Machibet777 Login Why patients over 90, 100 are opting for surgery

On February 15, 101-year-old Satish Chand Tyagi (in pic above) of Bulandshahr underwent a pacemaker fitting procedure at a hospital in Delhi. Despite the pain of the stitches, effects of the local anaesthesia and the general strain of a surgical procedure Tyagi only complained about the tea that was served to him post-op; he found it tepid.Surgeons report that they are operating upon nonagenarians and centenarians, like Tyagi, more than ever before. With longer life, better finances and safer surgical procedures, super seniors are not shying from getting a new knee or a pacemaker at a ripe old age. medium81869155Dr Balbir Singh, head of cardiology at Max Healthcare, said that while Tyagi was his first above 100 patient, he conducts angioplasty and pacemaker operations on 80-plus patients every day and on 90-plus up to twice a month.“Just 20 years ago doing an angioplasty on an 85-year-old or older was rare. Papers would get published in journals and colleagues would come and watch you perform the surgery. But not anymore,” said Singh. He added that with advances in medical technology and knowledge, surgeries have become safer for elderly patients. “What’s more, people are living longer, deaths due to infectious diseases have come down and finances are better,” he said.In 2019, a 118-year-old woman from Ferozepur got a pacemaker. In January last year, a 110-year-old woman underwent hip replacement surgery at PGI Chandigarh. A 100-year-old cardiologist living in Delhi underwent a hip surgery in May last year. And in 2018, a 100-year-old woman underwent a similar surgery in Coimbatore.India has gained more than a decade in life expectancy since 1990 – from 59.9 years to 70.8 years. A survey found that 17,000 people turn 60 in India every day. With people living longer, medical interventions in their 90s and 100s are but expected. And they can foot the bill as well. A survey by Agewell Foundation found that 35% of the 140 million-plus elderly living in India have Rs 20-25 lakh in savings. “People are living longer but they also want to be independent. They don't want to be a burden on their children. If this means undergoing a hip replacement at 95 then they will go ahead with it,” said Himanshu Rath, founder Agewell Foundation. medium81869437Mumbai-based orthopaedic surgeon Dr Pradeep Bhosale, director of arthritis and joint replacement surgery at Nanavati Hospital, said he has done 25-30 knee and hip replacements in above-90 patients in the past 33 years but most of them in the past five years. “We screen patients and choose only those for surgery who are in pain and discomfort only because of their orthopaedic issue. We avoid operating upon those with serious co-morbidities,” said Bhosale, who also emphasised the importance of having a strong backup team of anaesthesiologist, intensivist and ICU team for good outcomes.In Dehradun, Dr Hemanshu Kochhar, who consults at Max hospital, recalls a 2020 case of a 105-year-old lady who had a hip fracture. “Her family was apprehensive but she told me that ‘you do what you have to do’. She wasn’t scared. Even at 105 she was independent and cooked on her own. We did a partial hip replacement and she was up and about the next day.” Another patient of his, an 86-year-old lady with an arthritic knee asked him to operate on it so that she could go to her club daily and get back to playing golf. medium81869584However, risks remain. A study on outcomes of surgery in patients aged 90 and above, published in 2019, found that the 30-day mortality rate for elective operations was 0%, rising to 5.2% at 90 days and 15.5% at 1 year. Another study by researchers at Massachusetts General Hospital reported that complications from pacemaker implantation were slightly more common in patients in their 90s (6.3%) compared with those in their 70s (5.6%), and those over 90 were more likely to die before leaving the hospital (1.9%) than their younger counterparts (0.6%). boxcontentElective surgery checklist for nonagenarians and centenarians* No serious comorbidities* If on blood thinners, stop blood thinners before surgery* Maintain blood glucose and blood pressure* Do tests before the surgery to optimise an existing cardiac condition* Usually use local anaesthesia so that the heart and the lungs are not involvedBut these differences were much smaller than expected. “If the benefits outweigh the risks, we go for the surgery,” Singh said.Untitled Carousel 81389161