A very thirsty Kuvera tells us about his “water problem”
Imagine the scene. Covid-19 is about to hit hard a small village in England and everything will come to a standstill. I am devastated. So what, I hear you say. 184 countries in the world are affected, and why worry about this little place in England? Let me explain.
In 1975 I started life as a house officer at the Lady Ridgeway Hospital. Life was good and Guy Dabrera and I had a happy introduction to “doctoring” from the nurses in ward 9. But nobody knew that Sister P and I had frequent battles over the cold water in the fridge – I rather surreptitiously drank all 3 litre bottles during our 8-hour shifts of duty! But I could not help it. I was becoming increasingly thirsty as the day wore on and needed large amounts of ice-cold water to quench it. I was also having frequent “bathroom“ breaks. I got up once or twice in the night to pass urine and drink cold water. Podi Menike, who used to cook for Sobhani and me often shouted “mahattaya, I can hear water gushing out of the tap - the water cut must be over” (of course in colloquial Sinhala it sounded much better), as half asleep she heard me at it yet again, and thought the nightly water cut was over. Clearly the flow was good. Could this be diabetes mellitus – surely not because my weight was stable, and the Fehling’s test was negative.
I then did what all “clever” doctors do – ignored my symptoms completely as if nothing was wrong and hoped they would pass. But I was compelled to get my symptoms, which by now were severe, investigated in 2004 – believe it or not, 30 years after I first developed them!! I had a near 100% block in my LAD (and this I could ignore only for a year or so because it sounded more life threatening, and possibly couldn’t wait for 30 years!) and had to have angiography. The head of my department, a highly respected Professor of Neuroendocrinology was incredulous when I told him my story which went something like this. I drank about 15 litres of liquid and passed the same amount of urine every day - so, the majority of my waking hours were spent in the bathroom or by the fridge! Just picture it, 15 or more of those litre bottles. I also got up every 1-2 hours in the night to pass copious amounts of urine and drink cold water. I knew all the patient, visitor and staff toilets in our hospital and had actually used most of them. The first thing I did almost obsessively when I went to an unfamiliar place was to find the nearest toilet. Nothing, and believe me nothing, happened before that. I had a bottle of water in my car just in case. Thirst was constant and an extremely uncomfortable symptom and ready access to water was essential. When we left home, I had to be the last to the bathroom, rushing in at the very last minute when all were settled in the car and waiting for me. There also was a persistent discomfort in the lower part of the abdomen because my bladder was constantly full! Long flights were torture unless I could get a bottle of water from the stewards – and then the queue at the toilet. In other words, my life had become severely “hydrocentric” and these symptoms ruled my life.
The water deprivation test was unpleasant. But my dear friends, life became calm (no rushing around looking for toilets), serene (no anxiety about the lack of water) and almost heavenly (peaceful nights of unbroken sleep) after DDAVP spray (synthetic anti-diuretic hormone) was prescribed. Symptoms of cranial diabetes insipidus disappeared with the very first spray. I have a full night’s sleep and I don’t care where the toilets are now! Which brings me back to that small village in England. That is where my DDAVP spray is manufactured.