Straight from the
Heart :
The Story of My Tryst With My Heart Ailment
The Story of My Tryst With My Heart Ailment
Straight from the Heart (1) : The Story of My Tryst With My Heart Ailment
Straight from the Heart (2) : “Rational” Thinking, Irrational Acts
Straight from the Heart (3) : When the Unthinkable Happened : Angioplasty, 1999
Straight from the Heart (4) : Back to Life as Usual, with a Minor Throwback
Straight from the Heart (5) : Déjà vu
Straight from the Heart (6) : Opening Up to Open-Heart Surgery (CABG)
Straight from the Heart (7) : Post-Operational Recovery
Straight from the Heart (8) : One Year After
Part-I of VIII
Where Things Work
Wonderfully Well!
The Great Heart Team
at Kokilaben Hospital (KDAH), Mumbai
The Great Heart Team
at Kokilaben Hospital (KDAH), Mumbai
People pay the doctor for [her]
his trouble;
for [her] his kindness they still remain in [her] his debt.
– Seneca
for [her] his kindness they still remain in [her] his debt.
– Seneca
______________________________________________
What I underwent
The Background
Take care of your body.
It's the only place you have to live.
It's the only place you have to live.
(But, did I care?)
I deservedly paid for being an immoderate smoker by having
angioplasty done on me, with one stent, at Lilavati Hospital, Mumbai in
December 1999. I haven’t smoked since, have stuck to reasonably healthy habits, and have been on prescribed life-long
medication, including that for diabetes type-2, which actually erupted in
December 1999 only, as earlier tests had shown normal glucose levels.
The Beginning
I have been used to walking for about an hour daily in the
evening. In the latter-half of June 2014 I began to experience breathlessness
while walking, although I didn’t feel any pain in the chest or elsewhere, or
any palpitations, like I had felt in December 1999.
I visited Sanchaiti Hospital, Kandivali-E on 24 June 2014
and consulted my doctor, Dr Sejao Vidyasindhu. Dr Sejao, to my consternation,
took no time in declaring what I was experiencing was “Angina-equivalent”, and
that I must lose no time in getting ECG, 2D-Echo and Angiography (CAG) done;
and till that is done I must forget about walks, do no exertions and take
complete rest. He suggested the name of Dr Sunil Wani at Kokilaben Dhirubhai
Ambani Hospital (KDAH), Mumbai.
Angiography (CAG)
The heart
How cruel and unjust of nature
To entrust the seat of mind and soul
To a lowly pump that tends to fail
Unpredictably, erasing all!
(Source : web)
I consulted Dr Wani on 26 June 2014 at KDAH, and also had ECG
and 2D-Echo done. Based on the tests, Dr Wani advised I undergo angiography
(CAG).
I underwent angiography on 3 July 2014 at KDAH. It
revealed five major blockages (80% to 100%), including the one where the stent
was put in 1999 (100% blockage). Dr Wani ruled out Angioplasty and advised expeditious
Open-Heart Surgery.
Beating-Heart,
Off-Pump Open-Heart Surgery (OP-CABG)
Off-Pump Open-Heart Surgery (OP-CABG)
A cheerful heart is the best medicine of all
—provided it beats cheerfully!
—provided it beats cheerfully!
After checking up all the relevant facts from KDAH, on the
internet and from Dr Wani, and personally meeting beating-heart-surgery expert
Dr Vidyadhar Lad and discussing with him, we (my wife, two daughters and
myself) decided at KDAH itself on 3 July 2014, before leaving for home after
angiography, to entrust my fate to the deft hands of Dr Lad.
I finally underwent Beating-Heart Bypass Surgery, also
called Off-Pump Coronary Artery Bypass Graft (OP-CABG) Surgery on 9 July 2014.
I had a total of five grafts.
(Photograph below:
Courtesy — Wiki)
I had one more, that
is, quintuple grafts—total five.
What is Beating-Heart
Off-Pump Coronary Artery Bypass Graft
(OP-CABG) Surgery?
Off-Pump Coronary Artery Bypass Graft
(OP-CABG) Surgery?
Beating heart bypass surgery is, in simple terms, a bypass
surgery that is performed on the heart while it is beating. The heart would not
be stopped during surgery. A heart-lung machine would NOT be needed. The heart
and lungs would continue to perform during the surgery.
As opposed to the conventional On-Pump surgery, Off-Pump Beating-Heart
surgery has been proven to reduce side effects, because heart function is better
preserved if the heart is not stopped during an operation. The conventional On-Pump
surgery also carries the high-risk of heart not being able to bounce back after
surgery. Off-Pump Beating-Heart surgery uses special devices to stabilize the
part of the heart the surgeon is operating on.
In summary, the benefits of the Off-Pump Beating-Heart
surgery over the traditional/conventional On-Pump bypass surgery are quicker
recovery resulting also in lesser hospital stay; reduced risk of neurological
injury like stroke, memory-damage, and lesser risk of complications in heart
rhythm, kidney, or liver; better
preservation of heart function; and superior survival rate.
___________________________________________________________________________________
Where Things Work
Wonderfully Well!
And, Thanks To Those
Who Ensure It Is So.
Who Ensure It Is So.
Dr Sejao Vidyasindhu,
MD
A no nonsense thorough professional who always offers the right advice. Exercising economy of words, he doesn’t talk much, but doesn’t mince his words either.
His cryptic declaration of the state of my heart and the
immediate-next-steps-advice left me no room to fool myself that “things might
not be all that bad” and provided me no scope “to further kick the tin down
the road” buying more time, hoping, God willing, things might turn out okay
even otherwise.
We need more such doctors.
Dr Sunil Wani
MBBS, MD (Gen Medicine), DM (Cardiology)
MBBS, MD (Gen Medicine), DM (Cardiology)
Consultant Cardiologist,
KDAH
Dr Sejao had advised I get Coronary AngioGraphy (CAG) done
at the earliest at some really well-equipped centre through a cardiologist of
proven competence, honesty and integrity. He suggested, as top option, Dr Sunil
Wani at Kokilaben Dhirubhai Ambani Hospital (KDAH), Mumbai, and gave me his
mobile number. Knowing Dr Sejao as a thoroughly competent professional of high
integrity, I did as he advised, and am glad for it.
I was worried it was going to be a huge hassle, but
realising it couldn’t be helped, I sent an SMS to Dr Wani, to start with,
before embarking on the ordeal.
But, most unexpectedly, with Dr Wani responding promptly and
taking personal interest, the whole process—consultation, ECG, 2D Echo,
followed later by angiography (CAG) on 3 July 2014—went so smooth and in such a
hassle-free way that I couldn’t believe India, at least in such isolated
pockets, had so dramatically changed for the better!
Angiography, which was (and is) done in the absence of any
anaesthesia, allowed me to experience, observe and feel (the pain too) what was
happening. Catheter inserted through a hole made in the artery of my right-hand
wrist (generally the first and the preferred less painful option) didn’t quite
work on account of the possible cramps on its path up. As an alternative, a
hole in the groin (femoral artery or vein) was
made for the catheter. That procedure succeeded.
There was pain, but Dr Wani and his team executed the
procedures very competently causing minimal discomfort.
I felt immensely happy and relieved I had opted to have the
CAG done by Dr Wani. Many, many thanks to Dr Wani and his team.
Dr Vidyadhar S Lad
MBBS, MS, FRCS, M Ch, DNB
MBBS, MS, FRCS, M Ch, DNB
Consultant Cardiac
Surgeon, KDAH
I am at a loss of words to adequately articulate the
exceptionally high-level of competence and skill in their craft; the genuine,
empathetic care and caution; and the endearing, humbling courtesy amply shown
in practice by Dr Vidyadhar Lad and his team that ensured a smooth,
hundred-percent success to the difficult Beating-Heart, Off-Pump, Coronary
Artery Bypass Graft (OP-CABG) Surgery involving five grafts on me on Wednesday,
9 July 2014. What is more, besides the fact that there were NO adverse side-effects,
the procedure caused minimal pain and discomfort, and led to double-quick
recovery!
No amount of thanks are enough for Dr Lad and his team.
There would be much more on Dr Lad, Dr Wani and their team in the subsequent parts of this blog.
Kokilaben Dhirubhai
Ambani Hospital (KDAH)
& Medical Research Institute, Mumbai
& Medical Research Institute, Mumbai
In my humble opinion, KDAH would count as the best hospital
in Mumbai. It is superbly-equipped and has doctors of very high calibre. Its
staff is well-skilled and competent and its management is excellent. It is unusually
spacious, with wide corridors and high ceiling, and is fully air-conditioned.
Its wards, including the twin-sharing ones, are roomy, airy and well-lighted,
with extra-wide glass windows. The most notable thing about the hospital,
something I really appreciate, is its
cleanliness. It is conspicuously spic-and-span. Overall, the hospital has
uniquely positive, life-enhancing ambience.
Compared to the high-quality of services offered by KDAH,
its cost of treatment is very reasonable.
The many others I am
highly thankful to
I acknowledge with deep sense of gratitude the excellent
services and help provided by the following:
Assistants to Dr Lad: Dr Pravin Kulkarni, Dr Ganesh Rawat.
Anesthesiologists: Dr Alka Mandke, Dr Shailesh Kamkhedkar.
Perfusionists Stand-by: Sh. Prashant, Sh. Ravi.
Nurses: Ms Rakhee, Ms Renita.
Thanks also to those at the ICU and at the ward who took good
care of me, including:
Dr Shruthi
Nurses Ms Gibi, Ms Jomiya, Ms Lijy, Ms Nibi, Ms Niti, Ms Sharlot,
Ms Soniya, Ms Sneha
Attendants Sh. Sagar and Sh. Swapne.
And, of course, many, many others.
Family & Friends
My elder daughter Manasi working at Oracle, Hyderabad, and my
younger daughter Manini, director in a German software company, flew in from
Hyderabad and Munich respectively, leaving all their work, and proved to be of
great help to my wife Debu in managing all logistics and keeping me amused. My
son-in-law, Arun, also came in from Hyderabad to help out, as also my sister, Poornima Patil, who came over from Nagpur, and my elder
brother, Shrikant Puranik, who came over from Bhopal.
I am thankful to many who visited and/or phoned and enquired
and wished me quick recovery.
My elder daughter Manasi
My younger daughter Manini
Manasi and Manini at the Hospital: KDAH
With my wife Debu
* * * * *
Subsequent Parts of
this Blog-post
Interesting episodes, our arrogance of being rational while
indulging in irrational acts in practice, particularly in health matters, what
it is like to be at the receiving-end of the invasive procedures and
surgery—angiography, angioplasty and open-heart surgery, all of which I have
had the “good” fortune to experience—and interactions with the other
participants in the real story of my heart would be subjects of the subsequent parts of
this blog-post.
* * * * *
A Sharp Contrast
It is amusing how the experience at KDAH stands in sharp
contrast to the otherwise third-rate and sub-standard infra-structure, services
and facilities that Indians have the misfortune to be condemned to since
independence thanks to the poverty-perpetuating and misery-multiplying
Socialistic-Nehruvian-Bureaucratic-Babugiri-Dynastic claptrap—but for which
India would have been a first-world country by 1980 (had it followed
competitive capitalism and free-market economy). Our latest records of the
Dynacracy, that is, Dynastic Democracy: one-third of the world’s poor live in
India; and India is the open-defecation capital of the world!
Now that the Dynasty has hopefully been consigned to the
dustbin of history, and with Narendra Modi at the helm, hopefully things would
change for the better, and there would be many more pockets and segments
emulating the spirit of excellence à la KDAH.
I am tempted to
quote from my book, “Foundations of Misery, Part-I: India, 1947-64” detailing
the “Blunders of the Nehruvian Era” that still afflict us.
“Many countries, including those in SE Asia, which were nowhere
near India or were much behind India at the time India got independence have
marched far ahead of India. When you look at their airports, their roads, their
metros, their city-buses, their well laid-out cities, their infra-structure,
their cleanliness, their everything, you wonder why you have remained a country
of crumbling roads, overcrowded locals, overhanging scary ugly mess of mesh of
electrical, TV and internet cables blotting the skyline and brutally assaulting
even the “chalta hai” sense of terribly intolerable tolerance of the “have
given up” generations; a country of absent pavements or encroached pavements or
pavements that stink from the use they are not meant for, and where mercifully
for the walkers this is not so, they are but patches of broken down pavers,
punctuated by uncovered, or partially covered, or precariously or deceptively
covered man-holes, awaiting their catch; a nation of stinking slums and impoverished
villages, open drains and sewers, rotting garbage, squalor and stink all
around, children and men defecating by the road-side—all testimony to criminal
absence of the very basics of being civilised...
Most of the Indian towns, cities and metros are dirty, foul
smelling and hideous. They look like a defacement of spaces and a blot on the
landscape. Cities in the West, SE-Asia, China and elsewhere get better,
cleaner, smarter and spiffier year after year, while ours get worse, more
congested, more difficult to live in and more squalid.
How's it that we got so left behind? What is it that we did, or
did not do, after independence, that everything is so abysmal and pathetic? Why
an overwhelming majority in India is condemned to continue in abysmal misery? What are the foundations of this misery?
And all this unmitigated misery despite the overwhelming
advantage of India as a nation with first-rate people, plentiful natural resources, relatively
better position in all fields—infrastructure, trained manpower, bureaucracy,
army—at the time of independence compared to all other nations who have since
overtaken us, grand civilisational heritage, rich culture and languages, and
unmatched ethical and spiritual traditions.
Why did we fail to leverage such rich assets of a gifted
country?
* * * * *
Rajnikant Puranik
July 23, 2014
91-22-2854 2170, 91-98205 35232
