Like most other folks on dialysis, when I was initially diagnosed with kidney disease, my Blood Pressure (BP) would skyrocket. I was put on a potent cocktail of anti-hypertensives or drugs that would reduce the BP. When I was diagnosed with Left Ventricular Hypertrophy somewhere in late 2005, I was put on Cardivas 6.25 mg twice a day and Ramipril 5 mg once daily. With this my BP nosedived!

I started feeling giddy very often. When I went back to my cardiologist, he said about the BP, "Lower the better!" He did reduce the dose however but the BP would not rise. He asked me not to worry about it. Soon however the giddiness disappeared. It could have been due to something else (dry weight going up, perhaps) or I might have got used to low BPs.

Either way, I continued the drugs because they were good for my heart. Daily nocturnal home hemodialysis also did a world of good to my heart and my Ejection Fraction which had gone down to 30% came back to a healthy 70%!

Coming back to the BP, I often do 80/50 pre-dialysis and 90/60 post dialysis without any symptoms of hypotension. So, I have kind-of got used to low BPs now. I don't have any symptoms purely on account of low BP. When I pull out too much fluid however, I have those symptoms - cramps, giddiness, weakness etc. But not due to my low BP.

I have been a little concerned about this BP though. Is a low BP harmful for my overall health? I have heard from some doctors that they do not take up major surgeries if the BP is too low because of the risk of complications of general anesthesia.

So I talked to my HPS classmate and cardiologist Anuj Kapadia about this. He said that as long as I did not have any symptoms, it was perfectly all right. So, I am going to let this be for now.

The key, I think, is the symptoms. If you are feeling all right, don't do anything about it.

Andhera Pradesh?

Someone on dialysis usually takes a lot of medicines! For the longest time, during life with CKD, I never used a pill box. I had a big plastic box in which I had all my medicines and would take them as per my prescription which was stored in my head. Every now and then, some medicine would finish and then I would call my dad and he would arrange for it to be bought. After a few days, another one would finish and then another call to my dad and that would be arranged as well. Yes, my dad spoils me totally (even at this age!)

At one point, I started ordering medicines for the entire month. I would open this plastic box and then lay out all the remaining strips and then calculate the number of each tablet I needed, write it on a piece of paper and give it to my dad who would have the whole lot brought. Mostly, unless there was a change in prescription or I calculated wrong (which rarely happened!), I would be good until the beginning of the next month.

However, sometimes, I would get delayed in my stock checking exercise and this would result in me running out of a medicine suddenly and then frantic phone calls to my dad.

The first time I saw a pill box being used in India was when my aunt bought one for my grandmother who being diabetic, took a lot of pills as well. She kept forgetting her meds and this helped her never miss her dose. Great idea, I thought!

At Aashayein last year, we gave out pill boxes to all the patients and I took one for myself as well. Ever since then I have been sitting every Sunday morning after my customary visit to Poorna Tiffins and refilling my pill box. It has 21 sections for seven days a week, three compartments for each day - for morning, afternoon and night.

This has helped greatly. It serves two purposes. One, I need to remember or refer to my prescription just once a week while filling. And two, when I am going to run out of a med, I know on Sunday morning itself rather than in the middle of the week and I can make arrangements immediately to get them.

Here is my pill box after I filled out this week's medicines:

This is one question we all must keep asking ourselves. Have I found my calling? Have I found meaning in my life? Am I doing what I really want to do?

Finding your calling really makes you feel good. You look forward to your day. Life becomes a pleasure. Since most of our waking hours are spent working, it is extremely important that we do what we enjoy doing and what we feel satisfied with.

When you are working on something you do not truly love and are working on it simply for the money you are making, life becomes a chore, a burden, something you are doing day after day without really living it.

Your calling does not always have to be something spiritual - a higher good. It can be material. To me, it is doing what you enjoy doing the most. For example, I know that music is Timothy Marthand's calling, developing software is Kartik Thum's calling and painting is Venkateswara Rao's calling.

My calling came to me in the form of an email from Vikram Vuppala with the subject "Request for a brief meeting". Vikram had chanced upon my blog and then sent me an email asking to meet up. At that time, of course, I was firmly into software and had no inkling of how this was going to take over my life. I actually thought I would grow old banging away at the keyboard churning out software code! It started with one small step - informal advice. I slowly started enjoying it so much that I took up a formal role and now am doing this full time.

I often think what my calling would be had I not fallen sick? I feel it would be something to do with food!

There are many people who can go through life without ever finding their calling. That is a real pity. There are some websites that give advice on how to find your true calling. I am not sure that is a good way to do this. I believe that if it is a true calling, it will itself come calling! Like mine did!