Reader's Corner

Then fate took a hand in my future. Richard Fernandes, my husband, joined German Remedies as a medical representative, in March 1967. He actually remembers that I wore a black skirt and a white lacy hakoba blouse on my very first day of work, But before we could become friends, Richard was transferred to Nagpur. He would come to Mumbai only now and then. He was lonely in Nagpur specially since his friends were all tying the knot. So in early 1971, 29-year-old Richard determined to find himself a bride in Mangalore.

"Why are you looking in Mangalore?", said his colleagues. "There's Rita, Agnes, Mina working in our office!"

That very evening some of us girls were waiting at the bus stop when Richard offered us a lift in a taxi. He was handsome; light-eyed, and rather shy, and somehow he landed up at my house, because he too lived in Santacruz, and met granny and mummy.

Richie went off to Mangalore, was not impressed by the local girls, and wrote to me: "Why don't you marry me? I'll meet you when I return". I was surprised but pleased and showed the inland letter to my family. "We must tell him about your condition", they said in a unanimous perturbed voice. Richie called as soon as he returned to Bombay and I asked him to come over. My parents told him that I was a diabetic.

"I know that already through the office grapevine," he shrugged. "So what?"

Richie returned to Nagpur and a diabetologist friend told him: "Go ahead and marry this girl. She seems perfect. Don't worry, I'll look after her like a mother". Even police commissioner Ronnie Mendonca who was then in Nagpur echoed: "If you've decided to get married, do it. God will take care of the rest". After that the diabetes didn't bother him a bit.

The trips to Bombay became more frequent and Richie and I were engaged on the 10th of September and married on the 26th of December 1971, just after the Indo- Pakistan war.

After Bombay, I felt a trifle lost in Nagpur, but only for a while because there was so much entertaining that I soon made friends. After what I now realize was a miscarriage in April ''72, because diabetes can cause early abortions, I got pregnant. My due date was set at the 27th of April 1973. Diabetes had not hampered my fertility!

I was unworried but careful. Several medical college doctors reassured me and supervised my treatment. I checked my urine three times daily, took insulin thrice, had a blood sugar test once a fortnight, and had a moderate carbohydrate, prudent fat, high fibre, low sodium, diet. I didn't read up anything on pregnancy because there is no literature for pregnant diabetics.

In my fifth month, I returned to Bombay under the closely co-ordinated care of gynaecologist Janki Punjabi and my own Dr. Motilal Dhirwani. Municipal hospitals give you the best possible treatment if you, like me, are under caring doctors.

Today I realize the importance of effective control. Diabetes, if left to wander helter skelter, can create curious problems in pregnancy and delivery. There can be growth-retarded babies still births, extra large babies with poor chances of survival, malformations. My doom-and-gloom brigade were somewhat justified in their concern.

In my last month, I was admitted into a ward in KEM hospital because my blood sugar had soared to over 400 mg /100ml. I had gained too much weight and I had a lot of odoema. Granny never left my side, while my blood sugar was monitored meticulously and my food weighed out with care, so that the insulin was a perfect match.

Although I didn't know it then, diabetic pregnancies are seldom allowed to go to term because of the risk of uterine death at the end. After a Lung Maturation Test in which the amniotic fluid is assessed, it was decided that my baby was ready for delivery. A caesarean was fixed for Sunday, the 15th of April. Richie, who shuttled from Nagpur to Bombay, was summoned.

Now although caesareans at KEM are never performed on a Sunday, because doctors also need their rest, I had a battalion of ten to 12 doctors to help Ravi to emerge. Our prayers were answered. Ravi came out crying lustily at 10.25 a.m.

Why did we call him Ravi? Because when a nervous Richie woke up at 5.30 that morning he saw four Sadhus outside his window. They said to him in Kannada, which Richie understands: "Don't worry. You'll have a son. Born at 10.30 a.m. His name will be Ravi, for the sun and Sunday". These words imbued him with courage although he is not the superstitious sort. He was so impressed with their accuracy that we decided on the name Ravi, which also starts with an R like Richard.

In the ward, I had two hypoglycaemic attacks, perhaps because of the fasting before the caesarean. The nurses refused to give me sugar despite Granny's pleas, saying: "She's a diabetic!" Eventually, a doctor put me on a glucose drip and all was well. I did not breast feed my baby because there was no lactation after the colostrum appeared. However, modern thinking has it that a diabetic can breast feed her baby successfully with a dietary adjustment of the carbohydrates.

Ravi was not born a diabetic nor did he develop the condition. What were the chances of his becoming one? Very small. With a juvenile diabetic mother there is a 2 per cent risk, which means that if I had 100 children, only 2 would be diabetic.

After 8 days I was sent home, under Granny's eagle eye, with instructions regarding my diet, exercise, testing, and insulin.

Sadly, just as we were beginning to enjoy our baby, he got seriously ill with diarrhoea and chest congestion. Our tiny one-month-old was kept in an oxygen tent while the doctors looked grave. We prayed with all our might, while Granny, our anchor, stayed with her great grandson around the clock. "I want him back for Mina's birthday," she pronounced, just as she had 13 years ago, for me. He was. And he was never seriously ill again.

We went back to Nagpur in August. On the 6th of September, 1973. I learned that my Dr. Dhirwani had died. My whole world seemed to crumble. The doctor had been my rock for so many years. How would I survive without him?

In January 1974, Richie was transferred back to Bombay and we soon moved into this flat in Kurla. The question was: Who would supervise my treatment now. The first diabetologist I saw remarked nonchalantly: "People like you are not supposed to live too long!" Another one tried to put me, an Insulin Dependent Diabetic, on tablets, which only work on people who have beta cells. I ended up looking after myself, but I felt like a lost child.

In 1975, I started losing hair, my skin became scaly, and I bloated out so much that people asked me if I was pregnant. A doctor decreeded erroneously: "Your kidneys must be failing" and prescribed 10 Lasix a day to increase urination, and had my perfect eyes tested for diabetic retinopathy.

It was only in 1977, that I read an article on hypothyroidism in Femina. "Now I know why I’ve got all these symptoms!" I said, and met Dr. Akil Contractor. "There's no time for a test," Dr. Contractor said, after examining me. He put me on Eltroxin. Within 10 days there was a dramatic improvement. My thyroid gland was not producing enough of the hormone thyroxine. Once again, I had developed an auto immune disease, unconnected with the diabetes. Thyroid disease can also complicate pregnancy and childbirth. We decided that with Ravi our family would be complete. Three's company!

After which I consulted Dr. Vijay Ajgaonkar, who's been my friend, physician, and guide until today, at the S. L. Raheja All India Institute of Diabetes, in Mahim.

I had to record my blood sugar thrice a day after testing it with strips, take insulin before lunch and dinner, keep my diet within 1200 calories a day with 3 main meals and 3 snacks, lay off sweet stuff, and walk for 45 minutes daily.

In 1982, Dr. Ajgonkar, Dr. Aspi Irani, and Dr. Anand Nadkarni decided to start the Juvenile Diabetes Foundation to help diabetic children and their parents realize that they can lead a normal, happy, and fruitful life. I spoke about myself at one of their first meetings, as a walking-talking example.

Since the education in Kurla was not too up-to-date, we sent Ravi to stay with my parents in Santa Cruz to study in Sacred Heart School. We took him home for weekends.

And then there were a series of deaths that left me bereft and broken hearted. Granny died at 79, in 1982. Mummy died in 1983 of meningitis at 57. Daddy died in 1985. One by one they left me. Two generations disappeared. And there I was, thrust into the role of family matriarch, totally unprepared.

Ravi passed his SSC in 1988, and graduated with honours in political science from SIES College. After studying business management, he is now working as business manager in Duncan Industries. We have encouraged close communication with our strapping 26-year-old-son, and he has grown up ambitious, independent, and very caring.

But my main thrust is to give back to the JDF what it has given to me. I attend a Juvenile Diabetic clinic at the Lotus Eye Hospital every Saturday. I counsel parents to give them the confidence to deal with their children positively, without searching for so-called miracle cures. "Look at me," I say. "I've been a diabetic for 40 years!" One father who came to me burdened with despair said: "My world has returned. If my Riddhi grows up like you, what more can I ask for?" I infuse parents of marriageable girls, and the girls themselves, with hope. I show them pictures of Ravi, my son. My lines are open around the clock to those who want to talk on the phone. The numbers? 5229486 and 5223105.

Every first Sunday there is a Fellowship Meeting. We are also trying to get pharmaceutical companies to donate insulin at a lower rate for poor patients.

Injections are disposable and a child can be taught to inject himself as early as 4 years. Yet I am perturbed about the fact that parents are so worried about impending blindness, heart disease, amputated feet, kidney failure, that they stress themselves and their children overly much. I grew up unconcerned because I was shielded from the knowledge of complications.

After all these years. It was only in April 1999 that I had a frightening incident. Richie, now 57, and area manager of institutional services in German Remedies, had gone off to a meeting in Dadar, and Ravi was out of Mumbai, so I decided to go to Mahim to do my hair in readiness for a wedding that evening. Hair done, I took a taxi to Sion and then an autorickshaw to Kurla. But when the auto stopped in Kurla I was in a daze. I paid off the driver like a robot, got off and staggered around unseeingly. Luckily someone from the colony found me and I crumpled into their arms. They managed to get me home, washed my face, fed me sugar and Fruity. In the meantime, Richie, who had phoned a couple of times to get no answer, returned in a panic. He rushed me to Raheja Hospital by which time I revived and insisted on going home. Needless to say, the evening found me at the wedding.

Richie and Ravi are possessive and protective about me. Wherever we are, in church or at a party, one or the other is forever looking at me or touching my hand to see that I'm all right. "How lucky you are," say our friends. "They love you so much." I count my blessings.

Yes, by the grace of God I am fit. 50 years old. 5 ft 4". 60 kilos. Content and cheery. I take my insulin injections as matter-of-factly as you brush your teeth. Diabetes has not stopped me from doing whatever my heart desires, including indulging in the occasional dessert.