Physicians are known to be snobs. Notoriously. I know some of them. But there are others who are genuine and follow the Oath of upholding the ethics of helping and being kind to patients.
Case in point---
I was told by my cardiologist here, that I needed stent for my right Coronary Artery, because even though I had good collaterals from the left, I was symptomatic with shortness of breath and tiredness. He arranged for me to see a Cardiology specialist, Dr. John Lasala, who specialized in intervention. He also said that he sent his difficult cases to him in St. Louis and was very satisfied with the results.
I asked that I first talk to him and have him answer my questions that I had.
Last week, Dr. Lasala’s office called and said, “Dr. Ali, we have you scheduled for your stent procedure on the 7th of August.
I was disturbed. I told her that I needed to first meet with him and talk to him and see what kind of a person/doctor he is. She told me that he didn’t have outpatient clinic, and all he did was these procedures all the time! BUT, she went on to say, that he could call me and talk to me. I said that was fine, and was given a 10 O’clock time on Thursday morning.
I fretted and fidgeted, because I didn’t know what kind of a guy he was, and what he would think of calling a patient to talk to. Like I said, most physicians are snobs and have an attitude that can reach the heights of Eiffel Tower! I couldn’t sleep on Wednesday night. Got all my questions written out, and knew that he would perhaps call me, but maybe I would be kept waiting--- instead of ten, he would call me at 11 or in the afternoon.
At three minutes to ten on Thursday morning, the phone rang; it was his office, and he was ready to talk to me! Really??? I was impressed.
He had the most calming voice and allowed me to ask all the questions without interrupting me, and explained the procedure so thoroughly. He said he would work in tandem, with his partner, and both of them would be performing the procedure. Told me what kind of stents he would be using, and for how long he had been practicing etc.
He was so good to me. No attitude, no snobbishness, but genuine and down to earth etc. I was so relieved after talking to him, that I went to bed and slept for three hours straight!!
So that’s the story. The procedure is set for the 7th. I don’t know the time yet. They will call me on Thursday or Friday and tell me about that.
Hope everything goes well. Just thought I would let you all know.

You and I were one and the same.
I felt your beats, as you smiled at my breath
you wanted me to feel life, and
I played every game possible.

Respect, love and compassion
you filled in every pore of my being.
You promised me that you would
hold my hand, and let me reach giddy heights

A month ago, you betrayed me.
You let me fall, lose my dignity
not caring that I did all you’d asked me to do;
I had walked with you for miles

Played tennis and golf, and sweated
while you hammered the drums in my chest
encouraging me, cheering me on
until last month.

You clammed up!
Locked one of the doors and blocked
my entrance into your private chambers.
You gave me a heart attack……literally!

Such betrayal from a true and trusted soul mate!!

ZSA.

July 26, 2017 Written after my heart attack

Once I realized that I had no say in the matter, I resigned myself to the fact that I had to go to the hospital and have my problem taken care of. I called Humana my supplemental insurance company at home, and informed them, packed a small overnight bag, and went to the local Hillingdon Hospital.

The place was packed with patients, waiting to be seen by the triage nurses or the ER physicians. I waited in line for almost half hour before I could be seen by a triage nurse, despite the fact that I had a letter in my hand from the consultant that I had had a heart attack and that I should be seen by the ER physician immediately and admitted. After about half hour when my turn came, the nurse whose attitude was on the top of The Seeing Eye of London, had no time for me. She was asking me all sorts of questions as to why I was there, (as if I was faking my problem, just to be seen by her august majesty!), and what was the reason for admission etc. After explaining to her again and again about the setback I had with my health, she finally took the letter from the consultant; I was told to wait right there, and she disappeared into the bowels of that place. Returned after twenty minutes and asked that I follow her. We were taken into the ER part of the hospital. Never once did she ask me if I needed some assistance, like wheel chair or anything.

Once inside the ER and a cubicle, things started happening. A cannula was inserted in my vein and IV medication started to bust the platelet aggregation etc. Three hours later, I was transferred to an “Acute Medical Unit!” It consisted of a large hall with ten beds in it, separated by shower curtain like plastics. There was no question about privacy, HIPPA, or care for the patient. Each bed had about three or four visitors, sitting around talking loud, and the nurses were questioning the patients all personal details about their home lives, bowel habits, sugar problems etc. etc. Nobody spoke softly, even the nurses! Every one was loud and the cacophony was nerve wracking! This went on till about 12:30 in the night. Finally I called the nurse and asked for an eye cover so I could block the fluorescent lights in the room, and ear guards to block the noise of the visitors and the nurses. I asked them if there was no “quiet time for the patients to rest!” At that, the nurse stood in the middle of the room and yelled for all the visitors to leave, because some patients want to sleep!! I wanted to crawl into the ground!

In the morning was taken to the cardiac hospital around 11 by ambulance, where the situation was more professional. A couple of hours after admission there, I was taken to the cardiac cath lab, and an angiogram was done. I was told that I had a complete blockage of my right coronary artery, in the proximal part (Where the artery came out of the Aorta), and the catheter couldn’t be passed through the clot! I had such an out of body experience at that time. I really thought that I would be completely free of problem, and my blood vessels would be normal. I was not scared, not shocked, not stunned, just a “hmmm, is that so?” kind of feeling. Then I was told that because I had good collaterals, I did not need the stents put in, and that I was free to fly back home! I was ready to kiss the guy.

I am showing an angiogram picture of the blood vessel that is blocked in my heart as I write this. Hopefully, I will get a stent in the near future and have the blood supply restored as is seen in the second image here. I took these two images from google.

Looks like I am not able to upload the image from Google here. Sorry about that.

Image result for diagram of blockage of proximal right coronary artery.

I am waiting to go to St. Louis next week to see a super specialist there who does stenting of difficult cases. Apparently, my blockage was happening over several months, and the last straw was on that Saturday when the lumen was completely closed. The clot was too hard to put the catheter tip through, and personally I think, that they didn’t want to, to avoid complications. This was just well and good by me, and I appreciated that. I didn’t want to stay there one day more than was necessary.

So now I have started cardiac rehab, and am feeling like a wet rag. Sleeping a lot. But, the best thing is there is no fear. Nothing; not at all! Very Zen about it all. Enjoying the solitude at home. M is away in New York having fun with his brother. Saadia and Sayeed check up on me two or three times a day, bring me food which I really do not need, there is so much in the fridge already, and I have my books to keep me company. Continuing my painting, and hoping to finish editing my book for publication this year yet!

So that’s it dear friends. To all of you, who have written personally, have sent such GORGEOUS flowers and for the loving wishes of care and compassion, I am deeply and humbly grateful.

THANK YOU. THANK YOU AND AGAIN, THANK YOU.

Hope you know how much I love all of you.

London Trip (2)

Posted on July 20, 2017 by Zakiah

As I said in my last post, I felt so much better, within about a half hour after the ‘event’. Blood pressure taken at home, was somewhat high, mine is always very low, and that was another thought I had when I had the syncope, that perhaps my pressure had bottomed out for some reason and that was the reason I couldn’t feel my pulse. And now at home, the pressure reading of 138/86 was considered high by me. BUT, I was feeling better. My host wanted to take me to the ER. But he told me that going there would mean that I would have to wait for 6 to 7 hours to be seen by anyone, because of the fact that it was a weekend. And if I were to be seen at all, it would be by an intern managing the ER, because the Attendings and the Consultants did not do any work over the weekend. And because I had started feeling good, and because I was sure that it was a vasovagal syncopal event, and because doctors are the worse patients, I opted to wait till Monday!!

My classmates from medical school came to visit me on Sunday. Originally the plan was to meet them at the Kew Gardens in London and spend the day with them and with their spouses. But on Saturday, I called and talked to them and informed them about the setback that I had and they all came over to see me in Middlesex where we were staying with Adila and her husband Arif. It was a good reunion, and we all were laughing about the vasovagal syncope that I had, and how I was pretending to draw attention to myself etc. etc. They took all of us out to a South Indian restaurant in South Hall, a predominantly vegetarian venue. Had a great lunch amidst lots of laughter and camaraderie.

Later that night, Arif took me and M for a ride to Central London to see the city by night. Stopped at various landmarks and I was in and out of the car taking pictures of different things and places. While I realized that I had no pain or symptoms of angina, I did feel some discomfort as if there was a feeling of buzz in my chest. I had felt that for many months prior to the event, and also the shortness of breath. I always put it behind my thoughts; considering those symptoms to be age related.

Anyway, to make a long story short, Arif called the consultant on Monday morning, and tried to get me in. Of course there was no way to get in on such a short notice that same day. So I was given a 4 pm appointment on Tuesday, the 4th of July… three full days after my spell. The best thing was that this guy’s office was on WIMPOLE STREET! Do you all remember the Barretts of Wimpole Street? Robert Browning and Elizabeth Barrett Browning the poets of Wimpole Street?? OMG! I was so excited to go to that street, not to see the cardiologist, but to just walk on the ground of that hallowed street.

The Cardiologist was a young Indian man. He did an EKG, and drew some blood for electrolytes. The EKG was normal. I saw it, and it did not look any different from the ones I have had before. We had a long chat and he concurred with me, that it was probably a vasovagal episode due to the stress of travel, jet lag, irregular hours of eating etc. BUT, just before I left his office, he said, “DR. Ali, just to be safe, and for our peace of mind let us do a Troponin level.” At that all kinds of bells started tinging in my head. I just stared at him, as if to say, “How dare you!”

Troponin is a very specific cardiac enzyme, and tells you if there is an injury to the heart. The normal range is 0.01 to 0.03. Anything over and above is considered a suspicion or a definite cardiac event. So I subjected my self to another blood draw, and thanks to National Health System, the results are not seen immediately as we have here. (We get our results within 15 minutes to an hour) But the doctor told me that he really didn’t expect any problem and that I could go back, and he would call us the next day with the result of the blood work.

I was feeling fine on Wednesday morning. So Adila and I took off to go shopping. I had not done one iota of any kind of shopping for my children or grandchildren. I was excited to get a few things at the specialty stores there. We were in the store about 10:30 and had just started selecting a few clothes, when Arif came barging in to the store. He had driven from home and was looking for us in different stores. He looked at us, and said,

“Zakiah, I have bad news for you. The consultant called a few minutes after you left. You have had an MI. Your Troponin level is 2,500!! At first I thought he was joking. Two thousand five hundred?? I had never seen that high a result ever! Then he reached over and hugged me, saying, “I am sorry dear friend, but the consultant is very concerned, and he is arranging for a room at the local A&E (Accident and Emergency) hospital, and you will be transferred to the cardiac hospital in London proper for an angiogram and stents.”

I think I was out of my own body at that time. I was in a zone. I couldn’t think, couldn’t speak and couldn’t focus on anything. We got home and I talked to the consultant myself, and told him, “Listen, I do not want to go through the procedure here. I will start myself on Beta blockers and Ace inhibitors, continue with aspirin, and go home and get things done in my country. The guy said, “I very strongly advise against that. I will not allow you to be taking such a dangerous step.” Pfffttt!

Let me finish this tomorrow. Isn’t this so horrible?? What a nightmare!

← Gratitude

Posted on July 19, 2017 by Zakiah

As you all know by now, my trip to London was a bust. The best part was, that I was able to come home!! Actually, the best part was the treatment given to us by our hosts. If it were not for them, I am sure we would have been in bad waters.

We reached London on the morning of Thursday 29th June. Had a great time with my friends, who have settled in London for as long as I have been an expatriate here. We did a little local sight-seeing on Thursday and Friday. There was a huge banquet on Saturday afternoon to celebrate the end of the month of Ramadan. That was 48 hours after we had reached London.

it was a beautiful function, attended by almost two hundred families all from my town of Hyderabad, all dressed up in beautiful clothes, princely men and elegant women. We were seated at a grand table, and in attendance was the prince of Hyderabad, who wanted me to sit next to him. I did for a few minutes, and then realized that he was sort of creepy so moved back to my original place at the table. About 2 pm the appetizers started arriving. (Yes, all meals are delayed, and eaten very leisurely, at odd times.)

Just as the appetizers started making the rounds, I felt like I was sitting in a sauna. I looked around and everyone was happy, talking endlessly, same language all around, and they all looked very comfortable. I touched my forehead, and realized I had started perspiring. I felt like I needed ten pedestal fans around me, but there were none except for the central air conditioning. I decided I needed to get out of that hall, in order to get some fresh air.

I walked out but there was no fresh air there either. I remember holding on to the banister of the stairwell, and hoping I would stop sweating like a horse! Drops of sweat were pouring off my forehead and then I lost consciousness. I don’t know how long I was on the ground where I found myself when I came to. I kept looking at the ground wondering, ‘how did I manage to come down like this on the ground with such fine clothes? Why is my face next to the floor?’ Then I realized that I had probably fainted.

Because of the prosthesis in my left knee, it is very difficult for me to sit on the floor, and hence, like a turtle on its back, I struggled to somehow get up and again stand at the banister; after a couple of minutes, I sat along a ledge of a large glass window. My blouse was drenched in sweat, and I was continuing to perspire, and it looked as if the drops of perspiration kept falling like rain drops from my head, neck, arms and chest. NEVER had anything like this happen to me. I tried to feel my pulse, and it was thread and extremely feeble at best.

About five minutes later my friend Adila came looking for me. “Where have you been. I got worried. I though you were in the toilet, and realized you were gone too long.” I told her that I had fainted. She gasped and touched my arm, which was CLAMMY… ice-cold and wet! She ran to get her husband, who is a retired physician like me, and he catered to me getting me to hydrate myself, and we walked back in to the hall. About ten of fifteen minutes later, I started feeling better, the perspiration improved and because I thought I had a vaso-vagal syncope from stress of travel, improper eating habits, jet lag etc. I forced myself to eat some of the wonderful food they served.

Went home was given aspirin, and rested a little while my hosts started calling consultants about m condition. By this time I was feeling A-OK! Truly. No chest pain, nausea or shortness of breath whatsoever! Even went for a long ride to Central London to view the city at night and took lots of pictures.

I am going to stop here and continue this marathon tonight, and shall post some pictures hopefully.

I am deeply grateful to Janet (slmrt) for the post about my health. I thank each one of you who has commented and sent good wishes and prayers for me.

I am improving I think, and hopefully will not have another nightmarish situation like that again. I intend to write more about the experience in the near future. Don't give up on me yet.

Love you all.

Zakiah.