When I was 80 in 2010, my surgeon Dr.Paul Ramesh told me that if I if I chose medicinal aid it will be palliative but choosing bypass surgery will be more curative. The one memorable line which made me decide on surgery was his saying "I will do it as I would do it to my father." I am hale and hearty now and better than what I was at 80.
My suffering and relief - Before and after TAVR.
I am Ramanathan, a 69 years old retired Maths professor. I had a long history of COPD. In 2013 January I was diagnosed with a heart condition known as Aortic Stenosis, a narrowing of the heart valve which caused severe breathlessness and fatigue. I came to know that patients diagnosed with severe Aortic Stenosis had a life expectancy of only 2 to 5 years.
The remedy was to get the Aortic valve replaced. I approached a reputed heart surgeon of a highly reputed hospital seeking his help for the aortic valve replacement. But he was not willing to operate on me in view of the extremely high risk due to severe COPD.
While browsing the internet I happened to read about a new procedure called TAVR. But it was not available in India at that time and it had a first year survival rate of only about 60-65%.
I had to be on medical treatment since I did not have have any other options available. My condition was worsening year after year. From December 2016, I started to have severe symptoms including recurrent chest pain, severe breathlessness, incessant cough and fatigue that resulted in repeated hospital admissions. I was not able to sleep due to the cough. I could not lie flat on my bed and I had to lie down in an inclined position. My disability was so severe that I could not walk even 15 - 20 steps. Even talking was difficult for me because of the cough and breathlessness. My condition was so bad that even at my home I had to be put on Oxygen for all the 24 hours. While in the hospital I was admitted in the CCU repeatedly. I had completely lost hope on any chance of survival. That is when my family doctor Dr. (Major) Parthasarathy advised me to consult Dr. Sengottuvelu of Apollo Hospitals and informed me that he is an expert who has done several successful TAVR procedures.
I met Dr. Sengottuvelu. He assessed my health condition and explained me that TAVR is the only option available for me and it will definitely improve the quality of my life. I was evaluated for suitability of the procedure. Again after conducting several tests I was informed that my anatomy had a high risk factor even for TAVR, which worried me more. Due to the high risk, several other doctors advised me agaist TAVR.
I had less than half mind to go for the procedure initially. It was very costly and the risk was very high. I had very limited resources. It was an unbearably huge financial burden on me. I could not make a decision and was very much hesitating to proceed. Dr. Sengottuvelu and his team of doctors explained the procedure and its pros and cons to my family members, relatives and myself. It was also felt that if I don't undergo the procedure, the suffering and repeated hospitalization will continue till the end affecting the daily lives of my people. That will also be a financial burden for us. My family members and myself had a prolonged discussion on this matter and l finally agreed. The support of our relatives and family friends during this crisis had a strong positive emotional effect on me. Also the logically strong counseling by Dr. Sengottuvelu and his team had a great impact on me.
The TAVR procedure was done on 11th February 2017. I went through the procedure under general anaesthesia without any problem. There was no pain or any significant discomfort. I felt very much better immediately after the procedure. The incessant cough and discomfort disappeared. I was able talk effortlessly. All the physical and psychological stress had vanished. The crisis had blown over. The recovery was miraculous. Within five days I was discharged from the hospital. My whole family and relatives were very happy to see me walk and do all my routine activities.
Words are not enough to express my gratitude and happiness. I had a second lease of life. I will be always grateful to Dr. Sengottuvelu and his team for the patience and the time they spent with me and the extreme care they provided with meticulous planning. I am also thankful to Apollo hospital and the nursing staff who took care of me during my days of crisis.
Today is 10th October. 8 months have passed since my TAVR procedure. I am perfectly normal. I am able to walk more than a kilometre effortlessly.
Thank you Doctor for all that you have done for me.
I am a doctor and was detected with severe calcium deposits in one of my heart valves. The only treatment option was open heart surgery with replacement of the valve. Since I did want to undergo open heart surgery which involves cutting the chest bone, I searched the internet and found Dr. Sathyaki Nambala from Apollo Hospitals, Bangalore.
When I met Dr. Sathyaki and interacted with him, I found him to be such a humble person and highly knowledgeable in his field of minimal invasive/endoscopic heart surgeries. After meeting him in person, I was convinced that I will get my valve replacement done with him only.
On the day of surgery, I got myself admitted in the morning and various tests were done during the day. With all tests being normal, I underwent the surgery which lasted for 1 to 2 hours. The day after the surgery, I was asked to walk in the ICU and then shifted to my room. On the 3rd day, I was discharged from the hospital.
I would like to sincerely thank and appreciate Dr. Sathyaki for treating me, Dr.(Lt.Gen) Shiv Kumar Sharma, Director Medical Services who is a gem of a person and a very caring gentleman and Apollo Hospitals, Bangalore for giving me a news lease of life.
I was diagnosed with this fatal illness (Pulmonary Hypertension) in 2011 at just 18 years of age. Little did I know, my life would Change completely. I was an engineering student filled with dreams and hopes for my career and future. I was on a lot of medication which never relieved my symptoms but just prolonged my life. The side effects of these medicines left me debilitated for days. I couldn't enjoy simple activities such as bathing, dressing up, walking or climbing stairs. I was queasy and tired most of the time and carried my medicines with me wherever I went. Even though I had a hard life my only source of comfort was the Almighty. My condition deteriorated rapidly and soon I was hooked on to an oxygen machine. Viola, could things get worse?
It did!! I was in bed 24*7. My hangouts were mostly hospitals for the past few years, consulting doctors in search for a cure. In my case, a heart and double lung transplant was the only option.
Until one night I received a call from my doctor saying I have a suitable organ. It was the 14th of February at 4:15am I was wheeled into surgery. By the Grace of Jesus Christ my surgery was successful and the recovery was pretty quick. I am almost back to normal. The Lord has fulfilled the promise he gave me this year. I felt his presence personally.
I thank Apollo Hospitals, Chennai well wishers, family and friends for your continuous support and prayers. A special thanks to the entire heart and lung transplant teams of Apollo hospitals, Chennai.
In Sickness and in Health
The misty skies and hesitant drizzle make Chennai look alluring and mysterious, quite unlike the bustling, rapacious city of ten million people it has become. I walk in from the drenched streets to the fluorescent lit foyer of Apollo hospital. There is no chance to notice the structure, setting or decor, as I am swept right away into a clamoring mass of humanity. Slowly, this moving, flailing, mass of persons parts to reveal the individuals, the people who have come from everywhere, hoping for everything.
Almost unfailingly they clutch a plastic bag crammed with a record of their lives, the secrets of their bodies. Some of these bags are cheerfully emblazoned with names of popular silk sari shops, x-rays, ECGs and blood reports poking out between the handles. Some of them, these patients, shuffle along, others rush purposefully, determinedly chasing a cure for their ailments. There are those who look fearful. Some are hopeful, others happy. Most look exhausted... and some seem to have started the process of grieving. Almost everyone is accompanied by a family member and there are uniformed custodians of the hospital everywhere, directing the flow, moving everyone along, and preventing chaos. Almost 25 years ago I stood with my sister holding a silk cushion with a pair of scissors, ready for the President of India, Zail Singh to cut the ribbon inaugurating the opening of this hospital. The brainchild of our family doctor and dear friend Dr. P. C. Reddy, the hospital has grown and now is a chain, taking care of people everywhere. They have all walked these corridors to be treated or visit friends, family or colleagues; Indira Gandhi, MGR, Karunanidhi, Rajiv Gandhi, film stars, the middle class, rich and poor, the forgotten and cast off. Apollo is now a behemoth corporate structure with hospitals, clinics and pharmacies across India, South East Asia, the Middle East and Africa.
Right after graduating from Madras Medical College I worked briefly in the ICU of Apollo hospital. Dr. P. C. Reddy would make his lightening rounds and fix each doctor with his penetrating gaze and ask the one most pertinent question about each patient. I learned to cut through the red herrings, to distinguish the trees from the forest, and get to the core of the patient's problem. Later I went away to many gleaming hospitals abroad but I missed that... the frail patient lifting folded hands in a Namaste. A Namaste of thanks, of blessing or of supplication. Apollo has often been criticized for being elitist, for catering to the rich. What I have seen is often different. Doctors and administrators trying to discount prices, surgeons foregoing their fees, and everywhere around me the common man, the patient, gets the benefit of cutting edge technology at a tenth of the cost as a developed country.
Twenty years ago I watched through the glass, paralyzed with fear, and it seemed that Dr. Reddy was waving his arms, and directing an opera of tragic proportions. Instead, he was saving the life of my father, his friend. The pain had my father in its vice like grip as drug after drug did not work and his heart attack marched relentlessly on. Dr. Reddy did not give up, rock steady, a General with his troops, trying everything for endless hours. Finally he made the decision which was ahead of its times, to go into my Dad's arteries, even in the middle of the heart attack, with a balloon to open up the choked blood vessels. Many years later the New England Journal of Medicine would report trials and success of balloon angioplasty in patients during an acute heart attack. This time I am here again and my father once again is the patient. He has had a state of art surgery, coronary artery bypass on a beating heart and a pacemaker implantation. They could not have done better at Cleveland clinic or any leading center around the world. I am grateful for my father's life. More than that I am proud of the advancements and strides our hospital, my city, our country has taken. Patients routinely travel to India for joint replacements, heart transplants, and cosmetic surgery. The old guard of cardiothoracic surgeons, cardiologists, urologists, surgeons and Gynecologists still anchor the hospital, their compassion a guidepost for their newer upcoming colleagues. And they are everywhere, the young Turks, some my former college mates, the young world renowned Surgeons and doctors to whom patients are coming from across the globe drawn with the power of the internet and Google research.
Where does Apollo go next? Obviously the main goal would be to strengthen clinical excellence, expand teaching and clinical research and trials. There is however another great unmet need: India's large rural and underserved population. In Tamil Nadu alone there are only 3989 Government doctors in rural areas and approximately 12,000 in Urban areas. All teaching and district headquarter hospitals are located in Urban areas. The Private health care in villages is at best sketchy. There are many health service delivery questions the world grapples with. How to deliver optimum care to an ageing population and harness technology while controlling spiraling costs? How to deliver medical care by utilizing telemedicine and the internet to far flung areas of our world? How to control sanitation and infectious diseases? We hope Apollo's growth and renaissance will lead to the answers to this and so many more questions for a better India and a healthier world.
UPDATED ON 24/11/2022