Nagalakshmi Dhanaraj - tribute
by Prabhu Dhanaraj (son)
I was born when my Mum was 38. It was considered a miracle. Being the only son, my parents loved me a lot and my mum in particular was my best friend first and then a mother. We used to do a lot of activities together and shared lot of common interests. She was scientist and retired in 2002. She had lot of plans of travelling around the world and seeing places. All this remained a plan. Out of the blue in 2008, the day after Christmas she suffered a stroke.
Her condition was diagnosed as left hemiplegia due to RHD (rheumatic heart disease) and blockage of the right internal carotid artery. They expected her to recover fully, which she never did and was paralyzed on the left side. After a month of rehabilitation we returned home and she was able to walk around the house, though not as before. We had a full-time care taker who became a caring friend over the past 3 years and helped her with all her everyday chores. She also had a clot in the heart (due to RHD) and so she was on constant anti-coagulants (blood thinners) and anti-platelet tablets. Later on she also developed pulmonary edema due to which she was taking diuretics daily as advised by our family doctor.
October 2011
On October 22nd, 2011 when I visited home over the weekend, my mum complained that she hadn’t passed urine since morning. But just as I arrived she had passed it and so I did not think much of it. By evening she complained of pain in the inner leg and the home care nurse suggested a pain killer – slow declofenac which we administered immediately. She said she was better the next morning. I felt everything was fine. I returned back to work on Monday and kept in touch with her on phone everyday. I worked at Bangalore and my hometown was Mysore – a 2-hour drive.
On Tuesday, the 25th evening, she complained of “shivering” and “fever” at around 5PM. It was also raining heavily and we thought this was not a big deal. She was given few antibiotics as recommended by her physician who used to visit her once a week. On the 26th morning when she called me, she asked me if I could come home. It had been just 2 days since I saw her and I told her I would try, but anyway I am coming for the weekend as usual, I reassured her. I didn’t get to talk to her until evening as she slept through the day and even skipped lunch. Evening, when I called, she sounded cheerful and I felt she was improving. But, that night she suddenly couldn’t walk and squatted on the floor. With the help of the physiotherapist, who stays nearby, she was shifted to the cot and she slept well.
I was told about this the next morning and I rushed home on the 27th, found that mum continued to have shivering fevers. The doctor visited and gave a stronger dose of antibiotics. The whole day she couldn’t walk and the fevers continued at night with shivering. The whole day she hadn’t passed urine and we gave her the diuretics she usually took, after which she passed urine during the night sleep. We were relieved, but I suspected something more than a “viral fever” as our doctor had said.
October 29th, morning, mum was too sleepy. She couldn’t even keep her eyes open to eat breakfast. I asked her if we should hospitalize her, and she said, “You think and decide”. Her face was also swollen. By afternoon we summoned the ambulance and rushed her to the hospital.
She was put into the emergency and the neurologist whom she had been consulting visited her and we felt assured. A junior doctor ran some initial tests, found oxygen saturation levels low. Soon, a senior doctor arrived and took stock of the situation. We filled him on the various medications she was taking – anticoagulants, BP regulators, diuretics etc, they did a chest X-ray and probably felt it was a “UTI”. They did a urine routine and confirmed urinary tract infection (UTI). She was put into the ICU. It pained us to leave her alone there but we had no option and we felt it’s such a trivial thing as a UTI and that she would soon be all right.
We visited her over the next 2 days and I observed that they had not put a urine catheter and had trouble giving her a bedpan since she was bulky. She was cheerful though but felt traumatic to be in the ICU. I assured her she would be out soon and finally on the 31st October the doctors said they would shift her to the ward. I was late in arriving at the hospital and mum was very drowsy when I arrived at around 11AM and so I left her to nap for a while and made arrangements to be shifted to the ward. They said they would shift her by 2PM, then we waited upto 4PM and still there were signs of shifting and we got restless. We finally got word that she was in “deep sleep” and that is the reason she could not be shifted. At 6PM the doctors suspected something was wrong, did a blood gas test and found out Co2 levels were bit high and also did a CT scan. The CT scan showed a brain hemorrhage. It was SAH (Subarachnoid hemorrhage).