The Sky Gets Dark, SLOWLY!

In his book released in 2020 with the above title, on the pitfalls of ageing, Chinese author Zhou Daxin - the Mao Dun Literary Prize winner - provides a sensitive exploration of old age and the complex, hidden emotional worlds of the elderly.  Some Valuable Words of Wisdom from Daxin’s Latest Novel. He warns that, once you move to the other side of 60, the sky gets darker, and the light begins to wane until, one day, you are back to lying in bed like the baby you were born as.

In the book he writes, …Many elderlies speak as though they know everything, but of old age they are in fact as ignorant as children. Many elderly people are in fact completely unprepared for what they are to face when it comes to getting old and the road that lies ahead of them. 

My dream of leading a medicine-free life came crashing down with a silent thud when it stopped me dead on my track the other day during my regular evening walk.

Suddenly, without any warning sign, there was excruciating pain in both my calf muscles that prevented me from taking a step forward. I called my wife Vasantha and with her help managed my way back to the apartment. As is my habit, I Googled the symptoms and found that the severe pain could be due to:

• Lack of activity 
• Dehydration caused by low electrolytes and minerals
• Paque build-up in the leg arteries that prevents blood flow

I attributed my issue to the fact that I have been inactive (without walking and exercise for about 10 days because of sore throat and body pain) and I am generally poor in consuming water. So, I drank water with salt at regular intervals and also took a pain killer. 

My friend's daughter Dr Veena works at Mazumdar Shaw Medical Centre, Narayana Health City, Bangalore and with her advice and help, fixed an appointment with the reputed vascular surgeon Dr. Robbie K George at the same Centre.

My appointment was at 12:15 pm on 11-05-2023. I had read many 5-star reviews of Dr. George on the Net and at the very first sight he appeared full of positivity and very friendly. After narrating my current problem and my past history, he suggested it could be due to clogging of arteries and consequent lack of steady blood flow. He advised me that it needs immediate attention and the start of medication. He asked me to complete the following tests at the earliest and meet him again in the evening. 

1. COMPLETE BLOOD COUNT (CBC) I SERUM CREATININE
2. CT ANGIOGRAPHY LOWER LIMBS: ? embolic events in b/l LL
3. ECHO COLOR DOPPLER

When I met the doctor in the evening after the tests, he cited a case that brought home the enormous severity of my problem. In the morning he had examined a woman patient with very similar symptoms and in her case the blood flow to the legs had stopped because of narrowed arteries and consequently both her legs have to be amputated. 

Peripheral artery disease (PAD) is the narrowing or blockage of the vessels that carry blood from the heart to the legs. It is primarily caused by the buildup of fatty plaque in the arteries. In my case, probably a clot near the heart broke up and the pieces travelled down through the leg arteries where they got stuck in the narrowed portion. If the pieces had travelled up instead, it would have caused a sudden cut-off in the blood flow leading to a severe heart attack or a stroke.  

Dr. Robbie George also made two interesting observations:

1. What was accomplished in 5 hours in terms of consultation, tests, review, and medical advice would normally take at least 6 weeks in any 'advanced' country.
   
   This shows what efficiencies India has achieved in the healthcare sector, though we often brag about our other achievements only - being the world's fastest-growing economy, the dramatic advances made in the fintech ecosystem, and our contributions in technological startups and global businesses. 
    
2. The second point he made was posing the question: "If I do research on the Internet on Geospatial technology for three months will I become as competent as you are, having spent all your professional life in that field?". The sharp-witted doctor was ingeniously pointing out the stupidity of my decision to stop all my medicines eight years back, in spite of having two stents in my body!

I have written extensively on why I took the decision to go medicine-free: You Are What You Eat,    Sustaining a Strong Immune System,   Our Breakfast - Old Wine in a New Bottle!.

Finally, the doctor prescribed blood thinner injections and tablets for 4 days and asked me to meet him on Monday, after consulting a cardiac doctor first. Whether I need surgery to rectify the blockage will be decided then. 

And in the process my wife Vasantha learned how to administer a subcutaneous injection on me!

Old age does not come overnight! The sky gets dark SLOWLY, and the author asks us to prepare for the inevitable sunset years without panicking. He narrates some situations to keep in mind so that we will be prepared for what is to come: 

• The people by our side will continue to grow smaller in number. 
• We'll see many of our peers increasingly finding it harder to look after themselves.
• The younger generations will all be busy with their own lives. 
• Society will care less and less for us; no matter how glorious our career was, aging will always transform us into a regular old person.
• We should be prepared for uninvited and unexpected guests - fractures, diabetes, chest infections, cardiovascular blockages, brain atrophy, cancer... 
• We will have to live with illness and ailments; pain is an assurance that we are alive!
• Do not take on society’s troubles or our children’s and grandchildren’s affairs onto ourself. 
• Our duty is to get adequate exercise and keep at it consistently to maintain a positive mentality.
• Hospitalization will take us to another dimension completely; the occasional smile or gesture of affection of the caretaker are heavenly things for us.
• We should prepare for a return to the infant state; we arrived in this world on a bed, and after a journey of twists and turns, we will return to the same place - the bed.
• Our spouse may depart earlier than us, and what then come are days of emptiness. 
• We will have to learn how to live alone and to enjoy and embrace solitude.

Along with the dark sides of old age like disabilities, depression, and anxiety, old age is also the time to cultivate positive aspects such as mindfulness, wisdom, and spiritual growth! Now to end with an inspirational quote by Francis Bacon:

"I will never be an old man. To me, old age is always 15 years older than I am."