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My 18 week ordeal of double trouble

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by Dr. Lakshman Abeyagunawardene

I thought of writing this article in order to share with readers of the Sunday island newspaper, my recent experience as a patient suffering from two illnesses at the same time. I could describe this period as sheer mental agony as I had to bear the social as well as possible medical consequences of illnesses that plagued me over a prolonged period. Writing newspaper articles in my opinion, is one of the best ways in which at least one section of the community can be educated on health issues.

My professional career called for frequent lectures to be given to a wide variety of target audiences ranging from post graduate doctors preparing for examinations in Community Medicine and medical students, to humble village folks like new settlers in Mahaweli areas in the late seventies and early eighties. I always made it a point to emphasize the fact that the occurrence of disease is not only a biological phenomenon but a social one as well, a point that I picked up in my post graduate training and which has got etched in my mind through conviction. Subsequent developments as described later, led to the worst period when I was confined to the guest room in my home as I was not permitted even to climb the stairs that led to my comfortable bedroom upstairs. The move which was to last several weeks, involved shifting many personal items which were indispensable for day to day life.

It all began with a rash on the right side of my face involving the nose, cheek and areas around the eye. Although I suspected Herpes Zoster (commonly called Shingles) particularly because I recalled a bout of chicken pox over 50 years ago, soon after my Internship while working at the Colombo South Hospital. Although it is a self-limiting disease, I decided to seek medical attention because as far as possible, I try to stay away from self treatment except for very minor illnesses. Herpes Zoster is a viral infection that occurs with reactivation of the varicella –zoster virus that had been lying dormant in certain nerves for many years. Symptoms typically start with pain and a rash along the affected path of the nerve, followed two-three days later by a vesicular eruption.

With a 24- hour curfew in force, that weekend happened to be one where all “Channel Centres” were deserted. I therefore decided to go to the Emergency Room (ER) of Sri Jayewardenepura Hospital (SJPH) where the doctor confirmed my diagnosis and prescribed an anti viral drug called Acyclovir, pain killers Gabapentin and Panadeine. I was also referred to the Ophthalmic (Eye) Ward because my right eye seemed to be affected. Fortunately, the Senior Registrar on duty ruled out any involvement of the eye and said that my vision was normal. This was confirmed by the Consultant Ophthalmologist (Eye Surgeon) whom I later channeled as I was very concerned about my eyesight. As always, I diligently took all prescribed drugs but at the end of two weeks, I unfortunately developed Postherpetic Neuralgia (PHN) which is a known complication of Shingles.

I had heard of Post Herpetic Neuralgia (PHN) but never imagined that it was so painful. In general, all pain due to Neuralgia is very painful, difficult to treat and lasts a long time. I realized through experience, what it is like to be the sufferer rather than a doctor treating a patient.

Quite apart from my present illness, I was having spells of dizziness off and on, which I attributed to Gabapentin which is known to cause such side effects. On one such occasion it was so bad that I was about to fall. Fortunately, we were in our bedroom and my wife was at hand to prevent the fall and led me to my bed. My wife was quite helpless in such situations and called my son who lived close by and called for an ambulance. My son and the ambulance arrived almost simultaneously, but as I had not lost consciousness, I was able to explain to the paramedics that I was on Gabapentin and did not need hospitalization. Whether or not the paramedics understood what I said, they withdrew mainly because their patient was a doctor and knew what he was doing!

On a subsequent occasion, I had a syncopal (fainting) attack while I was having breakfast and my wife again had to go through the usual motions of calling my son and the ambulance. This time, I had lost consciousness and when I was back to normal, I myself thought that it could not have been due to the Gabapentin. Therefore, I didn’t resist hospitalization as I previously did. These two episodes clearly showed the importance of family support. I dread to think what a bachelor living alone would have done under such circumstances.

For a number of years, I have been having an irregular pulse. This drew my attention when it continued and my cardiologist referred me to a Cardiologist and Electrophysiologist who put me on what is called a Holter Monitor. After reading the report he said that I have a few extra systoles (ectopic beats) and that accounts for the irregular pulse. He further said that it is normal for some people and I needed no treatment. Mind you, that was about six years ago.

This time round when I lost consciousness, to cut a long story short, after the necessary referrals were made, the EEG that my Neurologist ordered showed some changes and my doctors decided that the origins of the changes had nothing to do with my nervous system but that its origins were cardiac (meaning that the origin of the EEG changes could be due to some defective movement of electrical impulses in the heart). So, I went back to my cardiologist who referred me to a Cardiologist and Electrphysiologist. The latter put me on a Holter Monitor again. Based on the history and the new Holter Monitor reading, he recommended a Pacemaker. I readily complied and he implanted a Permanent Pacemaker on September 8. Sutures were removed after about a week and I had to attend a “Programming Session” on September 27. The doctor reported that the surgical wound was clean and that the whole procedure was successful. The implantation of the pacemaker did not bother me at all, but the anxiety of anyone facing a surgical operation was telling on me.

I had to go through the procedure of pacemaker implantation while the pain in my right eye persisted. It was after my fainting episode and pacemaker implantation was recommended that I was debarred from climbing stairs. I was confined to the Guest Room and this is where my agony really started. My wife did not allow me to even go to the living room which was just three steps below. Towards the latter stages, I watched news on the small TV in the kitchen. I had to be satisfied with the laptop computer that my son brought. But it was a far cry from the Desktop I was used to. I missed my weekly shot of an alcoholic drink! I had not taken even a beer since the beginning of June.

I think I had a turnaround in my fortunes after the doctor did the Programming on September 27. It was this doctor’s advice that I strictly followed (more so my wife and son) because there was nothing more the Neurologist who was treating my neuralgic pain could do. The electrophysiologist who did the pacemaker implantation asked me to resume my regular evening walk but advised me not to drive the car till the end of October. When I asked him whether I could take my weekly shot of an alcoholic drink, he jokingly asked me whether it was Single Malt or Scotch. I replied that I take Single Malt , Scotch, Gin, Rum, Vodka, Tequila and even Ceylon Arrack in rotation, depending on availability. More than anything else, I was happy to be back in my bedroom, using my toilet, 52 inch TV in the TV room and the Desktop in my study.

Once the Eye Surgeon said that my vision is intact and the Cardiologist had successfully implanted the Pacemaker, I was free to take some decisions on my own. As I was bothered by the persisting pain in the eye, I went back to using Gabapentin when the eye pain was severe (discontinued since that episode of dizziness). Picking up information from the Internet, I started trying some home remedies like washing my eyes and using a warm compresses frequently. I also started taking a course of Vitamin B Complex and refrained from eating Bananas and Citrus fruits to help in the recovery of damaged nerves. If I continue to recover from the eye pain and the other minor symptoms of PHN, I will not be able to pin point and say that it was one specific intervention named above that was responsible for the turnaround. Being a doctor myself also certainly helped in many instances. However, I had resigned myself to think that recovery from PHN is very, very slow. As I recover slowly from PHN, I painfully realized the plight of many who are affected by Neuralgic pain and continue to suffer.

As a precautionary measure, I still keep away from my mobile phone and the microwave oven. The Pacemaker also restricts my movements of the left arm. I will continue to live with such restrictions for some more time. But I know that I have already seen and experienced the worst of this period of agony.

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Features

Islamophobia and the threat to democratic development

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There’s an ill more dangerous and pervasive than the Coronavirus that’s currently sweeping Sri Lanka. That is the fear to express one’s convictions. Across the public sector of the country in particular many persons holding high office are stringently regulating and controlling the voices of their consciences and this bodes ill for all and the country.

The corrupting impact of fear was discussed in this column a couple of weeks ago when dealing with the military coup in Myanmar. It stands to the enduring credit of ousted Myanmarese Head of Government Aung San Suu Kyi that she, perhaps for the first time in the history of modern political thought, singled out fear, and not power, as the principal cause of corruption within the individual; powerful or otherwise.

To be sure, power corrupts but the corrupting impact of fear is graver and more devastating. For instance, the fear in a person holding ministerial office or in a senior public sector official, that he would lose position and power as a result of speaking out his convictions and sincere beliefs on matters of the first importance, would lead to a country’s ills going unaddressed and uncorrected.

Besides, the individual concerned would be devaluing himself in the eyes of all irrevocably and revealing himself to be a person who would be willing to compromise his moral integrity for petty worldly gain or a ‘mess of pottage’. This happens all the while in Lankan public life. Some of those who have wielded and are wielding immense power in Sri Lanka leave very much to be desired from these standards.

It could be said that fear has prevented Sri Lanka from growing in every vital respect over the decades and has earned for itself the notoriety of being a directionless country.

All these ills and more are contained in the current controversy in Sri Lanka over the disposal of the bodies of Covid victims, for example. The Sri Lankan polity has no choice but to abide by scientific advice on this question. Since authorities of the standing of even the WHO have declared that the burial of the bodies of those dying of Covid could not prove to be injurious to the wider public, the Sri Lankan health authorities could go ahead and sanction the burying of the bodies concerned. What’s preventing the local authorities from taking this course since they claim to be on the side of science? Who or what are they fearing? This is the issue that’s crying out to be probed and answered.

Considering the need for absolute truthfulness and honesty on the part of all relevant persons and quarters in matters such as these, the latter have no choice but to resign from their positions if they are prevented from following the dictates of their consciences. If they are firmly convinced that burials could bring no harm, they are obliged to take up the position that burials should be allowed.

If any ‘higher authority’ is preventing them from allowing burials, our ministers and officials are conscience-bound to renounce their positions in protest, rather than behave compromisingly and engage in ‘double think’ and ‘double talk’. By adopting the latter course they are helping none but keeping the country in a state of chronic uncertainty, which is a handy recipe for social instabiliy and division.

In the Sri Lankan context, the failure on the part of the quarters that matter to follow scientific advice on the burials question could result in the aggravation of Islamophobia, or hatred of the practitioners of Islam, in the country. Sri Lanka could do without this latter phobia and hatred on account of its implications for national stability and development. The 30 year war against separatist forces was all about the prevention by military means of ‘nation-breaking’. The disastrous results for Sri Lanka from this war are continuing to weigh it down and are part of the international offensive against Sri Lanka in the UNHCR.

However, Islamophobia is an almost world wide phenomenon. It was greatly strengthened during Donald Trump’s presidential tenure in the US. While in office Trump resorted to the divisive ruling strategy of quite a few populist authoritarian rulers of the South. Essentially, the manoeuvre is to divide and rule by pandering to the racial prejudices of majority communities.

It has happened continually in Sri Lanka. In the initial post-independence years and for several decades after, it was a case of some populist politicians of the South whipping-up anti-Tamil sentiments. Some Tamil politicians did likewise in respect of the majority community. No doubt, both such quarters have done Sri Lanka immeasurable harm. By failing to follow scientific advice on the burial question and by not doing what is right, Sri Lanka’s current authorities are opening themselves to the charge that they are pandering to religious extremists among the majority community.

The murderous, destructive course of action adopted by some extremist sections among Muslim communities world wide, including of course Sri Lanka, has not earned the condemnation it deserves from moderate Muslims who make-up the preponderant majority in the Muslim community. It is up to moderate opinion in the latter collectivity to come out more strongly and persuasively against religious extremists in their midst. It will prove to have a cementing and unifying impact among communities.

It is not sufficiently appreciated by governments in the global South in particular that by voicing for religious and racial unity and by working consistently towards it, they would be strengthening democratic development, which is an essential condition for a country’s growth in all senses.

A ‘divided house’ is doomed to fall; this is the lesson of history. ‘National security’ cannot be had without human security and peaceful living among communities is central to the latter. There cannot be any ‘double talk’ or ‘politically correct’ opinions on this question. Truth and falsehood are the only valid categories of thought and speech.

Those in authority everywhere claiming to be democratic need to adopt a scientific outlook on this issue as well. Studies conducted on plural societies in South Asia, for example, reveal that the promotion of friendly, cordial ties among communities invariably brings about healing among estranged groups and produces social peace. This is the truth that is waiting to be acted upon.

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Pakistan’s love of Sri Lanka

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By Sanjeewa Jayaweera

It was on 3rd January 1972 that our family arrived in Karachi from Moscow. Our departure from Moscow had been delayed for a few weeks due to the military confrontation between Pakistan and India. It ended on 16th December 1971. After that, international flights were not permitted for some time.

The contrast between Moscow and Karachi was unbelievable. First and foremost, Moscow’s temperature was near minus 40 degrees centigrade, while in Karachi, it was sunny and a warm 28 degrees centigrade. However, what struck us most was the extreme warmth with which the airport authorities greeted our family. As my father was a diplomat, we were quickly ushered to the airport’s VIP Lounge. We were in transit on our way to Rawalpindi, the airport serving the capital of Islamabad.

We quickly realized that the word “we are from Sri Lanka” opened all doors just as saying “open sesame” gained entry to Aladdin’s cave! The broad smile, extreme courtesy, and genuine warmth we received from the Pakistani people were unbelievable.

This was all to do with Mrs Sirima Bandaranaike’s decision to allow Pakistani aircraft to land in Colombo to refuel on the way to Dhaka in East Pakistan during the military confrontation between Pakistan and India. It was a brave decision by Mrs Bandaranaike (Mrs B), and the successive governments and Sri Lanka people are still enjoying the fruits of it. Pakistan has been a steadfast and loyal supporter of our country. They have come to our assistance time and again in times of great need when many have turned their back on us. They have indeed been an “all-weather” friend of our country.

Getting back to 1972, I was an early beneficiary of Pakistani people’s love for Sri Lankans. I failed the entrance exam to gain entry to the only English medium school in Islamabad! However, when I met the Principal, along with my father, he said, “Sanjeewa, although you failed the entrance exam, I will this time make an exception as Sri Lankans are our dear friends.” After that, the joke around the family dinner table was that I owed my education in Pakistan to Mrs B!

At school, my brother and I were extended a warm welcome and always greeted “our good friends from Sri Lanka.” I felt when playing cricket for our college; our runs were cheered more loudly than of others.

One particular incident that I remember well was when the Embassy received a telex from the Foreign inistry. It requested that our High Commissioner seek an immediate meeting with the Prime Minister of Pakistan, Mr Zulifikar Ali Bhutto (ZB), and convey a message from Mrs B. The message requested that an urgent shipment of rice be dispatched to Sri Lanka as there would be an imminent rice shortage. As the Ambassador was not in the station, the responsibility devolved on my father.

It usually takes about a week or more to get an audience with the Prime Minister (PM) of a foreign country due to their busy schedule. However, given the urgency, my father spoke to the Foreign Ministry’s Permanent Sectary, who fortunately was our neighbour and sought an urgent appointment. My father received a call from the PM’s secretary around 10 P.M asking him to come over to the PM’s residence. My father met ZB around midnight. ZB was about to retire to bed and, as such, was in his pyjamas and gown enjoying a cigar! He had greeted my father and had asked, “Mr Jayaweera, what can we do for great friend Madam Bandaranaike?. My father conveyed the message from Colombo and quietly mentioned that there would be riots in the country if there is no rice!

ZB had immediately got the Food Commissioner of Pakistan on the line and said, “I want a shipload of rice to be in Colombo within the next 72 hours!” The Food Commissioner reverted within a few minutes, saying that nothing was available and the last export shipment had left the port only a few hours ago to another country. ZB had instructed to turn the ship around and send it to Colombo. This despite protests from the Food Commissioner about terms and conditions of the Letter of Credit prohibiting non-delivery. Sri Lanka got its delivery of rice!

The next was the visit of Mrs B to Pakistan. On arrival in Rawalpindi airport, she was given a hero’s welcome, which Pakistan had previously only offered to President Gaddafi of Libya, who financially backed Pakistan with his oil money. That day, I missed school and accompanied my parents to the airport. On our way, we witnessed thousands of people had gathered by the roadside to welcome Mrs B.

When we walked to the airport’s tarmac, thousands of people were standing in temporary stands waving Sri Lanka and Pakistan flags and chanting “Sri Lanka Pakistan Zindabad.” The noise emanating from the crowd was as loud and passionate as the cheering that the Pakistani cricket team received during a test match. It was electric!

I believe she was only the second head of state given the privilege of addressing both assemblies of Parliament. The other being Gaddafi. There was genuine affection from Mrs B amongst the people of Pakistan.

I always remember the indefatigable efforts of Mr Abdul Haffez Kardar, a cabinet minister and the President of the Pakistan Cricket Board. From around 1973 onwards, he passionately championed Sri Lanka’s cause to be admitted as a full member of the International Cricket Council (ICC) and granted test status. Every year, he would propose at the ICC’s annual meeting, but England and Australia’s veto kept us out until 1981.

I always felt that our Cricket Board made a mistake by not inviting Pakistan to play our inaugural test match. We should have appreciated Mr Kardar and Pakistan’s efforts. In 1974 the Pakistan board invited our team for a tour involving three test matches and a few first-class games. Most of those who played in our first test match was part of that tour, and no doubt gained significant exposure playing against a highly talented Pakistani team.

Several Pakistani greats were part of the Pakistan and India team that played a match soon after the Central Bank bomb in Colombo to prove that it was safe to play cricket in Colombo. It was a magnificent gesture by both Pakistan and India. Our greatest cricket triumph was in Pakistan when we won the World Cup in 1996. I am sure the players and those who watched the match on TV will remember the passionate support our team received that night from the Pakistani crowd. It was like playing at home!

I also recall reading about how the Pakistani government air freighted several Multi Barrell artillery guns and ammunition to Sri Lanka when the A rmy camp in Jaffna was under severe threat from the LTTE. This was even more important than the shipload of rice that ZB sent. This was crucial as most other countries refused to sell arms to our country during the war.

Time and again, Pakistan has steadfastly supported our country’s cause at the UNHCR. No doubt this year, too, their diplomats will work tirelessly to assist our country.

We extend a warm welcome to Mr Imran Khan, the Prime Minister of Pakistan. He is a truly inspirational individual who was undoubtedly an excellent cricketer. Since retirement from cricket, he has decided to get involved in politics, and after several years of patiently building up his support base, he won the last parliamentary elections. I hope that just as much as he galvanized Sri Lankan cricketers, his political journey would act as a catalyst for people like Kumar Sangakkara and Mahela Jayawardene to get involved in politics. Cricket has been called a “gentleman’s game.” Whilst politics is far from it!.

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Covid-19 health rules disregarded at entertainment venues?

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Believe me, seeing certain videos, on social media, depicting action, on the dance floor, at some of these entertainment venues, got me wondering whether this Coronavirus pandemic is REAL!

To those having a good time, at these particular venues, and, I guess, the management, as well, what the world is experiencing now doesn’t seem to be their concerned.

Obviously, such irresponsible behaviour could create more problems for those who are battling to halt the spread of Covid-19, and the new viriant of Covid, in our part of the world.

The videos, on display, on social media, show certain venues, packed to capacity – with hardly anyone wearing a mask, and social distancing…only a dream..

How can one think of social distancing while gyrating, on a dance floor, that is over crowded!

If this trend continues, it wouldn’t be a surprise if Coronavirus makes its presence felt…at such venues.

And, then, what happens to the entertainment scene, and those involved in this field, especially the musicians? No work, whatsoever!

Lots of countries have closed nightclubs, and venues, where people gather, in order to curtail the spread of this deadly virus that has already claimed the lives of thousands.

Thailand did it and the country is still having lots of restrictions, where entertainment is concerned, and that is probably the reason why Thailand has been able to control the spread of the Coronavirus.

With a population of over 69 million, they have had (so far), a little over 25,000 cases, and 83 deaths, while we, with a population of around 21 million, have over 80,000 cases, and more than 450 deaths.

I’m not saying we should do away with entertainment – totally – but we need to follow a format, connected with the ‘new normal,’ where masks and social distancing are mandatory requirements at these venues. And, dancing, I believe, should be banned, at least temporarily, as one can’t maintain the required social distance, while on the dance floor, especially after drinks.

Police spokesman DIG Ajith Rohana keeps emphasising, on TV, radio, and in the newspapers, the need to adhere to the health regulations, now in force, and that those who fail to do so would be penalised.

He has also stated that plainclothes officers would move around to apprehend such offenders.

Perhaps, he should instruct his officers to pay surprise visits to some of these entertainment venues.

He would certainly have more than a bus load of offenders to be whisked off for PCR/Rapid Antigen tests!

I need to quote what Dr. H.T. Wickremasinghe said in his article, published in The Island of Tuesday, February 16th, 2021:

“…let me conclude, while emphasising the need to continue our general public health measures, such as wearing masks, social distancing, and avoiding crowded gatherings, to reduce the risk of contact with an infected person.

“There is no science to beat common sense.”

But…do some of our folks have this thing called COMMON SENSE!

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