What tests are required
There are a few tests that a patient must do before they can go through top surgery. Dr Bheem talks about the required surgeries:
- Firstly we do a haemoglobin test.
- CBC is a complete blood count that includes a platelet count
- Then there is PT INR which checks if you have bleeding tendencies, say you get a wound do you bleed a lot. This is important because a bleeding issue will cause a lot of bleeding during surgeries.
- LFT and RFT, which is when we check if the liver function is okay and if the kidney (renal) function is okay, will it affect them at all? Because sometimes there is an effect on the liver or the kidney, these tests will see if the functions are alright or not. The liver functions increase sometimes when we take testosterone
- Lastly, because they are Gender Dysphoria patients we check for HIV and Hepatitis B too.
HIV and other Co-morbidities
So some people live with a few conditions that could hamper surgery and so we need to check if these comorbidities exist and if they do this the plan of action:
Delhi-based patients
So Dr Bheem categorises the patients as from inside Delhi and outside Delhi, “If the patient is from Delhi then I have to take my medical colleagues with me. We have no issue with HIV, we regularly operate on such cases of Gender Dysphoria. The thing in this is that we have to take precautions, we have to wear extra protective layers, so that can result in an increase in the cost so say, a 5k-6k increase or a 10k increase in the cost of operation. This is because everything has to be disposed of, and cannot be used again. So this is what we do when the patient comes in with such cases.”
Patients outside Delhi
“But then, if the patient comes from outside of Delhi then he will have to consult his own set of doctors for HIV, thyroid, diabetes or blood pressure. So whatever the issue is, even if it says kidney issues, one has to ask their physician, “Am I fit to do this surgery?” and then we take a decision. At least if there is a liver issue, then it could be a little difficult otherwise with the help of a physician, and specialists, we can do it. If it’s sugar, or blood pressure then we can bring it under control. If it is HIV, it depends on which stage you are in. If it is in the starting stage and the count is at 1500 then there isn’t an issue but then if a patient comes in with a count of 500, and the immunity is so low then it is not even justified to operate on them. In fact, if we go through with it there will be problems and the patient wouldn’t be able to heal. So if it is a patient from Delhi then we would like to operate on you however normally as possible.”