CARE’s Multi-Specialty Approach Helped Mr Narayanan Walk Again
In September 2015 during the course of a normal investigation I was found to have sarcoidosis and the pulmonologist recommended that I meet a rheumatologist. During the course of steroid intake I suddenly had severe pain in both the legs and became immobilized without any warning. Carried out MRI and other investigations but no respite was there and the pain was getting worse and not responding to any pain killers. As leg movements as well as walking was not possible, I was bedridden for almost a month, without any clue of what type of treatment was to be given.
Dr C Narasimhan, Cardiologist in CARE Hospitals who is known to us, took the responsibility of coordinating my treatment with consultations with a pulmonologist and rheumatologist. He recommended I consult Dr Praveen (Mereddy), specialist in knee and joint replacement. Dr Praveen advised a hip joint biopsy, as well as extraction of fluid to see what type of infection was leading to this issue. To his surprise, no infection or any other symptoms were noticed.
The case was getting further complicated as experts differed in their opinion on the type of treatment to be given. For a surgeon the decision making was getting complicated. Dr Praveen took the bold decision to replace the right hip joint, which was affected badly. The procedure took place in Jan 2016 and after that I was moved to the ward. The severe pain on the right leg was totally gone, apart from the surgical procedure pain. However, the pain on the left leg continued to bother me.
Physio was continued but it was difficult to do physio for the left leg. The left leg was shorter by a few inches as compared to the right leg. The pain was getting worse. The left leg X -ray revealed that the hip joint had moved up and was almost touching the hip joint cavity. Again Dr Praveen took the decision to replace the left hip joint, within 20 days of the first procedure.
Consultation with Dr Narasimhan and the sarcoidosis team continued with close monitoring and the steroid dose was suitably adjusted. The final result showed there was an unknown infection and I was put on antibiotics through drips at home with a specialised nurse.
After a month the catheter was removed from the neck. Throughout this period physio was continued. A long term calcium dose was administered to improve the strength of the hips. Every time I visited Dr Praveen he used to consult with all the specialists to see how further improvement can be done and he was successful in this process. After 4 months of this problem, lost muscles and strength could not improve at a faster rate.
With the advice of Dr Praveen the recovery was done over a period of 7 months with constant interaction between Dr Narasimhan and Dr Praveen. Physio was continued and quantity and type of food were also monitored to ensure adequate protein.
The entire team of Dr Praveen was very cooperative and special thanks to Dr Praveen and Ms Bhargavi; both of them went out of their way to give confidence to my wife. The counseling and support cannot be written in just a few words. Throughout the hospital stay, as well as making arrangements to ensure all the procedures went well. My wife used to call Dr Praveen and Ms Bhargavi at odd times also to get a clarification or change in medication and Dr Praveen and his team were very helpful.
Dr Praveen told me that he does not want me to lie and rot with pain and wanted me to see stand on my feet and walk as early as possible. Today his words are true. Even though the sarcoidosis continues to bother me I am on my feet and carry out my office as well as my house work, without much trouble.
S Sankara Narayanan