NO. OF DAYS CARED FOR : 2 YEARS 2 MONTHS

NO. OF DAYS CARED FOR : 191

Aged 70 years, Krishnakumari was a very poor widow and a destitute. She was the priestess in a temple, after her husband who was the temple priest died a while back. They had no children. They had looked after many a needy person in their lifetime and as a result, the entire community is shared the burden of looking after her during this traumatic period of her life. She lives in a room provided by a family free of cost. Others bear all the expenses for travel, medicine, food etc.

About two years back, Krishnakumari noticed a small ulcer in the inner part of her left cheek. She consulted a doctor who suspected that it was cancerous and referred her to a cancer hospital. Her teeth were extracted and radiation given but to no avail. She was taken to another private radiation centre for treatment and her condition seemed to improve. By this time though, the ulcer had opened as a fistula to the outer cheek. She was referred to DEAN Foundation with advanced cancer of the left cheek on 1 March 2007 . She had swelling of the left part of her face, discharge from the mouth and ulcers. She was unable to open her mouth, speak or eat and drink. She was in excruciating pain. The DEAN Foundation team visited her and a detailed history was taken. She was then thoroughly examined. There were three ulcers on her left cheek of which one had dead yellow tissue. Saliva and pus were dripping from these ulcers. The left cheek and left eye were swollen and inflamed. The nurses cleaned and dressed the ulcers and the doctor gave her morphine tablets for pain relief along with other supportive drugs. This gave her pain relief enabling her to cope with the ravages of the disease . She was under the care of DEAN Foundation for 191 days. Patients like Mrs. Krishnakumari are taken care of by DEAN Foundation with financial support from individuals, Corporates and Trusts. Every bit of financial aid that comes in, makes a world of difference.

NO. OF DAYS CARED FOR : 151

Aged 60 years, Munusamy was from a poor socio-economic background. He had not been earning for about four months due to his illness (cancer of the scrotum). His wife is a flower vendor. His son, who is an autodriver, supports him. Fortunately, they have a one-roomed hut to call their own. Munusamy noticed a painful lump in the scrotum 3 years ago.  After some unsuccessful treatment by local doctors, he was referred to a large hospital, where he was found to have cancer of the urethra. This had invaded the scrotal skin and made a huge ulcer with a large pocket of pus discharging through sinuses. 

DEAN Foundation's Palliative Care team visited him, and recorded the history of the disease. After examination, the ulcer, which was filled with pus and dead tissue, was cleaned. The fungating, foul-smelling ulcer required a special type of dressing to allow for maximum comfort even while mobile. Morphine tablets, antibiotics, antiemetics, vitamins, etc. were given to combat the severe pain and other discomfort. He was given IV drips occasionally to counter the weakening effect of the disease. He expired on 17 March 2007.

NO. OF DAYS CARED FOR : 191

Aged 14 years, Suchitra was a very sweet young girl. She lived in a thatched hut, which had no electricity, with her mother, an elder brother and elder sister; both daily wage earners. Her father had died of diabetes. When Suchithra developed bone cancer her mother had to stop working, to attend to her daughter's medical needs.

One day, Suchitra fractured her left thigh bone on falling down. Not realizing that it was cancer which caused this injury they promptly went to a local native osteopath, who didn't diagnose the disease. He applied some oil and herbal medicine and put her leg in a cast/bandage. They were asked to return but could not make it to the doctor.  So they themselves opened the dressing and to their shock found that there was a swelling and an ulcer and that the thigh was distorted and bent. Fearing that something serious had happened they rushed to a very large government hospital. She was admitted and investigations done which established the diagnosis as a malignant bone tumor (technically known as Osteogenic Sarcoma). This had caused the fracture, ulcer and the deformity of the thigh. It was too advanced for any curative treatment and so they dressed the ulcer and applied Plaster of Paris support (splint) to prevent further pain and damage at the fracture site. The doctors advised amputation which she refused when she was told that it wouldn't stop the spread of the disease. They sent her home saying that curative treatment was impossible due to the advanced nature of the disease.

That's when DEAN Foundation entered Suchitra's world. For the initial examination, the DEAN Foundation team opened the plaster casts and inspected the limb. There was a huge swelling on the knee and the thigh was bent and deformed. There was an infected ulcer on the front of the knee (2"x2") and another small one nearby. Movement of the leg was very painful. The heel was very tender due to pressure and weight of the leg falling on the heel. The team cleaned and dressed the ulcers with ointment and put back the plastic casts. Her liver was enlarged and palpable. To control her fever, pain and headache, antibiotics, painkillers, (particularly morphine injection and tablets), some steroids and intravenous fluids, anti-emetics and some vitamins were given. Horlicks, fruits, mattress and ice cream were also taken as a special treat. Home visits were made every alternate day. DEAN Foundation also entertained her by taking their pet monkey to play with her. She enjoyed the visits very much. With the support of Rotary Club members a theatre was arranged and few vacant rows reserved for viewing a Tamil movie, something she hadn't done ever since she had become ill. This was followed by a visit to the beach and dinner at a restaurant, all on a stretcher. A few weeks later, Suchitra passed away peacefully.

 

NO. OF DAYS CARED FOR : 44

Kavitha was a 29 year old housewife. She would have celebrated her first wedding anniversary soon. But life had other plans in store for her. Pregnant within a month of her wedding, she was diagnosed with end-stage cancer. Her husband accused her parents of having foisted a dying girl on him and declared that he was getting out of the marriage. The deserted wife now chose to go ahead with the pregnancy against all medical advice. She wanted her child to live even if she no longer mattered. Unfortunately she delivered a stillborn child at the eighth month. By this time, the malignancy was raging and Kavitha was in great physical pain. Kavitha slipped into a deep depression, unable to come to terms with her agony both physical and mental.

Our medical team visited her at home and provided nursing care as well as pain-alleviating treatment. She looked forward to their visits, especially that of the counsellor. Over this period, she was able to open up and express herself - her pain at her husband's behavior, her strong pride and affection for her understanding family and her own reactions to her illness. Gradually, she came to terms with her illness and began to accept its inevitability. Kavitha is no longer with us. We believe that with the active help and support of her parents and siblings, DEAN Foundation was able to care for her and alleviate her pain and discomfort during her last few weeks at home.

NO. OF DAYS CARED FOR : 183

Ramu, a 25-year-old carpenter, suffering from a rare progressive disease named Richter's disease for the past 10 years of his life, was referred to our institution. The first thing that struck the team on their initial visit to Ramu's home was the fact that his skin was stuck to the board of the bench he was lying on. There were severe painful contractures of all the joints of the limbs and extensive skin lesions. 

Ramu needed dressing from top to toe. The team had to carefully and gently release his frame and dress the skin. We then provided him with a water bed, a mattress, sheets, tubes of ointment and regular dressing and medication. Bedridden for 3 years his only support was his widowed mother, an ayah earning Rs.500 a month. So DEAN Foundation helped out with food as well. Regular dressings were done and medicines prescribed. Ramu needed to be admitted for institutional care as even for his daily ablutions he had to depend on his mother. He used to control his bowels and wait for his mother to return from work! At his sad plight, DEAN Foundation stopped his mother from going to work and paid her the monthly salary so that all her energies could be directed to caring for her dying son.

NO. OF DAYS CARED FOR : 2 YEARS 9 MONTHS

Mary hailed from Chennai. Her family consists of her two sons one of whom was a security personnel. The other son was a sales man. Three of her sons died during her lifetime. Her four daughters were married and living separately. Mary is 85 years old and sustained a fracture of the left hip (neck of femur). She also had bilateral immature cataract and hypertension. She was a very bold person with a positive attitude to life and its vagaries. She had fallen down about 3 years earlier, causing a fracture in the upper portion of the thigh bone. Surgery was not feasible due to her age. Traction treatment was given though. There was a shortening of the left lower limb. She had swelling of the left leg and pain on movement and was unable to stand without support, let alone walk. She had acute pain when she tried to move for which she was given medications. Her Blood Pressure was above normal. Under DEAN Foundation's treatment she has become normal and stable.

NO. OF DAYS CARED FOR : 10 MONTHS AND 12 DAYS

Malini was a lovely little girl, very cute and fair. Unfortunately, she was an orphan with cerebral palsy. She was looked after by the Missionaries of Charity for a while. A Physics teacher who was volunteering at the home for a few months took pity on this girl. She resigned her job, legally adopted Malini as her daughter, and tended to her like her own daughter. 

Malini was congenitally brain damaged; her physical growth was stunted and her mental growth was retarded. She was unable to move her body and her eyes were squinted. Her vision was 25% of the normal vision. Saliva dripped out of her mouth constantly. Her mouth was very wet resulting in mild fungal infection. She could not swallow as her throat muscles were paralysed. Food and fluids were given via a naso-gastric tube (Ryles Tube). Her lungs were very weak and full of phlegm which needed to be suctioned out continually. Nebuliser helped ease her lung congestion and consequent breathlessness. Due to under development of the brain the limbs had become very stiff, rigid and hence they were all contracted. The neck, on the other hand, was flaccid; it tended to hang to one or the other side. She was on physiotherapy. Malini developed Aspiration Pneumonia which continued in spite of treatment. She was anaemic and hence had mild swelling of the feet. She recognised her foster mother and cried or made a particular noise to catch her attention. 

The Team consisting of a doctor, a nurse and a volunteer visited her. We took a detailed case history and went through her medical records meticulously. We then examined her and recorded all the findings. The head (skull and brain) was very small; lungs were very noisy on examination. Muscles of limbs and body were wasted (not developed) due to disease atrophy. Suctioning, Ryles Tube management and complete nursing care were done. Her foster mother was trained to do suction and taught the nuances of nursing care. We counseled and encouraged her to carry on this difficult responsibility.

*All the names of Patients have been changed for confidentiality