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chest pain? a non-surgical, leg massage may help

ludhiana (punjab), sep 16 massage therapy for heart patients who are not in a position to go under the knife! it's actually happening here with doctors using a blood pressure machine and strapping the cuffs to legs to push in extra blood.

the enhanced external counter pulsation (eecp) therapy, commonly used in countries like china but yet to catch on in a big way in india, involves strapping large blood-pressure cuffs to legs and pulsing them in sync with a patient's heartbeat.

the heart responds to the extra flow of blood by naturally creating its own tiny new blood vessels for better nourishment.

"the patient feels as if he is getting a muscle massage," said sukhbindar singh sibia, who has been offering the therapy for a decade at his sibia medical centre in this industrial town, about 120 km from state capital chandigarh.

"eecp provides hope for patients who cannot afford a bypass or want to avoid it for economic, personal or religious reasons and is ideally suited for the indian setup," he said.

it is also helpful for those who have already undergone bypass surgeries or angioplasty and stenting and cases in which doctors refuse to operate because of diffuse coronary artery disease or because they have disease of the kidney or lungs.

there is the fear factor too.

for adeyeye adniran jacob, a finance manager from nigeria, eecp sessions in india worked as an alternative to bypass surgery. "i was afraid of a heart surgery; so i tried this therapy. i am happy i did so," jacob, who opted for the procedure in india due to the low cost, told ians.

ajay bhasin, a delhi resident, seemed equally satisfied: "i doubted the gains from eecp a little as i hadn't heard too much about it. but after undergoing it, i myself recommended it to my relatives."

the eecp technique, approved by the us food and drug administration in 1995 and proven to help patients with stable angina, or chest pain, comes relatively cheap. a five-seven week eecp procedure in the us costs around $7,000-9,000, almost a tenth of the cost of a bypass surgery.

in india, there are around 30 centres offering the service and, on an average, it costs around rs.88,000 (over $1,500).

but if it is indeed such a wonder treatment, why is not being used more widely or not known about?

according to sibia, the technique was grossly under-utilised mainly because of the lack of awareness among patients and low interest of the medical fraternity.

"in 2001, when i was about to start offering the first facility in the country, china had 10,000 eecp machines. india, till today, has just 30 centres offering the therapy," said sibia.

patients also don't easily believe that they would get similar results from eecp as other costly heart procedures, he said.

harpreet kaur, another eecp expert from punjab which has about seven such facilities, believes the therapy would grow in popularity with time.

"it's a relatively new technique; so it may take time to get accepted. the ecg (electrocardiograms) that we so commonly use now took decades to gain acceptability among patients and medical practitioners."

"there are documented studies to show that the therapy makes available alternative blood supply channels in a patient's body to compensate for the decrease in blood supply due to blocks in the larger blood vessels."

a supplier of eecp machines in india, who did not want to be named, gave another dimension for the low popularity of this low-cost yet effective therapy.

"in countries like china, eecp is common as the focus is on spending the least public funds for ensuring a citizen's productivity. in other western countries, the costlier the treatment the better it is considered for the vested interests in the private health sector," he said.

experts also forward a reason for punjab being home to the most number of eecp centres.

"the country's first facility came up in the state about a decade ago and since then the word about its benefits has spread in this region, encouraging patients and doctors to use it increasingly," said keerat kaur, another ludhiana-based specialist.

the therapy is not advised for people with high blood pressure, inflammation in veins, valve disorder and pregnant women.

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