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Bengaluru: A cancer patient requiring bone marrow transplant can become a complicated case if he or she belongs to Jehovah’s Witnesses denomination as blood transfusion is a taboo for the community even during life-threatening conditions. However, a four-year-old boy from Tanzania, who was suffering from fourth stage abdominal cancer and belonged to Jehovah’s Witnesses, successfully underwent bone marrow transplant (BMT) in Bengluru in what was a bloodlessprocedure. The treatment usually entails five to six blood transfusions, but in this case, doctors at Mazumdar Shah Cancer Centre, Narayana Health City increased his blood levels three weeks prior to the procedure. Ittai James Moshi from Dar es Salaam in Tanzania underwent the transplant in September 2019 and is recovering. Ittai’s parents, IT employees in Tanzania, shifted to Bengaluru in late 2018 for his treatment. “In mid-2018, my son started having high fever, body pain and stomach cramps. No medicine helped despite repeated consultations with pediatricians in Tanzania. By October 2018, he stopped walking,” said James Moshi. A private hospital in Bengaluru first treated Ittai for bacterial infection. “His infection had spread to the skeletal system. On seeing no recovery, a battery of tests were done. He was then diagnosed with cancer,” recalled Moshi. Read more at: http://timesofindia.indiatimes.com/articleshow/73281419.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

Kory Bradshaw says he was in a Toronto ICU with only months left to live when he got the phone call from doctors about getting a long-awaited double-lung transplant. Bradshaw, who has Cystic Fibrosis, didn’t hear anything for months after having gone through two false alarms since being put on the wait list for a transplant last May. “Third time’s a charm,” Bradshaw told Global News Monday. He and his wife, Renee Bradshaw, came to Toronto from their home in Kelowna, B.C., last January with the hope of receiving a transplant faster due to the better wait times in the city. The average wait time in B.C. is about two years, but in Toronto it’s around six months. After receiving the transplant over four months ago, Kory said he feels “amazing” now. “We can have a whole new life together, doing a lot of things that people might take for granted like walking and holding hands,” he said, adding he still has to get used being able to laugh properly. That new life together will also include a new modular home for them when they move back to Kelowna at the end of the month. In a cruel twist of fate, while Kory was in the ICU at St. Michael’s Hospital in Toronto in June, they received a call that their B.C. home was destroyed in a fire. “They believe it was from a discarded cigarette that caught our cedar hedge on fire, which spread in the shed into our house,” Renee previously said. Friends and neighbours quickly rallied to help them. Beth Shey, a neighbour they hardly knew, started a GoFundMe page to help them with living expenses while they were waiting for the transplant in Toronto. The couple said the new modular home should be delivered by the time they get back and should be move-in ready by late January. The Transplant Kory underwent his transplant at Toronto General Hospital, which does about 150 lung transplants every year. But Kory’s situation was unique. Since he and Renee are Jehovah’s Witnesses, and because of their beliefs, a blood transfusion was not possible. The couple said they searched for years but no surgeon would agree to attempt a bloodless transplant until they found Dr. Shaf Keshavjee, who agreed to perform the procedure as long as the couple understood the risks. Read more: https://globalnews.ca/news/3923183/toronto-general-hospital-bloodless-double-lung-transplant/

Ontario, Canada, robots to operate cancer in Jehovah's witnesses. The patient, a 70-Year-old high risk of prostate cancer, was a Jehovah's witness. His religion was one of the reasons why he decided to undergo surgery in st. Joseph's healthcare in Hamilton, home to a robot named da Vinci, whose firm metal hands can remove a prostate with little risk of blood transfusions prohibited by man's faith. On a recent afternoon, the patient remained unconscious on an operating table while surgeon bobby shayegan and his team threw a camera and three surgical instruments controlled through small incisions in his abdomen. Dr... Shayegan settled in front of a three-dimensional screen, joined the two joysticks who controlled the tools inside his patient's pelvis and proceeded to cut, cauterize and sew until he released the man's prostate, pulling it out through one of the original incisions. There was no blood. " that was routine said Dr. Shayegan later, holding the gland the size of a plum tree that he and the robot had withdrawn together. Very routine. This is how nine out of every 10 prostatectomy take place in the United States. Robot-assisted surgery is not the path of the future there - it is the path of now. https://beta.theglobeandmail.com/life/health-and-fitness/health/the-fight-for-robots-in-canadas-operatingrooms/article35897282/?ref=http%3A%2F%2Fwww.theglobeandmail.com

BENGALURU: A 50-year-old Nigerian national underwent an awake craniotomy, a surgery performed while keeping the patient awake, allowing doctors to test the patient’s functions throughout the operation. The surgery was performed on April 14 at Columbia Asia Hospital in Hebbal. Doctors performed cortical mapping that helps identify important regions of the brain that can be avoided and protected during the surgery. “Stimulating various areas of the brain to have different effects on the body, like touching the motor region results in twitching and touching the speech areas would prevent the patient from speaking briefly. This helped the surgeons navigate through the main affected areas and perform the surgery accordingly,” said Dr Arjun Srivatsa, senior consultant, neurosurgery, Columbia Asia Hospital. During the procedure, doctors engaged Samuel in a conversation. Samuel was operated upon to remove a brain tumour that affected areas of speech. Over the past three months, he had been finding it difficult to communicate, often forgetting words or losing his train of thought while talking. His condition worsened with persistent headaches and speech impairment. He was diagnosed with seizure activity in the brain and an MRI confirmed a brain tumour. Since he is a Jehovah’s Witness (accepting blood transfusion is prohibited), it complicated the surgery further. The three-hour surgery had no post-operative complications. Samuel is now able to communicate without any difficulty, said Srivatsa. Samuel with Dr Arjun Srivatsa http://www.newindianexpress.com/cities/bengaluru/2017/may/05/brain-surgery-performed-on-conscious-man-in-bengaluru-1601277.html

Much has changed as doctors have come to understand the risks of blood transfusions and the ways to avoid them — helped in part by studies of Jehovah's Witnesses. Michael Anderson, a Jehovah’s Witness minister who underwent a bloodless emergency bypass procedure after a heart attack earlier this month, was visited in his hospital room by Syl Jones, a fellow Jehovah’s Witness and an administrative resident/fellow at Hennepin County Medical Center. Dr. Daniel DiBardino didn’t have much time for niceties on Sept. 8 as he consulted patient Michael Anderson about the emergency cardiac bypass he needed. Anderson is a Jehovah’s Witness — opposed to donor blood transfusions — and DiBardino needed to know if he could breach that religious conviction during the procedure. “What if he’s bleeding to death, which occasionally can happen in cardiac surgery?” he recalled asking Anderson and his wife. “A lot of things can go wrong.” “Absolutely not,” was the reply. A decade ago, that answer might have touched off a doctor-patient argument or the kind of ethics crisis featured in medical TV shows. But as doctors have come to understand the risks of blood transfusions and the ways to avoid them — helped in part by studies of Jehovah’s Witnesses — much has changed. Hospitals such as Hennepin County Medical Center (HCMC), where DiBardino practices, have become more accommodating — and more adept at conserving patients’ own blood during surgeries. “When I was in medical school, honestly, that was never a thing; people didn’t talk about blood conservation,” DiBardino said. “You just used blood because that’s what you did. And that has changed.” Today, for example, surgeons understand that one unit of blood often works as well as two and that excessive blood from donors can result in transfusion-related complications and even deaths. As a result, HCMC has reduced the use of donated red blood cells by 32 percent since 2009. Other Twin Cities hospitals have reduced their use of blood products as well. HCMC has taken the approach a step further through its Bloodless Surgery and Medicine Program, including a firewall in its computerized medical records system that prevents doctors from ordering donor blood products once patients have refused them. The computer system gives doctors alternatives, such as medications that stimulate more blood production in the body, which they can consider even when preparing for emergency surgeries, said Dr. Jed Gorlin, who directs transfusion medicine at HCMC and is the medical director for Memorial Blood Centers, a regional donor agency. “In the heat of battle, you won’t remember all of those,” Gorlin said, “so it’s a checklist to go through all of that stuff.” The Jehovah’s Witnesses’ objection to receiving donor blood comes in part from interpretations of the Bible, including a passage in Acts that calls on people to “abstain from pollutions of idols, and from fornication, and from things strangled, and from blood.” Practical interpretations vary somewhat, Gorlin said. Some members of the religion accept the experimental use of a substitute made from cow’s blood, while others refuse it. A few object to the use of a machine that recycles a patient’s own blood once it has exited the body. But almost all reject transfusions of red blood cells from donors. Anderson, 66, has walked hundreds of miles visiting homes in southwest Minneapolis to teach his religion. He carried a medical directive with him for just such emergencies. Then, driving from his home in Robbinsdale to his Kingdom Hall on Sept. 8, the minister knew something was wrong. “All the way there, I had pain and it wouldn’t go away, and it wouldn’t go away and it wouldn’t go away,” he recalled. Medics determined that he was having a heart attack and gave him aspirin and nitroglycerin pills, which had eased his pain by the time DiBardino sat with him to discuss his surgery: a triple bypass to reroute blood flow around blockages to the heart. “There was no question ... transfusion would not be an option,” Anderson said in an interview from his hospital bed last week. Hemoglobin levels HCMC’s policy is to accommodate such objections for adult patients, when they are conscious and able to communicate their wishes, but not necessarily for parents acting on behalf of pediatric patients. A 1944 child labor decision in Massachusetts still governs such cases, stating that “parents are free to become martyrs themselves. But it does not follow that they are free ... to make martyrs of their children.” Once viewed harshly by the medical establishment, Jehovah’s Witnesses have taught doctors much about the body’s ability to survive surgeries without transfusions, Gorlin said. He gave a lecture in South Dakota this month titled “Management of blood: What we can learn from Jehovah’s Witnesses.” A key measure is the patient’s hemoglobin, the protein in red blood cells that carries oxygen from the lungs. Doctors once thought a hemoglobin measure of 10 grams per deciliter was the key threshold at which patients needed a transfusion. Now, they have found that patients are just as likely to survive if their levels drop to seven. In one local case, a woman who hemorrhaged after childbirth survived despite her hemoglobin dropping to 2.3. “Nobody really knows for any given person how much blood loss they’ll tolerate,” DiBardino said. “You just have to kind of put your faith into it.” ‘Every red blood cell matters’ Still, the odds of surviving the triple bypass that Anderson underwent are substantially lower without transfusions, DiBardino said. As a result, surgeons make it a priority to conserve blood, from the initial step — severing a leg vein to serve as a bypass line around a clogged artery — to connecting that bypass line to the heart. “It’s on your mind that every red blood cell matters for this guy,” DiBardino said. “You’re operating on the biggest structures filled with the most blood in the human body.” At the end of the four-hour operation, Anderson’s hemoglobin level stood at seven. But with rest, iron pills and other medications, it rose to 12. One week later, Anderson had fewer IV tubes and was standing and eating solid food. Two weeks later, he was back home. He believes his clean living helped him survive the surgery and said he is eager to ease back into walking and his door-to-door ministry. “It’s just a matter of pacing myself,” he said, “as I go.” http://www.startribune.com/minneapolis-hospital-embraces-bloodless-surgery/394648141/