Mr Stan Ayres
I contacted The Taj Medical Group in Warwickshire for help
with seeing a Cardiac Specialist in INDIA for my heart condition
– I required a procedure called Radio Frequency Ablation.
Dipa Jethwa Dipa Jethwa of The Taj Medical Group made all
the arrangements for my wife and I to go to India - flights,
visas, consultations etc. - The Taj Medical Group referred
me to see Dr. Chetan P. Shah M.D. (Medicine), D.M. (Cardiology),
FACC, FACP (USA) a US Board Certified Surgeon at Wockhardt
Hospital in Mumbai.
I attended this hospital for investigations into my Atrial
Fibrillation, which I only became aware of in 2000 when
I was 67 years of age. After 6 days of intensive research
and every conceivable test possible, they advised me that
the possible short term gain of reverting back into regular
sinus rhythm could not be sustained and the risks outweighed
any possible short-term gain. I appreciated their honesty
and the fact that their decision was for my benefit and
to their financial loss.
Because I had seen the professionalism and dedication of
all the Medical and Nursing Staff, I had the confidence
to request consultations with the Urinary and Vascular Surgeons,
who agreed to resolve my Urinary/Prostate problems also
to strip the varicose veins from my right leg. These procedures
were carried out simultaneously and excellent aftercare
in the ICU. During these procedures the Cardiac Consultation/Surgeon
was on call, should there have been any remote problem arising.
Having felt no pain at all during or after surgery, stimulated
me to have my hip x rayed, the outcome was that it had completely
calcified over the years and should be operated on at a
later date.
With less than 6 days to go before I left for the UK, I
asked to see the Dental Surgeon, she immediately spent three
and a half hours on my mouth, next day impressions were
taken, following day checks on the fit of the porcelain
teeth produced and finally on the fourth day she adhered
the top and bottom sets of tooth on top of the stumps of
my old teeth. I could not have received such excellent service
from any other hospital throughout the world.
Right from being met at the airport in the early hours
of the morning the unmatchable care demonstrated by all
the Nursing Staff, the beds being changed and the suite
being cleaned daily by the boys, the friendliness and approachability
of the consultants and doctors, makes me unable to praise
and thank them all sufficiently. I am prepared to allow
anyone to contact me at any time to ask me questions about
the events during my 20-day stay with them. My wife slept
in the same suite as myself, which facility is available
to husbands or wives, partners, relations etc so that the
patient has support from a loved one. In closing the charges
made were unmatchable in the UK or throughout Europe. I
assume this applies generally worldwide. We made friends
there.
My sincere thanks to all concerned – Dipa Jethwa
at The Taj Medical Group, the Surgeons and nurses at Wockhardt
Hospital in Mumbai.
Stan Ayres, N. Wales, UK
Mr Stan Ayres
Comprehensive Cardiac Evaluation plus Dental Treatment
June 2006
Mr Anthony Bestwick
Hi Dipa,
Yes, I'm well, thank you.
Perhaps you would like to use the attached story (see
copy below) I wrote for the AFIB Report?
As you will see, it summarises my AF story and also paints
Escorts and The Taj Medical Group in a favourable light.
The AFIB Report is available worldwide to all who suffer
(or have suffered from) Atrial Fibrillation from 1st June.
Many will read it. I hope it may
bring you further introductions in due course.
You can use this article free if you wish as long as you
define and acknowledge my authorship and copyright. I guess
I can also send you a photo
if you wish. If you wish to delete reference to the Medical
Tourist Company, that is OK as you were the people who arranged
my visit.
Best regards, Anthony
Mr Anthony Bestwick
Atrial Fibrillation
June 2006
The AFIB Report
June 2006
Page 7
My AF Story – Or ‘How it Zaps You When
You’re Not Looking’
by Anthony Bestwick
My story starts some 12 years ago in those heady days
when the world didn’t seem to have quite so many problems
as it does now. I was a 50 year old silversmith with my
own small business in a small town on the coast of Devon,
in the south west peninsula of the United Kingdom, and spent
my leisure time collecting rocks, exploring the old tin
and copper mines of Devon and Cornwall, playing the melodeon
and bodhran in the local pubs, and flying small aeroplanes
from nearby Dunkeswell aerodrome, a one-time US Navy wartime
bomber base flying Liberators across the Bay of Biscay.
I had been divorced for a few years after a long marriage
and was, emotionally, on the fragile side of neutral, though
I doubt I would have agreed with that if you’d mentioned
it then! As is the way of these things I’d eventually
found myself with a new girlfriend and that, dear reader,
is where my story really starts.
We split up. Nothing really unusual about that, although
it was as always painful, but this split coincided with
one of my frequent bright (or, in this case, not-so-bright)
ideas. I’d lose weight. Go on a diet. Not eat very
much. In fact, not eat at all. I certainly was not overweight
at 13 stone (184Lb) but summer was coming and I was determined
to lose a few pounds to be able to get into my summer shorts.
Now, I don’t know whether you’ve tried not eating
but I don’t recommend it. In my case it brought on
quite persistent pangs of hunger and a distant rumbling
from down-under which, try as I might, I could not ignore.
I cast around for some way to lessen the noise and my gaze
fell on ….. the coffee maker, with its usual welcoming
smile, in the corner of my office-cum-workshop.
And so it came to pass that, in the same week as the emotionally
draining split from my girlfriend, I came to live on strong
black coffee – as black as the night and as strong
as the bond between miser and dollar. The coffee machine
happily worked overtime, spewing out great mugs of the stuff
in response to my ever-increasing hunger pangs until I looked
more like a coffee picker than an English silversmith.
By the third day I began to suffer bouts of what I fondly
thought was indigestion, a general rumbling and banging
inside which reminded me very much of an old car I once
had. I ignored it, and carried on with the coffee therapy
but by the following Monday, a full seven days after the
start of my crash diet, I felt unwell enough to take the
monumental plunge of visiting my local doctor, to complain
about my indigestion.
I duly arrived at the appointed hour, expecting –
indeed resigned – to be given some indigestion medicine
and be sent on my way with a flea in my ear for wasting
his time. But no! ‘Come in’ he said ‘you
don’t look terribly well’. ‘No’
I said ‘I think I’ve overdosed on coffee and
it’s given me indigestion’. ‘Well’
he said ‘let’s just listen to your ..….
Nurse!’ he shouted ‘get the ECG equipment ready’.
And that, fellow afibber, was the first time I knew I’d
got a problem!
To cut a long story short, my ECG showed the usual and I
was whisked off to the hospital in nearby Exeter, a rather
grand place smelling of disinfectant and full of ill people.
I say ‘whisked’ but in the absence of any form
of public transport including an ambulance I was apologetically
asked if I would make my own way there, which I did. On
arrival at the hospital I was taken to a ward, made a fuss
of, given a loading dose of sotalol and asked to get into
bed. Now, I have to confess that I don’t like hospitals.
Even less do I like wearing pyjamas or getting into bed
in the daytime – and anyway, I only had indigestion
– so this now became a battle of wills. ‘I’m
not taking my jeans off’ I said. ‘You must’
they said. ‘I won’t’ I said, ‘I’m
not ill’. Well, we eventually compromised. My jeans
didn’t come off but I did eventually get into bed,
though only when it got dark. They didn’t really mind.
They were very good.
I was hooked up to a variety of machinery and told that
cardio-reversion was going to be done the following day
but, during the night, my heart went back into sinus and
the following day, to my great relief, I was given my freedom
and let out. Before leaving I’d had a long chat with
a heart specialist who told me that I had had Atrial Fibrillation,
probably caused by too much caffeine, and that it would
probably now be a feature in my life. ‘One more thing’
he said ‘You’d better tell the Civil Aviation
Authority about this’.
I did, and they very unhelpfully suspended my flying medical
certificate. That was the first impact that AF had on my
life. There were to be others …….
After discharge from hospital I had, as a follow-up, the
usual thyroid test and echo-cardiogram, all of which proved
to be normal. Slowly, I reverted back to my usual way of
life and resumed ‘business as usual’ apart from
the flying, which I really missed. Months went by, and I
started to think that it had all been a bad dream. I began
to rediscover my love of strong black coffee when suddenly,
out of the blue, wham! AF again.
This time the episode did not last long, just a few hours,
but I knew then that the original ‘happening’
had not been a one-off and that AF was probably here to
stay.
In those far off days ablation was very much in its infancy
in the UK and only done for flutter – to some extent
it still is even today, as we shall see – so the solution
put forward by medical opinion in the form of the local
doctor offered nothing more than pills. True, there was
available an intriguing variety of pills and as many as
I could eat, but pills are something else I don’t
much care for. I decided this was not an option.
Months passed with a few minor episodes of AF, all of which
reverted to sinus within a fairly short time but which nevertheless
made me very conscious that ‘I had a problem’.
As these months passed I became more and more determined
that the solution – for me – would be to beat
this thing on my own terms. I began to realize that, to
some extent and in some people, AF is life-style problem
and so I determined to find out, as far as was possible,
what might be triggering these episodes in me.
First, my coffee machine was consigned to history, though
I subsequently bought another when I realized you can make
thoroughly decent decaffeinated coffee which tastes just
as good as the stuff with caffeine! I had always taken several
grams of vitamin C a day but I now included a whole range
of other vitamins and health supplements and made serious
efforts to determine what part of my daily life might be
causing my AF.
Eventually, through trial and error, I found that caffeine,
emotional sadness, hard cheese, bananas and sleeping on
my left side were the main triggers for me. Alcohol, to
my delight and the relief of the world’s wine growers,
has never been a trigger but I know that it is for many.
I only ever drink red wine in moderation and the occasional
beer when playing my melodeon (though not at the same time)
so it may be that spirits do not agree with me, but red
wine and the odd beer certainly do.
Time passed and I formed a folk band with a banjo-playing
friend, and then a delightful lady who sings and plays the
guitar also joined the band. Dear reader, the course of
true love ran true, and this lady has now been my wife for
the past 6 years. Happiness does I’m sure lessen the
effects and frequency of AF but, to counter that, the taxman
certainly does not so I continued to have the odd episode
of AF as the months and years went by. And then, a dear
old friend died.
This friend was rather old and had been the best friend
of my own dear father, who had died when I was 13, so there
was a great bond of fondness between us, reinforced by the
fact that he did not himself have any family. By this time
my wife and I had moved from Devon to South West Wales,
where we now live, so as soon as we heard the sad news we
drove the 200 miles to where he lived and started to make
arrangements for his funeral.
By the time I arrived, I was in the grip of the worst AF
episode I had ever had. My heart was fluttering, racing
and banging like an old tin can, I had no discernable pulse,
and I was as white as a sheet and feeling pretty low.
There was no alternative but to carry on with the arrangements
and attend the funeral but after that, in company with good
friends and with a glass of red wine, I began to feel better
and as I did so my heart reverted to sinus.
But it was a terrible shock and what has since followed,
and the subsequent operation to cure my AF, is all as a
direct result of knowing that extreme sadness was always
going to trigger AF no matter how well I looked after myself.
Months passed without any further serious episodes, but
in my mind was the certainty that sooner or later this thing
would rise up and strike me again. I’d heard of catheter
ablation and had been told that it offered the best chance
of a cure, so I made real efforts to see whether this could
be done for me ‘free’ on our National Health
Service. I say ‘free’ but of course although
the NHS is free at the point of contact we do pay for it
through our taxes, and in my lifetime I must have paid for
the operation many times over.
Although kind and considerate and ready to offer a whole
warehouse full of pills the NHS – bless them, they
only get 90 thousand million pounds sterling a year in funding
– simply could not offer me catheter RF ablation for
AF. They might, just might, have been able to offer flutter
ablation if I’d waited until I was dead, but what
would be the point of that when I needed AF ablation and
wanted to get on with my life now?
The next avenue to explore was to see if the operation could
be done privately within the United Kingdom at reasonable
cost and in a reasonable time scale. Nope! £15,000
and a long wait if you were lucky enough to find someone
needing to practice the operation, in an environment where
AF ablation is a pretty new science. First of all, £15,000
was simply off the board – I don’t actually
believe there’s that much money in the world –
and secondly, I’d prefer not to be somebody else’s
learning curve. So, what to do? The usual well-known centers
of medical excellence such as the USA, Canada, France and
Germany were all very expensive or still learning how to
respond to emails. It seemed I had reached an impasse and
was doomed! And then, like a sunbeam bursting through clouds,
I discovered India!
India, as many will know, is a land of gentle friendly intelligent
people. It is a pragmatic land, an emerging world power
and – more importantly – the world’s largest
democracy. A land of the future certainly, but not, in my
mind, a world centre of excellence for medical procedures.
How wrong I was! A few simple clicks on my computer and
the amazing medical facilities of India lay before my eyes
- and there it was! At the Escorts Heart Institute and Research
Centre (EHIRC) in New Delhi I could get RF catheter ablation
for AF, including carto-mapping, for the all-inclusive price
of £2,300.
I contacted the Taj Medical Group within the UK, who can
facilitate arrangements for medical procedures in India,
and within days I had made the decision to go to EHIRC and
have the full works. Arrangements were soon made and within
weeks of discovering the medical facilities of India I found
myself at Heathrow Airport in London going through the interminable
– Take your belt off. Take your keys out. No, don’t
let your trousers fall down, shuffle through that archway
– but necessary security checks before boarding an
overnight flight to New Delhi with the excellent Virgin
Atlantic.
There can be few finer things than to arrive in India, bleary-eyed
from an overnight flight, in the morning rush-hour! Well,
perhaps a few but the first thing I saw on leaving the baggage
reclaim, apart from a few welcoming flies and the lovely
sunshine, was a smiling young Indian holding up a board
upon which was written my name in very large letters. Yes,
EHIRC had sent a chauffeured car, and the head of their
hospitality department, to whisk me off to the hospital!
Despite the traffic and the odd cow we arrived and, after
a few formalities, I was shown to a spotless room with panoramic
views of New Delhi - and a daunting array of medical machinery
on the wall above the bed.
I had many visitors during my stay, and without any doubt,
received VIP treatment from everybody. Tests started almost
immediately, and I was wheeled down to various laboratories
over the next two days for a variety of procedures which
were designed to diagnose my condition exactly and determine
the treatment required. My only real problem was with the
enormous baggy white draw-string two-part smock everyone
has to wear, which needs a masters in cunning if you are
to avoid it falling down to your ankles every few minutes.
I never quite got the hang of it. They probably still talk
about it. The tests, apart from one, were all quite reasonable
and very thorough. I was always wheeled to these tests by
two or three impossibly young but excellently trained nurses,
one to push, one to make sure I didn’t fall out and
probably one to make sure my smock stayed up. The hospital
was very busy – they do over 500 catheter ablations
per year plus every other form of heart surgery including
pediatric – and was highly efficient and superbly
well organized.
India, as you will know, is a land of Tigers and Elephants.
The Tigers tend to snack off people so are avoided but Elephants
are very popular. They come in all sizes, are usually grey
and most of them have trunks. I say ‘most’ because
some must be missing their trunks because that, dear reader,
is what they put down your throat when they do the transesophageal
echocardiogram - and they must be from fully-grown Elephants,
too.
My surgeon was the brilliant Dr. Balbir Singh, principal
consultant cardiologist working with the world famous heart
surgeon Dr. Naresh Trehan and, all tests being OK, my operation
was scheduled for the following day.
Everything went well. The AF was induced, carto-mapped and
ablated, and after 4 hours I was wheeled into catheter recovery
for a very welcome cup of tea. The operation itself consists
of feeding 4 catheters up through veins in your groin into
your heart, which sounds scary but is in fact quite OK.
The surgeon then induces the AF and maps the electrical
conductivity of the heart to determine the areas to ablate,
and then zaps these areas with RF energy.
The hospital was superbly equipped and the surgeons, doctors
and nurses are clearly as good as any in the world. The
food was excellent, with a choice of continental or Indian
cuisine (I had fish curry every day. I’d go back just
for that!) and the care and cleanliness is exceptional,
the hospital priding itself on a 0.3% infection rate. Following
my ablation I had a 24-hour Holter monitoring and then,
when that was complete and the results checked I was pronounced
free to leave. I could have stayed on in India – the
Taj Mahal is not far way – and the hospital would
gladly have arranged things for me but my wife was at home
in Wales so I was keen to return. Normally, when I find
myself in a land of sunshine and about to board a plane
to return to rain and grey skies, I have to be forced aboard
and chained to my seat but this time the allure of my wife
made me happy to skip aboard for the 8 hour flight to London
and the inevitable rain. I had been in India altogether
for 5 days, but it seemed rather longer.
As I write this it is now just three months since I returned
from India. I was told by Dr. Balbir Singh that the heart
can take this long to heal and settle down, but I have experienced
no problems so far and I am confident, as is Dr. Balbir,
that my AF really has been ablated. Time will tell, but
as each day passes my confidence increases. Did I make the
right decision to go to India? Definitely. Five days in
an excellent air-conditioned room with panoramic views,
satellite TV, Internet facilities and all the tests and
treatment for £2,300 sterling (less than 4,000 USD)
was simply amazing. Would I recommend the medical facilities
of India to anyone else who needs treatment that they cannot
get or cannot afford in the affluent west? Certainly, without
doubt. There are many world centers of excellence in India
offering almost every medical procedure.
As far as one can enjoy these things, I did enjoy my trip
to India. From the excellent Virgin Atlantic flight to the
friendliness and competence of the hospital staff, from
the delicious food to the friendships made, from the sunshine
to the allure of a new and exciting land – yes, I
did enjoy it. But I will never be able to look at an Elephant
in quite the same way again and I will never, but never
again, wear a huge and baggy white two-piece draw-string
smock with a mind of its own!
Anthony Bestwick: Anthony.bestwick@btinternet.com
Escorts Heart Institute and Research Centre website: www.ehirc.com
The Taj Medical Group: info@tajmedicalgroup.co.uk
______________________________________________________________
The AFIB Report
June 2006
Page 11
THE AFIB REPORT is published 10 times a year by:
Hans R. Larsen MSc ChE, 1320 Point Street, Victoria, BC,
Canada, V8S 1A5
E-mail: editor@afibbers.org
World Wide Web: http://www.afibbers.org
Copyright 2006 by Hans R. Larsen
THE AFIB REPORT does not provide medical advice. Do not
attempt self-diagnosis or self-medication based on our reports.
Please consult your healthcare provider if you are interested
in following up on the information presented.
Mr Russell Aiton
Russ
5 weeks post surgery
Russ with his wife, Joy in Bangalore, India
BEFORE surgery
Dear Dipa,
Many thanks for procuring the revised letter for me.
I have just returned from my GP appointment. His opening
statement was "you
look bloody marvellous!" the second commented on
the two stone in weight I
have lost and thirdly was an invite to sit down and tell
him all about my
experience!
I told him that the Taj Medical Group care package was
exemplary in its
organisation and the medical care at the hospital excellent.
Mention was
made of cultural differences in understanding/empathising
with the (Western)
carer during the stressful times, but that support from
the UK Team was
decisive and effective in managing these issues. Yes,
I told him...I would
do it again!
I discussed with him my drug and post Op protocols and
will be seeing,
probably privately, my Cardiac Consultant in the not too
distant future. All
in all, everything is very positive and going in the right
direction.
Dipa, if there is anything I can do, write, comment on
for you and your
company, or even be available for prospective patients
contemplating going
abroad for any surgery, I would be more than happy to
provide a balanced and
honest view point for them (whilst still in the UK :-)!).
If you don't mind, I'd like to drop you an email as we
progress along the
recovery and immigration roads.
Once again many, many, thanks for the life changing opportunity
you made
available to Joy and I.
Best and kindest regards
Russ
Russell Aiton, Carnoustie, Angus, Scotland
Mr Russell Aiton
Coronary Artery Bypass Graft (CABG) Surgery
September 2007
