Just after I had gone to bed after a heavy day of plenty of surgeries, I got a call from emergency room. A four year old baby has been rushed into the emergency with sudden inability to swallow & throat pain. In minutes I was there. Parents were in great anxiety & the child was crying continuously. Mother said that she had seen her playing with a two rupee coin and suddenly her condition became an emergency.

So we rushed her to X-ray department and found that the coin was stuck up in her upper part of food pipe. It was too big to go inside and too big to vomit out. It was completely stuck. It was blocking the food pipe and hence she could not even swallow her own saliva. I immediately called the anesthetist and rushed her to the endoscopy department. Although the child has dinner just few hours ago, I had to take her up and relive her from this life threatening situation.

Under general anesthesia, I entered the food pipe. Saw the coin impacted. Under anesthesia the coin had moved downwards. There was not much space in this small child's food pipe for me to manipulate it to come out. I gently pushed it into the stomach taking care that I do not damage her delicate food pipe. Once the coin was in stomach, there was ample of space for me to manipulate the coin & put it into a special wire basket that I introduced it thro my endoscope.

Under vision, I gently pulled put the coin thro the food pipe. The basket had gripped the coin so well that there was no chance that while removing the coin would fall into the windpipe or oral cavity. The parents were greatly relieved. Next morning the child was as playful as before and was discharged.

Parents should be careful about the objects that their children play with. I have removed buttons, parts of toys, coins, button cells and even pins. These are potentially dangerous and can cause sudden accidental catastrophe in the family.

He returned after two years. Last time he came for groin hernia operation on right side. Now he has returned – this time he has developed a new hernia in the left groin. He was extremely happy with the result of surgery last time and hence when he developed another hernia, he decided to come back to me again.
He flies down all the way from US. Why does he have to come to India for treatment? Simple – he has no health insurance. Health insurance in US is extremely costly. For someone like my patient who is a simple painter it is beyond his reach. Added to this is the financial recession. He had to move to a city in southern state just to get a job. Medical treatment in US without a health insurance policy is extremely costly. You can loose all your fortune if a health disaster strikes. Even if you have insurance, its difficult to get early appointment. Often patients have to wait for months to get a simple operation like that of hernia.
Groin hernia cost is almost 30 times compared to the cost that I offer. Cost for other diseases is also in same range. So flying to Mumbai plus the medical cost is still minuscule compared to fixing it in US.
US has got some of the best medical facilities. But you need money to access it. There is practically very less free treatment. Sound similar to the situation in third world. Isn't it?

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I got a call from emergency that a 32 year old female had come with severe pain in abdomen & vomiting. She had pain since five days and no she was also running fever. I went to examine her. She looked familiar. She had my old case papers. She meet me couple of years back. She had Gallstones but refused to get operated because she said it was hardly causing any symptoms.She felt that the stones were very small and her granny had carried all her life without any trouble. Now she had come with big complication. Her gall bladder stone had impacted in the neck choking the gall bladder. As a result the gall bladder was full of pus, a condition called Empyema of the gall bladder. To complicate the matters she had since her delivery developed diabetes. I took her up for an emergency laparoscopy surgery. First I evacuated the pus. his allowed me the hold & move the gall bladder so as to dissect it out from the liver. I delivered the gall bladder successfully. Took me double the average time. I had to keep a drainage tube so that the toxins from her abdomen will gradually come out. I had to keep a nasogastric tube so as to avoid fluid and gas accumulation. There was not much blood loss. She took longer time to recover but eventually did very well. If she has got operated couple of years back, she would have recovered faster and would have spend much less money. - See more at: http://drbcshah.com/waited-too-long/#sthash.YqOrR8J4.dpuf