Over the last couple of years, deaths of on-duty cardiologists, usually because of a heart attack and sudden cardiac arrest, have made headlines. Be it Dr Gaurav Gandhi, 41, in Jamnagar (Gujarat), Dr Adil Amin, 37, in Delhi and now Dr Gradlin Roy, 39 in Chennai, their deaths have drawn attention to how long hours at work, exhausting surgeries, ER crisis, stress, burnout and poor lifestyle have become additional risk factors for their heart health.
However, most cardiologists are aware that they are as much vulnerable as other Indians and sometimes tend to neglect their own heart health while prioritising that of their patients. But Dr M Sudhakar Rao and Dr Rocky Katheria, both 37 — one a cardiologist and the other an interventional cardiologist — at Manipal Hospital, Bengaluru, have worked around their busy schedules to maintain their heart health at optimum levels. “You literally hold your heart in your hands. It’s not about workload, everybody has theirs, it is about how to find your own discipline despite it. Also, most people judge good health with the externalities of appearance. ‘So and so looks fit,’ they say. But nobody looks at the 16-18 hour shifts that doctors have to do on their feet, sleepless nights, workplace anxiety, all of which build chronic risk factors like inflammation, blood pressure and bad cholesterol,” they say. Over to their fitness mantra:
Dr M Sudhakar Rao: ‘What you do today impacts how robust your health will be’
From time to time, I have to deal with high levels of bad cholesterol or low-density lipoprotein or LDL. I do not smoke or drink but I do have a family history. Then, I am borderline diabetic. So my life is a constant battle on how to keep my LDL and blood sugar levels in check.
I usually wake up at 6 am and prepare my five-and-a-half year daughter for school. Her school bus comes at 7.15 am and through our daily drill, I get some time to be with her. Between 7.15 am and 7.45 am, I get my 30-minute walk at a park in Jaynagar and roughly cover 3 km or 4,000 steps.
I am a vegetarian, so I have upma or poha mixed with nuts and split lentils for breakfast. I reach the hospital by 9 am and do incidental physical activity. This means I do not use lifts, I go five floors up and five floors down several times a day. This is how I reach my daily target of 10,000 steps.
Since I have four or five interventional procedures a day, my lunch is very light, a very small portion of either two chapatis with vegetable curry. Except emergencies, I am home by 8.30 pm and finish dinner by 9 pm. I always have a 10-minute post dinner walk so that my muscles can use up blood sugar efficiently and prevent spikes, calorie pile-ups and weight issues.
I sleep by 10 pm so that I have eight hours of solid sleep for the body to repair and unwind itself. Sleep actually absorbs my stress because sometimes we are on call during weekends too.
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Every six months, I do my tests given my family history. These include fasting sugar, HbA1c (average blood sugar), and a full lipid profile test. This helps me understand how I am doing and re-adjust my exercise and activity patterns if anything goes out of range. Since I have risk factors, I have done a CT coronary angiogram. This imaging test can be done once in five years to check the inside of your arteries. I check my blood pressure every month even if it stays normal. Everybody should check their blood pressure as it is silent and 90 per cent of hypertension patients come to us when it shoots up to 200/120 mm Hg.
Many say that the residency years, where medicos do back-to-back shifts stretching upto 36 hours are a stress builder. Indeed stress leads to chronic inflammation, one of the risk factors. But usually the effect of that stress remains for a decade. But how disciplined you live now impacts heart health for many years to follow.
My destress manta is simple: music and two family vacations, where I am completely cut off. Usually I am connected to my patients on the phone but on vacations, I let other consultants handle my cases.
Dr Rocky Katheria: Consistency of exercise is more important
I have no co-morbidity yet and would like to keep it that way. Mindfulness is a daily struggle when your favourite ice cream lands at your door at the click of a button. So I focus on my diet strongly, following an intermittent fasting routine, 12 to 14 hours of which is doable.
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I wake up at 7 am in the morning, drink chia seed soaked water followed by black decaffeinated coffee. I make sure I have three litres of fluid before 5 pm. I do not have too many solid foods during my work hours. On a usual day, I wrap up most procedures by 7 pm. As I live two minutes away from the hospital, my big meal is done by 7.30 pm. I ensure my plate is rainbow-coloured with a lot of vegetables, as salads and sauteed. I have a lot of moong sprouts, spinach, beetroot and paneer. I make sure there are at least five vegetables in every meal and there is a good combination of protein and fibre.
On weekdays, I have plant proteins. Animal proteins I have over the weekend. I ensure my daily calorie count does not cross 2,000. I always ensure that 80 per cent of my plate is clean and 20 per cent is indulgence.
I walk 30 minutes every morning, don’t go for fancy workouts. Consistency is the key and continuity helps. I do 10 to 15 minutes of strength training, home exercises using my own body weight.
My destress mantra is digital detox when I get home. After dinner, we always go for a family walk. This me-time is most important. I decided to relocate to an apartment which is two minutes from the hospital. While I can attend to emergencies better, it also gives me time to see my daughter when she comes back from school and feed her. Within 15 minutes I can do that and get back to hospital. But I get to be closer to her. That break keeps me going for the next half of the day without getting burnt out.
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