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Life 6.0 - After my long recovery from lung infection

I totally forgot this blog exists! Yes it has been more than a year since I wrote something and surprise, life already moved to another version. FYI, it's my bday (7 Feb 2018) and am sitting at some corner of Rajasthan in middle of Thar desert, a small town called Barmer. I feel less arrogant and yet more confident like never before, super conscious about my sleep and nutrition. With realizations that am not invincible and my body is just like a machine, if not fueled and oiled properly its bound to give me a hard time. Below is the story that will tell how everything changed.

The Story

At times life takes a turn which changes you forever. Tough times are essential for life as they leave back many learnings, and if a time comes when the life itself hangs on a brink due to your mistakes, your realizations are stronger and stays with you every moment. Something am writing down, not because I want to talk aloud of my so called survival story (actually it would be too much exaggeration as I wasn’t even hospitalized for a day), but my point is just to share what I learnt during this time.

First the background (you’ll know why it’s important)

In May 2017 I headed for Ladakh and was there for about 10 days surveying villages, I came back, 20 days later I was there again, then came back in June and then landed again on 1st July. July first week I was taking guests to my homestays, trekked to the Sumda-Chun village. Last 70 odd days were a rush, I was very casual about my food, I may have skipped many lunches and not to mention the amount of distance I walked on the streets of Leh to book cabs or buying stuff. This all apart from the 3 treks I lead and what followed next was Global Himalayan Expedition 2017 where we trekked for 130km over 15 days with 16Kgs in my bagpack (including a camera and a telescope :P). Again I remained casual about food and this time sleep as well.

Time for the icing on the cake, after the trek we were rafting in the ice-cold waters of Zanskar river when we were hit by a rapid, our boat capsized and I was in that gushing river. After being sucked in and out of 3 more rapids, I was almost backing-out so I started yelling. Finally rescued 15min later by a kayak. It wasn’t less than a mental trauma (I was crying, certain of some casualties!). With wet suits on, sun shining above, I was still shivering, and breathing hard, really hard, I was choking infact. I got rid of my helmet and life-jacket, but that breath took an eternity to be normal.

I wasn’t alone, 2 boats with 16 people went down that day but against my apprehensions, thankfully everyone was rescued. And it was now time to continue, for another 30mins till we reach the island where we were to camp tonight. “No more rapids” is what the rafting leader said, and honestly even I couldn’t take one more.. but minutes later our boat capsized again, in that gushing stream and this time I was below the boat, as I didn’t want to leave it, but I had to else I would have drowned.  I was in water but on that capsized boat I was pulled up with 4 others. Cannot forget that face of Ayush who was also holding the ropes, the only lifeline we had on the boat, not a word exchanged. Every passing rapid was scary as we didn’t had any control. In all that chaos we managed to shift to another boat, and finally it was over and we were on the island.. We now gauged the damage, 3 people had hyperthermia, the food/camps boat was okay.. our paramedic was on his toes.. a fire was made, hot soups served, but it was an anxious night, everyone scared.. I had a fever that night and next morning we had to do an unplanned trk across a mountain pass to reach the nearest road (no one was ready to raft). We stayed for a night in a random village that had a satellite phone.. our pickup arrived next morning and we were finally back in Leh, somehow in one piece. 10 days later I came back to plains, supposed to be back again in Ladakh 2 weeks later to lead another expedition, but wait this life will change and all plans will fall apart.


The real story

I was in Punjab with my family, just here for a couple of days before I head for Delhi. That night on 3rd Aug, it was about 3am, I had a severe pain in my chest, I thought it’s a heart attack :P I could hardly breathe but I did not bother anyone. It was only in the morning I asked my family to take me to doctor, I couldn’t even talk. Our most trustworthy family doctor did the right things I guess, first a chest X-ray and a blood test, but everything looked normal. Assuming just a muscle sprain, he gave few painkillers. The pain subsided, but was back few hours later. I held on it, applied ointments but I had sleepless nights. 2 days later we consulted another doctor, he looked at reports, some stronger pain killers, but what then followed was one of the worst night of my life. Not going in details, but I needed proper diagnosis of what was happening. As I caught fever now, this time we went to a pulmonary specialist who suggested an ultrasound. I was finally happy, in a different way though, to be diagnosed that something was wrong with my lungs. There was a fluid there, technically it’s pleural effusion. This doctor was a total a**hole. Though he was able to diagnose something, he was too arrogant to tell me why that fluid was there and why I am on a 10 days course of antibiotics. He did not even used the word infection, and worst he suggested no precautions and diet (see my review on Dr.Dinesh). His meds helped from day one, but I didn’t wanted to walk on a blind path, so I consulted another pulmonary guy, this time from a reputed hospital, SPS Apollo. Dr.Sikri was polite, young and told this effusion is either due to pneumonia or TB or in a rare case, a tumor. He reviewed the meds and asked me to continue for 1 week and then do another X-ray. A week passed, I had no pains and I ate normal food. The new x-ray was better so he suggested me to discontinue all the meds and I was happy with my recovery.

Two days later I had severe pain again in my chest, I called up the Dr.Sikri but he said just take a paracetamol and rest. But it didn’t help so I went for a check-up to Dr.Dinesh again and this time again in his arrogance (which was more coz I went to another doctor), he prescribed his meds for a month. Antibiotics for a month is the most ridiculous think I could get from a pulmonary specialist, I know the harm it does and I was in contact with a specialist in Mumbai (Dr.Karuna, grandmother of a close friend). She also suggested, not to take so much antibiotics else I’ll develop resistance to it. Still not able to figure out the reason of the pain plus it was getting worse each day and I was losing weight (59Kgs I never saw in 10 yrs). Dr.Sikri, my kind doctor this time suggested a CT scan which revealed a clot inside my lung which need to be sampled. A small procedure (according to him), in which they’ll put a needle in the lung and take a sample. The lung may deflate in the process so I may have to be hospitalized for a couple of days till it recovers back. I was again happy, in a different way though, that I have been diagnosed finally and whatever it is, atleast can be treated.

At the brink

Before going through the procedure I had a call with Dr.Karuna in Mumbai. When heard about the procedure, technically a needle biopsy of lung tissue, she explicitly told me to leave these stupid doctors and meet her known specialist at Bombay hospital. As per her suggestion it’s an unnecessary procedure that may lead to lung collapse, also called pneumothorax, and create a medical emergency.
So the flights were booked, and in that stress, especially my family who were thinking what’s happening with their son, we were to leave for Mumbai on 28th Aug. First to drive to Delhi, we woke at 03:00 am and while I was still on bed my mom was getting the breakfast ready and father was doing his prayers. That’s when I told, I can’t travel, cannot even move a step, am too weak. My dad called our landlord uncle and he suggested to take me to emergency of DMC hospital, one of the oldest in the city. I was apprehensive as my last visit was not so good and had heard all kind of stories, all bad ones. But here I met my savior, Dr.Sandeep Puri.

At last a good doctor

Funny developments as we entered the emergency of the hospital and I was asked to lie down on a stretcher. The stretcher rolled in and a bunch of doctors, mostly young students, surrounded me and checked my vitals. They couldn’t find any problem and asked me what’s wrong with you? I told my story and they said you need not to be admitted, you can just meet Dr.Sandeep in OPD :P
A 4 hour wait and finally we got a chance to meet him. I loved the way he dealt with me. I told my story and showed all reports. He did a thorough checkup of my chest and abdomen with his hands and stethoscope and he said everything is fine with my lungs. I told about my falling weight, fatigue and chest pains, he gave meds for a week and recommended a few blood tests, and most importantly the Mantoux test to rule out TB (why no one earlier did that!). When I asked about the clot in my lung, and biopsy, he said no need to touch that (I’ll tell later what was happening). Two day later when all reports came, there were no complication added and the meds were to be continued for 15days before next appointment. A hiccup happened about 3 days later when suddenly at night I was sweating and shivering, almost felt I’ll collapse. As it was late night, parents called up our family doctor and he just asked to have soda lime water and relax. It really helped and then we me the doctor again who prescribed a different set of meds this time.
Again felt normal for a few days but some mornings were bad; weakness, fatigue and shivering. Then I had these episodes weekly and this is how September passed.
And it was October, never felt better during the first 15 days, so I DISCONTINUED THE MEDS (I still regret doing that). Then came the bad days again, full day fatigue, sweats and shivers. Dr.Sandeep was surprised by my decision to discontinue drugs (I couldn’t help, 2.5 months of drugs was something I wasn’t used to). He had to increase the dose and this time I did a research about the drugs I was own. Those episodes of shivering and sweats were nothing but anxiety attacks and I was on drugs to help me out from that. It was a setback for me as I never expected to be on such a medicine, and as I researched more, the course may last for years.
So it’s 23Jan 2018, and am still on these drugs. The dose have reduced and the next checkup is in March, but am happy, leading a normal life. In December I did my first hike after months and about 75Km total distance in my walks since Dec. No more anxiety episodes since and am able to focus on my work, a different outlook and level of energy I can say. And yea, I weigh 75Kgs now, I never saw that in life :P

And today is my birthday, somewhere it looked bleak to reach here so I pledged a tree for each day i’ll live. Yesterday I planted 200 trees in Barmer (Rajasthan) with help of SankalpTaru NGO.

So what was happening (Long story short)

3 months rush of to and fro travel (from May to July) between Ladakh and Delhi, add to it the irregular and random food, add to it the exertion of about 200+ Km of trekking in the low oxygen of cold desert, plus the stress of handling my tourists and running around in Leh to book cabs and hotels. Icing on the cake was the double capsize in the extremely cold Zanskar river. All in all, I was on really low immunity and my lungs took a lot of stress, hence vulnerable to any infection. Bad luck it was Streptococcus pneumoniae the most common bacteria that causes pneumonia (I may have contracted the same bacteria on some other day and my immunity would have taken care without me even noticing, but it was wrong timing).

Well pneumonia is serious stuff, the bacteria attacks the lungs tissue causing the alveoli (oxygen-absorbing areas of the lung) filling with fluid. This is bad news as you will not be able to breathe properly. In response our immunity produces more fluid (neutrophils) further impairing of oxygen absorption by lungs. In my case the fluid entered the pleural region causing inflammation of the pleura membrane, hence the severe pain. If not diagnosed and treated in time, things can go really wrong. Not going into details and the immunity response is usually also accompanied by high fever, shortness of breath and cough which didn’t happen in my case.

If you contracted it you should really just rest and let the antibiotics do its work. Any workout is detrimental as your immunity is low already fighting a serious infection. Even if you try, the chest pains and shortness of breath will stop you. I was diagnosed but was not told anything else (in fact the word pneumonia was not said). After just 2 days of antibiotics and painkillers I was feeling amazing and walking for about an hour everyday (I guess 4-5Kms). Since I was on strong pain killers (read about voveron), there was no pain hence I was not aware of the damage I was doing to myself.

A week later I was out of pneumonia, so need not to take any more antibiotics. But since I left the pain killers as well the pain came back, this time worse and not limited to only the inflamed pleura, in fact the entire chest and upper body muscles.What was needed now was just rest and some painkillers. But what my very knowledgeable doctors prescribed was

Dr.Dinesh: Another month of antibiotics! L
Dr.Sikri: a needle biopsy of lung! L

But the CT scan did showed a scar in my lung, so Dr.Sikri was right? No! scarring in lung can happen after pneumonia which will diminish with time and lung functioning will return to normal.

And the last bit, the anxiety episodes I was having I could only relate it to the mental stress I was through, especially being a no-medicine person and a workout freak, who was forced to be on bed for a first time and take so many meds, that too for months (that's too long for me) plus these docs prescribed for biopsy and shit. The mental trauma was too much for me I guess. Still no complete answer to it, but good news is I feel perfect now. Last 3 months have been amazing and frankly speaking I now think it wasn't a big deal, just a disease that can happen to anyone, just that I was consulting some amateur and stupid doctors :)

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It's 1 July 2018, am in Leh since a month now. I am no more taking any medicines. Geared up for another expedition this month.. :)




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