N M Pemmaiah, 86, a retired captain from the Indian army used to lead a busy, active life. He would wake up early in the morning, go on his ritualistic morning walk, eat breakfast and then go grocery shopping.

Life after service was treating him well. Until covid struck. Pemmaiah, who used to take a lot of pride in his body’s immunity and its ability to perform well, even under the harsh environs he stayed in while serving in the army, suddenly found himself struggling to fight a disease he had never even heard about. And it left lasting damage.

Pemmaiah is sitting on the couch, doing particularly nothing, when Happiest Health visits his home in Marasandra, Bengaluru, where he lives with his son Kishore and daughter-in-law Priya. On his right, an oxygen concentrator hums away, working in full swing. A thin tube runs from the machine to two prongs below his nostril, delivering the oxygen his body needs.

Pemmaiah who was infected with covid during the height of the pandemic in 2020, has never truly fully recovered from it. He suffers from ‘post-covid lung damage’, due to which he must be on constant oxygen support.

Pemmaiah describes it differently. “Everybody asks me what happened. So, I tell them, ‘This is a long story, so I’ll try and tell it briefly. There are so many fish in the sea. When they come out of the water, some fish can breathe without any issues for 10 minutes, some can breathe for longer, maybe for half an hour without any problems.’ I tell people that I suffer from a somewhat similar condition where I can breathe properly for a few minutes but after that, I’ll need to get myself connected again to the machine that helps me breathe.”

Throughout our conversation, the distinct, humming sound of the oxygen concentrator is hard to ignore. “My lungs are functioning only at 50 per cent capacity. This machine takes care of the rest,” Pemmaiah says about the oxygen concentrator.

“I feel like I need this machine every hour of the day. I can manage for a short while without it, but I have not gone without the concentrator for a long time. When it is switched off, I feel like something is missing from my life. A few seconds after it is switched on, I feel normal again.”

“People also think that there are some medicines inside this oxygen concentrator. So, I tell them there is no medicine, it is only doing 50 per cent of the functions my lungs are supposed to do.”

Pemmaiah pauses during the conversation whenever his voice grows coarse and he cannot speak. During these breaks, Kishore and Priya rush in with a glass of water and a small pulse oximeter to monitor his oxygen saturation levels and pulse rate.

When his oxygen levels drop, he feels giddy, his hands shake and he feels a loss of strength in his legs. “When he stays without the concentrator, his saturation and pulse rates start fluctuating. We sometimes unplug him from the oxygen concentrator – when he is having food for instance. When he is eating, the saturation level is at 90. The moment he gets up to wash his hands, the level plummets,” Kishore says.

Pemmaiah, who has served in Kargil and Leh, both places known for low oxygen levels, finds it ironic that he now feels breathless walking inside his home.

Life is equally challenging for the caretakers, Kishore and Priya, who say they’ve spent the last two years on high alert. A wireless bell is kept by his bedside to alert them for any help.

The oxygen concentrator can supply five litres of oxygen per minute. Pemmaiah’s oxygen requirement has come down from three litres/minute to 1.5 litres/minute.

“The machine, on average, consumes 400 watts of power, which essentially means that a 400 watts bulb is running continuously, all day and night. This translates to a lot of electricity consumption,” says Kishore.

The frequent power outages are a nightmare. The family earlier lived in an apartment and faced power outrage. “Every time there was a power cut, we would frantically run downstairs to ensure the generator was switched on immediately. The management there was not very keen on running the generator throughout the day. We only recently moved into this independent villa where we have installed a higher capacity generator. There were times in this new house also when the switchover to the generator did not happen automatically and had to be reset manually, sometimes very late in the night. Now it is stable, though. So, you have to make a lot of provisions and adjustments to make sure he is safe,” says Kishore.

The oxygen concentrator machine requires maintenance. The humidifier bottle, the oxygen tube and the cannula need frequent cleaning. “I clean the bottle daily – it’s similar to how a baby’s feeding bottle is sterilised. We sterilise it with warm water and vinegar. You have to keep it in this solution for half an hour,” says Priya.

The entire house also has to be dust-free. “As the machine uses the air from the surroundings to supply oxygen, there are possibilities that dust on the concentrator or in immediate surroundings of the concentrator, could also get sucked in,” says Priya.

The family, however, has learnt to look at the bright side of things. Kishore says that his biggest takeaway from caring for his oxygen-dependent father has been the importance of leading with empathy in situations of crisis.

Pemmaiah has a positive outlook. In the initial days of breathing difficulty, he wasn’t very aware. “I didn’t know what I was doing, I didn’t know what I was eating. There was a time when I felt like giving up. My body had absolutely no strength. Today, I feel that I’m all right. I’m in this stage today thanks to my daughter-in-law and son’s treatment,” says Pemmaiah.

He poses an important question.  “I know that one day I’m going to die. Everyone dies someday. But until then, I’m happy. What is the point in staying unhappy over something that is bound to happen in the future?”