Sugam Charity and health awareness camp at Thatchankurichi, a village in South India

27th of February 2011

As part of our health awareness campaign from the charity we conducted this camp at Thatchankurichi a village in Tamil Nadu, South India. At the outset, i would like to thank the volunteers from the village without their help this would not have materialised. We would also like to thank the School Headmaster, The District Educational Officer and the Collector who have agreed for this camp to be conducted.

KMC and KMC Speciality Hospital provided their technical expertise of the Nursing School Prinicipal and the senior Nurses and their team. they worked hard over the entire session without any break. The doctors were again Dr Rajarathinam, Dr Mathimaraiselvan, Dr Geetha Ravi who worked for nothing at the end of the day, and in fact leaving their work commitments for the charitable work.

There was no treatment given at this site of the camp and no free medication were distributed. The aim of the camp to identify the problems and give free advice.

i am attaching couple of photos

with regards

Chockalingam

health awareness activities at Trichy

I am adding some of the articles written in press and some of the photos of the health awareness activities done at Trichy with KMC speciality and KMC hospitals.

Orthopaedic problems of bones and joints are many and we took on only four issues last year at KMC Speciality Hospital named by WHO bone and Joint Decade. they are 1. osteoporosis 2. arthritis 3. road traffic accidents 4. back and neck problems.

We have done Meet our Patients Meet where the press and the public could freely interact with our patients benefited from advanced ortho care treatment at KMC and KMC speciality hospitals.

We have done Bone and Joint Walk to raise awareness on Bone and joint problems as listed above.

We have given awareness talks to senior citizens who are pensioners in a standard format.

We have done first aid program to traffic personnel twice in the last two year to raise awareness on road traffic accidents 2. we have done many free orthopaedic consultations starting in march 2009 at KMC Speciality hospital both as camps and regular free clinics on Fridays for patients who cannot afford to attend a hospital such as ours. These have mainly targeted arthritic patients though osteoporosis and back problems have been covered.

We have done two ATLS type courses named Essentials of Initial Trauma Management at KMC Hospital for doctors sponsored entirely by KMC Hospital and all the consultants have gifted their time and efforts to teach the fundamental principles in trauma management.

I will elaborate all our activities in the next blog and list them and post more articles.

Regards

Chockalingam

Awareness article written on joint replacements

Article written on 24th December 2008

Advanced Ortho Treatment facilities at KMC Speciality Hospitals

Joint Replacements and Key Hole Surgery



What are joints and why do I get pain in my joints?

Joints are present when two bones meet allowing movement to occur.

The ends of bones are lined with a tissue called cartilage. This tissue is strong and smooth. This is lubricated with fluid in the joint.

Ligaments are tissues which hold the bones and allow movement in a certain direction.

Joints are damaged by commonly by diseases, injury, ageing or infection.

Problems with the joints are major causes of immobility and disability. We often see people who can only walk slowly, or for short distances due to pain due to the joint problems. Knee arthritis is very common as one gets old.







What is arthritis?

Arthritis means inflammation of joints. It can be due to many causes.

Your Orthopaedic Surgeon would be able to diagnose the cause of arthritis by taking a history from yourselves and examination. He would need to request specific tests if the cause is not clear by examination alone.






Is there a cure for my arthritis?

It depends on the cause of arthritis. The most common cause of arthritis is Osteoarthritis, which is wear and tear of the joint lining called cartilage with age alone. This can come earlier if there had been previous injury.

The treatment of joint disorders has greatly improved in the last thirty years in other countries and over the past ten years in India. This is partly due to the option of treatment with artificial joint replacements.

What are artificial joint replacements?

Artificial joints replace worn out [arthritic] joints. They are very commonly performed for pain and are very successful in relieving pain. Knees and hips are very commonly replaced, though artificial joint replacements are done for shoulder, elbow, hand and ankle as well.












How do they actually look like?

The picture shows some of the actual prostheses in joint replacements. These are not all inclusive as advanced designs are available for patients



What are current advances in joint replacements?

Only part of the knee replaced as shown in the picture below. Advances in metallurgy and materials in the prosthetic design are available to a patient in Trichy. Management before and after surgery has changed over the past few years. The surgeon at KMC Speciality would use the up to date management practised in UK due to his recent return from England.






Are these new or experimental?

No. These have been successfully performed for over thirty years. The joints are manufactured by advanced engineering methods. They are made of very high quality metal, ceramic and polyethylene. Over 60000 patients are receiving these prostheses by surgery in one year in Australia alone [2003-2004 figures]

Who will perform this at KMC and what is his experience

The surgery would be performed by a senior surgeon who has returned to Trichy after more than fifteen years of experience in UK. He has performed surgeries routinely for the past seven years as a senior surgeon. He had been practising in the largest centre for joint Replacements in UK where more than 4200 patients are treated per year alone [2007 figures]



He has performed research in this field in UK. This has been published and his article which is commonly quoted in the international literature.


“ Outcome of cemented-v-cementless fixation of femoral component in TKR with the identification of radiological signs for the prediction of failure
THE KNEE Dec 1; 7(4): 233-238 2000”

Is this treatment without any problems?

This treatment is very successful in relieving pain. However some patients can have complications. The surgery performed by an experienced surgeon can reduce the complications. Hence it is essential to know your Doctor and his experience who performs this surgery.


Will I be able to walk without limp and will my joint move normally after surgery?

As pain goes your walking will actually improve than before surgery. Hip replacement patients return to normality sooner even though it is a deeper joint. Knee replacement patients will return comparatively slower, however there would be no difference in the success of this surgery.

Treatment after surgery improves the success greatly and your Surgeon would advise you accordingly.

What Should I do?

If you or someone you know suffers from joint pain, please understand that one should not have to live with pain.

Not all patients with joint pain will need joint replacements.

Other causes of joint pain can be treatable completely by medication such as gouty arthritis. Some of the patients’ joint pain can be treated by medication such as Rheumatoid arthritis, though surgery can remarkably change one’s life with surgery.
Other patients can be treated by key hole surgery to the joints.

What is key hole surgery of knee?

I am sure you are aware of sportsmen twisting their knee and disappear from the sports scene for couple of months before returning to normality. They often sustain cartilage injuries which are treatable by key hole surgery. Surprisingly quite a lot of general population have cartilage problems, but choose to live with pain. They can also be treated by key hole surgery.

Open Doors For More Patients:Raising Awareness of Knee replacement in rural India

The Fourth of September 2010

We decided to make a video of one of my patients who had a knee replacement. The video showed the impact this operation can make to a lady in a rural place in India. This video raises awareness significantly of a disability which is silently crippling people in India. With so many other life threatening issues and health hazards, the disability due to arthritis is not well known or written.

Arthritis not only limits one's walking ability, also disables a person in activities of daily living. I quantify my patients' disability tailored to Indian conditions and also use international scoring systems. But seeing is believing and for the public, there could not be any better educational method than a video play back.

please visit the sugam charity web site from the useful links site to view this video.

Warm Regards

Chockalingam

"Invest health for your loved ones"

When i had the book given to me by one of our good friends at the hospital i work, it helped me greatly. i will elaborate on the book itself in another blog. The book opened up my thoughts and creativity quite a bit. Then, when i saw the mother of a cardiologist who was morbidly obese coming for a knee replacement with the associated risks, the thoughts started flowing to this subject of "Money and Health, the conundrum"

This blog is the continuation of the blog and if you have not read my earlier blog please go and read and continue>

How to combine money which is so well associated with comforts and health which is so associated with well being? Being healthy would enable one to enjoy the money and its comforts.

Saving money when you need to spend the money is one of the models i have been following since 1993. Saving money when you spend time for a good cause is a concept i had been exposed to when i started doing the charity walk for the cancer in UK.

is a new conceptWe at Sugam Charity thought of a model when one can save money for the time you spend for being healthy! after many trials, the model which we have come up with are the following. one can choose the method one wants depending on his circumstances.

1. Save money in a separate account or pot for the time you spend exercising for example. this could be pounds/dollars/rupees for the time you spend on trying to become healthy. Use this pot as exclusive pot for spending later when you want to have comforts like buying your hi tech headphones for example.

2. Save money for your loved ones when they do exercise is gifting someone money when they spend time for their health. one may say i do not have anyone whom i would like to see them healthy! or do not want to save money for someone else!

3. Spend time for your loved ones to become healthy for them to be able to spend time with you longer in the longer run is even better. this would be for you to exercise more for your loved ones as much as for yourselves. Quantfication can be in the form of money which you can save for them or for yourselves!

Think about these options and start using them in your life. i know few who have started already.

Hang on, it is time for me to exercise! no for work!!!!!!. The anaesthetist has anaesthetised my patient for surgery and the patient is waiting!!!!!!!!!!!!!!!!!!



Regards

Chockalingam

standards and Health Awareness among the public

As a professional, we are striving to give the best to our people who approach us. For this we constantly update ourselves and bring the current and the best accepted international standards we acquire to the place we practice our profession. The traditional models of spreading the awareness of @this provision of the current best practices, had been one of the following.

1. Patients who have benefited spreading the information. In India this had been the best method so far but it takes time. But the problem here can be the mass followers who may be barking at the wrong tree for sometime before realising!

2. Media and news and not everyone will have equal access to them

3. Presentations to our learned colleagues who in turn will spread the news! as it were. These can me informal meets, formal meetings and publications

4. Self advertising by the professional or the hospital itself. But there are no restrictions at the moment on these and can mislead to wrong treatment or health care.

But i think there is another way which is to make the health care delivery and advances to be transparent for the end user i.e the patient and the relatives to make their own informed choice. Though this may not be applicable universally at the moment to the common man in India, i feel that this is the best way.

This would involve in making the options available to the end user directly.

I may be wrong as the UK health care delivery model is completely opposite in that it sets the standards for the professional to practice and frees the end user in making these complex decisions of choosing.

For India this UK model will not be acceptable and the end user i.e the patient has to make lot of the decisions in choosing!. Hence the best way forward would be to make the best available options of healthcare transparent and widely available to the common man.

One needs to be very careful in choosing what is best and accepted current practice to be able to present them. We are at the moment started analysing this as a project and i will let you know the outcome soon!

Regards

Chockalingam

Setting Standards in Health Care

Setting Standards always has motivated me to work harder. There are areas where standards will improve with time alone as developments creep in as there will be exposure to everyone. however one should not wait for these and have to be actively engaged in these activities.

It is not just important for setting standards by yourself as the long term goal maintaining the standards largely revolve around the fact that everyone follows them. I have found this as the hard way as setting standards being easier, only to find out in dismay later that these are not followed.

It is possible for us to set standards and see them maintained only if the stakeholders are taken into confidence and even be involved in setting the standards themselves by discussion. On the otherheand,forcing them enforces the changes only if two conditions are met.. 1. If you are the paymaster or the employer and the people will do with fear. 2. they will do when you are around and will not necessarily follow them when you are not there.

This is a new learning experience for myself as the culture, ethics and the society is different to my exposure in the last few years. However people's needs and the necessities are the same! Hence we trod along and find ways to set standards and maintain them.

It is also important that standards have to be constantly reviewed as the present standards are not necessarily acceptable in the future and in fact they often are not. Hence persisting the standards one learns during their earlier experience will be detrimental by not bringing new standards.

This appears to be a complex post even to me after writing this but i will elaborate by a simmple illustration.

Pain after surgery or after major trauma is perceived to be normal or acceptable to most health care workers, but from the patient point of view it is not acceptable. Hence the standards for assessing and acting on the pain of the patient by the health care worker had to be changed when i started my practice two and half years ago in India.

We brought our own version of Pain assessment and management in colloboration with the nurse leadership. I found setting the standard was not the most difficult part as the hospital management were very receptive. however the maintainance of this simple standard as we set out is difficult even after two years.

This may be the fact that i did not involve all the stakeholders when designing the standard in the first place. I am still learning.

I hasten to add that our standard of assessing and managing pain is much much better than two years ago with the awareness and the attitude to be significantly in the right direction. Hence i am happy with what we are doing and we have implemented so many other standards in the past two years.

I will elaborate on these in the future blogs

Regards

Chockalingam