GOOD MORNING DOCTOR CHAPTER 3 ARRIVED AT AMRITA MEDICAL COLLEGE.

                         

 

             GOOD MORNING DOCTOR

CHAPTER 3
ARRIVED AT AMRITA

MEDICAL COLLEGE.

 

Amrita Hospital isa well-known medical center in India. It is one of the largest medical college in the country, spanning 125 acres with a total area of 3.33 million square feet. The hospital has over 1,400 beds. Every day, more than 4,000 outpatients come seeking treatment. Experienced doctors provide services here. On December 3, 2021, my mother and I arrived at Amrita Hospital. A few days earlier, we had scheduled appointments with Dr. Sudhindra from the Gastrointestinal surgery department, Dr. Pavithran from the Oncology department, and Dr. Haridas M. Nair from the Radiation department. The appointments were arranged based on advice from several friends in Kerala, Pune, and Bombay, including my daughter, Dr. Manju Kurakar, and my son-in-law, Kuriyan Arimboor. Mr. Kuriyan Arimboor is a Vice President at the highly esteemed Bajaj Company in Pune, and Dr. Manju Kurakkar is a Reader at the Sinhgad Medical and Dental College in Pune. My mother and I met with Dr. Sudhindra and discussed the situation. We reviewed the reports from the colonoscopy and CT scan conducted at Kottiyam. After thoroughly studying the reports and CDs, the doctor showed us the actual condition of the illness. My son, Manu Kurakar, had come from Bombay to see the doctor. Manu is working as a System Manager at SBI in Bombay. Manu’s wife, Moncy’s father, mother Rashmi, and sister-in-law George were also present.
I was shocked by the doctor’s detailed explanation about the illness. I hoped that life could have ended already. Although I hadn’t seen the biopsy report, the doctor said it was cancer and that it was at stage 3. Overcome with grief and unable to bear the sorrow, I went out to the veranda, hiding my tears from everyone. My mother, son, and others sought the doctor’s advice. Moncy came to the veranda and sat beside me, saying, “Dad, please don’t be upset. Everything will be alright. You will receive the best possible treatment available in the world. There will be some difficulties for a while, but it will get better.” Moncy stayed close to me, offering comforting words. My sorrow did not lessen. It felt like darkness was closing in around me. For a while, I sat with my eyes closed, saying nothing to anyone. I stayed like that for a long time, as if I were in another world. When I opened my eyes, I saw that besides Moncy, there was another person sitting beside me on my right. He appeared to be a destitute man. He was crying and unable to speak. With his heart heavy with accumulated grief, he was trying to steady his heartbeat. I approached the crying man and asked, "What are you crying about?" He replied, "The doctor said that my liver needs to be replaced immediately. It will cost at least 3 million rupees." The man began crying again, breaking down once more.
I couldn't comfort the man. I gently asked him, "Have you been taking any regular medications?" He replied that he had never used any medication in his life. I then asked if there was someone available to donate a liver. He pointed to a person sitting on the opposite bench and said, "That’s my son. He has agreed to donate his liver. He works in the army." The man appeared to be around 55 years old. In the face of his grief, my own tears seemed insignificant. I looked around and saw many others in the veranda, sitting in silence, deeply distressed. They had also just seen the gastroenterology doctor. I couldn't bring myself to ask about their reasons for sadness. Meanwhile Surya’s mother, Rashmi, and Sali rushed to me and said they were going to book an MRI scan for me and quickly left. Moncy stayed close to me. No one went to have lunch that day, and not even a drop of water was consumed. There were more than 60 people waiting to get an MRI scan that day. Based on the recommendation of Rashmi's friend who works in the Radiology department, we were allowed to have the MRI scan at 7 PM. We arrived at the Radiology Department by 6 PM. By 7 PM, I went to the changing room to put on the uniform. After changing, I waited in the veranda. After some time, we were admitted into the scan room. There were two people already waiting there, and I joined them. They informed us that the scanning would take at least 45 minutes.

I was unfamiliar with MRI scans and their sounds, as this was my first experience with one. It was only after undergoing the MRI that I came to understand what the procedure involves. It is a scanning method used to capture the structure and function of internal organs in the body. MRI (Magnetic Resonance Imaging) is a type of scanning that does not pose any health risks, unlike other scanning methods. Imaging technologies like X-rays and CT scans, which use high levels of radiation, can be harmful to the body if used excessively. In contrast, MRI (Magnetic Resonance Imaging) is fundamentally different. It employs a powerful magnetic field to produce detailed images of the body's internal structures, making it a safe alternative as it does not use harmful radiation. MRI scanning provides a higher level of diagnostic accuracy. It works by creating a strong magnetic field to scan the body. MRI is capable of imaging a wide range of body parts, including muscles, joints, bones, nerves, spinal cord, soft tissues, and blood vessels. It is particularly beneficial for examining the brain, neck, abdomen, and pelvic region. However, some individuals may find the sounds produced by MRI machines uncomfortable. Additionally, the procedure requires lying still in a narrow, confined space for an extended period, which can cause anxiety or discomfort for some people.
Patients with certain medical devices such as pacemakers that regulate heart function, implants used after bone surgeries, and infusion catheters should not undergo MRI scans. This restriction is due to the powerful magnetic field and radio waves used by MRI machines, which can interfere with these devices. MRI scans are generally not performed on pregnant women either. Additionally, metal objects like hospital beds, stretchers, and oxygen cylinders should never be brought close to an MRI scanner. Bringing such items near the MRI machine can cause them to move rapidly towards the machine, potentially causing severe injury to individuals caught in the path. To prevent accidents, MRI machines are installed in rooms with high safety standards that prevent magnetic fields from escaping. A list of items that could pose a risk is displayed outside the MRI room. The technician present will thoroughly inform the patient and their relatives about these safety measures. All metal objects, including keys, coins, and mobile phones, must be left outside the room. A metal detector is used to ensure that nothing has been forgotten. If a patient requires medical equipment, alternatives designed for use inside the MRI scanner are recommended. For example, oxygen cylinders made of aluminum and titanium implants are among the types of equipment that are MRI-compatible. By taking the necessary precautions, MRI scanning remains one of the safest imaging methods available.
It was my turn for the MRI scan. I was guided towards a large machine and asked to lie down inside it. The scan began, and what started as a small sound quickly turned into a terrifying cacophony of various noises. For the first few minutes, I tried to tolerate the intermittent sounds. As the intensity of the noises increased, they became very disturbing to my ears. I felt as though I was trapped in a large pit. I prayed to God and sought the intercession of Parumala Thirumeni, enduring the relentless noise. I could hear the sound growing louder and lasting longer. I asked out loud, "How much longer will this take?" Someone responded, "About 20 more minutes." Oh God, 20 more minutes in this confinement! I was not allowed to move my arms or legs, and I had no idea how much time had passed. I closed my eyes and lay there, unsure if I had fallen asleep. The noise eventually stopped, and I was surrounded by silence. A technician came and lifted the top part of the machine, saying, "Get up, the scan is finished." With his assistance, I got up, feeling a mix of fear and frustration. I spoke to the staff, but they did not respond, likely because they had been working since morning and were exhausted. When I exited from the MRI room, I found Molly, Rashmi and Sali are waiting for me in the veranda. It was already past 11 PM. By around 12:30 AM, Moncy and Rashmi headed back to Thrissur, while Sali went to a nearby lodging close to the hospital.
Molly and I returned to Kottarakkara in Joy's car. Throughout the drive, we received continuous phone calls from my son Manu in Bombay and my daughter Manju in Pune. My mother spoke with them, but I was unable to talk to anyone that day. Overwhelmed by the weight of my sorrow, I sat silently in the car with my eyes closed. We reached Kottarakkara around 4 AM, and there was no conversation between us. Once home, I lay down on the bed, my mind troubled by various thoughts. The next evening, Manu Kurakar arrived from Mumbai. We discussed the treatment options extensively, considering recommendations from various hospitals. Ultimately, we decided to proceed with treatment at Amrita Hospital. Within two days, we received the biopsy report. As Dr. Sudhindran at Amrita Medical College had predicted, the report confirmed the presence of cancer. It was identified as Adenocarcinoma, a type of cancer found in the large intestine. Cancer is one of the most distressing and feared conditions in today's world, representing one of the most agonizing diseases known globally. The normal processes of cellular creation, growth, and development maintain order in bodily functions. However, when these processes become dysregulated, they can result in physical illness. Cancer is marked by the excessive and uncontrolled proliferation of cells.
Various factors such as chemicals, radiation, pathogens, or lifestyle influences can trigger the transformation of normal cells into cancerous ones. These factors can initiate the disease by causing cells to grow uncontrollably. The term "cancer" is derived from the Greek word "karkinos," which means "crab," combined with "-oma," meaning "growth." This terminology was chosen because the appearance of some tumors resembled a crab with its spreading claws. Thus, the term "carcinoma" came to represent cancer, reflecting the disease's invasive and persistent nature. It is well known that every organ in our body is made up of countless cells. The excessive and uncontrolled division of these cells is simply referred to as cancer. The reason for the uncontrolled cell growth is the mutations that occur in the DNA of those cells. Cancer cells multiply and, after a certain period, enter the bloodstream. They then spread to other parts of the body through the blood and lymph, proliferating the disease everywhere. Cancers can be classified based on the location of the affected organ. Cancers that occur in the nose, intestines, reproductive organs, breasts, and bladder fall under the category of carcinoma. About 80% of cancer cases belong to this category. Cancers that occur in muscles, bones, and connective tissues are classified as sarcoma. Cancers found in the blood and blood-producing organs are categorized as leukemia. Leukemia primarily affects white blood cells.
Cancer that occurs in the lymphatic system is classified as lymphoma. Cancers in glands such as the thyroid, pituitary, and adrenal glands fall under the category of adenoma. The term "primary site" refers to the organ where cancer begins and spreads to nearby areas, impairing the function of that organ. "Secondary" refers to the spread of cancer to other parts of the body through the blood and lymph, leading to excessive and uncontrolled cell growth in those areas as well. This is why early detection and treatment of cancer are emphasized. If tobacco use is eliminated, it could prevent 50% of cancer cases in men in Kerala. Fruits, vegetables, and leafy greens can help reduce the risk of cancer to some extent. A healthy diet, regular exercise, avoiding substances, and maintaining a positive mental state are all excellent for cancer prevention. Women over 40 should perform self-breast examinations at least once a month to detect breast cancer in its early stages. Additionally, they should see a doctor at least once a year for a mammogram, which is a special X-ray examination. Mammograms can also be done using ultrasound and MRI. Men over 50 should have regular check-ups at least once a year to ensure they do not have prostate cancer. Colon cancer can also be detected in its early stages. If blood is observed in the stool, this disease can be treated effectively in its early phase. Tests such as colonoscopy are available for this purpose. Kidney cancer is one of the major health issues that causes approximately 180,000 deaths worldwide each year. The kidneys, located on either side of the spine above the waist, help filter waste and excess water from the body. They also play a role in producing red blood cells, maintaining bone health, and regulating blood pressure.

Kidney cancer typically starts as a tumor within the kidney. As these tumors grow, they can affect the kidneys' ability to filter blood effectively. The most common symptom of kidney cancer is a change in urine color. Even a slight red tint can indicate a problem in the kidneys. While this could sometimes be due to an infection, it's important to monitor for blood in the urine and consult a doctor for kidney cancer testing if such changes occur. Lung cancer's primary cause is the increasing number of vehicles and the carbon monoxide they emit. The heart is the only organ in the body that is not affected by cancer. Sudden unexplained weight loss or loss of appetite can be warning signs of cancer. Even well-educated individuals sometimes view cancer as a hereditary disease. However, the hereditary component accounts for only about 5 to 10% of cases. Cancer does not develop overnight, and its causes have not been fully established. Factors such as environmental pollution, chemicals, viruses, lifestyle, and genetics can all contribute to its onset. When someone is diagnosed with cancer, it's essential not to hide the information from them. They should be gently informed and helped to understand their condition. It's important to empower them to face the illness. Isolation should be avoided; the awareness that they are not alone is something their family and community should provide.
It's not about instilling fear or causing distress; rather, it's the responsibility of the family and community to provide support and understanding. If 80% of patients seek treatment in the early stages, they can often overcome the disease. November 7 is observed as National Cancer Awareness Day, while World Cancer Day is celebrated on February 4. When I learned that I had cancer, it brought immense sorrow. I thought my life would be cut short, and the atmosphere at home felt heavy with grief. Before long, we went to Amrita Hospital in Ernakulam with the biopsy report and other scanning documents. We arrived at the Amrita guest house around 8 PM.
When faced with cancer or any debilitating disease, it is crucial for all family members to stand together in support of the affected individual. Isolation can exacerbate feelings of fear and despair, making the journey even more challenging. By fostering an environment of love and understanding, family members can provide the emotional strength and encouragement needed during difficult times. Sharing experiences, engaging in open conversations, and participating in treatment decisions can help the person feel valued and connected, alleviating the burden of loneliness. Ultimately, a united family can create a powerful support system, empowering the individual to face their illness with hope and resilience.