Guts, cuts and so-whats

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A harrowing seven-month battle with intestinal tuberculosis, in hindsight, doesn't seem so bad after all. Even in harrowing times, life always goes on, albeit with painful pauses.

In the December of 2013, I was diagnosed with intestinal tuberculosis.

The results came after a cocktail of tests, an endoscopy, an MRI, multiple consultations and a harrowing week of uncertainty. For most of this period I was clad in a flimsy hospital gown and not much else. The nurses insisted; it was a hospital rule that could not be disputed.

I felt naked, alright, but it was more than skin-deep. Somewhere deep inside my body, the ileal-caecum, there was an inflammation. A kind of growth. And as parts of me came out in grey, unclear pictures, which were then held high and scrutinised by the doctors, I experienced a strange kind of disembodiment. I didn’t know of the existence of this part until then, so it seemed to me a sadistic rebellion.

Source: Wikipedia

The Ileocecal valve is the gateway between the large and small intestines. Tuberculosis of the bowel occurs rarely, but more commonly among people under 18 years of age.

The infection is attributed to consumption of dairy products or meat from tuberculous cows.

It could be anything really, a worried Dr. S told my mother. ‘Anything’ in doctor language almost always means malignancy. The scary 'C' word, however, is never said out loud. My mother sat outside the procedure room during the endoscopy, reading the hanuman chalisa. Not a particularly religious woman, she took refuge in prayer when she was low on faith in herself. Waking up in the recovery room in the throes of anaesthesia, I saw her pale face trying to put on a facade of confidence. The anaesthesia, thankfully for me, had numbed my otherwise anxious brain. The numbness persisted for hours, hours till Dr. V, whom I was terribly fond of, came and eliminated the possibility of cancer and my dad broke into uncontrollable sobs as Dr. V held him. An incident my otherwise undemonstrative father would repeat many times later, making social situations awkward, and I would fall for Dr. V in a way that would feel a lot like love.

“Ileo-caecal tuberculosis is a possibility,” the biopsy report said, unsure of itself. The gastroenterologist didn’t need much convincing though. She scribbled ecstatically on her prescription pad, telling me that tuberculosis is easily treatable. Swallowing heavy drugs for a few months was all I needed to do. There was relief. Relief not like holding your bladder for five hours and finding a nice, clean bathroom after. Relief like your doctor telling you you’re not dying of an incurable disease, and that you shall live long to have many regrets.

Unlike me, my mother always found comfort in people. She made several calls to family and friends assuring them that everything was fine. I proceeded to Google this fancy disease I had contracted — the Internet would be offended otherwise. There were pages and pages online listing complications, diagnostic difficulties and possible side-effects of the prescribed drugs — vision and hearing impairment, haemorrhage, bleeding, skin rash… all of which I spent the next few days experiencing, and running to my mother every few minutes only to hear her call out my paranoia and continue with her cooking.

When the first stomach pains came, they were mild but lasted the night. I tackled them by rubbing my feet aggressively, thinking of crushes from middle- to high-school while analysing why they’d gotten fewer with time. This worked sometimes. In the mornings, I would puke a few times before breakfast, and lay crouched with debilitating nausea after. It was normal to experience this, the doctor had warned. But if it becomes unbearable, she had asked me to come see her. I thought I was doing rather well, braving this pain and discomfort everyday till the first big attack. I didn’t go ‘see’ the doctor then, I was wheeled into the emergency ward of the hospital at 1 a.m by a horrified taxi driver.

Then come the ECG, tests for HIV, and questions like ‘do you have metal in your body’? Yes, I tell one anaesthetist, and bend my knuckles to reveal my claws of steel. Unfortunately for me, he doesn’t even crack a smile.

Laughter is the best medicine. Except when it hurts your tubercular stomach.

Hospitals have rather sadistic procedures in place, as I had mentioned earlier. After vomiting 20-odd times with dramatic acoustics (which I suspect woke most people in my quiet neighbourhood), I reached this reputed hospital in acute pain only to find myself waiting for half an hour till a bored nurse checked my BP. As my arm was squeezed, my guts protested more. She then slowly checked my temperature, breathing, eyes, tongue, even though I kept pointing to my stomach looking, I imagine, like a terribly dehydrated dog.

Finally, a small shoebox-like space was assigned to me. The nurse injected me with standard doses of Pan and Emeset despite me telling her they wouldn’t work; they were too passive for my raging body. But she didn’t believe me. So I writhed in pain for a half-hour more. Annoyed, she injected morphine straight into my veins. The effect was immediate; I did a small whirl on the bed and fell unconscious. Seven hours later, I woke up to a painless gut and sore stomach.

This became routine for the next couple of months. Every few days, and sometimes when my stars were favourable, once in a few weeks, I would go into the emergency ward as a homecoming. On one occasion they had to nasally insert a tube because I couldn’t ingest water without throwing up. In a rare act of rebellion, I pulled out the inserted tube using both hands with an inexplicable urgency. It was a socially acceptable way of giving them the finger.

Troubled by the number of visits, and mainly unable to figure out the root of this unusually prolonged reaction, my gastro suggested surgery. She put Dr. V back on the case, and I was happy (ecstatic) to see him again. He came, cracked a few characteristic jokes and then got pretty damn serious. He described what exactly they would be doing, how and who would be there in the OT. “There will be a scar. Where and how do you want it?” he asked before leaving. I felt a sudden love for my body, the same body I had had issues with until that moment. My stomach had never looked this beautiful before. I carefully assessed where the mark would be least visible if I wore a saree. I pointed vaguely to an area where I think would be ideal. “Done,” we shake hands.

Preparation for surgery is the most mortifying experience of all. As if it isn’t bad enough that someone you’re in love with is going to perform surgery on you. First they make you drink litres of Isabgol — draining your body of the last morsel of food. They insist on shaving you, EVERYWHERE. Then come the ECG, tests for HIV, and questions like ‘do you have metal in your body’? Yes, I tell one anaesthetist, and bend my knuckles to reveal my claws of steel. Unfortunately for me, he doesn’t even crack a smile.

In a rare act of rebellion, I pulled out the inserted tube using both hands with an inexplicable urgency. It was a socially acceptable way of giving them the finger.

The second tryst with anaesthesia was less smooth than the first. A little like the high of first love, which numbs you from everything — as against the tempestuous second, which pushes you to the extremes of cynicism-coloured wisdom. I woke up shaking violently, and a little after, felt like molecules of ultra-sensitive hormones strung together. In the room, I broke down, and the sobs made my stomach recoil, worsening the pain in the stitched parts. There were three small cuts, each about 3 cm wide. Dr. P then dropped the bomb — they hadn’t operated on me after all. A laparoscopy was done, and the gut was found to be perfectly healthy. Why was I getting these repeated attacks of pain, then? They all looked at me, faces full of guilt. They didn’t know, or, there could be several reasons… My parents decided to move hospitals as a last resort. By this time, I was 46 kg, a number I last saw on the scales in class 4. In the pictures my dad insisted on taking of me, I looked like the perfect cast for a tuberculosis warning advertisement — a thin layer of skin on bones, dark eye circles, patches on face and hands. With the medical bills piling up, it wouldn’t be such a bad idea, I thought.

You may have a drug-resistant form of tuberculosis, Dr. VG (nothing like Dr V) told me at the smaller hospital. He asked me to get admitted for a week, during which I was his lab rat. He stopped all drugs, and introduced what were second-line drugs. I was apparently lucky to have not lapsed into a jaundice or hepatitis; where my liver functions should have been 30 and 40, they were a 900 and 1,000. I tried to keep faith in him, but it had become difficult by that point.

He gradually increased the dosage and my body responded well, but recovery was not a piece of cake. My neighbours tried to find explanations in astrology. Some homam, some pooja, visits to some temples, archanai to specific deities. It was all done, but relief was minimal. Finally, the fatalistic reasoning comes: one has to endure the bad time for as long as it extends.

Swollen veins from repeated injections, insomnia, dizziness, nerve weakness, and frequent breakdowns — they were no longer in my head. Maddening emptiness alternated with a mortal fear of an impending attack. My last one came in June 2014 where, for 3 days, I was injected with morphine every 8 hours. Sometime in between, my sister, brother and aunt made visits to lift my spirits. In the middle of an MRI, which required me to drink 2 litres of a shit-tasting liquid, my sister prompted me to think of Quidditch. That helped me hold it all in, until the 45-minute scan was over.

During the seven month-ordeal, I cussed a lot, like an old Englishman — terrible, dreadful, awful, utterly, bollocks were part of my daily use. I visited the temple, regularly. I went back to work. I thought about love. I fell in love, in a simple and foolish way — the only real way to love. I read a young girl’s blog; she was dying from cancer. It was courageous and beautiful writing on life, death and the short distance in between. I saw my best friend who lives in Canada after years, and we had the same chemistry — unaffected by my being on a hospital bed and her on a plastic stool. I found myself in these extended moments of normalcy. And even though this came in hindsight, I realised that life had played out as usual, if with painful pauses.

My mother was right; it wasn’t so bad after all.

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