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Blood thinner reduces the risk of stroke.

 

Generally, in elderly patients with complaint of hypertension, the doctor prescribes a blood thinner like aspirin, warfarin etc. to reduce the chances of stroke. Our brain vessels are one of the most delicate ones and gets easily ruptured by the pressure of blood having high viscosity in hypertensive patients. Once ruptured, this may result into brain hemorrhage or stroke. Any damage to brain is irreparable. Hence it is of utmost importance to keep a check upon the viscosity of blood so that such damaging effects could be avoided.

Now, I would narrate two short stories involving two characters – one my mother and second my uncle.

My mother has 15 years old history of hypertension and was on aspirin for the above reasons since her very diagnosis. Monsoon 2011- Dengue mania breaks out in Delhi as usual. We go to Medanta hospital for routine checkup of my mother. Dr. Balbir Singh, Senior interventional cardiologist there stops the blood thinner in view of my mother’s marginally low platelet count. Four years since then, we don’t bother to consult any cardiologist to restart the blood thinner. Diwali 2015- My mother diagnosed with atrial fibrillation and when the cardiologist came to know that she is not on blood thinner since last four years, he really panics. Atrial fibrillation patients have relatively high degree of risk of stroke. After immediate control of fibrillation, Dr Upendra Kaul, senior cardiologist at Fortis hospital, for whom we really carry high degree of regard, prescribes the blood thinner Pradaxa [dabigatran etexilate mesylate]. After brainstorming at google for hours, I concluded this to be among the most proffered blood thinners worldwide in contemporary times. My mother’s heart gave her another miss (of course, not a long one) when she came to know that one tablet of Pradaxa costs Rs.70. When we went to Dr Kaul for review, she knowingly asks him- Do I need to take this medicine twice daily? (although she knew the answer). Dr Kaul replied affirmative with a short glance towards her (as if he knew the real intent behind the question). Now as both the participants understood the theme of the dialogue, my mother unhesitatingly said in a dim voice “It’s too costly’’. I still remember Dr Kaul’s equally dim but meaningful words echoing ‘’ what’s costlier than a life!!’ She was convinced. Still I tried to find a generic more economical alternative for pradaxa, but in vane. Just I got more convinced when I went to my native place, a remote district in Bihar. There my family physician asked me’’ Are you taking Pradaxa’’ . I replied affirmative. I could see the mixed feeling in his eyes. He said ‘’ Even I wish to prescribe this medicine to my patients here, but if I start with such medications , my clinic would soon get shut down with the allegation of my patients regarding my liaison with pharma companies’’.

Another story involves my uncle, again a patient of hypertension since last 10 years. He now resides at the countryside village enjoying mother nature in true sense. He got so embossed with the untarnished environment there that he started having the confidence that he doesn’t need any medications now. What happens next? No medication for hypertension, no blood thinner, no mediation with doctor, direct transmission to The Almighty!! He is lying in the ICU of Sir Gangaram Hospital with severe brain hemorrhage.

Oh My God !! Bless us !!

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