GOOD MORNING DOCTOR Prof. John Kurakar (a heart touching experience of cancer treatment) authored by Prof. John Kurakar CHAPTER 8 I HAVE BEEN DISCHARGED, STILL UNABLE TO GO HOME

 

                        GOOD MORNING DOCTOR

Prof. John Kurakar

(a heart touching experience of cancer treatment) authored by Prof. John Kurakar

CHAPTER 8

I HAVE BEEN DISCHARGED, STILL UNABLE TO GO HOME

Although I was discharged from Amritha Hospital on April 26, 2022, my health issues continued to be severe. My left leg persisted with swelling and began experiencing electric shock-like sensations. This was followed by several sleepless nights. Rather than returning to Kottarakkara, we remained in the guest room at Amrutha for an extended period. After a month and a half in the hospital following the APR surgery, living in the guest room proved to be quite difficult. Along with the stoma bag, a urine bag was also in use. I had to visit various hospital departments daily, and the Gastrosurgery department performed several Doppler tests to investigate the cause of the leg pain. A Doppler ultrasound is a noninvasive diagnostic tool used to evaluate blood flow through blood vessels by emitting high-frequency sound waves (ultrasound) that bounce off circulating red blood cells. Unlike a standard ultrasound, which produces images of internal structures, a Doppler ultrasound specifically measures blood flow and velocity. It is particularly useful for assessing various conditions such as:Venous insufficiency,  Poorly functioning valves in the leg veins that can lead to blood or fluid pooling in the legs, Heart valve defects and congenital heart disease, Issues with heart valves that affect blood flow, Arterial occlusion: Blocked arteries that impede blood flow, Peripheral artery disease, Reduced blood circulation to the legs, Aneurysm: Bulging arteries due to weakened vessel walls, Carotid artery stenosis: Narrowing of the carotid artery in the neck, which can increase stroke risk. During the procedure, a trained technician (sonographer) uses a hand-held device called a transducer, which is about the size of a bar of soap, to send and receive sound waves from the area being examined. The test measures how fast blood flows by detecting changes in the pitch of the sound waves. Doppler ultrasound can be an alternative to more invasive procedures like angiography, which involves dye injection for clearer X-ray imaging. It can also help doctors monitor treatments and assess injuries to arteries or veins.

Despite undergoing several Doppler tests over multiple days, no issues were found in my leg. However, the pain and sensations persisted without relief. Consequently, I consulted orthopedic doctors, who specialize in diagnosing and treating conditions related to bones, muscles, nerves, and joints, all of which are crucial for movement. Even after a thorough examination by the orthopedic specialist, the cause of the leg pain remained undetermined. I tried various medications without significant improvement. Following this, I sought help from the neurology department, where the doctors assessed my condition further. They performed not only blood tests but also a nerve conduction test (NCT) to investigate the issue. A nerve conduction study (NCS) is a diagnostic test used to assess the function of the motor and sensory nerves in the body. It evaluates how well electrical impulses travel through the nerves, helping to identify potential nerve damage. This test can be performed by specialists such as clinical neurophysiologists, physical therapists, chiropractors, or physiatrists (physical medicine and rehabilitation physicians). The nerve conduction velocity (NCV) test, a key component of NCS, measures the speed at which electrical impulses move through the nerves. During the procedure, electrodes are placed on the skin to stimulate the nerve and record the electrical activity. By analyzing the speed and strength of the nerve signals, the test can determine if there is any damage to the nerves or if there are disorders affecting the muscles or nerves. NCS is valuable for diagnosing various conditions related to nerve function and for guiding appropriate treatment.

Despite extensive consultations, neither the neurology department nor any other specialists were able to identify the cause of my leg pain, muscle spasms, and insomnia. With the urinary tube and bag left unchanged for two months, it was impossible to return home. We consulted urologists who tried replacing the tube multiple times, but due to improper urine flow, they were unable to resolve the issue. The doctors advised that I would need to continue using the urine bag for an extended period. Feeling completely overwhelmed by the combination of the stoma bag, urine bag, persistent insomnia, and the inability to return home, I felt that life had become unbearably difficult. My daughter, Dr. Manju, replaced the large urine tube with a leg bag, which provided some relief. The next day, we visited the psychology department, where the doctors recommended three to four days of counseling to help manage the psychological stress and emotional strain.Counseling is a process designed to mentally prepare individuals to address their own issues with equanimity. It involves a trained counselor and the individual experiencing conflicts working together to find solutions through mutual sharing. In counseling, the individual analyzes painful experiences and strives to find independent solutions to their problems. The goals of counseling include enhancing personal integrity, achieving good mental health, and acquiring life skills that contribute to life success.

However, when counseling did not yield significant benefits, we followed their recommendation and consulted psychiatrists. Despite receiving various medications, I did not experience any improvement. Eventually, we turned to the podiatric department, where we consulted doctors specializing in podiatry. Podiatry, or podiatric medicine, is a branch of medical science focused on the study, diagnosis, and surgical treatment of disorders related to the foot, ankle, and lower extremities.Here's a refined version of the translation. To relieve the leg pain, we purchased a pair of orthopedic shoes from the podiatry department and then returned to the guest room. After staying there for a few more days, we traveled to Kottarakara with a stoma bag and a urine bag, despite the unbearable leg pain. After coming back home and still suffering from insomnia and severe leg pain for several days, our son Manu Kurakkartraveled to Navi Mumbai, and we went to Mumbai with him. It was also a relief that our daughter, Dr. Manju Kurakar, is a Reader in the Maxillofacial Department at a medical college, which is about an hour and a half away from Navi Mumbai via the express highway.

Mental strength plays a pivotal role in overcoming disease, serving as a cornerstone of resilience and recovery. When faced with a health challenge, maintaining a positive mindset and emotional fortitude can significantly influence one's ability to cope with the physical and psychological stresses of illness. Mental strength helps individuals navigate the uncertainties and setbacks of treatment, fostering a proactive approach to managing symptoms and adhering to medical advice. It empowers patients to remain hopeful, which can enhance their overall well-being and potentially improve outcomes. By cultivating mental strength, individuals not only bolster their ability to endure but also create an environment that supports healing and recovery, demonstrating that the mind's power is integral to conquering physical adversity.