Lessons learnt in 2020

2020 has been a memorable year to, probably, every human on this earth. From hundreds of people dying each day to the economic downturn as a consequence, COVID19 has shaken the world never like before. With the news flowing about the success of COVID19 vaccines and countries purchasing them, we are hoping the “new normal” of putting the mask, maintaining the distance, cutting down the travel, and implementing many other precautionary plans will be gone over within a couple of months or at least a year. Better late than never, as they say: “This shall too pass.”

It truly wasn’t an easy year for anybody. So was it for this blogger. Beginning the year by leaving the role as a co-founder of the company started together with the school-friends and staying home for 3-4 complete months, 2020 was a year of a new start for this blogger in multiple ways. Let me share a few of the lessons that I learned and the realizations I made in 2020.

  1. The world can shut down: 

COVID19 has made all of us realize the extent to which things worsen. There is this new definition for the world of how bad things can go. We might have to crumble into our homes and apartments for months that too without a job. Countries can shut down, literally close down! Traveling or moving around in public can be a nightmare. Millions of us can lose our lives. These are the extremes that we now really know could happen.

2. There are hidden opportunities in crisis:

COVID19 did accelerate the e-commerce sector. Not only did it temporarily spike the revenues for these businesses but also did introduce many consumers into the eCommerce world. To a larger extent, this impact shall now remain forever. Even for countries like Nepal, where the use of tech was nothing more than an “extravagant” trend, the pandemic made the government realize the need for digitization. Had there been proper digital systems in place there would not be so many manual hassles such as paying the taxes, renewing the vehicles/driving license, distributing the travel passes during the lockdown, and tracking/controlling the COVID19 cases. Thanks to the initiators of Nepali digital wallets like eSewa and Khalti who broke the barriers and were well setup long before the crises. Else, neither would the banks so far would care to have a proper mobile app nor would we have any other source to facilitate cashless payments.

3. Patience is the key:

COVID really tested the level of patience in me. While I left the company as a cofounder, I thought I would start working after a good break of a month or two. But things didn’t turn out the way I thought. I had rejected quite a few offers that I received before the pandemic and had almost gotten into the job I wanted. Unfortunately, COVID took those positions away. I had to wait for over 5 months to land into a new job. Definitely, you don’t get to work at all the places you want to but I did get offers from some of the companies I wanted to get into (I rejected them. But that’s a different story). Amid the crisis, I got an opportunity to facilitate a class of undergraduate students too. The other side of the story is that I stayed home with little or no work for 3-4 months while I even hated to stay home on Saturdays. Now, that I work from home, staying at home for four days a week on average is the “new normal” for me. Nothing is forever – neither was the lockdown nor is the pandemic. Things will get better or we will get used to with this.

4. There is no destiny:

There is no destiny in life. 

Let’s put this simple. 

We do whatever we do to achieve something. We believe that this “something” will provide us happiness and keep us content in life. But happiness is not something to be achieved in the future. There is no way to happiness, happiness is the way. Don’t plan to get happy, and just be happy with whatever you have right now.

5. Keep your life in between reactive and proactive path:

Karna Shakya posted a status on his Facebook which really summed up the realization I made this year. Here’s the translated version of what he said:

“As you get old you don’t need a reason. My back hurt the whole night and I came to my Karma-Kunj early in the morning to get over my pain. I sat on the table hoping that if I can think of something else, I could forget my pain, and I opened my heart (thought). Slowly, I delved into my thoughts. I wrote whatever came to my mind.

Time supported me in a decent manner in my life. I played a lot as a kid, fell in love numerous times, traveled around, danced, and did many more. In reality, you don’t have to wait for the right time to work and to learn. You can gain knowledge, wealth, name, and keep up with your life at any time. However, those are not only the future of your endeavor. Now, at the age of 78, I am getting lost in the nooks-and-crannies of philosophy.

Religion, philosophy, -ism isn’t the truth. These are just shadows of verticles, views, and perspectives. There is no truth, there is only perception. Whoever can convince others, is the right. In this ostentatious life, we do need these types of perks because we need reasons to live and add romance to a boring life. However, our life is directed by truth, not philosophy.

Realistic people are of two types – Reactive and Proactive. Reactive are those who are rapturous, do not care about the future, and live in the present. They enjoy the principle of “Don’t ask me about tomorrow. Only the good will happen.” To be true, even this is one of the precise ways and a style of living a happy life.

Proactive people are aware and prefer to live for tomorrow rather than today. Sometimes they even tend to get lost in ideas while contemplating. They do climb the mountain of success but get lost in the clouds. That’s why after passing through these seven decades, the experiences of my life are now pushing me to walk through the glorious mid-way of the Reactive and the Proactive path.”

That’s exactly where I decided to stand after a year of contemplation. There are few things (not many either) to be achieved in life but not at the cost of giving up things that keep me happy at present. It’s a balance of present happiness and the zeal to achieve something in the future that keeps me going. Not too much, and not too less – Lagom.

6. One step at a time:

My reasonings worked in a deductive manner defining the consequence without thinking much about other ways to get things done. I realized that this has really pulled me back from achieving or doing a lot of things. Someone to me said “We don’t do more of planning. We do and then plan.” This is where I have started to focus. I do know I need to climb Mt.Everest. Had I been the previous me, everyday I would plan and think of reaching the top spending significant time in thinking if what/how I planned is the right way to get to the top. Further, every time I would think of summiting Everest, I would be unsure about my ability to get to the top. However, now, I plan the path once but plan on reaching a certain milestone every day. I deal with smaller chunks of larger problems each day. This not only keeps me going but also helps me focus and deal with a piece of the problem. While the ultimate goal of clinching the peak is in the back of my mind, much of my thoughts, energy, and ideas are preparing to take one more step to move ahead.

I believe these six lessons are enough to move ahead for a couple of years. After a couple of years, I shall once again revisit the past and redefine the philosophy of life as things change within and around me. Until then, amen! 

मित्र(ता)को परीक्षा

१२ कक्षा सकिएको केहि समय भईसकेको थियो । मेरो दिनचरिया भनेको एउटा बन्दै गरेको वेबसाइटका लागि कन्टेन्ट लेख्ने, फुपुको छोरा (भाई) लाई पढाउने, देश बाहिर पढ्न जानकालागि तयारी गर्ने, र ११-१२ पढ्दा सुरु गरेको ‘एक्टिभिजम’ कायम राख्न विभिन्न कार्यक्रमहरु संचालन गर्ने वा यिनमा सामेल हुने थियो ।  त्यसताका आफुले पढेको कलेज मेरालागि दोश्रो घर जस्तै थियो । पछिल्ला २ वर्षमा मैले त्यहाँका धेरैजना गुरु र अन्य स्टाफहरुसँग निक्कै राम्रो सम्बन्ध बनाएको थिएँ । त्यसैले फुर्सदको समय त्यहाँ पुगेर म सबैसँग गफगाफ गर्न छुटाँउदिन थिएँ । यस्तै गफगाफ गर्न पुगेकाबेला त्यहाँका प्रिन्सिपल सरले मलाई समय भए त्यहि कलेजमा इन्टर्नसिप गर्न अफर गर्नु भयो । प्यारो कलेज, त्यसमाथि आफुसँगैका अरु दुई मित्रहरु पनि त्यहिँ काम गरी रहेकाले मैले बिना अन्य प्रश्न सरको अफरलाई “यस” भने । 

“यस” भनेको केहि दिन पछि म नियमितरुपमा कलेजमा काम गर्न थालेँ ।  भर्नाको समय चलिरहेको थियो । मेरो काम मुलतः कलेज र पढाई बारे बुझ्न आएका नयाँ  विद्यार्थीलाई जानकारी दिने र भर्नाका लागि जाँच दिने विधार्थीको कपी चेक गर्ने नै थियो । कहिले काहिँ भने कोहि क्लास लिने शिक्षक बिदामा बसेको दिन मैले गएर क्लासमा विधार्थीहरुसँग छलफल गर्ने गर्नुपर्थ्यो । 

भर्खरै १२ सकेको मलाई उत्साह एकतिर त थियो नै तर त्यो भन्दा बढी डर थियो कि ती विधार्थीले म भर्खरै १२ सकेको फुच्चे हो भन्ने चालपाए कसरी टेर्लान् ?!

यसरी काम गरिरहेको बेला एउटा अर्को कलेजको स्नातक तहको परीक्षाका लागि हाम्रो कलेज सेन्टर हुने खबर आयो ।  करिब हप्ता-दश दिन चल्ने त्यो परीक्षा लागि एग्जाम-हलमा बस्ने गार्डहरुको आवश्यकता पर्ने भयो । यसका लागि को-को बस्ने भने छलफलमा मलाई पनि गार्डका रुपमा राख्ने निर्णय गरियो। भर्खरै १२ सकेको मलाई स्नातक तहको जाँचमा गार्ड राख्ने भन्दा उत्साह एकतिर त थियो नै तर त्यो भन्दा बढी डर थियो कि ती विधार्थीले म भर्खरै १२ सकेको फुच्चे हो भन्ने चालपाए कसरी टेर्लान् ?! समस्या त्यति मात्र रहेन जब मलाई याद भयो कि जाँच दिन आउने विधार्थी मध्ये एकजना सोहि कलेजमा मसँग पढेको साथी सञ्जिब थियो जोसँग मेरो कलेज पढ्दा निकै राम्रो चिनजान थियो । सञ्जिब सँगै अर्को विधार्थी भने हामी भन्दा सोहि कलेजमा पढेका एकजना सिनियर दाई थिए । उसै त कलिलो अनुहार भएको म, त्यसमाथि उनीहरुले मेरो बारे अरुलाई सुनाइदिए भने झन् कसैले टेर्दैनन् भन्ने पिरलो औधि भयो । यसका लागि उनीहरुको भएको क्लासमा मलाई नराखिदिन मैले एग्जाम-इन्चार्ज रहेका गुरुलाई आग्रह गरेँ र उनीहरुको छेवै नपर्ने निर्णय गरेँ । 

परीक्षा सुरु भयो ।  अलिक बुडो देखिन्छु कि भन्ने आशले केहि दिन यता मैले दारी काटेको थिइन र टिसर्टको सट्टा सर्ट लगाएर म गार्ड बस्न गएको थिएँ । पहिलो दिन सबैलाई प्रश्न पत्र र उत्तरपुस्तिका बाँडेपछि डराई-डराई चिट चोर्नेको कपि खोसीदिने कुरा सुनाएको स्मृति अझै पनि प्रष्ट छ । गार्डहरुलाई कडाईका साथ परीक्षा संचालन गर्न भनिएको थियो । सोहि निर्देशन अनुरुप १-२ पटक चोरेर वा चोर्न कोशिस गरेकाहरुको कपि मैले खोसिदिएको पनि थिएँ । त्यत्तिको कडाई भएको परीक्षा मैले आफुले पनि कमै मात्र देखेको-भोगेको थिएँ होला सायद । कपि खोस्दा होस् वा परीक्षा हलमा ल्याउन निषेधित मोबाईल-फोन जफत गर्दा, मलाई डर एउटै कुराको थियो – अरु कसैले म उनीहरु जस्तै ‘फुच्चे’ भन्ने थाहा पाए भने कि बाटो तिर कुट्लान् कि परीक्षा हलमा अर्को दिन देखि नटेर्लान् । 

मलाई डर एउटै कुराको थियो – अरु कसैले म उनीहरु जस्तै ‘फुच्चे’ भन्ने थाहा पाए भने कि बाटो तिर कुट्लान् कि परीक्षा हलमा अर्को दिन देखि नटेर्लान् । 

त्यसबेला अर्को क्लासमा एउटा घटना घट्यो । एउटा विधार्थीको मोबाईल-फोन कक्षामा गार्ड बसेको गुरुले जफत गरिदिएका रहेछन् । त्यसबेला स्मार्ट फोन हुनु ठुलो कुरो थियो । भर्खरै बजारमा आउन सुरु गरेको भएपनि धेरै मानिसहरु पुरानै ‘बटनवाला’ फोन चलाउने गर्थे । सरले भेटेको सो फोन पनि बटनवाला नै थियो । संयोगबस त्यो फोनमा कुनै किसिमको सेक्युरिटी-कोड हालेको रहेनछ । यस्सो एउटा बटन थिचेर हेर्दा फोन अनलक हुने देखियो । फोन जफत गरेको केहि समयपछि हामी केहि गार्डहरु स्टाफरुममा भेला भएका थियौँ । के सुरमा हो जफत गर्ने गुरुले फोन चलाउन थाले । गुरुले फोनमा भएको मेसेजहरु हेर्दा त्यस केटाको २ जना गर्लफ्रेन्ड भएको थाहा पाइयो । केटाका दुवै प्रेमिका पनि त्यहि कलेजका थिए र त्यहीँ जाँच दिदै थिए । हामी सबै यो कुरा थाहा पाएर गलल हाँस्यौँ । अहिले सम्झदा त्यसदिन सायद मैले नै अरुको फोनको म्यासेज हेर्नु गलत हो भनेर भन्नु पर्ने थियो कि जस्तो पनि लाग्छ ।

परीक्षाको अन्तिम दिन थियो । केहि कारणवश म मेरो साथी भएको परीक्षा हलको गार्ड परेँ । सञ्जिब मात्र हैन आफूभन्दा सिनिअर दाई पनि त्यहि क्लासमा थिए । भित्र छिर्नासाथ म डरले रातो पिरो भएँ । शायद नर्भस भएकै कारणले होला, मलाई त्यसबेलाको थोरै मात्र कुराहरु याद छन् । सबै कुरा सुमधुर चलिरहेको थियो ।  परीक्षा सकेर विधार्थीहरु हलबाट निस्कन थालिसकेका थिए । यसै बीच सञ्जिबले छेउमा रहेको उसको साथीलाई केहि सोध्न थाल्यो । मैले त्यसो नगर्ने आग्रह गरेँ । उसले केहीबेर त मान्यो तर फेरी बोल्न-हेर्न गर्यो। सायद जाँच सकिन थोरै मात्र समय बाँकि थियो, त्यसैले मैले अब कपि खोसे पनि साथीले पास गर्ने जति लेखिसक्यो होला भन्ने सोचेँ र उसको कपि लिईदिएँ । मित्र त्यसपछि केहि नभनी कोठा बाहिर गयो । त्यसयता सञ्जिबसँग लामो समय मेरो भेटघाट भएन ।

त्यसदिन सो कुरा सुनेर हामी साथीभाई बीच एक राउण्ड हाँसो गुञ्जियो । आखिर त्यो घटना सम्झन योग्य नै थियो । 

कलेज पढ्दा मेरो मित्रता कलेजका धेरैसँग थियो। आफ्नो-आफ्नो समूह बनाएर बस्ने मित्रहरुबीच म कहिले कुन त कहिले कुन ग्याँङसँग बस्थेँ। सोहि मध्येको एउटा मिल्ने ग्याँङको मित्र सन्जिब पनि थियो। ‘परीक्षा काण्ड’ पश्चात सञ्जिबलाई मैले फेसबुकमा मात्र देखेको थिएँ । करिब २ वर्ष पछि सञ्जिब सामेल हाम्रो ग्याँङ भेट्ने कुरा भयो र हामी नयाँ बनेश्वोरको एक रोडसाइड स्टिक-फुड स्टलमा भेट्यौँ । धेरै पछि भेटेकाले होला, मलाई ‘परीक्षा काण्ड’को वास्ता थिएन । कुरैकुराबीच सबैसामु त्यो दिनको कुरा पनि निस्कियो । भएको के रहेछ भने सञ्जिबहरुको त्यसदिन गणित विषयको जाँच रहेछ । गणित सञ्जिब र मेरा लागि उस्तै-उस्तै थियो – आतंक ! प्रश्नपत्र हेर्दा सञ्जिबलाई उत्तर आउने भन्दा नआउने प्रश्नहरु धेरै रहेछन् । पास गर्न हम्मे-हम्मे हुने स्थितिको सामना गर्ने अवस्था आएछ । यहि आतंकको बीच सञ्जिबको सोच एक असल साथी पनि हुने र छेउछाउका मित्रहरुको उत्तर अलि-अलि हेर्दै पास पनि गर्ने रहेछ। यसका लागि उसले जाँचको पहिलो २ घण्टा आफ्नो मित्रलाई अफ्ट्यारो नपर्ने गरि आफुले जानेको केहि प्रश्नको उत्तर लेखेर र चुप्प लाग्दै समय बिताएको रहेछ । बिस्तारै जाँच सकेर जाने विधार्थीहरु बढ्दै गएर क्लास खाली-खाली हुन थालेपछि मात्र उसले आफ्नो नजर अरु मित्रहरुको उत्तरपुस्तिकामा डुलाउन थालेको रहेछ । तर कर्मनिष्ठ साथीले त्यसो गर्न थालेको केहि प्रयासमै सञ्जिबको उत्तरपुस्तिका खोदिएको रहेछ । त्यसदिन सो कुरा सुनेर हामी साथीभाई बीच एक राउण्ड हाँसो गुञ्जियो । आखिर त्यो घटना सम्झन योग्य नै थियो । 

त्यस दिनको सञ्जिबसँगको भेटघाट पछि हामी बेला-बेला भेटिनै रहन्थ्यौं । तर त्यस घटनाबारे सबैभन्दा अचम्मको कुरा त मैले कयौँ भेट पछि मात्र सुन्न पाएँ । स्नातक सकेको केहि समय पछि सन्जिबले मलाई एकदिन भन्यो, “मैले ब्याचलर्समा फेल भएर दोहोर्याएर दिनुपरेको एक मात्र सबजेक्ट त्यहि (गणित) नै हो।” त्यति बेला पो मन चसक्क भयो । लाग्यो साथीका लागि जाबो नदेखे जस्तो गरेर उसलाई अलि-अलि हेर्न दिएको भएपनि उसले पास त गर्ने थियो होला नि ! आहिले पनि प्रिय मित्र सन्जिबसँग बेला बखत भेट हुने गर्छ र सोहि कथाले संबादका क्रममा प्रवेश पाईरहन्छ ।

What’s so real?

Over the past few months, I have been investing some of my time trying to dissect the philosophy of my life. The sole aim of this investment has been to figure out the good and the bad, the fake and the real, and the fair and the unfair, and rejuvenate my views towards life to some extent. The complexity lies in the fact that all of these terms are relative to one another. The answers aren’t easy, and I’ll probably never get answers to all of these but this journey of exploration has led me to some interesting realizations.


Talking about fairness, I liked the view that one of my friend’s husband had presented in his blog a while ago:

“So is the world a fair place? Of course not. Not even that, sometimes we cannot determine whether a situation is fair or not for the people subject to that situation. But more often than not, we can see through the blatant violations of fairness that are taking place.
So what can we take away from this?
We should not presume that we know the plight of the people facing a bad situation, for one. We hardly have the right to judge them for we do seldom see the complete picture. Also, do not let the little fairness we enjoy in this world fade away. If you would let it, you would come to regret it, much sooner than you could even dream.”


I happened to watch some of the videos about “Romanticism” in one of my favorite youtube channels – School of Life. This pushed me further into my journey to distinguish between the real and the nominal, or say what’s natural and what’s man-made.

So what’s natural? What’s man-made? Well, you may go back to the basics of grade one and say everything that humans did not create is natural. No doubt, this meaning is very true. Trees, soil, sun, mountains, water, air – all of these are natural. And, the ones that humans created, beginning from the tiny staple pins to the large Egyptian pyramids, are artificial/man-made. But let’s dive into the humans and look for what came naturally (real) to us and what came through our learnings and experiences? This question fairly sounds easy but is not. Give it a thought – did we learn to eat or were we taught? Well, hunger is an emotion that comes naturally, but eating is taught. We are taught to cook, and our taste buds crave for stuffs based on what we eat or have eaten. Some of us learn to eat with hands, some with fork and knives, and some with spoon. This example probably made the answer easy- the only natural thing that is within us is “emotion”.

Let’s get back to the video about “Romanticism”, where Alain De Botton, the presenter, talks about how the concept of romanticism has defined love and relationship. He talks about the fact that romanticism is fairly a new concept to this world that originated towards the end of the eightieth century in Europe. So what does romanticism say? Romanticism has defined over almost everything and every context of the human mind. It defines the good, the bad, the humble, and the cruel.

Amongst a few of which I have explored through, the most interesting thing that Alain talks about is how romanticism has defined love and relationship that is in practice in today’s world. It has defined the way one feels when falling in love or the way couples behave with each other in their relationship. All the feelings, including the “butterflies in the stomach” or the “blush blush” moments you had in high-school when the person on the other side of the “one-sided love” complimented you, are all that romanticism has defined for us. We all learned to love people the way we have been taught to, or the way we’ve seen or experienced it at some point of our life.

kuch toh hua hai

Moreover, we have been fueled with the romantic ideas of love through movies, their stories, and their songs. Remember the song “Kuch to hua hai” from the movie Kal Ho Na Ho? Well, that “Kuch to hua hai” feeling we get while falling in love is all romanticism which did not exist before the 17th or 18th century. Did you ever think that love, its feelings and its expressions were learned and not natural? I didn’t! Love as an emotion at its base might be real but at its feeling, as well as everything we do for love and in love has just been made up over the past couple of centuries.


So what is natural within us?  Our feelings are not natural because feelings are emotions that have been interpreted by our mind, and our mind makes those interpretations based on our learnings and experiences. Thus, probably only our generic emotions are real. I could only think of two generic emotions- happiness and sadness. No matter how neutral we might feel about something, it is tilted to either of the sides – the happy or the sad side. You are either happy or sad at every point of time. It seems to me that even when one calls himself or herself to be “unsure” about how he or she is feeling, it is sadness that the emotion is leaned towards.

In terms of expressions, the only real expressions a person can have is “laughter” and “cry”. That’s because a baby who is born begins his expression with a cry, no one has to teach a person to do that. Also, the same baby is never taught to laugh or smile, he or she just does it on his or her own. We might fake a laugh or cry but when we truly laugh or cry, it is a true expression that we present without any added toppings to it.

Only in the U.S.

I was inspired to write this post after having a conversation with a friend of mine about why single bed is called twin-bed in the U.S. There are few stuffs that probably happens or exists only in the U.S. The only disclaimer to my readers is that the information stated in this post are solely based on my personal experience and assumptions. As I haven’t had much chance to extensively travel to other parts of the world, these things might exist in other countries too; yet, they seemed little weird and different to me, and so have I tried to dig into what those weird issues are and the reason behind those being different.

  1. Twin-bed, not single bed: We were at this store looking at the mattress covers where I told my friend that I didn’t find any covers for single-bed mattress. “They are called twin-bed not single-bed here in the U.S.”, said my friend. I asked him why it was said so. He didn’t know it either. The only God I believe in – Google- had to help me find an answer. A person in one of the forums writes, “Twin bed is either of a pair of matching single beds ready to be joined to another twin bed to create twin beds. The word simply describes a bed which is stackable with another bed.”
  2. Double door in buildings: There are back-to-back doors a few feet apart in almost all the buildings in the U.S. I had guessed that having the doors few feet apart would be useful in maintaining the temperature inside the building. Since opening the door frequently allows easy exchange of the air outside and the air inside the building, it would be difficult to maintain the temperature inside the building. This logic really seemed to be true.
  3. Trucks and semi: Trucks in Nepal and probably all over the world would mean these:


semi truck

However, in the US trucks are these:

So, what is the vehicle in the first picture called in the U.S.? It is called “semi” or “semi-truck”. This is because the front portion (the half of the truck) with engine, dash and driver’s seat is separate with the container box. But how can trucks be smaller than semi-trucks? The answer is simple, “I don’t know!”

  1. Nice to meet you: This is how people introduce and exchange greetings when they meet for the first time:

Me: Hi, I’m Prayash

Other Person: Hi, I’m Smith. Nice to meet you!

Me: Nice to meet you too.

These are the times when I’m compelled to say it was nice meeting the person because how can you feel nice as soon as you meet the person and you have just told your name? I’m sorry, but I obviously need a little longer conversation to decide if I really felt nice meeting you.

  1. Everything is flavored: The height of consumerism can be felt in this nation so much that you can get every food in every flavor. You can have a vegan food made of soybean which instead is chicken flavored. Most of all I am amazed to see varieties of flavored water. Peach flavored, passion-fruit flavored, orange flavored… Why does the water have to be flavored? Isn’t that supposed to be called a juice?! I had never or would have never imagined of flavored water in my life. Am I too dumb about this?
  2. Cold inside, hot outside: This happens during the summer. When it’s way too hot and humid outside, you get this blissful moment as you enter a building since they have their ACs turned on. But as you sit in a place for a while you tend to feel cold and need a jacket. And it’s not just me who feels so, even the people who have lived in the US for a long time feel so. Why don’t they increase the temperature a little bit?
  3. Pizzas!: So this day we were at a mess/dining place for breakfast at 7AM in the morning. I started exploring the breakfast items that were available. One of the queues, to my surprise, happened to be for pizzas! People have pizzas for breakfast as soon as they wake up? God bless them!
  4. Water with ice and straw: The temperature might be negative 35 degree with piles of snow outside, but water with ice is a culture in the U.S. No matter how much you shiver with cold people sip in water with ice using the straw. More than the culture, I’m concerned about discarding the plastic straws which is used for a single-time. Thanks to one of the states – California, for banning on use of single-use plastic straws in full-service restaurants beginning 2019.

Having said that, the best thing about being in U.S. is that there are easy solutions for all our problems. Every problem is thought of and so do every problem has a well thought solution in this country! Cheers’

Keratoconus Diaries

Perhaps it was during the month of February or March when it hit me with an abrupt wish to put on spectacles for no reason. It was pretty normal for a kid of around eleven years, back then, to have such an illogical wish. I wanted it because I had collected some money out of the dakshinas during my bratabandha held back at our village in Eastern Nepal.  Every time I had some money I would give it to my parents and maintained a good record of the amount my parents owed to me. Once in a while, I would then ask my parents to buy me something out of my savings. Sometimes it would be a bicycle (gear-wala-cycle), or a Walkman, or some other stuff I had seen from my friends or on TV. Now was the time for spectacles.

With no other options left, my parents had to get their son a new pair of spectacles. However, they decided to take me to a doctor for an eye examination before getting one of those pairs. I clearly remember visiting the Lions Eye Hospital at Tinkune for the first time. Crowded with people all around, it had taken almost half of the day to have my turn and get done with the examination. The doc had prescribed me a pair of spectacles with corrective glasses for my myopic eyes. My first spectacle frame in blue color with lenses made up of glasses; I still remember the first time I wore them. It felt weird as I saw everything smaller and little shaken.

What I really see without the glasses or contact lenses.

I should have visited Lions twice or thrice every six months for the regular follow-ups for a few years. One sudden day, one of the doctors there told that I had this disorder called “Lazy Eye” and suggested me to visit some specialist who had her clinic at Tripureshwor. After visiting the specialist, I was asked to put on eye patch on my “active eye” and asked me to look only through the “lazy eye” for certain number of hours each day. It wasn’t an easy task to see through an eye with blurred vision. I struggled in the classroom to see what the teachers wrote. Not at all did it work well. After figuring out about the failure to use an eye patch, my dad then took me to TU Teaching Hospital’s eye department for the examination. Queues after queues, rooms after rooms, my examination was done. Although the term “lazy eye” vanished from the doctor’s report, I was told to have some other disorder in my eye. I was too small to understand or remember the term, but the docs had prescribed me a hard contact lens as a cure.

Putting on hard lens, in simple words, was clearly a torture. I would have rather chosen putting on eye patch, rather than this super hard plastic like material which felt like thorn in my eyes every time I had to wear them. I was in grade eight (around fifteen years) when I went to the school with that pair of lenses and would have more of my attention towards my eyes than towards the course work. I wonder how easy or difficult this thing would be to put those on these days as a grown-up man. I wonder if it really was such a pain in the ass because I was a kid or was it really a nasty little thing?!

I stopped putting on the hard lens and wore specs for a year. Sometime during this time, a relative of mine told about a specialist who was said to be a really good doctor. I started to visit him. Every time I visited him, he would have the power on my glasses changed. That was all that happened for next two years – a new pair of glasses in every six months.

After two years new pair of glasses session with the doctor, dad meet another doctor who sounded more promising. After couple of visits to this doc, I was suggested to put on soft contact lenses for better vision. Soft contact lenses worked like gem. I could see things a lot better. Almost five years I visited him. He was a good guy and took well care of my eye. However, sometime in between those five years, in 2015, I heard about the new laser surgery started at Tilganga Institute of Opthalmology and decided to try it. After visiting Tilganga and having a few examinations, I was asked to meet an consultant optometrist who revealed that I had a disorder called Keratoconus. The consultant asked me to visit some other specialist or visit his own clinic for a follow up. “Too commercial person” my mind thought when the doctor himself asked me to visit his clinic while I was right in front of him. Having no trust on the doctor, I continued with my previous doctor for the regular checkups.

Over the years, the lenses of my spectacles got thicker. I had begun my always on with chasma (glasses) life at the time when plastic made lenses was something new and I preferred the cheaper glass made lenses which would get scratches very easily. However, by 2015 the lenses were available in varied options and the glass made lenses were rare. The first time I had wore my glasses had a power of around -1 spherical power on both of my eyes. Now, it was around ten on my right and six on my left with cylindrical power added to it. I felt my eyes to have severely deteriorated and it showed no sign of stopping. I then decided to speak to one of my relatives who was also an optometrist. I told him about my regular doctor and about the incident at Tilganga. He then suggested me to have a thorough check-up at Tilganga once again.

November 2016, I visited Tilganga again. The optometrist who checked my vision coincidently told that my eyes seemed to be Keratoconic. He then told me to visit another room and asked me to tell the doctor that I could possibly have Keratoconus. The checkup was conducted, and the reports clearly showed both my eyes were Keratoconic. Keratoconus deals with the cornea of the eye and so was I asked to meet a cornea specialist. Upon meeting Dr. Reeta Gurung at Tilganga, I was told about a procedure called collagen cross linking (CXL). Since Keratoconus has no cure, she suggested me to have epi-on CXL which does not really cure the disorder but strengthened my cornea to stop the vision to worsen.

As one of the websites states, Keratoconus is a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. This cone shape deflects light as it enters the eye on its way to the light-sensitive retina, causing distorted vision. Keratoconus can occur in one or both eyes and often begins during a person’s teens or early 20s. Often, keratoconic patients experience changes in their eyeglass prescription every time they visit their eye care practitioner. It is caused when the corneal tissues weaken. Unfortunately, the reason behind this weakening isn’t much known.

CXL, one of the only options, except cornea transplant, to halt the progression involves putting on drops of Riboflavin (vitamin B) in the eyes for certain period of time and exposing it to the UV rays. There are two versions of corneal crosslinking: epithelium-off and epithelium-on. With epithelium-off crosslinking, the outer layer of the cornea (called the epithelium) is removed to allow entry of riboflavin, a type of B vitamin, into the cornea, which then is activated with UV light. With the epithelium-on method (also called transepithelial crosslinking), the corneal epithelium is left intact during the treatment. The epithelium-on method requires more time for the riboflavin to penetrate into the cornea, but potential advantages include less risk of infection, less discomfort and faster visual recovery, according to supporters of this technique.

It still took me a year to figure out if CXL was a right option. Firstly, I was afraid because I had been diagnosed with numerous disorders so far and wasn’t sure if the diagnosis was proper this time. Secondly, CXL was a very new procedure which was under clinical trials in several countries. In US, FDA was yet to approve the epi-on CXL while epi-off was just approved in April 2016. Europe had only recently approved it. The long-term outcomes and consequences of the procedure was/is still unknown. I also found out that epi-off seemed more successful then epi-on. Yet, with no better options and with a little hope to stop the worsening of my vision, I decided to go for CLX for both of my eyes in March 2017.

I had read and seen videos on CXL so much that the procedure didn’t seem much new to me. CLX for the first time was done in my right eye. It took me about three days to recover and get back to work. The second time, during the CXL of my left eye, I knew so much about the procedure that I was the one to brief about the disease to the assisting doctor during the procedure in the operation theatre. After almost a month, I was prescribed with disposable soft contact lenses for a few months until the hazing in UV exposed cornea was gone and the effectiveness of the procedure was could be analyzed. As I was out of the country for a year, I couldn’t go for any follow-ups.

After a year, I was back to Nepal. The very next day of my arrival, I went for the follow-up. Things seemed to have settled and CXL seemed to have worked. I was then suggested to go for mini scleral contact lens which could superficially correct my vision. Several trials and I ordered this super expensive lens. It was a magical moment reading the letters in the eye chart. Although the shadow of the letters couldn’t fade much, I could read almost until the last line. 6/4 is what I had achieved (it feels like 6/6 to me). As my optometrist said, I had gained a fine quantitative vision but not qualitative vision.  It had been quiet a while I had not seen such a picture-perfect world.

Normal vision, me without glasses or contact lenses, and with glasses. With the mini scleral lenses I see somewhat similar to the normal vision but with some shadow of the image.

In these few months, my achievement has been my friends asking me to read the letters and numbers which they cannot read from far, my courage to drive and walk in the dark, watch the 4K and HD videos with HD eyes, and see the world as it is. No more difficulties to figure out who is waving or is calling my name from a few meters away. Hopefully I will not have to go through the trouble of cornea transplant which has a risk of tissue rejection at any point of time in life. And that’s all in my Keratoconus diary so far!

Join the Facebook community of Keratoconus Patients, and Doctors in Nepal: https://www.facebook.com/groups/993265627680756/