Fourteen+ years later, here I am… again! And this, despite rigorously sticking to my daily goal of running 5 kms every day, eating very, very consciously, and indulging very occasionally and thoughtfully!
Two weeks ago, I felt a mild discomfort while running at higher speeds in one of my usual daily runs. I’d hardly classify it as ‘pain’. It felt more like acidity/heartburn. And when I stopped running, everything seemed normal. I pushed visiting a doctor for a couple of days, but when it persisted during higher speed runs and the discomfort started to feel a bit more pronounced on my shoulders too as mild numbness, I decided to check with a local general physician.
He put me through the same three things I was underwent in May 2011, fourteen odd years ago – ECHO test, ECG, and Treadmill Test. Given the variations in the Treadmill test alone this time, he recommended that I do meet with a cardiologist. He also added that I need not rush to one immediately since only high stress seems to trigger my discomfort, but that I should get this checked as soon as feasible without pushing it away.
That nudge, and Roshan Abbas’s LinkedIn post pushed me to head to Sakra Hospital, just for a casual check-up, which I thought I would complete soon and be back home by lunch.
But that casual check-up lasted the entire day since Dr. Sreekanth Shetty insisted that I go through an angiogram after looking at my Treadmill test results.
I was hoping to get a similar result like my angiogram at Vikram Hospital in May 2011 – no blocks! But, I wasn’t so lucky this time. There were two blocks and one of them was a Chronic Total Occlusion (CTO), meaning it was completely blocked at origin. My body had made alternate arrangements for it though! In response to my CTO, the heart muscle had developed collateral circulation using smaller blood vessels to bypass the blockage and supply blood to the area affected by the occlusion. But since these collateral vessels are smaller than the blocked artery, they cannot provide sufficient blood flow, particularly during physical activity. Just like how the smaller gullies get crowded when the main Marathahalli road gets jammed, several smaller arteries were doing the job of the right coronary artery 🙂
And because there was another 70% block in the left anterior descending (LAD) artery, I was starting to feel the discomfort now!
So, Dr. Shetty explained my options: angioplasty + stent for both blocks. He seemed a little unsure about the right-side CTO and said that if angioplasty does not work, my only option was bypass surgery! But if I opt for bypass directly, there would be no chance of angioplasty, so the sequence should ideally be angioplasty, and then, bypass.
“Bypass surgery” is the health equivalent of other major scares for most Indians, like ‘You have failed in maths’ or ‘Your bank account balance now is zero’. But once again, Roshan Abbas’s life update gave me hope and courage, and I decided to go ahead with the angioplasty.
The optics and symbolism are straight out of a 1980s K. Balachandar film – angiogram and discovery of two blocks on one day, Varalakshmi festival (the Tamil-equivalent of Karwa Chauth!) at home the next day, and angioplasty on the third day!
When the concerned person at Sakra Hospital asked my wife to sign a consent form which listed that my skin had no visible marks, bedsores, etc. (just like how a car service personnel looks around the car and asks us to sign a consent form listing what-is, where-is) he also asked her if there are any valuables in my body/self, and that they need to be removed. My wife told him, “HE is the valuable!” 🙂
Now, having gone through angiogram once, I am acutely aware that the actual procedures (both angiogram—and angioplasty) themselves are mostly painless. It is the surrounding effort that is incredibly traumatic.
In hindsight, I thank my 2011 experience of preparing me mentally for the 2025 experience. Back in 2011, my angiogram procedure was through the femoral artery. If you have no clue what it is, here goes – angiogram or angioplasty can be done via your wrist (radial artery) or just above your groin (femoral artery). With the former, you just extend your arm, and everything is completed at an arm’s length, literally. With the latter though, everything becomes 10x traumatic.
Interestingly, this time, my angiogram was through the radial artery, but the doctor decided that my angioplasty better be through the femoral artery since he needs to deal with both sides, for two blocks!
As I had painstakingly catalogued in my 2011 post, it starts with a dutiful hospital attendant casually coming your way for a ‘shave’. Not the usual shave, but your private parts, that, till now, you have mostly kept very private. It’s one thing for Pete Davidson or Milind Soman to advertise devices to self-shave the nether parts, but entirely another for a complete stranger to come to you offering this as a service as part of his professional responsibilities! I tried engaging this man with titbits of my prior experience, but he refused to respond, being focused on not leaving my private parts with nicks or cuts. Fair enough.
Considering I am some sort of a veteran in this whole affair by now—how many people, after all, get the top portion of their groin punctured thrice, huh? (if you count the one in 2011 and the two in 2025)—I’m forced to realize once again how the human body is treated inside the hospital vs. in the world outside it.
In the hospital, no one seems to dwell too much about existential worries about things like shame. Your body is a machine, and if it breaks down, anything that needs to be done to set it right, will be done. Clothes, private parts, shame, etc. have no place in this equation. Our warped obsession with the three in the outside world seems severely unhealthy, in comparison!
In any case, given the impending possibility of the bypass surgery, I (and my family) was still holding on to the hope that things will end with just the angioplasty alone.
Dr. Shetty started the angioplasty procedure around 4:20pm. Like in my 2011 angiogram experience, since only a local anaesthesia is administered (that did not eliminate 100% of the pain of being punctured four times on both sides of the groin area, though – twice for the anaesthesia injection and two more times to insert the angioplasty catheter – though I should admit that without the anaesthesia, it would have been 100x worse), I was staring at the ceiling and within the limits of how I can crane my neck while lying on the surgery bed. At one point, I got bored, closed my eyes and started thinking about random things that came to my mind.
Strangely, at around 4:35pm, completely at random, the imagery of seeing Udupi Sri Krishna, for the first time in 2021, appeared in my mind, even though I wasn’t consciously thinking about temples or Gods. The way devotees see the God in the Udupi Temple is very different from other temples where we simply land in front of the reigning deity in the temple’s sanctum sanctorum. In the Udupi Temple, we see the God through the Navagraha Kindi (nine-holed window)! At first, given how unusual it all was, I wasn’t able to see the deity, and it took me a few extra seconds to focus and really view the deity! That first experience of being unable to focus and then focus came to my mind out of nowhere, while lying on the angioplasty procedure bed!!
At that point, I heard Dr. Shetty tell me that he had managed to get through what he felt was a tougher job – passing the catheter through the total block on the right since it was an older block with heavy plaque accrual! I asked him in disbelief and a couple of tears, if this was the same one he felt would be a bit challenging, and he confirmed that it indeed was, with a smile!
Not just that – Dr. Shetty was both compassionate and thoughtful enough to get a doctor from his team to convey this update immediately to my wife who was waiting outside anxiously! My wife later told me that she was monumentally thankful for this update and that it made her cry her heart out in total relief!
Call it divine intervention or just a random coincidence, what mattered was that things fell in place, literally. From then on, Dr. Shetty proceeded to work on the second block too and by 5:25pm or so, both stents have been placed and the procedure was over!
Relief? Sure. But as a veteran in this area, I know that this relief is only one kind.
The real trauma, as I knew in cases with the procedure through the femoral artery, is the challenge of stopping the bleeding. This involves placing a heavy sandbag on the punctured area after closing it with industrial strength tape. The best part? I need to keep my legs unmoved for a minimum of 6+ hours to stop the bleeding since I was also on blood thinners to enable the procedure!
This also means, just like my 2011 experience, that I cannot pee all through this period! One of the reasons is being stuck, spread like an upturned lab frog. Two, the human capacity to pee while in the horizontal position (after having outgrown this habit as a baby) has been hugely underestimated. After I requested multiple hospital staff to hold a can to help me pee, I was finally left with no option but to opt for an external urinary catheter as a last resort. The result was 1.5 liters of pee – sorry, I know this is TMI (too much information) in the conventional sense, but please consider my observation about hospitals being the place where such TMIs do not matter at all.
The next morning, when the wonderful staff at Sakra Hospital kindly decided to remove the tapes, I knew what was awaiting me – the incredible pain of strong tape being yanked off! To be fair to the hospital staff, they made me feel very comfortable by constantly talking to me (to distract me) and doing their job slowly and steadily to reduce the pain. It worked, to a large extent and I would categorize this experience, despite two punctures on both sides, to be significantly better than the last one from 2011 at Vikram Hospital.
After a day in the hospital for observation, I was discharged on Day 3.
Having read this much, if you still prefer a tl;dr takeaway, here goes.
1. Please take your heart health VERY seriously even if you think (or know) that you are active and mostly eat healthy.
2. It is always better to walk into an angioplasty procedure calmly without drama (or ‘heart attack’) since you know what you are getting into proactively. Do not wait till things head to drama-level because it is more traumatic to your family than yourself.
3. No matter how controlled your diet is, incidences of heart-related ailments are heading towards people who are younger, every decade or so. We used to hear about such cases for ‘older’ people years ago, meaning 60-70-80s+. Nowadays, we hear these instances with people in their 30-40-50s. Puneeth Rajkumar’s death in 2021 still rankles me. Here was a 46-year-old man in the pink of his health, the world at his disposal as the literal darling prince of Bengaluru (and he earned it by being a truly wonderful human being at that)! He complained of uneasiness and died on the way to the hospital! I mean, if it can happen to a super healthy man like him, what are we normal mortals?
4. So, please insist on the periodic relevant checks – ECG, Echo, Treadmill test, Troponin test, CT Calcium Scan, etc. for you and your family members. Anyone can be susceptible. Do not allow your heart to jump on you, be one step ahead by making use of modern medicine’s evolution. Most people seem wary of doing these tests (either once or periodically) because of the fear that they might actually find something wrong. But that’s precisely ALSO why you should insist on getting these done periodically. It is always better to be prepared and decide your course of action when you are able and calm, as against something creeping up on you and you are in a panic.
5. Be extraordinarily careful and conscious about what you consume. What we have been warned about—the usual, including smoking, alcohol in strict moderation or simply avoid, consciously avoiding packaged foods and deep fried foods (I know this seems impossible in the Indian context, but consider the alternative!), including fresh vegetables and fruits in your daily diet so that it remains a larger part of your diet than the cooked food variety, are all monumentally important.
7. Of course, it goes totally without saying that you need to have some kind of activity as a daily habit. I would perhaps thank my 5-kms-a-day running habit as the signal for me to even realize that I was feeling discomfort at peak levels. That kind of warning is any day better than an incidence without warning that hits you suddenly.
8. The downside (sort of) is that after an angioplasty, you (as I have been) may be put on blood thinners for life (to prevent blood clots from forming in the newly stented artery) and this increases your susceptibility to bleed more from even normal wounds since thinners affect the natural clotting behaviour of blood. But this is a mighty small downside versus being dead and blood thinners are fairly common these days, and enough people have found enough ways to live a normal, active life with their presence in their lives. So, just count your blessings and stay healthy 🙂
PS: All through my procedures (both angiogram and angioplasty) this time, both me and my wife had extensively used ChatGPT to ask all kinds of questions and pouring our worries. The AI tools helped enormously, giving us informed context instantly. The same Q&A via a search engine would have been a lot more time consuming and laborious!