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Monday, September 29, 2014


Some people are arguing about Medicaid in the USA.
Democrats and Republicans differ.
But that is too far away from us.

Here, however, is an example of what Medic[p]aid looks like.

On the 20th September, at around 3pm I started a rising pain in my stomach. It got worse and worse until 5pm when I was in tears and called Dr Shamim who gave me an injection. The pain remained for a while and stretched now to my back. Nuzhat arrived, too.

The pain abated … but very slightly. Shamim told me to go see a doctor. I was taken to NMC (DHA - Karachi) by Nuzhat and him. Injections and medicine and more injections followed and the pain disappeared in about half an hour. I went home.

We all thought I should get an Ultrasound Test done and on the 21st I went again. The results arrived the next morning.
The report concluded with this: Gall bladder is slightly thick walled and distended. Multiple calculi are seen. One of them measures 1.0 cm. Sludge is also seen. These findings could be secondary to acute cholecystitis. Clinical correlation would help.
I checked on the Internet for what Gallstones really were

… and the effect the surgery would have on my diet.

The sites I visited said after surgery I could not have Ice Cream, Cream, Butter, French Fries, Burgers, Steaks, Sweets, Cheese, … and, much much much worse, no Coffee or Espresso

Of course the site holders live in the Glorious West and didn't mention Bundu Khan's Kabaab, Paratha, Tikka … or the Burns Road Sheermaal & Kabaab. And heavenly Mangoes!!! Obviously, those were not allowed, too.

I decided that this was it. No surgery! You can't ask a man to go through the last year(s) of his life like that! Jehan Ara visited and said Rukhsana has had the surgery and eats everything. A friend's daughter said she eats her usual meal. I was still not convinced.

Rather surprised, I phoned Shamim. He said you can eat whatever you like. He knew a couple of Doctors (Professors Aziz and Asad) who specialise in this and sit together at NMC. He phoned them up and made an appointment for me.

Shamim, as is usual for me to ask him to come along, went with Nuzhat and me. Dr Asad was not there but Dr Aziz saw me and the report and said you should get an operation. He gave me a prescription for being admitted to the hospital whenever I wanted to. His paper said Cholelithiasis. That's from the Greek: chol- (bile) + lith- (stone) + iasis- (process).

I have had a Quadruple Bypass 4 years ago and a Pacemaker put in a few days ago … so I asked if it was ok to have the surgery. Dr Aziz said I should check with my Cardiologist. Shamim spoke to him and he said it's fine. I can do a Laparoscopy and there is no need to for Cholecystectomy.

My next - and a much more important - question: What could I EAT after surgery? (Ohhh, of course, you CAN'T talk about DRINKING here.) Dr Aziz said, "Everything." I listed all my favourites and he said that's ok. I can have all of those things and get my wife to make a nice Biryaani, too. (I am not a Biryaani fan, but it helped to know this.)

Apparently those diets on the Internet are for the West! Don't you think some Pakistani or Indian Doctors should write about our diets, too?

I took the prescription home and thought I'd go into the hospital on Friday so that I could be out by Sunday. Shamim phoned me and said it'll have to be an open surgery as Dr Aziz's Cardiologist said that it would be risky. "Fine", I said. I will be in hospital on Friday.

3:00 pm was the time that NMC gave us after we phoned. Nothing to eat/drink from 1.30 pm. Surgery scheduled for 8 pm.

Now the show starts.

3:01 pm I am in the hospital.
4:04 pm I am in a room.

Or is my dead father in the room?

A young RMO (Dr Zohra Ghanghro) arrives. She is an extremely pleasant girl and is almost the main feature in this story. People take my Temperature. Blood Pressure. Blood is taken for checking if I have Hepatitis.

It's 5 pm. The Assistant Anaesthetist arrives. He is followed by the Cardiologist. Both say they will inform the surgeon before he starts the operation at 6 pm. 

Nuzhat calls Dr Ghanghro. Says I have eaten at 1:30 pm. Why has the surgery been brought forward. Doc goes out and phones people and says it could be 7:30 pm. At least that's what she thinks. I said that the Anaesthetist has not seen me yet. Nor has my Surgeon. She says she was told that the Surgeon had seen me. "Not at all", I say. And she rushes out to phone them both.

It is now almost 6 pm and the Assistant Anaesthetist arrives again. He asks me to sign a form that allows the Surgeon to go ahead. He says its a 'High Risk' operation. We ask him what 'High Risk' means. He says, "You might not come out of Anesthesia. Your age. Your previous operations. Your Pacemaker. Your Bypass. All that make the risks very strong. If you don't come out, they'll have to put you into an ICU. Maybe 1 day. Maybe 3-4 days. If that doesn't work, then they'll put you on a Ventilator."

WTF! All the doctors here have seen my reports. Why didn't they tell me this before I decided to have the operation? I was not going to take this risk for a Gall Bladder surgery. I'd rather have the pain and come back for medication. So I got up. Called Dr Ghanghro. Told her I am not having Surgery. Phoned Shamim and he said, "One shouldn't take such risks on a Gall Bladder or Appendix operation. Don't have the surgery."
(Later Shamim told me that it is the Anaesthetist's job to make sure that he gives the right amount of the right Anaesthesia and make sure I come out of it. There was no reason to think of the last part at all … unless the Anaesthetist had no confidence.)
Shamim phoned Dr Asad who said the surgery is due at 8(!) and he will get there by that time. Shamim decided to come there at 7:30 pm. We told Dr Ghanghro at 8:05 pm that I wasn't having the surgery. We'll inform the doctor when he comes in.

We waited.
And waited.
And waited more.

Dr Ghanghro said she'd get the blood reports ready. It was way past 8:20 pm. Had there been a surgery, the reports should have come in earlier. Anyway, she came back and said that the Hepatitis B report was here. The Hepatitis C would take a while. Right! After the operation, I guess.

My Hepatitis B report showed that the Max Count is 1.00 (One) but my count was 146 (One Hundred and Forty Six). Damn. I had a Hepatitis B problem. [Later at home I checked (Thank you, Google!) and in the USA the treatment was almost over a year and could go unto $25000 per year.]

Ohh … and I am now the w/o rather than s/o!

At 9:40 pm I decided to have a biscuit and water. Starving for 8 hours was making me (and my Diabetes) feel really bad. Shamim said he cannot believe this report to be right. I should check it at AKUH Lab the next day. Meanwhile Dr Ghanghro came back with the report on which she had added by pen that I don't have Hepatitis C. She found this out by phone since the report wasn't still ready.

Isn't that wonderful! I hope the Hepatitis C Report is OK.

We were now told that Dr Asad was in hospital and was operating another patient … after which he'd call me in if I agreed to have the surgery. I had, of course, said no to two people by now. So I was ready to go home. But I couldn't. Dr Asad had to sign the form before I could be released.

Shamim phoned him up and spoke with him. Do Surgeons use the phone and speak to the caller during an Operation? I guess in Pakistan they do. He asked Dr Asad to please tell Dr Ghanghro to speak with the Desk and release me. That was done … and I was finally home.

The next day I got checked for Hepatitis B at AKUH Lab.

0.361! No Hepatitis B.


I wonder where our 99% illiterates go with false reports.
They take the wrong medicine.
They die, I guess.


Thank you Nuzhat and a zillion apologies for all the trouble I have always caused you. Thank you, Sabeen, for being constantly in touch from UK. Thank you Jehan, for all your wishes and constant calls and visits. Thanks Ruhi & Misha for a short but delightful visit from UK.

Thank you, Shamim, for always being there.
Let's have more coffee tonight … and every night.

And thank you, Dr Zohra Ghanghro for being so helpful, full of energy, and being a good RMO. This is no place if your Professors are so faulty and unreliableI am sure your mother will allow you to go abroad and study. C'mon. Press mom hard. Her UCLA background will make sure to let you go and become a great Doctor.


The above was written yesterday. But I have an addition to make. Nuzhat went to NMC to collect my report for Hepatitis C and was given it … as well as another copy of my Hepatitis B that they had given yesterday. Except that it now read 0.25 instead of 146! Wow!!!


Will write more about today … in the next day or so.

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