1-7 November 2013 #679

Cheney’s change of heart

Dhanvantari by Buddha Basnyat, MD

DAVID MCNEW/AP
The way former US vice-president Dick Cheney fought with numerous life- threatening cardiac problems while holding several crucial government posts is stunning. While Nepalis may not have access to the kind of medical facilities that Cheney had, his ordeals serve as a cautionary tale for the rest of us.

Prevention of heart diseases is obviously the key. However, modern, innovative treatments that the vice president received again and again testify to the marvel of modern medical science. 

Cheney started smoking when he was 12 and soon he was puffing three packs a day. In addition, his daily meal consisted of very fatty food including a dozen doughnuts. At 34, he became the chief of staff to President Gerald Ford during which time he undoubtedly faced numerous tension-filled moments at the White House. Clearly Cheney was asking for trouble and he got it with his first heart attack in 1978 at the age of 37 when he was campaigning for the US Congress. He subsequently had four more attacks in 1984, 1988, 2000, and 2010.

As though these were not enough, Cheney also underwent angioplasty, open heart surgery, and had a pacemaker implanted. More catastrophic interventions followed. He needed an implanted defibrillator, a gadget that would automatically shock his heart if the heart rhythm became dangerously abnormal.

There is an interesting terrorism-related story regarding his defibrillator, when he was vice-president. Fearing a terrorist could assassinate the VP by sending a signal after hacking into his implantable device telling it to shock his heart into cardiac arrest, Cheney’s cardiologist ordered the manufacturer to disable wireless features. There are obvious medical risks that a VIP government official faces that ordinary patients are spared.

In 2010 when Cheney was convinced his end was near, he discussed burial plans with his family. He had a left ventricular assist device (LVAD), a battery operated heart pump, implanted just to buy time while he waited for a transplant. After a 20 month wait period he finally received a new heart.

About 4,000 heart transplants are done every year around the world, out of which more than half are carried out in the US. Effective immunosuppressive medicines since the 1980s have been pivotal in the donor heart not being rejected by the patient’s immune system. About 75 per cent of transplant patients will easily survive beyond three years and the quality of life is excellent. As the vice-president jokingly explains, he can do whatever he wants except ski downhill. And that too because of osteoarthritis of his knees. 

Although tremendous strides have been made in the treatment of heart problems, the focus especially in our part of the world has to be on prevention. So this Tihar we need to make sure that during the festival of lights, we stop lighting up cigarettes or bidis. Not overindulging in ladoos and pedas and controlling our consumption even after the festival are good plans. While science came to the rescue of Dick Cheney, we need to avert the disaster all together by leading healthier lives.