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COVER
STORY: PM'S KNEE SURGERY
The
Post-Operative Hours Are Crucial
To
minimise any pain the prime minister may feel, his doctors will take recourse
to the "spinal epidural" treatment. Simply put, a painkilling
liquid will be inserted into the prime minister's spinal chord, numbing
him below the waist. A catheter, a small balloon-like container filled
with a liquid painkiller, will also be inserted to keep pouring in the
fluid for 48 hours. This will ensure that the crucial post-operative hours-which
may actually be Vajpayee's supreme test-are comfortable.
Infection,
according to Marya, is the prime concern when a foreign object is inserted
into the body. This is what Vajpayee's doctors have to guard against.
The operation theatre should ideally have a laminar air-flow system so
that fresh, sterile air continuously flows in, preventing infection-causing
micro-organisms from settling down.
The prime
minister will be dressed in sterile disposable gowns, as will the surgical
team. Prior to the operation, Vajpayee's knee will be scrubbed with antiseptic,
draped and further covered with an antiseptic-coated net.
After the
artificial knee is in place, a little tube will also be inserted into
Vajpayee's knee to suck away blood for the next two days. This is the
human equivalent of pest control. Blood that may find its way to the knee
region could, after all, carry micro-organisms.
Another
possible complication-though with a 0.2 per cent chance of occurrence,
a statistical improbability-is an internal blood clot. This could occur,
Marya explains, because blood vessels of mainly elderly patients are more
fragile and easily bruised. Not taking chances, Vajpayee, has had his
blood tested for clotting.
The operation
should take approximately three hours. Yet, there will be no rest after
that for Vajpayee. That very evening, he will begin a six-week stretch
of physiotherapy sessions to prevent the new knee from getting stiff and
limiting the range of movement. In a sense, the physiotherapy is as important
as Ranawat's handiwork.
After four
or five days of immobility, Vajpayee should be able to move about with
a walker. After three weeks he should graduate to a walking stick. Within
two months, he should be able to stride confidently without support-and
into the thick of political action. The pain will be history.
Vajpayee's
brand new knee should be just as good as his old one-well, almost. He
will be able to walk and sit but there will be no more squatting on the
ground for him. Jogging and dancing, should the prime minister have the
inclination, are discouraged. Nevertheless, climbing stairs-whether to
the podium for a political speech or at the White House-will no longer
be a worry. If he wants to, Vajpayee will even be able to drive a car.
Artificial
knees have an average lifespan of 15 years. Occasionally, if not rarely,
they do create problems causing a swelling and pain. This could happen,
according to Marya, if the knee material is not of the highest quality
or if it is not lodged properly. Both happenings are hardly imaginable
in Vajpayee's case, with the world's best equipment at his command.
Too much
pressure can also affect the artificial knee. Warns a doctor at Breach
Candy: "The prime minister would do well to lose weight to be healthier."
The reference is to Vajpayee's extra 12 kg. There is, of course, the additional
if intangible burden of governing India. Thankfully, that will not cause
any medical problems for the prime minister.
-with
Sandeep Unnithan
Pg.1
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