Last Days at Home

During the final few weeks, she did experience more chest pains than normal, but these were not uncommon. Importantly, she did not present any other symptoms – no breathing problems, stomach pain, shoulder pain, nausea, vomiting, dizziness, speech problems, headache, pain during urination or passing stool, or sleeplessness – that could be indicative of something more serious.

During her last ten days at home, her BP readings were lower than usual (90-60, her usual was about 110-70), and her pulse much higher (105-110 range, while she usually had a low pulse, in the 50-60 range), but these combinations happen to her occasionally and vanish within a couple of days. While her lower-than-usual BP did puzzle and concern me, I was not alarmed – I was more tuned to being wary of high BP.

Her blood oxygen levels showed some volatility, but most times they showed 95% and above. 151 Sometimes however, it took forever to get the reading on the pulse oximeter, but even this was not unusual for her. 152

For almost a week, her leg pain (sometimes just below the knee, sometimes just above) and neck pain (back of the neck, just above the point where the spinal cord starts) ranged from mild to severe, but these too presented only while she was mobile. She had almost no pain at rest.

With COVID raging all around the city, and hospitals being obvious hotspots, I had to weigh on balance which was a more prudent way forward – wait for a few days for her problems to go away with some simple treatments I was attempting or take her to a hospital and risk COVID exposure.

What further facilitated my decision to keep her at home was the fact that her chest pain had gone away after a couple of days, her leg pain and neck pain seemed to wax and wane, she was hungry all the time, and she had started sleeping really well. Her low blood pressure and high pulse however persisted.

As I kept enquiring her everyday about any problems she had during urination or passing stool, one day, four days before she was hospitalized, she told me that her stool colour had been darker than usual for the previous two weeks. This was a rare delay by someone who reports symptoms almost immediately – she perhaps did not think much about it as there was no accompanying pain.

This was the first time alarm bells went off in my mind. The next day, I checked her stool, and it was dark brown – not red, not black and tarry, but closer to chocolate brown but with normal texture. The immediate thought that ran through my mind was internal bleeding, but I was not sure, as I had been told by doctors that stool with blood would look black and tarry, or if the blood was literally oozing out with the stool, really red.

I took pictures of her stool and sent them to my sister and niece who are both in the medical profession, but it was becoming clear that I had to take her to a doctor and get to the bottom of her symptoms.

I never suspected anemia until very late, and even then only because she was sleeping all the time. 153

A simple blood test at a local hospital revealed she was suffering from severe anemia, almost certainly due to chronic internal bleeding.

Her hemoglobin level was just 4!

She was taken to a prominent hospital in the city, and despite many restrictions and challenges owing to spread of COVID, was fortunate enough to get admitted and attended to immediately.

The Big Sleep <= Last days at home => Fighting till the end



151. Blood oxygen levels can be easily measured at home by pulse oximeters. These small instruments, clipped to a finger for a few seconds indicate oxygen saturation levels, a measure of how much oxygen is available in the hemoglobin. Acceptable levels are in the 95-100% range.

152. On reflection, it now appears that it took even longer than usual for blood oxygen measurement because there was so little blood to measure!

153. I realized I was wrong later. Anemia causes fatigue but not an overdose of sleep. Further reading suggests that anemia is in fact associated with insomnia!


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