In the Sunday Series today,  we have a popular article from our archives  where Dr. Harish Shetty, a renowned psychiatrist practicing in Mumbai, draws attention to the psycho social aspect of recovery from interventional procedures for heart diseases, a very vital yet neglected aspect of heart disease.

A Cardiologist walks out of the Intensive Critical Care Unit (ICCU)as the crowd follows him anxiously to check the health status of their loved ones, and the Doctor patiently explains. More often than not, an elevator is already waiting for the doctor when he comes out and the swarm of people moves into the elevator with him in the hope of holding a meaningful conversation with the doctor. Such scenes are common across hospitals.

 I do not know why ICCUs do not have a  peaceful place inside where such discussions can happen. 
 

The entire ordeal from the time of a heart attack to a discharge from the hospital can be transformed into a memorable experience if mental health professionals work in tandem with the life saving doctors.

The entire scenario changes! After the consultation of the Doctor and listening to the exact status of the heart problem the counselor takes over. The information shared leads to a flurry of feelings and thoughts. The turmoil may cause fear, confusion, sadness and also anger. A tsunami of thoughts too is a consequence. 'I may not live long', 'I have little time on the earth'.etc are some of the many catastrophic thoughts that may trouble the patient and also the loved ones. Here the counselors ease the pain by helping the destructive emotions to recede and heal both the patient and the relatives. As the feelings and the thoughts are laid on the table the chances of improvement multiplies. 

The 'dil' and the heart have a great influence on each other. They are close friends. They can hurt or heal each other.

 The metaphorical heart and the literal heart are always in conversation all our lives. Emotions have a strong influence over the flow of blood in the coronaries, in the way the heart beats and the health of its muscles. There is enough research to say that fear, anxiety & depression can hurt the recovering heart and cause more complications.

Also, those having heart attacks are very prone to depression that can worsen the disease process. Depression & Heart attacks can be a fatal combination. 
 

The Psychologist and /or a Psychiatrist as a partner with the cardiologist is the game changer. 

In the west, the mental health intervention happens as a natural process following an angiography or an angioplasty or a surgery shares Dr. Anand Rao, a renowned Cardiologist from Mumbai. Talking at the CardioCon conference organized by Dr. Gajanan Ratnaparkhi, another doyen in the field,  shared that sudden deaths among the young due to heart attacks are very common. And for me, I am witnessing people dying suddenly of heart attacks and suicides both a complication of this neo-globalized fast paced world. Both the heart & Mind are under great stress.....

The stoic Cardiac  Surgeons will always benefit if a Psychologist works along side healing the patient and the family. This will improve acceptance, compliance and better recovery of their patients. Imagine a marathon open heart bypass happening inside and the group of relatives being informed and counseled concomitantly- 'kya scene hai.'   

Failure in surgeries, death, complications and other similar issues will be better handled if the 'twins' work together. Doubts, suspicion and irrational surmises by relatives. Post-surgery or angioplasty the counselors also can play a great role in maintaining recovery.

Cardiac rehab gymnasiums also help. Counseling in a group also will help form support groups. Panic attacks, rushing to the emergency services frequently, post-angioplasty or a surgery and cardiac neurosis can be prevented if early education, counseling, and healing occurs right from the first consultation.  Increase in heart disease is also due to the lifestyles in a world that is undergoing rapid changes.........

It is so important for the Associations of Cardiologists and Cardiac surgeons to add a new weapon to their toolbox. Simply showing how a balloon angioplasty is done in the most modern way on a screen is not enough. Human skills and tectonically healing the heart through effective psychological interventions are also very important. 

'Jai ho' will be the song on the lips of the families.Both the hearts will heal...the doctor's and the patient's. 

 

This article was originallypublished on 11.03.18

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