Vanajakshi’s return To The Light
I’m Dr. Siddharth and I’m a HomeCare professional. I was new to Apollo HomeCare when we got a call regarding a new patient, and was puzzled when my mentor, Dr. Damayanthi, was reluctant to take her on. When I told the doctor that I couldn’t understand her reluctance, Dr. Damayanthi took me to meet her.
So I went to the patient’s home, on the outside, it was a beautiful house surrounded with greenery. The inside was beautiful too, but much more somber. I took in all of this as I was led to the patient, and the moment I laid my eyes upon her, the reason for Dr. Damayanthi’s trepidation became apparent.
The patient was an elderly woman named Vanajakshi. She was diminutive in her wheelchair, and was lost amidst the mask on her face, and the numerous wires and tubes attached to her person. She had been bound to her wheelchair for 3-years, ever since she was hospitalized after a cardiac arrest and was discharged against medical advice due to her distaste for hospitals.
The case had me immediately excited as my specialty was in cardiac conditions, and we took her on. I was fully convinced that with assiduous treatment Vanajakshi could be, if not up on her feet, then at least out of all her medical accoutrements and could lead a somewhat more normal life than she had for the past 3 years. I wanted to see her out of doors.
This, however, I found that I could not do as HomeCare was to have no part in Vanajakshi’s treatment. There was a family doctor engaged for that purpose, and our job was only to take care of her and to make her more comfortable, which our nurses did to admiration. A week after we were engaged to care for Vanajakshi, however, we received a call suggesting that she was in severe distress and suffering from breathlessness.
I posted to the patient’s home and tried to convince her attendants that she required immediate hospitalization. However, as Vanajakshi was adamant not to go to a hospital, we were obliged to get approval for home treatment for a patient who should rightly be in the ICU and could suffer cardiac arrest at any moment.
Upon receiving approval, we set up all the required equipment, finished the formalities, and began the treatment process that should have started when we were first engaged. For a few day, the situation was touch and go. We kept our best nurses at hand and supplied them with supervisors. We put her on infusions of diuretics and inotropes, along with a bunch of emergency drugs at the ready, for, not being in a hospital, we had to be prepared for any eventuality. My clinical team and I visited 3-5 times a day, and I would regularly call nurses to stay on top of the situation.
The situation was further complicated by deep-vein thrombosis which came in the way of infusion dosages, electrolyte maintenance, and fluid input and output balance. She was put on BiPAP catheters and IV fusions, and every moment of her progress was noted. After 3 days of intense fluctuation of Vanajakshi’s health, and sleepless nights on our part, she was, slowly but surely, on her way to recovery. She was losing 4-5 ltrs of excess fluids everyday thanks to the diuretics, she was slowly regaining her strength and we began to put her on the BiPAP only at night. The excellent care offered by my team was paying off in leaps and bounds, until one fine morning, my aim regarding Vanajakshi’s recovery was achieved.
I had said that I wanted to see her outside, and on that day, so she was. That was the first time I saw her face clearly without the tubes in the way, and I could see she was smiling, a scar on her nose from the mask she was now not wearing. There she was, sitting in the veranda with her husband, sipping chai and chatting with him as if she hadn’t been perilously close to an early end just weeks earlier!
We met their children who were supremely happy with us, gave us complete responsibility and assured us that no other doctor would be allowed to interfere with Vinajakshi’s treatment. To this day, Vanajakshi is enrolled with HomeCare and I have tea with her and her family every Monday morning.
All around me there are smiling faces, there is hope in their hearts, and the sun is shining in the sky. I couldn’t ask for more.
Disclaimer: The patient’s name has been changed to maintain anonymity.