Monday, May 31, 2021

“We don’t know about tomorrow,” said the horse, “all we need to know is that we love each other.”- Charlie Mackesy


Most of you might have read my experiences with Covid. If not, it can be read here https://npbang.blogspot.com/2021/05/up-close-and-personal.html

This blog post is about the last month, post-Covid, recovery phase. I will not repeat the things that I have already mentioned in the earlier post. And once again the disclaimer: It seems that the recovery process and timeline follow a long-tailed distribution. While many may have similar and expected experiences, many others have very different trajectories. It cannot be generalized. However, what is certain is, as Kabir said:

चलती चक्की देख के, दिया कबीरा रोये

दो पाटन के बीच में, साबुत बचा कोए

That is, between a pair of quern stones, nobody remains whole. In the context of Covid, once contracted, however mild, nobody remains as they were before Covid. Physically as well as mentally.

Homecoming: My 11 years old daughter made a poster that depicted the corona virus being killed and welcomed me home with excitement. While I have always been very fond of my home and long to get back to it even if I am away for a couple of days, the emotions that the return from the hospital elicited were intense. Legs too weak to carry me to every corner, my eyes took in as much of home as they could.

It felt like the Shahrukh Khan entry scene from the movie Kabhi Khushi Kabhi Gham. Except that I came in a car. Not a helicopter. And my daughter had a poster in her hand to welcome me instead of a puja ka thaali for aarti.

In the Storm: The primary concern for the first week was weakness and constant monitoring of oxygen saturation levels. Weakness was severe and oxygen levels did drop at times after walking a few steps or sitting for some time. Unfortunately, in the second wave, possibilities of post-covid complications were likely. So apart from weakness and oxygen levels, even a slight cough, or a headache, or eye ache, or discomfort in breathing, or a pain in the stomach, were all symptoms of black fungus or pulmonary embolism or a stomach infection or could be indicative of something else. Mind was on high alert and noticed every single change in the body. It continues to be, as the threat of a secondary infection or heart related problems loom until a few months post covid.

Upon recommendation from a friend, I read this lovely book “The Boy, the Mole, the Fox and the Horse” by Charlie Mackesy a few days after coming back home. And loved these lines: “This storm is real, and our fear is real,” said the horse. “But our love is also real, and in the end, love wins.”

Also, these “This storm is making me tired,” said the boy. “Storms get tired too,” said the horse, “So hold on.”

Weakness: Two things helped me regain some basic level of strength in about 10 days. First, drinking lots and lots of fluids. About 5 litres a day; water, coconut water, freshly made juices, buttermilk, and ORS. I could feel the improvement each day and even the difference on a day I had lower levels of fluids. Second, the fact that I was relatively fitter and healthy. After about 10 days, the improvement was not perceptible on a daily basis, and the delta became smaller with each passing day. My fitness level is down to zero right now. It is as though I have never exercised in my life. It may be a couple of months more before I go back to my pre-covid levels of fitness and that would now require starting with some conscious exercises and training. Patience is the key.

धीरे-धीरे रे मना, धीरे सब कुछ होय

माली सींचे सौ घड़ा, ॠतु आए फल होय

As Kabir says, everything happens at its own pace. As a gardener may water the plants with a hundred buckets of water, but the fruits arrive only in its season, similarly, whatever you may do, have patience and you will see the fruits of your hard work.

Food: While in the hospital, I lost 5kgs weight. My skin became dry, lost all elasticity, appeared wrinkled and sagged. Just a couple of days after coming back home, my appetite suddenly went up. I regained some taste. And wanted to eat all the time. Even now, a month later, I feel like eating all the time. With increased appetite, the weight came back, and some more . Here, I must say that I ate regular food that is cooked at home and did not make any attempt to eat healthier options that few people suggested. I included seasonal fruits (only mangoes, litchis and watermelons) and lots of fluids in my diet. The dryness of the skin has improved though it remains loose. Again, exercise should help with toning.

जिन खोजा तिन पाइया, गहरे पानी पैठ,

मैं बपुरा बूडन डरा, रहा किनारे बैठ

In these couplets, Kabir inspires us to work hard and seek. Those who search in deep waters, find something. Whereas those who sit at the fence for fear of drowning do not get anything. So, I must pursue fitness now and get rid of the fear that Covid has deep rooted in my mind, in order to get back to the pre-Covid level of fitness.

Anxiety and Insomnia: These two have been my companions frequently in the past as well. But I mostly had reasons to be anxious and could explain the sleeplessness. The frequency has now increased, and I have no reasons now.

मुझे नींद आए, मुझे चैन आए…

हालत क्या है कैसे तुझे बताऊँ मैं, करवट बदल-बदल के रात बिताऊँ मैं

पूछो ज़रा पूछो क्या हाल है, हाल मेरा बेहाल है

कोई समझ पाए क्या रोग सताए…

This super hit song from the Madhuri Dixit and Amir Khan starrer movie Dil (1990) describes my state quite well. The problem is that it is very difficult to explain this to anyone. Why am I not sleeping? What is bothering me? Even I don’t know. I cannot explain. It is just an after effect of Covid.

Yes, I have tried counting 1 to 10 to calm my mind and breath; yes, I have tried deep breathing many times but did not fall asleep; yes, I have tried white noise and various apps; none of them worked. I just hope this is temporary.

Concentration and memory: I’m an academician, a researcher. A lot of what I do requires me to have a good memory, to pull out anecdotes, facts, numbers, and findings, that I might have read long ago, from the depths of my memory. People used to tell me that I have an elephant’s memory. I would remember the page number in a book where I read something interesting. I have had moments in the last few weeks when I have struggled to recall names and words. Similarly, I pride myself for my ability to concentrate even amid many distractions. The nature of my work requires me to concentrate. I am not able to watch or read for more than 2-3 minutes at a stretch now. I would be devastated if Covid has a long-lasting impact on either my concentration or memory. I hope not.

Compare this to the days when I was doing a PhD. I had flat mates who were working. They would come back from work and put on the TV or loud music and partied often at our flat. I could study with complete focus at those times too. Sometimes, when there were too many people around, I would go and sit in the balcony that faced the very busy Banjara Hills Road Number 3 (Hyderabad) and studied under the streetlight that lit a part of the balcony as well (the balcony itself had no bulb/tubelight). I could easily concentrate and study even with all the noise on the road.

How do you feel? I have no answer to this question. It is a seesaw. On one day I feel good, on the other very low. One day I have no perceptible issues, the very next day, I feel that there is a faint ache in my heart that needs investigation. Yesterday, I was laughing and joking with everyone, today, I just want to be quiet. I don’t know how to answer this question.

One of my all-time favorite movies is Hrithik Roshan and Preity Zinta starrer Lakshya (2004). Javed Akhtar wrote these lyrics that seemed more like a conversation with a best friend rather than a song and were beautifully given music to by Shankar, Ehsan and Loy.

अब मुझको ये है करना, अब मुझे वो करना है

आख़िर क्यूँ मैं ना जानूँ, क्या है कि जो करना है

लगता है अब जो सीधा, कल मुझे लगेगा उल्टा

देखो ना मैं हूँ जैसे, बिल्कुल उल्टा-पुल्टा

These lines play in my head every time someone asks me, “How are you feeling now?” or “How’s your recovery?” In my mind even my expressions are similar to those of Hrithik’s as he is dancing to this song. However, I keep a straight face and say, “I am doing quite well. Thank you.”

Covid Conversations: The most difficult part of recovery is to stay positive. Unfortunately, the time around which I had Covid, the cases were at their peak across the country. There were depressing news of people losing the battle, shortage of oxygen, medicines, beds, and deaths of people too close to home. Each day, the conversations around the morning tea inevitably shifted to Covid updates even though we started out saying that we will not talk about Covid. It had an impact on the mood at home, it seemed like there was nothing to look forward to and there was the survivor’s guilt as well as the reckoning that I had come so close to becoming “news” myself. From the time the number of cases has started coming down, there is a distinct positivity in my attitude and a desire to get well sooner. Even though it is difficult, staying positive helps.

Many songs of Kishore Kumar are brilliant. However, this one from Safar (1970) is perhaps one of his best (debatable of course).

ज़िन्दगी का सफ़र, है ये कैसा सफ़र

कोई समझा नहीं, कोई जाना नहीं

[The journey of life is incomprehensible. Nobody has been able to understand it]

The unpredictability of life has been amply demonstrated to us by Covid. However, it has also shown the helplessness of the humankind and made us accept life the way it is…

ये जीवन है, इस जीवन का

यही है, यही है, यही है रंगरूप

थोड़े ग़म हैं, थोड़ी खुशियाँ

यही है, यही है, यही है छाँव धूप

-      Piya Ka Ghar (1972), sung by Kishore Kumar

I hope this will be the concluding part of my experiences with Covid and nothing major, worth writing about, happens hence forth. I would like to end with a word of caution. I still see many people relying on cloth masks. I too wore them. In fact, I have them in all variety; Pochampally, Ikat, Madhubani, Kalamkari, with embroidery, in all colours to match my dresses. They are not at all adequate. Don’t let your guard down. Double mask up. Because it’s worth it! 

Friday, May 14, 2021

Up Close and Personal


I am neither a doctor. Nor an expert. These are my own experiences and may not apply to many others or even any other. A few may read it just as another Covid survivor’s tale, a few may find it relatable, a few may be able to recall a point or two from this note later that might tilt them in favor or against a certain decision or behavior. For me, it is a chronicle of an event that will leave an everlasting impact on my life.

Puppets: On April 3rd, 2021, I cycled 100kms non-stop. It was no mean feat for me. Though little did I know that within a month, even taking 10 steps will be difficult. I had my entire May planned. I was on leave from April 24th to May 30th. I was to spend time doing nothing with my extended family. Alas, I am reminded of this scene from the 1965 blockbuster Waqt,

Waqt hi sab kuch hai. Waqt hi banata hai. Aur waqt hi bighadta hai [Time is everything. Time makes us. And time destroys us].

Whether we call it time or some super-power. There are certain things that are totally outside our control. As Anand (Rajesh Khanna) says in the 1971 superhit movie Anand, “Hum sab to rangmanch ki kathputliyan hai jinki dor upar waale ki ungliyon mein bandhi hai [we all are puppets of the theater whose string is tied in the fingers of God].”

I am not one to talk much about God. Even now I won’t. Most of you know me as a very organized and well-planned person. But the events of last month stumped each plan, everything that could go wrong, went wrong and my 5-weeks of planned leave from work now seems like a planned “Sick-leave”.

Non-Zero Probability ALWAYS exists: While taking all precautions, though not being paranoid, I believed that all of us will anyways get Covid some day or the other. It was just a matter of time. And the way I believe I contracted the virus proves that. I believe that I contracted the virus despite taking all precautions. I was not without a mask. It was perhaps an adjustment of the mask or touching of the nose or the mouth after touching an infected surface. Unconsciously. How much ever precautions one takes, none of us are safe really. So be vigilant, yet mentally prepared that you can get Covid. It is really not in your hands. We can reduce the probability of getting the virus. But we can’t make the probability zero.

Immediate Isolation: I got regular cough and cold to begin with. It had rained in Hyderabad on those days. It seemed like an allergy due to change in weather. Or at the most another episode of Sinusitis. In any case, I isolated myself immediately. And this is very important. Very early isolation is perhaps the reason my other family members and domestic help did not get it eventually. If in doubt, isolate. Completely. There is nothing like selective isolation. It is important to keep each family member safe. I often hear people say that if the entire family gets it, you are done and dusted. You don’t have to live in fear of getting it in the future. First, you can get it again. Second, each member’s body can react differently. It may not be a mild case for all. As far as you can, protect each member of the family. It is better to NOT get Covid at all.

Confirmation of Covid: In two days, I realized that I had lost smell and that is when I was sure that I had Covid. From the next day, I started to get fever as well. I started online consulting with a pulmonologist. All was fine. Medicines were regular Dolo, Zincovit and Limcee. SPO2 was above 94-95. CT Scan showed 4/25 or a 16% lung infection. It seemed like a mild case.

As a regular frustrated wife, mother, and primary caretaker of the home, I was “kind of” happy. To get food in my room for 14 days, no worries about taking care of the maids, buying groceries or vegetables, or taking care of anybody else’s needs. I would have uninterrupted time to watch mindless series on OTT platforms. Also, I would soon be on the other side. With antibodies! Free bird for at least a few months, post-covid. All wishful thinking. Short-lived.

Progression of the Illness: My temperature started to go up by the next day. It was not coming down with Dolo. It would come down momentarily with Meftal but then within an hour it was back to 103 degrees. This went on for 3 days. By then I had become quite weak. The next day I was asked to do another CT Scan that showed a 12/25 damage that is 48% lungs were infected. I was asked to get admitted. But my SPO2 was still above 92-93. I had no breathlessness, and the only concern was high fever. That too is apparently common in the latest strains of the virus. I was a bit skeptical about getting admitted. Was not feeling that sick. But Pavan did not want to take a chance. And I was not in a state to resist much.

Getting admitted would also mean that things were getting serious. It may not be as enjoyable as being at home and getting pampered! Plus, it was more hassle than what I was ready to let my family go through, with glee, albeit with a little guilt.

The Tipping Point: From the diagnostic Centre to home to hospital took about two hours. In those two hours, my condition deteriorated, and I started having breathlessness. I could not stand in the lift when going down to the car. I had to sit down. Could not walk from the lift to the car. By the time I reached the hospital, it was clear that I needed immediate oxygen support. I am writing this part in detail to convey firsthand experience of how things got critical in a just a couple of hours. And if we had delayed admission, it could have been a huge mistake. At the hospital, I was immediately put on oxygen support. I was told that I needed moderate oxygen support only and should be fine in a couple of days. I was put in a regular Covid room.

By the next day morning, my condition had deteriorated further, and I needed greater oxygen support plus monitoring. There was no further CT Scan done but it was clear that infection in my lungs had spread more. The SPO2 was coming down to 80 even with external oxygen support. Once again, it might have been very costly had we delayed hospitalization. I was able to get the right help and stabilized quickly only because I was already in the hospital. So, I do want to reiterate that early hospitalization is very important in case there are even slightest of signs of breathlessness or persistent high fever. Persistent high fever apparently internally spreads the virus very quickly and we do not realize it soon enough if we generally have a healthy lung.

Early hospitalization and correct medical support also ensure that we avoid panic and last-minute search for a hospital bed when things start to look bad. It is really a matter of hours in the case of oxygen saturation going out of hand. It is very easy for those critical hours to go by without getting the right medical support as you are figuring out hospital, doctor, bed, packing clothes, etc. Act as early as you can. Every minute counts.

For some reason, this song, written by Indeevar, from the Ajay Devgn and Tabu starrer movie Vijaypath (1994), kept playing in my mind for 2-3 days during this period. I imagined Tabu dancing in that garish pink lehenga:

aas ne dil ka saath na chhoda vaise ham ghabrae toh [hope did not leave me, though I was shaken/worried].

This line is quite appropriate, even though the complete song and the picturization of the dance in my head seems over the top and can be attributed to disorientation of my mind due to fever! But those of you who know me well know that I am perfectly capable of imagining such things even when my frame of mind is completely normal.

ICU Experience: The experiences at the ICU are life altering. You see people dying around you. Struggle of the medical force to keep someone alive. And you know that it could be you too any moment. The monitor beeps and you think “what has gone wrong?” Two nurses come to your bed together and call up a doctor. You know that something is wrong. But just trust the doctors. That’s the best that we can do as a patient. Also know that in an ICU you are being monitored round the clock and if something does go wrong, you are in the best place where a contingency can be handled. All parameters like oxygen saturation, chest condition (x-ray), blood sugar levels, heart rate, and all kinds of infections are tested for continuously. Even if something is slightly out of range, they control for it. Have that faith. Give yourself unto the experts. Keep all doubt, news and whatsapp university gyan aside. It helps.

ICU is not for rest: Doctors and nurses are truly stretched to the hilt. The working conditions donning full PPE kits are very difficult. We find it difficult to wear masks continuously. Imagine wearing a PPE kit for hours. It is frustrating to see the inefficiencies at the hospital. My analytical mind was unconsciously doing the math about how many nurse hours, bed occupation, doctor’s time, etc. can be saved if things are done in some other way or if simple things are done more consciously. But really, all resources are just focusing on keeping people alive. So, whatever the conditions, just focus on recovery, and get back home alive. Rest and relaxation can happen at home. Also, the hospitals can do an overhaul of their productivity and efficiency once the Covid wave subsides. Right now, they are doing a tremendous job of just making sure that people receive critical care.

One night, a nurse was playing a dhinchak Telugu song at a reasonably loud volume, at around 2am in the ICU. It was obviously quite frustrating, and I felt like Raja (Jimmy Shergill) from the movie Tanu Weds Manu, standing in front of the marriage bureau officer to get married while the officer chatted away on the phone with his “bebe”. While getting married was the most important event in the life of Raja and Tanu (Kangana Ranaut), it was work as usual for the marriage bureau officer.

Yes, it can be frustrating. But the nurses and doctors are humans too and the current situation is not a one-two day ordeal for them. They have been going through this over-stretched, under pressure, working conditions for too long. Give some leeway to them and the system. They are saving lives. Everything else is too trivial to complain about.

Weaning off the external oxygen support: It is a process where you need to take a leap of faith. You start feeling that you can’t breathe without the support. The heart sinks when you remove the oxygen support and slowly see the SPO2 go down to 88, 87, 86…A lot of will power needs to be mustered to keep increasing the time without oxygen support. The worst is that the SPO2 drops even if you just sit up from a lying down position. That’s the kind of weakness and lung damage that happens for some people. But remember that our system is very robust and resilient. It will bounce back. Again, keep faith, have determination, and take small steps at a time. Trust the doctors. If they say you can do it. You can.

I was shifted back to a Covid room from the ICU. The oxygen support was removed. I got off the bed and stood up to switch off the AC. There was no remote and the switch was a few steps away. I felt giddy. I held on to the railing of the bed. Took a couple of steps forward and held on to the wall. Felt giddy. Took a few more uncertain steps. Switched off the AC. Felt my head swing. I was holding on to the wall with all my might and sat down where I was. I looked around. For a moment I felt that there would be a hero who will hold me as I fall. There was none. I got up and walked back to the bed. Disappointed that I was in a hospital room and not in a Dilwale Dulhania Le Jayenge Karva Chauth scene and there was no SRK to hold me if I fainted. Covid rooms are lonely that way!

Post Covid complications: They are real. Especially if you have had a more than mild case. Weakness is severe. Inexplicable. Small things like brushing the teeth are tiring. Chewing is tiring. Limbs are like jelly. Where does all the energy and muscles disappear in a matter of a few days? Are these the same legs that pedaled 100kms?

There are other side-effects of medication that are random. For 5-6 days, whenever I closed my eyes, I was delirious. Images kept floating in front of my eyes at very fast pace. It was like being inside a fast-moving kaleidoscope. It was difficult to sleep. These side effects are slowly coming down.

On one of the nights when I felt delirious, I imagined myself on the sets of “Nainon me sapna, Sapnon me sajna, Sajnaa pe dil aa gayaa, Kyoon sajna pe dil aa gayaa”. I saw drums. The patterns on the pots, the dancers, and very fast dance steps. I am pretty sure there was no Jitendra because there was no “white”. Everything was very colorful.

The side-effects of steroids, stopping the steroids, need to be observed. Apparently, the steroids suppress a lot of activity in the body. Once the steroids are stopped, it is expected that a few discomforting symptoms may emerge. If these effects are mild, they can be ignored. They will go away on their own. If any of these symptoms are severe, then we need to investigate again.

There are many other minor things that don’t give a good feeling overall. Like for me, my ear drums are blocked. Eyes are always painful. There is a heaviness in the head. There’s a constant tingling sensation in the limbs. There is still no smell and partial loss of taste. All these are expected to slowly decrease.

Mental Frame post-Covid: In severe cases, it is close encounter with a life and death situation. Or at least we know that it could have been very close. So, there is a lot of contemplation that goes on inside the mind. Questions about the futility of everything, purpose in life, importance of family members, who matters and who does not, what matters and what does not, karma, dharma and yama, all keep cropping up. I don’t feel like talking to many people. I feel a sense of calm. There is a lot of concern about “if” there will be any “complications” during recovery. Mind is hyper alert for any new symptoms or any changes in the way I feel. I suppose this is all a part of the recovery process and slowly I will get back to being my silly self!

Whatsapp University Experts: If you get Covid, detach and totally ignore all unsolicited advice from self-proclaimed experts on Covid. Everyone seems to have advice to give on how to tackle Covid. Each covid case is different. Complication levels are different. And these people are not doctors, period. Get proper and timely medical help.

It amazes me to think that even in this age and date, there are people who think they know better than the others, are better read, better informed and therefore must impart their unasked-for advice. As though they have exclusive rights to the whatsapp university and the access to internet. Or maybe they have better reading speed and hence have read more articles than the others. Or have better comprehension than the others and hence must take it upon themselves to tell and explain to others how a Covid situation needs to be handled. Anyways, I do understand that it is difficult for a few people to refrain from giving gyan. It is their compulsive disorder. It has nothing to do with whether others’ want their gyan or not. For your own sake, ignore them. Get a qualified doctor’s help.

There are people who told me to take steam when I was in the ICU. Clearly, if taking steam would cure me, I would not have been in the ICU. There were people who told me what to eat and drink while I was in the ICU. A couple of people also sent messages asking me to tell the doctor about the medication that I should be given. If you are the patient, or the immediately family, just shut your mind from all such messages. There is no nice way of saying this.

Managing Calls and Whatsapp Messages: It is a good idea to create one message in the morning and one in the evening and send to the family and close friends whatsapp groups to avoid getting individual calls and messages. Despite this, there will be many calls and messages. I am not sure if there is an optimal way to handle them. We just hope people understand that for them it is one message. For the family and the patient, there are hundreds of messages and calls. Persistent calls and messages from a few people can be irritating. But just keep your calm and ignore them. Also, there are just too many things to take care of. We do our best in terms of replying to the messages and answering calls and hope that when we are not doing our best, people understand.

I apologize to those who complained that I did not reply to their message or did not answer their calls. It was my first time in the ICU. I was a bit, let us say, “not well”. So please do excuse me.

What I do want to emphatically say is that it is overwhelming to know that so many people care for us. We know that most of these people are just a call away in case we need any help. We know that they are really worried for us and are our well-wishers. We feel loved and important. Many of you have been silently supportive and our strength during the last couple of weeks. You know who you are, and we cannot thank you enough. We are eternally grateful for all the good wishes and prayers and lucky to have such loving friends, colleagues, and family.

Fitness and Covid: Many people wondered that I am so fit and do so much yoga and pranayama. How could I get Covid? Well, my yoga teacher tested positive too. He is one of the fittest people I know of. Plus, so many cricketers and bollywood super fits actors have got Covid. So, fitness has nothing to do with getting Covid or it’s severity. But there is a chance that I will have a faster recovery due to better immunity and generally a fitter profile. It is yet to be seen.

Overall, Covid is a very bad illness. Hope no one gets it. If at all anyone gets it, hope it is asymptomatic or very mild. Anything a little more than mild is not good and has long lasting impact on the feeling of well-being. However, one positive that has come out of me getting Covid is that now my husband knows how to “Dunzo” groceries and vegetables. Of course, it’s possible that one side effect of Covid is brain-fog for the spouse. So, he may forget it in a matter of days. However, I am hoping that “Dunzoing” is like swimming or driving. Once you learn it, it becomes muscle memory. Yet to be seen and tested.

Thank you for reading this account of my experiences and being a part of my journey for a while.