Saturday, October 11, 2014


     I believe in reincarnation and I also believe in Law of Karma.I do not have any direct proof for it , though I often come across the situation that leads me to believe that both of them are real. The question that is always asked is ,is it nature or nurtured?The things that we see in different family members occurring , is it due to the simple 'chance' or is it because the environment under which the family members are brought up is same or is it due to some kind of relationships that we develop that continues beyond single life ?(which means is it due to the our karma and it's effects , which causes reincarnation).I often see patients whose spouse also start seeing me if they have lung problems. So I often wonder when I see sick patients , whose spouse also has significant pulmonary or other medical issues.
      The story that I am going to tell is one that is related to the patient in my last blog . The patient that I described had 3 lung cancers at 3 different times and sarcoidosis and then developed breast cancer and died of it.One of these days this patient told me that I was going to see her husband . I had known him for some years as he used to come with her.Now he wanted to see me . He was a 70 years old white male who had significant cough, mainly dry and some shortness of breath. He was getting tired.He had mild cough and had some crackers on physical examination. I did the chest X-ray and then the CT scan . It confirmed that he had pulmonary fibrosis.I had also sent blood for rheumatoid arthritis and some other conditions that can cause the fibrosis. The rheumatoid factor was positive .So he had rheumatoid arthritis and it had caused the fibrosis in the lungs.The breathing test that I did,,showed that the diffusion capacity-how the oxygen is transferred across the lungs in to the blood,was reduced . This was consistent withe the diagnosis of the fibrosis. I sent him to a arthritis specialist and he was started on treatment for the RA.He came to see me in 3 months and was OK but did not look very happy .He had lost some weight and still felt tired. But he had no fever . His appetite was good ,but he was not gaining any weight. I decided to do the Bronchoscopy. Sometimes these patients with the fibrosis and the one that are taking immuno- suppressants ,get atypical infections, like atypical TB.It came back negative. So I decided to do the follow up .He came to see him Had lost more weight and was feeling more fatigued and short of breath.I did the new diffusion capacity .It was not any worse . I had done the Echo cardiogram , to rule out cardiac cause and it was OK. I walked him in our office for 6 minutes,and he did OK. So I was not sure as to the cause of his weight loss. I had asked gastroenterologist to do endoscopy ,colonoscopy to rule out occult cancer and it was negative.So I did not know and he WAS WASTING away. And it struck me .I was surprised that I had not noticed it before. HE was loosing not only weight, but was also loosing the muscle mass. I sent him to neurologist and this time my hunch was correct .He had myopathy, a muscle disease in which his muscles were wasting and as he was loosing the muscle mass he was loosing weight.There was no treatment for his condition.
     In the past he was the one who would help his wife ,when she was short of breath. He was strong and big and had no problems. Now he was himself short of breath and was weak. He could not be of much help.In next less than a year he died .
     So the question that I had was was by any chance that these two were married and both saw me and I had diagnosed  the different conditions , that would lead to death finally.

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