Tuesday, December 26, 2006


Dec 7th, Thursday 2006.

Bharat Mata ki Jai! Victory to Mother Bharat!


Dear Satsangi / YOGA Families.

Greetings: It is that time of the Year where we end with helping the needy esp. in Bharat. I personally feel that www.ekal.org is one of the best causes as it works with / for Adivasi Children. Give them the most basic education along with our Sasmkars and Personal & Community Hygiene. This schools are opened in the village where Govt. has not reached yet in last sixty years of Independence . Irony of it: The school I visited had Govt School too. Why? the Sir Panch said that it has only been opened for last two years and Ekal was for some five years. Instead of going to other villages w/o schools this is what is happening for whatever Godly reason. Then other interesting point is that Govt. school does not tackle Samskars and Hygiene. So Sir Panch said that in order to assure all the Kids in the community get the exposure to Valuable education in Hygiene & Samskar, they use Ekal Teacher for special classes.

Today there are 18225 schools running, reaching 547750 Adivasi Children. $1 a day goes long way! Since we know each other, I would like you to consider making year end, tax-deductible contribution at least for one school. If not start saving one dollar a day for next year and send Good faith amount now, whatever appeals to you heart. No amount is small.....

Special request to Gujarati folks: Please do not insist on Gujarat as the only preference as: I am told that 70% of the money that are contributed by USA is from Gujaraties. If everyone insist on Gujarat then they will have hard time as Gujarat is not really ready for either. This year, when I will visit Bharat in Jan-Feb 2007, I will have a meeting with Gujarati Ekal Leaders to get better picture personally.

I suggest to you that support whichever state you come from or feel allegiance to. BUT DO SOMETHING. I am very happy to say that SATSANG & Gurjar Association has formerly accepted to support Ekal People Movement. We would like to appeal to other regional organization to come forward to do the same.

My family has been sponsoring five to seven schools for last few years. Savitribahan & Prabhubhai Hingorani of Sadhu Vaswani Center has sponsored over forty schools in 2006.

For further information and the FORM, please go to www.satsangcenter.org & click on Ekal button.

NOW are you ready? Please get your check book out and consulting your spouse & inner conscience, Just fill out the amount appealing your heart. Shubhasya Shighram! Any thing worthwhile – Good, just act promptly, like NOW!

Lets fill those thirsty children with proper Education!

God bless you! God bless Bharat Mata!

- respectfully,

Sudhir Parikh nirusudhir1@yahoo.com 603-623-1930, Uttam Patel 781-270-9736,
Sangeeta Saxena 781-863-8886, Tarun Dave 978-998-0072, Bipin Parekh 978-256-2954
On Behalf of SATSANG Center , Gayatri Parivar, SATSANG Balgokulam, Gurjar (of NE).

Dec 23, 2006 My Triple Bypass Surgery Part IV – A Little Blip & Why me?

Dec 23, 2006 My Triple Bypass Surgery Part IV – A Little Blip & Why me?

Hari OM! I hope that you patiently went though the links I sent you in Part III. If you could not open the graphs, charts or tables in that Article for Asian Indians, please send me an e-mail and I will resend that 3 MG file in pdf. We Asian Indians need to study and understand it.

Now I am told that my condition was due to 75% genetics and 25% life style. I feel like screaming at this STAT. Many of my well-wishers including myself have question. How could I be the victim of a Heart Attack & undergo a Triple Bypass surgery? Further, if you did not know, on June 24, 1992, I had a Stroke (called TIA – Transient Ischemic Attack) that lasted some four hours. My left side was paralyzed and I even had lost my speech, but with Hanumanji’s blessings, I was saved within 4 hours. http://www.ninds.nih.gov/disorders/tia/tia.htm)

My life Style:

YOGA: I practice Asana part daily 22 minutes up to one hour.
YOGA: Pranayam – Practice of Breathing Exercises – 30 to 60 Minutes and 3 – 4 times Balanced Breathings 27 rounds.
YOGA: Meditation – 22 Minutes to 1 Hour including Pranic Healing / Cosmic Meditation.....
SUN YOGA: Sun Gazing – 30 Minutes (I have completed the HRM Protocol reaching a peak of 44 minutes!)
Aerobic Conditioning – 2.5 days a week during winter days and swimming 5 days a week in the summer of 2006.
Diet: A. Nuts – 5 to 10 pieces of Almonds, Cashews 5 to 7 pcs, Walnut 6 to 8 pcs, one fig, two dates, handful black Raisins, handful Sunflower seeds and Pumpkin seeds B. Boiled Vegetables with Green Chutney. This also includes green Legumes & Beans family. C. Salad once in a while D. Plenty of fruits esp. Grapes, Banana, and other varieties (five colorful kinds!) E. 1% Milk and Milk Products (sweets but controlled amount, more for taste). Yogurt with Honey, Resins, Dates, one table spoon of grounded Flax Seeds F. Chocolate controlled but sometimes difficult ..... G. I have avoided Rice, Wheat and other Grains in my diet. NOTE: Virtually No Salt and no spices. According to one Dietician, my diet is around 2600 calories. However, my weight has been steady around 130 lbs for over a year. I started this SATWIK Diet since April 9, 2005, Chaitri Navratri – Ramnavmi Week.
BENEFITS: The most important benefit I experienced was that (1) I lost 10 lbs and (2) my legs muscles felt Bionic. I could talk long walks or do rigorous aerobics and my leg muscles would not get tired. Also, I didn't run out of breath and maintained a lower heart rate. (3) Around 25th day, I lost almost all my cravings for the food that I loved.

SLEEP: My worst enemy. I cannot control Dreams and usually they are full of Negative Garbage. That’s why I think I have High Blood Pressure. So to help that, I fall to sleep with soothing chanting on my I-Pod.
Internally I am type “A” personality - workaholic, obsessive, and compulsive, persistently striving for something deemed worthwhile ...... Externally, I may project a type “B” personality - calm, cool, collected .......

BLIP in Recovery: I showed a remarkable recovery in the beginning. Within a day or two I started walking 15 minutes at a clip and within three days, two to three times a day. Then I walked 20 minutes with some five minutes rest at 10 minutes, twice a day. This is without pushing or showing off. As I was told, I gained 5 lbs in fluid build up right after surgery and peaked at 10 lbs within a couple of weeks. Under the direct care of Drs. Bhasker & Rita Jhaveri and Dr. Patil of Shanti Associates, I got my lungs x-rayed and blood test. They noticed some fluid build up in my lungs (Item #5 on my list of side effects, given by the hospital). I had some swelling in my both the legs but my right leg was a lot worse due to vein grafting. I took Lesix, a diuretic to get rid of the excess fluid, but to no avail. My system just gobbled that up. I was asked to keep my legs up as much as possible especially during sleep.

Then we flew 6 hours direct to LA from Wash DC. Fortunately, there was no one in middle seat, so I could keep my legs up above my chest level for the most of the journey. Within a day or so, I experienced running out of breath for the first time in my life. My legs and whole body felt tired after climbing just one flight of stairs. I reduced my walks to 20 minutes a day. We ended up staying for 5 days in LA. Two days after we came to Palo Alto, our family Cardiologist Dr. Shailan Shah ordered a lungs x-ray and found substantial fluid build up in the lungs.

Here we go: I was admitted to my third hospital (Stanford Hospital) in a month. (Thanx to the connections of Shailan to get quick response from the Hospital!) They doubled the dose of lesix through an Intra-Veinus. First day was a bang up day for fluid excretion. They decided to see whether I could get rid of excess fluid with medication instead of an invasive draining procedure. Well three days later I was released and now I feel like million bucks, even with some fluid left in lungs. I can walk one hour a day in a couple of clips without running out of breath. Besides, some 10% people go through this. In my case, (I know this is controversial), I succumbed to family pressure by changing my diet back to normal which my salt-less & spice-less system could not take it or simply, the salt retained fluid. During those days, I started drinking lot more water. Now I am back to a minimum salt diet but am continuing with rice, wheat & other grains. Right now I am restricted to intake of 48 Ozs of fluid. I keep my scorecard where I keep track of output v/s input of fluid and I must have more output by some 500 ml! (FYI: 1 Oz is equal to 30 ml.)

I have a daily breakfast of some 10 medications and there are constant changes in daily intake. I do not need to go through that explanation as it would be a special situation per individual. We did not want others to know about this little BLIP as Uttambhai may have rushed to have another prayer session! (By the way, we appreciate all those of you who could attend that first prayer session in SATSANG Center and those who did do prayers on their own. )

Back to the original question of “In spite of my HOLY (?) Life Style, why should I suffer from these medical emergencies?”


1. Medically: Whopping 75% is genetics and 25% life style. Then why should one bother with all the rigmarole of chasing to improve one's lifestyle. Like Hirabhai Thakkar used to say: Even if you are educated, you gonna die one day anyway, so why go through the headache of studying for all these years? Incidentally, Last year, when I went through Heart attack in August 2005, I was told that I have severe CAD.

Well to me, we must strive for our BEST then “As man proposes and God or Karma disposes”.

2. Religious Philosophy: It is Karma! We must pay for bad Karmas committed in past. What we are today is the result of past. Even Lord Rama would (could) not do anything to extend life of his father Dashrath for 14 more years to fulfill his wish of installing Rama as the King? Then who are we?

3. In my Case: They found that my two stents were 100% free & clear but the build up in Left Main (LM) grew from 40% to 70%. My diet may have helped in case of stents but the build up can keep growing in spite of diet? Another explanation I heard is that 40% was a guess and five doctors would have had different answers. While this year CMC also did Ultrasound during CAT procedure, which gives you more accurate reading. Then why do they not do an Ultrasound with every CAT procedure esp. when doctors see more blockages? Who knows? Maybe there is some guidelines they have to follow .....

4. Lessons Learned: Every problem presents a challenge or opportunity to learn something new. How could we reverse the CAD – build up in our arteries, esp. Cardiac. Hopefully, with so many Asian Indian Doctors, somebody, someday, will come up with a solution. I am told that my diet surpasses Dean Ornish’s proposed diet? Hopefully the answer is already there in Ayurveda or YOGA yet to be made common knowledge?

While bypass surgery may be a child’s play for Cardiac Surgeons, but to me its medical miracle! I marvel at their work! God bless these surgeons & Medical professionals!

Enough for this time! Part V will have some of our recommendations!

Wish you Happy Holidays! ENJOY!

Thursday, December 21, 2006

My Triple Bypass Surgery Part III

My Triple Bypass Surgery Part III

Dear Ones! Hari OM !

Here are some of the links that may enlighten you about this CAD - Coronary Artery Diseases - Problem
1. About Heart
2. About bypass Surgery
3. This may be good info but it may be an AD.
4. Heart attacks among Indians.htm - Already attached belowe. If you cannot open the graphs and charts and tables, please let me know, I will send you a file that has that already open and also pdf version. It is about three MB size, so make sure that you can receive it.
5. What to do in Emergency while going through Heart Attack - Power Point presentation. Attached herewith.
6. Learn CPR http://www.cpranytime.org/presenter.jhtml?identifier=3033740

In my case:

1. CMC Manchester had inserted Catheter through right groin area, for analyzing the problem. Also used Ultrasound to access the size of the blockages.

Washington Hospital Heart Center:

2. They put some needle set up for drawing Blood and introduce fluid / IV. They had one on my forearm and one on my neck.
The line in your neck is called a central line, a special IV (intravenous) for giving medicines. In my forearm was either a peripheral IV or a radial arterial line to invasively monitor BP constantly
3. They use fine saw to cut Sternum into half, to open the rib cage and keep it open for the duration of Surgery. That would put lots of strain, stress on involved muscles, ligaments etc.
4. Artficial Heart-Lung Pump was not used in my case?
Usually, The heart-lung machine puts additional strain on the heart because the heart is stopped.
5. Triple Bypass
· An artery was detached from the chest wall called - Left internal mammary artery or LIMA and the open end was grafted to the coronary artery below the blocked area. He by passed three blockages with this one. This involved a loop to jump across to another artery, hence, two.
· A piece of a long vein from my right leg was taken to by pass the old two stents, so as to avoid any complications of stents as heart area was open anyway. This is the third one.
· One end is sewn onto the large artery leaving your heart -- the aorta. The other end of the vein is attached or "grafted" to the coronary artery below the blocked area.
· Either way, blood can use this new path to flow freely to the heart muscle.
6. They put two tubes connected to suction pump, to continue collecting the fluid. It was taken off after a couple of days.
7. Catheter was introduced to connect to urinary bladder, which was also pulled out after a couple of days. .

OM Namah Shivay OM ! Sudhir

An Illustrated Guide to Understanding and Reducing Your Risk of A Heart Attack at a Young Age Enas A. Enas, MD, FACC the former having the highest and the


It appears that Asian Indians and chinese are at the opposite end of the CAD spectrum, with the former having the highest and the latter having the LOWEST rates of CAD"

The high rates of CAD in Asian Indians worldwide are accompanied by paradoxically low rates of conventional risk factors, such as smoking, high blood pressure and high Cholesterol. "

"Diabetes, together with the metabolic syndrome, accounts for a third of the excess burden of CAD among Asian Indians."

"Lipoprotein (a) level in Asian Indians are 5 – fold higher than American Indians and 2-fold higher than Whites."

Lipoprotein (a) is at least 5 times as dangerous as LDL in its ability to produce an early heart attack or Stroke."

"In Asian Indians, the adverse effect of elevated Lp (a) is markedly increased, by low level of HDL, high levels of LDL, triglycerides, and homocysteine."

"The risk of a heart attack may be increased 122 – fold, when high levels of Lp (a) coexist with high TC/HDL ratio, homocysteine, and any one of the usual risk factors – smoking, diabetes, or high Blood Pressure."

"AN increase in blood Cholesterol level of 10 mg/dL among Asian Indians appears to have the same impact as an increase of 40-50 mg/dL in other populations."

"Among Asian Indians , the CAD risk with Cholesterol level of 160 mg/dL is similar to that of Americans with Cholesterol Levels of TC 240 mg/dL."

“Waiting until chest pain to take proactive action against an early heart attack, is as foolish as waiting for labor pain to begin prenatal care.”


Magnitude of CAD among Asian Indians

Asian Indians have the highest rates of coronary artery disease (CAD), irrespective, of region, religion, gender, and education. These rates include incidence (new cases per year), mortality, and prevalence (the percentage of people alive with the disease). The CAD mortality rates vary more than 10-fold in men and women worldwide. CAD rates in a given country was once thought to be related primarily to the affluence and the size of its economy, as happened in the United States (U.S.) 50 years ago. Despite having the second and third largest economies, the Chinese and the Japanese have had the lowest rates of CAD, on international comparison (Graph_1), both having rates 4-fold lower than Americans.

(The conspicuous absence of India is due to lack of such national data on CAD) Graph 2


Graph 3 show the mortality rates among Asian Indians in comparison to other populations in
various countries.

Asian Indians with the fourth largest economy have a 4-fold higher rate of CAD than the US , the world's largest economy (Graph 4).

Graph 5 shows the 3-fold higher incidence of CAD among Asian Indians in Singapore .

Graph 6 shows a 6-fold higher rate of hospitalization (an indirect measure of incidence and prevalence) for heart attack, coronary angioplasty, and bypass surgery among Asian Indians than Chinese in the U.S. It appears that Asian Indians and Chinese are at the opposite end of the CAD spectrum, with the former having the highest and the latter having the lowest rates of CAD. The term Asian Indian refers to all those who trace their origin to the four countries in the Indian subcontinent - India , Pakistan , Bangladesh , and Sri Lanka .

CAD Rates among Asian Indian Women: The excess risk of CAD in Asian Indians is even greater in women than in men, despite the fact that tobacco abuse is virtually non-existent among these women (Graph 3).

Asian Indian women have a higher death rate from CAD than women of all other ethnic origins in the U.K. , South Africa , Canada , Singapore , Fiji , Mauritius , Uganda , and Trinidad . Although national data in the U.S. are not available, a similar phenomenon was reported from the state of California . Women develop CAD about 10 years later than men, but the prognosis of women with CAD is worse than men.

CAD Rates in India : During the past 3 decades, the average age of a first heart attack increased by 10 years in the U.S. , but decreased by 10 years in India . About 50% of all heart attacks among Asian Indian men occur under the age of 55 and 25% under the age of 40, unheard of in any other population. Also during the same period, CAD rates increased 3-fold in urban India and 2-fold in rural India . Ironically, this increase happened at a time when the CAD mortality rate declined by 54% in the U.S. as shown in Graph 7.

Currently, the prevalence of CAD in urban India is double the rate in rural India and 4-fold higher than in the U.S, which has an enviably low prevalence of only 2.5%. The CAD rates in urban India are similar to those among the generally more affluent overseas Indians. For example, the prevalence of CAD in New Delhi is 10% and Chennai 11%. The rates appear to be highest in Kerala (despite its highest literacy), where prevalence of CAD is 13% in urban areas and 7% in rural areas.

Ethnic Differences in Heart Attack and Stroke: The predominant form of cardiovascular disease is myocardial infarction or heart attack among Europeans and Americans, whereas it is stroke among Asians. Asian Indians are unique in having high rates of both stroke and heart attack. The underlying process in the vast majority of both these conditions is a disease process called atherosclerosis or hardening of the arteries. A gradual narrowing of coronary arteries over years (Picture 1) result in a characteristic chest pain called angina.

A sudden occlusion from a blood clot in an artery supplying vital areas in the heart results in a heart attack (Picture 2).

A similar occlusion in the brain results in a brain attack or stroke, which is a painless but debilitating condition. Such blood clots are almost always the result of the rupture of a young, soft, cholesterol-rich, and calcium-poor vulnerable plaque (Pictures 3

and 4)


The Paradox of Greater Risk of a Heart Attack with Less Narrowing of Arteries: Contrary to common wisdom, we now know that most heart attacks occur at sites with mild narrowing and not severe narrowing of coronary arteries. For example, only one in five of the heart attacks occur in sites with severe (>75%) narrowing, whereas almost half of all heart attacks occur with mild (<50%)>240 mg/dL. It is estimated that about 50% of Asian Indians have metabolic syndrome compared with 25% among other Americans. Metabolic syndrome and diabetes, however, cannot explain the excess burden of CAD among Asian Indians, because all minorities in the U.S. , including Blacks and Hispanics, have high rates of diabetes but low rates of CAD. The other risk factors of greater importance in Asian Indians are given in Table 3.

Cholesterol Made Easy - the Good, Bad and the Deadly
Although cholesterol is generally considered bad, not all the cholesterol in the blood is bad. The blood cholesterol consists of the "good cholesterol" or high-density lipoprotein (HDL),"bad cholesterol" or low-density lipoprotein (LDL), ugly cholesterol or very low density lipoprotein (VLDL) and the deadly cholesterol or lipoprotein(a) {Lp(a)}. The optimum levels of various cholesterols are shown in Table 4.

Good Cholesterol: HDL actually protects against heart attack; the higher the blood level of HDL, the lower the risk of heart attacks. Although not considered low, an HDL level of 45 mg/dL has a 2-fold and 25 mg/dl has a 4-fold risk of a heart attack compared to 65 mg/dL as shown in Graph 10.
In the Framingham heart study, those with HDL <40>260 mg/dL. HDL level is about 10 mg/dL higher in women than men worldwide. The optimum HDL level is 65 mg/dL, which is seen in Black, Chinese, and Japanese women. No wonder why they have low rates of CAD. The average HDL level is 55 mg/dL in White women and 45 mg/dL in White men. The HDL level among Asian Indians are about 5-10 mg/dL lower than Whites and 15-20 mg/dL lower than Blacks as shown in Graph 11.

The low HDL among Asian Indians results in high total cholesterol/HDL (TC/HDL) ratio, which is a powerful predictor of CAD risk in diverse populations. In the Quebec Cardiovascular Study, persons with TC/HDL ratio of >5 had a 2-fold higher risk of CAD than those with a ratio of <4.>5. In the CADI Study, 62% of Asian Indian men had high TC/HDL ratio, though only 20 % had high cholesterol levels (Graph 12)

Whereas high TC/HDL ratio >5 identifies more Asian Indian men, HDL<50>160 mg/dL.

Bad cholesterol: LDL is the true cholesterol villain that clogs up the coronary arteries. Newborns worldwide have an LDL of 35 mg/dL but LDL rises gradually in childhood depending primarily on the intake of saturated fat. Once the LDL level exceeds 80-100 mg/dL, it begins to be deposited inside the coronary and other arteries. This process often starts during the childhood, progresses silently for decades and presents as a cardiac catastrophe in the form of a massive heart attack or cardiac arrest but rarely as chest pain. The relationship of increasing risk of a heart attack with increasing levels of LDL and decreasing HDL is shown in Graph 13.
Ugly cholesterol: Emerging data strongly indicate that a triglyceride level >150 mg/dL is an important risk factor, especially in women (Graph 14).
Triglyceride levels are related to VLDL, which is usually 20% of the total triglycerides. High triglyceride levels make the LDL small, dense, and dangerous. Therefore, I use the term "ugly cholesterol" to describe triglycerides. Most individuals with high triglyceride levels develop diabetes in 5-10 years. The lowest risk of CAD is among those with triglyceride levels <50>20 mg/dL, the usual cut point for elevated Lp(a). Several recent studies in India , among patents with CAD under 40 years of age, have shown high levels of Lp(a) among 50-60% of patients and was the only risk factor in 30-40% of cases.

Although Blacks have the highest levels of Lp(a), the atherogenic effects of elevated Lp(a) are significantly mitigated by an otherwise anti-atherogenic lipid profile (high levels of HDL and low levels of triglycerides, and LDL). Conversely, the pathological effects of elevated Lp(a) are exponentially increased in Asian Indians, as a result of a highly atherogenic metabolic milieu, consisting of high levels of triglycerides, apolipoprotein B, homocysteine, glucose, plasminogen activator inhibitor-1, fibrinogen, C-reactive protein, and low levels of HDL, especially HDL 2b. More than a third of the Asian Indians have atherogenic levels of most of these emerging risk factors.

Multiplicative Effects of Emerging and Conventional Risk Factors: It is well known that diabetes not only increases the risk of a heart attack but also has a multiplicative effect with other risk factors. At any given level of cholesterol, the CAD risk is 3 to 4-fold higher among diabetic patients than non diabetics, as shown in Graph 16.

It is often not appreciated that the increased risk of a heart attack and stroke from high levels of Lp(a) is much greater than from diabetes. For example, high Lp(a) levels can increase the risk of CAD from other risk factors by as high as 10-fold, compared to only 4-fold with diabetes. The impact of high levels of Lp(a) in increasing the risk of a premature heart attack from other risk factors is shown in Graph 17.
More importantly, the risk of an early heart attack is greater with high TC/ HDL ratio than with high cholesterol as shown in Graph 18.

As an extreme example, the risk of a heart attack may be increased by 122-fold, when high levels of Lp(a) coexist with high TC/HDL ratio, homocysteine, and any one of the usual risk factors (smoking, high blood pressure, or diabetes). Thus Lp(a) is one of those rare factors, that can make 4 and 4, not 8 or 16, but 64 and beyond The estimated contribution of various risk factors to CAD among Asian Indians is given Graph 19.

Double Jeopardy from Nature and Nurture: These multiplicative effects of conventional and emerging risk factors appear to provide a plausible explanation for the excess burden of CAD among Asian Indians, many of whom are lean, nonsmoking, vegetarian, yoga guru, and marathon athletes. Further elucidation of the precise role of the multiplicative effects of other emerging risk factors in Asian Indians is urgently needed to develop appropriate preventive and therapeutic strategies. Selected factors related to nurture that make Lp(a) most dangerous are shown in Table 5. Since nature cannot be altered nurture should be attacked much more vigorously.

Why Asian Indians Should be Treated Differently

Lessons from Singapore : A study of cord blood in about 1000 newborns in Singapore has shown higher levels of Lp(a) among Indians than Chinese that parallel the adult difference in CAD rates. Singapore was the first country to report a 3-4- fold higher rate of CAD among Asian Indians compared to Chinese, nearly 50 years ago. During the past 30 years, the overall rate of CAD doubled in Singapore due to changes in diet and lifestyle. But a 3-fold difference in CAD rates between Indians and Chinese was maintained. Because of the genetic susceptibility, the adverse effects of conventional risk factors related to adverse lifestyle such as smoking, high blood pressure, high cholesterol, and diabetes are markedly magnified. It appears that increase in CAD risk from a weight gain of 10 pounds or smoking 10 cigarettes (or beedi) by Indians is similar to a 30 pound weight gain or smoking 30 cigarettes by other populations. More importantly, an increase in blood cholesterol level of 10 mg/dL among Asian Indians appears have the same impact as an increase of 40-50 mg/dL in other populations.

The database to support treatment recommendations is derived primarily from studies of White populations. The risk of CAD from all known risk factors is graded and continuous but genetic factors determine individual variations in disease susceptibility in response to environmental factors. For any given level of risk factors, the CAD risk among Asian Indians is at least double that of Whites. Therefore, the threshold of intervention and goals of treatment should be lower in Asian Indians than in Whites by 10% to 20%, akin to those recommended for patients with diabetes.

In the NCEP III, diabetes is regarded as a CAD risk equivalent, with an LDL goal of <100>40% of Asian Indians have high levels of Lp(a) and >90% have low levels of HDL 2b (the best of the good cholesterol), lowering LDL to <80>30%, and selectively increases the cardioprotective sub-fraction of HDL by >40%. It can be given safely in combination with statins. A new combination of Niaspan and lovastatin (Advicor) has just been introduced in the U.S. In postmenopausal women, estrogen replacement therapy can lower Lp(a) by 30-50%. In the Heart and Estrogen/Progestin Replacement Study, the risk of a recurrent heart attack was reduced by 50% among women with elevated Lp(a) without any harm whatsoever. Vitamin preparations containing folic acid, B12, and B6 (Foltx, Folgard, Folic Acid Extra) can substantially reduce elevated homocysteine levels and is advisable in those with homocysteine levels >10 micromol/L.


India is currently in the middle of a CAD epidemic that was initially observed and not yet abated among overseas Asian Indians. Although the conventional risk factors do not fully explain the excess burden of CAD, these risk factors are doubly important in Asian Indians, and remain the principal targets for prevention and treatment. Due to the genetic susceptibility mediated primarily by elevated levels of Lp(a), the adverse effects of the conventional risk factors are magnified several-fold. Therefore, the threshold of intervention and goals of treatment for various risk factors in Asian Indians should be 20% lower than Whites for LDL and 10% lower for all other risk factors (Tables 2 and 4).

It seems appropriate to begin preventive strategies at least 20 years earlier than in other populations (men 25 and women 35 years of age) because of the extreme pre-maturity and malignant nature of CAD. The benefit of statin therapy appears to far exceed that of treatment of hypertension, the impact of which is primarily on lowering the risk of a stroke. Therefore, lipid-lowering therapy with statins should be considered among the first line of treatment rather than the last thing we do. Remember, waiting until chest pain to take proactive action, against an early heart attack, is as foolish as waiting for labor pain to begin prenatal care. Daily exercise, avoidance of tobacco, and reduced intake of saturated fat could reduce both the need and the dose of medications and the importance of these measures cannot be overstated.

This article is a synthesis of the research findings and opinions of the author. It is not intended for instituting treatment, without careful evaluation of the individual risk and benefits. Treatment decisions on the use of medications must be made by a physician qualified and licensed to practice medicine in the respective geographical area. This article cannot be republished without written permission of the author.

For List of Reference Articles, see publications authored by Dr. Enas A Enas @ www.cadiresearch.com/publications.html

Events Leading to Bypass Surgery Part II

Events Leading to Bypass Surgery Part II

November 5, 2006

I started getting a little pointed pain in my back right behind the heart and that pain point kept moving in different locations from the middle to the upper part of my back.

November 8, 2006

I discussed the matter with Sharadbhai Radia about angina because he had similar experiences. Ignored angina pain could lead to sudden death or long-term damage to the heart. He recommended to me to get a checkup at the hospital.

November 9, 2006

I almost thought of canceling my advanced Yoga training for the weekend, as the pain became severe and persistent off and on. After that, I indirectly hinted to Niru that I am getting angina pain. Every time I gave Self Pranic Healing, the pain would subside.

November 10-12, 2006

During advanced Yoga training, my pain completely vanished suggesting those advanced techniques has profound impact on eliminating pain.

November 13, 2006

The pain reappeared and started getting worse. On Monday morning, Sharadbhai asked me whether or not I had gone to the hospital. Upon saying negative, he called Niru right away, expressing his deep concerns. Niru asked me what’s going on. So I told her everything that happened since the 5th. On Monday night, I gave myself Pranic Healing. It reduced the pain but would not eliminate it. In Middle of the night, I awoke with severe pain. Again I gave myself Pranic Healing but the pain and intensity would not go away. For the first time in my life, I took Nitroglycerine. I went to sleep, so I did not know whether that made any difference. On the eve of Tuesday morning, twice I pleaded to Shiva, Hanuman, and the whole assembly of Gods to bless me with bright light healing instantaneously. However, whatever will happen is the blessing of God, and that he will want me to learn something new from the experience.

November 14, 2006

At 9 AM, I called Niru to our Home Temple and mentioned to her what was happening since yesterday. Saying that if I had to make a choice, I would continue to heal myself using Pranic Healing & some other experiments (I should and could have done them a long time ago), but the danger is a severe heart attack and/or sudden death. I took another Nitroglycerine to no avail. Since Niru would have been impacted by this happening the most, I asked her to make the decision of what to do. We called Bhaskermama, and he said we should immediately go to the hospital.

So we checked in at CMC Manchester at 10am. This was the same hospital where I received two stents and one angioplasty back in August 2005. They conducted an EKG, blood tests, etc. The results came out negative. I complained about pain in the hollow of my breast bone. They also performed an ultrasound test to determine whether I had an aneurism of Aorta. Test results came out negative and as soon as I ate something, the pain disappeared. Another point of interest was that I had experienced some headaches, which I was told was a side effect of Nitroglycerine. That meant that I was not having a Heart Attack. However, the maverick pain returned. Yet I was told in the evening that on Wednesday morning, they will conduct stress tests. If everything is okay, I would be released.

November 15, 2006

When they called me for a stress test, the lady doctor in charge decided not to conduct the stress test and suggested to do a catheterization. She noticed some changes in the latest EKG and that, combined with my prior history, led her to recommend the catheterization. I was taken aback, so I hesitated to allow them to do that. They sent me back to my room to think about it. I kept on insisting that they should perform the stress test, thinking that I would have no problem passing it. She explained that if I go through a Heart Attack during the test, they would be facing some serious problems to perform any procedure.

A little later, Dr. Fink explained to me that the catheterization would only take 20 minutes and if they don’t find anything, I would be released. However, if we find something, I would have to preauthorize them to perform whatever is necessary to fix it. Since I couldn’t reach Bhasker and Shailan, I consented. After the catheterization, I was informed that I had 60% blockage in the left main artery and 85% and 90% blockages in the left branch arteries. The left main blockage had grown worse from 40% last year. The stents were 100% clean, so they recommended that I go for immediate bypass surgery as they do not place stents in the left main. Blockages in left main artery is considered to be very serious as it supplies blood to 2/3 of the heart.

I consulted my nephew, cardiologist Dr. Shailan Shah and my primary doctor Dr. Bhasker Jhaveri. I asked the hospital to send records overnight to Shailan. If Shailan approved of the bypass, then CMC was prepared to do surgery Friday morning. The hospital was very gracious in making the records available and talking with our doctors. So we postponed the decision until Thursday. Meanwhile, Shailan and Bhasker consulted with other cardiologists. 9 out of 10 cardiologists recommended bypass. However there was one doctor who is confident in installing stents in the left main. So the decision we had to make was to stent the artery or bypass it. For whatever Godly reason, Shailan did not receive the most important CD on Thursday, so we asked CMC to overnight a duplicate on Friday to his home address which they did. Shailan received the CD on Friday afternoon. After reviewing with other cardiologists, Shailan recommended the bypass. FYI, risks are involved in both procedures, however in a stent, I would have to take certain medications for my lifetime and still there is a risk of clogging those stents, as opposed to bypass, where you get a new clean artery.

Friday evening, we had a 6 way conference call between Raju, Sanju, Shailan, Bhasker, Mom & I to decide where the surgery should take place.

1] CMC could perform surgery on Nov 21
2] Washington Hospital could perform on Nov 20
3] Palo Alto/Stanford could perform on Nov 30

At this point, it is a forgone conclusion that surgery must be performed as soon as possible but not necessarily right way. We ended up choosing Washington Hospital because that hospital performs one of the most, if not the most, of this type of surgery in US. In addition, I could recover surrounded by Niru’s brothers’ families, so she would feel more comfortable. Finally, I could stay under the care of Bhasker and Rita and have accessibility to Shanti Associates who has my records for several years. Sanju would also be to stay with us to provide personal attention.

May God bless all these people who helped us in my time of need. During my stay in CMC, Uttambhai-Sarlaben, Kokilaben-Babubhai, Nirmalben-Prakshbhai, Sushilaben Radia, Govindbhai & Kashyap rushed to help. Uttambhai was given difficult task of keeping all other loved SATSANG families away so that I can have rest.

Next part I will elaborate on what I went through in my Triple bypass.

Many of you sent me e-mails & called. It makes me feel good to have close family of friends.

My Triple Bypass Part I

My Triple Bypass Part I:
November 20th :
We were very impressed by the response from the staff at Washington Hospital Center . We appreciate the help of Bhasker and Shah Associates. Their contacts at the hospital helped expedite the entire process. Raju, Sanju, Sandeep & Leah arrived from California that morning and joined the Jhaveri & Zaveri Families. Dr. Ammar Bafi was assigned to the surgery and kindly went over what to expect with me.

Niru-and our three sons briefly huddled in the Nurse’s office privately before I was taken into the expected 3 to 4 hour surgery. Just in case God felt that I am needed more somewhere else, I expressed my last desire for maintaining family unity. It was a very emotional moment for us. The way events were moving I felt that the surgery will be performed on Somavati Amas and that too during the most auspicious times of the day. So I felt much better about it...

When I entered the operating theater, some attendees mentioned not to worry, everything will be fine. My usual response was that I never worry! One nurse mentioned, “Do you trust us?” I said, “I trust God! And I know that he will guide all of you to perform this surgery and he will be working through you.”

November 21, 2006
Jai Shree Krishna !!!
This morning I woke up to find that I’m alive and that God had saved me. Lord Shiva heard and consented to everyone’s prayer. I vaguely remembered Dr. Bafi talking to me and saying that the triple bypass surgery was successful. I felt sedated. The procedure took one hour & forty-five minutes, and done without the help of artificial bypass pumps. Finding the 2nd ICU unnecessary, I was moved into a semi-private room. Later on, they transferred me to a private room.

November 24, 2006.
After careful observation and no further complications, I was released. Fortunately, I never suffered a heart attack but was saved from impending disaster. In retrospect, I need to thank the person in-charge of Stress Tests at CMC Manchester Hospital . She (Judy, as I recall) forced the issue of going through catheterization where a few more serious blockages were discovered.

My recovery is progressing extremely well. I am able to carry on conversations passionately! I can walk 15 minutes at a stretch without running short of breath or feeling tired. I walked three times yesterday and twice today plus did a lot of short excursions.

On behalf of my family, we thank SATSANG Families, YOGA Families, and you for your warm thoughts and deep prayers! We are deeply touched by your packages, cards, e-mails, phone calls and a special prayer arranged in SATSANG Center on November 20th Monday.

I firmly believe that Divine Forces has its ways of teaching us a lesson. I will write more about that in the future...
OM Namah Shivay OM ! – Sudhir
*** WELCOME even calamities as a blessing of GOD! ***

Bout with Destiny

OM Shri Ganeshay Namah OM ! OM Gam Ganapataye Namah OM !
OM Namah Shivay OM ! OM Natarajay Namah OM ! Jai Shree Krishna ! Jai Siyaram!
OM Hum Hanumate Namah OM ! OM Aim Hrim Klim Chamundai Vichchai!
OM Hreem Shreem Klim MahaLaxmai Namah OM !
OM Hreem Shreem MahaSarsvatai Namah OM ! OM Hreem Ved Matrubhyo Namah!
OM Namo Narayanay OM !
Bout with Destiny again! Welcome, even Calamities as the Blessing as God!
Dear SATSANG & YOGA Families!
Just so that you know what’s going on in my life these days, so that you do not worry about it if you hear from Someone else! I have been experiencing pain, pointed & spread behind my middle or upper back since last few days. Last weekend, if you remember, we had advance YOGA Session in Laxmi Niwas in the weekend of Nov 10th. That pain subsided during those two days. Then it reappeared fainted around midday on Monday November 13th!. It kept growing worse and on Tuesday morning, Niru & I decided with the help of Bhasker (Niru’s brother & also my physician, decided to go to CMC Hospital . They discovered a dangerous situation with my Left Main artery blocked about 60%. Then with lots of meetings with Shailan our nephew & family Cardiologist, Bhasker and our children Raju - Bhairavi, Sanju & Sandeep, we decided to come to Washing DC Hospital for By-pass Surgery.
So now that you know this, you may get the urge to call us and talk to us. We wish that, please do not worry, but JUST Pray now and especially during surgery and recovery period. I will be admitted on Monday November 20th in the morning. Surgery may take place either on Monday or Tuesday. You can just pray for our successful surgery and speedy recovery so that we can continue / resume our serving God.
Again, Just Pray and we appreciate your wishes and blessings.
OM Namah Shivay OM ! - Niru – Sudhir & Parikh Parivar. November 19, 2006
For God’s Grace: It is recommended to recite this Mantra 108 times:
OM Hom Zum Sah, OM Bhur Bhuvah Swa,
OM Trayambakam Yajaamahe, Sugandhim Pushti Vardhanam;
Urwaa Rukam Eev Bandhanaat, Mrutyor Mukshiy Maam Vrutaat;
OM Swah Bhuvah Bhur, OM Sah Zum Hom OM .......