20240714 USH India Meeting Transcript

This is the full transcript of Dr Sreekala's talk which is posted in Youtube https://youtu.be/6BPykI9GLqg?si=J2vgmHkYUwENiVAt


[Geri speaking] All right  Dr Sreekala. We are about to start.

[Dr Sreekala speaking] okay 

[Geri speaking] all right yeah thank you so much. As I had mentioned this talk is going to be recorded. That's why we have spotlighted our speaker and our two interpreters. So good  evening and good morning everyone. We have some  folks here in India attending as well as folks  in the US also attending. My name is Geri  Rosario G E R I and my sign name is I point  to my eyeglasses and I do the letter G sign ISL  sign for G which is like one fist uh above of  the other. All right so welcome everybody to  this USH India meeting and USH India is the  India chapter of the Usher syndrome Coalition.  okay and one of the things we focus on with the  Coalition is to connect researchers and   individuals researchers with individuals and  also other resources that we have in India as  well as abroad pertaining to Usher syndrome. So  as part of this goal, we wanted to invite  somebody from from Shreedhareeyam who Sreedhareeyam is providing treatment to folks with Usher  syndrome especially retinitis pigmentosa. Right now  we have four members of the Usher syndrome  Coalition who are patients of Sreedhareeyam. My  son is one of those members. Another member is  the son of Lata who whose son has been going  to Sreedhareeyam for I think at least 15 years. My  son has been going to Sreedhareeyam for two years.  All right. Before I continue, can I  please request Ravender, I thought you are   the the main (ISL) signer. If you can please start  signing, okay so it will be recorded. okay great.

So our speaker for today is Dr Sreekala. And  I received her profile and it's like very long.  She's such an accomplished doctor. She has  about 24 years of experience at  least 24 years of experience in Sreedhareeyam in terms of clinical experience. Now  Dr Sreekala wears a lot of hats in Sreedhareeyam and  what caught my attention is her involvement in  the research arm of Sreedhareeyam. She's  directly involved in a lot of research  activities including observational studies as  well as Interventional studies. And by the way  Interventional studies are what we sometimes  call clinical studies or clinical trials okay involved in these studies to analyze the effect of  aortic therapies and medicines she's also active  in product development as well as the publication  of research results in peer reviewed journals.  Now I specifically mention peer reviewed journals  because there's a lot of interest in seeing  peer reviewed research around Retinitis Pigmentosa  as well as Usher syndrome, peer-reviewed  research, published research, not just of one  patient but many patients, with a control group and  so on. There's a lot of interest there especially  for those who do not believe in ayurvedic  treatment. So anyway that is my brief  introduction for Dr Sreekala. This is going to be  a Q&A type of a talk so hopefully this will  be more interactive for our audience. Feel free  to ask questions. Okay? So I would my first   question for Dr Sreekala is that if you could please  elaborate a little bit about your background.  You are I believe third or fourth generation  in the Namboothiri family in this line of work.  if you could please elaborate a little bit about  your background as well as the history of Sreedhareeyam  in terms of treating eye conditions. Thank you.

[Dr Sreekala speaking] Thank you Geri. Good morning and good evening  to all. I'm very happy to be here in  front of you and very happy to see  all of you attending this. Can you  hear me? 

[Geri speaking] Excuse me doctor. I can hear some   background noise. Is anybody else hearing that?

[Aruna speaking] Yeah I'm hearing it too Geri. 

[Geri speaking] All  right. Just a minute okay let me make  sure that everybody is muted. If nobody uh  if everybody else is muted, that would be great. 

[Dr Sreekala speaking] Still you are hearing?

[Geri speaking] okay sorry if you could please continue. I'll  try to figure out that background sound.   

[Dr Sreekala speaking] Sure okay thank you. So regarding your  first question is regarding Sreedhareeyam no. Sreedhareeyam is a renowned ayurvedic institution.  Usually it has a history of around  400 years. It was founded in 1820 but  this is from our ancestors end. But  for my knowledge that institution that clinical  practice and that product medicinal development,  everything started in 1931 by Vaidya Thrivikraman Namboothiri, my grandfather grandfather's great grandfather. He  has started that and along with his brother  Vaidya Parameswaran Namboothiri. And he was more interested  in that production, production manufacturing of  medicines, ayurvedic medicines, herbal formulations,  separate formulations for each diseases. He they  have started as a small clinic in that. Usually  they used to visit the patients at their home and  they will attend the patient's condition. Conditions  will be analyzed and then medicines will be  prescribed. Like that it was following. He was  a great scholar of Sanskrit even Sanskrit because  as I don't know whether you know that the most  of the ayurvedic literature is in Sanskrit. So that  Sanskrit learning it's it's an important thing. So  he was a great Sanskrit scholar. He used to teach  the Sanskrit also. So they they were practicing  that and that was going on well, but from  that other things that Sreedhareeyam as an institution  started in 1999 because that is my father. My  father Dr NBP. Late Dr NBP Namboothiri. He and his brother  his brother Mr Narayanan Namboothiri that chairman,  the present chairman of Sreedhareeyam. They have started  this institution in a small small setup. Small  setup means 10 beded hospital like it just started  because that time from the beginning itself  we we were there in that institutions because  my father was an in the government services so he  was with the other research activities there  also. So we were looking after this institution and  it's after his retirement he joined fully to this  institution. So slowly that from the beginning  itself we were seeing that patients with this  retinitis, Usher syndrome and retinitis pigmentosa  are like patients we were seeing and because  of this progression nature of the diseases, we  very interested because at least they should have  maintained that vision in their lifetime. If  it's not curable also, they should maintain that  vision till their death, or at least they should  have some confidence in other activities also. So  we were so like that we were preparing some  medicinal and treatment modalities also prepared. So that it's because of that history Sreedhareeyam has remained  committed to the that preserving traditional ayurvedic  knowledge because that we are we we have that  other means in investigations from that modern  side also and that but the treatment aspect  everything with that ayurvedic knowledge, ayurvedic  tradition only ayurvedic only herbal formulations  and that formulations according to that the  ancient textbooks and some changes in that only we  were given because it's that preparations and  combinations everything depend on the ancient  ayurvedic text. So today that institution  is having a 400 bed hospital. So we we have  different branches in around 23 branches in  in Kerala and outside outside Kerala. Means all  over India. So that their inpatient facilities  are also there and outpatient facilities  are also there. And other than this eye  conditions , we are offering the other   other departments also. General conditions   also. General treatments are also there. And   Pediatric means then so means orthopedic  departments are there. And Women and Health Women  Health that is there. ?? and Rejuvenation  therapy is like that is there. Age related  degenerative conditions, old age therapies  like that it's that is other departments  are also functioning other than this eye conditions. So we have some now experienced  practitioners, great experienced practitioners  other than that family. Family members are also  around nine doctors or nine to 10 doctors are  there. And other than that any other experienced  practitioners are also working here in research  department and in the factory and   other this clinical setup also. We have a  our hospital is an accredited NABH accredited  hospital and we have a manufacturing unit also,  NABL accredited manufacturing unit. So all  the medicines are prepared there only and  the good lab facilities are also there  just to analyze that the quality of that medicine. okay.

[Geri speaking] All right. Thank you doctor. This is Geri.  We have a few people in the audience who may  not be familiar about ayurvedic treatment. So in  in layman's terms, can you tell us about you  know what is included in ayurvedic treatment. Is it  simply herbal medicine, oil massage, and so on. 

[Dr Sreekala speaking] iI's not like herbal medicine and oil massage  and all. Because ayurveda, the main aim of ayurveda is ____. That is the just I'm I'm just quoting a slogan,  that's all. Just maintaining the health of a  healthy person and treating the diseases. Okay.  That so main aim is to maintain the health of  a healthy person. So like that. For that it  is it has a different branches of ayurveda also.  Eight eight branches are there. Ashta, eight branches  of ayurveda in treating different conditions or  different areas of that our study of our body. So in that,  this eye conditions it's it's it's coming under  Urdhwanga Chikitsa. It means diseases above the neck, above the neck  Eyes, ears, nose and head. Everything included  under that. So that specialization is there, and  eight branches are there. So the after completing  that B-AM in the graduation, the specialization in  each section is there in that other doctors will  specialize in the other depart this departments  also. So then they will start it. So we can't say  that it is this is just just a oil massage and   herbal medicines because I don't know whether you  have heard about Panchakarma Therapies because Indians  will be knowing that. Panchakarma Therapies means five  five types of purificatory therapies. It's not like  a this massage and ___ or anything. That is all.   It's a preliminary things of that this Purva Karma. This  because before that starting that the main therapy  is that Panchakarma. So before that starting  the Panchakarma, some some preparatory things are  there this massage and all. Because because all  the things are it's not like for massageswill help for that. So that main purificatory  therapies that aims to eliminate that doshas (ie, that which can cause problems)  because ayurveda depends on that. Ayurveda principle depends  on that three doshas - Vata, Pitta, and Kapha. Three doshas are  there. So that three doshas we are treating that  Shareera (ie, physical body). The Shareera that all the body is considered  as a pancha bhuta, that five elements like Earth,  water, this fire, air, everything that pancha mahabhutas, space, everything. So so all the that three doshas are  derived from this pancha mahabuthas only. This this five  elements also. So the concept is that just because  all the doshas because the whatever the disease is  also, the that that balance of these doshas  are the health. And any imbalance in this doshas  will considered as disease. In all the parts of the  body, every everywhere this balance and imbalance  will be there. So that depends on the lifestyle  or the genetic problem, whether it is a genetic or  any acquired things or that. Because the disease  we classify the diseases into seven types. That is  genetic diseases, and then congenital, humoral,  then some traumatic ecological, and supernatural.  Or natural other diseases also. We consider these  diseases. So that the genetic means Usher  syndrome and all, it's it's a genetic disease.  It's it's a genetic entity. It's there, no? So  we consider this that this genetic this is that  genetic part is also described in that ancient  text. That time itself it is all described there.  Because of that that, along with that what is the union of the union of of this semen and  that ovum and semen, that  that all that health of that semen and ovum also, that all depends  on that the genetic factors also. So the in because that we have inherit that  inherited characteristic between the parents   and offsprings are facilitated by this this   units are this important aspect. This are there  are innumerate by Nature due to innumerable  organs and structures. Because of that this  unhealthy ovum and sperm, this diseases can occur. So that genetics is described. Accordingly the main  thing that the treatment aims to maintain that  quality quality of that health health quality  of health. And also that because some some  therapies like Shodhana (?), some purificatory therapies  will be there. Then brumhanam (?), improving that general  conditions also it's there. then the rasayana rejuvenative  therapies are also there. So in genetic disease  disorders like this Usher syndrome and all. This  Rasayana therapy Rasayana therapies will have that great  role because that will help the to maintain  that conditions or to stabilize the condition,  because it's not we can't say that it's curable,  but that can help to improve that quality  of or improve the quality of means vision -wise it improve the quality. And some some  different different types of rasayana, thisrejuvenations are explored there. It's a preventive  and therapeutic mode of management. So that  restores and rejuvinates the seven functional  the the tissues, rejuvinates the tissues  that the tissues. So the treatments includes  some preparatory things. And then purificatory things. And then that rasayana therapies. Rasayana means that  rejuvenatory things. That is all needed. Just  with some medicines, internal medicines  and just it will not have that effect. okay. 

[Geri speaking] All right. Thank you Doctor. I I hope  we haven't lost the the others in terms of  some of the terms that you had mentioned. But  I'm glad that you are also explaining some of  these terms because we have some non-indian attendees as well. 

[Dr Sreekala speaking] yeah yeah 

[Geri speaking] yes when I was  when my son and I were at Sreedhareeyam in in Kerala,  one of the things that Dr Narayan told us was why  we go through all of these treatments and why in  between visits to Kerala, that continued use of  the medicines is also important. He he mentioned  that it increases the blood flow. A lot of  these medicines increase the blood flow around  around the eyes and around the ears. And to keep  the cells healthy. You see, part of my understanding  is part of retinitis pigmentosa is a lot some of  the cells in the eyes are slowly deteriorating.  That's why the peripheral vision is  slowly going to deteriorate as well. So when he  explained to me the the need to increase that  blood flow around the eyes, so the the eye cells  continue to receive nutrients. For me that kind of  logic clicked in me, because it's in a similar way  as we are taking vitamins, we are taking healthy  vegetables, we're trying to keep the cells of  our body healthy. And part of the things that they  had prescribed for my son is certain type of diet,  certain type of foods that we have to avoid. And  also certain types of lifestyle things, like  for example protecting the eyes from the sun and  so on. So for me, the logic sort of made sense  because we have tried other uh medicine as well,  you know, and I didn't understand okay why would  this work and so on. 

[Dr Sreekala speaking] no that thing is that that  all the things because that that whatever that  you told know that some nutrients like vitamin  supplements and all. So like that this rasayana will work  because rasayana means that rejuvenative medicine. It's  it's like a a combination of medicine or some  therapies which have some nutrient effect. Okay.  But for accepting that nutrients, for absorbing  that nutrients, we have to prepare that our body.  We have to prepare our body because just  because if the body is not that prepared for  that for accepting that. Before that for that only  this Preparatory therapies like panchakarma and other  other things. Some some body treatments  and some other therapies are there. Then  then the last thing is that rasayana to maintain, to  maintain. Or in in Usher syndrome, other genetic  disorders, it's not curable no so incurable. What  this thing what is the main aim is to maintain that  condition. So in other diseases, this rasayana, in other  diseases also this rasayana therapies this that is there.  That rejuvenation the nutrients so so that is  like nutrients, giving nutrients. Okay so that is to  eliminate or just to uh fully curing that other  condition. Other some some diseases this rasayana this  type of nutrients will help. Okay for before this  applying this nutrients this this therapy is  also this some reju means purificatory therapy is  also there. So that includes that body purification  and some some eye treatments. So you'll be seeing  that no. Some eye therapies also will be there.  okay just to just to improve the circulation  and and along with that this diet also  important diet because that is because we are all  in ayurvedic concept, that main thing is that  that our stomach, means our digestion, whatever we  have, the digestion should be proper. Then only that  the health will be maintaining. So that should  be maintained. And that proper medicines and  proper time. So then then the exercises on. Then  stress relief things like so like that the yoga  also will help. Okay to some extent yoga will help  because it's direct impact is not there also. It  it can improve that circulations, improve that   mental power, improve that confidence of that level. Okay.

[Geri speaking] Okay this is Geri. Thank you Doctor. I also  wanted to share with the others sort of  the experience of of my son. So when we first so  this year is the second year that my son has gone  to Kerala to Sreedhareeyam. And for each visit,  we were advised to be there for 14 days. Okay  and the initial things that were done were  you know do all of this diagnostic eye tests. The  OCT test, the I think fundus photography, the  visual field test. And all of these were designed  to have that benchmark, have that benchmark.  And then the second time we were there, these  tests were repeated. So there is data maintained.  just a minute, okay so there is data maintained  to see what is the progression of of the vision.  Okay let me actually just just a minute, let me  spotlight Sonal now. and remove the spotlight.  Okay so now we have Diane for ASL and Sonal for  ISL. All right. So what what was I saying. So anyway based on our experience there, for the  treatment of retinitis pigmentosa, so there's a lot of different varieties  of treatments that my son had to go through.  And I'm going to explain things in more  layman's terms. I'm not going to use the the  actual name of the treatment because frankly  I had forgotten. So one treatment just just  to describe to to the others. One treatment was   there's like a a paste that was placed, herbal  paste, that was placed on top of the head  for a while, for around 30 minutes. Another  treatment was some sort of oil herbal oil  massage on on the eyes. Another treatment  was herbal oil massage around the ears because  again this is for Usher syndrome. Both eyes and  ears are part of the the treatment. And then  the other there's a variety of of of treatments.  The other treatment was there's like a an  like I don't know if it was ghee medicine or  I can't remember the name of the oil, it  was poured around the eyes for for around   30 minutes covered. The eyes were were covered  for a while. And there was like a a dough  placed around. And then after that someanti-inflammatory petals were placed on the eye  for a while. And I I I know I'm not doing justice  to the explanation of of all of these treatments,  but I have to say my son loved the treatments. My  son is 12 years old. He was not at all disturbed  by all of these treatments. He actually loved  it. And he was very very much relaxed by it. And  the other thing was that also the atmosphere in  Sreedhareeyam, if you're actually there in the hospital,  as opposed to just visiting you know a a day  patient, you get to meet a lot of patients with  so many different types of eye conditions. There is  diabetes that cause the blindness. There is Retina  Detachment. People who go there for cataracts. There  is actually a a Hindu priest who has been going  there after he had his eye operation, I think  it was for cataract or or something else. He kept on  going every year to Sreedhareeyam because he knew that  with eye operation, the cells and muscles around  his eyes have weakened and he kept on going there  every year to ensure that whatever is the health  of his eyes will continue, will be maintained to be  healthy. You also get to meet other people who have  had success stories. There was one guy now  I can't remember anymore what was the condition  of his eyes. He suddenly became blind and through  three visits to Sreedhareeyam, he was able to regain  his eyesight. I I was not I did not talk to him  directly, so I didn't know what was his condition.  I had met a lot of people there with retinitis  pigmentosa. A few patients with Usher syndrome. There was even one patient with Usher syndrome who  was specifically recommended to go there by his  regular doctor, regular eye doctor specifically  go there. So the atmosphere there to hear that  that ayurvedic treatment has actually helped  some of these different eye conditions and people  going back and their eyesight slowly improving  or being maintained was for me, as a parent of a  young boy, was very encouraging. I also like  the fact that there was no surgery involved  and no genetic thing. You know right now,  unless there's something proven with genetic  therapy, I'm a little bit hesitant for that. So I  wanted to to share that experience. Also  now I I want to ask the audience right now, if you have a questions for Dr Sreekala, I would  open the the floor for other others to ask.  okay I don't see.... Did somebody .... all right . So nobody has a  question right now. So I would like to  continue. Doctor, one of the things that,  as I mentioned at the start, people would  like to see is if there are any published  research on the effectiveness of the  ayurvedic treatment for maintaining the  health of the eyes with retinitis Pigmentosa. And I had   seen in the research website of Sreedhareeyam  that there is one paper I think it was  published in 2023, a case study for one patient  with retinite retinitis pigmentosa and the  you know the test results for the first  visit and the test results for for the second  visit. And it was a a published research. I also  noticed that there was another paper another research done although I could not see  the paper. It's entitled "Retinitis Pigmentosa  Ayurvedic Regimen: A comprehensive Protocol Tested  on 50 Participants." I didn't see any paper. I was  wondering how we can have access to that study  especially since it is for 50 participants.  We are very interested to know how these 50  participants reacted or to the to the the treatment. 

[Dr Sreekala speaking] Okay so uh no that uh we have uh that that in  retinitis Pigmentosa that published papers are  not that much. Published papers are not that  much. But we are on that research because we   are collecting that datas of previous years now,  previous years that we are that collecting that  and we are making it and then just to because  if one case if you publish like that also, it  will not be that much ___. We have to collect many  many cases now. So we are collecting. Our research  department is doing that work also. And we  are very very good very happy news are also  there because in because 15 to 20 years patients  are also there maintaining. They are visiting  and they are means still they are communicating  with us. And they are maintaining. They are doing  their work. They are active in their work. That  is because very we were very hopeful in  that. Because after hearing that after because  that they are visiting, means visiting means  not like every year the treatments like that  not like that but occasionally, once in four  years or five years also there. But in some cases  that deterioration is also there. Deterioration  is there but that is a slow slow deterioration is  also there. Okay we can't say that every case it's  like that. Some slow deteriation. So the datas we  are collecting. So we will be publishing because  for publications anyway we need that much this  one because otherwise it will not be that that  it will not be good. So there single cases are  many but in we have that this year I give you that. This year the total number of RP patients  from 1 January to this 30th June this this 2024  that is 172 patients were there. And that in that  new admissions were 24. 24 new admissions. Followup  patients but other 148 for patients were followup  patients. So total Usher syndrome patients admitted  in January to June, it's 16. So in that that many  patients are like IP (inpatient?) that three to four times IPs  or some one time IP like that also. It's there and  year means 15 years, 12 years, 13 years, that  that that much year they are following because  they following up. That age also it like above  50 patients are also above the age is like  above 50. They're also visiting. So that is  is a good thing. This positive thing and at  least they are maintaining. That's what we are  experiencing it's said. We can't say that the other because if you take that fundus photo  and then field test and everything any drastic  improvement in that, we are not expecting that.  But only that the main thing is that confidence  level is more because that adaptation from   bright to dark, when they enter into a dark room no,  the time of time taken for that adaptation  is improving. And at least they are confident in  moving, because we have college going students  and all. They are all because we are giving like  that that advice only, maximum to be self-dependent.  Don't depend on others. Self- dependent.  So they should have some confidence no. And   and to maintain that healthy lifestyle. That is a  very important thing because this can because  if it's associated already it's a genetic disease.  If it's associated with other lifestyle disorders  then it's it will be difficult na. The other other  things and the complications and all. So healthy lifestyle  should be maintained. And and follow up some some  treatments also it's it's good. We can't say  that every year it should be done because it's not  possible for everyone to do it continuously for  that long time no. So but some hopeful results  are also there in that in our collection datas. Okay.

[Geri speaking] Thank you thank you Doctor. I'm going to  read some questions that are posted in the chat.  One question from Dr Namita Jacob. From a deafblind adult who is not able to attend the meeting.  What is the science behind the approach  to the treatment of RP. Does it focus on  building the health of the retina? How is  it different from treatment of other eye conditions? So this is a question in the chat.  

[Dr Sreekala speaking] yeah yeah that that main thing I told as I told  you that in ayurvedic the treatment approach is slightly  different than allopathic because we are not just  treating that eye conditions only, because this  is it's a genetic conditions. Anyway we have  to treat that body itself that that Sharir, that body  full we have to consider. What is the nature of that  body. How is other conditions. Everything we have  to consider. So like that we'll plan that some some therapy.  Some rejuvenative, purificatory or regeneratory theraphies  also, along with some eye treatments also will be  there, that can improve that overal circulations  of that retinal circulations also can improve.  We can't say that that pigments everything will  be is only that. Structural changes will happen  in that. We don't expect that also. Only that  functional things will improve that. That   that way ... 

[Dr Namita speaking] If I can just clarify. Can I just  clarify the question. This is Namita. The I think what he was asking is in ayurveda  itself is the treatment for RP different from the  treatment for other retinal conditions? Is there ... 

[Dr Sreekala speaking] Yes it's it's it's different only because we are  I told you because because that it it's  not like same as some inflammatory condition.  Okay. 

[Dr Namita speaking] Right. 

[Dr Sreekala speaking] It's a degenerative condition  and inflammatory. This is a different things.  So that entire medicines and therapies, everything,  will change. Okay. 

[Dr Namita speaking] Yeah that makes sense. Thank you.

[Dr Sreekala speaking] okay. 

[Geri speaking] Thank you. On to the next  question. We have Lata whose  son has gone to Sreedhareeyam for at  least 15 years. Aruna would  like to hear her experience, Lata's experience,  with Sreedhareeyam. Lata, will you be able to talk? I think you are muted. 

[Lata speaking] Hello can you hear me now? 

[Geri speaking] Yes. 

[Lata speaking] okay  actually we it was not 15 years. We went from   from 2002. So it's almost 20 years. More than  20 years. It's actually the thing is that his  deterioration has been was controlled to a  great extent, that he could lead an almost  normal life, till some four years back. About  four years back that his condition was little  more bad. And Sreekala was the doctor. And   Arun was very happy with that and he keep  asking me when we are going back for one more  treatment. So his deterioration was in  2002. When we went there, he had very little  vision. But over the course of ___ years, he  has been able to maintain an almost normal life.  And he was even running his own business for photo. That was entirely due to Sreedhareeyam treatment.  Absolutely no doubt about that because  all the allopathic doctors were  saying that saying that there   was no, he would be completely  blind and you had to teach him braille. But see from Sreedhareeyam's treatment, he  was able to maintain a normal life till  four years back. That's sure. 

[Aruna speaking] I have another  question Geri. Is that okay? 

[Geri speaking] okay yes please go. 

[Aruna speaking] Dr Sreekala, what type of like what  documents or any past histories would you  need if we were to come and visit. We would  be coming from the US. So what kind of paperwork  would you need for us to bring if we were to  bring our daughter? 

[Dr Sreekala speaking] You just you can  send that that details of your the condition na. 

[Aruna speaking] okay she has a very special one. She  it's not just Usher syndrome. It's HARS 3B. 

[Dr Sreekala speaking] Okay. 

[Aruna speaking] So  I'm wondering if you would need like genetic  testing, all of that done like we have all of  that paperwork. 

[Dr Sreekala speaking] Anything because previous any  reports are there, then you can send it. Then  we'll see okay. And that present condition and  what how is how is she now. 

[Aruna speaking] Okay and then  like your the initial visit, how long does that  normally take. 

[Dr Sreekala speaking] The treatment you are asking? 

[Arun speaking] Yeah  the initial treatment.

[Dr Sreekala speaking] Treatments and depends  on the condition. It's three to two to three weeks.  Sometimes four weeks that inpatient treatments. But  depends on that conditions, we'll plan. Usually  three weeks initially. 

[Aruna speaking] Okay I'm just trying to  get an idea so that when we come, we have enough  time to you know prepare for it. 

[Dr Sreekala speaking] Yes yes that  other detail, if you if you you can send that mail  also no problem that you can send the report. After  seeing that, we can plan something and then  we'll inform you how long and how it works like  that. 

[Aruna speaking] One more question. II's not related to Usher  syndrome at all. Do you also have a treatment for cancer? 

[Dr Sreekala speaking] We are giving medicine but just   we are supporting with with the other system  of medicine support for supporting that  we are doing that treatments. But along  with the allopathic therapies. 

[Aruna speaking] Okay thank  you. 

[Geri speaking] So this is Geri. I remember for our  initial visit, before we actually scheduled  our first visit, we had an online consultation  with a doctor at Sreedhareeyam, where we had sent to them  whatever reports we currently have. For example the most current audiometry test, the  most current visual field test and so on  so. And then we had that initial consultation,  online consultation. And from there, they had  suggested to us how many weeks or or days  we we need to be there. So hopefully that  will help. I will share with the group the contact  information to make that initial online consultation. Okay okay. I'll move on all  right I'll move on to the next question.  

This is from Adrienne. I hope I'm saying the name  properly. It sounds like the treatment for RP and  Ushers involves mostly direct contact with the  eye and ear areas through oil and a abhyanga-type  massage. Is panchakarma also part of the two-week treatment or is it a separate recommendation for  better circulation, absorption of nutrients and  whole body health? I ask my question because I  know of a panchakarma clinic nearby in the  U.S. but I'm pretty sure they don't include eye  Treatment. But if panchakarma can have  at least a supportive role in treatment, that  would be a helpful place for me to start before  making the decision to come across all the way to India. 

[Dr Sreekala speaking] Because the treatments depends  on that that panchakarma, which panchakarma  it is, that depends on that condition of  that patient. okay. After assessing that  only that we have to whether that panchakarma is  needed. In some patients that panchakarma, all that  therapies will not be needed. But some therapies,  because mostly that in RP and Ushers, without  any other complications, that normal panchakarma  therapies also will be included along with this.  okay you'll plan according to that condition. Some  of them. Like yeah. 

[Geri speaking] All right. This is Geri. Adrienne, I hope that answered your question  otherwise if you can unmute yourself and you  can ask further details. 

[Adrienne speaking] So that is helpful  it sounds like so I have a Usher type 2A  and it sounds like from the answer I just  heard, it depends on the severity, like what  symptoms I have, how far it progressed, and it's  kind of on an individual basis. Is that correct?

[Dr Sreekala speaking] So panchakarma in in the treatment-wise and  also improving that for general means  to maintain the health also, this is recommended. Okay.

[Geri speaking] okay just a minute. Okay. I'm  trying to switch the ISL interpreters.  okay I think I've got it right. Okay so I'll move  on to the next question. This question is from Latha. My  son is five years old and has Usher type 2 C. At what  age can we start treatment at Sreedhareeyam so that he  can cooperate with a treatment? So five years  old. 

[Dr Sreekala speaking] Even 5 years we are treating because that  all the therapies will not be there. Accordingly  we can start some medicines also no, and some  some therapies, some minor therapies and some there  will not be some panchakarma and all, but eye treatments  will be there. And some internal medications also  can help in this age also. 

[Latha speaking] Okay so if we need to  stay in Sreedhareeyam, will _____. 

[Dr Sreekala speaking] for that after sometimes after  after seeing the reports and all we'll see  that, how severe now, how is that condition now.  That inpatient also we are doing in five year old  if the the child is cooperating. [Latha speaking] okay thank you.   

[Geri speaking] So so this is Geri. Just to inform everyone,  the for for inpatients in Sreedhareeyam, they  have a wide variety of accommodations. And for  me this actually suits depending on how much   people can afford the treatment. They have  wards where people actually share a a big room and  just have a a bed in there for themselves. And then  the the treatment cost would also be lower.  So and then there are wards, and then the  next level I believe is a standard room with no AC.  It has two beds so it has room for the patient as  well as a a caregiver. And then they have standard  room with AC. Again two beds but with AC. And  then the next level is a suite room that has a  a separate sort of living room and a bedroom  room that one has AC. That one also has a  small balcony. Okay and then there is there  are Villas also. And they have a separate what  they call I think "Ayurvedic Village" which  has more facilities and which usually a lot  of the foreigners stay there. They have better  facilities in there. Of course the treatment  cost will also be higher. So there is a wide range  of accommodation to suit the person's financial  capacity. I know of people I've met, people  who actually traveled from Mumbai to Kerala by  train. And then from the train station, they took a  bus to Sreedhareeyam. And they stayed in a ward. So the  cost of that is is much much lower versus if you  go there you go there by a airplane and then from  the airport there is a 2hour taxi ride going to  Sreedhareeyam. Okay and then you can stay in whatever type  of accommodation you can afford. So they have  inside the facility, they have their own food  court. By the way it's all vegetarian food. I know  some people who have gone there were a little  complaining a little bit because they they wanted  nonveg. Okay so they have that. They have laundry  facility. And then the other thing you have to  remember when you actually go there, especially  for the patients, you have to protect your eyes. You  cannot be moving around in the sunlight. So most of  the time, you will be asked to stay in your room,  preferably no devices because that will tire your  eyes. Okay nothing intensive eye work. So initially  people will have that sort of withdrawal with  this other you know a different kind of, what  what do you call it, situation where you have  to stay inside. You cannot use your your mobile as  much because that will tire your eyes and so on.  But then think about it, think about it as unplugging,  in that if you have a family member with you, it's  time for you to bond, and think of other things  you can do. After 5:00 p.m. people go out when the  sun is down, you see a lot of the patients outside,  mingling with each other, going for short walks  around the complex. It's very very relaxing. And I  have to tell you my kids love that. They love  the interaction with with other patients, hearing  the other experiences of the other patients,  going to the temple over there, and having that  serenity. And also just walking with me and it's a  bonding time with me. So I wanted to mention these  things because some people might expect okay I can  bring my laptop, I can do work while I'm over there.  Please try not to do that. And also they told  me no chocolate, no sweets and so on. So there is  going to be adjustments. Okay but that is based  on our experience. The other thing I wanted to  mention is that I have seen a lot of little kids  in there being treated for a variety of conditions.  So I've seen little kids less than five years  old. Okay. Now I wanted to ask if there are other other questions? So so I I will continue with with my questions.  Going back to the research that's going on  in in Sreedhareeyam. I because I myself, I am  a statistician. So I like to take a look at data  and I track the progress of my son. I track the  audiometry information and you know just also  the the numbers of his eyes. I'm still trying to  understand what's the different numbers involved  in the different tests so that I can I can analyze  it. But the fact that every time we went to  Sreedhareeyam, they did diagnostic tests. I think  there were at least four diagnostic tests. It it  it tells me that data is being collected and  data and that sort of tracking of of the health  of the eyes and I will will be there. So I am  very confident that Sreedhareeyam is going to  come up with with this comparative study  across more than you know more than just one  patient but right now they're trying to do 50  patients. So if there's anything that the  Usher syndrome Coalition can do to help with  this research, please let us know because we're  really very much interested in seeing what is  the effectiveness of ayurvedic treatment. The other thing I okay the other thing I wanted  to oh go ahead. 

[Dr Sreekala speaking] no no sure we we are also very  happy to to be with you know for that this  is we are trying for that. Thank you for your that. 

[Geri speaking] All right the other thing I also noticed  that there are other conditions that can also  lead to the deterioration of vision. And some  of these conditions such as cataract, myopia,  dry eyes, retinal detachment. I have heard  other patients with Usher syndrome report this,  especially the cataract. I've met patients in  Sreedhareeyam who have had these conditions, not RP,  but blindness due to diabetes. And they  are being being treated there. So I actually  wonder if there is also studies being done  for these other conditions like for for   cataract or retinal detachment. If there  are also studies being done right now to  see if the ayurvedic treatment is is helping with  these conditions. 

[Dr Sreekala speaking] yes yes yes we are doing that in  in diabetic retinopathy and all. We are doing in  studies and in that that there is Improvement  in that condition condition retinal conditions.  And that usually that patients used to because  in retinal edema and all, they used to have  injections, intravitreal injections and all. But after that  because with with ayurvedic treatments and some  therapies, sometimes internal medicine and  some external therapies also, that can help to  reduce that swelling edema swelling. And they  can reduce the number of injections or at  least to stop the injections. They are helping. But the thing is that they should have some  healthy life because their healthy lifestyle that  should maintain the diabetes and all. So like  that some diabetes treatment, along for that, the  diabetes treatment also will be providing that  for but they have to maintain that condition. If  they maintain their healthy lifestyle that this  can help that retinal health and vision loss will be  arrested. That way that we are doing that and  getting good results also. In Cataract on and  all, early stages early cataract, we are treating.  We are giving medicines to means so that can help  to prolong that this surgery and all. In mature  conditions, we also advise surgery for them if no  other complication is there. If any other nerve  issues are not there then we advise surgery only.  We are sending them for surgery only. And   and but in degenerative conditions like RP or  Ushers and all, that surgery anyway maximum will  prolong that maximum we'll prolong if if they  have cataract that much affecting their vision then  only we'll advise them to for surgery. Other  conditions that and detachment also in early  detachment it's if it's not not in a surgical  condition then we'll treat, otherwise if it's  a surgical case then we send them for surgery only. Myopia and also that good results for reducing  that power. And also then some are having without  glasses means for avoiding that glasses  also will help for that. The treatments will help. 

[Geri speaking] Thank you Doctor. Any other questions? Okay so no new questions in the chat  so I will continue with my question. So some  of our members here they require interpreters   because they are deaf with very low vision  and some members are completely blind. So  the question is will the interpreters  be allowed in the treatment room so that  they can help the patient you you know  understand whatever instructions are given by  whoever is giving the the treatment. Or maybe  there's another way of of of doing it. I I don't know. 

[Dr Sreekala speaking] Usually because most of them will be  if they are deaf and blind then somebody will  be there with them no. Some usually they come  with that some bystander. And and if they   are from outside then we advise them to be with  some some bystander because otherwise sometimes  because that the staff the treatment staff  everything because all of them can communicate  with everyone in that way so like that but if  it's if it's necessary we'll do like that also.  We'll provide like that. We will think of that  also. 

[Geri speaking] You mean you you'll think about the ...

[Dr Sreekala speaking] yeah we will think about that because usually  the most of them will be Deaf and blind then  there will be somebody will be there. But  otherwise also because some some cases if it's  very low vision they are staying in that ward so  others also will help with them. Others also  usually help with them because and staff also  will help for that for the treatments. They they  will help no problem. Only for their own work  no their own other normal work only they need  some help. But other usually they will they  can stay if some vision is there, but if it's  completely blind anyway it's somebody should  be there. But we'll think about that if if it's needed. 

[Geri speaking] all right thank you Doctor. I have  a question about cochlear implants. I do not  have experience with cochlear implants but if  there are oil treatments around the ear,  I don't know how that can be done with a  cochlear implant, or is it okay? I those who have  cochlear implants in the audience ... 

[Dr Sreekala speaking] But that  that because if cochlear implant it fits  there then therapies will will change  accordingly without obstructing that.  Okay.

[Geri speaking] all right all right okay I'm glad to  hear that. Now any other questions from the audience? If none, any   parting comments from Dr Sreekala?

[Dr Sreekala speaking] No. Only thing that because it's this is not  anybody's fault or like because born with a  problem, born with the hereditary complaints. So  whatever that we have to accept that condition   and others should help for that acceptance also.  And surroundings. Because you are all doing a very  good thing because this coalition also because  many I think I have gone through that some activities  the activities go with the Ushers syndrome but  whatever possible things because it's a  if it's not curable also because if you can  maintain that condition and if other system  if other systems are also helping for that  you should accept that and you should take  the benefit from that. And because we have to  fight with that and just just to improve our life no. 

[Geri speaking] That that that is true doctor. For for my son,  I want to be able to maintain the health of his  eyes and ears while I wait for the results  of other research, for example, gene therapy  and and others. So if his eyesight can be  maintained, of course with the guidance of us  parents, because simply doing the treatment without  a change in lifestyle or or diet is not going to  help. There has to be something from from us, from  the patient himself to say I want to maintain  my eyesight. I should not be whatever playing in  the computer for so long or being out in the sun  so much and so on. The other thing is that I  believe we also have to be aware of other  conditions that can further deteriorate our  vision such as diabetes. We might think that the  deterioration, a sudden drop in vision, might  be because of Usher syndrome or or retinitis  pigmentosa but it could also be due to something  else. That that is also possible. So we just have  to be very observant as parents be very observant  as individuals and I guess just try our best  to to maintain a (healthy) lifestyle. And I know not  everybody is going to believe in Ayurveda, but  for those who do believe in it and have seen  how it can work, hopefully this webinar has been  helpful for you. I am going to post in the  group the contact information for Sreedhareeyam. I will  also post this video after I edit the captions.  I'll post it in YouTube along with some contact  information. So beyond that I would like to  thank our guest Dr Sreekala. Thank you so  much. Hopefully I can meet you the next year  I'll take my son over there. And believe me I  would like to help with any kind of research  in in any capacity that that I can. Thank you .

[Dr Sreekala speaking] Thank you. Sure we will meet and I we are  also very happy to help you any kind of  help from our side. If you want then you  can sure without any delay we can help you  at any time no problem. 

[Geri speaking] All right. 

[Dr Sreekala speaking] Thank you for  giving me this opportunity for meeting all of  you. 

[Geri speaking] Okay thank you so much. Thank you. All  right I'm going to end the meeting soon.

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