I have been in medical practice for almost 35 years and in that journey of 35 years I have had to face many challenges in diagnosing and treating patients . Today I am about to share some of my experiences which will teach you how to handle the situation if you happen to face such a medical calamity.
20 years ago during one of such winter night around 2.00 a.m., I had a visitor–let us name him Mr.R– at my second floor home who came complaining of pain in the neck region and a burning sensation in the throat. Mr. R was 52 years old and had been a regular visitor to my clinic for treatment of diabetes[high blood sugar] and hypertension[high B.P.]. But today it was different–he was appearing pale,he was sweating profusely and had a look as if he had faced impending death. I felt his pulse which was very feeble and irregular, checked his B.P. which was 90/60 mm of Hg[low],he was breathing with difficulty[breathless],which was probably due to climbing stairs of my 2 floors home. He was feeling very uneasy. My diagnosis was that Mr.R had a HEART ATTACK. Without telling him so[to ensure that he did not panic],I casually told him”Let us visit the hospital” and personally took him to the hospital in my car.On reaching the emergency department,I ordered for a immediate ECG[electrocardiogram],which showed that Mr.R had suffered a massive heart attack. I immediately called for a Cardiologist,spoke to him on the phone,briefing him regarding Mr.R`s condition and admitted him in the ICCU[intensive cardiac care unit].Mr.R survived, having undergone bypass graft surgery later and is still visiting me for followups.He is now 72 years old,but is now a very disciplined person with well controlled sugar and B.P. A picture below will show you briefly what to expect in a heart attack:-
Coming back to Mr.R. At that time he was having a stressful job with shift duties,no proper time for eating food or getting some exercise,was a regular consumer of alcohol and was short-tempered—all a perfect combination for landing him in the above situation. As said earlier,with regular visits to my clinic and proper counselling, he now lives a very disciplined retired life[he had taken voluntary retirement soon after his bypass surgery].
So, if you have observed above,this patient had both diabetes and hypertension. Now the question is,could Mr.R have prevented this outcome? Answer is yes. Kindly follow the instructions noted below:-
A] If you are having Diabetes:-
1] Regular bloods sugar checking—fasting and post-lunch; sometimes random,to show that you are not going into hypoglycemia[low blood glucose].
2] Check HbA1c[ glycosylated hemoglobin] levels once every 3 months.This gives you a fair picture of your diabetes control in past 3 months.
B] If you are having hypertension:-
1]Check your Lipid profile[serum cholesterol].This is because,increasing cholesterol levels increases the chance of your arteries-both peripheral and coronary[of heart]-narrowing which leads to increase in blood pressure as well as blockages in the coronaries. To be done every 6 months.
2]Check your Renal profile[Kidney function test]. A healthy kidney ensures that all impurities like urea,uric acid,creatinine etc. are removed from the circulation. In hypertension,there are chances of kidney being damaged leading to rise in the above mentioned impurities. To be done every 6 months.
C] If you are having both diabetes and hypertension:-
Do all the tests recommended in A and B.
Having said all this, I will now move on to interpretation of above tests and what to do if they are abnormal in my Part 2 of this series in next blog. If you have any queries and / suggestions,be free to do so in leave a comment section.I will be glad to reply all of them.