BackHeart of the matter
A housewife from a traditional joint family struggles to practice low-risk cardiac behaviour after a coronary attack
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City parks," an editor in a publishing house said to me once, “are breeding grounds to find characters you want to bring to life in a novel."
A useful comment I left bookmarked in my mind. More on the advice of a sports injury doctor than this editor, I go to a city park at least once a week to alternate my gym routine. “Changing the firmament is crucial to observe the body’s response to walking or jogging as a fruitful exercise," the doctor had said.
The compelling fallout of changing the firmament is the exposure to the energy of people from different age groups who use jogging tracks in city parks to exercise in ways amusingly personalized to the tee. Besides my diehard fascination for how people dress at different times of the day, I am drawn to behavioural dynamics. Facial expressions and walking postures, finding unlikely corners to practice yogic breathing rituals, varying jogging speeds, the use of headphones, cross-body sling bags holding water bottles, combining salwar kameez with Nike sneakers, even chatting non-stop on a mobile phone while ostensibly trying to work out—they provide so many shades of insights.
On Sunday, I found my novel character. Because of our different walking speeds, we fell in step after two rounds of crossing one other. She was young and cheerful, wore a deep yellow, digitally printed, synthetic sari, her head was covered and the end of her pallu was tucked into her waist at the front to hold it in place. She was decked in gold jewellery, earrings rather large and jangly for a walk in the park, six gold bangles (I counted) and an opulent mangalsutra. My eyes darted quickly to her feet. How was she managing to walk in this garb, I wondered, she must have good shoes at least. Not particularly; she was shod in green-coloured Bata plastic slip-ons. She looked a bit overweight for her medium height and clearly exhausted.
Five minutes into idle chatter and we were discussing heart disease—the lady was in a sharing mood, not unusual in community spaces, but didn’t want to be identified for this column. Five months ago, the 33-year-old, married for four years, had a heart attack that mandated a bypass surgery. More than 80% of her major arteries were blocked. The attack had felt like a sharp singe of acidity and like many women reportedly do, she had avoided complaining until she was faint and giddy.
Pain in the heart? I asked, alarmed. “No pain, but severe heaviness," she said. This young housewife and mother of a two-year-old is now on a strict, cardiac diet, takes five pills a day, including blood thinners. She lives in a joint family.
“Nobody in our family has heart disease, though most members abuse food and drink. My husband and his brothers also smoke," she said, adding that she had been a fairly “balanced" person. Her tone was matter-of-fact, not resentful. “I just don’t understand how I have become a heart patient at this young age," she added. Of course, she never exercised, seldom visited doctors, never went for annual health checks, and habitually ignored aches and pains as “women in our family don’t have the privilege to fall ill or relax".
Now, despite a heart attack, which compromises the quality of her life and put her in a high-risk group for severe cardiac threat, her in-laws do not “allow" her to wear a salwar kameez or jogging pants for regular walks. Her husband has conveniently decided to keep mum. As a result, she huffs and puffs in her saris, expected to cover her head even while walking in the park.
In my many conversations with R.R. Kasliwal, the chairman of clinical and preventive cardiology at Gurgaon’s Medanta institute, cardiovascular disease among young Indian women has come up often. “It’s the subject of a book, no less," Kasliwal remarks and never in jest.
This was reiterated yet again by a recent survey titled Visualising the Extent of Heart Disease in Indian Women done by Bangalore’s Heal Foundation, the results of which were made public earlier this month. It mapped the trends of cardiovascular disease in women. Conducted among 577 cardiologists across the country, it showed that 54% doctors observed a rise of 16-20% in cardiovascular disease among Indian women in the last five years. Sixty five percent of these doctors said that they found low levels of estrogen to be one of the main causes for younger women developing heart disease. About 83% of doctors believed that Indian women are ignorant about heart disease, while 76% found that more women die due to delayed reporting in hospitals in case of cardiac problems.
The number of women suffering critical cardiovascular disease won’t remain a minority for long, say experts. But housewives, like the one I met, with no privilege of monitored exercise at a gym or a yoga centre, not even easy clothes to breathe better in humid and sultry weather, crucial me-time, or any respite from traditional obligations and chores (all aimed at the comfort of others), will obviously be at a peculiar risk.
Encouraged to minimize physical complaints and ignore cardiac rehabilitation despite a recent heart attack, so that “the family doesn’t have to apologize for a young and sick daughter-in-law", she falls into a terrible minority despite living in the capital of India in the day and age of preventive medicine and behaviour.
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