Thursday, 19 June 2008

Paper bag

Mr. and Mrs. Tamarind came to see Sheba at the clinic this morning.

Much water has flowed under the bridge since we first met this couple. He was semi-conscious and she was stoic. We were told by the small crowd of relatives and friends who were admitting him to not tell her that Mr. Tamarind had HIV. The strain will be too much – she doesn’t know anything about it. Sheba thought otherwise and politely asked Mrs. Tamarind what her husband was suffering from. Mrs. Tamarind slowly and clearly said: “He has AIDS”.

That was almost 3 years ago now. Mr. Tamarind came out of his brain-infection that he was admitted for. He was started on anti-retroviral medications – he went through various ups and downs – but was able to start his own business – complete with a Rs. 500,000/- loan from a local bank.

The last few months have had him losing weight. The anti-retroviral drugs do not seem to be doing their job. He is haggard and looks visibly ill again. We thought that they had primarily come to have him checked up.

Mrs. Tamarind found out in those early days that she also had the disease. It was a bitter pill, but she took it well – and continued to lovingly care for her husband over these months and years. When Sheba asked her whether she had any problems, she mentioned that she had some difficulty breathing.

‘How long has this been?’ asked Sheba. Mrs. Tamarind said it had been happening for 15 years. Occasionally gets an attack and then they take her to a hospital. At the hospital the doctors give her an injection – and then she is more or less back to normal.

With that the consultation was basically at an end – and after praying with the couple, they got up to go.

Then the fun started.

Mrs. Tamarind suddenly started gasping – deep, anguished gasps for air. It was a panic attack, one of the many that she had had over the years – and now it was happening at our centre.

In most circumstances this is treatable with a drug called diazepam. An IV line is inserted drug and drug given. After sometime the patient then is calmed – and is discharged none-the-worse. This is what numerous local practitioners must have done for this couple – and pocketed a goodly sum for their trouble.

Sheba called Dr. Marise who was also there that morning and asked her advice. Dr. Marise asked for a paper bag.

Our nurse aide Sunita found a newspaper and made simple bag out of it. This was then put over Mrs. Tamarind’s mouth who breathed into it for some time. A few minutes of the carbon dioxide rich air was enough to bring her came back to normal.

Sheba had to go to do a dressing on Mr. Nandu’s leg – so Dr. Marise sat down with Mr. Tamarind again to explain how to manage the panic attacks in the future. Why they come we are not sure, but we know that prayer changes things.

We also know that a paper bag can save thousands of rupess in fees for in-patient admissions.

Knowledge is power – especially when wedded with love and compassion.

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