Being diagnosed with coronary heart disease can be disheartening. Fortunately, there are excellent treatments, doctors and facilities to provide treatment and therapy. At Medical Referrals, we have over 50 experienced cardiologists and cardio-thoracic surgeons to provide a comprehensive range of treatments and , and impeccable care for cardiovascular problems.

Coronary artery disease – CAD – is among the leading causes of death, but with timely detection and appropriate treatment and care, including surgery, you can save your heart.

CAD Basics CAD occurs when one or more coronary arteries are narrowed or blocked  by artherosclerotic plaque builds up on the arteries that supply blood to the heart. If a blood clot – thrombus – forms on top of thisplaque, the artery becomes completely blocked and blood supply is compromised. That is when a heart attack ensues.

When Does Coronary Artery Bypass Graft (CABG) become unavoidable?

Coronary Artery Bypass Graft  - or, heart bypass surgery – is one of the surgical treatments recommended to treat patients
with serious narrowings and blockages of the heart. CABG is performed to relieve angina in patients who have failed medical therapy and who are not good candiodates for Percutaneous Intervention (PCI). PCI is a procedure where a small balloon is used to inflate the blocked artery, and it is followed by the insertion of a stent to increase coronary artery blood flow.
According to Medical Referrals consultant, Dr. Ong Kim Kiat, Cardiothoracic Surgeon, Gleneagles Hospital, Singapore – CABG is one of the most commonly performed major operations.
CABG is useful for patients with multiple blocked coronary arteries. This condition is often found in patients with diabetes.
CABG has been found to improve long term survival in patients with significant narrowing of the left main coronary artery and multiple arteries, especially in those with decreased heart muscle pump action.

CABG – A Delicate Procedure With Concrete
Results
This surgery involves harvesting and sewing a section of vein from the patient’s leg, or chest, to create a bypass around a section of a blocked or diseased artery. This new route provides an oxygen-rich blood supply to the heart so that it works properly.

Usual time spent in hospital: around a week
Success rate: 90%

Other Surgery Techniques

Besides traditional CABG. here are few new heart surgery techniques -

Off-Pump CABG

This technique allows for surgery on a beating heart – the surgeon does not use a cardiopulmonary bypass. Using special
equipment to stabilize an area of the heart, the surgeon goes to work. The use and benefits of Off-Pump surgery depend on the surgeon’s experience and the patient’s risk profile.

Medical Referrals’ specialist Dr. Sim says, “This type of surgery is challenging because the heart is moving. Because of this, it is not an option for everyone. Generally, the benefit is greater for older and higher risk patients.

Minimally Invasive Coronary Artery Bypass Surgery (MIDCAGB)

This surgery is performed with a small incision, about 3-4 cm. It may be done without stopping the heart, and some patients
can even leave the hospital in 48 hours. In traditional CAGB surgery, the surgeon needs to split the breastbone. MIDCABG is less painful, and recovry is much faster. However, this procedure is only used for patients whose blockages can be bypassed through this small incision and whose risk of complications is low.

Surgeons today, such as Dr. Naresh Trehan, use robotics to assist in performing this delicate surgery.

Endoscopioc Vein/Artery Harvesting

This technique has been shown to improve recovery and reduce infection and complications. Instead of making a long incision around the length of the leg, the vein or artery can be harvested through keyhole surgery – a small incision of 1 cm. This is used as a graft to bypass the blockage.

Stem Cell Transplant

“This treament holds promise for patients whose hearts are permanently damaged and beyond repair. It involves injecting new cells - either the patient’s own myoblast (muscle stem cells) or stem cells from the blood to replace damaged cells,” Says Dr. Sim.

In certain clinical studies patients’ damaged heart muscle improves after stem cell therapy.

How Successful Is Heart Surgery?
Complications following heart surgery are uncommon, says another Medical Referrals consultant, Dr. Ong at Gleneagles, Singapore.

Dr. Ong says, “In many patients undergoing heart or bypass surgery, the risk is less than 1%.”

However, although bypass surgery improves blood supply to the heart, it does not cure the underlying CAD.
Results and long term outcome depend in part on following healthy lifestyle recommendations and taking medications as
directed.

    If you need to check out high quality care, accredited surgeons, procedures, or rates for

        * Coronary Angiogram
        * Coronary Artery Bypass Graft Surgery (CABG)
        * Coronary Angiogram KIV PCI (Immediate)
        * Percutaneous Coronary Intervention

    send your query and details in an email to

    medreferrals@gmail.com

 

While the politicians debate, Ethan Ewing, president of Bills.com has put together these 10 ways to save on medical care:

1.   Keep up to date with checkups – Do not skimp on care to save a few dollars, especially if a health condition requires regular monitoring. Also be sure children get all necessary vaccinations. How to save: Many insurance plans cover well-child and preventive care visits with a low or no co-payment. Or look into health care clinics (such as those offered at some drug store chains) for discount exams and vaccinations.

2.   Ask for a discount – Some doctors give patients a cash discount for paying out of pocket. Patients with health insurance should be sure the physicians they see are in the network for a deeper discount on fees. How to save: Talk to the manager of patient accounts about the situation. Many providers and facilities will offer discounts of 10 percent to 50 percent for those who have lost their jobs or who can pay cash up front.

3.   Save with a FSA – Anyone whose employer offers a flexible spending account (FSA) should take advantage of it. An FSA allows employees to have money deducted, pretax, from their paychecks for medical care. For a $1,000 annual deduction, employees might save up to $350 (depending on the tax bracket). How to save: Look at canceled checks, bills or credit card statements to determine how much you spent on medical care last year. Then request withholding of about 80 percent of that amount, to be safe. However, if you do not spend the full amount deducted, you will lose it.

4.   Save on medications – Ask doctor if a generic medication will work as well as a brand-name one. Also investigate any possible discounts, from insurance to AARP to AAA. Mail-order pharmacies sometimes allow customers to order several months of medications at a big discount. How to save: Look at all the options, including discount medications from warehouse club and discount/chain stores, to find the best deal on needed medicines.

5.   Wear a helmet – Follow the same rules children should follow: Wear a helmet while on wheels. That includes skates, scooters, bicycles, motorcycles and skateboards. Also protect heads from injury when skiing or snowboarding, horseback riding, rock climbing or engaging in other potentially risky activities. How to save: A safety helmet costs less than $30. The average cost of care for a moderate brain injury is nearly $1 million.

6.   Get the flu vaccine - A flu shot or inhaled flu mist can avoid a bout of nasty illness, with days or even weeks of associated time off work. How to save: Flu shots typically cost about $25. Save more by seeking out a local nonprofit organization that counts part of the fee as a tax-deductible charitable donation.

7.   Read medical bills - Some experts estimate that eight of 10 medical bills contain errors or inflated charges. How to save: Ask for an itemized bill and read it carefully. Protest any erroneous charges to negotiate a lower fee. Review payments from insurance providers for accuracy, too, since providers often require patients to pay any difference between their usual charges and what the insurance company pays.

8.   Stay trim - A study released last week claims that obesity accounts for 9 percent of all U.S. medical costs. In addition, an obese person has $1,429 per year more medical costs, or about 42 percent more, than someone of normal weight. How to save: Eat moderately and exercise to keep body mass index below 30.

9.   Avoid the Medicare “doughnut hole” – Medicare-eligible patients with Part D prescription coverage must watch for the coverage gap, also known as the “doughnut hole.” After patients spend a certain amount on prescription drugs, they must pay all drug costs out of pocket until they reach a higher level of prescription expenses. Currently, Medicare Part D coverage stops at $2,700 and resumes when the patient’s out-of-pocket cost reaches $6,154 per year. To make things worse, Medicare applies the entire retail cost of drugs — not just the patient’s co-payment — to the coverage limits. How to save: Ask physicians to prescribe lower-cost or generic medications whenever possible. Less-expensive drugs can help postpone entering into the doughnut hole and make the coverage gap more affordable.

10.   Consider medical tourism - It sounds exotic, but it is no longer just for jetsetters. In 2007, 1.5 million people traveled just to Thailand for medical care. Even some U.S. insurers are coming on board to allow Americans to travel overseas to receive more cost-effective medical care such as knee replacement or other costly procedure How to save: Many insurance companies do not cover overseas procedures, so ask first. For those who must pay out of pocket, traveling might be worthwhile. Be sure to go to a medical facility accredited by the Joint Commission International to help ensure reliable, quality care. Medical tourism companies can help locate a reliable provider, but be sure to proceed very cautiously.

An additional tip on medical travel from Medical Referrals: If your treatment costs are over US$ 800, you should talk to us!

Call us or email us for any further information that you may need.

Vikkesh Khetarpal

Mobile: +91 9873062688

   

And ask us about our robust safety standards, quality assurances, tight monitoring – and really good prices.

 

Medicity Construction Underway At Gurgaon, India

Always at the leading edge of treatment + technology, Dr. Naresh Trehan also keeps people on their toes, even in times of recession. His passion is Medicity, one of India’s largest projects in multi-specialty tertiary care medical treatment – and construction is in full swing here. It is envisioned as an institute that will redefine standards of excellence in healthcare delivery by bringing together the best of infrastructure, technology, training, education and medical intelligentsia.

In 1969 Dr. Trehan was one of hundreds of Indians who went to to the United States. By the mid-1980’s was earning over $1.5 million a year as a Manhattan heart surgeon. Then he did what few Indian doctors do: he came back, prompted largely by the Indians who kept showing up on his operating table and asking why they could not get the same quality of care back home. He was driven to return, he said, by ”a certain amount of arrogance — a kind of national pride.”

‘‘I could do things better than most of my American counterparts,” he said.

He decided against practicing in an established hospital. Instead, with an industrialist backer, he founded his vision of a private heart institute and research center, The Escorts Heart Institute and Research Center and pioneered many aspects of cardiac surgery.

Today, he’s on a tryst with a new destiny with Medanta Medicity.

WHAT”s Unique about Medicity? Medicity aims to functionally integrate within one campus and one management the facilities of medical care, teaching as well as research and development. It also offers to explore the possibility of integrating knowledge of traditional and alternative medicine with modern medicine, through means of scientific research.

Medicity Views – when completed

With an investment of over $350 million, Medicity aims to create a world-class education and training centre backed by remarkable infrastructure, futuristic technology – that’s the extraordinary vision of Dr Naresh Trehan.

Medicity will offer a 1600 bed medical institute of world standards. The objective of Medicity is to bring in global healthcare delivery standards at affordable prices while firmly placing India on the international road map as premier destination for healthcare services, medical research and high-end medical diagnostics.

Besides offering the best of preventive and curative medicine, Medicity also offers to explore integrating the knowledge of traditional and alternative medicine with modern medicine, through means of scientific research.

Specialities

Medicity will provide integrated primary, secondary and tertiary care services spanning over 20 super-specialties and high-end services in:

• Cardiology and cardiovascular surgery
• Oncology (including medical, radiation and surgical oncology services)
• Neurosciences (neurology and neurosurgery)
• Musculo-skeletal (advanced orthopedics, joint replacements, rheumatology and physical medicine)
• Transplant services
• Minimal access surgery including robotic surgery
• Nephrology
• Advanced pediatrics, neonatology, gynecology and obstetrics
• Ophthalmology
• Internal medicine and respiratory medicine
• Plastic and reconstructive surgery
• Gastroenterology and hepatology
• Dermatology
• Dental and oral health (including oral and maxillofacial surgery)
• Endocrinology
• ENT
• Geriatrics

Traditional Medical Practices

An important objective of Medicity will be to validate – and integrate with modern medical system – those medical practices in our traditional and complimentary systems of medicine such as Ayurveda, Unani, Siddha, Tibetan and tribal systems that are compatible with science.

Perhaps Dr. Trehan would agree with Isaac Disraeli who said “It is a wretched taste to be gratified with mediocrity when the excellent lies before us.”

Medical Referrals Asia has the honor of listing Dr. Trehan among its Authors and Contributors.

Link

https://medrefasia.blogspot.com/2009/11/fieldnotesmedanta-medicity-update.html

Mr.K M Lal is a director with a media organization in New Delhi, and he provides counseling support to renal transplant patients at Medical Referrals.

I was diagnosed with Acute Renal failure in 1999. At the time, I lived in Gorakhpur, India, and was treated there for a year. One of the hardest things to come to terms with was that medication is just treatment, but not the cure. Kidney failure can be alleviated with medicines but not for long.

My symptoms were

• Swelling, especially of the legs and feet
• Little or no urine output
• Thirst and a dry mouth
• Rapid heart rate
• Dizziness
• Loss of appetite, nausea, and vomiting
• Feeling confused, anxious and restless, or sleepy
• Flank pain – pain on one side of the back, just below the rib cage and above the waist.

I came to New Delhi to the All India Institute of Medical Sciences (AIIMS) for further treatment under the care of Professor S. C. Tiwari.

My Whole World Turned Upside Down

Quite honestly, I was in a state of shock when I was told that my kidneys had failed and was told the consequences: seizures, bleeding, coma – and ultimately, death.

I am blessed with two children and I have a very loving wife. We have healthy habits and lead normal lives. None of us, before my diagnosis, had encountered prolonged illness. I don’t drink or smoke. I had a responsible position in an organization. What happened?

At 43, my whole world suddenly turned upside down. My biggest concern was that as the only earning member in the family – how would I take care of my home, children, the whole responsibility of the household – and along with all of this, the expense of my medicines and my treatment, all in the same package. It was a very tense period for me,

There is no specific treatment shown to unequivocally slow the worsening of chronic kidney disease. Diagnosed with severe CKD, the recommendation from Dr. Tiwari was to have a kidney transplant.

I could not put off having a transplant operation, and began the process of looking for a donor.

The first hurdle was: none of my family members had the same blood group match.

Legal vs. Illegal Alternatives

In India, the only way to have a transplant operation is if a family member donates an organ. That route looked like it was shut for me. I also visited the Singapore facilities to Discuss the status of Emotionally related donor and the legalities. Medrefasia guided me and was at my side all the way through in India and in Singapore.

Life was much easier with their support and backing. The doctors provided me complete support and gave a petient ear to my problems. Medrefasia people updated me of all developments taking in the case much before the doctor came in and told me about it.

There are legal ways to obtain a kidney and there are illegal ways. I considered what the consequences of taking the illegal route were. It is illegal to follow that route, but it is not illegal to consider it.

The first thing that occurred to me as I considered it was, even if I did get a kidney replacement, who would verify that it was healthy? Who would verify that the donor’s blood group was a match? Which organization would guarantee that the entire transplant process would be successful with an organ with suspect origins?

The entire transplant process would be a fiasco.

Before abandoning this pathway, I also looked for evidence that there actually were successful transplant surgeries conducted with illegally obtained organs – and the statistics were horrible. The recipients mostly died of infection or poor blood matching, or a variety of other complications.

An angel appeared!

I am highly grateful and thankful to my sister-in-law. She is like an angel to me. If I am here today, and sharing my experience with you all, it is only possible because she donated a kidney to me, and saved my life. When all the doors looked like they were shut, my sister-in-law offered one of her kidneys.

There is a myth that the donor suffers after she donates an organ but I must tell you this is untrue. The donor remains absolutely healthy and does not suffer from any ailments. There is a whole process that a donor goes through, including a thorough medical check and psychological evaluation and counseling which last several weeks.

Gratitude

My transplant has been successful. It has been 6 years. Looking back, I don’t really know how things fell into place. I know I had God on my side and am so grateful to the doctors who treated me – they were God-sent angels.

After the transplant, life has returned to normal – in other words, I have the same kinds of stress and accomplishments as anyone else.

Initially however, I lived in great fear of infection and organ rejection. The doctors assured me that they would let me know if there really was something to worry about, but I couldn’t shake the fear. Finally, I was told that one way to move past the fear could be to take on counseling other people who were facing the situation I had been in not so long ago.

Pay It Forward

I undertook training to be a counselor, and provided support to several hundred people at AIIMS for a few years, and that was hugely satisfying. It was my way of giving back to people – and, without even realizing it, I lost a paralyzing fear.

If you have a question, or need assistance in any way, I am now available here at Medical Referrals.  Please email me, or contact Vikkesh. His organization played a major role in my recovery, and you could not have better professionals on your side.”

Stem Cell Transplant: Hope & Life

For 22 year old S. Vigneshwaran blood cancer could have spelt the end. “We had lost all almost everything in five years of treatment. But my classmates took up the matter with my department head and they started raising funds.” The students of Anna University’s Guindy Engineering College raised a massive US$ 90,000, halfway to the estimated US$1,80,000 needed for stem cell therapy.

That’s when a philanthropic South Indian businessman stepped in to fill the gap.

Diagnosed with acute myeloid leukemia went through agonizing times. When they stumbled across possible treatments in stem cell therapy, they looked for options in India but ran across stumbling blocks:stem cell samples from from blood relatives did not match; and there was no cord blood bank in the country.

That’s when an unknown Australian donor stepped in to fill in the other gap. Mount Elizabeth Hospital, Singapore, a Parkway hospital stepped in, and within a week, located the donor.

The end of the road for Vigneshwaran’s AML was when Singaporean Dr. Patrick Tan, Mount Elizabeth Hospital performed the transplant. Two years later, this week, he has been declared cured of a disease where once, untimely and tragic death was considered inevitable.

Cross Border Health is much more than medical tourism.

The engine that drives it is international co-operation, co-ordination and collaboration in the interests of patients. Vigneshwaran’s case also brings into focus the need for active government participation in encouraging stem cell research and therapy in India, support for patients in the face of astronomical costs, and the need to allow foreign donor participation in the country.

Vigneshwaran’s Dream

Vigneshwaran hopes that his story of successfully fighting the disease will encourage hundreds of blood cancer patients and their family members to opt vigorously for stem cell therapy.

The End of the Superstitious approach to Stem Cell Therapy – the start of a worldwide political and scientific movement

Stem Cell research and therapy has been shadowed by skewed opinions and religious undertones. The issues are too wide to discuss in a blog. Suffice it to say that there is movement on the issues.

For example, recently,

Indian Union Minister for Science and Technology, Kapil Sibal, said the Department of Biotechnology (DBT) will invest approximately US$ 5 million over a period of two months for strengthening stem cell research in the country.

And to  present the icing on the Cake

President Obama will begin the process of dismantling barriers to research in the US in this vital area that promises effective treatments for grave diseases like Alzheimer’s, Parkinson’s and diabetes.

 

Referance

1. K PraveenKumar, Times of India 07 Mar 2009.

Link

1. https://epaper.timesofindia.com/Default/Scripting/ArticleWin.asp?From=Archive&Source=Page&Skin=pastissues2&BaseHref=CAP/2009/03/07&PageLabel=1&EntityId=Ar00105&ViewMode=HTML&GZ=T

Year            - 2009

Venue         -JaslokHospital Mumbai

Consultants – Dr Madan Bahadur treating Nephrologist, Dr Sameer Shah Hematologist, Dr Ganapati Bhat Oncologist

In a rare case Mr Singh the renal transplant patient a senior engineer in the Indian Government was struck by an explosive type of cancer Multiple Myeloma – Big boils erupted across his body that impaired his ability to sign and speak.  This is a rare instance where the renal transplant patient was struck by Myeloma. The treating doctors at Jaslok were put in a quandary as to what is causing it and how to fight it. The intake of Immunosuppressant (drugs which reduce the immune system of the body to accept the transplanted organ), which are a must for every transplanted patient, was helping in the acceptance of the transplanted kidney but at the same time was enhancing the growth of the Myeloma. The stopping or reduction of immunosuppressant would grievously hamper his renal transplant and put him at a grave risk

The doctors decided to udergo another transplant on the patient, but this time a bone marrow transplant using the patients own Stem Cells. No Transplant patient in India had ever undergone a Stem cell transplant as a rescue mission against Cancer.  This medical marvel proved to be a boon for Mr Singh who not only survived the Ordeal but was victorious. His recent PET (Positron emission tomography) scan shows complete eviction of the cancerous cells and complete recovery of the patient. Though the patient is being monitored regularly and is living his life at peace with complete abandon of the disease but the Doctors who have treated him are busy preparing the white paper for the filtering of the information to the world about this major Medical breakthrough.

Mr Singh becomes the first patient in Medical History across the world to undergo this treatment. Generally renal failure is a known complication in Multiple Myeloma patients and they undergo a Bone marrow transplant first before the renal transplant says Dr Hase a renowned Nephrologist at KEM hospital Mumbai. Whereas, Mr Singh has gone in the opposite direction, has become of great academic interest to the scientific minds of the World.

This Medical breakthrough allows us to believe that India is achieving Medical glory and the endeavors of the Indian Medical minds are scaling new peaks everyday. The advent of Medical Tourism and the inclination towards India in the growing numbers every year is certainly justified. In the coming years we are very sure of the South asian and south east asian countries taking the lions share of this Industry with the growing need of healthcare and rising costs in the west is making destinations like India, Singapore, Thailand, Malaysia, Uzbekistan etc the flavor of the month. They seem poised to show a sharp upside in the growth of this industry.

Stem cell transplants related and unrelated have been performed at various Asian destinations regularly and have shown significant and respectable clinical results. Recently India and Singapore have shown high inclination with dedicated research and registries specially for these procedures. And these breakthroughs are corroborating their developments and earnest desire for cures of the incurable a few years ago.

Referances

1. Malathy Iyer, TOI story 2009 , July 27

Links

1. https://epaper.timesofindia.com/Default/Scripting/ArticleWin.asp?From=Archive&Source=Page&Skin=pastissues2&BaseHref=TOIM/2009/07/27&PageLabel=1&EntityId=Ar00101&ViewMode=HTML&GZ=T

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