Malai

Malai was my favorite ever since childhood. It remained my favorite always. I had semi-monopoly on
whatever was produced at home. Complete monopoly once I was married and living independent.

My breakfast was malai and eggs. My dinner was often eggs! I was healthy as you can see in the picture
and working in a responsible senior position with a Management Consulting firm in Karachi. It was early
Nineties. I would sleep late after 2 am. Wake up at 9 am and reach office at 10:30 am. Well, I was
pampered enough in the workplace to get away with that so there were no problems. It would often be
that at 2 in the morning I would have the urge to eat. With children fast asleep I would take my wife
along and we would go on a little drive. There was an all-night café rather a tea shop and invariably at 2
in the morning I would find a large plate of malai which I would eat with a poratha. That was life!
Unhealthy but happy life! The hype about diet had not yet reached its crescendo in those days.

The problem with high cholesterol is it does not produce prominent symptoms. I discovered a monster
nurturing in me just by a chance.

It happened like this: In 1993 or 1994 my eldest, Ayesha fell sick and her LFT test was required. Late at
night around 11 we went and gave her blood sample in a 24/7 Lab which was at a 5 minutes drive. That
was the first time that while waiting for her turn, I thought of having my own LFT done too. I gave my
blood sample.

Liver function reports were normal for both of us. However, there was a remark at the bottom of my
report: Serum Lipidemic ! I knew the medical terms a little bit. I was alarmed. That was the first time in
my life I thought of cholesterol. Next day I did a 12 hour fasting and on my way to office gave my blood
sample for a Lipid Profile at the Ehsanullah Labs.

When I went to receive my report the girl at the counter said the report is with the pathologist. He has
instructed that it should be collected from him. That was quite unusual. So I went inside and into the
Pathologist’s office. When I gave him my receipt his first question was, “Where is the patient?” I said,
“Nobody is the patient. It is my blood report.”

There was an expression worth seeing on his face, as if he was handling a dying man and that too
without a hope ! He stood up almost in a panic and said to me, “ Aap bethye bethye please …kharay
kyun hain….apke sath kon aya hai?”

I said koi nahi aya hai. Ap report dijjye na. He looked at me as if I was a ghost. His voice was shaking
when he asked me if I had done the fasting right. I said 12 hours. Then he told me and I understood why
he was in such a panic. He said my cholesterol was 550. He said they couldn’t believe it. Their machines
were set at a maximum of 450 and they had to do my analysis manually.

He told me to repeat the test. They would not charge for it. I should do a complete 12 hour fasting and
give the sample again. I agreed and gave the sample again the next day.
The result was same . Cholesterol 550. Triglycerides 1500. Total lipids around 2200 ! They wrote under
the report, “Tested Twice!”

Now here was I. Feeling hale and hearty. Fully energetic and healthy but with a lipid report that could
cause a heart attack by merely looking at the results. My first thought was to go to a Cardiologist. I
didn’t waste time. From the lab I went straight to Ziauddin Hospital. It would be around 6:30 pm. I asked
at the reception how many Cardiologists were present in OPD at that time. They said Three. I said who is
the oldest? The man gave me a name. I eliminated him in my mind. I did not want to go to an old man
who would probably have had no CPE and would have repeated his old knowledge over and over again. I
said who is the youngest? He said there was a new young Cardiologist who had arrived from USA
recently. I said I would like to see him. I got his appointment and within 20 minutes I was in his chamber.

He took one look at the paper and summarily dismissed my report saying, “Unbelievable. The report is
not correct.” Then he saw the bottom print, “Tested Twice” and murmured, “Oh they have tested
twice….but this is something I have never seen….” His next question was obvious, “Do you have any
complaint?” I said no. After 20 minutes, an ECG and physical check up I was out of his office with a
prescription for lipid lowering drug regimen. He had said everything is fine so far. You have a normal
ECG. Your physical check up shows no signs of any disease but cholesterol has to be lowered.

I did not buy or take any medicine that day. Next day at the office I typed out my medical history from as
far back as I could remember. I made it in bullet points. Every little thing. It went to almost 2 pages of
printout. I had made a decision. I was not going to follow the Cardiologist’s prescription. Now that I was
clear in that department, I must go to an Internist. My case was not that of a cardiologist.

I sought an aged physician (here aged because I valued experience in internal medicine) who was
excellent but a complete eccentric. And he read my lab report first. Looked at me and said, “Tum zinda
kese ho?”. Then he read my write up and smiled. Probably for the first time he must have smiled in his
professional time. Said to me, “Acha kia likh ke laye ho. Bohot acha laga….. Ab chalo leit jao”.

Then once he had thoroughly examined me he said my tongue was in a horrible condition. Oral Thrush.
(See, the cardiologist had missed it!). Then he wrote the prescription for all the things. For Lipids he
prescribed Bezalip and Zocor ...and said to me, “If you wish to be treated by me, don’t read the medical
literature of these drugs. You won’t take medicines if you read.” I made up my mind to read! Then the
strict diet regimen and physical exercises. He explained everything and asked me to come after 1 month.
He said he expected the cholesterol to come down to 250 in 6 months time.

For the next one month I was eating boiled chana, egg-white ‘fried’ in water, home made chapatti of
bran with some added flour and my life became a hell. I lost several kgs but the reports after a month
left the physician and I both surprised. Cholesterol was 310. Triglycerides around 500. As much shocking
was the initial report this speedy lowering of lipids left the physician a bit confused. After another
month, my cholesterol was 220 and I stopped Zocor without consulting the doctor. After another 2
months I stopped Bezalip as well. I maintained my cholesterol at around 200 which no doctor would
advise but any way I got my first heart attack 21 years later and that too blockage in only one artery.
NB All readers are advised to follow the doctor’s instruction and not follow me.