Connect with us

Features

My 18 week ordeal of double trouble

Published

on

by Dr. Lakshman Abeyagunawardene

I thought of writing this article in order to share with readers of the Sunday island newspaper, my recent experience as a patient suffering from two illnesses at the same time. I could describe this period as sheer mental agony as I had to bear the social as well as possible medical consequences of illnesses that plagued me over a prolonged period. Writing newspaper articles in my opinion, is one of the best ways in which at least one section of the community can be educated on health issues.

My professional career called for frequent lectures to be given to a wide variety of target audiences ranging from post graduate doctors preparing for examinations in Community Medicine and medical students, to humble village folks like new settlers in Mahaweli areas in the late seventies and early eighties. I always made it a point to emphasize the fact that the occurrence of disease is not only a biological phenomenon but a social one as well, a point that I picked up in my post graduate training and which has got etched in my mind through conviction. Subsequent developments as described later, led to the worst period when I was confined to the guest room in my home as I was not permitted even to climb the stairs that led to my comfortable bedroom upstairs. The move which was to last several weeks, involved shifting many personal items which were indispensable for day to day life.

It all began with a rash on the right side of my face involving the nose, cheek and areas around the eye. Although I suspected Herpes Zoster (commonly called Shingles) particularly because I recalled a bout of chicken pox over 50 years ago, soon after my Internship while working at the Colombo South Hospital. Although it is a self-limiting disease, I decided to seek medical attention because as far as possible, I try to stay away from self treatment except for very minor illnesses. Herpes Zoster is a viral infection that occurs with reactivation of the varicella –zoster virus that had been lying dormant in certain nerves for many years. Symptoms typically start with pain and a rash along the affected path of the nerve, followed two-three days later by a vesicular eruption.

With a 24- hour curfew in force, that weekend happened to be one where all “Channel Centres” were deserted. I therefore decided to go to the Emergency Room (ER) of Sri Jayewardenepura Hospital (SJPH) where the doctor confirmed my diagnosis and prescribed an anti viral drug called Acyclovir, pain killers Gabapentin and Panadeine. I was also referred to the Ophthalmic (Eye) Ward because my right eye seemed to be affected. Fortunately, the Senior Registrar on duty ruled out any involvement of the eye and said that my vision was normal. This was confirmed by the Consultant Ophthalmologist (Eye Surgeon) whom I later channeled as I was very concerned about my eyesight. As always, I diligently took all prescribed drugs but at the end of two weeks, I unfortunately developed Postherpetic Neuralgia (PHN) which is a known complication of Shingles.

I had heard of Post Herpetic Neuralgia (PHN) but never imagined that it was so painful. In general, all pain due to Neuralgia is very painful, difficult to treat and lasts a long time. I realized through experience, what it is like to be the sufferer rather than a doctor treating a patient.

Quite apart from my present illness, I was having spells of dizziness off and on, which I attributed to Gabapentin which is known to cause such side effects. On one such occasion it was so bad that I was about to fall. Fortunately, we were in our bedroom and my wife was at hand to prevent the fall and led me to my bed. My wife was quite helpless in such situations and called my son who lived close by and called for an ambulance. My son and the ambulance arrived almost simultaneously, but as I had not lost consciousness, I was able to explain to the paramedics that I was on Gabapentin and did not need hospitalization. Whether or not the paramedics understood what I said, they withdrew mainly because their patient was a doctor and knew what he was doing!

On a subsequent occasion, I had a syncopal (fainting) attack while I was having breakfast and my wife again had to go through the usual motions of calling my son and the ambulance. This time, I had lost consciousness and when I was back to normal, I myself thought that it could not have been due to the Gabapentin. Therefore, I didn’t resist hospitalization as I previously did. These two episodes clearly showed the importance of family support. I dread to think what a bachelor living alone would have done under such circumstances.

For a number of years, I have been having an irregular pulse. This drew my attention when it continued and my cardiologist referred me to a Cardiologist and Electrophysiologist who put me on what is called a Holter Monitor. After reading the report he said that I have a few extra systoles (ectopic beats) and that accounts for the irregular pulse. He further said that it is normal for some people and I needed no treatment. Mind you, that was about six years ago.

This time round when I lost consciousness, to cut a long story short, after the necessary referrals were made, the EEG that my Neurologist ordered showed some changes and my doctors decided that the origins of the changes had nothing to do with my nervous system but that its origins were cardiac (meaning that the origin of the EEG changes could be due to some defective movement of electrical impulses in the heart). So, I went back to my cardiologist who referred me to a Cardiologist and Electrphysiologist. The latter put me on a Holter Monitor again. Based on the history and the new Holter Monitor reading, he recommended a Pacemaker. I readily complied and he implanted a Permanent Pacemaker on September 8. Sutures were removed after about a week and I had to attend a “Programming Session” on September 27. The doctor reported that the surgical wound was clean and that the whole procedure was successful. The implantation of the pacemaker did not bother me at all, but the anxiety of anyone facing a surgical operation was telling on me.

I had to go through the procedure of pacemaker implantation while the pain in my right eye persisted. It was after my fainting episode and pacemaker implantation was recommended that I was debarred from climbing stairs. I was confined to the Guest Room and this is where my agony really started. My wife did not allow me to even go to the living room which was just three steps below. Towards the latter stages, I watched news on the small TV in the kitchen. I had to be satisfied with the laptop computer that my son brought. But it was a far cry from the Desktop I was used to. I missed my weekly shot of an alcoholic drink! I had not taken even a beer since the beginning of June.

I think I had a turnaround in my fortunes after the doctor did the Programming on September 27. It was this doctor’s advice that I strictly followed (more so my wife and son) because there was nothing more the Neurologist who was treating my neuralgic pain could do. The electrophysiologist who did the pacemaker implantation asked me to resume my regular evening walk but advised me not to drive the car till the end of October. When I asked him whether I could take my weekly shot of an alcoholic drink, he jokingly asked me whether it was Single Malt or Scotch. I replied that I take Single Malt , Scotch, Gin, Rum, Vodka, Tequila and even Ceylon Arrack in rotation, depending on availability. More than anything else, I was happy to be back in my bedroom, using my toilet, 52 inch TV in the TV room and the Desktop in my study.

Once the Eye Surgeon said that my vision is intact and the Cardiologist had successfully implanted the Pacemaker, I was free to take some decisions on my own. As I was bothered by the persisting pain in the eye, I went back to using Gabapentin when the eye pain was severe (discontinued since that episode of dizziness). Picking up information from the Internet, I started trying some home remedies like washing my eyes and using a warm compresses frequently. I also started taking a course of Vitamin B Complex and refrained from eating Bananas and Citrus fruits to help in the recovery of damaged nerves. If I continue to recover from the eye pain and the other minor symptoms of PHN, I will not be able to pin point and say that it was one specific intervention named above that was responsible for the turnaround. Being a doctor myself also certainly helped in many instances. However, I had resigned myself to think that recovery from PHN is very, very slow. As I recover slowly from PHN, I painfully realized the plight of many who are affected by Neuralgic pain and continue to suffer.

As a precautionary measure, I still keep away from my mobile phone and the microwave oven. The Pacemaker also restricts my movements of the left arm. I will continue to live with such restrictions for some more time. But I know that I have already seen and experienced the worst of this period of agony.



Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Features

Ranking public services with AI — A roadmap to reviving institutions like SriLankan Airlines

Published

on

Efficacy measures an organisation’s capacity to achieve its mission and intended outcomes under planned or optimal conditions. It differs from efficiency, which focuses on achieving objectives with minimal resources, and effectiveness, which evaluates results in real-world conditions. Today, modern AI tools, using publicly available data, enable objective assessment of the efficacy of Sri Lanka’s government institutions.

Among key public bodies, the Supreme Court of Sri Lanka emerges as the most efficacious, outperforming the Department of Inland Revenue, Sri Lanka Customs, the Election Commission, and Parliament. In the financial and regulatory sector, the Central Bank of Sri Lanka (CBSL) ranks highest, ahead of the Securities and Exchange Commission, the Public Utilities Commission, the Telecommunications Regulatory Commission, the Insurance Regulatory Commission, and the Sri Lanka Standards Institution.

Among state-owned enterprises, the Sri Lanka Ports Authority (SLPA) leads in efficacy, followed by Bank of Ceylon and People’s Bank. Other institutions assessed included the State Pharmaceuticals Corporation, the National Water Supply and Drainage Board, the Ceylon Electricity Board, the Ceylon Petroleum Corporation, and the Sri Lanka Transport Board. At the lower end of the spectrum were Lanka Sathosa and Sri Lankan Airlines, highlighting a critical challenge for the national economy.

Sri Lankan Airlines, consistently ranked at the bottom, has long been a financial drain. Despite successive governments’ reform attempts, sustainable solutions remain elusive.

Globally, the most profitable airlines operate as highly integrated, technology-enabled ecosystems rather than as fragmented departments. Operations, finance, fleet management, route planning, engineering, marketing, and customer service are closely coordinated, sharing real-time data to maximise efficiency, safety, and profitability.

The challenge for Sri Lankan Airlines is structural. Its operations are fragmented, overly hierarchical, and poorly aligned. Simply replacing the CEO or senior leadership will not address these deep-seated weaknesses. What the airline needs is a cohesive, integrated organisational ecosystem that leverages technology for cross-functional planning and real-time decision-making.

The government must urgently consider restructuring Sri Lankan Airlines to encourage:

=Joint planning across operational divisions

=Data-driven, evidence-based decision-making

=Continuous cross-functional consultation

=Collaborative strategic decisions on route rationalisation, fleet renewal, partnerships, and cost management, rather than exclusive top-down mandates

Sustainable reform requires systemic change. Without modernised organisational structures, stronger accountability, and aligned incentives across divisions, financial recovery will remain out of reach. An integrated, performance-oriented model offers the most realistic path to operational efficiency and long-term viability.

Reforming loss-making institutions like Sri Lankan Airlines is not merely a matter of leadership change — it is a structural overhaul essential to ensuring these entities contribute productively to the national economy rather than remain perpetual burdens.

By Chula Goonasekera – Citizen Analyst

Continue Reading

Features

Why Pi Day?

Published

on

International Day of Mathematics falls tomorrow

The approximate value of Pi (π) is 3.14 in mathematics. Therefore, the day 14 March is celebrated as the Pi Day. In 2019, UNESCO proclaimed 14 March as the International Day of Mathematics.

Ancient Babylonians and Egyptians figured out that the circumference of a circle is slightly more than three times its diameter. But they could not come up with an exact value for this ratio although they knew that it is a constant. This constant was later named as π which is a letter in the Greek alphabet.

Archimedes

It was the Greek mathematician Archimedes (250 BC) who was able to find an upper bound and a lower bound for this constant. He drew a circle of diameter one unit and drew hexagons inside and outside the circle such that the sides of each hexagon touch the sides of the circle. In mathematics the circle passing through all vertices of a polygon is called a ‘circumcircle’ and the largest circle that fits inside a polygon tangent to all its sides is called an ‘incircle’. The total length of the smaller hexagon then becomes the lower bound of π and the length of the hexagon outside the circle is the upper bound. He realised that by increasing the number of sides of the polygon can make the bounds get closer to the value of Pi and increased the number of sides to 12,24,48 and 60. He argued that by increasing the number of sides will ultimately result in obtaining the original circle, thereby laying the foundation for the theory of limits. He ended up with the lower bound as 22/7 and the upper bound 223/71. He could not continue his research as his hometown Syracuse was invaded by Romans and was killed by one of the soldiers. His last words were ‘do not disturb my circles’, perhaps a reference to his continuing efforts to find the value of π to a greater accuracy.

Archimedes can be considered as the father of geometry. His contributions revolutionised geometry and his methods anticipated integral calculus. He invented the pulley and the hydraulic screw for drawing water from a well. He also discovered the law of hydrostatics. He formulated the law of levers which states that a smaller weight placed farther from a pivot can balance a much heavier weight closer to it. He famously said “Give me a lever long enough and a place to stand and I will move the earth”.

Mathematicians have found many expressions for π as a sum of infinite series that converge to its value. One such famous series is the Leibniz Series found in 1674 by the German mathematician Gottfried Leibniz, which is given below.

π = 4 ( 1 – 1/3 + 1/5 – 1/7 + 1/9 – ………….)

The Indian mathematical genius Ramanujan came up with a magnificent formula in 1910. The short form of the formula is as follows.

π = 9801/(1103 √8)

For practical applications an approximation is sufficient. Even NASA uses only the approximation 3.141592653589793 for its interplanetary navigation calculations.

It is not just an interesting and curious number. It is used for calculations in navigation, encryption, space exploration, video game development and even in medicine. As π is fundamental to spherical geometry, it is at the heart of positioning systems in GPS navigations. It also contributes significantly to cybersecurity. As it is an irrational number it is an excellent foundation for generating randomness required in encryption and securing communications. In the medical field, it helps to calculate blood flow rates and pressure differentials. In diagnostic tools such as CT scans and MRI, pi is an important component in mathematical algorithms and signal processing techniques.

This elegant, never-ending number demonstrates how mathematics transforms into practical applications that shape our world. The possibilities of what it can do are infinite as the number itself. It has become a symbol of beauty and complexity in mathematics. “It matters little who first arrives at an idea, rather what is significant is how far that idea can go.” said Sophie Germain.

Mathematics fans are intrigued by this irrational number and attempt to calculate it as far as they can. In March 2022, Emma Haruka Iwao of Japan calculated it to 100 trillion decimal places in Google Cloud. It had taken 157 days. The Guinness World Record for reciting the number from memory is held by Rajveer Meena of India for 70000 decimal places over 10 hours.

Happy Pi Day!

The author is a senior examiner of the International Baccalaureate in the UK and an educational consultant at the Overseas School of Colombo.

by R N A de Silva

Continue Reading

Features

Sheer rise of Realpolitik making the world see the brink

Published

on

A combined US-Israel attack on Iran.(BBC)

The recent humanly costly torpedoing of an Iranian naval vessel in Sri Lanka’s Exclusive Economic Zone by a US submarine has raised a number of issues of great importance to international political discourse and law that call for elucidation. It is best that enlightened commentary is brought to bear in such discussions because at present misleading and uninformed speculation on questions arising from the incident are being aired by particularly jingoistic politicians of Sri Lanka’s South which could prove deleterious.

As matters stand, there seems to be no credible evidence that the Indian state was aware of the impending torpedoing of the Iranian vessel but these acerbic-tongued politicians of Sri Lanka’s South would have the local public believe that the tragedy was triggered with India’s connivance. Likewise, India is accused of ‘embroiling’ Sri Lanka in the incident on account of seemingly having prior knowledge of it and not warning Sri Lanka about the impending disaster.

It is plain that a process is once again afoot to raise anti-India hysteria in Sri Lanka. An obligation is cast on the Sri Lankan government to ensure that incendiary speculation of the above kind is defeated and India-Sri Lanka relations are prevented from being in any way harmed. Proactive measures are needed by the Sri Lankan government and well meaning quarters to ensure that public discourse in such matters have a factual and rational basis. ‘Knowledge gaps’ could prove hazardous.

Meanwhile, there could be no doubt that Sri Lanka’s sovereignty was violated by the US because the sinking of the Iranian vessel took place in Sri Lanka’s Exclusive Economic Zone. While there is no international decrying of the incident, and this is to be regretted, Sri Lanka’s helplessness and small player status would enable the US to ‘get away with it’.

Could anything be done by the international community to hold the US to account over the act of lawlessness in question? None is the answer at present. This is because in the current ‘Global Disorder’ major powers could commit the gravest international irregularities with impunity. As the threadbare cliché declares, ‘Might is Right’….. or so it seems.

Unfortunately, the UN could only merely verbally denounce any violations of International Law by the world’s foremost powers. It cannot use countervailing force against violators of the law, for example, on account of the divided nature of the UN Security Council, whose permanent members have shown incapability of seeing eye-to-eye on grave matters relating to International Law and order over the decades.

The foregoing considerations could force the conclusion on uncritical sections that Political Realism or Realpolitik has won out in the end. A basic premise of the school of thought known as Political Realism is that power or force wielded by states and international actors determine the shape, direction and substance of international relations. This school stands in marked contrast to political idealists who essentially proclaim that moral norms and values determine the nature of local and international politics.

While, British political scientist Thomas Hobbes, for instance, was a proponent of Political Realism, political idealism has its roots in the teachings of Socrates, Plato and latterly Friedrich Hegel of Germany, to name just few such notables.

On the face of it, therefore, there is no getting way from the conclusion that coercive force is the deciding factor in international politics. If this were not so, US President Donald Trump in collaboration with Israeli Rightist Premier Benjamin Natanyahu could not have wielded the ‘big stick’, so to speak, on Iran, killed its Supreme Head of State, terrorized the Iranian public and gone ‘scot-free’. That is, currently, the US’ impunity seems to be limitless.

Moreover, the evidence is that the Western bloc is reuniting in the face of Iran’s threats to stymie the flow of oil from West Asia to the rest of the world. The recent G7 summit witnessed a coming together of the foremost powers of the global North to ensure that the West does not suffer grave negative consequences from any future blocking of western oil supplies.

Meanwhile, Israel is having a ‘free run’ of the Middle East, so to speak, picking out perceived adversarial powers, such as Lebanon, and militarily neutralizing them; once again with impunity. On the other hand, Iran has been bringing under assault, with no questions asked, Gulf states that are seen as allying with the US and Israel. West Asia is facing a compounded crisis and International Law seems to be helplessly silent.

Wittingly or unwittingly, matters at the heart of International Law and peace are being obfuscated by some pro-Trump administration commentators meanwhile. For example, retired US Navy Captain Brent Sadler has cited Article 51 of the UN Charter, which provides for the right to self or collective self-defence of UN member states in the face of armed attacks, as justifying the US sinking of the Iranian vessel (See page 2 of The Island of March 10, 2026). But the Article makes it clear that such measures could be resorted to by UN members only ‘ if an armed attack occurs’ against them and under no other circumstances. But no such thing happened in the incident in question and the US acted under a sheer threat perception.

Clearly, the US has violated the Article through its action and has once again demonstrated its tendency to arbitrarily use military might. The general drift of Sadler’s thinking is that in the face of pressing national priorities, obligations of a state under International Law could be side-stepped. This is a sure recipe for international anarchy because in such a policy environment states could pursue their national interests, irrespective of their merits, disregarding in the process their obligations towards the international community.

Moreover, Article 51 repeatedly reiterates the authority of the UN Security Council and the obligation of those states that act in self-defence to report to the Council and be guided by it. Sadler, therefore, could be said to have cited the Article very selectively, whereas, right along member states’ commitments to the UNSC are stressed.

However, it is beyond doubt that international anarchy has strengthened its grip over the world. While the US set destabilizing precedents after the crumbling of the Cold War that paved the way for the current anarchic situation, Russia further aggravated these degenerative trends through its invasion of Ukraine. Stepping back from anarchy has thus emerged as the prime challenge for the world community.

Continue Reading

Trending