Tuesday, April 15, 2014

Dealing with body wastes and other issues - I

I recently read Family matters by Rohinton Mistry which describes many difficulties involved in taking care of a bed-ridden patient. In the novel, the 79 year old Nariman Vakeel is cared for by his daughter Roxana after he broke an ankle during a walk. It describes the anxiety, stresses and strains, the patience and the physical strength required for looking after a bed-ridden patient. These aspects are often missed when people see the finished sausage.

Probably the most demanding aspect of the work is dealing with body wastes. Technology has made a lot of progress but there is no easy way of handling body wastes which are messy and don't smell nice. Waiting for insects and bacteria to do the cleaning would be a bit inconvenient. When I was in the hospital after the stroke, one doctor used to say that I was the only patient in the hospital without smells. I used to wonder about that because nurses with similar training used to look after the other patients. I was lucky in drawing the most dedicated nurses.

In Sea of Poppies by Amitav Ghosh, a Zamindar called Neel is imprisoned on a charge of forgery. He finds himself in the same cell as an opium addict who suffers from withdrawal symptoms because he is denied the drug. Neel watches in horror as the prisoner lies helplessly having periodic convulsions, mouth drooling, having scabs and sores because of insect bites and body caked in feces. (Dinosaur feces and dinosaur pee may be fine but being plastered with your own feces is not a fate one dares to think of.) The plight of that prisoner is a world away from the care I get.

For eg. some months back, when I was suffering from back pain, I inadvertently and unexpectedly passed motion on the bed. No preparations had been made since there was no one in the room who I could warn. It was a while before Jaya came to the room and I informed her about the mess that I had created. Then she and the nurse had to spend an hour cleaning me up, changing the sheets and ridding the room of the smells. The task was made more difficult by the fact that I had to be manoeuvred around the bed with great care because of my back pain. If somebody had come into my room after the cleaning, he wouldn't have known that the room had been a mess some time back.  I don't know how but the cleaning is often done with good humor as if nothing had happened.

If I am sitting in a wheelchair and can give a few minutes warning when I feel as if I might pass motion, I can be shifted to the bed quickly and the necessary arrangements can be made to make the cleaning process easier. But if I am unable to give a warning (as it happened when typing this post) then cleaning up the mess is mighty difficult. And the stink! If I can smell it (my ability to smell is reduced- I was thinking of writing that my 'olfactory prowess is compromised' but Orwell would have frowned) you can guess that Jaya and the nurse would not have had it easy. And my best laid plans for the day would have gone astray. I will feel, like Agastya Sen in English, August, 'hazaar fucked'.

While returning from the enjoyable trip for the reunion, I passed motion at the Mumbai airport. (At that time my bowel movements were a bit irregular because of the antibiotics and painkillers I had had. This meant that I was in some tension throughout the trip but nothing happened till the final leg of the journey.) Nothing could be done at the airport and it was almost midnight by the time we reached home and I could be cleaned up. A bottle of perfume was purchased at the Mumbai airport and sprayed on me at regular intervals. The bottle was empty by time we reached home. There wouldn't have been too many occasions when a bottle of perfume had been used so liberally.

And I bet not many have  enjoyed watching the Queen's Necklace at night while sitting on shit. Boy, the tension I was in throughout the trip! But I was fully packed, the perfume was doing its job and the passengers looked relaxed so maybe I was exaggerating the possibility of a stink. Stephen Hawking travels a lot and I wonder how he manages such inconveniences. Talks about black holes are fine but I also want to know about more mundane matters.

There are other regular routines like brushing, trimming nails, shaving etc. Over time, Jaya learnt to do these things smoothly. Doing these activities on oneself is much easier than performing them on others.  You are not sure how much pressure to apply, for eg, during shaving. Too much pressure and you nick the skin, too little and you don't remove the hair. And you have to be  more careful because I might suddenly cough. Once a barber nicked my nose when I coughed suddenly. He remarked that he had caused nicks at many places in the face but this was the first time he had nicked anyone's nose! Nowadays Jaya does the shaving for me.

She has to do all this and also do outside work like go to the market and bank since her father no longer drives a vehicle. She also has to help around the house since her mother has had two knee replacement surgeries. And she has to look after a teenage son which is more stressful than looking after two babies simultaneously. Sometimes when people find her sleeping at 5 pm they will be surprised. They will not know that she may have slept after 3 pm, that  I may have woken her up because I suddenly wanted to pass motion, that she may have had to wake up 2-3 times the previous night because I had wanted to pass urine...

Apparently there are people whose job is to act as standardised patients and feign myriad diseases, syndromes, conditions, and habits. I wonder if someone acts as a standardised patient for brain stem stroke. What sort of training do they get?

PS: Just as people have to do horrible tasks for me to relax, many people have to do mind numbing jobs for us to get the stuff that George Carlin talks about.

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