These winters

It is obvious that winters will come every year. I do not like winters as I tend to bleed badly during this season. My bleed becomes severe and profuse leading to irritability of mood. 

The same happened in the beginning of this winter season. I suffered from menstrual bleed three times in a month. I felt extremely frustrated and felt very low. After that I had ulcer bleed which contributed in lowering my hemoglobin. Currently I am feeling tired and fatigued.

Now I am again waiting for my menses to hit me hard. I know I will again bleed for a month or so. Winters are extremely troublesome for me. I am keeping my fingers crossed.

From Denmark... With love

I am always amazed by Almighty's plans. I never expected to have so many wonderful people around me until I came to know about my bleeding disorders. I never made good friends. Most of them could not understand my disease and it was difficult to get along with them. I believe that we meet people with a specific purpose. Some give us happiness while others give us life long pain and tears. 

I happened to meet a wonderful young woman from a Scandinavian country. She read my blog post and sent a message to me. I was overwhelmed by her words of accepting her as a friend. I am glad that I replied to her message. She has also has a bleeding disorder but it is different from mine. We have developed a nice friendship and are in constant touch with each other. I am so happy to know her. She told me about her experiences and how she has been dealing with her bleeding disorder for so many years. One important common thing in both of us is that we love dogs like anything. She has two dogs and they are absolutely fabulous. They play with my friend and have fun with her. I miss having a pet. She is a wonderful pet owner. She makes sure that the babies (this is what she calls her pets) feel happy and cheerful. One of the pets is very naughty and enthusiastic while the other one is very wise and calm. But I like both of them.

It is so wonderful to share our thoughts and experiences with each other. Our cultures, languages and traditions are different but our hearts are so close to one another. I wonder how people meet and become best pals forever. I never expected that I would have a loving and caring friend like her. I am fortunate to have her in my life. I thank my VWD because of which we happened to meet and became each others' confidante.

Oh! these menses...

I worry a lot about my menstrual bleeding. I keep thinking about it most of the times. I am not obsessed with it but as a female with a bleeding disorder it is quite normal. The thing which I hate the most is having profuse, heavy and prolong menstrual bleeding. I just do not like it. My work efficiency gets decreased during menses. Sometimes I have to take leave from my work which I dislike the most. This time my menses started when I was making IQ report of a patient at the OPD. My lower back started paining badly and I could hardly move. It was so difficult for me to reach the metro station and board the train to go back home. Somehow I managed to start walking from the hospital and ultimately reached the metro station. The train was late by 7 minutes and I had to stand. There was no space available for sitting. The train came and I got a sigh of relief. Surprisingly the compartment was extremely crowded and I was getting irritated. There was a group of girls who were talking so loudly that I felt like scolding them. But I had no energy to do so. Frankly speaking I had no right to scold them. We live in a democratic nation and everyone has freedom to expression through words. Isn't it? I would have surely got into an argument with those girls in the train. Then suddenly an old woman pushed me so hard that I fell on the floor. I do not understand why can't people walk in a civilized manner. She didn't even say sorry to me. I starred at her but did not say anything. I was very annoyed by her behavior.

After reaching home I took painkiller, factor injection and hot water bag therapy. I slept for four hours and felt a little better when I woke up. My mum asked me to stay at home and rest for a day. I agreed and decided to stay back at home.

I took an off today so that I could rest. My lower back pain is still there but it will subside in few days. Sometimes I feel that having a bleeding disorder is a real challenge. It makes me weak for a while but with my mum's support and care I always face it bravely. My friend Suchu called me and asked about my condition. It was so nice to talk to her. Her soothing words gave me comfort. I really love her and she also loves me truly. We have a wonderful bonding and we also have share common interests. 

Today is my second day of bleeding and I got many get well soon messages from my friends. I am hoping to get back to my work tomorrow.

Psychiatry and bleeding disorders

I always wondered how Freud treated his patients with his unique strategy called "Psychoanalysis". Fortunately I am studying Psychoanalysis in depth these days. I am really excited and thrilled to know all the techniques used by Freud. I also believe that a person's past plays an important role in the development of psychopathology at the conscious level. When there are conflicts between the conscious and unconscious level we tend to see or find people with mental disorders. Frankly speaking I never wanted to pursue a career in Psychiatry or Clinical psychology but it was my destination. I always hated it and never wanted to deal with mentally ill patients. The field of mental health never allured or thrilled me. But it was my mamma who always ignited an aptitude towards Psychology and Psychiatry. I used to complain to my mamma that it is so difficult to deal with mentally unsound people as the manifestation of the psychiatric symptoms is absolutely different from diseases and disorders of other organ systems. I never realized that there were diagnostic classification systems developed for making diagnosis of various mental disorders. There are two major systems of classifications of mental disorders: ICD 10 (International classification of diseases) and DSM IV ( Diagnostic and statistical manual of mental disorders). I feel comfortable in using DSM IV TR to make diagnosis. It has details and descriptions of Psychiatric disorders in points which is easy to read and remember. ICD 10 on the other hand is very descriptive which I do not like. 

It is so unfortunate that Psychiatric disorders are not given importance by people and there are various taboos associated with Mental health profession. If someone considers to consult a psychologist or psychiatrist then the family members and friends think that the concerned person has become mad or has lost his/her senses. I do not know how to define normal and abnormal behavior in life. I can differentiate between deviant and normal behavior as per the diagnostic criteria but I cannot say that we all are sane or so called normal individuals. We have our own mental conflicts and confusions in life. Unfortunate are those who cannot deal with those mental conflicts and get a label of mentally ill person. Labeling a person with a particular mental disorder has been a controversial issue in the field of mental health. When a person gets a label of a psychiatric disorder then the attitude of the friends, family and colleagues changes. They think that the mentally ill person can harm them or cannot live life in a normal way. I feel pathetic to see the condition of the patients who are not given food and kept in isolation just because of their mental disorder. The understanding of mental disorders of the general mass is insufficient and has created many taboos for the afflicted individuals. There is a need to make others understand that mental illness is not communicable, it can happen to anyone and people who have mental disorder are not necessarily violent.  

I read about Mood and Psychotic disorders in my Bachelors. Both these mental illnesses always allured me. I think that it would be wonderful to estimate the number of cases of mood disorders in women with bleeding disorders. It is so unfortunate that there is hardly any effective literature available for the researchers to further research on unipolar depression or bipolar affective disorder in females with Von willebrand's or hemophilia or other bleeding disorders. It is really important to give appropriate psychological care to bleeders irrespective of their gender. But being a female with bleeding disorder, I am a little biased and think that females need more psychological support and professional help than their male hemophiliacs counterparts. The reason is simple of my belief  i.e, women are diagnosed late in their life, have little resources to deal with their bleeding episodes, there is denial by the family members as well as the medical professionals that can make the afflicted psychologically weak at times. I have personally experienced the need of a mental health professional at the times of crisis and confusion being a bleeder. Fortunately I have a mental health professional at my home who always gave me psychological support. She helped me when I felt low and doubted my abilities. It is fruitful to meet a counselor or psychologist when we are confused and want instant solutions for our problems. There is one major principle of counseling i.e, the solution lies within the person itself, it is the counselor or psychologist who guides the person to reach towards that solution. So I personally feel that psychological services are important for women with bleeding disorders and also for those without them.

Now I am madly in love with Psychiatry and have acquired the skills to help people with or without mental disorders. The beauty of being a mental health professional is that we treat/heal people who are facing challenging in living life in an effective manner as well as those whose behavior deviates from the normal. As I always say "there is no universal definition of madness or insanity and we all are not absolutely normal".

An unexpected visit to the hospital

Some things in life occur unexpectedly. But everything that occurs has a purpose behind its existence. Accepting it with an open mind helps in facing the reality and truth of life. The same principle is applied on health ailments according to me. Since Friday my lower abdomen is paining badly. I cannot get up from the bed because of my pain. This is why I could not attend my OPD today and decided to see a surgeon. I am not a kind of a person who avoids visiting hospital. I like the environment there and it teaches me how to carry the candle of hope when life seems to full of uncertainties. But today's visit to the hospital was unplanned. I was trying to ignore my pain thinking that it would subside on its own. Unfortunately the pain continued for more than three days to such an extent that I had to take an injection of painkiller. Then I seriously thought of going to a doctor. Sometimes we avoid our bodily conditions which become big headaches for us in the future. How unfortunate are those who cannot afford the cost of health care treatment. 

This morning I consulted a surgeon and he examined me. He advised an ultra sound and blood tests. I had to wait for an hour for my turn at the radiology department because there was a huge rush. I sat on a chair and waited for my turn. Ultimately my ultra sound and blood test was done. The ultra sound finding revealed that there is inflammation in my Ceacum (the first portion of the large bowel, situated in the lower right quadrant of the abdomen). My blood reports will come tomorrow. I am trying to ignore my pain so that I could do my work but my pain is really troublesome and severe. I hope my pain and inflammation will subside soon. I am keeping my fingers crossed.

A wonderful day at St. Stephen's

Today I met my team - mates after a long time. It was so nice to know that they missed me a lot. I could not attend my Psychiatry OPD because of my surgery. So I made my mind to go to the hospital and give them a surprise. Everyone looked lively, happy and cheerful. I must tell you that our Psychiatry department is all women's department. We have no male psychiatrist or clinical psychologist in our team. Being the only women department, we feel proud on our women power. It is so nice to see all the ladies at work and trying their best to provide the best treatment to all the patients. When I first joined St.Stephen's I was worried about the kind of team - mates I would work with. But I was given a warm welcome and accepted by everyone. Our department head Dr R is the most cheerful person I have ever met. She has charm which attracts the patients and her treatment is a miracle for them. Our clinical psychologist Dr S is a real sweet heart. She makes sure that I have my coffee on time. I do not like having coffee or tea but when she requests me to join her I am not able to say NO to her. On the other hand, Dr J is a very serious person by nature. She says that I am more like her in terms of clinical practice. She makes me sit with her during the therapy sessions so that I could learn. Dr J is fond of reading and you will always find a new book on her table. Her area of interest is addiction and adolescence disorders.

So I started my day by traveling in the metro train to reach my hospital on time. Dr S was amazed and happy to see after my surgery. I had my breakfast with her. Then our psychiatric social worker Miss A came and joined me and Dr S. By that time no patient poured in so we chatted for sometime. We discussed about the rebellious behavior of today's adolescents and how the parents can better deal with it.

While we were discussing this Dr R came and greeted us with a wonderful smile on her ever charming face. She was so happy to see me again in the department after my surgery. Ultimately Dr J came. She was having bad migraine today but she was enthusiastic to see her patients.

My first patient had depression because of various precipitating factors. He has no permanent job and has some financial problems. This patient is supposed to pay a heavy debt as he took loan for his daughter's wedding. His daughter's in laws did not take her to their home after she gave birth to a baby girl. I felt extremely sorry for that patient. Is it a crime to give birth to girls? I wish people realize the potential and importance of females and stop considering them less than males. It is so paining to know that we still come across such stories where giving birth to a girl is considered a crime. Is our country really making progress? God knows.

The second patient was an old lady of 75 years. She had some memory deficits and was hardly able to tell anything. Her son and grandsons were with her. It was really nice to see a close knit family. The grandsons were very anxious to know about their granny's condition. The support of the family is important in recovery of the patient's condition. The old lady is fortunate to have such loving people around her.

Then a lawyer practicing in the high court came to meet Dr R. She was her very old patient. The patient was diagnosed a chronic psychiatric illness many years and was prescribed treatment. It was so nice to see her doing well. She continued the treatment and felt much better. Dr R counseled her regarding importance of continuing the treatment as she was insisting to stop all the treatment modalities including cognitive behavioral therapy and medications. 

These three patients touched my heart. I hope that our patients do well in their life and recover.

I was tired after the OPD and everyone wanted me to have lunch with them. But I denied as I wanted to  write about today's experience. But Dr S wanted me to taste the sweets she made. She knows that I really like sweets. She makes wonderful Indian sweets with lots of sugar and milk. So, before leaving the hospital I had nice sweets made by Dr S. Our team has different food habits. Dr R and Dr S try to avoid sweets and junk food but they want others to have it and enjoy. Their wish is that I put on more weight. They say you are lean and we want to become like you. All crazy ladies. Both of them try their best to reduce their weight but fail to do so whenever they see Dr M's homemade cheese cakes. Dr M is a neurologist and a part of our gang. She makes wonderful cakes and pastries. So everyone waits for her treat. Dr M is herself a fitness freak. On the hand, I do not have anything during our coffee break unless and until Dr S persuades me. It is like a daughter mother relationship which I share with her. She is an excellent mentor and a very sweet person to gel with. Our department is never dull because of such wonderful ladies and their dedication to serve human race.

On the whole, my first day at the hospital after my surgery was really memorable and exciting. I will surely remember this day.

Cheers to our all women's team at St. Stephen's.

Its doctor's day in India

Every year Doctor’s Day is celebrated in India on the 1st of July. This observance fulfills a need to show the doctors and physicians in our lives how important they are to us and how invaluable their treatments are that cure us. The celebrations are indicative of the respect that they command in the lives of their patients and thus obligate them to fulfill their responsibilities as well. 

Doctor’s Day is celebrated in India on the 1st of July every year. This day has been chosen as a mark of respect to the contributions made by Dr. Bidhan Chandra Roy, who left an indelible mark in the history of medical profession in India. July 1st was his birthday as well as his death anniversary in the year 1882 and 1962 respectively. 

I am blessed with wonderful, kind and compassionate doctors. My doctors treat their patients like their brothers and sisters. I make sure that I congratulate them on this special day for all their hard work. Doctors ease our pain and put their efforts in making our life beautiful. I am fortunate that I met numerous doctors in my life who left a deep impression in my mind. They not only treated me but also inspired me to a great extend. I really respect my doctors and pray that they continue to serve the mankind in the best possible way.

My heartfelt gratitude to all my wonderful doctors.

On doctor's day I would like to pay my tribute to all those doctors who took care of me

You are a beautiful light

Which makes others life bright.

You have the power to heal

And you give people a wonderful feel.

You have a reservoir of compassion

Which you exhibit with great perfection.

You feel others pain and agony

And make them realize that life is a beautiful journey.

You guide others with firm determination

And they end up finding their real destination.

Your pleasant words are like a honey comb,

Sweet to the soul

And healing to the bones.

Being a father

Being a father is not a joke. It is tough and exciting at the same time. A father not only nurtures his child but also sees his own image in him. Anyone can produce babies but the real challenge is in upbringing the children in the best possible way. Upbringing not only means telling the child what is right or wrong morally but giving freedom to the child to think beyond the set norms. A father is the one who guides his child to understand the reality of life. A father is like a teacher who has the capability to teach his child the most amazing things. He has the potential to encourage his child to find the meaning of his existence. A father sometimes becomes a friend to provide comfort and give a helping hand to his child in tough times. He is the ultimate source of love and affection for his children, a shadow which remains with his kids every minute and a guiding light which is always bright.

A father gives unconditional love to his child and keeps him safe. The love of a father is something which is precious for the child. Fortunate are those who have loving, caring and compassionate fathers with them. Life becomes beautiful with the existence of a father. He is the one who fills our world with vibrant colors and makes life a satisfying journey. 

He is the one who accepts our faults and shows the right way to us. A father is also a mentor who trains his child to face all the odds of life and become a winner. He finds true joy when he sees his kids smiling. Their smile gives him every pleasure of life.

He appreciates his child on his victory and never underestimates the importance of loosing. A father tells his child that it is absolutely fine not to be a winner every time. Loosing is an opportunity to learn from our mistakes and put more efforts next time. He also makes his child understand that loosing has nothing to do with failing or feeling less of oneself. Loosing for others happiness is more important than winning which gives lifelong satisfaction.

A father can sacrifice his own happiness for his child but can never see his child in pain. He would do all the things for his child to be pain free and won’t let tears come in his child’s eyes. 

“Greatest gift I ever had

Came from God; I called him Dad”

Meeting with my most adorable doctor

Last week I met my Gastroenterologist. It was such a nice feeling to meet him. My doctor is really a compassionate being. He believes in learning from the patients experiences. Dr Sanjeev takes keen interest in treating each and every patient. He has a charismatic personality. He was so happy to see me. My doctor asked about my academics, bleeding disorder and the current medicines I am taking for my Paradoxical puborectalis and Solitary rectal ulcer syndrome. He seemed worried for my anemia. Dr Sanjeev has advised me to get a Hemogram (laboratory test to determine the level of Hemoglobin in blood) done as soon as possible. He thinks that I might need blood transfusion. 

I met him for the first time in 2007. I went to the hospital for consulting him regarding my irritable bowel syndrome. I had to wait to meet him as he was doing Proctosigmoidoscopy of a kid. After completion of the procedure he asked his assistance to call me inside the endoscopy room. I wished him and sat on the chair. He gave me an opportunity to tell him everything about my bowel problems. My doctor listened to me patiently. Suddenly he asked me whether I was into medical profession. At that time I was pursuing my Bachelors in Medicine and Surgery. I told him that I just started my MBBS. Then he asked me about my interest in sub discipline of medicine. I told him that my interest had always been in GI surgery, Clinical hematology and Cardio thoracic vascular surgery. We established a nice rapport with each other. This is the most crucial phase of treating any patient. Establishing rapport with the patient and giving him/her assurance regarding privacy, trust and attention helps a lot in a long lasting doctor patient relationship.

My doctor was glad to know that I had a medical background so he started telling me about the etiology (cause) and manifestation of symptoms of Paradoxical puborectalis. He was suspecting this disorder of gut motility with reference to my case. There were various tests which he advised me to get done immediately. Unfortunately most of the tests were not available in the city where I live. I had to go to another city for my tests. My doctor gave an elaborated description of every test and how they would be useful in ruling out other disorders of gut in my case. I just loved the way he taught me about motility disorders and various tests like anorectal manometery, defeacography, colonic transit time study and balloon expulsion test. I must say that my doctor is a great and dedicated teacher. Above all, he is a great human being.

Four years have passed but I cannot forget my first meeting with Dr Sanjeev. I always get a smile on my face when I meet him. My doctor makes sure to make me aware about the various advancements happening in treating my condition. Every time I visit the hospital he would ask me about my Von Willebrand and the efforts I am putting for making life better for other girls and women with bleeding disorders. My wonderful doctor always motivated me and helped me to discover a winner in me.  He is a teacher, guide, friend and father figure to me. I really respect him a lot. I wish all doctors were like him.

From batchmates to friends ... a journey

The first day of my university was an eye opener for me. I realized that it won’t be easy to survive in this harsh world. I knew that I would be meeting and facing people who may or may not like me. In the beginning I was extremely guarded and used to keep mum. I was totally into books and considered others arrogant, rude and insensitive. Those who bunked lectures were devils for me. It was very difficult for me to become friendly with any of them. I always thought that my batch mates won’t be able to understand my bleeding disorder. I must tell you that I have a very bad habit of forming preconceptions about others. 

Most of my batch mates started considering me an emotionless being. In the first semester, all of us were trying to know each other. A nice bonding was created between all of my batch mates but I was still guarded. I tried to maintain distance from them and allowed none of them to know about my Von Willebrand's Disease. I would become irritated when someone used to give wrong answer to the professor’s question. Frankly speaking I became very rude with my batch mates. I was secluded. No one ever tried to come and talk to me. My faculty mentor would ask my batch mates to suggest me to worry less about studies and have some fun. Once she agreed to sponsor outing of our batch just for me. It was really touching. But I denied. 

After few months, I had an argument with Ashna. That was the day which marked the beginning of a wonderful bond between me and my batch mates. I cried and told them about my bleeding disorder. They were shocked to know about it. Surprise is the appropriate word to describe the reaction of my batch mates. Shohinee wiped my tears while Suchitra gave a pat on my back. All of them made me realize that they were not insensitive human beings. 

                                     

Now, our batch is like a wonderful family which laughs together, dines together, shares joys and sorrows together. My friends respect and love me. There is a special bond of understanding between me and Suchitra. One thing which is common in both of us is our obsession for DOGS. We go to dog academy (which is in our university) together to play with dogs and understand their behavior. Both of us are keenly interested in animal psychology. Our favorite dog is Genius who is cute golden Labrador. Ashna is the food monster of our batch and Shohinee (we call her “Sho”) is a superb baby sitter. She is extremely good at dealing with kids. Sho has a lot of experience as she worked for more than two years with ADHD, Autistic and MR kids. Fortunately I was always posted in the adult psychiatric units. Mehej (our Miss Assom) tells me that I must work with kids in the psychiatric unit because the manifestation of the disorders or psychiatric condition of kids is different from adults.  I am trying to work with kids who have behavioral or neurobiological disorders. 

Coming back to my batch mates, Tanya is the one who keeps track of my grooming. She makes sure that I wear matching pant with my kurta (a kind of Indian outfit) or shirt. It took me a long time to open up with my friends. I am fortunate that all of them understood that I am a different person who prefers to be in my own world of thoughts. I must tell you that my friends gave me a nickname “Prawat”. I know it sounds very manly but it is alright. Whenever they call me by this nickname I feel their love and affection for me. I am fortunate that I am blessed with such caring and compassionate batch mates.