DOB OCTOBER 21, 1987.

It was April 28, 2011 &about half past nine in the evening when I got call on my mobileas usualfrom Shantanu, my son.He was staying in hostel in Greater Noida&had joined one real estate company in Noida as an executive trainee on April 18, 2011 after completing his masters in business administration (Retail) from IILM.The information which he gave me was absolutely unusual. Hesaid,‘today he came out from his office at 4.0 pm for some work & while crossing the road felt numbness in his right foot, could not balance & fall down on the road.He tried to call for help but speech was blurred.Within few minuteshe regain his senses, got up & came back to the office.Thenalong with one of his colleague he went to see a nearby doctor who suggested him some test.He came out from doctor’s clinic about 7.0 pm & it was too late to carry out the tests & he was suppose to drive back to the hostel, about 50 km away. So he decided to  carry out these tests tomorrow’.He was telling me &I was feeling his voice was quite low with tremor in his speech. I was almost dumb for few seconds& feeling shiver in my spine. He continued, ‘it has happened to me last week also, while driving the car &now he has taken 2 days leave from office to get it checked at Meerut’. Iinterrupted & said, ‘I would come right now’. But he insisted,‘he is feeling tired & want to sleep, so no need to  arrive in midnight as it would take at least 3 hrs from Meerut to Greater Noida by car,better to reach early morning tomorrow’. With some hesitation I agreed & asked him  to give my mobile number to his classmate, who was staying with him in the same room, to convey me about any abnormality in the night.Whole night I was restless & half asleep.

 

Next day exactly at half past eight in the morning I reached to his hostel. He opened the door, looking very tired but to my surprise he wasalone in the room. ‘Where is your classmate’? I questioned him. He replied, ‘his friend is sleeping next floor above’. I got little upset but kept cool& said,‘we woulddrive back to Meerut where I would arrange your complete medical checkup’.He nodded his head in agreement & said,‘I am feeling very weak & pain in head too’. I asked him to brush the teeth& eat breakfast which I had brought with me. He got up from the bed & went to bathroom to brush the teeth. But after few seconds he came back staring at me. I just simply asked, ‘have you brush the teeth really….so quick’?But he did not respond.Rather he intended to sit down on the bed,pulling his  right leg & continuously staring at me. I called him again &then again…….. but he did not reply,staring at me continuously. These were the same symptoms which he had explained me yesterday night, within a minute it flashed in my mind.

Immediately I rushed out for the help & within 15 minutes he was admitted in nearby Astha hospital. Doctor in OPD checked him & informed that there was no need to worry. We have given him the medicines & he would be alright within 2 hours. I felt little comfortable & thought that my son was in the safe hands,but still there was some nervousness. ‘How much you are sure’ ? At least 4 times in next one hour I asked the doctor. He responded confidently & repeated his earlier statement. Suddenly it came to my mind that Shantanu has not eaten anything since morning, so I asked doctor again what should I give him to eat. Dr. replied, ‘may be some fruit juice’. One of my helpbought some juice can from outside & I asked Shantanu to open his mouth to take some juice. He opened his mouth & gulped juice 2-3 times but I noticed, he has not opened his mouth in a normal way.Rather his lips  were open little bit from the extreme  left side of the mouth. I felt something  was wrong &doubted paralysis attack.I informed immediately to doctor in OPD, butagain very confidently he repeated his earlier statement. I was notconvinced with his answer. I contacted one of my colleague in office, whose uncle was medical practitioner,heading a private hospital in Noida. He arranged a telephonic meeting between the doctor in OPD& his uncle. But the doctor in OPD  assured him that everything would be alright. By the time it was already more than 2 hrs & there was no improvement in Shantanu’s condition. I was getting restless & again requested doctor in OPD  to see Shantanu. He said, ‘some time it may take 3 hrs… sodo not worry. I have given him the medicines & we have to wait for the blood report too’. So far I was quite polite & believing him,but now I started losing my patience& retaliated with disagreement & said,‘to me it seems to be a paralytic attack’. Okay, ‘then we would take second opinion from visiting neuro physician from Sharda University Hospital, coming within half an hour’. Neuro physician arrived, examined him & declared brain hemorrhage. He advised to go far CT scan in Sharada University hospital, 5 km away, as this facility was not available in Astha hospital. CT scan was carried out by the technician but now doctor was not available to see the report. I called neuro physician on his mobile &requested him to come & see  the report. He did not come to see the CT scan report, probably busy visiting some other hospital,but he discussed the report with  technician.Technician confirmed himanormal report&doctor passed it to me. By this time it was half past two in afternoon& Shantanu was lying on the stretcher unmoved with wet cloths, half naked, covered by the hospital sheet. I was very nervous, looking to the irresponsible attitude of these doctors &the hospital’s set up. I was almost dumb & not able to think what to do now. Suddenly I got call from my office colleague, who was in touch with me since morning, asking me to move to Fortis hospital where he had fixed the appointment with Neuro physician & explained him the condition of patient. By 4.0 pm we arrived in Fortis& neuro physician was waiting in emergency. He took charge of Shantanu& immediately started medication. Later on, he told me if I were late by one more hour thenShantanu’s life would have been on stake as it was a major brain stroke. He added,‘if you had reached here with in 3 hrs then with one shot of TPAimpact of the stroke could have been averted.

Later on, it was confirmed major brain stroke with left MCA infarct,fully blocked at close to its origin, resulting damaging quite big area of left side brain including language part. Accurate reason of this blockage doctors could not traced out. They suspected either a clot or artery chip out due to some earlier accident. He was kept in ICU for about 3 days & then shifted to a private ward. His power in the right side of lower& upper limbs were 0.0 on a scale of 5.0. He was not able to produce any sound. For food they had fixed up tube through his nose. He used to look at us, probably trying to recognize us. Physio & speech therapist started coming from very third day. Physio was a very thin & lean young girl. She used to try hard to move to & fro his paretic leg, but started sweating like anything within few minutes. In factit was not her fault as Shantanu was bulky& over weight, i.e. 125 kg & 6 feet tall. Speech therapist also used to leave room giving us lot of instructions to follow, instead of trying her technique on him. I felt, they were just doing their duty. It happened many times, when they visited he was sleeping, but they did not turned up later. A big group of doctors used to visit twice a day & prescribing various test every day. I noticed many times tests were repeated even though the previous report was not received. But I did not argue with them. I felt they were treating him as a client not a case. It was proved later on at the time of final settlement of the bill. Lot of tests were carried out in Fortis& his all reports were found normal except than three times higher homocystine level in the blood. He was discharged from Fortis after 2 weeks when doctor declared stable brain condition.Doctors prescribed him some medicines to continue as well as physio & speech therapy. They told me that further recovery would be there with these therapies only& may take 3 months.  Rest medication would take care that in future same incident would not repeat & some medicine he would have to take lifelong. I prepared myself mentally to fight a long battle, at least for the next 3 months, though I was completely shaken.

Then he was shifted to Meerut (home town) & about 6 weeks he was kept in Meerut Institute of Mental Health & Neuro Sciencesfor further recovery.  In this hospital also the same story was repeated but by then I was used to it . A very senior renowned physiotherapist of this area, who was the visiting doctor in the hospital, was attending him in the morning & his assistant in the evening. As the time passed by  I could see improvement in Shantanu’ upper & lower limbs. He was able to produce some basic sounds. I was impressed by their efforts. Later on I learned about flexion & extension synergies & common phenomenon to have movement in upper limb due to flexion & movement in lower limbs due to extension. It was very difficult to have extension movement in upper limbs & flexion movement in lower limbs. I felt they did not tell me the fact, rather they tried to please me.I arranged his discharge from the hospitalon July 1, 2011, once he managed himself to use toilet. At the time of discharge that senior physio advised me to bring Shantanu every day at 11.0 am to other nearby hospital having big rehabilitation centre with lot of machines& he was the head of it.I accepted itbeing the best known available choice. His assistant started visiting Shantanu at home. I thought, in the rehabilitation centre he would give personal attention to Shantanu as before. But hewas totally a different person there. Shantanu was instructed to do some exercises on machines followed by physiotherapy by experienced ward boys& some time by interns. Any how some noticeable improvement was there in his daily activities. He was able to sit down & get up, walking, climbing the stairs taking support of railings, sitting in the car. He was limping while walking as he was taking total body weight on his left leg. Right leg was coming forward with some circular movement. There was some inward curl of the right foot.  Right hand was always bent from elbow & close to his stomach. Wrist & fingerswere turning inside like half open fist. I told my observation to senior physio &I requested for his personal intervention, he came to see Shantanu for 5 minutes,advised to his people & left. I was not satisfied & then one day I caught him in his office & asked, ‘when you expect Shantanu to recover fully’? He responded philosophically,coming time would tell…..have faith in God. I felt cheated & cursed myself to waste two & half months in this rehabilitation centre. I continued with this arrangement until September, 15until  I foundanother option, a young physiotherapist. With speech therapist also, introduced by the hospital, it was the same story. He was practicing in the city for the last 20 years. He started  to teach him Hindi consonant & vowels  sound& visiting him daily in the hospital. After getting discharge from the hospital I was taking Shantanu to his clinic daily. One day I asked him,‘whatever you teach, does he understand ? He said, ‘I can‘t answer it…..You have to discuss it with neuro physician. I continued with him as there was no other option. Later on in mid August I found another speech therapist, a young boy employed in a deaf & dumb school. He arrived at home & examined him. First time I learned the word ‘ Global aphasia’,his inability to read, write& poor comprehension.

From here onwards two times physio & one time speech therapy daily continued at home along with the medication prescribed by the neuro physician. So far his so called recovery or improvement in daily activities was noticeable in first 3 months but onwards it was so slow that it could not be noticed even by the physiotherapist. Only the people who were there 24 hrs with him could feel tit bit changes.Butnow 5 months were over & hope for further improvement was getting diminished. But physiosuggested me that in some patient it continues up 6 month& more. Knowing that I kept my patience intact but at the same time I started realizing that therewere some limitations in their expertise & not able to tell me exactly about the fate of my son. One said 'only time will tell & difficult to say.....' & other one said, maintaining more positive attitude, 'some time recovery continues up to 1-2 years or may be long....'. I was restless & desperate to find best solution of this problem, so I started to search on the web about the other therapies & came acrossStem cell transplantation, Hyperberic oxygen therapy, miracle medicine Zolpidem, Sensory triggered techniques etc. etc., but none of them assured 100 % recovery.

OVERCOME THE MYTH

Fortunately, at the end of sixth month, I reached to the web site of Dr. Rajul Vasa ,through the testimonial of one of her patient & totally a new chapter was open. I read every word of it atleast three times &got fully convinced with her technical approach. I downloaded all the material & given to my physiotherapist & asked to go through it. Next day they told me that they never studied/heard about re-re organizing the brain through exercises.Whatever they know, was to keep the muscles soft enough by the exercises so that whenever command starts coming from the brain then that time muscles should  not be tight. They did not take much interest in the new concept  but I was convinced & acquired a firm belief on Dr. Vasa’s approach. I mailed her & she responded promptly with a caution to follow her protocol strictly. I sent herethe videos showing his physio exercises, walking, sitting & climbing up & down pattern, hospitals reports& explained  Shantanu’s present condition - power in lower limbs about 75 %. He can walk with shoes on his own in the house but on the road needs some hand.In upper limbs some power, with respect to extension is there up to wrist, but no movement in the fingers.In speech comprehension, with respect to understanding,  receptive has improved a lot,  but complex comprehension yet to be improved.He watches television, operate his laptop to watch movies & can utter few words like asking for food, milk, water etc. He laughs a lot on comic scenes. Many times we ask him whether he understand it or not ? In reply he always says" Yes". He tries to speak what he thinks but it seems that there is lack of coordination & correct word does not come out. Overall his understanding seems to be fair but reproduction of vocal language is very - 2 less.Daily routine job, like using toilet, bathing ( I help him little bit due to fear of slipping & rubbing soap on the right side where left hand can not reach), wear cloths, wear socks & shoes etc. some time doing himself.He can not readlong sentences but can recognize some individual words. Same way he can write some words by left hand.Last month doctor asked to check the homocystine level & found in normal range.

In fact Dr. Vasa wanted to see Shantanu  in her OPD in Mumbai, but I was scared to take him out for a long  journey. I requested her & she was kind enough to see me alone. An appointment was fixed & I met her at Mumbai  on 27th Nov. 2011. I arrived in her OPD before time &got opportunity to meet some of her patients. One was Nahid Ansari ( through whose testimonial I reached to Dr. Vasa’s site). She just said, ‘Mr. Mittal you are at a right place & fortunate enough to reach to Dr. Vasa within 7 months. I am from Mumbai but I did not know  & took very long time to reach her’. Finally  I met Dr. Vasa, very determined & straight forward.She explained me in depth her philosophy of treating the stroke patients& assured me Shantanu’s full recovery. To my surprise she said, ’there is no hidden cost. You might be thinking about it before arriving here’. Later on I met with Trupti & Nitin Shingala, Bharat Bhai & his wife, Kishan Batra & so many other patients. Everyone looked satisfied & full of positive energy. They  also offered their  support with respect to arrangement of boarding & lodging at a very negligible & unbelievable rent if I take Shantanu there. I felt as I am in a big family where everyone was concerned & ready to help. I stayed there about 4 hours, made some videos of patient exercises, interacted with patients &learned about their recovery  under the watchful guidance of Dr. Vasa. Before departing Dr. Vasa demonstrated me two exercises which Shantanu has to follow & advised to stop all conventional physiotherapy as well as medicine for spasticity.She cautioned me to send feedback periodically through mail & videos.

I came back from Mumbai  & asked my physiotherapist to stop their conventional passive & active resisted therapies & follow the exercises advised by Dr. Vasa. I demonstrated them & shown the videos of those two exercises. Since December 2, 2011 onwards Shantanu has shown considerable improvement, the day when he started to follow the exercises advised by Dr. Vasa. Certainly, those exercises has broken the barrier of recovery process which was almost stagnant. Now one& half month has been over & I could clearly see some changes in his walking pattern & body weight balancing. Earlier when he intended to climb on stairs then his right leg was coming up with some circulatory movement & at the same time taking support of the side wall. Now he was able to climb on the step without any support as well lift his leg more vertically & able to put a good amount of load on his right leg. Also circulatory movement of leg has beenreduced. Earlier he was not able to get up from bed (18 ‘’ height) on his feet without his left hand support. Now he was able to get up even from  sofa (15’’ height) on his feet without any support. Earlier his right heel was always high in air from the floor while sitting &doing paretic leg exercise &used to touch the floor after few seconds. Now the gap between the heel & the floor as well time to touch the floor, while sitting& doing paretic leg exercise, has been reduced.  Earlier when conventional physiotherapy was going on, then that time physiotherapist were supporting the hand  close to elbow & then giving to & fro movement for shoulder muscle strengthening. Now hewas able to move his hand to & fro & hold it vertically without any support, suggesting better condition of shoulder. Earlier there was elbow extension movement in laid down posturebut now that movement seen in standing position too. His shoulder dropping seems to be reduced .Earlier he was not able to load&balance on his paretic leg. Now he became self reliant to balance his weight on his paretic leg with bent knee & move his left leg to & fro without any support. His walking pattern seems to be improved & more free flow like due to increased loading on paretic leg. In sitting posture,increased movement noticed in paretic ankle when pulling it upward  as compared to earlier stage. Inward curling of  paretic foot reduced a little though still visible, as well fingers softer than earlier. Paretic wrist & fingers joints softer than earlier, although the medicine for spasticity named Baclofen has beenstopped since 7th December ‘ 11.Earlier  there was consistent pain in his right thigh when touching. That pain has been eliminated completely.His complex comprehension seems to be little improved. Earlier he was not catching one to one conversation quite often.Now,in group conversation, he understands better & react with his limited spoken vocabulary.

I know this is not the end – still long way to go. But most important is, my helplessness has been converted in to a firm belief&I feel  very confident for  the absolute recovery of my son under the watchful guidance of Dr. Vasa.Her outstanding work has spoken its volume to overcome the myth.  Same time I feel that more & more patients should be able to get benefit of her breakthrough treatment.

Please feel free to contact me if anyone has any question or I can be of any help.

Nishant Kumar Mittal (Father)

Meerut (U.P.), India

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