Question 1

Dialysis

Accepted Answer

Preparing for your dialysis session: The Dialysis Ward is an outpatient facility that seeks to provide the best care possible for patients who have kidney disease or kidney failure. Our medical team of doctors, nurses and technicians are highly experienced and trained to ensure the comfort and convenience of every patient at each dialysis station. Dialysis keeps your body in balance by removing waste products, salt and extra fluids from your blood, to prevent them from building up when your kidneys can no longer do this. It also helps in keeping a safe level of certain chemicals in your blood, such as potassium, sodium and bicarbonate and in controlling your blood pressure. At The Aga Khan University Hospital, we offer services for haemodialysis. In haemodialysis, a machine acts as an artificial kidney to remove waste and excess fluids and chemicals from your blood. Before you can begin your first haemodialysis session, you will need to have minor surgery in your arm or leg to make an access (entrance) into your blood vessels. This access site will be used to connect you to the dialysis machine and is the site where blood and fluids will flow in and out of your body. Before coming to the Dialysis Session, You will be asked to restrict the amount of water you drink, depending on your weight. This is to prevent the excess accumulation of fluid in the body. You will be asked to follow a strict nutritional food plan, to prevent the build-up of minerals (including sodium, potassium and phosphorus) in the body. ​ What to expect during the dialysis session: You will sit or lie on a bed. You will be able to read, use your mobile phone and listen to music or go to sleep. You may feel dizzy or have muscle cramps caused by the rapidly changing blood fluid levels in your body. Each haemodialysis treatment lasts about four hours and may be done three times per week. The time needed for your dialysis depends on: How well your kidneys work How much fluid weight you gain between treatments How much waste you have in your body The size of your body. ​​ What to expect after the dialysis session: Our medical team at the Hospital will guide you on the care you will need to take at home to prevent issues with changes in blood pressure. You will also be educated on how to take care of the dialysis access site to prevent any possible infections. ​ Locations: D1 Ward, Main Hospital Building, The Aga Khan University Hospital, Main Hospital Campus, Stadium Road, Karachi 2nd Floor, Jena Bai Hussainali Shariff Building, The Aga Khan University Hospital, Main Hospital Campus, Stadium Road, Karachi Telephone: (+92) 21 3486 4150 (+92) 21 3486 6422

Question 2

Endoscopy

Accepted Answer

Preparing for your endoscopy: If you are suffering from a gastrointestinal medical condition (related to your oesophagus, stomach, or colon) that requires diagnosis and or treatment, you may be scheduled for an endoscopy. An endoscopy can also be used to diagnose diseases of the ear, nose, throat, heart, urinary tract, joints, and abdomen. Endoscopy can be a nonsurgical or a minimally invasive surgical procedure that allows the doctor to examine, remove tissues or treat the body areas using an endoscope. The endoscope is a flexible tube with a powerful light and camera attached to it. The endoscope is inserted into the body through small incisions or natural body openings and allows your doctor to view pictures of your digestive tract on a display monitor. If you are taking medications, you may be asked to stop. You will be asked to stop taking blood-thinning medicines a few days before the surgery, as these increase the chances of bleeding. You should inform your doctor if you have any medication allergies or have had any adverse reactions to medications. You should inform your doctor if you are pregnant or have any other medical condition so that special precautions can be taken. You may need to fast for 4 to 8 hours before the procedure to ensure your stomach is empty, if you are having an upper gastrointestinal endoscopy. For a colonoscopy: You will be asked to change your diet a few days before the procedure. Changes will include elimination of fibre and foods with small seeds. You may be given a laxative to take the night before coming in for the procedure. You may also be asked to drink a cleansing solution to clean out your bowel. You may be given an enema 2 to 3 hours before the procedure. You may undergo a rectal examination to help the doctor look for any bleeding or abnormal growths. ​​ What you can expect during the endoscopy: You may receive anaesthesia and/ or a sedative depending on the type of endoscopy. Anaesthesia blocks the awareness of pain. A sedative relaxes you. The sedative may make you feel lethargic and slow after the procedure and usually takes 24 hours to wear off. The effects of sedatives may be manipulated by other medications. To avoid such issues, please inform your doctor about any other medications you are taking. Throughout the procedure, our health care team will monitor your temperature, blood pressure, and heart rate. Your doctor will review and, in some cases, record the images from the endoscope. He or she will also perform any procedures, such as collecting tissue for testing. What you can expect after the endoscopy: After the endoscopy, you will be taken to rest in a recovery area. You may experience some mild side effects depending on the type of endoscopy. These can include but are not limited to, a sore, dry throat or bloating and gas. Complications from an endoscopy are uncommon, but they can happen. They can include a hole or tear in the area being examined, bleeding, and infection. Talk with your doctor right away if you have any of the following symptoms: Fever Vomiting Chest pain Abnormal stool Shortness of breath Severe abdominal pain or other unusual symptoms Locations: D2 Ward, 2nd Floor, Main Hospital Building, The Aga Khan University Hospital, Stadium Road, Karachi Telephone: (+92) 21 3486 1422 (+92) 21 3486 1423 (+92) 21 3486 1424

Question 3

Oncology Day Care Services

Accepted Answer

Our oncology day care services are especially designed for patients suffering from all types of cancers. Most cancer patients do not need to be admitted to the hospital and can be treated through a day care service such as ours. Our team of highly qualified nurses and doctors are specially trained in the field of oncology and will offer you high quality treatment delivered with care and compassion. The oncology day care services are equipped to offer patients a range of diagnostic and therapeutic modalities. ​Chemotherapy: How to prepare Your chemotherapy schedule will depend on the type and stage of your cancer and the goal of your treatment. Chemotherapy can be delivered through various ways: injection (shot in a muscle or under the skin in the fat), directly into the artery (intra-arterial), directly into the area containing the organs such as stomach, liver, ovaries (intraperitoneal), directly into a vein (intravenous (IV)), tablets, pills, capsules or liquids (orally) or as a cream that you rub on your skin (topical). You can prepare for your chemotherapy by: Asking your family and friends to help you with arranging meals, taking care of your children and your home chores. Planning your time so you can rest on the day of and the day after chemotherapy. What to expect Chemotherapy affects patients in different ways, depending on how healthy you are before treatment, the type and stage of your cancer, the kind of chemotherapy and the dose you are getting. Some people do not feel well right after chemotherapy. The most common side effect is feeling exhausted, tired and worn out. ​ Radiation Therapy: How to prepare Radiation therapy treats cancer by using high-energy waves to kill the cancer cells. The goal is to destroy or damage the cancer without hurting too many healthy cells. Your Radiation therapy schedule will depend on the type and stage of your cancer. Your radiation therapy team will take you through a planning process to determine that the radiation being given reaches the precise spot in your body where it's needed and you find a comfortable position during your therapy. When you come for radiation therapy, you will be expected to lie on a table whilst the machine (linear accelerator) moves around you to deliver radiation from several angles. You must lie still. You may hear a buzzing sound. Each radiation therapy session may last from 10-30 minutes. Our medical team will be able to observe and communicate with you from a room right outside the radiation therapy room. You should speak up if you feel uncomfortable or any sort of pain. What to expect Radiation therapy affects patients in different ways, depending on how healthy you are before treatment, the type and stage of your cancer, and the kind of therapy and the dose you are getting. The most common side effect is feeling exhausted, tired and worn out. Blood Transfusion: How to prepare Blood transfusions are provided to our cancer patients as well as patients with other blood disorders such as thalassemia. Your blood will first be tested to determine your blood type (A, B, AB or O) to ensure that you are compatible with the blood you are given. What to expect You will be comfortably seated or made to lie down for the procedure. The blood transfusion can take from 1-4 hours, depending on which parts of the blood you receive and how much blood you need. Before the transfusion begins, we do an identification check to ensure that you are being given the correct blood. Then an IV (intravenous) line with a needle is inserted into one of your blood vessels. The donated blood that's been stored in a plastic bag enters your bloodstream through the IV line. You will be monitored throughout the procedure. Please alert your nurse immediately if you feel: Fever Shortness of breath Pain at the site of transfusion Chills Unusual itching A sense of uneasiness The needle and IV line will be removed. You may develop a small bruise around the IV site, but this should go away with time. ​ Locations: Ibn Zuhr Building, Main Hospital Campus The Aga Khan University Hospital, Stadium Road, Karachi Telephone: (+92) 21 3486 1814 (+92) 21 3486 1815