Story of Mexican patient’s Biliary Atresia Surgery in India

Baby Gabriella - From Mexico

Biliary Atresia Surgery - Dr. Ravi Mohanka

Having babies is the ultimate pleasure a person experiences in life. We yearn to have healthy, happy babies and wish for them the best of everything. As a first-time parent, this feeling is entirely new and different, and just aptly becomes dreadful when something unusual is found with the little angel. In my child’s case, it was jaundice extended which turned out to be biliary atresia, a rare condition in infants. All thanks to Dr. Ravi Mohanka Top Hepato-pancreato-biliary surgeon in India and his wonderful team in India and Forerunners Healthcare- Medical Service Provider that saved my precious bundle of joy in all possible ways. I owe her life to the best efforts put in by them in treating my child, and I can safely call them the God-sent angels who gave my baby the life she is living today.

You must be wondering what it is all about, and who I am sharing my story with you. Well, I am a woman from Mexico of Indo-African origin. My name is Samantha. I faced the toughest time of life when my first baby came into the world. We named her Gabriella and lovingly call her Gabby. So, when Gabby was handed over to me just after the delivery, I found her eyes a bit pale. My doctor told me that it is common for babies born a bit jaundiced and that the paleness will subside in 3-4 days. The baby was quiet and sleeping mostly, so all seemed normal with her.

Cut to about four weeks after her birth date, I noticed that the paleness has not gone away. There were certain other things which seemed not normal, such as:

• Her skin was distinctly pale
• Urine was supposedly dark as it left brown spots in diapers
• The stool had certain paleness with a greyish tint

I also noticed that Gabby had become quite irritable and the abdomen looked a bit enlarged than normal. Being the first time parent, all of this alarmed me to no extent and I decided to put my fears to rest by seeing my pediatrician. She gave me an appointment about three days later, which mounted my worries a lot. Anyway, I went to see her. She asked me the questions related to her feeding habits, about all that paleness. She also pointed out the swelling in the abdomen and asked me to get certain tests done which included:

• X-ray of abdomen to confirm enlargement of liver or spleen
• Ultrasound of the abdominal region to rule out the possibility of small gall bladder
• A certain blood test to check the liver function.

All these reports took about another one and a half-day. The doctor gave some oral supplements to keep the baby’s nutritional requirements well-met as she suspected it to be something related to liver abnormality. When we received the reports and went to see the doctor again, she told me that there is a strong possibility of biliary atresia.

She told us that biliary atresia is a rare condition found in infants. Just one in 15000 children are found with this condition. So, the treatment also is costly and has no alternative than doing diagnostic surgery to find the exact condition of the liver. All this fell on me like a bolt from the blue and I started crying right there. Thankfully, my partner (the father of my child) was with me and acted like strong moral support. Both the doctor and my partner consoled me and made it very clear to me that I will have to be my strongest version for the coming months.

My doctor very patiently told me what the disease means and what it does. She told us that biliary atresia is a disease in which the bile from the liver fails to come to the gall bladder due to blocked bile ducts or absence of biliary tree in the child’s liver. This abnormality causes liver cirrhosis eventually and is certainly fatal if left untreated. She suggested getting a small diagnostic surgery done. It was to be followed by corrective surgery in which the bile if accumulated, is drained, and the damaged ducts of the liver are removed. She told us this whole procedure is called the Kasai procedure.

We came home feeling totally lost and scared. We knew that our child is in danger and that the problem has to be solved at the earliest. Our doctor told certain very important things about biliary atresia, which were:

• This condition is diagnosed only when the baby is 3 to 6 weeks old.
• It is completely curable if the surgery is done within 4 months of age.
• The success of the procedure depends upon the extent of damage caused to the liver.
• Kasai procedure is not the final cure, if it fails, which is rare, it may require a liver transplant.
• The sooner the surgery is done, the brighter the chances of baby recovering fully from the condition and living a normal life.
• It is characterized by the build-up of bile inside the liver due to failure of working of bile-ducts or due to their absence, which ultimately starts eroding the lining of liver and disrupts its functioning.

“Why my baby only?” – I felt very frustrated. It was not at all expected as my baby was doing really well, and we had no idea something so dangerous was happening with her. Her inability to communicate her discomfort broke her heart completely.

We knew our baby was in danger, and naturally, we wanted a fast and feasible solution for the situation. We consulted some of the liver care groups in Mexico but were completely disheartened by the amount of money the treatment required. The long waiting time was another factor that made the situation more difficult. We, at a point, started thinking that we had lost the battle, even before we started to fight it. Things, but changed miraculously one day when my friend from India came to see me. She had heard a lot about medical tourism in India and shared the concept with us.

She told us that in India, the best treatments of all kinds are available. People from all over the world come in millions of numbers every year to this country for medical surgeries. And mostly they have Successful Biliary Atresia Surgery in India Patient Story all over. The country is known for world-class hospitals and medical services. Medical tourism companies are also quite active and act fast and in a very responsible way. We read about the cases where everything was arranged in just a period of a month or so.

We immediately started Googling about the medical tourism companies in India and tried to collect as much information as possible. After several hits and trials, we zeroed in on the name Forerunners Healthcare Consultants. This was one medical tourism expert that had a fabulous track record and had explained their way of working in great detail on their website. With all hope and courage, we dialed the number given on the website. A woman with an angelic voice took our call and asked us about our concern. We had several questions to ask, some of which were:

We made it clear to her at the very start what our doctor told about the urgency of surgery. She empathetically listened to us, and gave us prompt replies, which were:

She asked us to share all diagnostic reports and the doctor’s opinion at an email ID and assured us the best treatment and the fastest response, to begin with. Without wasting any time, we shared all the reports and prescriptions of our doctor in Mexico to the email ID given. The lady at Forerunners Healthcare Consultants acknowledged the receipt of the medical records of our daughter both through email and on phone. She promised to get back to us in a maximum of three days’ time.

We, with fingers crossed, waited for the reply. Meanwhile, we discussed it with our employers about the possibility of our going to India for the baby’s treatment. My employer understood the condition and assured all possible help in this regard. We, in spite of trying very hard, could not stop ourselves from following up with the lady. She patiently attended to our concerning queries each time and requested us to stay hopeful and positive. She shared with us the names of the doctors to which she had sent the reports.

So, we spent the remaining two days reading about the doctors’ profiles and the work done by them. Of those profiles, it was the profile of Dr. Ravi Mohanka Top Hepato-pancreato-biliary surgeon in India, which made us very comfortable and confident of the best treatment. Since the medical services in our country required us to wait for quite long, it made no sense to us to put our baby in further danger by spoiling her chances of recovering from the disorder fully.

Finally, we got the revert from the lady. She told us:

We did as instructed and sent all the documents required, and waited for our tickets. It took about a week’s time. My baby was doing well and was on supplements. This somehow relaxed us and we prepared for our going to India.

On the 5th of July in 2016, we landed in India. It was about five weeks since our baby was born. The appointment with the doctor was just the next day. The coordinator greeted us warmly at the airport and took to us a very comfortable and posh hotel in Mumbai. She asked us about our food preferences and etc. and arranged everything as per our convenience and requirements. The very next day at 11 am, we reached the hospital. It was certainly a very clean and neat hospital and had everything quite systematic about it. We were asked to wait in the lounge and were accompanied by a representative of Forerunners Healthcare Consultants.

Finally, we got to meet Dr. Ravi Mohanka is Best Hospitals for Biliary Atresia in India. Impressed as we were from his profile and achievements, what actually floored was his warm behavior and smiling face. We felt as if we were in safe hands. He took a nice look at our baby and examined with care. My baby was crying at that time, but suddenly stopped crying and started staring at the doctor’s stethoscope. While playing with her, he examined the swelling in the abdomen and advised us three tests:

• Liver function blood test to find the latest position
• Diagnostic surgery
• Operative cholangiogram which confirmed the diagnosis of biliary atresia.

All these tests were done at the same hospital and under the supervision of experienced pathologists. The diagnostic surgery was arranged the very next day. The doctor gave us the time at which we were supposed to see him and suggested to admit the baby to keep it under medical supervision. I was allowed to stay with the baby and my partner was also given a comfortable lounge and he had the option of going back to the hotel too. ‘I will take care of the baby’, I convinced my partner and asked him to go and take rest in the hotel.

The next day, our coordinator had collected the blood test report. We went to see the doctor and waited for our turn. The doctor had a copy of the report on his computer. He explained the procedures to us in detail. The procedures required were:

• Diagnostic surgery: He explained that bile ducts will be surgically examined for blockage or damage.
• Operative cholangiogram: During the diagnostic surgery, a dye will be injected through gall bladder and x-ray will be taken. If the dye does not go from bile ducts to gall bladder, it will confirm damaged ducts.

He told us that all this procedure will take around one hour or so. We agreed to the procedure as we were scared of the scarcity of time and wanted to treat our child as fast as possible. The doctor also insisted not to waste time any further owing to the fragility of the situation. Every minute seemed very important to us at that time. The doctor was also very concerned about the situation and was taking every possible care to make things fast for us.

The results of diagnostic surgery confirmed the biliary atresia as anticipated. We cried and smiled at the same time. I cried as we could not imagine our childbearing so much discomfort and smiled that we had the treatment in hand. The decision to perform corrective surgery, Kasai procedure, was taken. We asked Dr. Ravi Mohanka who comes under Top 10 GI Surgeons in India:

• Is it a painless procedure?
• Are there any risks associated?
• What is the success rate?
• How long will my baby require to stay in the hospital?

He explained everything to us about the procedure and the risks associated. He said:

• Baby will be given general anesthesia, and the whole procedure will take 3-4 hours.
• The risks are negligible in our baby’s case as the liver was not damaged much, only draining of bile and connection of working bile ducts to the intestine was required.
• The Success rate of Biliary Atresia Surgery in India is more than 90% in this situation.
• Baby will be kept under observation for a week, after which we could fly back to our country.

After a day of tests and observation, Gabby was taken in for corrective surgery. We were kept posted about her condition throughout the surgery time. The coordinator called us regularly and talked to us in a very comforting manner. She prayed for her speedy recovery and Successful Biliary Atresia Surgery in India and instructed the representative who was with us to take good care of us. He politely asked us for food and beverages and did all things possible to make that difficult time easy for us.

Finally, the surgery was over. A list of post-operation schedule was given to us. My baby was shifted to post-natal intensive care and we had to keep all the patience in the world as we were not allowed to meet her. We understandably co-operated and occasionally went in to see her. She was sleeping most of the time. Nurses took very good care of her and were very particular about changing her diapers, giving her medicines and feeding her.

Meanwhile, Dr. Ravi Mohanka met us again and shared with us the outcome of the surgery. He explained to us clearly that the procedure was successful and that our baby is a very good fighter. He shared that we will have to be regular with her medication and follow-ups as the situation becomes completely clear only after the few years of surgery. He showed us the damaged portions taken out and explained to us in advance, through a video, the whole procedure that was performed.

• The disease was diagnosed within six weeks of age.
• Kasai surgery was carried out within 6 months of age, which had increased the chances of full recovery for the baby.
• The baby was responding well to the medicines and supplements and was not showing any allergic reactions.

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