Life not easy after heart surgery

Life not easy after heart surgery

By Tri Hafiningsih

JAKARTA (JP): Six-year-old Aji Bangun seems no more physically
different from any other boy his age. He is just as active as
most of his friends.

But a closer look shows a boy who is actually too small for
his age. Weighing a mere 16 kg, Aji's tiny frame is able to
squeeze under a low table or hide under a chair. His mother,
Rumsinah, and father, Agus, can carry him around with ease.

Aji had heart surgery three years ago. Doctors "sealed" a hole
in his heart so that he could survive to live a relatively normal
life.

Aji, four-year-old Lusi, nine-year-old Martha and six-year-old
Nurul were among the children and adults attending a meeting for
post-surgery coronary heart disease (CHD) patients in Jakarta
last week.

The meeting, sponsored by Mitra Keluarga Hospital in East
Jakarta and Health Care of Australia Group, a foundation managing
all Mitra hospitals, was the third of its kind for patients who
had heart surgery between 1992 and 1998. The gathering reunited
the patients and their relatives with the hospital's
administrative staff, doctors and paramedics.

Life was not easy for Aji's parents when they found out that
the younger of their two children had a coronary heart ailment
three years ago.

"That explained why he got tired easily and turned blue after
just a few jumps or running around the house," Rumsinah recalled,
adding that the doctors' diagnosis also explained why Aji had
never put on weight. He weighed only nine kilograms from when he
was 10 months old until his third birthday.

Rumsinah and Agus said they did not know exactly what happened
to Aji. "All I knew is that something was wrong with his heart,
and that it would cost him his life if he did not have it
operated on," Rumsinah said.

Surgeon Triatmo Budiyuwono told the meeting that in most
cases, children's heart problems cleared up once they passed the
critical post-operation stage. All heart surgery patients,
however, bear a common badge: a surgical scar across the chest.

He said parents should not be concerned about whether their
children could handle strenuous physical activity.

"They are not sick anymore. They deserve to grow up normally
and can be very healthy and strong," he said.

But another doctor, Anna Ulfah Rahayoe, who treated most of
the hospital's children patients said that children born with
heart ailments should be treated as early as possible to
compensate for the impediment of their physical and mental growth
development while sick.

Anna reminded parents that their children should continue to
undergo regular medical checkups to make sure that they are
living a normal life.

The meeting's organizers, who plan to hold similar gatherings
in the future, included a discussion to help the participants
understand how to lead a healthy and normal life after heart
surgery. Other problems related to health care of children with a
history of CHD were also touched upon.

Triatmo said that children were able to forget the fact that
doctors had cut into their chest to fix their heart but that
adults usually could not. Either way, former patients should
change their habits after surgery.

"You may have to kick all the bad habits that brought you to
the operating room." He said that leading a healthy life was a
lifetime commitment: "That is, if you don't want to go back to
the operating room for another 'fix up'."

He warned that repeated operations may yield undesirable
results.

Triatmo said post-surgery CHD patients and people with no
history of heart problems should both pay attention to a number
of risk factors.

"If you are a male over 45, a female over 55, have gone
through menopause, are a current smoker, have ancestors with a
history of heart problems, have a high level of blood
cholesterol, a diabetic, suffer from hypertension or on anti-
hypertension therapy, then you are at high risk of getting a
heart attack in the near future."

Doctor Suharyuni, in charge of the hospital's cardiac
rehabilitation program, said his staff had developed an
integrated recovery program for post-surgery CHD patients, which
usually took at least six months to complete.

"The three-phased program is developed to ensure a thorough
recovery for patients, so they can lead a normal life after such
trauma," she said.

The first is a recovery phase which takes one to two weeks,
starting the moment a patient is moved from the intensive care
unit.

The next phase is a treatment period for at least one month.
During this phase, a patient undergoes an individual physio-
therapy program.

"A patient starts with 'passive' movements, exercised on his
hospital bed. When the program is completed, the patient should
be able to walk at least 1.5 kilometers with ease," Suharyuni
said.

The last phase is a post-treatment period, in which a patient
and his family must regularly visit the hospital for "active"
exercise programs and consultations with doctors.

For Eri Sumardi, 50, life had just "begun" two years ago after
he had coronary by-pass surgery. "I watch my diet, exercise
regularly and avoid stress," he said.

Eri has shunned junk food and meat. For exercise, he strolls
around the neighborhood every morning. He fasts every two days
for his stress management.

"I lost eight kilograms through regular fasting, and more
importantly, I always feel cool," he said, adding that he was
glad to be a "new" person -- much healthier than he was before
his heart attack.