NO OF DAYS CARED FOR : 2 YEARS 2 MONTHS

NO. OF DAYS CARED FOR : 191

Aged 70 years is 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 sharing 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 was 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 March 1, 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 ulcer 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 continues to be under the care of DEAN Foundation. 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

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 discomforts . Occasionally, he was given IV drips to counter the weakening effect of the disease.  On March 17, 2007 he expired.

NO. OF DAYS CARED FOR : 191

Age 14 years, was a very sweet young girl.  She lived in a thatched hut, which has 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 Osteogeni \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's 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 and anti-vomiting drugs 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 years 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 physical and mental.

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. 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.

NO OF DAYS CARED FOR : 183

Lawrence was a 25 year old carpenter suffering from a rare progressive disease named Richter's disease for the past 10 years, was referred to our institution. On the first visit to Ramu's home, the first thing that struck the team 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. They had to carefully dress the skin and release his frame gently. We then provided a water bed, a mattress, sheets, tubes of ointment and regular dressing and medication. Bedridden for the past 3 years his only support is his widowed mother, an ayah earning Rs.500 a month. So DEAN Foundation helped out with food as well. The team provided a waterbed, mattress and linen. Regular dressings are 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. So 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 the totol monthly cost of her salary to her, so that all her energies could be directed to caring for he dying son.

CARED FOR : 2 YEARS 9 MONTHS

Hails from Chennai. Her family consists of her two sons one of whom is a security personnel. The other son is a sales man. Three of her sons died during her lifetime. Her four daughters are married and living separately. Mary is 85 year old and sustained a fracture of the left hip (neck of femur). She also has bilateral immature cataract and hypertension. She is a very bold person with a positive attitude to life and its vagaries . She fell down about 3 years ago, causing the fracture in the upper portion of the thigh bone, but operative (surgical) treatment was not feasible due to her age. Traction treatment was given though. There is a shortening of the (L) Lower limb. She had swelling of this leg and pain on movement and is unable to stand without support, let alone walk. She has acute pain when she tries to move. Her Blood Pressure was 190/110mm of hg three years ago. Under DEAN Foundation's treatment it has become normal and stable.

CARED FOR 10 MONTHS AND 12 DAYS

Malini is a lovely little girl, very cute and fair and poor. Unfortunately, she is an orphan with cerebral palsy. She was looked after by the Missionaries of Charity for sometime. 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 is congenitally brain damaged; her physical growth is stunted and her mental growth is retarded. She is unable to move her body and her eyes are squinted. Her vision is 25% of the normal vision. Saliva drips out of her mouth constantly. Her mouth is very wet resulting in mild fungal infection. She cannot swallow as her muscles are paralysed. Food and fluids are given via a naso-gastric tube (Ryles Tube). Her lungs are very weak and full of phlegm which needs to be suctioned out continually. Nebuliser helps ease her lung congestion and consequent breathlessness. Due to under development of the brain the limbs become very stiff, rigid and hence they are all contracted. The neck, on the other hand, is flaccid; it tends to hang to one or the other side. She is on physiotherapy. Malini developed Aspiration Pneumonia which continues in spite of treatment. She is anaemic and hence has mild swelling of the feet. She recognises her foster mother and cries or makes 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