Four surprising lessons from my angioplasty

A couple of months ago I went through an angiography, followed by an angioplasty to open up a blocked coronary artery. Stented and ready for the next 100,000 miles, I am back with a vengeance - working, playing golf, exercising and even climbing hills. I am also wiser due to a few surprising lessons I learnt in the process. Some of these lessons might be handy for others.

Staying physically fit does not keep heart disease away

I have been physically fit all my life. As a kid I played several sports, and have continued playing at least one sport ever since. Although I did not get into a regular fitness regime until a few years ago, my daily routine has generally included walking and going up and down stairs. I have been playing golf for many years, and I walk very briskly on the golf course - an average of 6-10 kilometres a week.

I have never been overweight, and have always been classified as "physically fit", and that is how I have felt. Until two months before my surgery. So what went wrong?

Coronary heart disease is caused by the gradual blocking of the coronary arteries - arteries that supply oxygen-rich blood to the heart muscles. The supply of blood keeps the heart muscles pumping, but when this blood supply is interrupted, the heart muscle(s) can stop working leading to angina or a heart attack.

The blockage of the coronary arteries is caused by the deposit of fat tissue on the arterial walls. Two major factors determine the tendency of our body to deposit these fats.

1. The amount of fat and cholesterol in our blood, which depends upon our diet and metabolism
2. The propensity of our body to deposit the fats on the artery walls. This factor varies among people, and is not very well understood. It appears to be genetically inherited.

Regular exercise has a limited influence on (1) above, but in general the gradual blocking of our coronary arteries continues in spite of regular exercise. Symptoms do not start showing up even during vigorous exercise until the blockage exceeds 70%. I have been doing regular vigorous exercise for several years now, and my symptoms did not show up until my main coronary artery (LAD) was blocked almost 100%!

So remember this: you may be physically fit and exercising regularly but your coronary arteries may be getting blocked anyway and angina or a heart attack may be on its way.

The biggest predictor of such a situation is your family history of heart disease. Additional risk factors are high blood cholesterol and stress. If you are at risk, talk to a cardiologist and undergo the required tests regularly. Even if you are not at risk, it is best to be aware that your coronary arteries are getting gradually clogged.

Regular exercise may save your life - but not the way you think

I just said that exercise does not prevent heart disease, and now I am saying that exercise may save your life! Contradiction? No.

Regular exercise, especially vigorous cardiovascular exercise, results in a greater demand for blood from our heart. If our coronary arteries are not able to supply enough blood to the heart to increase the pumping action, some of the smaller blood vessels (capillaries) around the coronary arteries gradually take up this load. Over time, with regular vigorous exercise, the capillary network can become quite large. This network of smaller coronary blood vessels is called the collateral network.

Strong collaterals act as a safety net and can prevent heart attacks even if the main coronary arteries are blocked. In my case a set of strong collaterals probably saved my life because my main coronary artery was almost 100% blocked. The strong collaterals were a result of years of vigorous exercise and were clearly visible during the angiography.

Of course before undertaking a vigorous exercise program, it is important to consult a doctor. Any exercise program, particularly later in life, must be built up gradually to avoid a sudden strain on the heart.

Symptoms of heart disease can be quite unusual

Like most people, I had always associated heart disease with chest pain, shortness of breath, or a pain in the left arm. While these are common symptoms, they are by no means the only ones.

The only symptom I ever had was a sort of choking sensation in my throat whenever I exercised. Because I did not know better, I ignored this symptom for almost 6 weeks. This ignorance could have killed me.

Finally when I spoke to my doctor, he recognized the symptom for what it was. I discovered later that there are other lesser known symptoms of heart disease like a feeling of suffocation, burning sensation in the chest, a pain in the left shoulder or a pain in the jaw.

This is what I think one should do: if you encounter any sort of discomfort that shows up as a result of increased physical activity, particularly in the upper body, report it to your doctor and get help.

In my case, even if I had reported my symptom to a doctor over the phone, I would have been treated 6 weeks sooner. I was very fortunate to get away with the delay.

Heart disease can be reversed!

Yes this sounds too good to be true, and honestly I don't know if it is true.

After my surgery, a good neighbour gave me a book to read - "Reversal of Heart Disease in 5 Easy Steps" by Dr. Bimal Chhajer.

Dr. Chhajer is a cardiologist who has pioneered a program called SAAOL (Science And Art Of Living). Believe me, I am a sceptic, and am not convinced easily when I hear something that sounds too good to be true. However a lot of what Chhajer says makes sense. The program prescribed by the good doctor is not easy to follow, but I am experimenting with it.

One interesting consequence of the program is that with the zero oil cooking at our home, my wife had unexpectedly dropped a few kilograms of weight. Whether I reverse my heart disease or not, we are staying with the program!

Happy living!

APJ Abdul Kalam - The Perfect Indian

Our beloved APJ Abdul Kalam is no more. Long live Dr. Abdul Kalam.

Since our nation's independence no one has captured the imagination of fellow Indians like Abdul Kalam. He was bright. He overcame huge odds to excel. He was a pioneer in moving important national priorities forward. He overcame bureaucracy to deliver impressive results.

When asked, he assumed political office, enriched & enhanced it, and made the ceremonial role of a president meaningful through his curiosity and dedication. He continued to positively influence young minds well past the sell-by date of most people. He understood technology and evangelized it, and he understood the real problems of ordinary citizens.

And yet he was humble beyond belief. His genuine connection with people around him is what ultimately defined the man.

I hear TV anchors, print journalists, political party mouthpieces, and "intellectuals" endlessly and meaninglessly debate the "idea of India". My president, my fellow Indian APJ Abdul Kalam was the idea of India.

As I type out this message, unable to stop tears welling up in my eyes, I think of this little muslim boy growing up in a family of modest means, equally at home in a mosque or a temple, this outstanding scholar and engineer, a teacher, friend, philosopher and guide to millions around him, I have mixed emotions - joy at having lived in his time, sorrow that he is no longer among us, pride at what he accomplished, and hope that with a vision and hard work, anything is possible in our country.

Good bye Dr. Abdul Kalam, we will miss you. You are the Perfect Indian.

Two congressmen - Tharoor & Aidiot

Nothing noteworthy or interesting comes out of the Congress party these days, other than their dynastic leaders shooting themselves in the foot or taking periodic sabbaticals.

However two well educated and articulate congressmen have figured out how to stay in the media spotlight, and make their points in their own unique ways.

Shashi Tharoor has been in the spotlight for many reasons. The homicide/suicide investigation into the mysterious death of his wife continues, but that has certainly not cramped his style. He continues to speak his mind, to the utter discomfort of his party's first family. His latest disagreement with the party regarding disrupting parliament has not gone down well with his party president and he has been publicly rebuked for his position. He continues to give fodder to the BJP to needle the Congress party.

Tharoor has also been in the news for his brilliantly argued position on reparations from Britain to India for their loot during the colonial rule. The Oxford debate video has gone viral and has won Tharoor much praise for his argument and superior oratory skills, even from the Prime Minister of India.

All in all Tharoor is an exciting young politician, a highly skilled and intelligent orator, a guy who is not afraid to speak his mind.

On the other hand there is Mani Shankar Aiyer - I fondly call him Mani Shankar Aidiot. Mani's singular traits are his extreme adulation for the Gandhi family, and pathological hatred for Narendra Modi.

For all his (supposed) intellectual prowess, Aidiot shows himself to be a clown when he speaks on these two topics. Reason goes out the window, and all that remains is the raves and rants of a senile old man, somehow hanging on to his role as a party mouthpiece, courtesy his many friends in the media.

Is the world heading for an over-population disaster?

Hans Rosling is a Swedish doctor, academician, and statistician. But he is best known for his astonishing ability to weave engaging stories around statistics.

Here he busts many population myths around overpopulation, and where the planet earth is headed.

This is a long video, but one of the most insightful and surprising I have seen in a long time. Take the time to watch it in full. I hope you enjoy it as much as I did.

And I bet you will have tears in your eyes when Andre is able to buy his bicycle at about the 40 minute mark!

Kiwis, do it for the Crowe

Cricketer Martin Crowe is dying and he may not live to see the finals of the 2015 World Cup. Crowe was diagnosed with follicular lymphoma two years ago, which has since transformed into a rare blood disease called double-hit lymphoma. Only 5 percent of patients live up to 12 months.

Crowe is perhaps the best batsman to represent New Zealand, and he was one of my favourites during his playing days. Ian Botham called him the most technically accomplished batsman of his time, an era that included Sunil Gavaskar, Geoff Boycott, Vivian Richards, the Chappell brothers, and many other outstanding batsmen. Crowe was also part of the New Zealand world cup team in 1992, when New Zealand played some great cricket, losing a close semi-final match to eventual champions Pakistan. Crowe scored a magnificent 91 in that match.

As Crowe fights for his life, the Kiwis have emerged a serious contender for World Cup 2015. They perhaps have their best limited overs side ever, and are coming off a very successful 2014 in all formats of the game. In Brendon McCullum they have an inspirational leader, who is at the top of his game. McCullum in fact was the one who broke Crowe's record for the highest Kiwi Test score recently when he scored 302 to overtake Crowe's 299.

I am rooting for the Kiwis in this world cup, and would love to see them win it for Martin Crowe.

Why I want Virat Kohli to up the ante on sledging the Australians

I went to school in New Delhi a long time ago, and one of my enduring memories from that time in the mid-1970s is my encounter with a school bully.

I was in the 9th grade and no more than 5 feet 3 inches tall, perhaps smaller. Even by Indian standards I was a small kid. I was also very shy, and afraid of confrontation. In short, I was the perfect target for a bully, and not surprisingly, one of them found me.

This guy was younger than me, but a lot bigger in size. Our first encounter was when I accidentally pushed him while going down the stairs, and he turned around and gave me an earful, following which I shrunk about 30% and promptly withdrew into my shell, not unlike a turtle, when confronted with danger. I could see that the bully enjoyed the encounter, and over the next 3 months humiliated me at every opportunity he got. Fortunately for me I am blessed with a temper streak that makes its appearance very rarely, but when it does, I take the world on with no fear for my physical well being. This streak made its appearance one day, and my desperate physical grapple with the bully had to be dealt with by a bunch of onlookers after I bit this guy a few times during the encounter. There was some blood involved, but the bully got the message. He never messed with me again. I learnt a very valuable lesson in life - the best way to deal with bullies is to stand up to them.

Australian cricketers have been bullies on the cricket field since the time I have followed cricket. I have watched some of our best cricketers get sledged and humiliated by the Aussies over the years, and I have wondered why our guys have not stood up to this nonsense. Starting in 2008, the Indian cricket team started giving it back to the Aussies.

Matthew Hayden is the latest commentator on TV talking about "not crossing the line" as far as on-field banter is concerned. Who the fuck drew this line? Is it part of the official cricket rule book? Has "the line" been published as part of the guidelines for cricket ethics? Not really. The bully has defined "the line", and it has been the final word on sledging since no one has ever challenged the bully.

That is why I am fascinated with the likes of Virat Kohli, Gautam Gambhir and James Anderson. They have decided that enough is enough and the Aussies need to be dealt with in a language they understand.

David Warner is the quintessential Aussie cricketer - aggressive, in-your-face, and a bully. He wants both sides to "tone down the send-offs" in the Sydney Test. He is saying these things because he has got back what he used to dish out, and doesn't like it. He is also playing the Philip Hughes card to plead for better behaviour at the SCG. Fuck David Warner.

My hope is that Kohli and team give Warner a couple of send-offs at the SCG that he will remember for the rest of his life. That is why I want our guys to up the ante on sledging and on-field banter at the SCG. The only defence these guys have is the scoreline, which could have been 2-0 in India's favour if a few things had gone their way. There is no harm in reminding the Aussies of the scoreline when they visited India last. Screw the scoreline Virat, give the bully what he doesn't want - up the ante and stand up to them. They are cracking, and we will see them running to the authorities with their tails between their legs very soon!