Ans. It began gradually, and nobody could think of such a diagnosis in the beginning. It began on 17 October 1994, when I had a bout of very high–grade fever for only a day. With just one tablet of Ciprofloxacin [1], it disappeared. As everybody does, I stopped treatment with only one tablet. Before that, I used to go to the gym, I used to exercise regularly, I used to run. But after that episode of fever, I started feeling a little weak. I was about 68 kg before that. I started losing weight gradually from October till the next May.

In May 1995, I saw a family with massive pulmonary tuberculosis. All of them–father, mother and children–all of them were suffering from tuberculosis. One of them needed an operation, so they had come to me. At that time I felt something going wrong in my chest, I don’t know what, I can’t explain it to you, but I felt that I was getting their infection.

In the last week of May, I started getting fever in the evening. About 100 degrees. I was working so I ignored it. In the second week of July, I got a severe sore throat, and high–grade fever, and it just did not come down. The fever used to range between 101–102 degrees. I took Bactrim [2] for the sore throat and some other antibiotic, but I did not respond. I started feeling dehydrated, getting weaker.

One fine day I felt that I needed indoor care. I felt I needed to get admitted. So I contacted a local surgeon and asked him to admit me. I forced him to start IV fluids on me because I knew I was dehydrated. Nobody else could believe I was dehydrated, because till then my weight was 64 kg–the weight was not fitting into the picture.

I think I got admitted to hospital on 16 July 1995. My brother was to get engaged the next day.

Ans. I was put on IV fluids but the fever never came down. It remained persistently at 100 degrees, and would shoot up to 102, 103 degrees. So a physician was called, he examined me and went out of the room. The physician asked me to get my Elisa test done. The test was done, but the result was not revealed to me. The doctor assured me that everything was fine, but I knew something was wrong. Just the evening before, I had asked my wife to have a look at my throat. She examined me and said I had candiadiasis [3]. I could not believe it. I was shocked. That was the beginning of the disaster that was to unfold.

Nobody told me that I had tested positive on Elisa. But the moment the reports arrived, the doctor referred me to Dr V.R. Pai at K.E.M. Hospital in Pune, then one of the only doctors treating HIV. Everyone in the house was shocked. We went through disbelief, mental trauma and all the emotions that go with it, but we were still hoping against hope that it may not be true. Maybe he had done something wrong; maybe it was not correct.

By then my illness had crossed all possible limits. My fever used to range between 104–105 degrees; it never came back to normal. I was terribly dehydrated. I had lost all my appetite. I could not even eat a teaspoonful of food, water or anything solid.

Ans. The Western Blot test was done at K.E.M Hospital, but for two days I was kept in the dark. By now, I had some inkling that something was terribly wrong with me. So when Dr. Pai came on his rounds, I asked him, "Just tell me what is wrong with me." I asked this question in a sitting position. But I was so weak, that by the time I finished, I fell back.

After I regained my composure, he told me I had HIV. It was a terrible thing to reveal. I just closed my eyes and said, "Oh God". And then everything was just over. My whole life was spoilt, in the sense that apart from the personal loss, my professional life was also spoilt. As a positive surgeon, you can't operate. This is a small place–it was like a big bomb going off and it destroyed me down to zero professionally.

Ans. I was in that hospital for about eight days. I suffered from all sorts of infections. I had herpes, I had severe diarrhea, I had fever, I had massive pulmonary cough, my whole left lung was fired, I was breathless and in between I had massive tachycardia [4] with my pulse rate going up to 160.

After eight days, there was no improvement. I was just as bad as I was before. In between, the doctor had put me on AZT. At that time, AZT used to cost about Rs. 6,000 (US$ 133) a month. It was not available in Pune, so my brother had to go to the Cipla factory, 10–20 km away from Pune with a prescription and get it from there. The doctor put me on one 100 mg tablet, three times a day, which was inadequate, and was actually half the dose. We took 'against medical advice' discharge because there was no improvement.

We came back to my hometown, Ratnagiri, on 28 July. Personally I wanted to die, if at all, in my own house, not in a hospital. Mentally I was ready to die. In fact I wanted to die, because all that I had learned in all these years was literally washed away in two days. I also experienced apprehension, fear about the status of my wife, my child–my daughter was just a year old then, and it was terrible to think of their condition.

I had given up hope of ever living and was ready for death. The most horrible time was when my wife went for testing, and even more horrible than that was when my daughter was to get checked for HIV. Those 48 hours before we got their results was the most horrible time. But with all God's blessings, my wife tested negative, she's still negative, and my daughter turned out to be negative too.

Ans. I could not attend my brother's engagement. We explained my status to his in–laws–they thought about it for a day, but they are educated people and so they accepted it. I could not even attend his wedding.

Ans. When I came back home, the diarrhea, weight loss and fever continued. My hemoglobin dropped from 12 to 6.7 because of the side effects of AZT. The AZT was stopped because I could not tolerate it.

For three months from 16 July onwards, I did not sleep for a minute. When I yawned on 17 September, my face was so taut that I could not even yawn properly. When I finally slept between 1.30am and 4.30am, everyone was so happy, that finally my cycle was returning to normal. My mother told me that during this time, I looked like a dead man. I had no expression whatsoever. I would keep staring at the ceiling all day and night long. Then gradually I came back to my normal cycle, but I was bedridden and my weight was down to 43 kg. All activities were carried out in my bed itself. I used to use a bedpan, have my meals in bed. Just by getting up in bed and lying down I used to feel breathless, because of low hemoglobin, no resistance, multiple lesions, massive tuberculosis, and God knows what other complications I had.

Ans. By the end of September, physiotherapy was started, and I started getting out of my bed. In the last week of September, for the first time in three months, I came out of my house and sat on a chair. It was a pleasant evening. I cried for 10 minutes because getting back to this stage seemed impossible.

In between, we heard that Dr. Pai had met with an accident and passed away on the Mumbai–Pune highway. A truck had struck his car and the gory description came in the newspapers. The description was a terrible reminder of death for me. It was like the God of death telling me, "I can take you any way I like, anytime." For me, it was living my death all the way through till 1998. It was not a happy, ordinary life. I would describe it as living my death.

During this period, I used to take about 17 tablets [5] a day. Apart from that, the local ayurvedic physician started me on two different medications – one of them was a kada or broth, which I took three–four times a day. I also drank wheatgrass juice every day.

I also took streptomycin injections, which were terribly painful. There was no fat on my buttocks, so they were very painful. Every second day, the same side was used for injection. I tried my thigh once, but it was so painful that I could not stand. So it was decided that the buttocks were the ideal site. After three–four injections on each buttock, it was hell every time I had to be injected. It's a thick oily injection, which you have to inject with a large bore needle. There was no fat, no muscle, and it used to go very close to my bone. I used to yell literally for 10 to 20 minutes after every injection.

Ans. Because, personally I believe you must take the best available in all practices. I don't say that ayurvedics or homeopaths are quacks. Personally I have experience of ayurvedic, homeopathic drugs that have worked very well, even before I was sick. So I thought why not try this out? That was our attitude, in the sense that if it is going to work, then I will be better; if it is not, then it is not harmful.

When this illness started, everybody was so shocked that they had all given up hope. But it was my wife who said, maybe if he pulls through this time, maybe after two years we will have some invention, some drug we will be able to buy. This was her attitude, and it is her attitude that saw me through this hell that I've been through. In 1995, no one expected me to live except my wife.

She was so calm, so composed, even through the acute illness. She was to appear for her post–graduate endopathology examination during my illness, but unfortunately she could not complete her post–graduation. She left her studies to stay with me and now she's a medical officer in a local hospital. It was her attitude, her willpower that saw all of us through these days of turmoil. If my wife were not there, I don't know, maybe I would've been up there.

Ans. Yes. The moment I started recovering, all of us being doctors here, we knew that if I have to get back to work, then I would need some exercise, so why not try this?

One of the complications that developed was foot drop [6]. It was not evident but I could feel it because moving my right foot upwards was difficult after I came back from hospital. To recover from that I needed physiotherapy, and being a doctor myself, I knew I needed some exercise, at least to move my hand and legs.

So it started with just moving hands and legs, 10 times, three times a day. Then getting up and lying down, and after maybe 15 days of such therapy, I could walk with a walker in my own room. Just to walk twice in this room was difficult for me in the beginning. After 15 days of such exercise, I came out for the first time. Till then, the room was my everything–every activity was conducted in the same room.

Ans. By then everybody, every Tom, Dick and Harry in Ratnagiri, knew about my HIV status. And it was a terrible time because nobody used to even come to me. Well, one fine day, a gentleman came and offered me work as a part–time professor. It was a god–sent opportunity to get away from this vicious cycle of no practice, no income, just sit at home and think about yourself, think about your disease, think about your own death…

So I started work as a part–time lecturer in physiology and anatomy at a local college. I worked from 11.30am till 1.30 pm, taking one–two lectures a day. Apart from that, the Indian Medical Association started a cancer detection centre. That was also a part–time job where I could examine, diagnose and refer. I started going there around 9.30am till 11.30am. This job lasted for about four months.

Ans. Yes, I was back to my health. My weight picked up till 52 kg, my hemoglobin came up to around 10, 11 maybe, and I was in a position to work, I regained my strength, I used to exercise a bit with the Exercycle, my diet was fine, I used to eat a lot, maybe my TB treatment was working–I was still on anti–TB treatment. I'd stopped all ARVs, all kadas, all wheatgrass juice. I was taking only anti–tuberpostine.

But it was still a terrible time. To come home at 1.30, sit and do nothing. In February this job got over, so I was jobless again, My wife had to leave her post–graduation, find a job. For about four–five months, we were both jobless. Every negative thought used to run through my head. It was not depression; it was a combination of 'n' number of emotions put together, it's not explainable, what the feeling was.

Ans. Well, I remember we had gone for somebody's engagement that summer, While coming back, I was having a soft drink when I felt pain radiating from my back to my neck. That was the first indication of the illness. By the end of May, I was finding it difficult to swallow. It was difficult to get gas out of myself so I used to bend just to get that gas out. Nobody suspected what was going wrong because the throat was clear. In two months, I lost about 14 kg; my weight went down to 38 kg. I was a skeleton, lying down, not responding to any treatment.

I started getting ulcers in my mouth. Nobody could diagnose what it was. The number of ulcers in my mouth increased to about 23. My intake went down. I used to eat only potato chips, that too without any salt, chili powder or spices. Finally a stage came where I could not swallow, and I started drinking only half a bowl of milk, half a bowl of kokum [7] juice, and one or two glasses of coconut water. The pain was terrible–just to think of swallowing made me wild. I couldn't even swallow my own saliva. It was thick and very sticky, and I could not swallow it so I spat it out. I would keep a small bowl near my bed and spit in it. By the evening, the bowl used to get full.

Everybody was really tired of this sickness. My father was tired of it. It was terrible for my mother to see her son suffer so much. She used to cry everyday. We left no stone unturned – we tried allopathy, homeopathy, pandas [8], bhagats [9]. I had accepted that I am going to die one day, but through the course of illness the Almighty killed me without actually killing me.

During that period, I used to be highly irritable. I used to quarrel with everybody about small problems. I had no control over emotions, and the starvation for such a long period had produced cerebral atrophy [10]. The HIV itself leads to cerebral complications known as dementia. Fortunately, I could recognize everybody, but I lost orientation in time and space. But the cerebral atrophy had progressed to such an extent that I had lost control of my natural reflexes, I used to pass urine in my bed at night–it was difficult for me to control it. By then I was terribly afraid to even sleep.

At this stage, we decided that my daughter should not stay with us. So she was put in a boarding school near Bombay.

Ans. I was again admitted to a hospital in Pune on 18 August 1996. My mother had shown my horoscope to an astrologer; he said if I was admitted on this day, I would get well, otherwise I wouldn't. So I was admitted on 18th August. I met Dr Vinay Kulkarni–he was the first physician to diagnose my ulcers as herpes. It was a relief! When I heard it was herpes, I mentally collapsed and I knew that I could pull through. Maybe I had a small .0000 percent chance of recovering. I was put on Acyclovir [11] drip, and I started eating a little food. The ulcers started healing with Acyclovir.

My aunt in America rang up at that time–she knew about my status. She told my family that there were drugs available in America, which she would send us. By then our financial condition had gone down, but she was ready to support us. She sent me a bottle of 90 tablets of Creximon [12], which used to cost Rs. 27,000 ($600).

Creximon was available in a big 800mg capsule form, and it was difficult for me to swallow capsules. The moment I saw the capsule, I refused to take the drug. Being irritable, plus the vomiting, and the fasting that goes with it (once I had vomited I could not eat for two hours), I got very angry and told them, no matter what the cost of the drug, there's no way I'm going to take it. I told them, no drugs, if at all, I'd take ayurvedic drugs.

My aunt called again, saying that there were two new drugs, Didanosile and Lamivudin, which were water–soluble and could be swallowed. That was the first time a two–drug combination was being tried. She sent us a supply of three–four months. So I had an uninterrupted supply without any problems. Then a third drug called Ritonavil was added to the therapy.

With Ritonavil, Didanosile and Lamivudin, my appetite increased, though my weight didn't. I used to still weigh around 47 kg. The cerebral atrophy effects went down. My energy levels increased, the number of opportunistic infections went down, but my CD4 count never came up–it was in the range of 40–60. I took this three–drug combination very regularly till May 1998, when I started developing oral cavities and my appetite went down. Dr Kulkarni suspected viral resistance to these three drugs. At that time, my treatment was changed to the current line of treatment, which is Didanosile, Stavudin and Nelfinavir. I have been taking this for the last six years–from May 1998 to May 2004.

Ans. Actually I am taking Nelfinavir at sub–optimal doses–the actual dose is three tablets, three times a day. What I'm taking is one tablet three times a day, but I am very happy with it and so far, so good.

Ans. Yes, it has worked well. But apart from this combination of drugs, from 1997 onwards I developed my own lifestyle and diet, on a trial–and–error basis. If I saw something new, I used to eat it in small quantities to see whether I could digest it or not. I started doing yogasana [13], pranayam [14], and sudarshan kriya [15] daily. I attended Art of Living courses to learn the sudarshan kriya, and I learned pranayam and yoga on my own by following books.

Ans. I read certain books that claimed that hatha yoga [16] could cure anything and everything under the sun. I also realized that yogasana, pranayam and sudarshan kriya treat the negative aspect of the mind as well. To get over all this, not only do you need a good physique, but also a good attitude and a strong mind, which is able to accept theillnesses, but still has the power to fight back, and the hope that you will win one day. As I started practicing these, gradually things changed. I do yoga for an hour every morning, and after that sudarshan kriya or pranayam, one of the two. After that I do kapalbharti [17], which I've also learned. This induces a state of mental calm. Today I've come to a stage where my mind understands what's going on, what's wrong, what's right.

All these – yoga, pranayam and sudarshan kriya – are meant to balance your sympathetic and parasympathetic nervous system. In my opinion, HIV is a manifestation of the imbalance between these two nervous systems. So once I started following all these principles, there was a huge difference between what I was before and what I am today. The more expert you are in yoga, pranayam and sudarshan kriya, the healthier you are. There is something known as mind–body coordination, which is achieved through these three. It's not something I can explain; it has to be experienced. It means understanding your own body; it gives you a sense of what to eat, what will impact your body.

I followed a course that tried to balance the sympathetic and parasympathetic, and somehow it has worked in my case. Otherwise, with optimal doses of drugs and the current status of medicines, I should have developed resistance. Apart from that I should not have survived for so long and reached the level that I have. My CD4 was 38, today it is 273. I don't get any opportunistic infections. I am feeling fit enough to work eight hours a day. That is the biggest achievement that I can put forward for following this way of life. For a person whose CD4 was 38 once upon a time, to live for 10 years and to work eight hours a day is a dream come true.

Ans. It's the lifestyle, the diet, the attitude–everything matters. During the course of the exercise, it's not that I never fell sick; I did. But my attitude was to overcome the problems; the resolve was there to fight. And of course the resources were there to fight–that is most important. Apart from that support, everything else mattered.

I was very lucky to be in a position where I could afford ARVs. When I started this therapy, it cost me around Rs.30,000 (US$ 666) a month for all three drugs. Today the cost has come down to Rs.2,000–3,000 (US$ 44–66) a month. In the beginning it was very difficult to manage the drug costs and the illness, but with the development of drugs, things have changed.

Personally speaking, I feel it is the lifestyle and attitude that matter. There are many centers that teach yoga, but until you understand why these things have to be done, it is very difficult to get output from anything, be it ARVs, lifestyle change, anything.

Ans. I don't know whether to call it a holistic approach. I feel it is not only the drugs and believe me, the diet I am following is one of the cheapest and simplest of diets.

Ans. It does not involve any mega vitamins or anything. I have never taken any nutritional supplements throughout my illness, except when I took hematinic syrup during my first illness, which totally destroyed my teeth. I also had, and still have panchamrut [18] everyday. Panchamrut gave me a lot of energy, and reduced the number and duration of opportunistic infections. It made a tremendous difference to my health–it changed the way I looked, my strength. The ghee (clarified butter) in it, especially made from cow's milk, is very useful for the white blood cells' killing capacity, and I think this helps in that process.

My daily diet consists of chappati (bread), dal (lentils), all green vegetables and rice. I also eat a fistful of channa (roasted Bengal gram), groundnuts and jaggery everyday. There are many cereals and vegetables that are avoidable, generally those that are alkaline. There are certain vegetables that take 21 days to assimilate in our bodies – carrots, eggplant, mooli (white radish), and masoor (lentil). People who are yogis [19] avoid these vegetables. I started experimenting, starting with masoor, which gave me a lot of trouble–I developed diarrhea and stomach problems. I found that these all were probably alkaline. I also started avoiding cauliflower, cabbage, beans, and all vegetables that are sticky when cut open. I don't eat any processed food, tinned foods, or any foods containing Monosodium Glutamate (MSG)–no artificial flavors. I avoided eating out. You really don't need too much money for this diet–it's really very simple.

Gradually things improved. When my CD4 fell so low to 38, not only was my appetite totally lost, but also my capacity to digest and absorb. Nothing was left in my body.

It is the total lifestyle change along with drugs that helps. It is not only the drugs, not only the lifestyle change. You have to combine them and follow it regularly, day after day, week after week, month after month, year after year, and still be prepared to say, yes, I don't have any results.

Ans. In July 1997, my father passed away. Just before that, we had had a big fight. My mother and I went to Mumbai, just to cool down. At that time, I had some mental peace. One day, suddenly the thought struck me that I've gone through so much of pain and still I am not dying. Maybe I am not destined to die with HIV.

We came back and shortly after that, my father passed away. It was a terrible blow for me. One of his friends had come to meet my mother. When he saw me, he could not recognize me. My mother told him all that had happened, and asked if he knew somebody who could help me. He suggested a Mr. Dongre from the nearby town of Kankavli. My mother wrote him a letter explaining our circumstances. Mr. Dongre came to meet me on 31 August 1997. That was our first meeting. He told me, "Don't worry. You will be all right."

Then he took my foot in his lap, put his hand on my head and said, "Don't worry". I just laughed at him. I thought he was mad–how could I believe any person who came and told me I would be all right? So I forgot about it.

After 15 days, he called and said he wanted to take me to the Pandharpur [20] shrine of Vithoba, the most religious place in Maharashtra. He came here with his wife, and took me to Pandharpur by car. Throughout the journey I was sitting next to him. He kept his arm on my thigh. We got to Pandharpur. That night he requested me to sleep along with him. He had a big room so I slept next to him. The next day we returned. Again I was sitting next to him, and he kept his arm on my thigh–nothing more was said, nothing more was exchanged.

When he left Ratnagiri, I realised that he had given me something. I don't know exactly what it was–the mental peace, the acceptance to be at peace with myself and the world – I have no words to describe it. Since that day, my attitude, behavior, everything changed. Irritability vanished, acceptance came.

I know it was he who changed this behavior. When I talk of determination and devotion, I believe it is his gift to me, so I don't call him a friend any more; I call him my guru [21]. Whenever I spend time with him, I get mental peace, happiness, and satisfaction. The fact that I can be happy in spite of my physical condition, and the familial and social turmoil, itself is a gift. He told me to do Jap [22], which I started. The more I did it, the better it was.

I am here today only because of that jap. I've reached a stage when I can manage myself even when I am alone. It doesn't bother me whether I am going to die the next moment, or after 10 years–I don't even think of it. Even if it is in the next moment, I am ready for it. It is that sort of attitude of courage that comes automatically from within you. Whatever I am today is because of him

Ans. My personal observation is that after I started following this lifestyle even the disease was part of recovery. If I had a tummy upset, a body ache, cough and expectoration, everybody would tell me to rest. But I would tell them not to worry, as this was a part of the recovery. Even though I was looking sick, actually I was improving. If you look at the clinical picture, it was that of an illness, but internally I would feel that this is part of recovery. And time has proved it. For instance, if I were not recovering, my CD4, capacity and weight would not have increased. Today I'm 53 kg, at that time I was 47 kg. So I don't know how relevant this is–this is more of a scientific discussion.

Ans. Whatever I have derived differs from the current medical scene a lot. People don't accept what I put forward or tell them, as they have not had the experience that I've gone through. It is very difficult to find somebody else who is so devoted to carrying out these things. If you tell somebody, do yoga, it's good for you, even a healthy person does not do it on a daily basis, forget about somebody who is sick. I have done yoga when my body was aching, I've done sudarshan kriya when I had fever, I've done yogasana when I was sick–it is just the dedication and determination that matter.

Ans. The most difficult health challenges were all three episodes and the drug resistance. The most difficult thing was that I was not able to earn anything for my family in spite of learning so much and working so hard. In the past nine years, I had no source of income. I see cases, but they are from such poor classes that they are not able to pay my fees. I don't charge them, so even with my practice, my income is not even Rs. 1,000 (US$ 22) a month. That is the biggest thing I cannot digest. Now that I'm fine, I am still not able to earn–that is difficult.

I have had a very good healthy childhood, and I cannot give the same to my daughter. That was another thing that was very difficult to digest. During my childhood we used to go out, we used to have fun, we used to go for holidays–that becomes a bit difficult with my status. I cannot go and eat anywhere else, I have to restrict my food. Then sometimes my daughter gets angry and says, "Why can't we go out anywhere?" That's a part of this.

Ans. It is important for my wife, my mother. But for my kid, she is not of that age to understand all this. She looks at what all her friends are doing. That was the most difficult part. The experience was of not sending children to my house to play with my daughter. My daughter never had a problem going to anybody else's house, but she had a psychological problem as to why no one came to her house.

Apart from that, coming to terms with the fact that in spite of doing so many things, you are still going to fall sick, not be cured and people might still look at you and say you are sick.

Ans. I believe it's the way one speaks. If you are experienced, then your words carry some weightage, some value; if you are not experienced then it's a hollow speech. It's the way you put things across. Somehow after going through all this, maybe I have developed the knack of putting things across in the right perspective, in a way that they understand. It's a whole spectrum in which you have to judge the patient's level of understanding and the level of your talk. In my opinion, my experience has taught me a lot of things. Generally I don't reveal my status to them, but now that we have formed a group of positive people, they know that I am also affected.

Ans. Yes. For seven years, from 1995 to 2002, I could not practise because my CD4s were very low and there was always the fear that I might catch some contagious disease. It was only in May 2002 that I started practice. After that, I created my own NGO for positive people called Guruprasad. The name protects people's identities. It's a small NGO, we collect private donations. We try to help people in all possible ways. If someone wants money or assistance for rehabilitation, sewing machines, any small business. We don't give loans, whatever grants we get, we try to help. We give money for last rites, investigations–the routine needs of the patients are met with the funds that we collect. Apart from that,whenever we come together, it is a natural bonding between all those affected.

Ans. The goal is different–the ultimate goal is to cure myself–I don't know if I will help others or not. As a landmark, if I can take care of myself, if I can produce some extraordinary results, then I would say that all the efforts taken by my wife, all my relatives, all the money spent on me, it was worth it. If not, then yes, maybe I tried my best.