Coronary bypass:

Sri Lanka is the place for it

by Thirumeen

Coronary artery bypass, is commonly known as 'Bypass' in Sri Lanka as in most other countries. There is a mad rush to go to India not only to perform the surgery, but also to seek advice or a second opinion of the tests done in Sri Lanka.

In this exercise, first, ECG is done and to identify the problem or the blocks in the artery an Angiogram is done. When I suffered an attack I was rushed to a private hospital. A series of tests were done and medication given by keeping me in the hospital for about four days. In my coronary artery a couple of blocks were identified and I was to go for this surgery in two weeks' time.

At this news both, my relations and friends, advised me to go to India to perform the surgery, or at least to seek an opinion. In fact, it was my first experience to get myself admitted in a hospital, in my lifetime.

However, after careful inquiries and study, and with a second opinion, I decided to do this surgery in Sri Lanka. In fact, in Sri Lanka, this surgery is done in private hospitals like Durdans, Nawaloka, Oasis and Appollo and in the government hospitals in Colombo and Galle, and semi-government hospital at Jayawardenapura, and each of these hospitals perform 3 to 4 Bypass surgeries per day, and in Sri Lanka over 350 are done per month.

The purpose of my writing is to make known my experience, to the hundreds of patients who may, (at the growing rate of this type of surgery) know certain secrets, so that they will be able to decide wisely in case they encounter this problem of health.

I was admitted to the hospital on June 17, in order to perform the surgery on the following day. Since I am a diabetic, extra care was taken. I was taken to the theatre early morning and a tablet was given to me by the anaesthetist.

Thereafter, I was not aware of what happened to me until I gained conscience in the Intensive Care Unit, ICU. It took a little over four hours for the surgery. I was in the ICU for about three days, and when I became normal by their tests, all extra tubes, injectors and oxygen were removed, and I was transferred to another part of the ICU where I was kept for a day, and then transferred to a room in the Cardiac Ward, in the hospital. I was carefully kept under observation by regular visits of the team of doctors, nurses and attendants, and was discharged after about nine days from the date of surgery.

Of course, I was advised to rest for two weeks before I visit the doctor for a check-up. The team consists of the Cardiologist, the Surgeon, Anaesthetist a host of doctors and a host of nurses.

Successful surgery

In my impression, having successfully undergone the surgery I find that there are young doctors in Sri Lanka who are quite capable of performing this surgery. The young nurses who looked after me, especially when I was in the ICU, alone, without my wife or daughter, was excellent.

The doctors and nurses are efficient and dedicated and compassionate in handling, not only the pre-surgery but also post-surgery. They all collectively maintain an atmosphere where I felt like a second home, during my stay in the hospital, in the comfort and the satisfaction one gets from the team that gave a problem-free healthy life.

When one has all the facilities and the best of personnel to handle the case, why should one think of going outside the country? Perhaps a decade ago, Sri Lanka would not have had the necessary facilities and the personnel, but today, with development, I am of the opinion that a person going abroad for an exercise of this nature is foolish or misguided.

I say 'excellent' on the overall performance. Infact, there were little shortcomings which may be useful for the Management of the hospital to take note, in order to rectify, and the doctors could advise the management to take remedial measures. I state so with good intentions, without any malice or prejudice against anybody.

Cost of the Surgery

Cardiac bypass is so common in Sri Lanka, and several hospitals are capable of handling it. In the recent past, packages have been introduced, namely, for an angiogram Rs. 28,000 and for the surgery Rs. 345,000 plus a deposit of Rs. 15,000 for exigencies. A sum of Rs, 50,000 to be paid at the time of obtaining the date for the surgery and the balance Rs. 310,000 to be paid at the time of admission to the hospital, for the surgery. I did not know about this package, and when I went to the hospital for a check-up I was kept for four days to take the angiogram.

The angiogram revealed that there were blocks and I was advised to go for a surgery in two weeks. If so, why was I kept for four days, without sending me out the same day or the following day after the angiogram, and if necessary after the other tests were taken? To my surprise, I was given a bill for Rs. 96,000. Had I known that there was a package for this, I would have paid only Rs. 28,000 or a little more. Then, selecting the package for the surgery I agreed to pay Rs. 325,000 plus Rs. 15,000, and on making inquiries with the hospital management that I will pay the agreed amount.

My view on this is that if the hospital provides packages they do so taking into consideration the risks involved in encountering abnormalities or other added problems, at the time of surgery or after the surgery and the authorities must be able to assure good health despite any new problems arising, at least till such time as the patient leaves the hospital.

To my surprise, I received an additional bill for Rs. 55,000 apart from the package of Rs. 345,000 and the deposit of Rs. 15,000. I explained to the management that my operation was normal and I did not encounter any problem, nor did I complain of any problem while in the ICU, CCU or in the Cardiac Ward and that I am entitled to the refund of the deposit of Rs. 15,000.

The additional bill referred to the medicines given to me and I am thankful to the management that they allowed me to leave the hospital with no additional amount. But despite my appeal made to the Chairman I was not refunded the deposit of Rs. 15,000.

My suggestion to the hospital authorities is that they must fix the package taking into consideration all risks or additional expenses that may arise, and once the amount is fixed no additional amount should be asked, for otherwise the package is meaningless. It is noteworthy that a deposit of further Rs. 15,000 taken by the hospital is reasonable taking into consideration the risks involved, depending on the patient.

Indian Influence

I find there is a trend, of Sri Lankans visiting Indian hospitals for this type of surgery, and others seeking opinions. But now, this trend is less. Perhaps, Indians have set up hospitals in Sri Lanka. I also find Indian doctors teaming up with Sri Lankan doctors in the hospital, where I observed that they wield a greater measure of influence in instructing hospital authorities in transferring their patients from ICU to cardiac wards and visiting their patients frequently. More efficient doctors in Sri Lanka to serve the people, is good.

In my opinion, we must be able to project an image as I find that there are very capable young doctors in Sri Lanka who can serve with a Sri Lankan identity. Infact, Sri Lankan doctors are UK qualified and they are qualified doctors who are unable to engage in this duty due to lack of opportunities.

I am told that there are about four UK qualified doctors in the government service, idling, without being given any opportunities. The government and the Department of Health should take early steps to give them the necessary encouragement and the opportunity to serve the country.