Sunday, February 17, 2008

Allergic bronchitis in Amritsar

Well, I'd like to say that everything went lovely for me in Amritsar and I saw the Waga border, the Golden Temple, Jallianawala Bagh, and took the 1st class Shitbadi train back to Delhi. Unfortunately, it didn't. And here's what happened:

I started to feel sick after seeing the Waga border. On the ride back to the hotel after the border ceremony, I didn't talk much with the driver. After I got back to Amritsar I went straight to the Crystal Chowk for dinner. I wasn't hungry but I had to eat some food so that I could take the medicine that a doctor from that morning had prescribed (antibiotic for a throat infection, decongestant, and bronchodialator). At the restaraunt the service was extremely slow and I felt weaker and weaker. I was a sick man and I looked it. Finally the food came. I ate some of it, took my medicine, and left.

I came back to my room to sleep. I wrapped myself in the blankets, turned on the room heater, and tried to sleep. I couldn't though. I got up to go to the bathroom several times and looked at myself in the mirror. I noticed myself looking slighly pale / ashen. I also felt a tingling sensation in my hands. It had been there all day but now it was climbing up to my forearms. I was slowly losing sensation in my arms. I also felt my breath becoming more rapid and shallow and my pulse rise. At about 4:30am, thanks to both my common sense and my training in Emergency First Response, I realized what was going on. I was having an 'asthma attack' of sorts. I wasn't able to breathe deeply so I was breathing more rapidly to compensate. Still, it wasn't enough to get enough O2 to my extremeties and I was starting to feel the effects of O2 depravation in my hands (hence the tingling). My bronchioles, the air sacks in the lungs which expand to collect the air we breathe, weren't dilating sufficiently for some reason. Therefore, less oxygen was available for extraction to the blood stream. I felt 95% sure that this problem wasn't going to solve itself and therefore decided to seek immediate medical attention.

I packed up my bags, dropped my keys at reception, and woke up the sleeping receptionist to take me to the nearest 'good' hospital. We flagged down a cycle rickshaw and for 15 rupees he took me to Sri Muni Lal Chopra hospital.

I walked inside and there was no one around. I looked in one of the exam rooms and I saw large rat scurrying under a cabinet. There was no one at reception so I went up one floor to the nurse's office. There I saw three people (2 nurses and medical student) sleeping. I woke them up and told them my problem. They called the doctor from the third floor to examine me. He took his own sweet time coming down to see me and acted as if he was doing me a favor by seeing me. He didn't want to admit me and instead wanted to give me nebulizer treatment and send me home. I demanded to be admitted or be allowed to go to a different hospital. Finally, they decided to admit me. What would be the point of taking the nebulizer treatment, feeling better, going home, having the same problem come back, and going back to the hospital?

Once admitted, I was given oxygen treatment and an IV. It took some time for the nurses to find a good vein and after poking in a few places they found a vein near my left wrist bone. The IV contained a water-salt-glucose solution. I was given a shot of steriods in this location as well. I was given antiobotics and bronchodilators orally. My oxygen saturation was about 90% but quickly reached 100% after the oxygen treatment and medicine.

I stayed in the hospital for 1.5 days. I missed my train back to Delhi on Sunday because at that time I didn't feel well enough to travel. During this time, Jasvir's grandfather came to visit me a few times. I befriended the staff of medical students, nurses, and cleaners too. They spoke to me in Punjabi, and I tried to speak to them in Hindi. Communication was hard but fun. I became the most popular patient on the floor due largely to my accent and the strong interest I took in my treatment plan. I even got to use my 'Tu soni kudi hai' ('you are beautiful', in Punjabi) on my lead nurse. Rather than slapping me, she blushed. At the end, I tipped the cleaning staff. One lady from the cleaning staff even tried to set me up with one of the medical students who was taking care of me - I was not opposed to the idea and neither was the medical student ;)

The diagnosis was allergic bronchitis with a throat infection. My main doctor, a chest specialist, recommended that I see an ENT in Gurgaon for my throat infection.

That week, I recuperated at home. Breathing was a bit labored in those first few days after I returned. But, I took the medicine I was prescribed and saw an ENT, who give me some additional medicine and an inhaler. I used this medicine and stayed clear of spicy foods. By the time my family came to India, I had mostly recovered.

So, what caused this mess? Here's my analysis:

1) Pollution - and dust - just a bad combination for your throat and lungs. I feel strongly that this caused my throat infection. Since the hospital visit, I've taken to wearing a handkerchief around my mouth, especially when I go to Delhi.

2) Cold weather - not nice air for your lungs to breathe. It's harsh and dry. Also, the apartments are not warm and you can wake up sick, which often happened to me during the winter.

Bottom line, I've learned to protect my lungs and health in general much more vigilantly here in India. I can't let illnesses prevent me from traveling. Anyways, I need to make a return trip to Amritsar to visit the Golden Temple and Jallianawala Bagh.


Anonymous said...

Your article is not half as adventerous as the real story Ravi ;). Kidding!!
Yeah, a lesson for all the Americans in India. "911" doesn't really work here they way it does in US and is not the best call always.
I want to tell those who don't see Ravi every day, now a days, that he has become lot stronger and healthier now. Learnt to live the harsh life and cope with the conditions.

Not as much fun as living in Kenya or Uganda but you had a fair share of it.

Ready to go on your next excursion!! Aint ya...

-- saurabh

Anonymous said...

I am glad you had the presence of mind to admit yourself into a hospital and secondly, not to check out of the hospital until you felt fully OK to travel back. Your conservative approach when facing problems sure helped I think.

I suggest you should plan to revisit Amritsar to see the temple and other sights but more importantly to thank the people, in particular, Jasvir's grandfather, who took care of you when you were there.


rpolitte said...

Hmm... welcome to the club of needing last minute health care while traveling! Fun experience huh? This is the reason I now bring along my own syringes, etc. just in case I do something klutzy and end up in an ER... need to make sure everything is safe.

How were the India hospitals? I'm totally interested to check those out as lots of good stuff has been written about them.

On another note: when my family went to India - all of us were coughing up black stuff after a couple days, and I had to share my inhalors with everyone. It was very difficult breathing, and humidity is necessary at night.

Anonymous said...

WAy to tough it out RR. . .now you are a true medical tourist!