Mini - Reunion at Hyde Park Residencies

Pram hosted a dinner at her Hyde Park Residencies last night to welcome Speedy.

Standing L to R: JC, Suri, Chandra, Swyrie, Speedy, Lucky, Lama, Kusuma, HN

Seated: Sriani, Chirasri, Sura and Pram.

(Wasantha, Senerat and Gnanis are not in the picture as they had already left). 

 

To see the full album, please click on:

 

http://www.shutterfly.com/share/received/welcome.sfly?sid=2AbuXDFo5YslHjA

 

 

Sriani Snippets 5

IT ONLY HURT WHEN I LAUGHED - The Reality of a Hysterectomy

Sriani Basnayake

Hysterectomy or the surgical removal of the womb is a very common operation today. Unfortunately, many women are terrified at the thought of undergoing this operation, and the explanations of their gynaecologists seem to be nullified by the negative facts trotted out by every woman they subsequently meet, who has had a hysterectomy, or knows someone who has had one. I suppose human nature is such that one tends to believe the story of someone who has actually experienced the procedure, rather than the doctor who advises them not to worry, that it is a simple operation etc…etc..for they feel that somehow he hasn’t undergone the procedure himself.

This is what prompted me to write this article to ‘Lanka Woman’, for I had a hysterectomy done three weeks ago, and I thought that I would be able to help and reassure many women by sharing my experiences as a patient.

Fortunately there wasn’t much of a time lag between the decision to operate, and the date of the operation. However, in that week, everyone whom I met who had undergone the procedure, or had stayed with such a patient in hospital, told me that it is extremely painful for the first two, three or four days, (it differed in different cases) but not to worry for the pain  will gradually decrease with time. Even though I was a doctor, some went to the extent of kindly volunteering to relate various rare complications that occurred in their patients. All in all a pretty grim picture was painted. Even though it did upset me at the start, I chose to forget the negative thoughts, and placed myself in God’s hands.

The evening before my operation, the Archdeacon anointed me, and at the end of his prayers, all my residual fears and apprehensions vanished, and a wonderful calm settled over me.

My brief sojourn in hospital can be summarized as follows – The operation was performed on a Thursday morning. On Friday morning, I got out of bed, walked out of my room, and was sitting on the verandah outside when my Gynaecologist came on his morning round. My stitches were removed on Saturday, and I was discharged on Monday morning, and advised to take a bath. So I came home, and stood under the shower and felt thoroughly refreshed. On the seventh day I was gently pruning my rose plants despite violent protests from my daughter.

Due to the post operative sedation, my recollections of Day One are hazy, but I must emphasize the fact that I had absolutely no pain whatsoever from the second day onwards. I dare say there was that slight pain when getting in and out of bed, or coughing, but that was all. This is the absolute truth, and for a person like me, whose pain threshold is very low, it was remarkable not to experience any post operative pain. Those who visited me in hospital will vouch for this, for some remarked that I didn’t look as if I even had a tooth out, while others said that I looked the same as I did sitting in office.

The only time I experienced pain was when I was visited by an eminent surgeon in the General Hospital, who is as well known for his transplant surgery as for his inexhaustible storehouse of jokes. He used to pop into my room each morning while on his rounds. His jovial disposition was an instant mood elevator for any patient, which I’m sure, accelerated my recovery process. Each day he left my room cracking a naughty joke, and that was the only time when my wound really hurt, for I could not stop laughing for the next five minutes.

I must be grateful to have been in the hands of a wonderful Gynaecologist, whose personal charm equals his surgical skills, and I feel that both these attributes are equally important as far as the welfare of the patient is concerned.

I know that very few patients would have the good fortune that I had of having one of my medical batch mates as the skilled Anaesthetist in attendance. Additionally, I had that extra bit of luck to have a caring niece as the House Officer.

ADVICE TO PATIENTS

Carefully follow the instructions given by your doctor both pre and post operatively, and you will have no problems. Never compare instructions with those given to your friends, for each case can be different.

I was advised to get operated on at the General Hospital Colombo, and I am ever grateful for that advice, for despite a few other comforts or privileges one may enjoy at a Private Hospital, you can’t match the Theatre and Emergency facilities, and availability of trained nurses, as found in a Government Hospital.

ADVICE TO RELATIVES

I know how anxious family members are to be with their loved one before she is wheeled off to the Operating Theatre. At such a time, please do try hard to look bright and cheerful, and crack a joke if you can, for the way you look during those vital few minutes can have a profound effect on the morale of the patient. On many occasions I have seen relatives stand round the patient and gaze down at her like the chief mourners at a grave side. The poor patient may feel that she is being given a tearful final farewell. I felt like that momentarily when my Mother bent down and kissed me before I was wheeled out to the Theatre. The look on her face, (I don’t blame her, she may have been terrified) and the kiss had only to be coupled with the words “deepest sympathies” and she could easily have been at a funeral house. Fortunately this was counteracted by the beaming faces of my daughter and cousins, together with the thrill of going down in that ancient contraption of a lift in Merchant’s Ward, which is manually operated on a system of pulleys and ropes.

ADVICE TO VISITORS

Be thoughtful enough not to visit a patient for 24 hours, or preferably 48 hours after major surgery. You don’t need to be a doctor to be able to look at a patient’s face and gauge whether she is in pain, or in a mood to carry on a conversation with you. If she doesn’t look up to the mark, make your visit as brief as possible. Please don’t keep talking endlessly and then ask the patient “how do you feel”, for she can never tell you plainly “I feel like throttling you”!

I had such a pleasant stay in hospital that I could hardly believe that I had undergone major surgery. In addition to the expert surgical and medical attention provided by the doctors and hospital staff, there were so many other factors which I feel contributed to my comfortable and happy stay in the ward.

The care, concern and kindness shown by my friends and colleagues, some of whom arranged a roster to be with me for the first two days, was overwhelming. I go crazy over flowers, and many showed their concern by saying it with flowers. It was wonderful to come out of anaesthesia and find myself surrounded by masses of exquisite flower arrangements and roses sent by thoughtful friends.

The humorous episodes are also unforgettable. My four year old niece Amrita had been taken to a hospital on very few occasions, and these had always been to visit Aunts after childbirth. So you can imagine her disappointment when she searched all over the room (and under my sheet) and couldn’t find the baby!

Children, these days, are very advanced. Amrita and my five year old nephew Caesar wanted to know where the cut was, its length, was it sewn up with thread, or pasted with sellotape, gum or paste, plus a whole host of other ‘surgical’ details. By this time they had climbed on to my bed, and were perched precariously over my abdomen, and as curiosity would not only have killed the cat, but their Aunt as well, I agreed to a “special exposition” just for the two of them!

I hope that my experience will help to allay the fears and anxieties of Lanka Woman readers who may have to undergo a hysterectomy in the future. Should your gynaecologist advise you that such an operation is necessary, don’t hesitate or postpone it, for today it is a very simple procedure, and you can take it from the horse’s mouth – it only hurt when I laughed.

(This article was first published in the Lanka Woman paper on the 8^th of May 1991)

It was written mainly to allay the fears of so many women who are terrified at the thought of having to undergo a hysterectomy. After the article appeared in “Lanka woman”, I got at least 20-30 calls from unknown women, thanking me for dispelling unwanted fears, and giving them the courage to face the operation.

 

 

Some Thoughts About Rugby

By Nihal D Amerasekera

The beautiful game of rugby is quintessentially British.  It started as a sport in 1824 at Rugby School which is 90 minutes drive away from my home in England. I have had the good fortune to visit this great school established in 1567 when my elder son played 1^st XI cricket for a rival public school.   The elegant sweep of the 500 year old school buildings is breathtakingly beautiful. The view of the school as a backdrop to the lush green sports ground is stunning. It was the British who brought over the ethos, curriculum and the sports to Ceylon from their own Public Schools. Eton, Harrow and Rugby were the breeding grounds for the army officers and administrators who helped to govern the colonies of the Great British Empire.  The novelist George Orwell wrote: 'Probably the battle of Waterloo was won on the playing-fields of Eton’. Thomas Hughes attended Rugby School from 1834-42 and has written a graphic account of his life as a boarder in “Tom Brown’s schooldays”.  He recounts the camaraderie, friendships, the highs and the lows in ‘vivid technicolour’. I have posted a photo of Rugby School in the  hope that when you watch your next game of Rugby you will reflect on where it all started  nearly 200 years ago.

I dedicate this short account to my friend and batchmate Sidath Jayanetti who played Rugby for Royal College. His fearless tackles and sweeping runs will be long remembered as will be his friendly smile and genuine kindness. I remember with much fondness our happy time together in Kurunegala all those years ago. How time has flown !!

A Get-together of old friends

Mahendra (Speedy) Gonsalkorala is on a short holiday in Sri Lanka.

Sriani Snippets - 4

THE BRADBY – AN OLD AUNT GOES DOWN MEMORY LANE
Sriani Basnayake 

Come June, and Bradby fever grips a fair percentage of Royalists, young and old, and at times ‘infects’ loyal supporters in distant climes who faithfully make their annual pilgrimage to that sacred shrine – ‘The Bradby’. 

One feature of ‘the Bradby’ has been that there has been no gender bias, for even though the game itself is an all male affair, the interest in the game is shared by a large segment of the female population, ranging from sisters, admirers, girl friends, friends of girl friends, mothers, aunts and even grandmothers. In my life, I seem to have gone through all those categories. 

Being a sentimentalist, in recent years I have viewed the Bradby with a mixture of extreme happiness tinged with some sadness. At the 125^th Royal Trinity Bradby encounter, when my handsome nephew sporting his no: 8 jersey ran on to the field, I basked in reflected glory, and floated on cloud nine for one long glorious hour, for it was the first time in the history of the Bradby that three generations of one family, three Dissanayakas (father, son and grandson) had played for Royal. My father (S.A.Dissanayaka) played for Royal in 1931 and captained in 1932. My brother Laki played from 1962-64, and his son Gemunu from 1996-98. Cruel fate prevented my brother  from achieving one of his life-long ambitions, that of seeing one of his sons playing in the Bradby. I am sure he and his father would have cheered lustily with all the other Royalists on that far brighter shore, when in 1998, his son as Vice Captain, played brilliantly to humble the Trinitians on their home ground, and win the Bradby Shield for Royal. 

As mentioned earlier, the female of the species gets interested in Rugby for reasons beyond the game. I first went to a rugger match as a young teenager, and knew next to nothing of the rules of Rugby.  It happened that I went only for matches involving the Royal team, for those were the matches that my brother went for, and as I had to be chaperoned by my dear brother, I was sent with him, and my parents were blissfully unaware that he abandoned me from the moment we reached the grounds until it was time to depart.

I took great delight in watching my handsome rugby heroes run on to the field, and was dazzled by their flying tackles, brilliant solo runs and the excitement of the rucks and mauls. My heart missed a beat when my shining knights in armour got tackled, trampled and squashed, and at times injured, and ended up looking a “bloody muddy mess’. 

Gradually I gathered the finer points of the game, but by this time I was interested only in my brother’s rugby skills, and kept my eyes glued on him throughout the sixty minutes. The tension and excitement was too much for me when he got ready to execute one of his famous drop kicks, and I still remember those legendary drop kicks at the Nittawela grounds that helped Royal to thrash Trinity 14/6, and win the Bradby Shield in 1964. 

A quarter century later, his two sons followed the family tradition and played under 17 rugby, and their ageing aunt’s interest in the game was re-kindled. By this time, the effects of advancing age were affecting their aunt’s vision to such an extent that I could spot my little hero on the field only by the number 8 on his jersey, or later by his scrum cap. In addition to the ill effects of the natural process of ageing, my concentration on the game, (or to be more precise, on my nephew) was constantly interrupted and disturbed by other distracting elements which are now part and parcel of popular rugger matches…. viz ..Vociferous female supporters. 

A rugger match is a place for females of all ages to display their fashions, their anatomical endowments, and to see and be seen. The numbers that fell for tackles in the stands may have far surpassed those tackled on the field. The antics in the stands often convinced me that there were much faster numbers on the side lines than the fastest three quarters on the field. Females with little knowledge of the game keep shouting instructions to the players, and one wonders whether their high pitched screams of “tackle low”…  “pass it….pass it”  or “go boy go” etc were meant for the players on the field or those sitting by them in the stands, who were either tackling too high, or had not found touch even though they had covered considerable ground up and under. When fashion decrees that the hemlines go higher and higher each year, the 22 metre line has coincided with the 5 metre line, and the playing area has been so drastically reduced that any blind man will be able to touch down between the posts without the slightest chance of being off side during the entire operation! 

As I pen these lines in this millennium year, I do not know whether I will have the pleasure of watching still another Dissanayaka take the field, but even otherwise, I can enjoy the evening in the company of the ageing Bradby heroes of yesteryear, go down memory lane, and sing:

                        “And we their loyal sons now bear

                         The torch, with hearts as sound as oak,

                         Our lusty throats now raise a cheer

                         For Hartley, Harward, Marsh and Boake.

(This article was first published in the Royal College Bradby Souvenir of 2000, when Sriani’s nephew Gemunu Dissanayaka was Vice Captain of the Royal College 1^st XV).

(Sent in by Indra Anandasabapathy)

Health |​​From the New York Times                                   

Study Finds Alternative to Anti-Cholesterol Drug

By GINA KOLATANOV. 17, 2014

Inside

Photo

Dr. Robert Califf, a Duke cardiologist, led a six-year study of a new cholesterol-lowering drug.      

Jeremy M. Lange for The New York Times          

For the first time since statins have been regularly used, a large study has found that another type of cholesterol-lowering drug can protect people from heart attacks and strokes.

 

The finding can help millions at high risk of heart attacks who cannot tolerate statins or do not respond to them sufficiently. And it helps clarify the role of LDL cholesterol, the dangerous form. Some had argued that statins reduced heart attack risk not just by lowering LDL levels but also by reducing inflammation. The new study indicates that the crucial factor is LDL, and the lower, the better.

 

The six-year study, reported Monday at the annual meeting of the American Heart Association, involved 18,000 people who had had heart attacks or episodes of chest pain so severe they went to a hospital. They were randomly assigned to take a statin or a combination of a statin and the alternative drug to further reduce LDL levels.             

                       

Both groups ended up with very low LDL levels — those taking the statin, simvastatin, had an average LDL of 69, and those taking simvastatin and the other drug, ezetimibe, or Zetia, in a combination pill sold as Vytorin, had an average LDL of 54. No clinical trial had ever asked what happened when LDL levels get below 70 because, said Dr. Robert Califf, a Duke cardiologist and the study chairman, “many people were nervous about going this low and imagined a lot of possible toxicities.”

 

Statins lower LDL by preventing it from being made. Ezetimibe lowers LDL by preventing cholesterol from being absorbed in the gut.

 

The drugs were so effective that there were few cardiac events among the participants but eventually a difference emerged. There were 6.4 percent fewer cardiac events — heart disease deaths, heart attacks, strokes, bypass surgeries, stent insertions and hospitalizations for severe chest pain — in those assigned to take Vytorin. The amount corresponded to what was predicted from the extra degree of cholesterol lowering with the combination drug.

 

Those results translate into 2,742 events in those taking simvastatin and 2,572 in those taking the combination drug. That means, said Dr. Christopher Cannon, a principal investigator and cardiologist at Brigham and Women’s Hospital, that two out of every 100 people who would have had a heart attack or stroke by taking the statin avoided those outcomes by taking the combination drug.

 

And, adds Dr. Califf, the study found no side effects from ezetimibe — no excess cancer, no muscle aches no headaches. “It looks like placebo,” he said.

The study was sponsored by Merck, the maker of Vytorin, but the investigators had the right to publish what they wanted, with final say over what they wrote.

“Fantastic,” said Dr. Sekar Kathiresan of the Broad Institute and Massachusetts General Hospital who studies the genetics of heart disease but had no part in the study. “A truly spectacular result for patients.”

Dr. Harlan M. Krumholz, a Yale cardiologist not associated with the study, said he wished there was a peer-reviewed journal article instead of a presentation of the results at a meeting — the data analysis was completed just last week — but, assuming the result holds up, “this is the result we were hoping for.”

 

At the same time, and by sheer coincidence, two other groups of researchers reported genetic studies that supported the trial’s conclusions. One, led by Dr. Brian A. Ference of Wayne State University School of Medicine found that gene mutations mimicking the effect of ezetimibe and ones mimicking the effect of statins had the same effect on heart disease risk for a given reduction in cholesterol. The implication, he said, is that “lowering cholesterol with ezetimibe, or a statin, or both, should each lower the risk of heart disease by about the same amount.”

 

The other, led by Dr. Kathiresan, examined mutations that disabled one copy of the cholesterol absorption gene, producing the same effect as ezetimibe. The result was a 50 percent reduction in cholesterol absorption — the same as produced by ezetimibe — and an LDL reduction of 12 milligrams per deciliter of blood, also the same amount as produced by ezetimibe. The mutation, which gave people the equivalent of a lifelong exposure to ezetimibe, reduced the heart attack rate by 50 percent.

 

The study’s results are making many wonder about the latest cholesterol guidelines, which did not mention any drug other than a statin. And instead of providing goals for cholesterol levels, they simply advised those at high risk to take a statin.

“The guidelines didn’t say they didn’t believe in cholesterol, but they made it clear that the evidence is for a statin, not for any agent that lowers cholesterol,” said Dr. Eugene Braunwald, a study chairman who is a cardiologist at Brigham and Women’s and a longtime leader in the field.

 

Dr. Neil Stone, the head of the guidelines committee and a cardiologist at Northwestern University, has a more nuanced view of what the guidelines say, but adds that the study result “gives doctors another option if they have a patient who can’t tolerate a high-intensity statin.”

 

The new data are in sharp contrast to what happened in 2006, when ezetimibe seemed useless. The study was small, with just 750 participants, all of whom had very high cholesterol levels. Instead of looking at heart attacks or strokes, the researchers looked at a surrogate, the buildup of plaque in the carotid artery of the neck. That made the study quicker and easier than waiting for people to have heart attacks. But it was not clear whether those carotid plaque measurements really reflected heart attack risk.

But ezetimibe had been approved purely on the basis of its ability to lower LDL. With that stunning negative result, the question about LDL’s lowering could not be avoided. Perhaps statins, the exemplar for the benefits of lowering LDL levels, were effective for more than just their effects on LDL.

“This is as bad a result for the drug as anybody could have feared,” said Dr. Steven Nissen, the chairman of cardiovascular medicine at the Cleveland Clinic, when the 2006 ezetimibe results came out. The results, he said, were “shocking.”

The drug, Dr. Nissen noted in a telephone call Friday, had reached 17 percent of market share for cholesterol-lowering drugs with no evidence of benefit.

“Now we have the result,” Dr. Nissen said. “They were successful, and that’s great. But at this point, it really doesn’t matter. They made their $30 billion.” The drug will be available as a generic in 2016, Merck says.

That the drug was promoted and sold for so many years without evidence that it helped was inexcusable, Dr. Krumholz said.

“The fact that the trial exists says there was uncertainty,” he said. “The company and the investigators and the scientific community were uncertain about it. This is a cautionary tale.”

“The results could easily have gone the other way,” he added.

For Dr. Cannon, the study has a broader lesson. “It reminds us that lowering LDL prevents heart disease,” he said.

Now, Dr. Braunwald said, the arguments over cholesterol lowering should be settled.

“People can stop yapping.”

 

Correction: November 17, 2014
An earlier version of this article misspelled the name of a drug in the trial. It is Vytorin, not Vitorin. It also misspelled, in two instances, the name of another drug. As the article correctly noted elsewhere, it is ezetimibe, not ezetimide or ezitimibe. And it mispelled the surname of a doctor not involved in the trial. He is Dr. Harlan Krumholz, not Krunholtz or Krumholtz.  

 

Rosetta, the comet chaser

 

During the past 10 years European Space Agency’s Rosetta spacecraft was on a journey of 6.4 billion KM from the Earth bound for comet 67P, which hurtles away at 15KM per second and is situated 500 million miles from earth. The project was the first of its kind to reach its destination. It was launched on board a rocket. It had solar cells to provide electric power, its ‘orbiter’ carried 15 experiments and the ‘lander’ probes called Philae carried drills to sample beneath the comet’s surface. On th 12^th November 2014 Rosetta landed on Comet 67P which hurtles at 15 KM per sec. The craft got its name from the Rosetta stone of ancient Egyptians, which had hieroglyphics, carved on it revealing the history of Pharaohs. The present Rosetta hopes to discover the secrets of the solar system including the origin of planet Earth. Scientists celebrate this landing on one star while other stars watch us. Switzerland made the space watch capable of spanning 10 years.                                                               

                    

Comet 67P chosen for landing Rosetta

 

Rosetta with its landing gear

Rosetta bounced twice before settling down and stabilized finally, I KM from expected site of landing and settled at the edge of a crater unfortunately, a place where it will not receive direct sunlight to charge its solar cells.  Rosetta sent a tweet, ‘I’ll tell you more about my new home, comet 67P soon.’ A lot of data has now come from it but the cells need charging and it said in another tweet, ‘I am very sleepy’.

Sleep well little probe!

What scientists learn from Rosetta will rewrite textbooks.

·        Origin of man’s space program goes back to 1^st Oct 1957 when Soviet Russia launched the first satellite Sputnik into outer space.           

·        Americans felt humiliated but they reached the moon, 384000 KM from earth with Apollo 14 on 20^th July 1069 when Neil Armstrong walked the moon.

·        Few years later on 20^- 07- 1976 the American probe Viking 1 travelled 100 million KM landing on Mars, the red planet.

·        In 2005 the European probe Pagine, went 10 times as far, more than 1.3 billion KM to Saturn’s moon Titan.

And now to crown it all Rosetta is safely landed on Comet67P in November 2014 and once it faces the sun again its solar cells will recharge and send us valuable information even of the origins of life, so the scientists think.

                       *******************************

Put together by ZitaPereraSubasinghe from programmes on Euro News and BBC Radio website Ref: What is a comet

http://rosetta.jpl.nasa.gov/science/comet-primer/what-comet