The heart of the matter

The human heart is an amazing yet mysterious organ. It is about the size of a clenched fist and weighs less than half a kilogram. Yet it beats continuously without rest and can create enough pressure to squirt blood to a distance of up to 10 metres. In one year it beats about 35 million times. But what makes it start ticking at the embryonic stage is still a mystery.

On Sunday, the nation was informed of the news that the father of singer Siti Nurhaliza has passed away after undergoing heart surgery. Tarudin Ismail had collapsed at his home in Kuala Lipis and was brought to Ampang Puteri Specialist Hospital where bypass surgery was performed. My condolonces to Siti Nurhaliza and her family on this tragic loss.

I first caught hold of the news on TV that night. The images of Siti and her family at the hospital reminded me of another traumatic event I experienced at that very same hospital four years ago. It involved a very close friend who also suffered a heart attack.

When I was based in KL a few years ago, I was part of our company's Tender & Contracts Department. Our task was to prepare tender and bid proposals for various projects. It was quite a tough job and working late into the night was a norm. We were a small team, only three of us : myself and two colleagues named Hasnul and Shaifudin. Although the job was tedious, we enjoyed what we do because each of us specializes in a certain area and we complement each other very well. Hasnul is the longest serving employee, having been there when the boss first started the firm. His dedication to his work is second to none and that is why I enjoy working with him.

We often work late together, going home well after midnight. On days before tender submission, it is not unusual for us to spend the night at the office.

On one particular evening we were having our dinner at the mamak restaurant at the ground floor of our office. I told Hasnul that I was tired and would be going home a bit earlier than usual. Hasnul told me that he would be staying back for a while longer to work on a tender proposal for a land reclamation project. After dinner, we returned back to our office. I went to my room to tidy up my desk and before leaving, I popped over to Hasnul's room to say goodnight. He was already concentrating hard in front of his laptop and probably smoking his third or fourth cigarette since the dinner break. Hasnul is the heaviest smoker among all my friends. Two packs of Dunhill a day is standard. I asked him how much longer will he be. Another couple of hours, he said.

As I wished him goodnight, it was already past 10pm.

Although I was very tired, I didn't sleep very well that night. When I woke up at daybreak, there was already a message on my mobile. It was from another colleague named Wan Lutfi. The message was brief but serious : Hasnul di ICU Ampang Puteri. Heart attack.

I quickly got dressed and sped off to Ampang Puteri. I reached the hospital in 15 minutes to find Lutfi standing just outside the hospital compound, enjoying a morning puff. He told me that Hasnul called him at home at around 2.30 am, complaining of chest pains. Lutfi, who stays at Gombak, rushed to the office at Setiawangsa and found our friend still conscious. He drove Hasnul to Ampang Puteri's emergency ward at breakneck speed.

After being briefed with a few more details I requested Lutfi to go home, shower up and then arrange to bring Hasnul's family to the hospital. Hasnul was already in intensive care and unconscious. I proceeded to the hospital's admissions office to take care of the administrative details. Around 11 am, I managed to speak to Dr. Ahmad, the consultant cardiologist. He told me that Hasnul's heart had stopped just as Lutfi managed to bring him into the emergency ward. They had to use the defibrillator to zap his heart a few times and get it pumping again. If Lutfi had been a few minutes late, my goodnight wish to Hasnul the previous night would have been the last words I spoke to him.

Dr. Ahmad informed me that he has put Hasnul on medication and hope that my friend's condition would stabilize before advising on the next step. I then returned to our office to update management on the situation and planned to come back later in the evening. At around 5pm, I received news that Hasnul's condition had taken a turn for the worse and the doctor advised for bypass surgery.

I rushed back to Ampang Puteri just in time to see my friend being wheeled into the operation theatre. Hasnul's wife, although visibly sad, kept her emotions in check but her children can be seen sobbing quitely. There was nothing much I could do except to console them of their anxiety.

The operation was carried out to bypass four blocked coronary arteries. The replacement blood vessels were taken from the patient's lower leg.

The next day, I visited my friend again but he was still under heavy sedation. It was only on the following day that he has recovered sufficiently for me to sit at his bedside. The sight of all those tubes and wires attached to him was a bit depressing. He was conscious of me sitting by his bed and made the effort to say a few words. I told him to take it easy and not to speak if it was causing him pain. I then relayed back to him the story that he had joked with me a few weeks earlier.

Actually, I had been a bit unwell myself a few weeks before. I was absent from the office for a number of days and only left a message with my secretary that I was resting at home. I did not return any phone calls or messages and this gave the impression that my illness was quite serious. I was away for an unusually long time, causing some colleagues to speculate that I was hospitalised. When I finally turned back up for work, my friends were relieved to see me. At that point, Hasnul mentioned that he had wanted to visit me but didn't know which hospital I was in. He was afraid that he might be too late and joked that the visit he would be making was to my house to recite the Surah Yassin (verses from the Holy Quran), meaning at my funeral. We all had a good laugh at that time, not knowing that the remark made in jest can turn out to be dead serious.

As I related the event back to Hasnul, I couldn't hold back my tears. I held his left hand firmly with both of mine as I cried. If Hasnul had collapsed all alone that night at the office or if he had failed to make that phone call to Lutfi or if Lutfi had delayed in rushing him to the hospital, then my friend would have been gone forever. And it would have been me who would be at his house to recite the Surah Yassin.

A male internal plumbing problem

Of late, the posts in this blog has been getting sparse. From a regular posting every 3-4 days, it has now dropped to once a week.

The past fortnight was a bit more hectic than usual. Work commitments aside, a large part of the last week was spent attending to my father-in-law's medical condition. He suffers from prostate cancer, considered the most common cancer disease afflicting men, especially those aged above 50 years old.

We have known about this ailment for some time. My FIL had undergone treatment at a few specialists before but nothing much could be done primarily due to his advanced age. He is 93-years old. When we received news the previous week that he was admitted to the district hospital in Mersing due to urinary complications, we knew the advanced stage of the disease has begun.

After a few days at Mersing Hospital, we transferred him to the Johor Specialist Hospital in Johor Bahru. The Consultant Urologist at JSH reviewed my FIL's case and advised that a prostatic stent be inserted to relieve the blockage caused by the enlarged prostate. This procedure does not involve surgery and in my FIL's situation, the only practical option available. The insertion of the stent however, does not treat the prostate itself. It is just a measure taken to enable my FIL to pee. The application of drugs to treat the prostate has shown mixed results and in any case, takes too long to be effective.

The insertion procedure was carried out yesterday afternoon. My FIL is now recovering but the full effect of the process is yet to be seen. As I've mentioned, we still need to consider the state of the cancer of the prostate itself. It seems that nothing much can be done about that. There will come a time when there is nothing else that we can do, but pray.

Mending a deformed backbone

Earlier this week I received news that the teenage daughter of a very close friend had undergone major surgery to correct her abnormally curved spine. I was in Kuala Lumpur on Wednesday morning for a project meeting and later took the opportunity to visit my friend and his daughter at their home in Shah Alam.

Mariah Raihanah bt. Khushairi is 18 years old. Her backbone has an abnormal lateral (sideways) curvature to the right. The medical term for this condition is scoliosis. It's the first time that I've heard of the term so I looked it up on the internet to learn more.

Image from www.eurospine.org

Scoliosis is more likely to occur in girls than boys. The specific cause of this condition is not known. The spine curves either to the left or right. In some cases, it curves both ways, giving the backbone an S-shape. The degree of curvature is called the Cobb angle and anything above 40 degrees is considered severe. Non-severe curvatures can be corrected using a brace, especially if the condition is detected at a young age. Severe cases can only be rectified by surgery.

Scoliosis is not caused by bad posture, sporting injuries or lifting heavy loads. The condition does not actually cause much pain but if left untreated, may cause complications to other internal organs in future.

Raihan's spine was curved at 48 degrees. She underwent a 5-hour surgery at Damansara Specialist Hospital three weeks ago. Alhamdulillah, the operation was successfully done and she is now recuperating at home.

Khushairi showed me the X-ray images of his daughter's backbone taken before and after the surgery. The `before' image shows a curve in the lower or lumbar region of the backbone. The `after' image shows the affected vertebrae straightened with a short metal rod about 8" long and held in place by five screws. The operation also involved taking a piece of bone from her rib cage, crushing it to a paste that's later used as a filler in between the vertebrae to encourage fusion and therefore restraining the curvature from progressing further.

I cannot but imagine how complicated the procedure must have been and the pain and discomfort that Raihan is going through. But she seemed cheerful enough and very positive when I talked to her.

My wishes to Raihan for speedy recovery. You sure are a brave girl, my child.