Monday, September 25, 2006

Killer Lifestyle

The following is my column today, September 25, 2006 at the op-ed section of the Manila Standard Today.

In a span of three weeks, four people I know underwent a heart bypass surgery. Two of the four were close family members—my eldest brother and an aunt. A fifth person, a distant cousin, was also scheduled to undergo a bypass, but the family decided to seek a second opinion and this doctor thankfully recommended a cheaper procedure—an angioplasty— instead. And what do you know, a third opinion from the country’s busiest heart surgeon (an appointment scheduled for 6 p.m. meant an audience with him at 11 p.m.; time management truly needs to be included in the medical school curriculum) ruled out both bypass and angioplasty. It turns out, medication and a stringent regimen of dieting and exercise was enough, thank you very much.

Nevertheless, our gene pool became the object of unwanted bashing and we are still trying to shift from denial to acceptance to action. However, we have also realized that a heart bypass is no longer the “last recourse” method of medical intervention that it was once touted to be.

It appears that there are now more hospitals in the Philippines that are equipped to conduct this very delicate medical procedure and that the number of surgeons who are qualified to do bypass surgery has quadrupled. Unlike in the past when doctors had to go abroad to acquire the specialization, I am told that this is not the case anymore today as the specialization can be acquired here. This is definitely good news. Thus, a bypass is now considered almost like a regular medical procedure, almost like a tonsillectomy. But then again, it is double-edged sword.

On one hand, it is heartening to note (pun intended) that we have in our country the capability to perform this life-saving procedure. On the other hand, it does seem that the accessibility of the procedure has also made it too convenient for many doctors and hospitals to prescribe it and I am told that very often, it really is not that absolutely necessary.

Proof of that is what happened to the distant cousin I mentioned earlier. The first doctor the family consulted immediately recommended a bypass and presented a rather gloomy prognosis for the patient unless his recommendation was heeded. The family prepared to raise the huge amount required (at least half a million pesos, if there were no complications involved) and was bracing for the procedure. But then a second opinion was sought and this doctor admitted that while a bypass would be ideal, an angioplasty was still a possible solution. Emboldened by the development, an appointment with the country’s supposed top cardiologist was made and he ruled out both bypass and angioplasty and instead prescribed medication and a strict diet and exercise regimen. The patient is now doing well, largely aided by the lifting of the threat of financial bankruptcy, and his prognosis looks good.

I am not knocking the procedure and accusing doctors of making a cottage industry out of it. I will state for the record that I believe that a bypass is a necessary last recourse and we must be grateful the procedure is now available in the Philippines for those who need it. But we must also be realistic and admit that doctors and hospitals need to recoup investments. Sadly, a heart bypass costs an enormous amount of money and is still beyond the means of the average Filipino who can’t even afford basic medication.

Incidentally, my eldest brother works in Bangkok as a musician and underwent bypass there. His hospital bill came to around P200,000, almost a third of what the procedure would ordinarily cost here. This comparison is appalling. Add to this the fact that medicine costs so much cheaper in Bangkok, believe me. The last time I was in Bangkok, I stocked up on medicines and I was on pins and needles when I faced the local customs officials wondering what justification I could give if I were nabbed for drug trafficking. Fortunately, the customs officials were probably having a good day so I escaped a potentially harrowing ordeal.

At the same time, I really wonder if the accessibility and seeming convenience of the procedure is creating a false sense of security. I wonder how many people out there are clogging up their arteries with cholesterol, nicotine, and whatever else causes blockages of the veins in the heart because the procedure is available, anyway. A heart bypass is truly a paradox.

My doctor friends tell me that lifestyle diseases, mostly cardiovascular ailments, are now the number one cause of death in the country. Aside from heart problems, more and more people are getting diabetic and hypertensive at an early age. It does not take a genius to figure this out, given the lethal things we ingest everyday. I did a quick survey of friends my age who also live stressful lives and was shocked to discover that many among us are already hypertensive. Even my best friend who is a total health freak and who goes to the gym everyday and eats wisely is hypertensive! As in my case, the usual culprits were cited: Stress and genes, which are sadly two things we have very little control of.

I wonder when our leaders will sit up and read the urgent writing on the wall. People are dying every day due to clogged arteries! This is a major cause for alarm and it is about time that more deliberate steps are taken to warn people about the dangers that lurk behind the pervading lifestyle of ordinary Filipinos. Unfortunately, many of our business organizations still have to grow a conscience—they not only gloss over the harmful effects of their products, they actually spend huge amounts of money to encourage us to patronize them. They bombard us with all these advertisements enticing us to stuff ourselves to the gills with all the cholesterol, the toxins, the nicotine, the alcohol, etc., that will eventually kill us. Hurray to television ads, kids today actually think that soft drinks are a substitute for water and that burgers, French fries, ice cream and chocolates are the four basic food groups.

In other countries for example, cigarettes are not sold openly, unlike here where one cannot go 20 meters in our streets without encountering a cigarette vendor. At a 7-eleven store in Bangkok, we had to ask where the cigarettes were as these were not displayed in their counters. And when we actually were able to buy some, we were horrified to see pictures of sick people prominently displayed in the cigarette cases and the warning “smoking can kill” in really bold letters— not the subtle “smoking is dangerous to your health, mind.”

This is wishful thinking, but perhaps our legislators can put their energies into crafting and passing legislation that will squarely address the rise of lifestyle diseases instead of squabbling over things the public hardly cares about anyway. It will be a tough job as the business sector will expectedly put up a good fight. Of course, it is naive to think that business and politics are separate to begin with. But it has to be done because the country’s health system does not have the resources to pay for the huge bill attached to cardiovascular diseases. Heck, we do not even have the money to pay for the most basic health services.

Prevention is still the best cure and the sooner we do this, the better. Fortunately, the other medicine—laughter—is still readily available courtesy of the funny antics of our leaders; but that kind of comedy is sadly becoming less and less funny every day.

Erratum: In my column last week, I inadvertently attributed the legal opinion I cited to a fictitious person. The reader of my blog who deserves the credit is Domingo Arong, not Rayon. My apologies to Mr. Arong.

6 comments:

vic said...

Most Cardiovascular disease and hypertension leading to heart attack is caused by high level of LDL or bad cholesterol that partially block the blood vessels and when the plaque sometimes hardened to the point that it will completely block the circulation of blood supply. I myself, have a case of high cholesterol level and was in statin medication, but now switched to ezemtimibe (also a cholesterol lowering drug) and taking two different maintenanace medications for lowering Blood pressure plus a daily dose of 81 mg of Aspirin. A by-pass surgery is only necessary if the blood vessel in the heart is already clogged to the point where a new vessel in needed to do the job. I’ve seen many ex by-bass surgical patients who are back to normal health. We are quite lucky, since our health care is universally funded by the taxpayers, and our hospitals are equip with all the modern and updated equipments, and our physicians don’t get paid by their patients, but by the government funds. But still some people are too lazy to do their regular check ups, and those especially with oversized girth need to be very extra careful with their health. As my overweight family doctor will always tells me, exercise, diet and medication and when I throw the wisdom back to him, he just tells me, he’s too busy taking care of our health..

BongA said...

vic,
as always, you make very interesting and enlightening comments that seek to widen the discussion rather than narrow it down. someone did tell me that aspirin helps blood circulation; and maybe I should ask my doctor about it. am taking lifezar for my hypertension - i used to take combizar but the frequent trips to the bathroom was affecting my sleep.

Yeah, the advantages of a real state social services program.

thanks for dropping by again!

vic said...

Bong, you're welcome. I believe the combizar is some kind of combination with dueretic pill or water pill that encourage the kindney to suck the salt out the blood system i'm also taking it in combination of candesartan cilexetil and do you have any idea how much water pill cost here (generic) next to nothing. but it a very appropriate for salty diet patients. aspirin the low dose, as long as you are not allergic is the best blood thinner around. Plavix is 20X. I know the price because it is shown in our official receipts, although we usually don't pay or pay only percentage of it. I incur over 10 grand a year on my maintenance medical care. It's kind of hard to imagine, but getting it for free here enable me to help my brother and his wife for theirs that cost 15 thousands pesos monthly.

snglguy said...

My late dad's side of the family have a long history of heart problems too, with numerous relatives suffering from it in one form or another. My dad suffered a stroke and was bedridden for a long time before he passed away last year. I guess that makes me a likely candidate.

BTW, congrats on your first anniversary as a blogger, Bong. Here's to more entries. :-)

PS: Haven't been able to check on other bloggers' updates since my dsl connection conked out the day before your first anniversary.

BongA said...

Vic,
yup, it is a diuretic - which is why I had to stop taking it; the trips to the bathroom was keeping me awake!

we're getting old. sigh.

bong

BongA said...

singleguy,
thanks! havent been able to do my usual blog hops also. but i will. hurray for archives!

bong