The Auspicious "Sakalavadhyam" Crescendo Plays for Anna

In South India, Sakalavadhyam is a no-holds-barred, all-instruments crescendo, that plays at the most auspicious moment in a religious ceremony.  So at a wedding, the Sakalavadhyam will be played at the time the “Tali” / “Mangalsutra” is tied. Normally, as the priest chants the blessing shlokas, someone on the bride’s side, normally her mother’s brother (mama), will signal the band that the critical moment will be in a few seconds. Then, just as the groom starts to place the Mangalasutra around the bride's neck, the same mama will beat an imaginary drum in the air with his index finger.  And the all-instruments crescendo will start! Loud. Fast. Vibrant. Building pace and rhythm till the mandatory 3 knots are tied. 

Why am I telling you about a Sakalavadhyam? And what does it have to do with Anna and his diseases?  Well……here goes the tale…….

A couple of days ago, I went to visit him in the early evening.  It was raining cats and dogs. When I reached his flat, he was sitting under the awning of the rear courtyard, watching the downpour.

As usual, I said “Hi Anna!” and asked him if he was enjoying the rain.  

He smiled, and said “Yes”.

Again, as usual, I asked, “Anna, have you done potty today?”

Anna said “No.  How long has it been?”

“Four days Anna. If you don’t do it today, then instead of taking you to the mall, I will have to take you to the hospital for an enema”.

Till now, I have been able to avoid enemas for Anna.  Till now, whenever I have threatened to take him for an enema, potty has happened in 12 hours.

So Anna says, “It is truly an auspicious occasion when I do potty”.

I smile.

He then adds, with a big grin, “All we need to complete the auspicious occasion is to play the Sakalavadhyam!!

We laugh.

He is right.  The days he does potty, I raise my hands in the air and say “Yay!”

Playing the Sakalavadhyam is far more dramatic.  Great idea Anna!  Don’t think religious people will understand tho’.  It doesn’t matter.  Potty and Sakalavadhyam do, I hope.  And they shall be forever linked in my mind. 

Of Pills, And Pill Dilemmas

Just pill paraphernalia
Pills segregated into zip lock bags,
pill boxes, sachets, bottles, pill cutter

I am 87 years old. I have Parkinson’s Disease, mild dementia, diplopia and postprandial hypotension. And hence, in addition to ingesting food to keep my body running, I also ingest a large number of pills.  Approximately, 15 different ones every day.  For all my doctors can do, is to delay the relentless march of degenerative diseases and manage symptoms with medication.

Pills manage the symptoms of my diseases, for there is no cure.  Pills not just to manage the symptoms of the diseases but also to counteract the effects of some pills themselves.  So it is ironic that I take pills to manage the effect of other pills.

Every week, my daughter, fills pill boxes with the week’s medication.  My attendant ensures that I take my pills at fixed times. But there are times when I am disoriented, or hallucinating, or nauseous, or too sleepy to swallow, and yet these dreaded pills & capsules need to be swallowed. Often I am cajoled to take them, and less often forced.

Sure I have the choice to take the critical medication i.e. Carbidopa/Levidopa and the option to not take the non-critical medication i.e. Vertin 24. And yes, this is the flexibility that I / my attendant needs to have (after consulting my daughter, of course).  This is a decision, given my illnesses, I cannot make or implement on my own.  For, to me most of my pills look alike.  The independence and dignity that comes with being in charge of my medication, has been taken away from me.

My morning pills with one large round white one missing!

By and large, all pills are white, small, and with writing that cannot be read by the naked eye.  And yet the Pharmaceutical industry expects my 87 year old eyes to read what is embossed on a tiny pill?  Even with a magnifying glass it is almost impossible to determine which pill is which. And just imagine how difficult it is for my daughter to tell my attendant to give me the "2^nd largest white pill with a cross groove on one side”, or some such hugely descriptive, non-precise method of identifying medication.

There is a simple solution.  If the major Pharmaceutical companies got together, they should be able vary size, shape and colour of pills meant for the elderly.  It would be so simple for anyone, including me, to identify the “big baby blue round” pill as Syndopa CR, or the “little glossy orange round” pill as Ecosporin.  It would be easier for my daughter to describe pills and for my attendant to identify pills.  It would be easier for my daughter to fill pill boxes.

So why has the Pharma industry not done this?  Surely there can’t be that many pills for common diseases of the elderly!  And hopefully, the change in the manufacturing process will not be so dramatic as to warrant an increase in the price of medication. And, yes, getting FDA approvals may be an issue, but can you lobby on behalf of a large population of senior citizens?  I am sure you can.  I am sure you can let us retain the dignity of being responsible for our own medication.  I am sure you can.  But, will you?

For my father whom I see struggle to identify which pill is which, three times a day, every day!

It worries him, it frustrates him, & it makes him feel he is not in control.

All the elderly want is the dignity of the independence and control that they had in their youth.