Kamal Shah

Kamal Shah

Hello, I'm Kamal from Hyderabad, India. I have been on dialysis for the last 13 years, six of them on PD, the rest on hemo. I have been on daily nocturnal home hemodialysis for the last four and half years. I can do pretty much everything myself. I love to travel and do short weekend trips or longer trips to places which have dialysis centers. Goa in India is a personal favorite. It is a great holiday destination and has two very good dialysis centers.

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Thursday, 03 March 2011 08:25

My iPhone 4 is now in Mumbai

I have been yearning to get an iPhone 4 from the time it has been announced. I couldn't get it from the US too. The main problem was Apple did not sell the phone without an AT & T contract. So, there was no way you could get a phone even if you could unlock it here.

Then, I somehow got to know that factory-unlocked iPhone 4s were being sold by Apple in some countries like Hong Kong. My cousin Nisha was travelling to Hong Kong in November and I asked her to buy one for me from there. She went to the Apple store in Hong Kong when she was there. There was a waiting period of 4 to 6 weeks! They asked her to leave her credit card details and her phone number and they would call her when the phone arrived. My cousin did that despite having to leave Hong Kong in a few days. The plan was to get a friend to pick it up and send it to India whenever it arrived.

Four to six weeks became two months. But finally the phone arrived at the Hong Kong store. My cousin got a call and she requested a friend to pick it up. Now the next step was to bring it to India! We waited and waited for someone to make plans to come to India from Hong Kong. My cousin, by now, was as anxious as I was to get the phone. Shipping it wasn't an option. Who wants to risk shipping an iPhone and have it come through Indian customs?!

A few misses (people coming but we not knowing) later, finally the lady who picked up the phone herself arrived at Mumbai a couple of days back. Nisha has yet to lay her hands on the phone but confirmed reports say the phone has indeed arrived.

I am off to Mumbai this Saturday to pick it up.

... http://www.kamaldshah.com/2011/03/my-iphone-4-is-now-in-mumbai.html

I have seen such conflicting opinions about the blood tests people on dialysis need to do regularly - monthly, quarterly and so on. Every doctor, every hospital and every dialysis technician has his or her own opinion. Yes, every individual has a specific requirement and the list of tests will vary depending on his or her condition. But there surely must be a common bare minimum that every dialyzor must get done, right?

Hemoglobin is probably the only test that everyone concurs. Most people get this done every month at least. A good hemoglobin is essential for general well-being. It also dictates the amount of Erythropoietin you need to take.

On the rest of the tests, pretty much everyone has their own opinion.

Some people get the Creatinine and Urea done every month. I totally understand getting these done for people in the early stages of CKD. What purpose does the Creatinine serve, however, once someone is on regular Maintenance Hemodialysis? The kidneys have pretty much shut shop, never to open again. What is the point in doing the Creatinine? A test should be done if, based on the result, some action can be taken. If someone's Creatinine goes up by 2 points, is the frequency of dialysis going to be increased? If the Creatinine has gone down by 2 points, are you going to reduce his frequency of dialysis?

Coming to Urea, if you are going to do the pre-HD and post-HD urea and use it to estimate the Kt/V, a measure of adequacy of dialysis, fine. Doing only the pre-HD urea serves no purpose, in my humble, non-medical, only-based-on-common-sense opinion.

Clinics that are concerned about HCV cross-infection often insist on a SGPT, a liver function indicator, every month. That is fine and should be encouraged with the rampant cross-infection with this virus (at least in India) these days.

Calcium and Phosphorus are tested with varying frequency. With the amount of trouble I had with both of these, I would really suggest keeping a tab on these. At least quarterly, if not monthly?

The biggest problem with dialysis in India, as I keep repeating ad nauseam, is that patients have to pay out of pocket for their medical expenses. When that happens, automatically, non-medical factors come into play while deciding the frequency and type of blood tests. At NephroPlus, we are constantly battling this problem. Patients often suspect our intentions when we recommend blood tests for them. I can totally understand and relate to their thinking. So, it is important for patients to be educated and aware enough of their medical condition to be able to take such decisions in their best interests, balancing their financial concerns with their medical ones.

... http://www.kamaldshah.com/2011/03/which-blood-tests-do-people-on-dialysis.html

Monday, 28 February 2011 08:43

Have you tried Google's App Engine?

Recently, MVK, my friend, told me about Google's App Engine. Call me disconnected but I had no clue about this fantastic service from Google. They have this whole infrastructure where you can run web applications on their servers. And this is not just simple static websites but full featured applications! 

They have a choice of two development environments you can use - Java and Python. They also have a persistent store that your apps can use. So, you can pretty much have everything on their server. And like most things Google - the basic service is free! You can also serve the application from your own domain name.

I was really thrilled when I got to know this and explored it a little. It is a pretty decent service. Well, they have a few restrictions but what the heck - its free! Nothing problematic at first sight. But I am guessing you can't use it if you are going to have hundreds of users hitting your app every hour. For anything from simple to medium complexity and traffic, you should be able to use this.

I haven't yet done anything significant with this so far. But I do plan to take it for a spin soon. I have a requirement that I have been trying to have a decent solution for, for some time now. This should be ideal.

The only thing that worries me is the extent to which we are all dependent on Google!

... http://www.kamaldshah.com/2011/02/have-you-tried-googles-app-engine.html

Sunday, 27 February 2011 10:15

Alvida Afsar saab

Ghulam Ahmad Afsar is no more. Afsar saab, as I used to call him, came thrice a week in the morning to NephroPlus for hemodialysis. I used to interact with him almost every time he was there. He was a man who had seen life in its various hues and shades, the darkest of which were probably his last. He switched to another center a few weeks back for some reason. I got to know a few days back that he passed away.

Afsar saab was an unlikely loser in the game of life. He would not take no for an answer when he thought something was not being done right. He would raise his voice and fight for what he believed was correct. He took very good care of his health. He was proactive and totally in control. He would do a little bit of exercise every day too. He maintained excellent control over his diet. I am at a loss as to how this happened.

To think that someone I met only a few days back and had no sign of any complications is no more is very difficult to come to terms with. This is the nature of this disease. The disease will never kill you but the co-morbidities that it brings along with it will. Its almost as if each of us is sitting on a time-bomb that is ticking away. Nobody knows when the timer will run out.

Whenever I get to know that someone on dialysis has died, I get very uncomfortable. My heart becomes heavy, like lead for a while. I become a little scared. John Donnes' lines are so true:

No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.

Each man's death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.

... http://www.kamaldshah.com/2011/02/alvida-afsar-saab.html

Saturday, 26 February 2011 05:58

The mellifluous Suprabhatam

I remember the Suprabhatam from my childhood. In the apartment where I lived, one of my neighbors used to play it every morning. At that time, I was not very spiritually nor very musically inclined especially not Vedic Religion or Carnatic music! But it stayed with me somewhere at the back of my mind.

Some time back, I somehow got this urge to listen to it. I asked around and sure enough, got a copy of M. S. Subbulakshmi's excellent rendition of this masterpiece. I have been listening to it almost every day for the past few weeks. It leaves me spellbound!

Who is it that sang this with the legendary MS? Was it Radha, her foster daughter? MS and her mystery companion have sung the verses with flawless pronunciation of the rather difficult Sanskrit words. Hours of practice have probably gone in before such a divine performance. All the verses are sung by the two voices in perfect sync. The other voice matches MS note for note, letter for letter.

There is something about the Sanskrit words, the simple, rhythmic tune and the way MS has sung it that really mesmerizes you. When I was looking for more information about the Suprabhatam, I found a remix by A. R. Rahman. How was it? Pathetic! Nothing can match the MS version.

The verses themselves are invocations to the Lord to wake up. You can read the entire set of verses here along with English translations.

Here is a You Tube video that has the audio with images from Tirumala and the verses as subtitles:

... http://www.kamaldshah.com/2011/02/mellifluous-suprabhatam.html

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