The Australian Medicare System
I have been meaning to pen this article for ages, but refrained as I could not name the Doctors involved for legal reasons. Right now I am at a stage with one foot in the grave and my days are numbered and don't really care do I about legal implications after I am dead and gone?
I want to share my bad experiences with Specialists in Sydney so I can die empty hoping this article will get publicised and other Australian Citizens can benefit from my Nightmares.
I intend to share not just my nightmares but also about TRUE BLUE doctors who were God sends who saved me time and time again
Each Medical Specialist is like an independent SILO working in Isolation and under the belief he/she is a specialist and knows everything about their field of expertise, when most know very little and do not make the effort to keep abreast of medical advancements.
This System is so flawed and Medicine like any other Profession has "The Good The Bad and The Ugly and The Greedy" who are in there only to make money and they have zero liability & they can kill as many people with wrong diagnosis and medications and continue believing they are saving lives.
There is not one doctor meaning a specialist physician who looks at the patients body as a whole any more. Each one is a Spare Part Specialist like we find amongst car wreckers
The Australian GP's role has been reduced to that of "Glorified Triage Nurse" outside of a hospital.
They do some basic blood tests and X ray CT scans, Ultrasounds etc and prescribe antibiotics and write scripts for medications initiated by specialists etc and are forced to send you the patient packing to a Specialist Physicians in their network who are mostly vultures preying on the sick prescribing unnecessary drugs to retain patients on their Client roll earning mega bucks so they can buy their Mercs and Mansions.
It is not the GPs fault at all as there are Brilliant GPs whose hands are tied by the system and Specialists rule. This Really Sucks.
As I see it
"Inky Pinky Ponky" what can I give this donkey based on symptoms is the Basic Mantra and Tantra. Whole thing Sucks
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Here I Go:
I came to Australia in July 1976, to do my Masters Degree in Building Sciences at Sydney University. It was an eye Opener as Faculty members were all Professionals with hands on experience in the subjects they were teaching. Learning was Fun and Faculty members were all Friendly very unlike India. I found it refreshing.
On the other side of the coin I was shocked out of my wits when one girl at the Uni asked what I was eating and I said Curds. (aka Yoghurt) and she said
"Yuk, You are eating Bacteria".
English speaking but very backward I thought. Moral of the story not every one who speaks English is educated in the true sense.
A Year later, I applied for a Casual job at a Company called 'Gaydec' that imported Christmas decorations as well as made tinsel garlands and Christmas trees for Westfield stores. I was interviewed by the manager Gavin and we spoke in English and I told him I was doing my Masters at Sydney Uni. He was happy and told me I had the job but as I was leaving he asked me a question that floored me: he said "Do you speak English ?" I did not believe my ears. I said "I thought we spoke all this time in English did we not ?" He felt embarrassed and apologised saying he was not thinking clearly :-)
Thursday Nights was Late Night shopping until 9.00pm and it sounded strange to me as all shops in India were open seven days a week and until 10.00pm. Then on week ends all shops shut doors at 12.00 noon and the rest of the week end the City of Sydney was like an abandoned town as we see in Western Movies
Oh the Coffee in Sydney was the worst. I paid "Aud One Dollar" when I earned $90 as a Casual worker and got the worst coffee in a Polystyrene cup from Greek Cafes and it looked and tasted like Dish water.
From a Sleepy Country Town in 1975 Sydney after the doors were opened to migration by PM Bob Hawke in particular, Sydney in 2022 is the most vibrant Australian City and the Coffee is Sydney Cafes is something worth dying for and has killed off American Star Bucks that sold large buckets of dishwater that tasted like fish water as Coffee.
Thanks to the French, Italian and Lebanese influence for the us enjoying the best Coffee in the world. ( I am not knocking Melbourne as they may not be far behind )
What I found most interesting and attractive in 1975 was University Education and Medicare was Free for all Australian Citizens.
Thanks to Visionary Labour PM Gough Whitlam for coming up with the Concept arguing Australia was
"A Land of Milk and Honey with a meagre population that could afford free Education and Healthcare".
We have to Salute Liberal PM Malcolm Fraser who legislated the same and made it a Reality.
Now even before I knew where Australia was, born in 1946 just after WW II and just before India Got its independence, I managed to survive a misdiagnosis.
in 1955 I had a bad cough that just would not leave me. TB was very prevalent in India at that time and immediately my family members decided I had TB and my Uncle Took me to a TB specialist. This Dr Xavier was a Hot Shot and Head of Dept who was treating my aunt who had TB.
No tests no examination nothing what so ever, he decided I had TB and Prescribed Two Injections a Day of Streptomycin that we could not afford to start with plus it meant two trips to see the family doctor daily.
This went on for six months and the cough got worse and I was dying. Incessant cough had caused a Hiatus Hernia and Inguinal Hernia at that very young age.
A Family Friend and a Good Samaritan whom we affectionately called Railway Engineer Uncle. Told my mother you have to see another doctor or you may lose your only son. so he took my Mother and me in his old Bomb of a Car an Old Ford Prefect to see a Dr Gunasagaran, e Respiratory specialist who had just returned from UK.
I started to cough badly when in the waiting room and the doctor stepped out of his room and asked my mother how long I have been coughing like this and what treatment I was on. When he heard I was being treated for TB. he got angry. Which Idiot said he has TB. He has whooping cough and compounded his own medicating and it was a green graduated bottle costing my Mother Rs 10 and he said by the time this is over he should be ok. and he was right.
But the damage had been done. I had been given 2 Streptomycin Injections a day for 6 months which was 180 days so 360 Injections in Total.
God alone knows how I survived this onslaught due to medical incompetency
My 1st Bad Experience in Sydney
1979 - For several years I had been suffering from Blocked nose and was addicted to Otrivin Nasal drops even when I was in India. So I asked my GP friend and he referred me to an ENT specialist. To be honest I don't remember this quacks name. He just looked at me and said almost every second person from the subcontinent has this Blocked Nose syndrome. So Go home and "Inhale Steam".
Now even my great grand mother made us all inhale steam and here I was in Sydney, grudgingly paying some Aud $ 200 out of my meagre earnings as a part time student with no medicare or Health insurance. What a Bummer. Did he have to charge me at all ? "Money Money Money its a rich mans world"
My 2nd Bad Experience
1982 - I consulted a Dr Bridger, an ENT Surgeon at POW. He did not even ask me to take a seat as I walked into his room, he tilted my head backwards with me standing and said "Rhinitis" ask my secretary to book you in for surgery and I did.
On the said date I admitted myself at POW. The anaesthetist saw me and said this is a straight forward surgery and will take about 30 to 40 minutes and you should be back in the ward in about an hour or so. I was wheeled into the theatre around 2.00pm and my then GF was panicking as I was not back in the theatre until 10.00pm. The staff nurse at the ward had no info to share.
There was a Botch up in the theatre, the anaesthetist could not intubate me and I just stopped breathing and the procedure was aborted and I was held in observation in post op room.
It was around 3.00am a Nurse on Night duty told me in confidence they almost lost you and I could not believe what I was hearing. She whispered into my ear "Don't go back to that Butcher". Never saw her again in my life but it was like a message in a Bottle for me from above
Dr Bridger did not have the decency to come and see me in the ward the next day and explain to me what had happened. The aneasthetist gave some feeble excuse that because of my beard he did not know I had a small mouth opening. All that I gained that day was a bruised mouth and tongue with cuts and a chipped tooth and a Big Fat Medical Bill and my life back
My God Send 1:
I had the same surgery for Rhinitis done successfully at St George hospital in 1985 by ENT Surgeon Dr Trevor Williams. He administered local anaesthesia for the throat to stop me from gagging, struggling and putting up a fight.
I also had a surgery for Inguinal Hernia done in 1987 at POW with no Dramas at all with anaesthesia.
I decided to stay away from doctors especially "So Called Specialists".
1989 :- A Bit of medical History. I fell asleep on the sofa in a late night medical clinic. The GP had to wake me up and checked my son's fever and prescribed some antibiotic and then asked me do you fall asleep at the drop of a hat ? I said Yes. Do You snore ? I said Yes and my wife is threatening to walk out on me. He said "You have severe sleep apnoea and you must go and see Dr Sullivan, a Pioneer in Treating sleep apnoea at RPAH". I did and have used my CPAP Machine since 1989 for 33 long years.
Another time a Group of friends were having a picnic in a national park when one complained of mild chest pain. So the doctor friend rushed to his car and brought his BP machine and his BP was OK. I asked for my BP to be checked too and it was 180/100 and I had no clue that I had BP until that day. Was Prescribed Capoten and changed to Tenormin later as Capoten gave me this annoying single coughs. BP was up and down with Tenormin so it was changed to Avapro 150mg and I was on it for a Long time
My 3rd Bad Experience:-
In January 2000, soon after my mother passed away, I started to experience all sorts of crazy symptoms. When I was driving my Right Hand would go to sleep and I virtually talked to my hand to get its act together. Then I started to experience Visual disturbances every morning about 9.00am after I reached work in my right eye. It started as a small zig zag in orangish colour and started to get bigger and bigger affecting vision and I could not read text on my computer screen. Other Times tiny Bubble would appear in my right eye and the bubble grew bigger and bigger and magnified alphabets. Crazy symptoms for sure. Had no clue what was going on. My colleagues said it sounded like Migraine.
My then GP Dr. Chemilioska sent me to an Eye Doctor, Prof James Lance Migraine specialist and a Cardiologist.
Eye doctor did not have a diagnosis, Prof. Lance being a Migraine specialist had a doppler of the neck done and diagnosed it as Migraine Hemiplegia and Prescribed Sando Migran which started to give me severe head aches. I never had suffered head aches before.
My GP Dr Chemilioska was Kind enough to tell me she had about 5 other Patients like me all hypochondriacs. God Bless her for her Diagnosis
I was at the cardiologist who administered a Sestamibi Injection (a kind of a dye for echo Cardiogram stress test) and said he would grab a sandwich, come back and do the treadmill test. This was on 7th April 2000.
Something strange was happening to me. My mouth went dry and I was feeling numb all over the body and my face and felt like throwing up. I told the receptionist who thought I was reacting to the injection and paged the cardiologist who came running and said "Shit he is having a stroke" and grabbed a wheel chair and wheeled me from the Specialist Centre on Carillion Avenue to Prince Alfred Emergency.
He Yelled and told the Triage Nurse, quick this gentleman is suffering a stroke as we speak. Get the Neuro Registrar to see him straight away and he left. (so much for duty of care. He could have stayed on and expedited the process but abandoned me instead )
The Triage Nurse, could not be bothered and she had to exercise her authority to show who was in charge of Emergency Dept.
I was sitting in emergency for an hour fading away and she took her own sweet time and an hour later found me a bed and ordered all the blood works. In bed for a few hours I was beginning to feel better and she discharged me. Never bothered to call the Neuro registrar. Total negligence in my opinion.
Lawyers Opined later that I should sue RPAH for negligence, and it was my son who said "Dad you are alive and that is what matters. We are not Gold Diggers you know" . Words of Wisdom from my Junior and I was a very proud Dad
My 4th Bad Experience
On 13th April 2000 I suffered a Massive Brainstem Stroke and admitted to RPAH emergency where I was told it was caused by a dissected Right Vertebral Artery also diagnosed as Lateral Medullary Syndrome with Horners Syndrome . It was a lot of Gobligoo for a man half conscious and struggling to stay alive
The Right side of my face and right hand and entire left side of my body was paralysed. I had double vision, could not swallow even my saliva without choking, could not speak, Non stop hiccups and severe ear ache in the right ear. I became a vegetable over night. I was seen by neurologist Dr Davis once in the ward before he took off on Easter Holidays. That was my Good Fortune as I had the smartest Neuro Registrar looking after me.
My God Send No 2
Dr Steve Vucic I could tell was Brilliant Neuro registrar despite being so very young. I remember him telling his colleagues "This is a Typical Text Book Case" and that I was in emergency on the 7th of April 2000 and had they administered Plasma the stroke could have been prevented.
He diagnosed it as an Ischemic stroke (reducedblood supply) and put me on Heparin straight away.
Three weeks in Hospital and two in a Rehab I was back on my feet.
I owe it to the two Irish Back packer Physiotherapists at Alwyn Rehab in Strathfield who told me you are too young at age 54 to have a stroke and worked me hard, beyond my capacity and helped me recover. My God sends, how I wish I could thank them in 2022
There was something Dr. Steven Vucic did not do and I can never understand why to this day?.
My Blood test results showed my Platelet Count was 890 (150-300 normal then) and glaring at him. Not only him, there were a hundred neuro students and neurologists who all came and examined me as I was a unique case and checked the charts hanging at the foot of the bed. Besides I had at least 15 doctor friends visit me and look at all the reports hanging at the foot of my bed and not say a word. Must be medical ethics not to question doctors incharge. Something I can never understand.
As a Professional engineer if I saw another engineer making a mistake in his structural design I will point it out immediately to avert a disaster
Me being an engineer I did not even know there was a vertebral artery in the neck, leave alone know what Platelet was even if I had seen the chart myself.
My first appointment with Neuro three months later was a disaster. Dr Steven Vucic was happy to see me walking and took my file, but Dr Davis grabbed the file from the Registrar and said "He is My Case".
In that one month I was home before my appointment, I read a lot on the internet on my Fancy XT Computer with a 40 meg hard disc and a Floppy drive & a Monochrome monitor and joined the Massachusetts General Neurology Forum and educated myself on my condition and rattled off a few question.
I asked Dr Davis if I could have a Vertebral Artery bypass ?. He got very angry and told me don't read all the rubbish on the internet and waste my time.
I told him I had contacted a Vascular Neuro Surgeon in Oregon USA Dr.Timothy K Liem, who had successfully conducted Vertebral artery Bypass surgery.
Dr Davis lost his cool and blew his lid and used Bloody Language and was cursing internet.
I held my fort and asked him "Doc my stroke is Blood flow related should I not see a Haematologist ?.
His response "If you want to see a Bloody haematologist go see a haematologist"
I said "I want to see some one at RPAH" and he said "go see Prof Harry Island".
I never again saw the quack Dr Davis after my first post stroke appointment. Don't believe he was even worthy of being a Vet for my Dogs.
My God Send No 3 :
I came home and phoned to get an appointment to see Prof Harry Iland at RPAH. I got the standard reply from the receptionist that he was fully booked and I could not see him for another three months. (Receptionist are like German Shepherds guarding their masters).
I told the lady, I may not be alive that long and she says come in tomorrow at 8.30am. Prof Iland had a Trainee Lady Doctor with him and when he realised I was admitted at RPAH for my stroke, he said let me go and look at all information available in the hospital computer system
What I saw next was bewildering.
The Prof returned and his face was Red with Rage and he mumbled to his trainee, this gentleman was at this bloody hospital and his platelet count was 890 and the bloody Neurologist did not inform Haematology.
A question arises that the Blood tests were done at RPAH and should have raised alarm bells in the Haematology Dept but it did not, suggesting that even the hospital system is lacking badly.
I looked at him and said Doc, "I am just the patient and was a vegetable when in hospital from 13th April 2000".
I could hear him muttering under his breath "He did not suffer a Dissection as diagnosed but an Occlusion of the right vertebral artery and his platelets are still so high, he could have suffered another massive stroke"
The next Thing I knew I was having Bone Marrow Biopsy which showed I had "Essential Thrombocytosis" which he told me.
I was cheeky and asked "why is it Essential Doc" and he chuckled and said "Ram is is because we buggers as doctors do not know why".
He straightaway prescribed Hydroxyurea 1000mg three times a day, max dosage to bring the platelet count down as quickly as possible, to prevent more blockages and further strokes.
Here is why I adore Prof Iland. Take a read of his detailed report to my GP below.
Prof Harry Ilands Letter to my then GP in year 2000
(Click on above Caption to read the letter)
My 5th Bad Experience:
Every time I turned my head I suffered an attack which I was told was Called a TIA or Transient Ischemic Attack caused by reduced blood flow to the brain
Having given neurologist Dr Davis the flick, I had to find a new neurologist who knew what he was doing. If I remember right I consulted over a dozen or may be more Neurologists in Sydney alone
Time Line:-
- Discharged from Alwyn Rehab in Strathfield on 12th May 2000
- Dr Davis last Consult on 22nd May 2000 ( did not want to see him ever again as he was rude and crude)
- Dr Keith Lethlean 9th June 2000. He did a few basic neuro tests like standing straight and closing my eyes to see I was falling to my right, making me walk a straight line which I could not and checking the strength and sensation in my hands and legs. After all this he told me I may be depressed so I should see a Psychiatrist Dr Jacobs. Offered no treatment what so ever for my TIAs.
- Dr Yannakis 6th July 2000. He was not happy with the MRI from RPAH and insisted I get another one done at North Shore Hospital. Medicare allowed only one MRI a year. So I was out of Pocket by about Aud $900. I happened to show the new MRI to Prof Iland first and he put it up on the screen and showed me the lateral medallary infarct and also told me the MRI of the neck was not done to show the blocked vertebral artery.
My sister accompanied me when I saw Dr.Yannakis with the MRI, who just read the radiologists report and told me there was not much wrong with my brain. I was perturbed as I knew what was in the MRI and asked him to show it to me.
Believe it or not he mounted the MRI Image upside down and tried to fob me off. (Obviously he could not read MRI Images) .I showed him how to mount the MRI Image and told him it cost me a lot of money and you had not included the neck in your referral to the Radiologist, making it useless
He was not a happy man and took out his prescription pad and prescribed a tablet called Interferon or what ever. I paid my dues of Aud $ 250 and tore the his script and tossed it in the bin as I walked out and my sister who accompanied me was even more furious with Dr Yannakis who did an Inky Pinky Ponky on me and I felt sad for nearly twenty seniors in his waiting room, all depending on this specialist blindly
- Dr Charlie Teo July 2000 A doctor friend of mine suggested I consult Dr. Teo as he was exceptionally good neurosurgeon. So I did. He studied my MRI and said I remove brain tumours so you should see Dr Stoodley who is a Vascular Neuro Surgeon and I did (good Honest man)
- Dr Marcus Stoodley July 2000. ( Big Story)
- 28th July 2000 - Admitted to POW Hospital for an Angiogram
The Night of my admission the neuro registrar came to the ward with a loaded syringe. I asked him what it was and he said Vit K Injection to bring your INR down. I said do you know what my INR is Now ? He said No, but I am following Dr Stoodleys Instructions. I asked him
"what If I have a stroke tonight because of this Vit K". He looked startled and said "I agree with you. You are Right. We should do an INR first and the decide on Vit K Dose".
Phew and we believe Doctors know everything.
It appears Junior Doctors don't question their Bosses and that is not right
Angio next day was not smooth sailing either.
For those who do not know what an angiogram is here is a blurb:
An angiogram is an X-ray procedure that can be both diagnostic and therapeutic. It is considered the gold standard for evaluating blockages in the arterial system. An angiogram detects blockages using X-rays taken during the injection of a contrast agent (iodine dye). The procedure provides information that helps your vascular surgeon determine your best treatment options.Good I stood my ground and said No to Vit-K Injection the previous nigh. Just went off Blood thinners playing safe. I was awake and could see on the computer screen the probe moving up the arteries like a Plumbers Eel used to clean clogged drains all the way from the Femural artery in the groin to the neck. As I was watching It I was thinking what it he punctures an artery or dislodges a Plaque ? Kept my Fingers crossed
I could see it went right up to my Right subclavian artery. I could hear the Radiologist saying "I thing we have gone far enough and can see there is no flow in the right vertebral artery may be a trickle flow and we should stop here".
Dr.Stoodley insisted he push the catheter further.
Next thing I knew it triggered a Massive attack and I had nausea was trying to throw up and was choking and coughing away. The Probe probably dislodge a blood clot God Knows. There was Panic and the Catheter taken out in a Hurry and I was quickly wheeled back to the ward, instead of being kept in Observation.
I am certain it affected blood flow to my Pica and Triggered a massive TIA that could have ended up in a further infarct in the Pica region
I was discharged only on 10th August 2000 after 13 days of Confinement against my wishes by Dr Stoodley who wanted to perform a PICA Bypass surgery.
I was looking for a vertebral artery bypass in the neck to restore blood supply to the Brain stem. He was not interested and he wanted to perform what he said was a "Pica ByPass Surgery".
Family and friends started to pressurise me and said Dr. Stoodley is a PhD from Stanford, so he knows what he is doing, just get operated.
I had a gut feel it was not right.
Every night around 8.30pm Dr Stoodley would visit me in the ward and try and convince me to say "Yes to the surgery".
We had many discussions of Blood Viscosity and Reynolds Number and Bernoulis theorem and Turbulence caused at the mouth of the Pica artery caused by Venturi effect, me being a Hydraulics Engineer.
I SIMPLY REFUSED TO BUDGE.
My God Send No 4
One Good thing happened at POW Private. Dr Stoodley asked Dr Gilles the Stroke specialist at POW to take a look at me.
Dr Gilles acknowledged my TIAs as they were recorded by the nursing staff and were not imaginary and said Warfarin alone was not good enough and added Plavix 75 mg.
Dr Gilles also told me "Mr Krishnaswamy, be thankful that you are still alive for in 16 years as Stroke Specialist at POW I have seen cases like yours only in Autopsies."
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My 6th Bad Experience
On the 9th Day I was wandering in my hospital ward aimlessly as I was confused about the surgery. I was reading every thing that was posted on the notice board in the ward.
I saw a note that said "No Cannula" should be there for more than three days.
OMG it was the ninth day and I had the same cannula in my Right hand from date of admission. I was angry and questioned the Staff nurse. The Blame game started and no one wanted to accept they had stuffed up. So much for Nursing in NSW and it was not even the Public Hospital it was POW Private.
One nurse friend explained saying all top nurses work full time in public hospitals, Private Hospitals hire mostly casuals to save money :-(
I asked my nephew who was an IT expert to print out each and every article on PICA Bypass that he could find using search engines. Believe me there was no Google searches then just Yahoo and Copernicus etc. My nephew obliged and brought me a big fat file. I read each and every article and used a highlighter lavishly.
I was right, Pica Bypass surgery had been abandoned in USA as early as 1985 as it had very high mortality rate.
So Dr Stoodley was planning to experiment on me like a Guinea Pig
That was it, sitting in my Hospital bed at POW I phoned Prof Harry Iland at RPAH He was not there but returned my call soon after.
When I mentioned PICA Bypass this is what he said
"Ram get the hell out of the Hospital right NOW and don't let any bastard open up your brain as you may not come out alive from the theatre".
That was all I needed. I packed up and discharged myself from the Hospital.
Prof Harry Iland saved my life one more time
- 15th August 2000 - Contacted Dr Timothy Liem, Port Land Oregon USA an expert in performing Distal Vertebral Artery Bye Pass by Email
- 23rd August 2000 - Admitted once more at RPAH Emergency with stroke like symptoms and nothing came of it
- 28th August 2000 - Neuro surgeon Dr Michael Morgan. Dr. Stoodley suggested I consult Dr Michael Morgan at North Shore hospital to get a second opinion and I did. He did not examine me or even look at my angio and MRI but blindly endorsed Pica Bypass. That told me he was Stoodley's friend and was not going to let Stoodley down. More money and time wasted trying to find a Neurologist who knew what he was doing
29th Sept 2000 - Received a surprise of my life a Long email from Dr Timothy Liem with an apology for the delay in responding, He explained my condition as Right sided Horners Syndrome (lateral Upper medullary syndrome)
He later concluded his free consultation saying, it appears that the vertebral artery is blocked way beyond the cervical spine region into the Brain stem up to the mouth of the PICA and as such vertebral artery bypass was out of question plus it was six months too late.
This to me is the Power of the Internet being able to consult a surgeon via email
7th January 2001:
Dr Stoodley in his email wrote " I have to say it has continued to Puzzle me that you are much more prepared to accept advice and diagnosis from remote doctors based on email than you are prepared to accept the recommendations of your local specialists who have special training in cerebrovascular disorders and who have actually taken your history examined you and studied all your x rays.
I imagine you would also be perplexed if I came to you for engineering advice and then out more faith in a remote engineer whom I have never met and had just had email discussions with.
(I found this email Pathetic and Unprofessional)
NEVER SAW HIM AGAIN
- 12th Feb 2001 - Dr. A R Srinivasan Madras India did a thorough study and said there was not much he could do as I He made one suggestion about Pain Management. He said remember the brain has two hemispheres. If you have severe pain say on the left side of your body say left hand or leg, suggest you apply pressure to the exact spot but on the opposite side and you will notice your pan will be halved.
If it is continuous pain tie a Torniquet he said. ( words of Wisdom indeed that I practice these days unconsciously even for ear aches and one sided head aches)
- January 2001 - NIMHANS Bangalore
National Institute of Mental Health and Neuro Sciences. Consulted the stroke specialist Dr Hegde, who confessed he had never seen such amazing MRA and MRIs and Angio Images and there was nothing they could offer (honest admission of his limitation)
- Dr Hegde - Neuro surgeon Manipal Hospital Bangalore. Had never seen a similar case ever and could not assist
God Send No 5:
I was busy Packing to fly to India and the telephone rang. It was one Krishnan who worked for GE Alsthom. Another mutual friend had told him about me and he took it upon himself to phone me and share his sons story.
The son had a broken arm and had a steel rod to fix the fracture.When the bone came good the lady doctor who removed the steel rod cut a nerve and the kid suffered from excruciating pan for years and all that was offered was Pain killers. He took the child to India to an Ayurvedic Clinic and came good. He said Ram give it a shot and I said I will check it out
- Desiya Ayurvedi Clinic - Calicut
Admitted on 16th Feb 2001 and discharged on 14 March 2001
Post Stroke Parasthesia on the left side of the body meant I had very little Pain or Temperature sensation on the left side of my body but felt pain deep inside my bones and the only treatment offered in Sydney was OXYCONTINE an Opiate and I was getting addicted to it.
I admitted myself on one condition Nil medications by Mouth as I was on two Blood thinners.
It was agreed that the in house treatment would involve "strict diet and two massages a day" and they promised to bring the pain sensation back and they did in just after two weeks. I could feel my toes in my left leg suddenly. Something western medicine cannot even contemplate.
When I was at this Clinic, there was another British Lady who had severe arthritis and western medicine did not help. She arrived all arched over using a walker and three weeks later she was walking straight without a walker. The Lady just could not stop talking about it and we were all Happy for her
- Dr Devadasan Singapore 30th March 2001.
He performed a Transcranial doppler and was perturbed by his findings and agreed I had Horner's syndrome Plus Neck Tongue Mouth Syndrome and prescribed Lamictal, Rivotril, Sibelium & Ginseng
- Dr. Lance 23 July 2001- Back in Sydney I went back and consulted Prof Lance who had diagnosed Migraine Hemiplegia pre stroke and prescribed Sando Migran. Dr Lance later prescribed Epilum, saw me a couple of times and washed his hands of me saying he was only a Migraine Specialist.
2002: London
I had sort of learnt to live with daily TIA's. Just had to grin and bear it. Decided to take the risk and travel to UK to attend my older Doctor Sister's 60th Birthday as well as check on my Younger Doctor sister an Anaesthetist who had suffered a stroke on Christmas day in 2000.
My 7th Bad Experience
I was staying with my Doctor Sister at Lowestoft, Suffolk enjoying the world cup soccer. One morning we went to Royal Paget Hospital Norfolk to get my INR done.
At 3.00pm we had a call from the Emergency Registrar at Royal Paget Hosp saying my INR was 11.0 and I needed Vit-K Injection immediately or I could bleed to death externally or even internally.I remembered my experience at POW plus I did not want to leave as the soccer game was on.
My sister being a doctor yelled at me and dragged me and I said "something is wrong. INR cannot be 11.0 as I feel fine as ever".
As we entered the hospital the registrar was waiting with a huge syringe full of Vit-K. Now I was battling the registrar and my doctor sister.
I put my foot down and said "No way you are going to inject me with that". The Registrar asked "What do you want me to do?". I said I want to talk to my Consultant Haematologist Dr Sadatullah who had seen me earlier. He said not possible as he is at home.
So my sister called the consultant at home and he asked me "Ram what do you want us to do ? I was the one who instructed the Registrar".
I told him repeat the INR test again and prove to me my INR is 11, as I should have died by now and I have not.
He said that is fair enough and INR test was repeated.
Guess what my INR was not 11.00 but 1.1
Talk of Medical Botch ups !!!
Had I dropped Dead on the Hospital ER floor the report would have said "doctors did everything to help save this man but he collapsed & died unfortunately"
Phew narrow escape it was, a second time. Had I not refused the Injections I would have dropped dead on the floor in the ER room. Some one up there was looking after me. (This is not a Sydney story but to lay emphasis on medical stuff up's all over the world)
9th July 2002 - Dr John V. Jestico Neurologist, Royal London Hospital (My sisters neurologist).
He wrote a most amazing report on my conditions which you can read here.
Dr Jesticos Comprehensive Report
Aside he told me Ram, I trained at RPAH Sydney and it is a wonderful hospital. Look at your sister she had a stroke on Christmas Day in 2000 and to this day in 2002 I am not able to convince NHS to have an MRI done. So don't waste your time and money in London Go Back to Sydney. So very truthful and honest a doctor . True Blue Medicine Man
My God Send No 6:
Dr Robin Sengupta Neuro Surgeon New Castle upon Tyne UK a friend of my good friend Dr Atish Sengupta- Orthopaedic Surgeon in Sydney.
I stayed with Dr Robin Sengupta as his guest for the night. We discussed my condition thread bare and he admitted that Pica Bypass surgery was not an option.
He gave me the most valuable suggestions that made me bounce back to 95% recovery
He said "Ram you are a clever engineer from IIT Madras and should be able to understand what I am saying".
The two vertebral arteries in the neck go up and become the Basilar artery and it is like an inverted "Y" section. For you the Right vertebral artery is occluded up to the mouth of the Pica. If the clot had gone beyond would be dead by now. Now that you were put on heparin in RPAH thinning the blood and now on Plavix and Warfarin to keep the Blood as thin as necessary to flow into the Pica whose mouth is Partially blocked by a clot.
Now I want you to understand that the blood is flowing up the dominant Left vertebral artery and up into the Basilar and back down the partially open Right vertebral feeding the Right AICA and Right PICA arteries supplying the Brain stem. This is Called Retrograde Flow
Now your cardiologists will want to keep your blood pressure down but they are wrong as you need the BP marginally high such as 140/90 to ensure the retrograde flow to your Pica.
No Neurologist in Sydney had explained any such thing and I have maintained a BP of 140/90 minimum and I am still kicking around in 2022.
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18th July 2002:
Back in Lowestoft My doctor sister was extremely concerned about my snoring despite my Resmed CPAP mask plus there were too many stop starts as I would stop breathing and go all silent.
She decided I needed a Uvulo Plasty Surgery but not possible at hospitals in London as I was a visitor. So I had the Uvulo Plasty Laser surgery done at the Private Clinic in London on 18th July 2002 by Prof Kamani.
It cost my sister a Packet (UK 2360 sterling pounds) to silence my snoring so she could sleep in peace.
Once the anaesthesia wore off Boy was I in the worst pain I have experienced in life for two long weeks. Could not speak could not swallow or eat. After it healed I slept in peace for about six years until the scar tissues grew back with a vengeance and I was snoring again like a 2500cc Triumph Rocket Motor Bike
Received some valuable tips from Dr Kamanis at sleep clinic
1- Continuous sleeping pulse Oxymetry to determine lowest O2 levels at night
2 - Fish Oil Tablets - Omega 3 Fatty acid
3 - Because of sleep apnea make sure you do not have pulmonary Hypertension
4 - Regular Echo is not as Good as Transoesophagal ECHO ( what ever that is)
August 2002 Back in Sydney
I needed to find a new neurologist and was referred to Dr Ronald Joffee at North Shore Hospital. I kept consulting him though he had nothing to offer
25th Nov 2002
Back at Concord Hospital Sydney Emergency with severe stroke symptoms
(To be continued - OMG I Have 20 more years to cover to reach 2022)
After my return from Overseas consulting specialists in Singapore India, USA and UK I came to the Conclusion that there was not much neurologists could do and did not bother with neurologists
Summary:
One Ischemic stroke caused by a blocked vertebral artery diagnosed as Dissection by Neurologist and Occlusion by Haematologist, resulting in Lateral medullary Infarct with Horner's syndrome and Neck Tongue Mouth Syndrome
One Condition Treated by 10 Neurologists in Sydney alone
1-Prof Lance, 2-Dr Davis, 3-Dr Steven Vucic, 4-Dr Keith Lethlean, 5-Dr.Yannakis, 6-Dr Charlie Theo, 7-Dr Marcus Stoodley, 8-Dr Gilles, 9-Dr Michael Morgan, 10-Dr Ronald Joffee
who prescribed
Sando Migran, Epilum, Lamictal, Rivotril, Serequel, Sibelium,Plavix Warfarin and there were so many other drugs whose names I do not even remember. God knows what damage these drugs did to my Brain.
Dr Jacob my psychiatrist concluded that Sibeliuem caused mental disturbance and that I was not depressed
Neurology was akin to Astrology in many ways with endless number of differing predictions and tablet prescriptions based on symptoms.
Conclusion very few Neurlogist have any real understanding of the human brain and its chemistry. Just use symptom sorters to Push drugs for Pharma.
Inky Pinky Ponky what can I give this donkey syndrome.
Also Patients in OZ love doctors who prescribe new medicines.
It is more about lining pockets than patients welfare in OZ abusing the Medicare system
My Young Chemist says he is so sorry to see seniors taking home bags of medicines each month, prescribed by multiple specialists, medicines they do not need but don't complain as it costs pensioners nothing.
Seniors are Major Target for Specialist Physicians in OZ for pushing Drugs
Year 2000 to 2002: Two years on the medical treadmill looking for cure which I did not find but I found something every very special in NSW Healthcare system
God Sends No 7
1- Paramedics: I love the 000 operators. At 4.30am I was having a stroke and with my wife on a Plane to Tokyo, God gave me the strength and determination to roll over grab the land line ( there were no Mobile Phones then) and dialled 000. The lady says "Sir your speech is slurred so just say MMM if you agree".
You are Ram Krishnaswamy - Mmm.
Your phone number is 96422090,- Mmmm.
You live at 14 Telopea Ave Strathfield -Mmm
We are rushing an ambulance to you right now, make sure some one opens the door. I mumbled and said my son is in his bedroom with door closed and we have a steel security gate.
The Voice says "Sir in that case we will send the Police and the Fire brigade in case they have to break the door down to get you out. Mmmm I mumbled and hung up.
Fortunately I remembered my sister who lived close by had a set of house keys so I dialled her.
Within a few minutes my brother in law arrived, so did the Ambulance Police and Fire engine within minutes of each other.
Had there been delays, It would have been "Thy Kingdom Come" for Me
Paramedic walked into the bed room and asked me to stand up. It was then I realised my left leg was like a tree stump DEAD as a LOG
The Paramedics helped me out of bed and I threw up like I have never before in my life. Was messy. Paramedics told me not to worry and it is better that your stomach is empty.
They could not manoeuvre the stretcher down the winding staircase so police Paramedic and ambulance men rolled me back on the bed and used the bed spread to carry me down stairs.
The ambulance ride from Strathfield to RPAH seemed to take for ever suggesting how desperately I wanted to be in the hospital. Throughout this trip the paramedic kept telling me not to fall asleep and kept up the chat. They also gave me Maxalon Injection.
Once at the emergency the speed with with Triage organised everything was amazing and once in ICU and the ward eventually the Nursing care was simply the best.
If I am still alive today I owe it to the Paramedics and Nurses at RPAH who were on the ball 24/7. God Bless them all for their dedication
2003 to 2004:
The focus changed from my neurological issues linked to my stroke to borderline diabetes and spinal injury.
Slightly raised blood sugar levels and I was referred to Dr Cromer an Endocrinologist who prescribed Diabex 500mg twice daily. With time the dosage kept climbing and so did my sugar levels until it reached 1000mg 3 times a day. I was chasing my tail.
Even if I had nil by mouth from say 4.00pm and my BSL was 7.5 at bed time I was waking up with a fasting blood sugar of 10 to 11. Was not Making sense and all that was happening was I was gaining a lot of weight. My pant size went up from size 34 to size 38
CROOK BACK:
End 2003 December I slept in my favourite Water bed but could not get out of it as I had excruciating back pain caused by Pinched Sciatic nerve. Paramedic came and tried for a while until they ran out of ideas and were scared to move me in case the damage became irreversible. I lay in bed for about two days and slowly managed to pull myself out of the waterbed on my own.
I managed to go to Concord hospital emergency and the registrar told me no point in us admitting you now as all Spinal Surgeons will be away on Christmas holidays so come back to ER on 2nd January 2004.
Believe it or not I was there at Concord hospital for ten long days from 2nd January and no one saw me as Dr Steel who was supposed to see me was still on Christmas Holidays.
Basically I was just filling a Hospital bed as a Patient with Private Health Cover bringing in revenue for the Public Hospital.
Dr Steele when he returned from holidays, did not bother to even come and see me the Patient but looked at my report and told the registrar he is on two blood thinners and it is too risky to take him off both blood thinners for a major spinal surgery as he might have another stroke so ordered a cortisone injection in the spine at L5 and discharged me .
Spinal surgery ruled out for good, I ran from mPillar to post to find a lasting remedy for Left sided sciatica that had me walking crooked like a crab from time to time. I listed to every recommendation from every well wisher, saw physiotherapists in far off places at Ermington and Lane cove, saw many chiropractors and even had six months of acupuncture. Everything was HOG wash. One Physiotherapist just hooked me on a Traction machine all the time so he could attend to other patients.
When I was feeling very down and dejected and walking my dog Rajah, I saw a Brand new Physiotherapy Clinic on Liverpool Rd at Boulevard Intersection.
I finally met another God Send Pascale Boutros (Hanna). Pascal know the human anatomy inside out and from 2006 to 2022 I get my treatment every Monday and I have avoided the Knife as well as Pain Killers. I also met Joe the Physiotherapist at Pascals Clinic and he now works at Victoria medical centre where my GP is and they have kept me on my Feet.
Thank You God 🙏🙏🙏
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What followed is another crazy story.
I woke up one morning with a strange feeling on my right ankle bone so I scratched it and there was blood on my fingers. I got up and examined and I could see the ankle bone the lateral malleolus as there was no skin or flesh covering it. Off I went to Concord Hospital immediately.
Several doctors saw me in ER and did not have any conclusive diagnosis. Registrar said we think it is a White Tail spider bite.
I said impossible as I am stuck at home and what is a white tail spider any way ?never heard of it.
There were no Private rooms available so I was admitted with two old men in the geriatric ward. One was dying of lung cancer and the other was this 95 year old man who had lost his memory and reverted to childhood and crying all night asking for his mother and I was stuck in bed with no escape as my leg hoisted and on antibiotic drips
The man with lung cancer asked me what are you here for and I said "A White Tail Spider Bite".
He said "Don't believe these wankers they do not know what they are talking about. Bull Shit White Tail Spider "
I can never forget his Golden word of Wisdom.This poor gentle man died in his sleep the next night.
I got discharged and Nurses came home every week to dress the wound. The ulcer would not heal for six months and the nurses concluded it must be Skin Cancer.
I was off to RPAH Skin Clinic to see if it was skin problem - negative, so was sent to the diabetic clinic to see if it was Diabetic Neuropathy and next to the Cancer Clinic to see if it was Bone Cancer. (No one sent me to the SPIDER Clinic to see if it was a White Tail or Red Tail Spider :-) )
All were negative
I asked God, do I need this shit on top of all my complex health problems ?
A Miracle Happened: Believe it or Not. God Replied soon after
At RPAH Diabetic clinic there was a very senior gentleman in his 80s I presume, from Sri Lanka waiting his turn for tests. I waved and said Hello to him and then we were ushered to different rooms for tests.
When they were done with me, I got to the car park and into my car and drove out of RPAH. The same gentleman was standing at the bus stop. I pulled up and offered him a lift. He declined as he lived in Homebush and a bit out of the way for me he said. I insisted and he got in and we got talking about our health.
He said "Ram the Best Srilankan Neurologist Dr Darrel Weinman is now a GP on Liverpool Road in Burwood not far from your home and he is a "Genius and you must go and see him".
Another God send of a Stranger whose Name I don't remember, who walked into my life passed me a message and disappeared
My God Send No 8
Dr Darrel Weinman was not allowed to Practice as a Neurologist in Sydney so became a GP. He was so popular as a GP his waiting room was always packed day and night, six days a week.
In my Opinion Dr Weinman knew more than all the neurologists in Sydney I had consulted all put together.
So Until 2012, I did not consult any other neurologist.
It took Dr Weinman a Month or so to come to grip with all my health issues me being a new patient and him not having access to my medical history.
He said Ram you have a Bag full don't you?
Narrow Airway, Intubation Problem, Sleep Apnoea, Hypertension, Hyper acidity - (Gord), CVA with blocked Right vertebral artery - (Lateral medullary infarct with Horner's syndrome),Severe Sciatica, Ottosclerosis in the right ear with Tinnitus, Thrombocytosis, Diabetes and not to forget White Tail Spider Bite on Your ankle ( and he chuckled)
Dr Weinman explained to me his thoughts in a CLEAR and Concise way
"Your Brain suffered a stroke when blood supply was cut off in the right vertebral artery causing a lateral medullary infarct meaning some brain cells died for lack of blood supply. Blood supplies Oxygen and Sugar that is needed for brain cells to survive.
That aside you have no Neurological disease and you don't need any Neuro drugs and unfortunately you have been prescribed too many drugs for no reason.
So best we get rid all all Tablets which I don't think you need and limit it to medicine for BP, Thrombocytosis, Gord, Diabetes and Blood Thinners Plavix and Warfarin. He switched me from Tenormin to Avapro for Hypertension
My question is why did not any other Neurologist go down the logical path ?
On hind sight I am thinking Plain greed and each specialist wants to hang on to every patient who gets referred to him by his network of GPs, by prescribing something and asking the patient to come back in 3 months time.
My Conclusion is Medical Specialists Prey on Patients especially the Seniors
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Dr Weinman and Prof Harry Iland were perplexed about the ulcer on my ankle that would not heal. If it was not cancer why was it not healing even after six long months ??
There were no answers
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My God Send No 9:
Then steps in another God Send from USA, NEOMA with a message
I was a very active member of the MGH General Neurology Forum and Neoma was a stroke survivor and all forum members reached out and helped each other.
Neoma was a rare name and she explained that she was a Cherokee Red Indian and Neoma meant "One who walks on Water".
I joked with her saying "I am an Indian from India where we Walk on Fire"
Neoma asked me to send her a list of all medications I was on to see if one of the medicines could be a cause for my ulcer
I rattled off my list: Diabex, Somac, Hydroxyurea, Plavix, Warfarin, Lamictal, Rivotril, Sibelium, Seroquel, Oxycontin blah blah blah. Every one in the forum said if the stroke did not kill you these drugs will Ram :-(
I said "yes enough to kill a donkey I suppose"
A week later Neoma wrote "Ram I think I have found the culprit" and sent me link to an article published by German researchers. The Culprit was Hydroxyurea.
I was on max dose of 3000mg a day considering my Platelet count was very very high at 890. The urea went down the leg and got deposited in the ankle and the body had no way to flush it out of the system.
I dashed off to see Prof. Iland with this info and copy of the research paper that said as many as 6000 patients being treated with Hydroxy urea had ulcers in their ankle bones.
He shook his head and said "Impossible Ram this happens to one in a million patients" and I said Doc " I am that one in a Million Unlucky Jonah and it is not your fault, as all you were trying to do is bring the Platelet count down, which you have as from 890 it is now down to to 360 " .
Prof Iland thought he could drop it to mim dosage. I showed him the exposed bone on my ankle and said No way doc I might get an ulcer on the other leg too
"The Only alternative I have is Anagralide but this can cause Leukemia" he said.
I said Doc " What difference does it make if I don't take Hydroxyurea and die of high Platelets or take Anagralide and die of Leukemia?"
He said Ram "You are a funny man and you can joke about it but it worries me that you can have another stroke".
I went off Hydroxy urea the same day and a scab formed over the ankle ulcer finally. Since then I have been just on Plavix as Platelet suppressant.
From the time I got off Hydroxy urea in August 2004 when Platelet count was about 360 by 2009 My Platelet count Climbed to 550 but I stayed away from Hydroxyurea
On 15th January 2009 I got infected in Chennai, with Dengue Virus and overnight Platelet count plummeted from 550 to 200. Thank God I did not need Blood transfusion whilst holidaying in India.
From 2004 to 2017, I felt safe as my GP Dr.Weinman knew what he was doing and I accepted what ever deficits I had sustained, stopped worrying about having another stroke and learnt to relax.
2006 - My Wife's Medical Nightmare
10th Dec 2006 I was going to turn 60 and my Older sister wanted me and my wife to be with her in Madras to celebrate it like a wedding as is the South Indian Custom.
20th Nov was a friends son's wedding so I got there on the 18th of Nov, nice and early and my wife Mithu was going to join me around 5th Dec.
On Thursday the 24th Nov Night I get a frantic call from my wife Mithu. She is distraught and sobbing. I had to calm her down and tell me what was going on.
She says I am bleeding in both my eyes and I cannot see. I said how is this possible ?
Your Eye Dr. Dr Campbell saw you in September and you were so happy to come home and tell me that he told you that "for someone living as a Type 1 Diabetic for over four decades your eyes were as good as Gold".
My wife says I don't know. Come home soon, I need you here Badly. Was too late for me to fly out that very night so I took the flight on Friday night and was in Sydney on Saturday morning
Eighth Bad Experience:
Optalmologhist Dr Derek Campbell has been checking my wife's eyes for many years. How does she end up with retinal detachments in both eyes within two months of his saying "Your eyes are as Good as Gold" Another quack in the system who should have been sued according to lawyer friends but we chose not to
9th Bad Experience:
By the time I got to Sydney my wife had consulted an eye specialist Dr John Sarks in Strathfield who had seen her and asked her to come on Monday Morning for an Eye Injection called Avastin. I had to do a Google search to see what it was
"Avastin is a drug that is injected into the eye to help treat from eye diseases. The drug blocks the growth of abnormal blood vessels in the back of the eye. Those blood vessels can leak and affect vision, causing vision loss. Avastin is the brand name for the drug, which is called Bevacizumab.
