Ticking Time Bomb!!

He was startled from his sleep by the sound of her breathing. It was laboured. He glanced at the clock behind him - 4:00 am. His gaze moved around the room and landed on her face. He took in her soft features, her smooth skin and it dawned on him that this could be the end. Her mouth was slightly open, her lips were dry and pale. She had fallen asleep in an upright position, propped up by several pillows. She said she felt better that way. He could see her chest heaving underneath her nightgown. Something was definitely wrong with his wife. Why couldn’t the doctors figure it out? There was nothing as frustrating as watching someone you love, go through the rigors of disease. Especially the kind that played hide and seek such as this one.

"Ujana," he whispered. His neck muscles popped, as he got up and walked over to her. Must have been from the numerous nights they had spent sleeping on the couch. She had fallen so ill and uncomfortable, she couldn’t lie in bed anymore. "Ujana," he gently shook her. Her eyes twitched but she didn’t open them. Instead her forehead creased from the disturbance and the realisation of the pain she was in. He knew she was in agony because she brought her palm to her chest.

"Ujana, let's go back to the hospital. You are getting worse." She opened her eyes and gave him a blank stare.

"What will it change Jasiri? We have been to the ER six times. Six times!" She emphasized. Articulating those few words made her even more breathless. He stood motionless, deep in thought. Then he picked up his phone and called a mutual friend of theirs - a doctor.

“Doc, sorry to call this early.” He paused. “It’s Ujana. She is really unwell.”

“What’s going on?”

“It’s a long and winding story Doc. Can I indulge you?”

“Carry on.”

First visit

Ujana felt a sudden, sharp pain in her right leg while running to catch the train for work. She remembered having taken a motorbike ride the previous day. As the day progressed, the ache caused her to limp around helplessly. She decided to get herself checked. The doctor suggested she may have pulled a muscle. She was put on muscle relaxants and the dull ache seemed to subside.

Second visit

A week later while walking to the train station, she developed sudden chest pain and difficulty in breathing. She still proceeded to go to work but later that evening, the pain got worse. She checked the drug insert of the muscle relaxants. In one of the side effects, she noticed it said, “stop the drugs and consult your doctor if you develop chest pains and palpitations.” So she stopped and went to the hospital the following day. The doctor agreed that it must have been side effects of the meds. He gave her painkillers and something to clear her chest.

Third visit

Still no improvement. Jasiri took her to a higher tier hospital hoping for more specialised services. By now she was panting like someone who had run a 100m dash. They walked into the ER at 3 pm and by 7pm, no one had attended to them. When they finally got to see her, she was coming apart like an overheated engine. She was sweating and in obvious pain. They ran some tests which all came back normal and concluded that she had “pleurisy.” She was given IV painkillers and some antibiotics to take home. They left, hopeful that she would get better. After 3 days however, there was still no change. She would walk around the house panting like a lizard on a hot rock. Showering and going up and down the stairs was an up-hill task - and so began their medical tourism. Jasiri took her back to the first hospital they had visited.

Fourth visit

They got there at 7pm. Peculiar enough, Jasiri began to mirror her symptoms. Something similar to couvade syndrome - a condition in which a male partner has a sympathetic pregnancy. He actually mirrors the symptoms and behavior as his expectant wife. Google it. Anyway I digress, Jasiri now had a cough and chest pains. Speaking about their concurrent symptoms may have led the medic they met, to suspect they could be having tuberculosis. They were tested - and found negative. The doctor however, was very keen and took time to listen to them and examine both of them thoroughly. After more blood tests and x- rays, a diagnosis of pneumonia was made. More antibiotics.

Fifth visit

Ujana seemed to get better for a day- maybe it was the placebo effect. Three days later they were back in hospital again! They asked for the doctor they met the last time they were there, but he was off duty. They instead met his colleague - a female doctor. After explaining their long journey at the hands of different medics, she asked whether she could consult with a senior colleague. After having an extensive discussion with her colleague, they concluded that the antibiotics were the problem. “They are too weak,” they said. So, Ujana got stronger antibiotics. Jasiri was not convinced. He almost did not want to leave and suffer through another distressful night. But what choice did he have? He trusted in the fact that they were the experts and knew what they were doing.

It’s funny, really. Life crawled by with an eerie obscurity. It was now a month of hospital visits with little to no improvement. They had started accepting her symptoms as a way of life. She began to adjust to her new normal. She would walk slower, sleep upright, avoid any strenuous activities; hoping for the day her life would return to the way it was. On this particular Saturday, while driving to visit a friend who had just delivered in hospital, they had a motor vehicle accident and rolled in their car. They were not badly hurt. A few bruises here and there. They opted to go to hospital for a check just to ensure there were no internal injuries. They happened to be close to the hospital they had visited on oh so many nights. When they got there, after brief chit-chat, the doc said they looked fresh as daisies; besides it was a minor accident that had occurred hours ago. They were discharged. It’s interesting they did not mention the chest issue. It actually went unnoticed.

Sixth visit

It was late at night and Ujana was unusually restless. Jasiri, against her will, took her back to the ER. They had grown accustomed to these visits. They even knew the best time to visit the ER; in the wee hours of the morning. As expected, the place was not busy. There were a handful of patients so it didn’t take long. Jasiri narrated the story again. He knew it so well, he became accustomed to using medical terms in his explanation. The doctor even asked him if he was a fellow medic. When he was done, the doctor said, “I think she has some form of indigestion.”

“What!” Jasiri shrieked. He proceeded to release all his pent up frustration on this young medic. He didn’t give him a piece of his mind - he gave him all of it. “Look at her. Look at her breathing doc. Does this look like indigestion to you?” He turned to Ujana; she looked as pitiful as a three-legged dog. She had given up. “Let’s go,” he barked.

They left. That was the day they called their friend.

Jasiri felt he had reached the end of his rope. He was desperate. Their friend decided to send them to the National Referral hospital for a litany of tests. With all the strength and hope they could muster, they were there first thing in the morning. They ran all the tests but they all turned out negative. Where was this illness hiding?
Surprisingly enough, during this whole period Ujana would still manage to report to work. She was unproductive — of course — but showing up took her mind off her troubles. So Jasiri reluctantly drove her to the office. Their friend called them to get an update on the results and asked to speak to Ujana directly.

“Ujana, are you sure you have told me everything? Think Ujana. Is there anything you could be leaving out?”
“Well…..apart from the leg pain, chest pain and difficulty in breathing, there is honestly nothing else.”
“Wait. Did you say leg pain? Which leg? Right or left? How long ago was that?”

He told them to turn around immediately and get a CT scan of her chest. By now, their insurance had run out. They were ploughing for pennies. She wanted to wait. He insisted. They looked for the money and she went. It took a lot of time and Jasiri at some point had to leave for work as well.

She remembers being in the scan room after the procedure and at some point she noticed the technician was looking straight at her. He called his colleagues - two of them- and pointed at something on the screen. They all stared in awe and then simultaneously looked at her. She knew then, they had found something. “Please don't let it be bad.” She prayed.
They asked her to wait 2 hours for the official, typed report. To kill the 2 hours she decided to go across the road for a cup of tea. It didn’t take thirty minutes, they called her back to see their resident doctor. By the time she gulped her tea, paid her bill and went back, the doctor had left. He had to go to class. They gave her the scan with the report and told her to see a doctor as soon as she could. She called Jasiri. He got there as fast as greased lightning. They opened the envelope together. They were not sure what they saw but Jasiri remembers seeing the words - large clot in the right lower lobe and smaller clot in the left lower lobe.. Jasiri called his friend to ask what the report meant.

“There is a hospital across the road, right?” Go there, NOW! and show the scan to the first medic you see.” He shouted.

“Ok.” Jasiri sounded calm. He probably didn’t understand the magnitude of this diagnosis.

Ujana had been a ticking time bomb for a whole month.

They walked slowly to the ER. Relieved to finally know what her diagnosis was; yet scared of what it meant. He got to the reception, walked straight into the triage room, took out the CT scan and told the nurse, “ Hi, my wife has a clot in her lungs.” The nurse got up suddenly and summoned the emergency team.

Finally, someone was listening. Ujana would be ok.
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Pulmonary embolism is a life threatening blockage of one or more of the arteries in your lungs. In most cases, it is caused by blood clots that travel to the lungs from deep veins in the legs.

Symptoms vary greatly; depending on how much of your lung is involved, the size of the clots and whether you have underlying heart or lung disease. Common signs and symptoms include: shortness of breath, chest pain that is often sharp, often stopping you from taking a deep breath and a cough - which may produce blood streaked sputum.

In a few unlucky people, there will be no symptoms and it will be diagnosed posthumous.

Certain factors can increase your risk: A family history of the same, heart disease, certain cancers, surgeries, prolonged immobility, smoking, being overweight, supplemental estrogen like in birth control pills, pregnancy and trauma.