Chapter 9
Aysha
@matwamango
Part 9
Recap-Kanya speaks to Radha about giving Ranbir a second chance and not let love slip through her fingers again. Ranbir picks Kanya's mobile and finds out Kanya has a heart condition. Pooja makes Ranbir promise not to tell Kanya and to look after her. Ranbir takes Kanya home early and rearranges his diary to fit Kanya round his busy schedule.
Ranbir wakes up takes his wash comes out looking Hot in his casual wear with a tight T-shirt and Jeans. He faxed paperwork to his office in India and had invoices sent through to California about a new endorsement idea on gel for men a new product being lined up for testing. After all that he made sure his new electronic range that they were doing a proto type in Japan was coming on OK. It was supposed to be a craze there where the computer has functions all rolled into one but poceket sized unfortunately the storage wasn't too good so they were still working on that. He called around for Kanyas doctors to make sure he knew how bad Kanya's condition was but due to patient confidentiality he couldn't get much out of the stupid doctor. So Ranbir decided he would pose as Kanya's fiance. It wouldn't be hard convincing Kanya as he'd use Radha as an excuse.
Kanya got up finally and headed to the bathroom. Ranbir went down to order their breakfast and make some calls to Pooja who told Ranbir that she has no idea the extent of Kanya's condition as Kanya didn't want her sister to know until things got really bad. Ranbir thought if her own sister hasn't got a clue how could he help her. He didn't want anyone to die before their time before even fighting for their life but from what he saw of Kanya she already gave up on life and was too busy trying to enjoy it. He was never so into Kanya back then but she definately made him see so much strength and goodness in her to know she was using her time for a good cause but at the time it was stupid. He had to know why she wasn't getting treated.
Breakfast came up and Kanya was out by then looking better than ever.. She looked at Ranbir who was fiddling abut with his mobile making Kanya a little uneasy. She never saw Ranbir so out of it before. She gave him his coffee and took her Orange juice and started to gulp it in one go. She ate her Pancaks with syrup and strwaberry jam while Ranbir stuck to his toast. Ranbir finally broke the silence wanting to know what Kanya was upto?
K-Nothing much going to the children's centre not far from here and then relax i guess.
R-I thought U were suppose to see someone at this hospital. U mentioned it to Pooja.
K-Thats some other day.
R-U said today on the phone yesturday. I don't care what Ur into but i'm going there later on to meet with some company to do with pharmaceuticals i'd drop U off and do my thing and meet up later on.
K-But!
R-No buts its final. Stop sulking.
K-Am not.
R-R 2.
K-No i'm not.
R-We R not playing this game come on. I got nothing better to do with my time so i'll join U today if U don't mind.
K-U'll get bored.
R-How do U know i'll get bored? I might surprise U.
K-Well see about that hey come on if your going to go.
They head out and visit the centre where there R loads of kids wth dissabilities and KAnya goes and gives them a hug. They all know Kanya as she's been there the past 3 days spending hours there. She starts mucking in with painting activities that the children were doing. Ranbir just stood there thinking what had he gotten himself into. Kids everywhere. That too disables ones he didn't have a clue what to do with a normal kid he had to work with autistic kids along with once that looked like they were going mental.
K-Come on Ranbir. Its fun just be normal and not your usual bossy self.
R-I'm not bissy just assertive.
K-Keep telling yourself that.
This one kid named Sean came round and tugged on Ranbir's shirt. Ranbir just followed the kids aimlessly not knowing full stop what to do. He took Kanyas advice and just started painting with the child. Sean was smiling. Ranbir actually started enjoying himself letting himself ease into everything. He started to help Sean wash his hands and his own but looked at his expensive Armani shirt that had paint on it. For once he wasn't bothered. Ranbir saw a sports section and played a little football with the hyperactive kids. Kanya had noticed a different side to Ranbir. A playful side compared to his always stern look there was a soft look she found totally attracting her towards Ranbir.
Ranbir saw Kanya started doing some throwing and catching for sports and all the kids were smiling at how lame Kanya was and each wanting to show her how it was really done. Kanya started getting the snacks ready which was milk and a piece of fruit. The children had to sit round the table in irder to have their snacks. Ranbir saw Ravi wouldn't drink any milk so he got a carton and started drinking as well as encouraging Ravi. It was finally time to go as the children's parent came to collect their child from th centre and Kanya left with Ranbir to go to the hospital.
Ranbir had a doctor friend that was working in the same place and dropped Kanya off. He made sure he was seen with Kanya and let the guy know that he was KAnya's fiance but they were keeping it all hush hush as it was early days. Her doctor was Keith Matthews. He had got Kanya's file out and placed them on the table while Ranbir had sneaky look at them.
Hypertrophic cardiomyopathy
Associated symptoms
The clinical course of HCM is variable. Many patients are asymptomatic or mildly symptomatic. The symptoms of HCM include dyspnea (shortness of breath), chest pain (sometimes known as angina), uncomfortable awareness of the heart beat (palpitations), lightheadedness, fatigue, fainting (called syncope) and sudden cardiac death. Dyspnea is largely due to increased stiffness of the left ventricle, which impairs filling of the ventricles and leads to elevated pressure in the left ventricle and left atrium. Symptoms are not closely related to the presence or severity of an outflow tract gradient.[20] Often, symptoms mimic those of congestive heart failure (esp. activity intolerance & dyspnea), but it must be noted that treatment is very different. To treat with diuretics (a mainstay of CHF treatment) will exacerbate symptoms in hypertrophic cardiomyopathy by decreasing ventricular volume and increasing outflow resistance.
Risk factors for sudden death in individuals with HCM include a young age at first diagnosis (age < 30 years), an episode of aborted sudden death, a family history of HCM with sudden death of relatives, specific mutations in the genes encoding for troponin T and myosin, sustained supraventricular or ventricular tachycardia, ventricular septal wall thickness over 3cm, hypotensive response to exercise, and bradyarrhythmias (slow rhythms of the heart.)
Treatment
In all patients with hypertrophic cardiomyopathy risk stratification is essential to attempt to ascertain which patients are at risk for sudden cardiac death.In those patients deemed to be at high risk the benefits and infrequent complications of defibrillator therapy are discussed; devices have been implanted in as many as 15% of patients at HCM centers. Treatment of symptoms of obstructive HCM is directed towards decreasing the left ventricular outflow tract gradient and symptoms of dyspnea, chest pain and syncope. Medical therapy is successful in the majority of patients. The first medication that is routinely used is a beta-blocker (metoprolol, atenolol, bisoprolol, propranolol).If symptoms and gradient persist, disopyramide may be added to the beta-blocker.Alternately a calcium channel blocker such as verapamil may be substituted for a beta blocker. It should be stressed that most patients' symptoms may be managed medically without needing to resort to inteventions such as surgical septal myectomy, alcohol septal ablation or pacing. Severe symptoms in non-obstructive HCM may actually be more difficult to treat because there is no obvious target (obstruction) to treat. Medical therapy with verapamil and beta-blockade may improve symptoms. Diuretics should be avoided, as they reduce the intravascular volume of blood, decreasing the amount of blood available to distend the left ventricular outflow tract, leading to an increase in the obstruction to the outflow of blood in the left ventricle
Ventricular pacing
The use of a pacemaker has been advocated in a subset of individuals, in order to cause asynchronous contraction of the left ventricle. This form of treatment has been shown to provide less relief of symptoms and less of a reduction in the left ventricular outflow tract gradient when compared to surgical myectomy. Kanya won't allow it.
Kanya a high risk. Refusal to take treatment. Prescribed drugs given.
Ranbir by then sees Matthews coming and shuts the file quickly and see's Kanya already in tears. His heart wrenched for her. Why would she refuse. If the stupid operation would save her lfe why would she refuse? He didn't care about the promise he made to Pooja no way no how. He would make her have the operation before it was too late.
Matthews looked at Ranbir. Knowing full well why Ranbir looked like he lost colour in his face.
Dr.M-U ok?
R-Yes.
Dr.M-So U going to put some sense into that crazy girl.
R-Will try.
Dr.M-Good she needs someone there for her. I wanted to call her sister but she wouldn't have it. Its like she doesn't want to live.
R-Thanks bro.
Dr.M-Make sure nobody knows or its my neck.
R-See Ya bro. We need to meet up sometime for a drink.
Dr.M-U owe me one.
Keith goes back to see Kanya who comes out and wipes her tears. She see's Ranbir and tries to cheer up but Ranbir doesn't have any of it but doesn't reveal to Kanya he knows the truth.
They walk out silently in his car while the chauffeur drives. Kanya looks st Ranbir.
K-U know don't U.
R-Know what?
K-It was all a ruse. I know U Nanda. Go on say it.
R-Say what?
K-I'm sorry the works thats how it works now.
R-Look Kanya i think U R a little crazy and i have no idea what U R on about.
K-Fine.
R-Yes I know i snneaked a peek in your files while the doctor was talking to U. I'm a business man. So curiosity got the better of me. As for feeling sorry i think U've been hit hard and trying to ignore your problems by using all your energy into something noble. I think everyday i'm seeing a new U and really don't know how i'm going to not rave on about U.
K-So U don't pity....
R-U can never make me feel pity for U I know U a lot better and would never dare it. One thing for sure i won't treat U any different. Got that. If we have fights i'm not letting U win.
K-Ranbir U R an enigma U know.
R-Well U miss Secretive need to let loved ones in not push them aside. It won't hurt any less.
matwamango2008-08-11 11:18:58
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Comments (8)
Nice Update. Hopefully Ranbir makes Kanya to see sense and get the operation done. Next time make a longer update. Keep up the good work.
16 years ago
pls continue soon i loved the update..
16 years ago
great update continue soon!
16 years ago
thanks for the pm it was amazing plzzzzzzzzzzzzzzzz continue reli soon
16 years ago
WHy would Kanya refuse tretment maybe with Ranbir their she'll say yes And I can't wait to see how Radha reacts when Ranbir poses as Kanya's fiancee Awesome update Plzzzzzzzzzzzzzzzzz continue sooooooooooooon
16 years ago
oooh once again a brilliant part...! and wow kya bemaari hain.. oo my sherr has to put some sense into her!! anyhow excellent part di and continue soooon!
16 years ago
Reli good but short plz update soon and make it longer and dont kill kanya!!!
16 years ago
gr8 part thnx for the info continue soon
16 years ago