.Brahmadev Ghadge (50) wasn’t able to report to work for eight months due to Hepatitis B-related liver cirrhosis; his son Rahul donated 60 per cent of his liver to his father. Laxman Bhogan (53) had to wait for seven months for transplant.
It was a good day for two ailing constables in Mumbai, when both received a transplant of a much-required organ after being diagnosed with serious illnesses of the liver. Both constables had been diagnosed with two different types of Hepatitis diseases, and doctors had told them that the disease had severely damaged both of their livers over the years, for which they would need to undergo a liver transplant. Fifty-three-year-old Laxman Bhogan’s ordeal began last year during Ganeshotsav, when he started suffering from symptoms like acute weakness, recurrent fluids accumulation in his abdomen and drastic weight loss.
While he was diagnosed with liver cirrhosis two years ago, doctors found that he was suffering from autoimmune hepatitis, which caused decompensated cirrhosis. “I wanted to donate a portion of my liver, but my blood group was different,” said his wife Purmila.
Doctors at Mulund’s Fortis Hospital, where he was undergoing treatment, told the Ghatkopar resident that he was on the waiting list and would be informed when the organ was available. After seven months of being bedridden and losing more than 15 kilos, the Bhogan family then received the call they were eagerly waiting for.
“A 35-year-old man who was suffering from intracranial bleeding was declared brain dead, following which his relatives agreed to donate his liver. He worked as a driver and we suspect a brain aneurysm could’ve caused the bleeding,” said Dr Rakesh Rai, senior transplant surgeon at the privately run hospital.While the surgery was successfully conducted last month, Bhogan is now recuperating at home and said he looks forward to resuming work at the Worli police headquarters. “We spent nearly R18 lakh for his liver transplant. We had to approach the central government, and then we got his monthly salary when he wasn’t able to work,” said Purmila.
“It was a struggle to get all the money and we had to borrow it from relatives and well-wishers,” she added. Brahmadev Ghadge (50) was recently diagnosed with Hepatitis B-related liver cirrhosis after suffering from similar symptoms like Bhogan.
The head constable at Byculla police station lost around 30 kg due to the disease, following which his 24-year-old son Rahul donated a portion of his liver recently, giving his father a new lease of life.“We found out just last year that he was suffering from Hepatitis B for so long that it had completely damaged his liver. He wasn’t able to work for eight months and we were then referred to Dr Rai. I offered to be the donor so my father can start living again,” said Rahul, an engineering student.The cop was recently discharged from the Mulund hospital and is now recovering from the transplant in his Vashi residence. While the Ghadge family managed to collect R13 lakh for the transplant, they got R5 lakh more through various charity organizations.
He said, “Many police constables are suffering from liver diseases but they receive no support. Most of them are from lower economic backgrounds so they have to arrange for the funds through charity which is unfair as higher police officials don’t face such issues.”
Scientific evidence shows that taking an aspirin daily can help prevent a heart attack or stroke in some people, but not in everyone. It also can cause unwanted side effects.
According to Robert Temple, M.D., deputy director for clinical science at the Food and Drug Administration (FDA), one thing is certain: You should use daily aspirin therapy only after first talking to your health care professional, who can weigh the benefits and risks.
“Since the 1990s, clinical data have shown that in people who have experienced a heart attack, stroke or who have a disease of the blood vessels in the heart, a daily low dose of aspirin can help prevent a reoccurrence,” Temple says. (A dose ranges from the 80 milligrams (mg) in a low-dose tablet to the 325 mg in a regular strength tablet.) This use is known as “secondary prevention.”
However, after carefully examining scientific data from major studies, FDA has concluded that the data do not support the use of aspirin as a preventive medication by people who have not had a heart attack, stroke or cardiovascular problems, a use that is called “primary prevention.” In such people, the benefit has not been established but risks—such as dangerous bleeding into the brain or stomach—are still present.
When you have a heart attack, it’s because one of the coronary arteries (which provide blood to the heart), has developed a clot that obstructs the flow of blood and oxygen to the heart. Aspirin works by interfering with your blood’s clotting action.
Care is needed when using aspirin with other blood thinners, such as warfarin, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixiban (Eliquis).
What about people who have not had heart problems or a stroke but who, due to family history or showing other evidence of arterial disease are at increased risk? Is an aspirin a day a safe and effective strategy for them?
Again, Temple emphasizes, the clinical data do not show a benefit in such people.
He adds, however, that there are a number of ongoing, large-scale clinical studies continuing to investigate the use of aspirin in primary prevention of heart attack or stroke. FDA is monitoring these studies and will continue to examine the evidence as it emerges
The bottom line is that in people who have had a heart attack, stroke or cardiovascular problems, daily aspirin therapy is worth considering. And if you’re thinking of using aspirin therapy, you should first talk to your health care professional to get an informed opinion, Temple says.
Finally, how much aspirin you take matters. It’s important to your health and safety that the dose you use and how often you take it is right for you. Your health care professional can tell you the dose and frequency that will provide the greatest benefit with the least side effects.
If your health care professional recommends daily aspirin to lower the risk of a heart attack and clot-related stroke, read the labels carefully to make sure you have the right product. Some drugs combine aspirin with other pain relievers or other ingredients, and should not be used for long-term aspirin therapy.
This article appears on FDA’s Consumer Updates page, produced in public inter
For the past two days, I attended the Medical Travel International Business Summit in Miami Beach. The summit was organized by ProMed, which is the Council for International Promotion of Costa Rica Medicine.
While the summit was much smaller than the 5th World Tourism and Global Health Care Congress that I attended in October 2012, nonetheless, it was informative and allowed me to finally meet a few of the people I have connected with on LinkedIn, and who have read my blog.
The first person I met on Wednesday was the woman who assisted a woman named Joy Guion, whose employer, HSM Solutions, I discussed in my post, US Companies Look to ‘Medical Tourism’ To Cut Costs. Maria Segovia is the Operations Manager for Medical Tours Costa Rica. Her company shared a booth with a company called GoEasy, a transportation company that was featured in the ABC report, and the Hotel Bougainvillea, a hotel in San Jose, Costa Rica. Maria told me about the CEO of another company, Rajesh Rao, who helped HSM send Joy and other HSM employees and their families for medical care in Costa Rica.
I spoke to Mr. Rao this morning after he gave a presentation entitled: Global Health Options: A Success story in the US Employer Market. His company, IndUShealth, is based in Raleigh, NC and was founded in 2005. They signed their first employer client one year later, in 2006, and began serving HSM Solutions in 2008.
IndUShealth is now the leading corporate medical travel program administrator in the US, and provides comprehensive medical travel administrative solutions to self-funded employers. Their staff consists of a Medical Director and experienced Nurse Case Managers. The offer wide range of surgical procedures from bariatric surgery to several orthopedic procedures, and their partners in Costa Rica are the three companies I mentioned above, and the Clinica Biblica Hospital in San Jose.
On Wednesday, I also met, spoke to and attended the presentation of William Lacy, the President and CEO of the Association for Corporate Health Risk Management, or ACHRM. His booth was way in the corner in the back of the exhibit hall (figures they’d stick Risk Management people in a corner), and I introduced myself and told him about my background and we have some things in common that might lead to something down the road. During his presentation, he discussed why medical tourism should pursue self-funded employers. He cited a rapidly changing health care delivery model and that self-funded employers are a growing trend.
Two other individuals I met there yesterday were a husband and wife who I connected with on LinkedIn back in 2012, before I even attended the MTA Congress in October of that year. Their company, Custom Assurance Placements, Ltd., (CAP) is is a wholesale insurance broker in Columbia, SC. They provide excess and surplus lines as well as admitted markets for retail insurance agencies. They also create and manage custom programs needed for a selected risk or exposure group.
According to the LinkedIn profile of the President, Tracy Simons, CAP has markets for long haul trucking, coastal property, commercial auto, workers compensation, coastal homeowners, pollution liability, non-profit organizations, international travel insurance, foreign package policies and more. In addition, they have developed a medical travel accident product for medical travelers or medical tourists which covers complications and accidents called Global Protective Solutions. They also provide liability for employers and facilitators involved in medical tourism. Tracy has spoken on risk management for medical tourism or medical travel in several countries and cities around the world including Brazil, Costa Rica, Colombia, Monaco, Spain, New York and Las Vegas.
I specifically wanted to mention these companies for a very good reason. There are a number of individuals in the workers’ compensation industry who poo-poo the idea of medical tourism in workers’ comp, whether it is for fully insured employers or for self-funded employers. While both the ACHRM and IndUShealth have worked with self-funded employers on the health care side to offer medical tourism as an option, there are companies and employer organizations out there who would probably be able to accommodate the workers’ comp industry in doing so, if they only realized that they are wasting far too much money chasing after fee schedules, negotiated prices that are still higher than what medical tourism can offer, or the favorite cost reduction program de jure. And with a company like Custom Assurance and their Global Protective Solutions company, the issue of liability and other issues can be addressed to the satisfaction of not only employers, but to carriers and medical tourism facilitators.
While going through my email, I found an article from the Workers’ Comp Insider blog’s Health Wonk Review. An article they featured from Insurance Journal, entitled 10 Challenges Ahead for Workers’ Compensation, by Andrea Wells, discussed some of the challenges that lie ahead for workers’ compensation. One area she mention was technology and innovation. Ms. Wells quoted Thomas Ryan, the CEO of Lynch Ryan & Associates, the publisher of the Workers’ Comp Insider blog , as saying the following: “When it comes to technological innovations, the health care industry’s advancements dwarf anything that’s developed in the workers’ comp industry for years.” The P/C insurance industry, Ryan says, “is very slow to innovate and is lagging behind other industries, as well as other parts of the insurance industry, in adoption and rapid movement to technology usage and innovation,” and goes on to say that “the workers’ comp industry is way behind and it must catch up.”
This is also true for the implementation of medical tourism into workers’ comp. Yes, there are barriers. Yes, there are those who benefit from and defend the broken dysfunctional system. Yes, there are others, who while calling for change, attack and criticize the very change that the health care side is looking at and that employers like HSM are offering to their employees as an option. Yes, there are politicians who get paid off by doctors, hospitals, and the other service providers to write workers’ comp rules and regulations that limit choice of medical provider and only protect the bottom-line of attorneys, doctors, hospitals and service providers. And yes, there are those, whose blind super-patriotism, egos, prejudices and knee-jerk reactions are holding back millions of injured American workers, both native-born and immigrants, from getting better medical care at lower cost, simply because they or their friends in the workers’ comp industry have a vested interest in keeping the status quo or with the increasing Latinization of the American workforce are willing to let them get sub-standard, expensive and sometimes needless treatment in the name of making a buck off of their pain and suffering.
We aren’t the best when it comes to providing health care, and there are pages and pages of data to support this and other problems we have in health care, but burying your head in the sand (or some other place) will not solve them. We need to look elsewhere, and countries like Costa Rica are providing the means and the resources to do so. The only thing lacking is the will to do it, and to swallow our stupid, vain, egocentric, super-patriotic, all-American, bullet-headed pride.