First
the good news. Multiple sources have confirmed that the condition of
Tamil Nadu Chief Minister J Jayalalithaa has improved significantly in
the past 48 hours and she has been off the ventilator during the day.
She is on respiratory support only for some time in the night as a
precautionary measure.
The CM
however, still continues to be in the Critical Care unit at Apollo
Hospital. Apart from antibiotics, her treatment includes medication to
help her in breathing and also nebulisation.
The CM
however, still continues to be in the Critical Care unit at Apollo
Hospital. Apart from antibiotics, her treatment includes medication to
help her in breathing and also nebulisation.
"We are not so worried any more. We are a lot more relieved," said a source who is aware of Jayalalithaa's treatment
AIADMK leaders who have access to information from inside
the Critical Care unit at Apollo Hospitals also confirm that
Jayalalithaa is conscious. "She is also aware of what is happening
around her," says CR Saraswathi, spokesperson of the AIADMK.
The
next step would be to slowly move her away from the bed, where she has
been for more than three weeks now, and make her sit on a chair. Passive
physiotherapy that Apollo's medical bulletins say the CM is undergoing,
is part of the treatment to help her do this.
But despite the improvement, Apollo Hospital and the Tamil
Nadu government are fighting shy of announcing it to the world. That is
because experience shows that an ARDS (Acute Respiratory Distress
Syndrome) patient even when he or she shows dramatic improvement, is
deemed vulnerable.
ARDS is a life-threatening medical
condition, characterised by inflammation in the lungs. ARDS is triggered
by pneumonia and sepsis, one of the reasons why intensivist Dr Richard
Beale, an experienced investigator in the field of sepsis, ARDS and
clinical nutrition, was flown in from London to treat the CM. An
intensivist by definition is a doctor who specialises in treating
critically-ill patients.
Experts point out that ARDS is
known to have a high mortality of up to 50 percent. When it is
accompanied with other ailments, it only complicates the issue and the
treatment. In Jayalalithaa's case, her diabetes, hypertension and
cellulitis — ailments mentioned in her 2014 bail plea at the Karnataka
High court — were factors the team of doctors took into account.
"If
it was a 30-year-old patient, the body recovers that much faster. Since
the CM is 68, she needs that much more care," said a source.
Given
her medical history, doctors are of the opinion that her recovery is
remarkable. But they would want to monitor her for some more time as
with her diabetes, the risk of secondary infections always exists.
Hospitals,
especially Intensive Care Units, are a more risky place for critical
patients. That is because hospitals are teeming with virulent bacteria.
If an infection is contracted from the community, it requires a basic
antibiotic for treatment. But if a patient contracts an infection from
the ICU, bacteria is likely to be resistant to basic antibiotics and
doctors have to prescribe high-end antibiotics. Such potent antibiotics
in high dosage can lead to side effects like diarrhea, renal failure,
myopathy and neuropathy.
In order to ensure against any
such complication, Jayalalithaa has been kept in a part of the Critical
Care unit where no other patient is admitted. This means getting a
secondary infection is out of the question.
It is
expected that if the CM continues the same pace of progress, she could
be out of hospital soon. However, she would still need significant rest,
care and physiotherapy for at least two months. It is not clear whether
Apollo doctors would prefer Jayalalithaa to rest under their
supervision at the hospital or send her home by the end of October.
Doctors,
who are visibly relieved now, were not in the same state of mind
earlier this week. In fact, the hospital in consultation with Dr Richard
Beale and the team of specialists from AIIMS had reportedly decided
that if there is a further deterioration in Jayalalithaa's health, she
will be shifted to either AIIMS in New Delhi or to a hospital abroad.
That possibility has now been firmly ruled out. "She will come out like a tigress," said a source.
thanks findia
