The uneventful weekend was coming to an end for Prasant Tripathy, a Bhawanipatna-based contractor. He went to bed looking forward to the new week, but in the dead of the night, around 2am, he suffered a heart attack. Lipsa, Prasant’s daughter, says, “My father was only 50. He had all along believed that he was in perfect health. He had been an active football and badminton player in his younger days and had gone for a health screening two years earlier. The results indicated that he was healthy. However, tests done following his death showed that he had actually suffered a heart attack.” There are many like Prasant who succumb to heart disease at an early stage of their life as awareness about heart failure, its causes, and treatment mechanisms remains low, suggesting that our healthcare system and society are not prepared to deal with the growing cardiac problems.
Death due to cardiovascular disease is on the rise in India, causing more than one quarter of all deaths in the country and affecting young adults the most, suggests a study published recently in The Lancet Global Health. Odisha is witnessing a simultaneous surge in incidence of heart failure, including among relatively younger men and women who were earlier considered out of the risk bracket of this condition. Many people suffering from heart failure do not have the condition diagnosed. Many others who have been diagnosed fail to get appropriate treatment which makes them highly susceptible to sudden cardiac death. With World Heart Day around the corner, Sunday POST gets some cardiologists to answer important questions about cardio-vascular diseases among the young population.
Padma Shri awardee Dr K K Aggarwal, President of the Heart Care Foundation of India, says, “Cardiac diseases include coronary artery disease, heart attack, arrhythmias, heart failure, heart valve disease, congenital heart disease and cardiomyopathy. Heart disease and other non-communicable diseases (NCDs) such as diabetes, hypertension, cancer, and stroke are steadily on the rise and will soon take on epidemic proportions. The urban population is three times more likely to have heart attacks than those living in rural areas. The reason for this can be attributed to stress, aberrant lifestyle, and hectic schedules that leave very little or no time for physical activity. In recent times, healthy looking adults present with cases of cardiac arrest, stroke and hypertension or were at risk of developing any of these diseases at any point in their lives.”
Citing the case of Anant Bajaj, managing director of Bajaj Electricals, who died August 10 after suffering a cardiac arrest at the age of 41, Aggarwal says, “Coronary heart disease mainly occurs in patients over the age of 40, but younger men and women can be affected. An age cut-off of 40 to 45 years has been used in many studies to define “young” patients with heart disease or acute heart attack. In the Framingham Heart Study, the incidence of a heart attack over a 10-year follow-up was 12.9/1000 in men 30 to 34 years old and 5.2/1000 in women 35 to 44 years old. The incidence of heart attack was eight to nine times greater in men and women aged 55 to 64 years.”
Asked if there any strategies to prevent heart attacks, he says, “If you can walk 500 meters in six minutes, you do not have significant underlying heart disease. Besides, people should avoid refined carbohydrate food to say no to heart diseases. People suffering from cardiovascular diseases have to quit smoking completely.”
According to cardiologist Raj Kumar, who is also a faculty at Indian Institute of Emergency Medical services, one of the main reasons for the rise in heart diseases is lifestyle choices. This is well documented and well understood, he says. Alcohol, smoking and a sedentary lifestyle lead to cardiovascular diseases among the youth. Exercise and an active lifestyle can prevent you from falling prey to these diseases.
Earlier, it was believed that blocks cause heart disease. Recently, renowned cardiologist BN Hegde revealed in a video that blocks are not the cause of heart diseases. Disagreeing with this viewpoint, Raj Kumar says, “Dr Hegde has his share of controversial views. It is established that blocks in the blood supply to the heart invariably cause heart attacks. Anyone who says otherwise is preaching quackery.”
Umesh Jena, cardiologist at SCB Medical College and Hospital, points out, “Both mental and physical stress are high today, particularly among the young people. Highly competitive and intense work demands lead to increase in risk factors for heart diseases, such as stress, increased incidences of diabetes and blood pressure. These conditions are aggravated by smoking, excessive consumption of alcohol, lack of exercise and lack of sleep. Polluted environment is also another factor behind the rise in heart diseases. Lifestyle modification is a key factor to reduce the risk as well as prevent premature heart attacks. It is simple, affordable and effective.”
He adds: “Regular aerobic exercises like brisk walking, cycling, jogging, and swimming help in reducing heart attacks, BP, and weight and controlling diabetes and lipids. If you do physical activities for 30 minutes a day and 100 minutes a week, there is less chance of falling victim to heart diseases.”
Every year 25,000 people die of cardiovascular diseases in Odisha, according to the Odisha Economic Survey. It is the second major cause of death after old age ailments. Asked about these grim statistics, Jena says, “Thrive on healthy food, instead of junk food, which means our daily diet must include plenty of vegetables, fruits, nuts, soya products and low-fat dairy products. One should substitute milk with soya products, which are rich in vegetable proteins, and calcium and minerals. One should avoid hydrogenated vegetable fats used in fast food, cookies, chips etc., as they are more dangerous than saturated fats. One should avoid overheating and reuse of cooking oil. We should also avoid refined oils.”
“Avoid tobacco consumption and excessive alcohol. Despite a busy schedule, try better time management, and learn to organise and balance your lifestyle. As people these days are computer and tech-friendly, they are largely leading a sedentary life. Regular exercise or yoga can help to keep heart disease at bay. Yoga is the best activity to keep a person physically and spiritually healthy. It is an excellent stress management technique and can control heart disease,” says doctor Anamika Tripathy of SUM hospital.
She continues: “Heart failure is a condition in which the heart muscle is unable to pump enough blood to meet the requirements of the body. This leads to fluid build-up in various parts of the body causing swelling of the feet and breathlessness, particularly on exertion and on lying down. Adopting healthy habits from childhood or adolescence is essential so that we can prevent the risk factors for heart attack.
Man with a golden heart
Laxman Rao has been working tirelessly to channel financial aid from the government to needy patients, including those with major heart problems
Meet Laxman Rao, a resident of Cuttack, who leaves no stone unturned to help poor heart patients hailing from rural areas to meet their medical expenses. He started extending a helping hand to poor patients in the year 2013 and, so far, he has helped 60-odd heart patients to undergo operations and get access to other services with the help of government funds. During an interaction with Sunday POST, he kept getting calls every few minutes from unknown people seeking his assistance.
Asked about the help he provides to patients, Laxman says, “I am a poor man with no income. I have dedicated my life to the service of people from my childhood. Financially, I am dependent on my wife. So, it is impossible on my part to bear the medical expenses of heart patients. What I do is take them to hospitals and help them get funds under Orissa State Treatment Fund to get treatment free of cost. People from rural areas are unaware of government schemes and when anyone from their family is diagnosed with major diseases, they sell their house and even land title to meet medical expenses. So, my role is to make them aware of government schemes. I approach the concerned government officials to get the poor patients sanctioned money under government schemes so that they can get free treatment.”
When he was pursuing Plus II, Laxman was so moved on witnessing the suffering of a cancer patient that he decided to serve patients belonging to rural areas. “In 1986, I had gone to SCB hospital to visit a friend who was undergoing treatment there. I came across Bhaktirata Ray, a cancer patient. I found her writhing in pain while her relatives were running hither and thither to arrange blood for her. As her family members could not arrange blood, she died shortly. For two days after that, I couldn’t sleep. It made me realise that money really matters and showed me how poor people are deprived of healthcare services for lack of money. I decided to do my bit for those people. That apart, another incident also pushed me to lend a helping hand to poor people. My aunt was suffering from cancer. A few days before her death, her body started stinking. No one showed a willingness to attend her. She was kept in a separate room. I took care of her during her last days, but I couldn’t save her. These two incidents compelled me to live my life for others.”
Though he started serving poor ailing people from the year 1986, Laxman made up his mind to serve heart patients after a 2013 incident left him in shock. “A 12-year-old girl Barsharani Barik had holes in her heart and was undergoing treatment at SCB hospital. Though her family members urged the concerned doctor to operate upon her immediately as her condition was worsening, the doctor said no. The concerned doctor Naba Kishore Patnaik delayed the operation. I approached the then district collector who provided Rs 3,000 and Rs 5,000 from the Samaj Relief Fund following which she was operated upon. Later, I helped the family get funds sanctioned under the Orissa State Treatment Fund. It was then that I decided to help heart patients. There are many cases where patients are running from pillar to post to avail healthcare services.”
Laxman says, “I am surprised how people get my phone number. Though my wife shouts at me every day for doing nothing for my family and helping unknown people without taking a single penny from them, I don’t feel bad about it. I try to convince her by saying, “You are there to look after my family. Let me live for those who are running from pillar to post to avail healthcare services.”
The story of Laxman’s marriage is also interesting. “Upon being informed by a fellow villager, I rushed to take an ailing lady to hospital for treatment as she was staying alone with her only daughter. She was so pleased with my help that she asked me to marry her daughter a day before her death. I kept my promise. After my marriage, I spent all the savings of my mother-in-law in the service of poor people. There were days when we went to bed on an empty stomach. We led a good life after my wife got a job in SCB as an attendant. However, I have continued to help hapless people which is why, most of the time, my wife quarrels with me.”
Laxman continues: “I feel sorry when a patient dies despite my help and doctors’ efforts. In 2015, Chandan Panda, a resident of Mayurbhanj, called me seeking funds for the treatment of his wife, Sasmita. She underwent valve replacement surgery after her husband got funds under the government scheme. Sasmita used to call me ‘Bhai.’ She used to say, ‘Because of you, I got a new lease of life. You are a messenger of God for me.’ Though she recovered well initially, she died some months later. When her husband informed me about her death, I could not help crying.”
Recounting the sad tale of Suman, a 10-year-old boy, he says, “One morning, I got a call from Alekh Sahu, Suman’s father. He wanted me to help him get funds under the Orissa State Treatment Fund to get his son, who was suffering from blood cancer, treated. After he reached Cuttack, I took Suman to Sishu Bhawan. After his condition deteriorated, he was rushed to Acharya Harihar Regional Cancer Centre. During his stay in Cuttack, I developed a close bond with Suman. He used to ask me, ‘Uncle, when can I go back home? I want to study.’ Despite the doctors’ best efforts, he died. Even today his words echo in my ears. I still miss him.”
RASHMI REKHA DAS, OP