May 15, 2011

INDIA: Surgery’s silver lining

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NEW DELHI / The Hindustan Times / Wellness / May 15, 2011

By Rhythma Kaul, Hindustan Times

At 107, Vidyawati Chopra, who underwent a hip-replacement surgery last month, joined a growing list of over people over 80 years of age, who agree to go under the knife despite their age. Nearly 10% of surgeries in hospitals are performed on people such as her, up from barely 1% till a decade ago.

Vidyawati Chopra (107) opted for hip replacement surgery, enabling her to walk. Post surgery period has been good and she has had "no pain." Photo: Ronjoy Gogoi/ HT

“We were a little skeptical, but she was keen. Doctors convinced her that many old-aged people were undergoing various surgeries these days with good results,” said Meera Chopra, her granddaughter. “She wanted to take a chance, to get rid of a bed-ridden life,” added Chopra.

Post-surgery, Chopra has had no pain, and undergoes regular sessions of physiotherapy to improve her joint movement. “In a couple of months, she should be able to move around without any difficulty. The surgery has proved good for her, else she wouldn’t have been able to walk at all,” said Dr Dattatreya Mohapatra, orthopedic surgeon at Primus Super-specialty Hospital , who did the surgery.

In a country where life expectancy is 70 years, from a mere 35 years in 1947, and nearly 15% of the population is more than 65 years of age, more doctors are performing surgeries on old people. In Delhi-NCR combined, about 150 knee replacement surgeries take place in a day.

“With improved longevity and advanced diagnostic tools available, we have a substantial amount of old people in need of surgeries,” said Dr Anil Bhan, senior cardiac surgeon, Medanta- The Medicity. Recent WHO data says non-communicable diseases, especially related to heart, will be a major killer in coming times.

Last week, Dr Bhan performed a twin surgeries — open heart bypass (for two blocked arteries) and abdominal aortic aneurysm repair (abnormal ballooning of the vessel that supplies blood to lower parts of the body), on an 85-year-old man. “No one could have imagined this till some time ago. The patient’s positive attitude really made it easy,” said Dr Bhan.

Advances in medical technology and techniques have given people above 80 years the right to an improved quality of life. “Chronological age should never restrict people from living a better life. Many of them are as fit as people much younger to them,” said Dr AK Bisoi, professor, department of cardiac surgery, All India Institute of Medical Science (AIIMS), who recently performed open heart by-pass surgery on a 99-year-old man. “One patient insisted I operate him on his 90th birthday,” Dr Bisoi added.

“Support systems are becoming almost non-existent, and so it’s important for old people to not be dependent on anyone as far as possible,” said Dr Mohapatra.

T. Nath (85) has undegone twin surgeries - open heart by pass (for two blocked arteries) and  abdominal aortic aneurysm repair.
Photo: Manoj Kumar/HT

Besides the surgery, the post-operative recovery period is also critical (see box). “Older people have weaker healing capacity,” said Dr Anshuman Agarwal, senior consultant urologist, Fortis Hospital, who recently removed the enlarged prostrate of a 94-year-old using laser technique. Fifty per cent of men above 60 years have prostrate problem and 30% of them undergo surgery.

Pre-operative screening has seen maximum improvement in last 10 years and helped improve the outcome.

“We have state-of-the-art equipment that helps us evaluate risks and plan the surgery, optimising the chances of survival, as opposed to an emergency surgery,” said Dr Bhan.

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