Assessment at Sri Ramachandra Medical Centre (SRMC) – Day 1

Hi all,

this post is about sharing our experience on getting my son assessed from Ramachandra Hospital in Porur: (This happened in April 2019)

My son has been going for therapy ever since he was diagnosed for ASD (2 years now). However after the initial diagnosis done by the pediatrician, we never had any further assessment done. We have been continuing the typical therapy models of speech, OT and special education till date. However we have been feeling the need of a proper assessment done as he is going to complete age 5. We need to know whether we are proceeding in the right direction or not. Also we found changes in his behaviours and sensory issues, which were on the negative side! Also April and May were the vacation months for the schools, hence my son need not take leave from school during this period. Hence decided this is the right time for the assessment.

From past discussions in the Scan Telegram group, many parents have suggested the following places where proper assessment takes place:

1) Sri Ramachandra Hospital, Porur

2) NIEPMED, Kelambakkam

3) Egmore Child Hospital ..

However Egmore child hospital had some negative feedback as well, hence I left out that place. Wanted to decide among Ramachandra and NIEPMD. Since Ramachandra is private sector, we thought the service would be organized and prompt. We would have all the expertise required to be consulted under one roof even though it may be on the expensive side. (I sincerely regret the decision made.)

Sri Ramachandra Medical College (SRMC) has been providing assessment for Autism Kids for some time now. Karthikeyan Child Development Unit i.e. KCDU is the unit under SRMC that provides this service.

Appointment:

To get an appointment for your kid, please call 044 – 4592 8540. You will not get appointment on the same day when you make the call, it will most likely be a week from that day. We got an appointment like 8th day (8 days from the day i called for appointment), so we confirmed the same, thinking delaying further will prolong the appointment date further.

Reporting Time:

They will ask you to be in the hospital by 8:30 am. But most of the doctors and specialists arrive only by 9 am. However since it is a big hospital, there is a biggggggggggggggggggggggggggggggggg waiting time for everything and everywhere.

(Its like a government office, you cannot get your requirement completed in a day, you will be made to come multiple visits.)

Day 1:

We reached SRMC at 8:30 am. There is ample car parking space available. In my opinion, next to Chennai Central and Airport, SRMC will be the place where the number of vehicles that travels in and out are huge in numbers. You cannot walk safely inside the compound, it’s like every second few cars pass by.

I imagined KCDU is a separate unit or block where all essential services of a pediatric related will be made available in one place, asked few securities about the KCDU block, as we were unaware which building we have to enter. No one was aware of such a Unit or name at security officers level. Hence called the KCDU number for appointment and found that, they are in Udayar Block, 2nd Floor,C2 Section. Inside C2, you have to report to room number 9, after getting registered in the Reception.

(If you are coming by car, drop off all of them in the Portico (big one) in Udayar block and you can then proceed to park your vehicle, so that everyone can avoid the walk to and fro from parking lot to the hospital block excluding the driver.)

We entered Udayar Block, you cannot enter further past reservation without a patient or attendee tag placed on your wrist (like the one they provide you in MGM Theme park). Green Color tag is for the patient and Orange color tag is for the attendees. Up to 3 attendees are allowed to accompany the patient. (For Infant no tag is required, we carried our second child who was 1.5 years, no one asked anything)

There is a writing table with registration forms placed (like challans in the bank), you fill up the details and stand in the queue. Almost all counters are for registration purposes only, even though the plaques hanging above them suggests for different services. You have to mention that you have come for KCDU and number of attendees to them, they will provide a print out, a file, patient tag and attendee tags. The amount needs to be paid in advance which amounted to 750 Rs. (Seven hundred and fifty rupees)

After placing the tags on your wrist by the personnel, you will proceed to the lift as KCDU is in second floor. Ensure that you stand in the correct lift. The one in the right side end is the lift where you have to stand, as that lift service is restricted only till 2nd floor. There will be a lift personnel who would direct if present, else take the right most lift that goes only till 2nd floor. After reaching 2nd floor it is easier to locate C2 as there are arrows pointing with clear directions. Get inside C2, you will find the reception, find a nurse take the height and weight measurements for your kid, as it would be asked while creating case history. The nurse will write it in the file some where the measurements. Now report to Room no 9. (Every room is clearly marked with numbering).

Here you will find the lady, she is the organizer for all your upcoming tests and appointments till the assessment gets over. (Be Nice to her, if you can.) She will take your basic information, before sending you to the Pediatrician. There is a standard form, which she will fill in by asking us the details, remember the below questions, you will be asked these in every department in SRMC. (Not sure what is the point of collecting the same details every time …). Here are the questions:

1) Parents are related to each other i.e. marriage happened within the relative’s network or outside.

2) Conceived naturally or not

3) Pregnancy is Normal Delivery / C Section.

4) What is the birth weight

5) Was he kept in Incubator after birth due to any complications?

6) Did the mother consume any medical procedure during pregnancy?

7) Who referred you here?

8) Was it a full term pregnancy or premature one? Etc.

After providing all the requested information to her, she will ask you to wait outside. This wait was the longest period, as we waited for around 1:30 hrs. After the waiting period, we were called by another lady doctor did not get her name, Dr.Abhinaya I guess. (Based on the signature on the prescription given on final day) She will collect the case history from you, this again will have the questions that was asked by the organizer earlier. The entire 4 year history of my son was covered in 10 lines on the prescription slip they have. She speaks very fast, the number of words she spoke per minute is on the higher side. Now after her visit, we are asked to wait again.

Now we met the Pediatrician Dr. N.Udayakumar. The doctor who collected the case history earlier from us, began the knowledge transfer process to him. As a general rule when the communication passes from one person to another, there will be loss of information as the understanding levels are different. There were few misinterpretations made to him, which we interrupted to correct, but Dr.Udaya kumar is a very different personality. For his experience, he does not have patience to listen to the parents. We have to say “Allow us to speak” many times since instead of mutual conversations it became one sided lectures. He did not make any attempt to interact with my child. We clearly lost interest to even attempt further communications to him.

After that brief meet, we were listed a serious of tests to be taken up.  The tests prescribed were:

1) Speech and Hearing Test

2) Psychology Test

3) Blood and Urine Test

4) Occupational Therapy test

5) Ophthalmology Test

(We found that the tests prescribed may vary based on the child when we spoke with other parents who came for assessment for their Child). After this we went to the organizing lady, who asks us to go for the Speech and Hearing Test. This is in the same floor, but in a different location E2.

SPEECH and HEARING TEST

We went to E2 and gave our file. Began our waiting sagaa…

First we were called for Hearing Test, which is taken by the student/trainee I guess. My son sat on a chair, there were speakers on the left and right side, with some lights as well. They will trigger different speakers at different point of time to see if the child responds to the noise or not. Later, ear plugs were inserted in the ears, with sounds being played for another test as well. My son did not co-operate for both these tests, the rooms were designed for Air conditioners, but when we visited AC was not working as a result there was no ventilation, it was suffocating for me as an adult. It took few attempts and struggle to complete the tests. He passed the test.

We broke for Lunch, the canteen is a busy place, highly unorganized, heavy crowds, very limited seating space, very slow in service etc. so be prepared for that. Plan accordingly to have lunch before the peak hours, so that the time spent in canteen is very minimal, as you have lot more waiting to be done. It is very good option if you pack foods or parcel food, so that you have it in the waiting cabin itself, instead of visiting the canteen.

We gave the file for speech test and waited. The questions that were asked by a senior women literally pissed off my wife. They asked for the purpose for the visit, my wife told we are going for therapy since his diagnosis we want to know his current level through an assessment…. This response did not go well with the senior women, below were the questions fired immediately by her:

• Why are you going to different therapy center ?
• So you will not come for therapy to Ramachandra ?
• Assessment will not be helpful since you are not coming to Ramachandra for therapy?
• You only need a report on his current status right ?

The senior women just lost it, when we told that we are going for therapy outside and came only for assessment here. Later she handed the file to the juniors.

We were called by two students/trainees, who began asking questions to us first about our son, after that they began assessing our kid. They had a file which contained pictures of words, action words, pronouns, etc.  I was very satisfied with the detailed examination done by these two trainees, it also gave us an idea on areas where my son was struggling. They did not complete the test fully, they kept the portion of it pending for another day, as it looks like the senior person (they refer to as “Mam”) was not present on that day. We agreed as we need to come again for other tests as well.

In both Speech and Hearing test, only one parent is allowed to accompany the child.

BLOOD and URINE TEST

After completing hearing and speech we went to the Organizing lady, who directed us to go for Blood and Urine test. This is in the same building, but in first floor. There will be a place for providing samples.

• For Iron it is 360 Rs (300 Rs in Apollo)
• For TIBC (Total Iron Binding Capacity) it is 360 Rs (300 Rs in Apollo)
• For Vitamin D it is 1985 Rs ( Rs.1250 in Medall labs)
• For Routine Urine Complete Analysis it is 150 Rs. ( This is 190 rs in Apollo)
• For Drugs and Disposables it is 10 Rs ….( Yeah, you are charged for the needles, cottton, band-aid separately)

I made my son sit on my lap and held him tightly, the blood was extracted in two tubes. I found for two tests i.e. iron and vitamin D, they extracted way more blood than what was required. I recollect a similar load of blood was given by my child in Medall Labs, when we took a series of tests for metals, allergies, etc. where the report itself ran for 6 pages.

For urine test, they need at least more than half the bottle of sample, since my son urinated minutes before the test, we collected the container and gave the sample next day.

The day (day1) came to an end…. To be continued…

Regards,

Saranya and karthik

karthiksaranyaparents@gmail.com