Dr Manyilirah On Matters

Cardiovascular and Thoracic Surgeon at Bokamoso Hospital, Dr Willlian Manyilirah continues his conversation about what it means to be a heart surgeon, why he does what he does, dangers of cardiovascular disease, and when people should see a doctor about heart problems.

How can people prevent cardiovascular diseases? Which lifestyle factors play a role in preventing heart disease?

Avoid sedentary habits, smoking, unnecessary stress and unhealthy diets. Get routine medical checks. Early diagnosis and appropriate management of diabetes, hypertension, throat and lung infections. For the women wishing to get pregnant- plan the pregnancy, avoid certain medicines during pregnancy, avoid alcohol and smoking, and get vaccinated against rubella and flu, and start early antenatal attendance.

What about physical exercise? Does it help to decrease the risk of cardiovascular disease?

Yes, aerobic exercises have a tremendous positive effect and impact on cardiovascular health.

If someone already has an existing cardiovascular condition, is it recommended to engage in exercise?

Moderate aerobic exercises of 30 minutes, performed about five times a week can greatly ameliorate symptoms of existing cardiovascular condition. These exercises may include brisk walking, running, playing tennis, swimming, regular home chores, etc.

What do you find most challenging about working in surgery?

Losing a patient after offering what you believe was the best care in the circumstances. is by far is the most challenging and depressing part of my job as a heart surgeon.

Talking about the surgery, what factors determine whether a minimally invasive procedure is needed versus an open surgery?

Patient related factors include the location, size and complexity of the lesion to be treated. Surgeon factors include experience and skill. Institutional factors we take into consideration are the nature of equipment, availability and skill of the support staff and cost of the procedure.

Putting myself in place of a patient, having your heart being operated on sounds super scary. I’d rather remove all my teeth (and tooth extraction is up there on the list on worst fears) How do you deal with that as a doctor?

Extensive counselling, counselling and counselling takes away the fear surrounding heart surgery. Cardiac surgery is performed in a very controlled environment and pain during the surgery should not be a major concern. Actually, modern cardiac surgery should perhaps elicit less unpleasant emotions than tooth extraction!

What can patients expect in terms of recovery after surgey?

Most patients make a full recovery in 12 weeks. A patient should be able to sit in the chair after 12-24hrs, walk around the ICU bed and about after 1-2 days, walk more freely after 3 days and walk down and up the stairs in about 5-7 days. Most patients will be ready for discharge from the hospital in about 5-8 days

Discuss some of the conditions treated by having heart surgery?

Acquired heart conditions such as blocked heart vessels (coronary arteries), damaged heart valves caused by infections, abnormal swelling of the great vessels (aneurysm) and massive clots in the pulmonary arteries. Congenital heart conditions such as defects (holes) in the heart, narrowed heart valves and great vessels, to mention but a few.

Why is ensuring you have a healthy blood pressure so important? And why is it worse to have high blood pressure as opposed to low blood pressure?

High blood pressure damages the heart muscles and its vessels (coronary arteries) in the long run, causes bulging (aneurysm) and possible rupture of blood vessels, both in the brain and outside of the brain, causes diseases of the kidneys and other body organs. Low blood pressure is equally bad, as it can lead to stroke on the extreme end of the spectrum and dizzy spells on the