I came to Australia in 1976 to do my masters and the plan was top head back home on Completion. Met my wife to be in Sydney the following year. She was from Singapore. She was not keen on living in India and Singapore was Ok for a three day holiday but had nothing for me on offer, a mundane commercial pit with no sport. So the choice was to move to Canada or Stay in Australia. Canada was accepting applications from Professionals like me but I hated the cold weather. Believe it or not Despite PM Gough Whitlams efforts to change the Australian Immigration Policy, when I arrived the PM was Malcolm Fraser and White Australia Policy Prevailed. Any way we both went about our University education she doing her bachelors degree in Accounting and me my PG Studies. I arrived in July missing the first six months of the course and it took me longer to complete and then I fell in Love with Acoustics and ended up working towards a PhD in Acoustics.
The Good thing about Malcolm Fraser was that he implemented many policies of Gough Whitlam like Making education free and medicare for all Australian citizens, considering it was a huge continent with abundant natural resources, with a meagre Population of about 18 Million people and hence a land of Milk and Honey so education and health care should be available to all for free.
In 1983 Australians elected Bob Hawke as Prime Minister and that marked the beginning of a new era.
In 1976 I remember an Aussie teen ager telling me that the Yoghurt I was eating was Yuk Bacteria and the whole State died at Mid Day on a Saturday as all shops had to close by Law. Weekends were the time to go out and have fun shopping but not in OZ. Not to forget the One Dollar Coffee served in white Polystyrene cups in Greek Cafes that was yuk and eating Chiko Rolls..Was a very very backward country then, almost like a country town in US Midlands.
Immigration Policies Changed under Bob Hawke who offered 65000 Illegal Migrants amnesty to become citizens of Australia. Unfortunately I was not illegal as I had a valid student Visa, Yet I applied and was rejected as I was a student and law said I had to go back to India and apply after two years. I was not going to accept this lying down, so I appealed to PM Bob Hawke Directly saying why some one like me who had not done anything illegal had to be penalised when 65K people who broke the rules are being allowed. Believe it or not in about two weeks time I received a letter in the mail from PMs office asking me to submit my passport to immigration and here I am in 2021, having lived in Sydney for 45 years of my 73 year life. Had a wonderful life and a most rewarding Career, both worth killing for.
Millennium dawned and my life fell apart health wise and from year 2000 to 2021 I have had some fab experiences with Very Very Good doctors but have faced so many situations where quackery would have killed me but for my own alertness.
1- My Stroke Nightmare:
In February 2000, I realised something was wrong with me. I told my GP a Lady Doctor that I was getting visual disturbances in my Right eye and my Right hand wanted to go to sleep when i was driving. Instead of giving it serious thought she told me to my face I have many patients like you who imagine a lot and keep complaining. Any way she sent me to an eye specialist who said there was nothing wrong with my eyes, then to a Migraine specialist who sent me for a Ultra sound of the arteries in my neck and concluded I was suffering from Migraine hemiplegia and prescribed a drug called Sando Migran. This mad me extremely drowsy and my symptoms continued. so he prescribed Epilum which mad me even more sick. Something was of concern so my GP sent me to a Cardiologist. He gave me a shot of Sistimibi a radioactive dye to study my heart during Echo whilst running on a tread mill. Never happened as I had the worst TIA. was rushed to ER by my cardiologist who told the Triage Nurse I am a Cardiologist. This gentleman is having a stroke right now so please get the Neuro registrar to examine him straight away. Don't know why she was not bothered. Took her own sweet time finding me a bed and filling out forms and getting some mandatory blood tests organised. she never informed the neuro registrar and I was discharged 4 hours later with a diagnosis of Migraine by the Triage Nurse. This was on 7th April 2000. On 13th April 2000 I suffered a massive Brain stem stroke caused by the occlusion of my Right vertebral artery. It affected the right side of my face my right hand and the entire left side of my body was paralysed.
A simple dose of a Blood thinner like Aspirin would have averted the stroke. My GP, Ophthalmologist, Neurologist and Cardiologist, Hospital Triage Nurse all failed me. Worse still after admission to RPAH when the MRI showed a Blocked vertebral artery a simple Plasma Injection would have dissolved the clot and saved me. No the Neurologist said it was not Occlusion but a dissection and a text book case as seen only in autopsies. My Platelet count was 890 and the Neurologist did not call a Haematologist on Board. Another quack of a neurologist at RPAH.
Looking back now I realise that treatment with heparin at RPAH and warfarin later thinned my blood and allowed Retrograde flow to my AICa and PICA that kept me alive.
Five weeks after discharge from hospital and rehab, I had my first visit to my neurologist. I was keen on seeing the Registrar who saved my life, but his Boss Took my file as it was a unique case. This man did not do anything for me when I was in hospital and when I asked him a few questions about a vertebral artery bye pass, he barked at me saying I am the specialist don't tell me what you read on the internet as it is all crap. IO asked him Doc I see it as a blood related issue should I not see a haematologist. He barked at me again and said "You want to see a haematologist go see a bloody Haematologist" I kept my Calm and said tell me who to see at RPAH and he scribbled Prof Dr Harry Illands name on a piece of paper. I walked out thinking I am not going to see this moron again.
Prof Illands secretary told me when I went to haematology in he round floor that I could not see him for another three months. Doctors secretaries Play God in Australia leading to man y mishaps. I told the lady Id be dead in three months. so she went and checked with the Prof and she said he will see you tomorrow. we need to do a lot of blood tests so don't eat or drink anything after midnight
Next Morning I saw God Himself in a doctors coat . Prof Harry Illand. If I am alive today it is because of him
When he realised I had been admitted at RPAH on 13th April when Paramedics rushed me there, he said give me a few minutes Im will look at the computer and be back.
When he returned to his room, his face was red with Rage and he was "F"ing this and "F" ing that. He ten told me that my platelet count was 890 and the first thing that should have been done was to inform haematology which the neurologist did not. I did not know what 890 platelet count meant so I asked a dumb question what is the normal range doc and he says 150 to 300 (This as now been changed to 150 to 450). He said with such high platelet cunt you could have suffered a second stroke, bloody Idiots he said in disgust.
Next thing I know, he was performing a Bone marrow test and the registrar was trying to tell me that i would be painful and I told him doc My left side is paralysed and I wot feel a thing if you chopped my leg off and he said "I love your sense of Humour" and went on with the procedure. Treatment for high platelets called Thrombocytosis was started immediately using a medicine called Hydroxy urea,
I spent my time on my Posh Amstrad Computer that cost me $7500 and it had a floppy disk and a whooping 40 meg hard drive with a monochrome Monitor trying to understand Vertebral artery dissection and Thrombocyytosis which is often linked to gastrointestinal or lung cancers.
This is when I found the Massachusets Stroke forum and became an active member. Unfortunately for me not one of the stroke survivors had survived a brain stem stroke caused by vertebral artery dissection/occlusion. I kept reading archived posts until I came across a lady who had complained of similar symptoms I had experienced but she had died presumably. In that thread I spotted a John who had responded and when I got in touch with him he told me about a Lady in Florida Andrea Convay, who had bth vertebral arteries dissected when she went on a roller coaster ride. You can read all about my VAD Club in my Blog
There was hope a Vascular surgeon in New Orleans was an expert in performing Vertebral artery By Pass. Thanks to internet I was able to contact the surgeon.He said it was not possible as my blockage was not in the neck but high up in the brainstem plus it was too late. As I was having multiple TIAs each and every day IO consulted a Surgeon at Prince of Wales hospital who was very very keen on performing not a vertebral artery bye pass but a PICA Bye pass in the Brain stem. he had never done one before and I was his guinea pig. I consulted Prof Illand and he said don't let any bastard open your brain up Ram as you may not cone out alive from the theatre. This was the second time my God Send was saving my life. The surgeon held me in the hospital for 13 days to force me to agree. I said No way and discharged myself from the Hospital.
One good thing happened though he called on Board the Stroke specialist Dr Gilles, who realised my platelets were very high and put me on Plavix an anti Platelet medication. That stopped my Tia's.
I can never forget Dr Gilles telling me "Mr Krishnaswamy, thank your lucky stars that you have survived and around still" "Why doc ? " I asked and he says as stroke specialist for 16 years I have seen cases like yours only in autopsies.. Another God send. May his soul RIP
From 2000 to September 2012 I would have consulted nearly 20 neurologists and very few knew what they were doing, conduct basic tests to establish symptoms and deficits look at me and do an Inky Pinky Ponky what Can I give this Donkey.
There was another God send who looked after me from 2003 to 2017 when he passed away. I ran into a n elderly Sri Lankan patient at RPAH and offered him a lift home to Homebush and in that short ride he hqad a message for me. That I should consult Dr Darrel Weinman a brilliant Sri Lankan neurologist who was Practicing as a GP not far from y home.
Can you explain this in any other way other than God sending me a message. I never saw this stranger again
Sept 2012 I blanked out in a restaurant and Paramedic were ordered to take me to Canterbury hospital where there was no MRI machine. God had better Plans I think, as the next day I was seen by a lady Neurologist Dr. Penelope Spring. She was calm and composed. Listened to my long winded story examined me thoroughly ordered another MRI and said "I have a gut feel that the problem is not neurological but one of depleted B-12, as you are on massive doses on Insulin. Your Endocrinologist should have kept an eye on your B112 which she did not. Blood results came the following day and I virtually had no Vit B 12 in my body. One Injection and I was back on my feet.
My Diabetes Nightmare:
Trauma often causes Diabetes so I was not at all surprised when my sugar levels started to creep up in 2003 and was assumed to be Type 2 Diabetes and prescribed Diabex automatically plus other medications and then despatched to an endocrinologists have seen several. mostly drug pushers like the neurologists Did not matter what i did my fasting blood sugars were about 9 or 10 even if I starved all day the previous day. I was put on fast acting insulin 5 units and had a massive hypo in 2007 By 2015 I was taking 30 units of fast acting insulin 2 times a day plus long acting insulin 50 units a day and my weight crept from 80 kilos to 110 kilos and the lady Doctor I was seeing could not be bothered.
Again I had to join a diabetes forum and find out from other diabetics that what i was suffering from was not type 2 diabetes but Type 1.5 Diabetes also known as LADA. Latent Auto Immune Diabetes in Adults. My Endo did not want to hear about this self diagnosis plus she had not even monitored my B-12. Another quack I thought who was there, raking in money.
I asked my Sleep apnea specialist if I had LADA ? he said yes looks like you have what is called "metabolic syndrome, where insulin produced by your pancreas are rejected by the body cells resulting in high blood sugars. so he referred me to the Metabolic clinic at Concord hospital. I phoned the Ckinic and the nurse in charge asked me what my weight was and I said 110 kilos and she says sorry sir you do not qualify as the min reqd weight to join the trials in this clinic is 135 kilos.
I ask Dr Penelope Spring who is now me Specialist Physician and she refers me to endocrinologist Dr. Bronwyn Bishop. One Visit and my Diabetic woes are out the window. she said I have the perfect medicine for you. It is a Diabetes medicine called Forxiga. It takes the sugar out of the blood and sends it out through the kidneys unlike other diabetes medicines where the liver does the work. Initially there will be much increased urine output and emergencies you have to be prepared for but this will go away once your high Hba1c drops to about 7.5. also you have to watch your kidney functions as this medicine could have adverse effects on your kidneys. Believe it or not Insulin went out the window from the time I started on Forxiga Plus Galvumet. So Dr Bishop thank God knew what she was doing unlike all my previous endocrinologists, who were pill pushers.
My Heart Nightmare:
My GP Dr Weinman, wanted me to see a Cardiologist and referred me to his Favourite Specialist Dr Con Yannakis. A Good doctor. Unfortunately for me he went on a long tour of Europe and I came under another Cardiologist in the same clinic. Everuy three months I saw him and had the same complaint that i was extremely short of breath, he would do an ECG and an Echo and told me the same thing again and again that my heart was fine and that I had what he called Exercise induced Asthma and that it was all on my mind.
January 2018 I had to scream at him and insisted on a Holter Monitor and the next evening he tells me OMG you have BradiCardia and need a Pace Maker urgently and I have organised the surgeon and the procedure will be done tomorrow morning. I had no clue what Bradi cardia was and there was no time to look at the computer as I was into the hospital straight away. The Surgeon was fantastic and he used awake anaesthesia and kept talking to me and explaining what was going on I could see he Medtronics Rep open a new Box of Pace maker.
After the procedure when I was under observation the surgeon tells my son your Dad is lucky as he had stage three Bradicardia and on his last leg. I received he state of the art Pace Maker costing Aud$ 25K with a remote control that I had by my bed side and could relay to my Cardiologist if I thought something was wrong and not feeling well. The Remote sat in a Box as my cardiologist told me the Concord Hospital did not have the facility to get on line input from my machine. I am just a patient and I believed everything my Cardiologist was telling me. Every three months Medtronics technicians checked to see if the Pace Maker was working ok. On one such occasion I asked the technician what use. y remote monitor was sitting in a box. It was then I found out the TRUTH. There were Cardiologists who were PaceMaker specialists I should be seeing and he shared two names in confidence. I also asked how come my Cardiologist did not diagnose my heart problem until it got serious. he said I should not be telling you this, a Holter Monitor would have picked this up straight away. Plus the machine your cardiologist uses for an ECG is obsolete and has only six leads. It needs one with 12 leads to detect Bradi Cardia. This Cardiologist of my Put my life at Risk for ten odd years with the same BS diagnosis that I had exercise induced asthma and that It was all in my head. Many people told me I should sue RPAH and the Endocrinologist and the Cardiologist and I can her my lawyer sons words of Wisdom " Dad we are not Gold Diggers, you are alive and let us count our Blessings?
There are so many quacks out there working as specialists. This is understandable as many students chose to be doctors not because they want to care for the sick but because it guarantees them a Cushy life and a Lot of Dollars
We are lucky if i in 10 is a Good genuine doctor who cares for the patients. One neurologist could not read an MRI and was blindly going by the radiologists report that missed the occlusion of the right vertebral artery Must be another quack. I had to show the neuro where the blockage was. I tore up his prescription and never saw him again.
As long as Prof harry Island was my haematologist I was safe. but he retired and my nightmare has started. My haematologist did nothing for 2 years and again it was my neurologist Dr Penelope Spring looking outside the box indicated I might have developed Myelo Fibrosis which my haematologist did not pick up
The GPs Plight: There are GPs and GPs and a Patient can find a Good GP and Latch on to them. But then the Aust Medicare system allows Go to do blood tests and five prescriptions and refer a patient to specialists and have to accept the specialists diagnosis and treatment. No "Ifs and Buts" and once a specialist prescribes a treatment the GP cannot override it either.
The problem becomes even more Complex when a Patient is under the care of half a dozen specialists like me as I need a Neurologist, a Cardiologist, a Respiratory Specialist, a Gastroenterologist, an Endocrinologist, Skin specialist, ENT Specialists.
Each an d every ones prescribes one medicine or the other and they are more interested in asking you to come back in a few months.
They are all independent Pillars looking at only one organ or part of the body. You as a Patient are nt one human body any more but an assembly of spare parts.
The major issue is that None of the specialists talk to each other and most do not even bother sending a report to the GP like it used to happen earlier.
I am lucky in that I give all my Prescriptions to one Chemist and often it is the chemist who raises the alarm saying you should not be taking this medicine Ram when you are on blood thinners.
Majority of patients buy medicines from any chemist and start consuming them with the Blind Faith that the specialists know what they are doing. Even if hey know everything about the medications they prescribe, it is unlikely they know everything about every medicine.
Since the specialists want talk to each other as Time is money and they need to see more patients the Medicare system gets rorted as so many medications go to the bin.
Medicare needs a soft ware system that collates every patients treatments and quickly analyses all medicines prescribed to see if there are contra indications
