Manas who immediately called after seeing the X-Ray film. “I will be there in Adonis for my night shift, so I will meet you then.”
We had no option, we admitted Maa and she would again be under the supervision of Dr. Soni and Dr. Karve. Once Maa was taken to the ICU, all the required tests were done in the initial one hour itself.
I was intently listening to Dr. Soni when he informed, “The pumping of Auntyji’s heart has reduced to nearly 20,” while showcasing the results of the 2D Echo.
“What should be the normal value?”
“More than 50”
“What can we do now?”
“We’ll see, it’s a complete heart failure, we are starting the medications,” informed Dr. Soni as he walked away.
My sister was now completely grief-stricken, I was trying to stay outwardly calm, but my heart was racing at beyond imagination. We met Dr. Manas when he came for his night shift, and he explained that Maa’s SPO2 value was stabilizing due of the NIV machine. Next day morning we were hoping that things stabilized further, but that was not the case.
“Her SPO2 stabilized, but her pulse has now shot up,” explained Dr. Manas while completing his shift; the monitor above Maa’s bed was showing her pulse had raced to 150 and was further increasing.
By evening when Dr. Manas returned Maa’s pulse had come under control and below 100, but now her urine output had gone down considerably. The doctors were solving one problem but were ending up with a new problem to solve.
“Auntyji’s Kidneys have shut down,” explained Dr. Kumar a senior Kidney specialist. “One of the reasons could be because of the episode which happened yesterday (high pulse),” he further added.
“What can we do now?” I asked with a grim face.
“One, we can wait, because sometimes the body can restart things on its own, but if that does not work, we have the option of doing a dialysis,” he replied. “But I must caution you, as it is my job to do so, that in this state dialysis is also risky,” he calmly informed.
I consulted Dr. Karve who at that point in time was on his rounds, “The chances of survival in this case are very slim, we are trying all we can. The only good thing you have done is said no to using a Ventilator, as in your mothers case it will cause her more trouble.”
I was feeling lost, I did not know what to do. I wiped the tears rolling down my eyes while walking down the stairs. I reached the waiting area and explained the situation to my sister and one of our aunts who had also reached the hospital.
“Dr. Manas said, Maa has 24 Hours, if we don’t do the dialysis” informed my sister, now sobbing uncontrollably.
The sun was about to set, and we informed our relatives to come and meet Maa one last time. Around 8:30 PM, Dr. Manas met us and tried convincing us we should give the dialysis a shot as that is the only option left to try. His words somehow motivated us and we gave our consent to go ahead with the procedure.
I went down to the medical store to quickly get the required medicines for dialysis when my sister called me “Come up, leave everything, and come?”
“What happened?”
“She went, come up.”
I was heartbroken, without waiting another second, I left the medical store and sprinted three floors. I slowly entered the ICU and moved towards my Maa’s bed, the nurses and doctors were trying to revive her.
At that moment in time, the same image wherein I dreamt losing my mother, was there, right in front of my eyes.
***
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Very engaging and emotional Harish.
I almost cried reading this. This is beautifully written which carries a lot of weight.