Penelope Walsh speaks to surgeon Professor Uwe Klima to learn what this life-saving job entails in a country with such a high incidence of heart disease
The comfort of the UAE’s luxury lifestyle can come at a price to your health. Poor diet and a lack of exercise mean diabetes and obesity rates are alarmingly high compared to global averages, while another looming threat is heart disease. In the UAE, 41 percent of under thirties suffer from high blood pressure (a risk factor for heart attack and stroke), compared to a global average of 25-30 percent, and it is anticipated the figure could rise to as high as 60 percent by 2025.
‘You have cases where emergency surgery decides over life and death, if you don’t do it they will be dead, if you do they’ll have a 90 percent chance of survival. It’s really up to you to make a difference.’
This is Professor Uwe Klima, heart surgeon at the American Hospital Dubai. He says that in a work-centric country such as the UAE, work-related stress gets added to the already dangerous mix, and sees frazzled professionals who perform high-pressure roles on his operating table at an average age of 45 rather than 65-70, as elsewhere in the world.
It’s an immense responsibility that heart surgeons wield. Not all patients are even prepared to put their life in their hands. ‘Everything comes with a certain complication rate and it is really important that you warn patients before you pick up the knife. Briefing patients before surgery is extremely important in this part of the world, since there is a certain mistrust of [Dubai-based] doctors. People need to see your face so that they can establish a level of confidence.’ Klima reveals that a practise dubbed ‘doctor hopping’ occurs in the UAE, whereby patients will seek out as many as five medical opinions.
Originally from Vienna, Professor Klima has 25 years of experience as a surgeon, with nearly four of those in Dubai. ‘When I was a little boy, I wanted to become a pilot, but I couldn’t because I wore glasses, so I decided to focus on a different career.’ Professor Klima started medical school in Vienna, and says that from the very beginning of his training ‘surgery was the only thing I wanted to do’.
‘For surgery you have to have knowledge and good hands; the result really depends on your manual skills, but at the same time, you need the knowledge to make the right decision at the right time.’
A typical day for Klima starts between 7.30am and 8am, and although his schedule varies, he usually leaves the clinic between 5pm and 7pm. In an average week, provided there are no emergency cases, Klima will be in the operating theatre three times, although he is in the clinic every week day. One or two days before surgery – especially delicate surgery – Klima will take good care of his hands, which involves placing no strain on them through contact sports, heavy lifting or gardening. Activities such as using a computer keyboard, however (which we imagine runs the risk of repetitive strain injury), can be good for moving and training the fingers. This is good news, since Klima tells us a great deal of his time in the clinic can sometimes be taken up by the administrative activities involved with running a department. ‘That’s the problem in medicine everywhere, administration takes over,’ he says. Klima is always on hand to act as council to other experts within different departments of the hospital: ‘If a pulmonologist spots a tumour on his patient’s lung in an X-ray, he may ask for my advice on how best to progress with this particular case.’
One week after surgery, Klima will again meet with patients in the first of a series of checkups, typically over a three-month period. He looks for wound infection, instability of the chest bond (at the sternum), takes X-rays to see that the lungs are fully inflated with no fluid around them and that the shape of the heart looks normal, as well as removing stitches and adjusting the patient’s medication.
‘Close routine follow-ups on patients who have undergone surgery is very important because the patient’s body changes dramatically over time,’ he explains. ‘The beautiful thing about open-heart surgery is, if everything goes well, you can wake the patient after two hours, which is key because the most feared complications are neurologic, such as a stroke. The next day they are sitting in a chair, a week later they’re walking around and ten days after the surgery they can already get back to their daily routine.’
Nevertheless, the role of a heart surgeon can pose emotional challenges. Post surgery, Klima tells us how rewarding it is to see the smiles from patients who have been very sick, especially those who were most anxious about surgery. Pre-surgery, however, Klima has found operating on children especially psychologically challenging. ‘If you operate on a child on Sunday, you lose the whole weekend thinking about them and perhaps 20 family members who will be affected by the outcome of the surgery.’ Even so, he explains how imperative it is to keep these emotions out of the operating theatre. ‘Once you wash your hands and put your gloves on, you concretely focus on the sick organ and curing it. If you got emotionally involved your fingers would probably tremble, which wouldn’t be great when performing open-heart surgery.’
Ultimately, with heart disease, the best possible care you can take is prevention. With such a high number of the UAE population ‘at risk’, now’s the time to re-evaluate your diet, exercise and consider the cost of not making any changes.
American Hospital Dubai, Oud Metha Road (04 336 7777).
Three key tips for a healthy heart
Cut down on salt
UAE versions of some international food products contain higher levels of salt, and residents average 7g a day compared to the recommended 5g per day maximum. Preparing meals from scratch at home will give you more control over your intake.
Eat the right fats
Add anything deep-fried to your ‘banned’ list and instead introduce olive oil, avocados, raw, unsalted nuts and oily fish into your diet. Watch portion sizes though, as they are still high in calories.
Walk more
Use public transport instead of your car; a brisk ten-minute walk to the metro station every day is a good place to start. Or if you’re in a mall, walk up the escalator instead of standing on it.
