Wednesday 27 March 2013

Bone Cancer - An Accident Can Be A Life Saver As This Bone Cancer Patient Experienced It First Hand


Amputation is not the sole remedy when bone cancer is the disease in question, limb saving surgeries are in existence. Numerous patients have benefited from the advances made in the technologies available in detecting and treating of bone cancers. Further, the expertise of the treating orthopedic oncologist also matters and very countable numbers of such specialist orthopedic oncologists are available in the entire of the world who have the expertise and confidence in suggesting limb salvaging surgeries to treat bone cancer. This case is of a young patient who undertook a medical travel to India for his bone cancer treatment. His medical travel to India not only ensured that he was cured of bone cancer but he was cured of bone cancer without having to amputate his affected arm.

This case is of a young patient who was eighteen years of age. The patient had a bike accident. He was injured in the bike accident and he also fractured his right arm. While being treated at a hospital in his native country for the fracture the treating doctors in the hospital noticed an abnormality in the x-rays of his right fractured arm. They had certain suspicions and accordingly they asked him to visit an oncologist.

The patient had the cast on his fractured hand for nearly three months. When the cast was removed the doctors noticed that the fracture had a malunion. To add to the woes of the patient the doctors also noticed that the cancer had worsened. They immediately referred him to a cancer hospital.

The only remedy to save the life of the patient that the doctors in the cancer hospital in his country could arrive at was amputation of the bone cancer affected right arm. The patient and his family were torn in grief. They visited numerous other cancer hospitals in their country in search of an alternative as opposed to the arm amputation. Nothing positive emerged from their quest.

It is during such a time that the patient's family came to know about a cancer camp being conducted in their city. They immediately visited the camp. Our hospital has conducted such cancer camps in numerous countries and multitudes of patients from those respective countries have benefited from the camps. Patients visiting these camps are in a position to meet the oncologists directly, understand the kinds of treatments that are currently available, and also gain an understanding of the survival rate and success rates of the treatments the oncologists suggest.

The patient too presented his case to an orthopedic oncologist at the cancer camp. The orthopedic oncologist studied his case and suggested that his bone cancer could be cured and that too without amputating his bone cancer stricken arm. The patient and his family's joy knew no bounds. The orthopedic oncologist also made an important observation that the case was still a high-risk one and the mortality rate was quite high.

Though the solution to the bone cancer was in sight, affording the treatment and traveling to India for the treatment was the next of the patient and his family's concern. The patient and his family were in dire poverty. However the patient's family did not want their financial status in becoming a hindrance to the patient's treatment. They firmly took a resolution that they would indeed travel to India and ensure that the patient received his treatment.

The patient's family put forth a brave effort and worked real hard in organizing the necessary funds for his treatment. They requested for donations, and for this they contacted numerous individuals and charitable organizations. They also requested their government for some funds. They also went to the extent of selling off their only small parcel of land to raise the necessary funds.

Once they had raised the necessary funds the family decided to send the patient to India for his treatment. At his point of time they realized that none of them knew English and there was no way of them communicating with anyone in India. A relative of theirs demanded a fee of USD 2000 for helping them with English translation. Not wanting to waste their hard earned funds on trivial matters they pursued for an alternative. Finally an English teacher decided to volunteer the patient for free.

While the fund raising activities were in progress, the patient was already on chemotherapy.

On 24th September, 2012 we received the MRI scan reports of the patient on a CD. The treating orthopedic oncologist went through the patient's MRI scan reports and concluded that the treatment he would be performing on the patient would be a wide excision, or en bloc resection with vascularized fibula transfer.

On 11th of October the hospital sent a visa invitation letter to the patient to enable him to travel to India for his bone cancer treatment.

The patient arrived in India on the 29th of October, 2012. The hospital made the necessary arrangements to pick the patient, his attender, and the translator from the airport. The hospital also made the necessary arrangements for their stay at the hospital's guesthouse. 

Upon the patient's arrival at the hospital the hospital made the necessary arrangements for consultation with the treating orthopedic oncologist and for the patient's evaluation on an outpatient or OPD basis.

The patient was admitted to the hospital on the 30th of October, 2012. The patient was posted for surgery on the 31st of October, 2012.

The surgery that was performed on the patient was wide excision, or en bloc resection and vascularized fibula transfer. The affected bone was removed from the body, irradiated externally, and reinforced with a vascularized fibula from the leg through microvascular surgery. The entire duration of the surgery was eight hours.

The patient was discharged from the hospital on the 5th of November, 2012. The patient was in a position to fly back to his country on the 16th of November, 2012.

Bone Cancer - A Doctor's Cancer Camp Made All The Difference To A Young Patient With Bone Cancer


The word 'amputation' spells terror even amongst the bravest of humans, and when a child less than five years of age had to face a similar situation wherein one of it's limbs required amputation as it had developed bone cancer, one can only guess the plight of the child's parents. They were crestfallen. It is only the medical travel they undertook to India to treat their daughter's bone cancer brought normalcy and order back to their distraught life.

Bone cancer can strike at any moment and that too when you are least expecting it. Such was the situation a child less five years of age too was faced with. The child had just learnt to stand on it's legs and take small baby steps when she developed pain on her thigh; she was all but two and half years of age. Her parents noticed a lump on her thighs. They took her to numerous hospitals in their country, but none of the doctors they visited were able to give them an exact diagnosis of the child's lump in the thigh.

Of the numerous doctors they visited in their country only one doctor was able to conduct a proper diagnosis and conclude that the child had developed bone cancer. The child was immediately referred to a cancer hospital in their country. The doctors at the cancer hospital suggested to the parents that the only way the child could be rid of the bone cancer was by amputation of the affected limb. The parents were heartbroken since it was only a few days before which their child had made it's first attempt to walk. Amputation of it's limb was going to steal the gift of walking 'naturally' away from the child, forever. It was during the month of May 2012 that the parents were faced with the question of whether to, or not to amputate the stricken limb. They asked for some time to think over it and take a decision.

During the month of June, 2012 the parents came to know of a cancer camp happening in their city. The cancer camp had numerous international oncologists visiting the country. They visited the cancer camp with their child's case and sought a second opinion from the visiting oncologists. One of the visiting orthopedic oncologist from India was able to shed some light on the matter and broke to them a gladdening news that the bone cancer could be tackled minus limb amputation. The doctor rested his hopes on treating the bone cancer through a combination of chemotherapy and surgery.

The child started off with the chemotherapy sessions during the month of July, 2012 itself. The results post the chemotherapy were posted to the oncologist in India. The latest of the medical reports of the child were received by the orthopedic oncologist on the 24th of July, 2012. He studied the reports and suggested that the child should undergo surgery. The surgery he specified was extracorporeal radiotherapy or ECRT. The child's parent were also advised that the stay at the hospital for the treatment would extend up to 10 days. Thereafter they may have to remain in India and outside the hospital for another 14 days.

Our hospital took the economical status of the child's parents into account; they were economically backward, and offered them a rebate of 30 percentage on the entire treatment plan and stay. The hospital also went forward and helped the child's parents with letters and other paperwork which helped them solicit the necessary funds for the surgery through donations and other fund raising campaigns in their country.

The child traveled to India along with her father on the 26th of October, 2012. The hospital had made the necessary arrangements to pick the child and her father from the airport. The hospital had also organized a translator for the convenience of the child's father. The child's father could speak in only his native language and none other.

Once the child arrived at our hospital, we arranged for their stay outside the hospital in our guesthouse and made them feel comfortable. We then proceeded to briefly explain to them the exact course of treatment and the rest of the things that mattered.

The child was posted for an evaluation on the 26th and 27th of October, 2012. After the evaluation the child was admitted to the hospital on the 28th of October, 2012. The child was posted for surgery on the 29th of October, 2012. The orthopedic oncologist and his team conducted the extracorporeal radiotherapy, or ECRT on the child in a very successful way.

The child recovered and was discharged from the hospital on the 5th of November, 2012. The child was able to fly back to its native country on the 7th of November, 2012.

The child was able to walk on the 4th day without any pain. She was the bravest child I ever saw, she never cried while dressing ,wherein the grown-ups scream,in a similar situation.

The best thing about the baby was she was always smiling, and post the operation she went back to her home smiling .

Thursday 21 March 2013

Bone Cancer - A Case Of Metastatic Osteosarcoma Of Femur And How A Young Patient Survived It


This is a case of how a young patient's medical travel to India gave her a new lease of life.

On 26th of July, 2012 the reports of a young patient was sent in to us, and from the reports it was established that it was a case of metastatic osteosarcoma of femur.

Metastatic osteosarcoma refers to the osteosarcoma that has spread from the bone at which it initially started to one or more other parts of the body. It commonly spreads or metastasizes to the lungs.

The treating doctor suggested that treatment for this patient was still possible as the lung lesions were small and it was resectable. The treating doctor also established the fact that the survival rate of this patient was as low as 20 to 30 percent.

The treatment plan that the doctor put forward was that the patient requires neoadjuvant chemotherapy. As part of this process the radiation therapy that was planned out was a total of 25 fractions at the rate of 5 per week. The chemotherapy that was planned out was to be administered on the first 5 days of the radiation therapy and also on the last five days of the the radiation therapy. The patient need not be admitted in the hospital for the chemotherapy sessions and could visit the hospital for the treatment on a day care basis, and so it would involve 10 day care sessions.
Limb salvage surgery – The treating doctor had decided for a megaprosthetic replacement for her affected bone together with lung metastatectomy.

Upon receipt of our analysis, the patient immediately started out with the doctor's suggestions of neoadjuvant chemotherapy at a cancer hospital in the patient's native country. The neoadjuvant chemotherapy treatment almost went on for a month and a half. The effects of the treatment forced the young patient to shave off her hair; the chemotherapy and radiation therapy sessions usually have a toll on the patient's hair.

Our hospital forwarded the medical visa invite to the patient on the 27th of August to enable the patient to travel to India for the treatment. The patient arrived at India on the 14th of September, 2012. The patient was accompanied by her parents. The patient was advised to carry all her previous medical reports along. Once the patient arrived at the hospital, we briefly explained to her and to her parents the next treatment that had been planned out for her.

The patient underwent a thorough evaluation PET Ct scan, x- rays , MRI and blood tests on the 15th and 16th and the PET CT reports revealed that the patient did not have any metastasis in her lungs, which meant that it was cured by the chemo and radio therapy sessions. Also, the lesion in the thigh had shrunken.

We counseled the patient and explained to her family that the success rate of the procedure that we were about to undertake was only about 30 percent. Post the procedure and with the passing of some six months, the patients will need to undergo another evaluation to determine if there is any recurrence of the metastasis. If any metastasis is noticed during this evaluation then it would turn out to be a very unfortunate situation and the patient may survive for only a few more months. In such a situation, numerous surgeries will be required and those surgeries will be quite traumatic on the patient, and no clear benefit would emerge from it.

The patient's family was further advised that during the surgery the young patient's leg's growth center may require removal since it was noticed that the lesion was in the very vicinity of the growth center. It was advised that the young patient will need to wear shoes that suitably compensated for the growth of her other leg. It was also advised that a leg lengthening surgery could be undertaken once the patient attained an age of 18 years to correct the height mismatch of her legs. 

The surgery was posted for on the 17th of September, 2012. The surgery was a success and the patient had to remain in the hospital for 10 days post the surgery. She was able to walk on the third day after surgery. Once discharged from the hospital, the patient had to stay outside the hospital for a period of another ten days after which the fit-to-fly certificate was issued to her.

Thus, the patient flew out of India healthier and with a new lease of life.

Wednesday 14 November 2012

Hernia Surgery - Laparoscopic Mesh Repair Surgery at Affordable Cost


An International female patient aged around 26 years of age presented with paraumbilical hernia with a defect measuring 2 cms. The swelling was first noticed a year back, and 3 months post her delivery. The swelling was prominently visible on coughing, and was reducible.

The doctors at her home country had advised a ‘laparoscopic mesh repair’. Since the cost of the surgery was beyond her insurance coverage, she had to look for alternatives outside her country. The cost we quoted to her for the surgery at our hospital in India was affordable to her, and she found that it was within her insurance coverage.

She flew down to India and underwent surgery at our hospital. She was in India for 7 days.  On her arrival at India, she visited the hospital and had a consultation with the treating doctor. She was posted for surgery after two days; in accordance with her request to get herself accommodated outside the hospital. She was admitted to the hospital a day before the surgery. She underwent a ‘laparoscopic mesh repair’ for ‘paraumbilical hernia’. She was back to the ward on the same day and was doing well.

She was advised stay in the hospital for two days since she reported mild pain in her abdomen.
The surgery was a success and she was back in her country 3 days post the operation.

Tuesday 13 November 2012

Eye Surgery - A Childhood Injury Left Untreated Had to Be Fixed a Good 20 Years Later to Save Eyesight with Surgery Which Included Penetrative Keratoplasty


Childhood injuries can terribly go wrong if left untreated. This is what a patient who visited our hospital for eye treatment experienced firsthand. He was some 7 years of age when he had an injury on his right eye which he had left untreated until recently; he would have gone blind in his right eye if not for the treatment he had at India and in our hospital.

The ophthalmologist’s investigations of his right eye revealed that his posterior segment appeared normal and the
 ophthalmologist could clearly rule out endophthalmitis and atropic bulbus. The only factor that needed some keen assessment was the amount of amblyopia he had, and the treatment would be decided strongly based on this factor.

Further, from the reports presented, it was not clear to the ophthalmologist as to the amount of corneal opacity that was present in the affected eye. The ophthalmologist had no options but to request the patient to fly down to India for further evaluation and appropriate treatment. The ophthalmologist was in no position to give an estimate to the cost of treatment since everything was dependent upon his evaluation of the patient in person.

When the patient finally arrived at India he presented himself with total loss of vision in his right eye. The injury that he had left untreated for some 20 years had now developed into total corneal opacity with vascularization. The treating ophthalmologist gave a clinical diagnosis of  adherent leucomo. The ophthalmologist observed that the left eye was functioning quite normally. The ophthalmologist also suggested that the patient undergo a
 B-Scan and also an OCT.

These tests revealed that the
 posterior segment of his right eye was perfectly normal, but the anterior segment could not be made out. As previously observed from the reports the patient had previously presented, the new reports too confirmed that Endophthalmitis and atrophic bulbus could be ruled out.

The new reports helped the ophthalmologist to arrive at a treatment plan. The treatment plan that was decided was a combined eye surgery. The eye surgery planned was
 cataract extraction and penetrative keratoplasty and also ocular implantation with guarded prognosis.

But, these procedures had to wait for almost 15 days since the eye bank was yet to make ready the required cornea. But eventually the wait paid off and the promised
 cornea arrived. The patient was scheduled for operation the very next day. The eye surgery was to be conducted under general anesthesia.

The ophthalmologist was keen at operating the patient very early in the morning; sometime past 5.30 am.

The eye surgery that was done included ciliary staphylomectomy. Pupilloplasty was conducted and the anterior chamber was formed.
 Rubeosis iridis was noticed in the patient. The cornea was removed and replaced. All the procedures were carried out under general anesthesia.

The patient was advised rest for almost 10 days. The checkup by the ophthalmologist post 10 days of the surgery revealed that there was no rejection of the graft, and the corneal button had a normal appearance. The
 anterior chamber was clear with a mild hyphema.

The patient had to leave the country and hence he was prescribed oral steroids and the course would last for 3 weeks.

The patient is now doing quite well and his eyesight has been successfully restored.
 

Stem Cell Therapy - The Miracle that Allogeneic Mesenchymal Stem Cells Did to a Small Girl Injured in a Shooting Accident


The medical travel to India that a small international patient undertook changed her life for ever. The following is her case.

A shooting accident resulted in bullet shrapnel piercing into the spine of a small girl. The spine injuries the girl suffered snatched away from her, the ability to walk. She suffered great agony and was in constant pain in her legs. She became totally bed ridden.

Since there was no treatment available in her country for her disability, she had to undertake a medical travel to India. It is merely through word of mouth that the girl's relatives became aware of the facilities available at our hospital and they immediately decided to seek medical treatment at our hospital. They decided to undertake a medical travel to India only because many of their compatriots too were treated at our hospital and were doing pretty well. They hold our hospital in high esteem.

The relatives sent in the girl's case report to our hospital, and the expert doctors of our neurology department suggested that the girl should undergo stem cell therapy.

Once the patient had flown down to India for her medical treatment, she was immediately admitted to the hospital, and the treating doctors conducted the necessary investigations on her. Doctors at our hospital realized that her spinal cord was pierced by more than 100 splinters from the bullet during the accident. Any surgical treatments to treat the problem is not available, or is known to be existent, during this point of time for such cases.

The treating doctors realized that the only treatment solution available to them at this point of time was stem cell therapy. Accordingly, the treating doctors performed intrathecal injection of allogeneic mesenchymal stem cells on her.

Within weeks of the stem cell treatment marked changes were noted in the small girl. The girl no longer felt pain in her legs. Her condition gradually improved and she was advised physiotherapy.

In some weeks time, the girl who suffered great pain in her legs and was disabled, was able to walk on her own feet.

Stem cells therapy is an emerging medical treatment and the miracles it is worthy of creating are just but being revealed. This small girl's case is one such instance. When her relatives had lost all hopes of the girl ever being able to walk, they placed their last hope upon our hospital and stem cell therapy. Their belief in our hospital and stem cell therapy eventually paid off, and she was able to walk again!

Stem cell therapy is continuing to reveal miracles at our hospital, and this is but one of the numerous cases of patients recovering from fatal spine injuries at our hospital. The uses of stem cell therapy is multitude and our hospital continues to put it to good use, thus changing the lives of numerous of our patients.

A medical travel to India can be a life changing experience when the medical treatment is carried out at our hospital, and numerous of our international patients are bearing witness to this truth.

The patient testimonial to this particular case can be viewed by following this link: http://www.youtube.com/watch?v=LXgQt8khhV0

The girl was discharged from the hospital by the end of February, 2012.

After six months of the treatment the girl was able to walk, but only with ample support.

After about nine to eleven months, the girl was able to walk on her own.



Heart Surgery - A Complicated Case of Mitral Valve Repair and Coronary Artery Bypass Graft (CABG)


A 65 year old man from Middle East presented with a case of severe chest pain and breathlessness. He had a previous history of myocardial infarction. He was moderately built. He presented to us his medical records such as current ECG, Echo, and a complete case history written by his family physician. The medical records were perused by the expert panel of cardiology and they advised that an angiogram and CATH study be performed on him for further evaluation, since the records the patient presented did not give the doctors the complete picture about his condition. The evaluation done at the hospital revealed multiple blocks in the Coronary Artery, which required immediate surgical intervention. Also revealed was a leaking mitral valve which required immediate correction.

His blood examination revealed high creatinine levels, which meant that the patient may have a renal failure after surgery, and which may require dialysis. Doctors assured that the surgery had a success rate of 80%, but they also discussed with the patient’s relative about the risks and complications associated with the surgery. The relative was in acceptance to the doctor’s suggestion of surgery and was ready to go ahead with the corrective procedure. The relative was also made aware that the mitral valve repair had a chance of failure, and if it were to fail, then a mitral valve replacement may be required. The mitral valve replacement had a success rate of 95%.

The patient was posted for mitral valve repair and CABG, and the surgery was successfully done. He was in the Intensive Coronary Care Unit for 7 days.

Later on, he was shifted to the ward and was stable. He was discharged from the hospital after a fortnight.
The patient and his relatives were really content that they had decided in favor of the surgery, despite it being a very complicated one.