India has emerged as a leading healthcare destination for the people from all across the globe.The world class hospitals infrastructure ,expertise of Indian doctors,reasonably low cost of medical treatments,flexible accommodation rentals have made India a preferred destination for global medical traveler.
We are guided by the aim of bringing in transparency in specialized medical treatment of our Global guests,delivering true value of money,health to sick and smile on ailing faces.
Successful bone Surgery for Nigerian guests in India-CMCS Health.
Mr Ugwu Chinenye is a bright young man from Nigeria. He met with a road accident in Nigeria and suffered multiple fractures. Surgery was done at a hospital in Abuja, Nigeria but after many months of surgery and having his leg in repeated plaster casts, the bone could not join. It made him walk with a big limp and that too with a walking stick.
The family doctor in Nigeria recommended the guest to us with X-ray films of the patient.
We discussed the case with leading orthopedic surgeons of New Delhi and Gurgaon and selected Dr Raju Ishwaran at Max Hospital for his surgery.
After receiving their passport scan copies, we sent them a visa assistance letter and treatment offer letter and helped them procure Medical and medical X visas for patients and attendants.
On their arrival in India, we received them at the Airport and took them to their guest house booked for them for their India stay as per their choice and budget.
They were immediately given two prepaid SIM cards and Internet connectivity on their arrival in India for communication with family members back home.
As per their scheduled appointment, they were taken to the hospital for consultation with their treating doctor at Max Hospital, Saket, New Delhi, India.
The treating doctor at Max Hospital recommended certain tests for Mr. Ugwu to decide on the treatment course and budget after evaluation.
Proper evaluation and transparency in medical treatment play a big role in the successful outcome of treatment. We atCMCS Healthpractice strong professional ethics for our Global guests's best benefit.
A proper explanation by the treating doctor before the start of surgery/treatment prepares the patient better mentally.
Guest Mr. Chinenye was given an estimate for surgery and explained about the treatment course and expected outcome. The doctor has decided a redo surgery for him with an implant for the joining of the bone, surgery was also intended toCorrect the shortening of the limb.
The guest was admitted to the hospital one day before surgery and after essential tests before surgery, surgery was performed the next day by the treating doctor.
Recovery was quick and smooth for the guest and soon he was made to walk after surgery.
The guest was discharged from the hospital after successful surgery, with instructions to walk with crutches and not put weight on their legs for at least three months.
Post-treatment sightseeing and shopping for gifts for people back home in Nigeria.
Drop to the Airport after successful surgery, good memories of India, and a smile on face.
Important Links about Nigerian Patients' Medical Treatment in India:
Since a good number of Global guests prefer to come to India for their specialized medical treatment, it is opening newer avenues for people associated with Indian Medical and healthcare Industry. At Complete Medicare Solutions , We are all geared up to provide the best of the services to our Global guests. The motive and driving line for us at CMCS Health is to bring in total transparency and deliver satisfaction and value for money for our global guests coming to India for their specialized medical treatment. Many guests now come to India for Knee and Hip joint replacement as well as other Orthopaedic surgeries.The cost of joint replacement surgery in India is much lower than anywhere in world. Our Specialist orthopedic doctors are at par with any best orthopedic surgeon in world in expertise and on hand experience. We are using best quality of implants from world leaders in orthopedic implant manufacturing companies like Zimmer, Smith & Nephew and Johnson & Johnson. The specialized Orthopedic surgeries performed by our expert and well experienced doctors are:
Arthroscopic Surgery:
Arthroscopic surgery is the surgery performed by trained and experienced orthopaedic surgeons by using an arthroscope. Arthroscopic surgeries are minimally invasive surgery and are generally used to examine and treat many medical conditions of joints,including torn cartilage or “meniscus”, torn surface (articular) cartilage, ACL reconstruction, and trimming of damaged cartilage.The advantage of arthroscopic surgery over conventional open surgery is reduction in post surgery recovery time and better success rate because of less damage to connective tissues.
Knee joint replacement surgery is performed when the conservative treatment fail to give desired results in patients of osteoarthritis, rheumatoid arthritis or psoriatic arthritis.Knee joint replacement surgery may involve a partial or total knee joint replacement. The diseased or damaged surface and cartilage of knee joint is replaced with metal and plastic implant to restore mobility to knee joint. Knee joint replacement surgery is performed generally for debilitating pain arising because of meniscus tears ,cartilage deformity or degeneration, ligament tears , a sudden bone trauma in young patients and elderly patient suffering from advanced arthritis . Minimally invasive surgeries are performed now for shorter hospital stay and quicker recovery time. Our doctors give the choice of implants to our global guests depending on the age and requirement of patients. Best quality imported implants are used for excellent results.
Post knee joint surgery care and management:
The treating orthopaedic surgeon makes a complete follow up and rehabilitation plan for the patient post knee joint replacement surgery. Certain care is advised for knee joint replacement patients that are a periodic elevation of legs for preventing deep vein thrombosis, lower leg exercises for proper blood circulation, supporting stockings and in certain cases blood thinning medication for a period. Other precautions include prevention of fractures and infections, physiotherapy regimen for attaining complete motion of the joint. Patient has to walk initially with help of walkers or crutches to avoid full body weight on the new joint. Complete recovery from a knee joint surgery and full movement of joint may take up to three months.
Hip Joint replacement surgery:
Hip joint replacement surgery is a surgery performed to replace the faulty and diseased hip joint with a prosthetic implant. Hip joint replacement may be partial or complete.Hip joint replacement surgery is performed for arthritis affected hip joints. A hip Joint replacement is considered by orthopaedic surgeon, when all conservative treatments fail to give pain relief to patient. Hip joint replacement surgery can be performed both by traditional way and by minimally –invasive technique.
Post Hip joint replacement care and management:
Certain precautions have to be taken from six to 12 months after hip replacement surgery, pivoting or twisting on the involved leg needs to avoided. Patient should also not cross the involved leg past the midline of the body nor turn the involved leg inward and avoid bending at the hip past 90 degrees. This includes both bending forward at the waist and squatting. After the hip joint has healed, certain sports or heavy activity should be avoided. Patient should keep in mind that the replacement joint is designed for usual day-to-day activity.
Other Orthopaedic surgeries:
The other routine surgeries like repair of fracture of femoral neck surgery, repair of trochanteric fracture , repair of rotator cuff tendon, repair of radius/Ulna. Repair of femoral shaft fracture, repair of fracture of Tibia /fibula, surgery for Repair of bones that have not joined properly ,surgery for correction of shortening of limbs, Surgeries for congenital bone defects and surgery for trauma and sports injuries are performed by expert orthopaedic surgeons of India.
Rehabilitation plays an important role for early movement post surgery; we are associated with Best Indian Hospitals and Orthopaedic surgeons with well experienced Physiotherapist for our global guests.
In our earlier blog about commonly asked questions about breast cancer , we have discussed about signs and symptoms of breast cancer , risk factors , diagnosis and various treatment options for breast cancer treatments in India.In this blog we are going to discuss a chronic but serious complication of breast cancer treatment - Breast cancer related lymphedema(BCRL). Lymphedema usually occur in breast cancer treated patients after about 4 to 6 weeks of surgery or radiation and then go away over time. The most common type of lymphedema is painless. It tends to slowly develop, most often within 3 years of surgery. It does not get better without treatment.
Almost 1 in 5 breast cancer patients who have undergone breast cancer treatments develop lymphedema. Lymphedema is a chronic complication of breast cancer treatment. Usually it occurs within weeks of treatment and subsides on it's own.But it can occur at anytime in the lifetime of breast cancer treated patient and if not prevented or treated early , it can be permanent and hampers the quality of life of a successfully treated breast cancer patient.
What is breast cancer treatment-related lymphedema ( BCRL):
Lymph is clear watery fluid that drains out from the blood capillaries into body tissues. The major functions of lymph are as follows:
Drains out the extra fluid consisting of toxins and other waste products, formed due to metabolism between the cells into blood stream.
Lymph helps in absorbing the fats and proteins from small intestine by transporting it to blood stream.
Lymph also contains white blood cells that form the immune system of the body to fight again infections.
Because of breast cancer or breast cancer treatments ( surgery and radiation therapy ) the fluid drainage channels of lymphatic system are hampered and the lymph fluid can not be drained out quickly and start getting accumulated causing the area to swell causing lymphedema. Lymphedema can develop in the arm or hand of the affected side. It can also develop in chest,breast,shoulder,trunk or on the back
If Lymphedema is not treated in time it can get worse. It can be painful and moving the affected arm or hand will be difficult.
Signs and symptoms of Lymphedema:
Lymphedema may have a slow onset of swelling in the arm , hands or fingers of the affected side or it could be acute too.
An unusual sensation in the hand of the affected side , usually numbness or tingling even before the swelling is noticeable.
Symptoms of lymphedema post breast cancer treatment may include:
A recent change in skin either in appearance or texture such as itching , tightness, redness , rash or tightening.
Feeling of discomfort , achiness , tingling or increased warmth in affected area hand , chest, breast or underarm.
Feeling fulness or heaviness in affected area arm , chest , breast , underarm, shoulder or back.
Tightness or difficulty in moving shoulder , hands and wrists.
tenderness in the elbow
Burning or shooting pain sensations that may seem like pricking with pins and needles.
Slight puffiness or swelling in arm, hand, breast, or chest with a temporary indentation of the skin when one presses on it with one's finger (this is called pitting edema).
Veins or tendons in the hand that are harder to see, knuckles that look less pronounced, or once-wrinkled skin that looks smoother.
Fever or flu like symptoms
If one observe a sudden swelling in the arm , hand , chest , breast or underarm , one must seek medical attention asap as it may indicate an infection, a blood clot (also known as deep vein thrombosis), or cancer recurrence that is affecting the lymphatic system.
What are risk factors associated with breast cancer treatment related lymphedema:
Any event that might damage the lymphatic vessels and interrupts the channels of lymph drainage systems can be the causative factor for development of lymphedema or it's flare up. All the breast cancer treatment modalities including breast cancer surgery , Radiation therapy for treating breast cancer or even chemotherapy increases the risk of one's developing lymphedema post breast cancer treatments.
Breast cancer surgery as causative factor for lymphedema:
( Lumpectomy ) along with involved lymph nodes specially the axillary lymph nodes in the armpit area. But a breast cancer surgery may also cause lymphedema in breast cancer patients. Your breast cancer surgeon and healthcare professionals will advise you the preventive measures to avoid lymphedema post breast cancer surgery.
An extensive breast surgery for treating breast cancer can disturb the lymph drainage channels of lymphatic system and may become a causative factor for lymphedema. Total mastectomy as compared to lumpectomy increases the risk more.
Axillary lymph node dissection ( ALND) largely determine a breast cancer patient's risk of developing breast cancer treatment related lymphedema ( BCRL).
Both extensive axillary lymph node dissection ( ANLD) as well as less extensive Sentinel lymph node biopsy ( SLNB) increases life long risk of developing breast cancer related lymphedema ( BCRL) in breast cancer patients.
Sentinel lymph node biopsy ( SLNB) is an effective option for staging the axilla while minimizing the risk of lymphedema in patients with clinically node negative breast cancer patients.
A lack of breast reconstruction post breast cancer surgery also increases risk of developing BCRL.
Breast cancer radiation therapy as causative factor for BCRL:
Radiation treatments for breast cancer can affect the lymphatic system. Scar tissue from radiation therapy may press on or narrow the lymph vessels and nodes that remain after breast cancer surgery. This damage interferes with the flow of lymph out of the arm and upper body.
Regional lymph node radiation ( RLNR) is also a causative factor for breast cancer treatment related lymphedema ( BCRL).
Regional lymph node radiation ( RLNR ) either supraclavicular with or without posterior axillary boost significantly increased the risk of breast cancer treatment related lymphedema risk compared to breast or chest wall radiotherapy alone.
Lack of breast reconstruction post breast cancer surgery as a causative factor for BCRL:
Mastectomy ( total removal of cancer affected breast ) itself is a major risk factor for breast cancer treatment related lymphedema , recent studies suggest that patients who have not undergone a breast reconstruction surgery post breast cancer surgery stand a higher chance of developing breast cancer treatment related lymphedema.
Chemotherapy induced breast cancer treatment related lymphedema:
Chemotherapy for treatment of breast cancer can be given both prior to breast cancer surgery or post breast cancer surgery. Certain breast cancer treatment chemotherapy protocols involving taxanes ( paclitaxel or docetaxel ) are also associated with increased risk of breast cancer treatment related lymphedema.
Intravenous chemotherapy may increase lymphedema risk if it’s placed in the arm on the same side of breast cancer surgery and lymph nodes removal.If chemotherapy is given IV through the pick line , it should be given from the opposite arm.Any picking with a syringe either to collect blood samples or administration of an Intravenous medication must also be done from the opposite arm of surgery side. It is advisable to give chemotherapy for treating breast cancer through a chemo port ( a small implantable device that is put in the upper chest area below the collar bone and under the skin ). It is used to draw blood and give treatments — including chemotherapy drugs — without a needle stick. A chemo. port can remain in place for weeks, months or even years.
Obesity and living a sedentary life style as a causative factor for BCRL:
People who live a sedentary life style and are obese ( overweight ) are more prone to develop breast cancer treatment related lymphedema post breast cancer treatment.
Sometimes the extra fat in obese women put pressure on lymph nodes and vessels and consequently disturbs the lymphatic system channels. Any disturbance in lymphatic system channels hampers lymph flow and drainage and thereby fluid build up takes place causing lymphedema.
Eating healthy and doing regular and suitable physical activities ( exercises ) not only keeps your weight in check but also reduces the risk of developing BCRL.
Any injury or infection can flare up BCRL:
A breast cancer patient may have fewer lymph nodes due to breast cancer surgery and any injury or infection can cause inflammation to body tissues. This inflammation may make the lymphatic system work harder because of increased blood flow and lymph fluid.
When one's lymphatic system can not cope up with this increased blood flow and lymph fluid due to infection or injury , a lymphedema can occur or gets flared up.
Air travel as causative factor for BCRL:
Air travel specially long distance flights or changing to connecting flights may increase the risk of flare up of Breast cancer related lymphedema.
Although it is not proven but theoretically there is a strong possibility that the
hypobaric–hypoxic environment inside the aircraft,
coupled with low cabin pressure, and the protracted
reduced movement and dehydration experienced on
flights, might be
sufficient to incite or exacerbate breast cancer treatment related lymphoedema( BCRL).
How you can reduce risk of BCRL post breast cancer treatment:
Taking good care of arm on the surgery side.Your breast cancer surgery team doctors will advise you to elevate the affected arm a few times a day for the first 24 to 48 hours after surgery. You will be advised when it is safe to prop up the affected arm on pillows.
You will be advised to stretch your arm to workout the underarm. Most of lymph nodes are located in the armpit ( underarm) area. You may also be advised to lift the affected arm at shoulder height or above your head to restore the mobility and reduce chances of shoulder stiffness.
Always inform the laboratory technician or nursing staff to prick the needle in the opposite arm for blood sample collection or medicine administering. Also blood pressure should be measured ( putting the blood pressure band) on the other arm.
Protect against insect bites by using insect repellent (at least 50% DEET), and carry antiseptic cream for cuts and grazes.
Limit your alcohol intake.
Keep you arm clean and moisturized.
Avoid wearing too tight sleeved clothes.
If you’re travelling to a country where quick access to good-quality medical care is difficult, ask your GP for a course of antibiotics to take with you in case of infection. If you develop signs of infection in your ‘at risk’ arm or hand, treat the infection as early as possible, even if there’s no swelling.
Diagnosis of breast cancer treatment related lymphedema (BCRL):
Following diagnostic procedures are employed to diagnose a BCRL.
Sequential circumferential arm measurements.
Water displacement.
Infrared Perometry.
Bioelectrical impedance analysis.
Management of breast cancer treatment lymphedema (BCRL):
Once the BCRL is established in a breast cancer treated patient , there is nothing like a complete cure currently but providing symptomatic relief and avoiding complications of BCRL are the objectives of BCRL management. Management of lymphedema focuses on swelling reduction and symptom alleviation while minimizing exacerbations of swelling. Treatments include pharmacological therapy, surgery, complete decongestive physiotherapy (CDT), mechanical pneumatic pumps, and infection prevention and treatment.
Following procedures are employed for helping the BCRL patients.
Pharmacological management of lymphedema uses benzopyrones, flavonoids, diuretics, hyaluronidase, pantothenic acid, and selenium.
Surgical treatment for lymphedema includes microsurgical lympho-venous or lympho-lymphatic anastomoses, debulking, and liposuction.Surgery does not cure lymphedema, use of compression is necessary after surgery. Surgery for treatment of BCRL have it's owns cons like recurrence of swelling, poor wound healing, and infection. Surgical treatment should only be considered when other treatments fail, and with careful consideration of the benefits to risks ratio.
Chronic lymphedema leads to formation of excess subcutaneous adipose tissue secondary to slow or absent lymph flow.Liposuction can help to remove excess fat tissue.Liposuction increases skin capillary blood flow without further damaging already compromised lymph transport capacity in breast cancer survivors with lymphedema. Patients are able to maintain limb size reduction with the use of compression garments after liposuction. Liposuction does not correct inadequate lymph drainage and is contradictory when pitting edema is present.
Complete decongestive therapy (CDT) is the standard care for lymphedema.This approach includes manual lymph drainage, multi-layer, short-stretch compression bandaging, gentle exercise, meticulous skin care, education in lymphedema self-management, and elastic compression garments.
( This information is copied from Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management
Mei R Fu)
Fu MR. Breast cancer-related lymphedema: Symptoms, diagnosis, risk reduction, and management. World J Clin Oncol 2014; 5(3): 241-247 [PMID: 25114841 DOI: 10.5306/wjco.v5.i3.241])
Feel free for any clarification or getting opinion from the best Indian breast cancer treatment specialists. You can send your queries to us on WhatsApp no: +91 9582056061.
Medical Treatments in India with Best Doctors in Best Indian Hospitals.
Leukemia or Leukemia can be classified as group of cancers that originate in Bone marrow and are characterized with abnormally high number of white blood cells . These while blood cells are not fully developed WBCs and are termed as blasts or leukemia cells. These abnormal WBC suppress the production of normal blood cells that ultimately culminate in anemia and other symptoms.
What are various Types of Leukemia :
Leukemia or Blood Cancers can be classified into sub-types depending on the time of disease progression and type of cell that has undergone the genetic mutation.
When the cells are multiplied rapidly and the onset of disease is fast it is termed as acute whereas when the onset of disease is slow and the symptoms are barely noticeable it is called chronic.
When the genetic mutation occurs in the myeloid cells the leukemia is termed as Myelogenous Leukemia whereas when the lymphocytes undergo the genetic mutation the leukemia is called lymphocytic leukemia. Depending on these characteristics disease Leukemia can be classified in four major sub-types.
Acute Myelogenous Leukemia (AML)
Acute Lymphocytic Leukemia (ALL)
Chronic Myelogenous Leukemia (CML)
Chronic Lymphocytic Leukemia (CLL )
In this series about various Blood Cancers ( Leukemias) and their treatment in India ,The first one is about Acute Myelogenous Leukemia ( AML).
Acute Myelogenous Leukemia (AML):
AML is the mutation in immature blood cells on the myeloid lines. In AML Patients there is an over production of immature WBCs ( Blasts) ,which occupy the majority of Bone marrow and hinders the production of normal blood cells. As there is reduced production of normal blood cells ,AML patient will be prone to anemia , bruising and bleeding easily and recurrent infections. The leukemic blast cells eventually overflow into blood stream and can get accumulated in other organs like liver,spleen,lymph nodes,central nervous system ( spinal chord and brain) and testicles.
Signs and Symptoms of AML:
What are Risk factors associated with AML :
Following factors are identified as higher risk for developing AML.
1.Smoking:
Smoking is the only proven life style related factor for AML. Researchers attribute about 20% of AML cases to smoking tobacco.
2. Radiation:
High dose radiation exposure (As in case of a survivor of Atomic bomb blast or nuclear reactor accident) are at a higher risk of developing AML most often about 6 to 8 years of exposure. Radiation treatment for cancer also increases the risk of AML. The risk varies with the amount of radiation and the treated body part.
Continuous Low level radiation exposure like from X Ray machines and CT scan machines are also linked to risk of developing AML in foetus in formative years , that is the reason doctors practice to limit the exposure in children and pregnant women.
3.Chemical Exposure:
Long term exposure to certain chemicals like Benzene is considered a risk factor for AML. Benzene is a solvent used in the rubber industry, oil refineries,chemical plants, shoe manufacturing, and petroleum-related industries, and is also found in cigarette smoke, gasoline and motor vehicle exhaust, and some glues, cleaning products,detergents, art supplies, and paints.Unconfirmed researches also link heavy exposure to formaldehyde as a risk factor for AML.
4. Chemotherapy Drugs:
People who have undergone chemotherapy with medicines like cyclophosphamide,procarbazine,
chlorambucil,melphelan,busalphan,cisplatin,carboplatin,epirubicin and doxorubicin for treatment of other cancers are also at a higher risk of acquiring AML later on.
5. Certain Blood Disorders:
Certain blood disorders are also associated with increased risk of AML. Chronic Myeloproliferative disorders put the sufferer at a higher risk for AML.
Myelodysplastic syndrome (MDS) may develop into AML if not treated in time.
6.Genetic Disorders:
People born with certain genetic disorders are at a higher risk of developing AML. Genetic disorders like Fanconi Anemia,Bloom Syndrome,Kostmann syndrome,Neurofibromatosis Type 1,Diamond-Blackfan Anemia, Le Fraumeni Syndrome increases the risk of AML.
7.Age and Gender:
Although AML can occur at any age but men above 50 are at a higher risk of AML. AML is more common in men than women.
HOW AML is diagnosed ?
Once you approach a doctor for your sickness and symptoms usually after an abnormal CBC (Complete Blood count ),doctor will take your family history , do a physical examination paying special attention to your eyes,mouth,skin,lymph nodes,liver ,spleen and will look for areas of bleeding and bruising or any possible infection. Your risk of Having a Leukemia will also be assessed by the doctor. If your doctor suspects your sickness to be leukemia,he will order a CBC and peripheral blood smear.
Depending on these test reports your doctor may refer you to a Hematologist ( An specialists of blood diseases).
At CMCS Health ,we are associated with well qualified and experiencedHematologistsfor best treatment of our global guests.
A hematologist will have to diagnose your disease ,staging of disease and suitable treatment options if you are suffering from AML.
The Following tests and scans will be recommended by your Hematologist for confirmation of diagnosis,staging and deciding about treatment course.
Bone Marrow Tests:
The samples for the two tests are usually taken from the back of pelvic ( hip) bone, which are carried out simultaneously.These two tests are :
Bone Marrow Biopsy
Bone marrow aspiration
The other tests and screenings are:
CSF ( Cerebro-spinal fluid) samples are collected through a Lumber puncture or spinal tap if your doctor suspects that the disease may have spread to brain and spinal chord.It is also done for administering the chemotherapy drugs either to prevent the leukemic cell invasion of CSF or treat the spread of disease to brain and spinal chord.
Routine microscopic examination
Cytochemistry
Flow cytometry
Florescent in situ hybridization ( FISH)
Polymerase chain reaction ( PCR )
There may be other imaging tests recommended by your treating doctor ,not for diagnosing AML but for staging and gauging the spread of disease. These tests may include chest X rays,CT scan ,CT guided needle biopsy,PET/CT, MRI and Ultrasound.
Treatment Of AML:
Treatment of AML is mainly chemotherapy , sometimes chemo is given along with a targeted therapy drug, Bone Marrow transplant or Stem cell transplant are also used for patients who are in higher risk of relapse of disease.In special circumstances Radiation therapy and surgery is also combined with Chemotherapy.
For Any Queries regarding medical treatment of Leukemia or Blood Cancers in India with Best Indian Specialist Hematologists at well equipped Indian Hospitals please contact at:
Life Saving-Cost Effective-Organ Transplant in India | CMCS Health
Today India is one of the leading destinations in Asia for Life Saving - Cost Effective -Organ Transplants in India. Total transparency in proceedings ,Ethical modus operandi,Globally at par competency and expertise of Doctors and paramedical staffs,modern and well equipped treatment centers have made India the sought after country among the global population for an organ transplant.
The history of Kidney transplant in Indiadates back to 1970's and since then India has consolidated its position not only among the natives but among the people from all across the Globe.The beginning of Kidney transplant surgery in India in the first few years of it's inception was involved with grooming of surgical skills and mastering the immunosuppression for acceptance of the newly transplanted graft in the recipient and minimizing the graft rejection.With passage of time,the success rates achieved with advent of newer immunosuppressive medications and growing in expertise of surgery skills are phenomenal.
As all the new beginnings are surrounded by controversies ,the live donor organ transplants program was also marred by the news of organ trading and commercialization from many quarters.
Indian Government on it's part passed the The transplantation of human organ act (THO) to curb the menace and regulate the live donor organ transplants in India which made the selling and purchasing of humans organ for transplant a crime and approved cadaveric organ transplant after the brain death of a healthy person as a viable option for the patients advised an organ transplant by the medical specialists.
Since the cadaveric donation is still in a nascent stage there is a huge shortfall or gap in the demand and supply for patients seeking an organ transplant to overcome an end stage disease of kidney,liver, bone marrow,lung,heart or pancreas.
Certain amendments have been made since then by the government to regulate the organ transplantation for end stage diseases. The New amendments allow a live donor organ transplant from close relatives with strict guidelines.
As per the new ruling of the government of India, for regulating the Organ transplant in india following parameters are to be met:
For a live donor Kidney or Liver Transplant the Following people are considered as related donors:
The blood relative who are allowed to donate for a end stage organ failure patient are Mother,father,son,daughter,brothers and sisters and a husband/wife. After much deliberations Grandparents and grandchildren are also included in list of blood relatives.A DNA /HLA test is done to determine the relationship of donor and recipient along with other legal documentations for proving them to be blood relative,in front of Government of India appointed Organ transplant committee for approval.
In case there is no blood relative available for a patient,other relatives may also be considered as live donor with proper documentation and proofs of their being relatives and that the donation is being done only because of altruism and affection and no financial gain for the donor or pressure of any sort is put on the donor. Again the donor and recipient have to appear in front of Government of India appointed organ transplant committee for approval with all relevant documentation and a personal interview.
Cadaveric Donations have still not picked up as desired and there is a huge gap between the recipients waiting for a donated organ and cadaveric donations. Now because of awareness created by certain NGO's and government bodies the cadaveric donations have very slowly started picking up,but still the gap between demand and supply is mammoth.
Doctors ascertain that for a Live donor Kidney transplant , the donor have to be a healthy individual between the age of 18 years to 55 years.
The renowned Kidney disease and kidney transplant specialist of India ascertain the risk and post donation life of a live Kidney donoras safe and without any foreseen complications. The risk for live donor's single Kidney going bad are similar to that of a person with both kidneys.
A through screening of the donor before transplant,ensures that there is no abnormal risk to donor and post donation life of the donor.
The expertise of doctors and post transplant Paramedic and ICU staff,well equipped and well managed hospitals have made the live donor kidney and liver transplant see a success rate of almost 95%, with no major or abnormal risk to life and post donation life for the donor.
Precautions for a transplanted kidney to last you your lifetime - CMCS Health.
Congratulations!
You have a successfulKidney transplant. The newly grafted kidney is functioning well in your body. You do not require Hemodialysis anymore.
Many of the patients think that after a successful kidney transplant, they are perfectly healthy and can do anything they want to do as they were doing before they suffered CRF or ESRD.
True! You are no longer dependent on Hemo-Dialysis, But you must take adequate precautions to make the new grafted kidney last you your lifetime.
When you return home after a successful Kidney transplant, you want to drive yourself, pursue a sport you were enjoying before your kidney disease, go to a movie or market, or any other crowded place, want to entertain guests at home, want to restart your intimate life with your partner.
You can do many of these things, but in moderation and with proper guidance and following instructions from your kidney transplant doctor's team.
Your Medications:
Your Body has a God-gifted immune system to ward off infections and form a defense mechanism.
Since the newly grafted kidney is not your own body part, your body's defense mechanism will take the graft as a foreign material and will attack the new kidney as a natural attempt to protect you. This may lead to rejection of the new kidney by your body. To save the new kidney from being rejected by your body's immune system. Your transplant team doctors will prescribe certain medications called immune suppressant medications. These medications are your lifeline as they protect the newly grafted kidney. Remember these basics about your life-saving medications.
Your Transplant team doctors will prescribe your medication depending on the lab. Tests are done to know the exact dosage required. Never ever increase or decrease the dosage of your anti-rejection medications on your own or without your KTP doctor's approval. Do not change the brand of medicines, you were prescribed by your doctor.
The Medicines prescribed to you have a biological half-life, so to maintain the presence of your medicines in your blood all the time, you must strictly adhere to the dosing schedule prescribed by your doctor,i.e. exact prescribed dose at a particular time of the day, every day. Do not delay the medicine time or jump the dosing schedule. You can put an alarm on your mobile phone to keep you reminded about your medicine time.
Always carry your medication with you, when traveling or going out of the house, so you do not miss your dosing schedule.
Stock an adequate quantity of your medication, so you do not miss your dosing schedule if you run out of stock before your next supply.
Always keep a list of your medications and dosing schedule prescribed by your KTP Doctors with you.
Do not take any over-the-counter medicines, for any short-term medical condition without approval from your KTP doctors.
Keep the medications in a place as recommended on the medicine box, do not expose them to overheated or damp places.
Keep a regular check on the expiry date of your medications, to avoid consuming expired medications.
Do not discontinue your anti-rejection medication no matter how great you feel, even if you think your transplanted kidney is working well. Stopping them may cause rejection to occur.
Your KTP Doctors will recommend periodic testing of blood levels of your anti-rejection medications to ensure the right dosing, Keep on doing these recommended blood tests at told intervals and inform your KTP doctors without fail so they can tailor the dose as per your body's requirement. Many transplanted patients slacken in this routine once they feel perfectly healthy, which exposes them to the risk of graft rejection.
If you are diabetic or hypertensive, You will be required to keep a regular check on your blood pressure and blood sugar and take the prescribed medicines accordingly, as uncontrolled high blood pressure and blood sugar are major reasons for your kidney going bad.
Precautions for warding off Infections:
Since you are on Immunosuppression medication to avoid rejection of a newly transplanted kidney, you are prone to the dangers of acquiring viral and other infections easily. Following precautions need to be taken by a kidney transplant patient to keep on living a healthy disease-free life and save the kidney graft.
Maintain good personal hygiene, like brushing off your teeth and cleaning your mouth after meals, wearing clean and sterilized clothing, and washing and sanitizing your hands frequently and before eating. Avoid getting shaved at parlors that use the same razors for many people. While getting haircuts tell your barber, to use proper precautions and use a new disposable blade.
Avoid eating outside food or food cooked and served in unhygienic conditions, improperly or half-cooked foods. Fruits and vegetables must be properly washed and peeled off to avoid consuming pesticides or other impurities and disinfectants. Follow the diet plan prepared by your KTP team dietician. Avoid eating too much sugary, fatty, and fried foods. Ensure proper fluid intake as advised to you.
When going to crowded places like cinema halls, airports, hospitals, buses or railway stations always cover your face with medical masks prepared for the purpose of warding off infections. Avoid shaking hands with many people.
Avoid being around people who are suffering from contagious infections.
.Tell the lab technician while at a pathology lab for blood tests to take adequate precautions.
Regular and proper Follow-up with your KTP doctors team as advised:
After a successful Life-saving Kidney transplant, your KTP team will give you proper guidelines and instructions for follow-up. You need to follow up on these instructions in totality.
You need to contact your KTP doctors team immediately if you have any of these abnormal symptoms:
A fever higher than 100 Degrees Fahrenheit. Flu-like symptoms such as chills, aches, headaches, dizziness, nausea, or vomiting.
Fluid retention ( Swelling or Edema )
Sudden weight gain ( greater than 4 pounds and within 24 hours.
New pain or tenderness around the transplanted Kidney.
A significant decrease in urine output.
Maintaining a healthy lifestyle:
Exercise regularly :
The key is moderation and understanding your limits as a person, who has just undergone surgery. Your body is still weak and will take its own time to return back to full strength, so you should not push your body initially. Walking is the best exercise to start with. You can start with what time your body permits you without tiring it too much and gradually increase the time.
Do not start doing strenuous exercises and lifting weights initially as is not advised in any stomach surgery for at least three months.
Regular exercise post-kidney transplant helps a kidney-transplanted plant gain overall improved health as it improves blood circulation, and helps in controlling blood cholesterol, blood sugar, and body weight. Regular exercise increases endurance and improves muscle tone and the functioning of the lungs and heart.
Driving:
Driving is not advised for the initial 2 to 4 weeks post-kidney transplant as your body may suffer from tremors, weakness, and blurred vision till the time you get used to your post-transplant medicines. These effects of medicines may last for a few months. Once your body gets used to your medications, with your KTP doctor's permission, you can resume driving.
Sexual Activity and Fertility:
The most frequently asked question by a transplanted patient. A person's sexuality is affected when they suffer from CRF or ESRD. Men may suffer from impotence and loss of sex drive while women's menstrual cycle may become irregular or stop completely. Post kidney transplantation some of the aspects affecting the sexuality of a CRF or ESRD patient will definitely improve. Chronic fatigue experienced by a kidney patient diminishes post-transplantation and improved health makes sexual life more enjoyable. Men will have fewer problems in gaining and maintaining an erection while women will resume normal menstrual cycles and overcome lack of vaginal lubrication during coitus.
Sexual activity was not very important before the transplant but with improved health post-transplant, it comes higher on your agenda.
It is common for transplanted patients to resume living a normal life as they recover, and active sexual life is no exception.
For women, it is important to maintain good hygiene before, during, and after as they are more prone to urinary tract infections because of being on immunosuppression medications. Urinating before and after coitus and drinking more water reduces the chances of acquiring a UTI.
In case you get infected with UTI, consult your KTP doctor for the same.
Managing Diabetes:
Corticosteroid like prednisolone (Wyesolon) increases the blood sugar level but after two months when the dosage is reduced, it will start becoming normal. You may require your diabetes medicines or insulins to keep your blood sugar levels in check as advised by your doctors. Your doctors may advise a controlled carbohydrate diet and regular exercise to keep your blood sugar in check.
Managing Blood pressure:
The targeted blood pressure for a kidney transplanted patient is less than 130/80. You will require your blood pressure medicines to continue post-transplant under the supervision of your doctor. Doctors will advise you blood pressure medication, and keep your weight in check by advising exercise and a low-salt diet.
Maintaining a normal Lipid Profile:
Many kidney transplanted patients may have higher blood cholesterol and lipid profiles due to side effects of medication, gaining weight, poor diet, lack of exercise, a family history, and proteinuria in certain cases. Your KTP doctors will suggest a heart-healthy diet, regular exercises, and lipid-lowering medication for keeping a check on your lipid profile.
Controlling Obesity:
Weight gain is common after a successful transplant. However, being overweight may make you prone to heart disease and New-Onset diabetes post-transplant. To avoid being obese a kidney transplant patient should take a healthy, balanced diet and exercise regularly to burn extra calories.
Bone Disease:
Bone diseases in a transplanted patient are called chronic kidney disease-related mineral and bone disorders. (CKD-MBD ). It may cause your bones to be brittle and prone to easy fractures. Your KTP team may recommend routine blood tests for calcium, phosphorus, parathyroid hormone (PTH), and vitamin D.
Gout:
Due to side effects of your kidney transplant medication like cyclosporine, your body may find it difficult to excrete excessive uric acid from the bloodstream. High blood uric acid results in the deposition of uric acid crystals in joints causing swelling and pain termed as Gout. Certain dietary control may be advised by your doctors like cutting down on red meat, seafood, sugared soft drinks, and alcoholic beverages, especially beer.
Travel:
Traveling should be avoided in the first two months after the transplant to cut down the chances of infection. If traveling to another continent, you may require certain vaccinations to protect you from any epidemic disease prevailing. You must also carry a sufficient quantity of your post-transplant medications with you.
Vaccination:
Live vaccines like Varicella Zoster, BCG, smallpox, intranasal influenzas, Live oral typhoid Ty21a, measles, mumps, rubella, oral polio, yellow fever, and live Japanese B encephalitis vaccines must be avoided.
Vaccines that can be taken after consulting your KTP doctors team are DPT, Haemophilus Influenza B, Hepatitis B ( Before transplant), Hepatitis A, Pneumovax, Inactivated polio, Influenza types A & B, Meningococcus ( In high-risk cases), and Typhoid.
Skin Care:
Corticosteroids like Prednisolone (wyesolon) may cause acne on your face, shoulders, chest, or back. Cyclosporine may cause these areas to be oily. Wash this area thoroughly with water at least three times a day every day. Avoid vigorous rubbing or scrubbing, instead use a wet washcloth and mild soap to remove accumulating oils, dead skin, and bacteria. Avoid using soaps that contain oils or cream-based.
Eye care:
Kidney transplant patients are advised to have annual periodic eye check-ups with an ophthalmologist. Prednisolone (Wyesolone) can cause cataracts and changes in vision.
Dental Care:
You should brush your teeth at least once or twice every day, Use mouth rinse after meals to avoid accumulation of bacteria.
Quitting smoking:
Kidney transplant patients must quit smoking after the transplant to avoid complications and chest infections.
Pregnancy:
Pregnancy may occur after a successful kidney transplant. Your KTP team will advise you to avoid pregnancy in the first year of the transplant. Proper monitoring by your KTP team and Gynecologist is needed for the safety of both mother and baby and dose adjustment of your medication may be needed.
Click on the following Useful Links to Learn More About Kidney Transplant in India.
