Thursday, December 21, 2006

The Coronary Drama

Having my practical attachment done in the National Heart Institute (IJN), it'd be a crime if I don't share what I've learn there for the past 3 weeks. Seriously, I've learnt a lot, and mostly it is about how my future is likely to be.

Looking at the middle-age men and women, some as young as 41 years old, and the older men and women, some as old as 78 years old, coming in and out of the cardiology clinic, lining up at the dispensary, sleeping in bed in ICU, lying on the fluoroscope table while a doctor pushes a wire into an artery through a hole on their groin and goes straight to their heart with the doctor's eyes fixed on a TV in front of her - phew - made me realize how awfully morbid and mortal coronary heart disease is. I mean, it could be me lying on the table in 25 years to come!

So to do justice to the guilt and fear a feel, I am doing my part to educate the general public on how coronary heart disease begin and ways to protect yourself from this life-sucking disease.

To make it interesting, I shall present it in a form of drama. And it shall be named:

And I have substituted the medical-jargon characters with something closer to us...

So the drama begins...

One fine day, in the happy land of Karut-nary, there was a Road that heads staright to the Used Car Store. Along the road is a straigt row of Cars that are moving in a rather rhythmic, orchestratic and undisturbed fashion to the Used Car Store. The Used Car Store manager is very happy, as constant supply of cars made sure his business runs smooth.

Another fine day, someone opened a KFC restaurant next to The Road. With its doors open, few Michelin Kid gathered in the restaurant. For the time being, The Road is not blocked and all of The Cars can still move to the Used Car Store freely. The manager is still happy. The medical name for this state is called The Fatty Streak.

However, more and more Michelin Kids flock The KFC. At one moment, there were too many Michelin Kids in and around The KFC, and the comotion partially blocked The Road. The Cars became congested before the block, slowing them down, and fewer cars reach the Used Car Store. It affected the business in the store so much, that the cost of buying cars are exceeding the profit of cars sold. So there is a deficit in supply. The Used Car manager is furious, angry and unhappy, but at least he is still alive. The medical name for this state is ischaemia.

One unfortunate day, the Michelin Kids flocked The KFC one person too much, and the restaurant exploded, completely blocking the road with debris and Michelin Kids body parts. Now no cars can go through. Without Cars coming in, the Used Car manager had to close his business, and fearing that loan sharks might go after him, he torched himself and succumbed. Poor guy. The medical name for this state is infarction (heart attack lah).

So that was how the town of Karut-nary fell apart. THE END.

Pretty sad isn't it. Now, let's study the characters. Who are the bad guys in this drama? Obviously, The KFC and The Michelin Kid. So if we can turn back time, how do we prevent the town of Karut-nary from falling apart? Simple. We get rid of the bad guys.

Numero uno, get rid of The KFC.

There are several ways of avoiding The KFC. The famous ones are:

1. Prevent high blood pressure: High blood pressure literally means the pressure in your blood vessel is higher than normal. This high pressure strains the vessel wall, making the vessel susceptible for injury. Once the injury is there, there is a good chance fatty streak ensuing. So exercise and take less salt. Get your blood pressure checked regularly, once in 3 months at least. Once in 2 months is ok. Once a month, your just sinking your doctor's heart.

2. Stop smoking: Smoking makes the blood vessel more fragile and injury-prone. And don't go saying "I only smoke 2 cigarette a day. It won't happen to me." Smoking 1 or 40 cigarettes a day don't make a difference as far as vessel injury is concerned. Of course some backward-thinking moron will take this statement differently by saying "Hey if smoking 1 is just as bad as smoking 40, let's just then smoke 40." But then again, they're morons.

Numero due, get rid of The Michelin Kid

Simple math. No cholesterol, no cholesterol deposit.

1. Take low-fat diet: Cholesterol comes from 2 sources. The one that our body makes by itself and the one you eat. But those you put into your mouth are the ones that matters. Try using less fat in your food. Boil it, steam it, barbeque it, grill it, eat it raw. Just hold the butter/oil/fat aside.

2. If you have to take fat, take the healthier ones: Yes, there are such thing as healthy fat. Polyunsaturated fat is healthy. Trans fat is not. As a matter of fact, trans fat is evil. What's trans fat you ask? Well, Planta, Dorina, Crisco, Daisy are trans fat. Simple test, if the margarine doesn't melt and remain in firm-to-soft consistency in room temperature, there's a high chance it's trans fat. So throw those in the dustbin. Use vegetable oil, olive oil or even palm oil instead.

3. The only way to lower down your LDL (Life Destructing Lipoprotein) cholesterol is by exercie (of course you can use statins, but those are for sick people. Cool people don't pop pills). So exercise your way to a wide open coronary vessel. An adequate health-preserving exercise should total 150 minutes a week. That is either 3 days a week 50 minutes a day, or every day for 25 minutes. Make sure you sweat when you exercise. Sweating indicates you are working above resting metaboism. Walk on the park while smelling roses ain't gonna work.

So now, are you looking for a group to run with? Join the pipot primates weekly Saturday run. Info is available here


Thank you.



Blogger saifs said...

Bro, that was one hell of a presentation :D Hitchcock put tabik la ko :D I like the way you defined LDL! LOL! So far, I'm doing everything in your list (yes, EVERYTHING :D No more questions, just in case someone i know is reading this :D). I'm just training hard so that when i get back to Malaysia, i can participate in Azman's Fun Run With Hot Chicks :D

22 December, 2006  
Anonymous Azman said...

Yaaaaaa. Mari, mari, mari!! Come join the fun run!!

22 December, 2006  
Blogger Kenny Sia said...

Stumbled across your blog when I was searching for some running related information. Broke my back laughing.

That's one helluva blog man. Keep it up and hope to see you participating in a full 42km marathon soon.

25 December, 2006  
Anonymous bacin said...

alamakkk.. lepas swim pagi tadi kita org semua belasah kfc hihihi.. lepas tu baru rasa bersalah :p

25 December, 2006  
Blogger zebrallini said...

baru makan KFC sama bacin semalam

26 December, 2006  
Blogger The Eraser said...

No more NASI LEMAK after Saturday Run ... waaaahhhhawahhhhhh!!!

26 December, 2006  
Anonymous Azman said...

Kenny Sia left his mark on my blog!!! Holy Crap!!!!!!!!!!!! Thanks for the encouragement Kenny. Do visit the other running blogs on my list of links. They are better runners and writers than I am. You'll enjoy reading them writings.

To Bacin, Zebs, The Eraser: Haha. Jangan le haramkan terus. Boleh makan, but in moderation lah. Seminggu sekali. Plus, you guys workout almost everyday, and sometimes twice a day, so boleh le makan slightly more than the average Joes, like me. Hehehe.

26 December, 2006  
Blogger bola2api said...

HAHAHAHHAHAH gila lawak!

u remind me of my biology class :) I was THAT close to becoming a doctor..

26 December, 2006  
Anonymous Azman said...

Aini, don;t worry. You will always be Meredith Grey to me. In a good way. Hehe. :D

26 December, 2006  
Blogger bola2api said...

alamak .. Grey's anatomy semalam sedih laa.. aku nangis ler...

27 December, 2006  
Blogger Jeff said...

Very good thread. You are talented.

I would like to invite the reader to check out my story. I am a 59-year-old man who was told in the spring of 2004 that I needed an immediate quintuple coronary artery bypass. I had two vessels that were 100% occluded and three that were 85% blocked. Despite my massive coronary artery disease, the doctor said my heart was in great shape, but the vessels that delivered them oxygen were clogged. How could that be? I asked. I was not given a satisfactory answer. All the cardiologist, a cardio-thoracic surgeon he brought in to consult, and my own primary care physician would say was that I "was a walking time bomb" and if I didn't have the CABG right away, I could keel over from a stroke or heart attack at any time.

I didn't fall for these medical terrorist scare tactics and got a second opinion from a noninvasive cardiologist. I've been treated with medication now for going on three years. My symptoms of angina are virtually under control. My cardiologist told me there is no reason why I shouldn't live 20-30 more years without worrying about angina.

Please, when a doctor wants to give you an immediate CABG, get a second opinion from a noninvasive cardiologist. And, please, ifv you have friends of family who are in their late 40's to mid 60s, show them my blog and have them read it from the first posts of September 2004 to the most recent. It might just save their lives.

27 December, 2006  
Anonymous Azman said...

Dear Jeff,

The beginning may sound a bit off, but do read on.

Learning the condition of your coronary vessels, and if I was your treating doctor, I would've recommended CABG for you immediately, telling you that the surgeons need to harvest your saphenous veins from your legs, bring down the internal mammary artery to your heart, and even opt to harvest your radial artery. Gory, I know. And I would even use the "walking time bomb" metaphore.

But reading your story made me sit deep in thoughts. When I become a practising doctor (hopefully in a year's time), will I be addressing other concerns that'd be brought up by the patient? Will I explore more into the patient's needs instead of what I want? Will I listen instead of hear?

Certainly, the patients I will be seeing, like you, are humans. They are not cases in text books. This is when science becomes art, and goes beyond text books.

I may not yet understand the rationale of your cardiologist opting for optimal pharmacological treatment, but thanks to your story, Jeff, someday I will.

27 December, 2006  
Blogger Raymond Hee said...

oh my,another medico runner i presumed

28 December, 2006  
Anonymous azman said...

Aaahaha. Medico-runner? I wouldn't put it that way.

29 December, 2006  
Anonymous jaja said...

i smell kfc here :p

04 January, 2007  
Blogger !jenna! said...

You are an AMAZING blogger. AMAZING.

24 January, 2007  

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