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Home for the Holidays (And For Health)

For many people, a medical vacation is – literally – a medical ‘vacation.’ No wonder the emerging popularity of medical tourism.

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In 2007, ONLY two years after she started working as a nurse in Philadelphia in the US, L.T. Magallanes needed to have some dental work, specifically three fillings and a complete cleaning, done. Of course she had dental insurance, just as she had other insurances provided by her employer, “but it only covered part of the (projected costs reaching) over $1,140,” she says, meaning that “I had to share, to co-pay the costs, which would cost me over $570. (And) while the amount is actually affordable, it meant foregoing, even if only temporarily, a lot of stuff – and that’s including going home for a well-deserved vacation after three years.”

After mulling over her options, and with the help of her mother based in Las Piñas City who did some “dental investigation price canvassing in our hometown in my behalf,” Magallanes decided to visit, instead, their family dentist, who was willing to do all the needed dental works for only P6,500, approximately only $162 (at P40 to $1 exchange rate).

So late last year, Magallanes was able to come home to “look after my well-being while vacationing,” she says. “It’s like hitting two birds with one stone, as the cliché goes. And it can’t get any better than this.”
Magallanes is actually one of the continuously growing number of people discovering the benefits – and joys – of medical tourism.

MERGED BENEFITS

Medical tourism, the “act of traveling to other countries to obtain medical (including dental, surgical, et cetera) care,” as defined by the philippinemedicaltourism.info, has actually been growing in prominence due to “a combination of many factors, including exorbitant costs of healthcare in industrialized nations, ease and affordability of international travel, favorable currency exchange rates in the global economy, rapidly improving technology, and standards of care in many countries of the world.”

“More and more people from all over the world are traveling to other countries not only as tourists who come for sightseeing and shopping but also to get medical, dental, and surgical services from hospitals and other health destinations,” Dr. Carlos Lasa Jr., a certified plastic and reconstructive surgeon specializing in aesthetic/cosmetic surgery and liposuction, states in his Web site cosmeticsurgeryphil.com. “The Philippines is also fast becoming a favored destination for patients seeking quality medical care at very affordable prices. The high costs of healthcare in industrialized countries, the improved standards in foreign countries and the lower costs of air travel have made medical tourism a popular trend. In the Philippines, for example, both local and foreign patients who otherwise couldn’t afford medical procedures such as plastic surgery benefit from the highly favorable exchange rate. The cost savings are significant,”

The Philippine government is actually pushing for the country to become a preferred medical tourism destination. But it is, however, still the private practitioners that take more active steps in promoting the country, such as the Philippines’ top hospitals.

For example, if the average surgeon’s fee for eyelid surgery in the US is $2,500, in the Philippines, a qualified surgeon only charges $600 to $1,500. For liposuction, surgeon’s fees in the US average $2,000 per area; in the Philippines, it is only around $800 for the first area and $500 for succeeding areas.

This is because “lower overhead costs and professional fees makes it possible for surgeons to perform these surgeries at a fraction of the cost of the same procedures in the US, the UK, and other countries, without sacrificing quality of care,” Lasa adds.

Touted as a “revolution in health care,” medical tourism is expected to earn select Asian and Latin American countries a total of $4.4 billion by the end of 2012. India alone is forecasted to generate $2 billion of that figure, according to the Confederation of Indian Industry, with over 150,000 medical tourists visiting the country annually. The Singapore Tourism Board (STB) estimated that some 270,000 medical tourists visited Singapore in 2004, earning the country $500 million in Singapore dollars (nearly $300 million US dollars).

And there’s room for more players, too, since even while official statistics on medical tourism have still not been collected, the number of those availing of medical tourism is estimated to grow at a rate of about 15% annually, with most of the patients coming from the Middle East or Asia, though the US, Canada, and the UK are also starting to take notice of the trend.

For the Philippines, on top of these markets, there are the overseas Filipinos, too, who, like Magallanes, are looking at caring for their health while coming over to reestablish their roots in their home country.
Aside from the Philippines and India, countries like Mexico, Brazil, Costa Rica, Dominican Republic, Hungary, Israel, Jordan, Lithuania, Malaysia, South Africa, and Thailand actively promote medical tourism.

The appeal is understandable.

According to Forbes Magazine (forbes.com), “rising health care costs are inducing patients to seek treatment overseas. The appeal of this phenomenon is driven by cost savings as high as 90%, depending on the procedure and the country in which it is performed.”

Cutting costs is important, since in the US alone, it is estimated that over 45 million US citizens are without health insurance, and even more with health coverage that they consider inadequate. In fact, on average, every sick person in the US spends at least $1,000 in out-of-pocket expenses after obtaining treatment, what with the medical insurance premiums rising by 87% on average since 2002, even as earnings for the same period only increased by 20%. Thus, those offering cheaper fees are gaining prominence – a knee replacement surgery in the Philippines may only cost $6,000, as opposed to $50,000 in the US; a heart bypass surgery around $10,000 in India, as opposed to $60,000 to $80,000 in the US; a gastric bypass surgery in Thailand less than $5,000, as opposed to $10,000 to $20,000 in the US; and a hip replacement in Turkey only around $7,000, with the cost doubling that in the US.

But Forbes Magazine states that “the benefits go beyond costs. Consumers gain from cost savings, but may also receive excellent care from highly qualified doctors (since) many providers offer more personalized care, i.e. a higher physician-to-patient ratio, than is commonly available in, say, the US or Canada.”

“For many people, a medical vacation is exactly that – a medical ‘vacation.’ Imagine recuperating after surgery on a white sand beach while sipping island drinks and receiving full-body massages. Think about all the exotic foods, tourist attractions, and shopping you could enjoy.”

Better yet, even as offshore medical procedures can be performed for as little as one-tenth the cost of what would normally be charged in the US, “the facilities offshore are state of the art. These are modern hospitals that often are newer and have much better technology and equipment than hospitals in the US, (and are) typically staffed by Western doctors and surgeons trained in Western medicine, (providing) equal or greater quality surgical care than US hospitals. These surgical procedures are performed with the same technology and expertise, yet cost a fraction of the price.”

Also, as noted by healthmedicaltourism.org, many countries heavily regulate or even ban select elective procedures or complicated surgeries, such as hip resurfacing, which was only recently approved by the US Food and Drug Administration despite its widespread use. Worse, even where the procedures are available, many are troubled by wait times (in Canada, over one million Canadians claim to have experienced or are still experiencing difficulties in access to health care and support).

And then, of course, there’s the vacationing part. “For many people, a medical vacation is exactly that – a medical ‘vacation.’ Imagine recuperating after surgery on a white sand beach while sipping island drinks and receiving full-body massages. Think about all the exotic foods, tourist attractions, and shopping you could enjoy,” the Web site further states. “The fact of the matter is, most of us need medical treatment from time to time, and most of us plan vacations every year or so. Why not combine the two into an all-out medical vacation that provides you with everything you need, want, and desire?”

Not that medical tourism is not troubled with issues of its own, too, according to Forbes Magazine, since “consumers also face risks when undergoing treatment in a foreign country,” including the difficulty in follow-up when the patient returns home; expensive care may be required if complications occur; and the differences in malpractice laws in other countries. Thus, caution is advised.

As for Lasa: “Whether patients are having… surgery abroad or in their home country, choosing the right surgeon is the single most important decision they will make. To ensure best results, patients should choose an authentic… surgeon with the training and experience that is essential for the success of their surgery.”

LOCAL SCENARIO

The Philippine government is actually pushing for the country to become a preferred medical tourism destination, with a provision in the Executive Order No. 372 (released in October 2004) calling for the creation of a public-private sector task force for the development of globally competitive Philippine service industries, which include medical tourism, as well as retirement and leisure, and information technology and logistics.

It is, however, still the private practitioners that take more active steps in promoting the country, such as the Philippines’ top hospitals, including the Asian Hospital, Capitol Medical Center, Kidney Institute of the Philippines, Makati Medical Center, Medical City, Philippine Heart Center for Asia, St. Luke’s Medical Center, and UST Hospital.

And for these players, cost is still what drives this growing segment of the travel industry. And the local prices continue to be competitive, too.

This, most certainly, is what drove Magallanes to opt to have her dental procedures in the Philippines. “(After having the procedures done, many) told me I actually helped a growing industry in the Philippines,” she says. “But for me, that didn’t even enter the picture (when I decided to have what I needed done in the Philippines). It was simply to have them done well without costing me too much – which I was able to have done (in the Philippines). That I have vacationed while there, that’s most certainly just a bonus, a welcome bonus.”

And for many, this is the very appeal of medical tourism.

Believing that knowing on its own is not good enough, "you have to share what you know, too", Mikee dela Cruz gladly shares through his writing. A (BA) Communication Studies graduate, he had stints with UNAIDS, UNICEF and Ford Foundation, among others, writing "just about everything". Read on as he does some sharing through Zest Magazine.

NewsMakers

Natural therapy shows promise for dry-eye disease

Castor oil has been proposed as a natural product that could offer a safe, effective and easy-to-use alternative to existing therapies.

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Researchers at the University of Auckland are running a trial of castor oil as a potential safe and natural treatment for dry-eye disease following a successful pilot study.

While exact figures aren’t available for New Zealand, in Australia, it is estimated dry-eye disease affects around 58% of the population aged over 50. Advancing age, menopause, increased screen time, contact lens wear are just some of the risk factors for developing dry eye disease.

Blepharitis is the most common cause of dry-eye disease, accounting for more than 80 percent of cases. It is a chronic condition with no known cure.

“Currently, patients are left grappling with symptoms of dryness, grittiness and, in some cases, watery eyes that feel uncomfortable impacting on their quality of life and work productivity,” says doctoral candidate and lead clinical investigator Catherine Jennings.

Current treatments, such as antibacterials and anti-inflammatories, are generally unsuitable for long-term use, due to significant side-effects and potential for antimicrobial resistance.

“Often patients are left feeling helpless when attempting to manage a chronic condition,” Jennings says.

The current trial is of a product containing cold-pressed castor oil enhanced with mānuka and kanuka oils applied using a rollerball attached to a small glass bottle.

“The previous pilot study, conducted by our research team, was unique in its use of castor oil in such an application on the eyelids, with the product not known to be used anywhere else in the world for treating blepharitis,” says Jennings.

Castor oil comes from a flowering tropical or subtropical shrub from the species Riccinus communis. It has been used therapeutically for millenia, including more recently in eye cosmetics and eye makeup removers.

In the pilot study, 26 patients with blepharitis were treated with cold-pressed castor oil over four weeks. They had measurable improvements in symptoms, such as reduced redness of the lid margin, decreased thickening of the eyelid, and a decline in bacterial profusion, as well as reduced eyelash crusting.

Building on the success of the pilot study, the research team is now engaged in the more extensive double-blinded, randomised and placebo-controlled study. They are aiming to recruit 92 participants and generate robust scientific evidence for clinicians.

The ultimate goal is to sustainably improve quality of life for this large group of patients using a natural, safe and effective product, principal investigator Professor Jennifer Craig says.

“Castor oil has been proposed as a natural product that could offer a safe, effective and easy-to-use alternative to existing therapies,” Craig says.

“My hope is this study will produce evidence-based guidance for clinicians with regard to offering castor oil as a possible management option for patients suffering from blepharitis, so they continue to enjoy a great quality of life, read the books they love, be productive in their work environment and enjoy other visual hobbies.”

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For epilepsy, yoga may be good for your mind

People who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

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For people with epilepsy, doing yoga may help reduce feelings of stigma about the disease along with reducing seizure frequency and anxiety, according to new research published in the November 8, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology.

“People with epilepsy often face stigma that can cause them to feel different than others due to their own health condition and that can have a significant impact on their quality of life,” said study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in New Delhi. “This stigma can affect a person’s life in many ways including treatment, emergency department visits and poor mental health. Our study showed that doing yoga can alleviate the burden of epilepsy and improve the overall quality of life by reducing this perceived stigma.” 

For the study, researchers looked at people with epilepsy with an average age of 30 in India.

Researchers measured stigma based on participants’ answers to questions such as: “Do you feel other people discriminate against you?” “Do you feel you cannot contribute anything in society?” and “Do you feel different from other people?”

Researchers then identified 160 people who met the criteria for experiencing stigma. Participants had an average of one seizure per week and on average took at least two anti-seizure medications.

Researchers then randomly assigned participants to receive yoga therapy or sham yoga therapy. Yoga therapy included exercises in loosening muscles, breathing, meditation and positive affirmations. Sham yoga consisted of exercises that mimic the same yoga exercises, but participants were not given instructions on two key components of yoga believed to induce a relaxation response: slow and synchronized breathing, and attention to the body movements and sensations during practice.

Each group received seven supervised group sessions of 45 to 60 minutes over three months. Participants were also asked to practice sessions at home at least five times a week for 30 minutes. They tracked seizures and yoga sessions in a journal. After the three months of therapy, participants were followed for another three months.

Researchers found when compared to people who did sham yoga, people who did yoga were more likely to reduce their perceived stigma of the disease. People who did yoga had an average score of seven at the start of the study and an average score of four at the end of the study, while people who did sham yoga had an increase from an average score of six at the start of the study to an average score of seven at the end.

Researchers also found that people who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

In addition, people who did yoga were more than seven times more likely to no longer have seizures than those who did sham yoga.

There was also a significant decrease in anxiety symptoms for people who did yoga versus people who did not. They saw improvements in quality of life measures and mindfulness.

“These study findings elevate the need to consider alternative therapies and activities for people with epilepsy facing stigma,” said Tripathi. “Yoga may not only help reduce stigma, but also improve quality of life and mindfulness. Plus, yoga can be easily prerecorded and shared with patients online using minimal resources and costs.”

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Eating a vegan diet could reduce grocery bill 16%, saving over $500 a year – study

Total food costs decreased in the vegan group by 16%, or $1.51 per day, compared with no significant change in the control group. This decrease was mainly attributable to savings on meat, -$1.77 per day, and dairy, -$0.74 per day. Changes in purchases of other food groups (e.g., eggs and added fats) also contributed to the observed savings.

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Food costs decrease 16% on a low-fat vegan diet, a savings of more than $500 a year, compared to a diet that includes meat, dairy, and other animal products, according to a new analysis from the Physicians Committee for Responsible Medicine published in JAMA Network Open.

“We knew that a vegan diet significantly reduces your risk of conditions like heart disease, diabetes, and obesity—and now we have proof that opting for beans instead of beef will also lead to significant savings on your grocery bill,” says study co-author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine.

The research is an analysis of a Physicians Committee study in which participants were randomly assigned to a vegan group or control group. The vegan group was asked to follow a low-fat vegan diet consisting of fruits, vegetables, grains, and legumes, while the control group was requested to make no diet changes. Calorie intake and food costs were not limited for either group.

For the food cost assessment, the participants’ dietary records were linked to food price data from the U.S. Department of Agriculture Thrifty Food Plan, 2021.

Total food costs decreased in the vegan group by 16%, or $1.51 per day, compared with no significant change in the control group. This decrease was mainly attributable to savings on meat, -$1.77 per day, and dairy, -$0.74 per day. Changes in purchases of other food groups (e.g., eggs and added fats) also contributed to the observed savings.

These savings outweighed the increased spending on vegetables, +$1.03 per day; fruits, +$0.40 per day; legumes, +$0.30 per day; whole grains, +$0.30 per day, and meat and dairy alternatives.

The findings support previous research showing that a plant-based diet provides more cost savings than one that includes animal products.

In addition to the cost savings, the study found that a low-fat vegan diet resulted in weight loss and improved body composition and insulin sensitivity in overweight adults.

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