Dr. Ashok

A left ventricular assist device is an electromechanical device used in cases of advanced heart failure. In later stages of heart failure when the heart is weakened and no longer able to pump the necessary amount of blood, a left ventricular assist device can be surgically implanted to assist the heart’s functions.

A left ventricular assist device is often used as a short term solution and is different from a pacemaker, which is a long term cardiac assist device. The cases in which a left ventricular assist device is often used are:

• As a temporary solution while a cardiac failure patient is on a transplant list or otherwise waiting for a heart transplant.
• During recovery from cardiac surgery when the heart is not strong enough to function on its own. The device would soon be removed as the patient recovers.
• During recovery from heart attacks

Having a left ventricular assist device implanted gives the heart time to rest and recover, leading you to the point where your heart can go back to functioning on its own. However, there are cases where a left ventricular assist device can be implanted as a long term solution. This treatment is called Destination Therapy and requires implanting a left ventricular assist device for several months or several years.

How a Left Ventricular Assist Device works?
A Left Ventricular Assist Device can only be surgically implanted. It has both internal and external components with a pump attached to your heart and a controller on the outside of the body. The pump is attached to the heart with a tube that directs blood into the aorta. The pump and the controller are connected through a cable called the driveline. Since the Left Ventricular Assist Device is powered by electricity or batteries, a power source is also worn outside the body and is attached to the controller, powering both the controller and the pump.

How a Left Ventricular Assist Device can affect your lifestyle?
Many people around the world have Left Ventricular Assist Devices implanted on both a temporary and permanent basis. While a person should be resting while recovering from a heart attack or cardiac surgery, it is possible to go about your normal daily life whilst having a Left Ventricular Assist Device implanted. While certain exercises and stress should be avoided when having a heart condition or when implanted with a Left Ventricular Assist Device, with carrying cases for power sources and controller that can operate from various different power sources, it is easy to live a normal productive life.

Back pain is one of the most common debilitating disorder in the world today. The pain affects 90% of people at some point of their lives. Human back comprises of various structures (see figure) which are nerves, bones, muscles, ligaments, and tendons, any or all of which can be a source of pain. Once back pain occurs, it may become chronic (more than 4 weeks) and you shall need to consult a pain physician for relief and accurate diagnosis.

Since prevention is always better than cure,  you can save yourself from having back pain if you follow these basic tips:

1. Regular Exercise in Correct Form: Regular exercise is important to maintain proper muscular strength of the back. Human back is supported by several big muscle groups (see figure). They serve two functions - one is to facilitate the posture and movements of the back itself and the other is to help movements of the rest of the body appendages (arms, head, pelvis and legs).The health of these muscle group is important to take stress off the spinal bones and maintain proper function. Most of these muscles are red muscle fibers as they need to maintain their activity for prolonged periods of time. Just to give you an idea - your biceps (arm muscles) have to work only when you bend your arm. But your back muscles have to function all the time - whether you sit, walk, stand or even sleep. But the point is what kind of exercises are good for your back? The best exercises for back include body weight low impact aerobics like brisk walking, swimming, stationary bicycling, extension exercises and yoga. What is important to remember while doing these exercises if that you need to be gentle in your movements and achieve correct "form" - this is possible if you can ask someone (preferably a trainer) to observe and point out whether the back stays straight during the exercise. It has been seen that arching and excessive bending is associated with injury to the back while exercising.

2. Stay Hydrated and Eat Natural Nutritious diet:The inter vertebral discs contain 70 - 80% water. The muscles and tissues have 60% water content. Therefore, it is important to stay hydrated. In addition, you must eat a nutritious diet consisting of green leafy vegetables, good protein source and just enough carbohydrates. Deficiencies of essential nutrients like Vitamin D can result in diseases like osteoporosis. Another important aspect is to maintain body weight within healthy limits. This is very important as increased belly fat is linked to increased back pain due to mechanical factors.

3. Lift objects correctly and maintain proper posture: While lifting objects, keep them as close to body as possible. Do not slouch or bend excessively while lifting. Just keep your back straight at all times. You may bend your knees a little if required (see figure). Think before you lift and get help if needed.

While working, you must not sit for more than 45 minutes at a stretch. Walk for two minutes, go to a colleague's desk and say hi or even just drink some water or visit the washroom. Humans evolved as hunter - gatherers and our bodies are more adapted to walking / standing than to sitting for prolonged periods. Those of you who travel more and have to sit for long periods of time also need to follow above tips - avoid prolonged sitting in same posture.While exercising, improper position can do more harm than good. Therefore, proper form and posture is a must.

Bonus tip: Avoid cigarette smoking and those who smoke cigarettes to decrease your chances of having degenerative disc diseases leading to chronic back pain early in life.

Word of caution to prevent permanent damage: In case of back pain, which is not responding to home remedies or over the counter painkillers, please contact a Pain Physician to pinpoint the diagnosis and appropriate management.