Health Risks In Paradise
By Dr Harold Gunatillake – Health writer
FRCS, FACS (US), FIACS (US),
AM (SING), MBBS (Cey)
There are many health risks facing the people in the Paradise Isle, especially those living around congested suburbs and outskirts of Colombo. Risks not thought of until a panicky anxious moment, due to a sudden illness of a loved one. One would realise there are a multitude of such risk factors and this presentation is to make people aware of such situations and help them take preventive measures.
Living in congested suburbs like Battaramulla, Malabe and beyond, and other similar congested suburbs with narrow arterial roads, would be some good examples of suburbia living for such eventful situations. Take the situation when one purchases a property on a narrow lane leading from a narrow two-lane main road. One could easily drive up those narrow lanes on the left hand side with ease as you are on the left lane. If the property is on your driving side, turning right would be a problem from the oncoming fast traffic. Stopping vehicles to give you the way to turn right is not the done road etiquette. You may signal to turn right; the traffic behind you may pile up for long stretches, would give you an agitated moment if you are the conscious guy who cares for motorists. The motorists behind will toot their horns in anger and frustration as they find it difficult to reach home in time.
Experiencing chest pain
At the end of the day you reach home after a hard stressful time at work to relax with your family and by any chance if you happen to be the unfortunate victim to develop chest pain (angina), as seen in an impending heart attack, what would you do, or to be precise what can you do?
Call the ambulance?
Fortunately, a privately-run health company ambulance service is in existence for many years, and is fairly efficiently run in addition to on-call ambulance services provided by private and public hospitals in emergency situations. It is advisable to display ambulance telephone numbers near your telephone for an emergency situation.
Calling an ambulance during rush hours, before and after office hours, may be disappointingly futile for obvious reasons. It is unlikely that other vehicle drivers will give sufficient road space to negotiate through, even if they make an attempt through those narrow roads. Even after the ambulance arrives at the scene, going back for life support care is another problem.
In more affluent countries intensive care facilities and trained para-medics are engaged, and they reach the emergency site in no time. Of course, the health watchdogs and the mass media watch any lapses by these services.
The next best option is to find private transport from a friendly neighbour, or make your loved one drive you to the hospital if you do not have a driver. Having a driver is a great privilege and advantage these days in the paradise for emergency situations, and especially parking your vehicle in congested busy areas.
Whether you have a driver or not, getting onto to the road from a side lane is most panicky, and other ongoing vehicles may not allow you to negotiate onto the lane on left side of the road going towards the city areas during rush hours.
It would be a catch 22 situation now. When the teaching is that intensive care facility should be available within minutes of a heart attack situation, your spending hours on the polluted dusty road-side may bring you panicky moments with shivers. At moments like this, you ask for help from the Lord, if you believe in him, but it will be of no avail as it is a human problem and not an ecclesial one.
In America over a million people get heart attacks every year. In fact, it is estimated that every 34 seconds somebody in the United States has a heart attack. It is observed that the number of deaths from Ischaemic heart disease has been reduced due to getting to a hospital more quickly and recovery is more likely.
In Sri Lanka it is reported that the incidence of Non-Communicable Diseases (NCDs) is very high and Ischaemic heart disease seems to be the leading cause of death among people in working age groups (15-69 years). Though there is much lack of health education for healthy living, the incidence of death from these dreadful diseases can be minimised if quick, resuscitative measures are available within minutes. Such unwarranted deaths could be avoided by widening our arterial roads, and the incidence of death from medical emergency situations can be reduced.
So, it is inferred that the width of our roads is linked and inversely proportional to the incidence of heart disease, just like other risk factors, such as obesity, smoking, diabetes, hypertension, among others.
The lesson is clear that our existing roads needs to be widened with additional lanes for traffic.
In a situation where you are stuck on the road with angina pain, what temporary action could you take?
If you are on aspirin regularly, it is advisable to swallow a soluble aspirin with water immediately. The aspirin may not help those not on aspirin therapy daily. Aspirin may reduce your chance of having a heart attack or a stroke if you have certain risk factors, such as diabetes, high blood pressure, high cholesterol, or smoking. If you have a higher risk for a heart attack or stroke, aspirin will have even more benefits for you.
Some people shouldn’t take aspirin daily. These include people who are allergic to aspirin, who have a stomach ulcer, or who recently had a stroke caused by bleeding in the brain.
Aspirin is usually very safe. But there is an increased chance of bleeding when you take it every day.
Even if you take aspirin every day, you still need to follow a healthy lifestyle to reduce your chance of having a heart attack or a stroke. Eat healthy foods, get regular exercise, keep your blood pressure and cholesterol levels under control, and don’t smoke.
You need to know the risk factors for heart attacks or a stroke?
The common risk factors are:
• High blood pressure-uncontrolled
• High cholesterol (disputed by some)
• Low HDL (good cholesterol) levels
• Uncontrolled diabetes
• Family history of heart disease
• If you are a regular smoker
• Age – Men older than 45 and women older than 55 have higher risks
People who run the risk of heart attacks should carry a nitro-glycerine spray, in addition to having soluble aspirin ready at hand.
More advice to improve heart health:
Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fibre grains and breads, and olive oil, and coconut oil.
• Get regular exercise. Your doctor can suggest a safe level of exercise for you.
• Control your cholesterol (disputed) and blood pressure.
• Manage your diabetes.
• Lower your stress level. Stress can damage your heart.
Take a daily aspirin if your doctor advises it.
Can you prevent a heart attack?
Heart attacks are usually the result of heart disease, so taking steps to delay or reverse coronary artery disease can help prevent a heart attack. Heart disease is the number one killer of both men and women in Sri Lanka, so the above steps are important for everyone.
Very few heart attacks due to atherogenesis are familial or genetic. Today, it is the unhealthy lifestyles of our people that cause heart disease.
The majority of working people in Sri Lanka reach home by public transport after finishing work at 5 o’clock. Reach home quite possibly late after changing a few buses to reach home. How can the medical profession advise such people to exercise daily?
We advise the average working class person to eat healthy food. Can he afford it? Healthy food like dark green vegetables and fish among other foods is expensive, and beyond the reach of the average working class man. Even high protein sprats, being poor man’s protein once upon a time, are not within the reach of the average wage earner.
With the increasing cost of living the average man is getting poorer in health and most of them are reaching malnourished situations. These poorer souls have become a desperate and unfortunate set of human beings in the paradise.
This is the dilemma facing our people, not the rich and the affluent.