Albert Einstein, while describing relativity said, "Put your hand on a hot stove for a minute, and it seems like an hour. Sit with a pretty girl for an hour, and it seems like a minute. THAT'S relativity.”

You might wonder what relativity has to do with finding good Baklava. Bear with me for a bit.

So, there I was, returning from the Indian Society of Nephrology's Annual Conference after winding up the last day this morning (NephroPlus had a stall and coming up is a post on the happenings), I took the short cut from Hi-tec city to Banjara Hills that goes through the road that houses "Sweet Nirvana", a place where I was told you get great Baklava.

Baklava is something I have been dying to eat from many years now. My yearning began when my grandmother returned from the US and Canada after a visit to her son and daughter. Apparently, my uncle, her son, makes great Baklava. My grandmother is very well read and has a flawless command over language. She described the whole process by which my uncle made the Baklava. He laid out the sheets of 'flow-dough' and then brushed it with syrup and then put crushed walnuts and then another layer of 'flow-dough' and another round of syrup and walnuts. And then he baked it at such and such temperature for so many minutes. The whole description caught my fancy and I have been dreaming of eating the Baklava since then. This was at least fifteen years back.



I have eaten what people thought was Baklava. I have eaten what people called Baklava. But I don't think I ever ate what was actually Baklava! Weddings, restaurants, no place served the real Baklava. Note that I had never eaten the real thing to actually know what it was supposed to taste like either. But I had made a mental note of what it was supposed to taste and look like and always compared it to that!!

So, I stopped at Sweet Nirvana and asked for some Baklava. I was told there was only one slice left. I asked how much it cost.

"Two fifty"

"Two hundred and fifty rupees?"

"Yes sir!"

"Ok, please pack it."

I was asked to sit at a table and wait. Rs. 250 for one slice of Baklava? I started thinking about how I will explain this to my mother!

In a few minutes I was on my way home. The container was opened and my parents asked me what it was. I told them. The slice was fairly big. We all took a portion. My parents said it was 'ok'. I kind of liked it. It was the closest it had come to my mental image and taste.

Then came the tricky part.

"How much did you pay for it?"

"You won't believe it! This thing usually sells for a couple of thousand. But I got it for six fifty!"

"What? You paid six hundred and fifty for that?"

"It is not at all like the Baklava we bought from Dubai. That simply melted in the mouth. Tell me the truth."

My mother was fairly sure the stuff she got from Dubai was better. Especially since this was six hundred and fifty rupees!

After a few minutes of this charade, they were convinced that it cost Rs. 650.

Then I told them, "I was just joking. It actually cost only two fifty."

"Don't tell lies Kamal. I am sure you paid more."

"I swear. Do you want to see the bill?"

"Yes, show us the bill"

I darted to my room and brought the bill and gave it to my mother.

"Hmmm. Rs. 250."

She was actually quite happy!

I said a mental thank you to Albert Einstein for his theory of relativity and took another piece of the Baklava. I promise that this time it tasted exactly like what I had in mind.

A friend posted this from YouTube. I found it hilarious! This scene is very popular for such spoofs.

For the last few weeks, I have been having bone pain again. I had severe bone pain towards the end of 2009. At that time I had realized that it was due to multiple factors - the low Calcium level in my dialysate and the low levels of Vitamin D in my body.

The problem with things that develop gradually in the body is that you are not sure until it becomes bad. For the last few weeks, I had pain on and off but I did not do anything about it. I was always wondering if it really was serious or was it just a passing phase? For example, joint pains can happen once in a while without indicating anything important, right?

But for the last few days, the signs were unmistakable. The only difference from last time was the areas in which the pain was there. While last time, it started mainly in the feet and back, this time, it is in the shoulders and back. It is quite bad in the morning. In fact so bad that I invariably get up at around 4 - 4:30 with the pain!

A few days back, I concluded that something was definitely wrong and got a battery of tests done including those for 25 hydroxy Vitamin D3 and 1,25 dihydroxy Vitamin D3 apart from Calcium and PTH. Both the Vitamin D3 results came back low. Especially the 1,25 test was shockingly low. The report says it was less than 1.6 pg/ml whereas the normal is 19.6 to 54.3! They don't even give a value. Just less than 1.6, they say. So it could practically be 0!

I went over to my nephrologist yesterday and he put me on Calcitriol 0.5 mcg once daily. Hopefully, this should correct my problem.

Ask any dialysis patient worth the little salt he eats which is the blood test he would most commonly associate with kidney disease and chances are that the answer would be creatinine. From the time you get diagnosed, everyone talks about creatinine. "How much is your creatinine?" is a question I have been asked the most, even more than, "What is the secret of your good looks?"

I have talked a lot about Creatinine in a recent post here.

However, a very interesting perspective about Creatinine was offered by Dr. Ashwin Aiyangar at the patient meet we had at NephroPlus recently. What he said was that Creatinine is a product of the breakdown of a certain compound in the muscle. So, if your muscle mass increases, your Creatinine increases.

Many people on dialysis in India have a huge malnutrition problem. Many nephrologists do not impose any diet restrictions on such patients. Heck, they are not even getting the basic nutrients; what is the point in asking them not to eat this or that? Many dialysis patients are so malnourished that their potassium and phosphorus are below normal!

So, in this context, the Creatinine is a good measure of how well you are eating. This is true for those dialysis patients that are on maintenance hemodialysis or those with End Stage Renal Disease. (Note that the end stage is not end stage as in end stage of life but end stage of kidney function!) These patients need not worry when their creatinine is too high. All that means is that they are eating well and they don't need to worry about being malnourished. These patients should check their creatinine only to serve as a marker of nourishment, never as a marker of kidney function.

In patients who are in the early stages of kidney function, the creatinine serves as a marker of kidney function and they should be worried if their creatinine is going high.

For the last few months, every Sunday morning at 6, an autorickshaw roams around in our locality and on the loudspeaker begins a sermon in Telugu. The voice is not pleasant. The sermon lasts about twenty minutes and then some music is played for a couple of minutes. The intent is obvious.

I have nothing against any religion. To each his own. However I am dead against this intrusive attempt to proselytize. The worst part about it is that it is entirely ineffective. Who would be willing to listen to a horrible voice trying to thrust religion down your throat at 6 on a Sunday morning? Anyone thinking about converting would have second thoughts!

Religion is a highly personal thing. It should never be worn on your sleeve. I wrote about this here and here earlier too. It has now spread to almost all religions. Its almost as if they are each trying to outdo the other in being 'heard'!

I doubt if any religion was like this a few centuries back. They have all evolved so much. Most have moved into becoming more external rather than internal. More about show, less about reality. More about competition, less about inner introspection. The clergy are often to blame.

Even my own religion has fallen prey to this trend.