Frequently Asked Questions

If your child is diagnosed with any of the above-mentioned conditions. If your physician/pediatrician has advised a bone marrow transplant as an option. Children who are diagnosed with cancers and do not respond to chemotherapy. Children who remain unwell and have recurrent infections. Immunological testing and a visit to an Immunologist is warranted. The immunologist would guide you, in case a transplant is needed in your situation.

Pediatric Bone Marrow Transplant (BMT) is a complex procedure requiring hospitalization for a month and sometimes longer. Following are the steps involved: The patient is evaluated for the need for a transplant. In some conditions, a bone marrow transplant is an emergency (for example – severe combined immune deficiency), while in others, it is an elective procedure wherein patients are stabilized before undergoing a transplant. Donor selection – Akin to blood transfusion, where one needs to transfuse blood with the right blood group; a match between the donor and recipient is of paramount importance in Pediatric Bone Marrow Transplant (BMT). HLA matching is carried out using blood samples or buccal swabs. Healthy siblings who are fully matched on HLA typing offer the best outcome in most of the transplants. Haploidentical transplants (with mother/father being the donor) and matched unrelated donor (MUD) transplants are the other options. Conditioning – Here, the patient is admitted and medications are administered to prepare him/her for the transplant. Bone marrow transplant – Bone marrow-derived from the donor is administered as an intravenous infusion to the patient. Post-transplant recovery – The Patient is given medications and is observed for recovery. This period involves periodic blood tests to ensure recovery is smooth.

The broad group of conditions where Pediatric Bone Marrow Transplant (BMT) is useful are as follow - If the bone marrow starts failing to produce blood elements – Aplastic anemia. These individuals have low hemoglobin, white cell counts, and platelet counts and require monthly blood transfusions. Providing new bone marrow from a healthy donor can cure these patients. If the hemoglobin is abnormal – Thalassemia, sickle cell anemia, and other hemoglobinopathies. These children require periodic blood transfusions and Pediatric Bone Marrow Transplant (BMT) can be curative for these diseases. Cancers–Blood cancers (acute leukemia), solid tumors (neuroblastoma), and many other cancers can be treated with Pediatric Bone Marrow Transplant (BMT). Primary Immune Deficiency diseases – Some children are born with a problem in their immune system and fall ill repeatedly. They may be hospitalized for infections on several occasions. Repeated ear discharge, pneumonia, or diarrhea are often noted. Such children require immunological testing. In many of these immune deficiencies, Pediatric Bone Marrow Transplant (BMT) is curative. Severe Combined Immune Deficiency is often present in young children who fail to gain normal weight and fall ill repeatedly. This condition is universally fatal without a Pediatric Bone Marrow Transplant (BMT). Metabolic diseases – Some children are born with defects in the enzymes required for a normal metabolism - Inherited disorders of metabolism, congenital storage diseases.

Thyroid Surgeries are Safe surgeries with minimal risks. Speak to your surgeon before Surgery and clarify all your doubts and concerns. Your surgeon will allay all your fears regarding the surgery.

Thyroid surgery is generally a safe procedure. The vast majority of patients undergoing an operation on the thyroid gland have no complications. However, as with any surgical procedure, there are some risks associated with the operation and these will be fully explained to you by your surgical team.

Patients who have had a total thyroidectomy or near-total thyroidectomy will need thyroid tablets postoperatively and this will be life long.

The thyroid gland is close to many nerves and blood vessels and hence the surgery carries a minor risk involving injury to these structures. These are more likely to occur in patients undergoing Surgery for cancer Lymph node surgery Surgery for a large thyroid (goiter) Revision thyroid or lymph node surgery   Nerve Injury: There are nerves running in close proximity to the thyroid gland which is responsible for the quality and the pitch of your voice – Recurrent laryngeal nerves and the superior laryngeal nerves one each on each side. Injury to these nerves may result in a change in voice These voice changes are usually transient lasting for few days to few weeks. However, in very rare scenarios especially in thyroid cancer surgeries, there is a minimal risk of permanent voice damage. Hence professionals whose career involves their voice – like singers and teachers need to discuss with your surgeon prior to surgery. Uncommonly injury to laryngeal nerves on both sides may warrant placing a breathing tube through the windpipe (tracheostomy). In most instances, it is short-term. Low Calcium levels: We have four parathyroid glands, two on each side, each about the size of a grain of a lemon seed attached behind the thyroid gland. They are involved in regulating calcium levels in the blood. Normally the surgeon identifies and saves some or all of these glands. However, during thyroid surgery the parathyroid glands can be bruised, damaged, or excised, causing low calcium levels in blood manifested by a sensation of tingling in the fingers and lips (pins and needles sensation) and/or cramps in the fingers. Even if the parathyroid glands are saved, there may be stunning of the glands causing low calcium levels for several days to weeks. These may be managed by replacing calcium usually orally by tablets.   Other Potential Complications Neck Numbness: Some patients may experience numbness around the thyroid surgery scar after their operation. This usually subsides with time. Swallowing Difficulties: Mild swallowing difficulties may occur usually pain-related improves with analgesics Wound related issues: Swelling around the wound may be seen for a few days – these are usually normal after surgery. Wound Infections are rarely seen Occasionally fluid may accumulate behind the wound called a seroma. Normally subsides with time. Thyroid Storm: An Extremely rare complication in patients with the overactive thyroid gland (thyrotoxic patients) undergoing surgery Caused by a sudden excessive amount of thyroid hormone released into the bloodstream during surgery. Hence all thyrotoxic patients must be put on medications to achieve normal thyroxine levels prior to surgery.

Normally an absorbable suture would be placed at the operative site and may not require removal of sutures. In case of any nonabsorbable suture usage, your surgeon will let you know when can they be removed. Thyroidectomy is not a particularly painful operation and pain relief is rarely necessary after 72 hours. It is normal to feel tired following thyroid surgery and it may take up to a month before you feel you have your energy levels back.

You can take a normal shower 24 hrs after removing the drain tube. After a shower, just dab the wound dry with a soft towel. However any excessive soakage at the drain or wound site will need to be informed to the surgeon and wetting the wound may be delayed.

Normally a dressing will be present on the operative site for about 24 hrs which will be removed on the next day of surgery. No special care may be required except keeping the wound dry and clean. A tube may be in place to drain out excess fluid from the operation site. This may usually be removed 24 – 48 hours after surgery.