1. Stuart Agnew From England

Hello, I am Stuart Agnew [born in 1949] a farmer from Norfolk in the UK. In August 2005 I stepped backwards off a farm trailer [thinking that there was room for another step] and fell about four feet onto hard concrete with my right hip taking the full force.

It was sore for a couple of days and I then completely forgot about it for at least two years. About two months later I was walking amongst my chickens and my right hip appeared to give way. I had never previously felt such an odd sensation but it did go away only to return more and more frequently. By December 2005 this had become a constant ache obliging me to limp. By March 2006 I had develped a pain in both lower knees and that combined with the bad hip was making all movement difficult.

A doctor friend watching me walk one day ordered me to go and see a doctor because he was convinced I had arthritis. An x-ray was taken in June 2006 and arthritis was confirmed. I did not want to get hooked on painkillers and I also felt that a certain amount of pain would at least force me to walk in a way that would do the least damage.

My many siblings were by this time taking it in turns to suggest to me that I needed a hip operation. At the time I was told that these had a life of about 12 years and there was no certainty of the success of a repeat operation when the time came. I let matters drift. The knee was getting worse and I was told that this was a direct result of my limping to protect the right hip

In Summer 2007 I was told that a farmer of my age [Ross] had just had a hip operation so I gave him a ring. This is where I heard about the 'Birmingham Hip Resurfacing' technique. Ross was delighted with his result and suddenly I felt hopeful. It is essential to catch artritis in the early stages if Resurfacing is to be successfull.

I was now resolved to have surgery, but how ? when ? and where?

First option was the National Health Service(NHS). But I was utterly disillusioned with the NHS and its laid back attitude towards arthritis. Going Private in the UK was expensive, about £ 11,000.

I was mulling this over with some friends in Oct 2007 when someone said they thought they had heard that you could get cheap hip operations in India.

Just for the hell of it I typed 'Hip surgery, India' into the seach engine of my computer and up came Bala's name. There were some testimonials to read which encouraged me and so I e mailed him and asked if it was possible to do my hip on Mon 4th Feb 08. [This was an ideal time for me].

When he responded he said he was delighted to hear from a potential patient in Norfolk as he had worked in both Kings Lynn and Cromer hospitals. I found this very heartening as it gave us some common ground.

He mentioned that my proposed date was no problem, but he would need to see my x rays. I sent him the report of the x rays that I had received { trying to get the actual x-rays out of the NHS is like trying to get blood out of a stone.] Again there was a positive response from him, my hip was suitable for Resurfacing. I asked Bala what would be the cost of the operation and he said he would charge £ 3200. I agreed that this was acceptable and that I was now his patient. I then added the cost of the flight [business class] and that brought the whole thing up to about £5000. This included the internal flight from Bombay to Coimbatore which Bala organised for me.

On the evening of Fri 1st Feb I flew from London on a 777 and the business class seat was well worth the extra money. A man of 6ft 6ins could have lain horizontal. Due to time difference and having to wait for my internal flight I didn't reach Coimbatore until Sat evening. I was met at the airport by 'Jana' one of the surgeons on Bala's team and he took me out to dinner. This was very much appreciated. After dinner he drove me to the hospital which is a large 550 bed speciality hospital with a 'de-luxe' suite to which I was taken.

Bala was there to meet me . A slim, friendly, energetic man with very good English. I mentioned that my hip had travelled very well and it seemed as though a cure was already underway. He told me that the x-rays we would take the following day would resolve exactly what sort of a problem I had.

My room was actually a pair of rooms. One for the patient and one for relatives. Both with their own bathroom. Cooking facilities are provided for relatives to prepare meals for the patient. In my case Violanna the ward Sister was responsible for meals and maintaing a stock of bread, milk and corn flakes in the other room. During my stay the room was swept every day and washed at least twice.

First thing the next morning [Mon] I was bathed and 'oiled' with a material that would help prevent bed sores. I was visited by the anethiatist who warned me that I must expect some pain and discomfort after the operation as there could be unwanted side effects from a dependency on pain killers. However the pain would steadily diminish with time.

I was then wheeled up to the theatre and given the gas mask. I woke up on a trolley outside the theatre and as soon as the nurse noticed this she sent for Bala. He arrived and told me that my operation had been a success and that there had been enough good bone on my femur to do the standard Resurfacing. I doze under the influence drugs for the rest of the day.

I wake up on Tues hurting everywhere and taken for a post-op x-ray. Half an hour after this is completed Bala rushes into my room waving the x-ray saying how pleased he is with the result Wed and Thur are still difficult for me. I have no appetite and can't sleep. On Wed I am gently taken out of bed, stood upright, given a walking frame and told to walk. Much to my surprise I was able to and in fact I found it far more comfortable to quietly stand or shuffle about with the frame than to sit or lie.

On Thurs night Bala leaves for a three day medical conference [ he had wanted to operate on me the previous week because of this engagement, but I couldn't manage the earlier date]. He is a bit worried about my lack of sleep and wants me monitored closely. In turns out that I have a really good sleep on Thursday night and improve very rapidly from then on. Meanwhile Bala has to give two presentations at the conference of several hundred surgeons. One of these is about his hip work, but the other is about a clip he has designed to assist in holding bones together during operations on fractured legs etc. He actually got the idea of this clip during his time in England whilst watching a mechanic [called Kevin] working on cars. Bala had a similar clip made up to his own specification in India, called it the 'Kev-clip' and has been using it to good effect ever since! I mention all this to demonstrate that Bala is not just some cowboy surgeon doing cut-price work at the bottom end of the market. He is just the opposite. He is a highly respected orthopedic surgeon, considered by his peers to be a genuine leader in his own field.

I was considered fit enough to swap the walking frame for a stick and to my surprise I was told that I must hold the stick in my left hand, despite having the operation on the right hip. Once I had got used to this there was no stopping me and I walked regularly around the passages over the next few days without problems. I took the physiotherapy sessions seriously and always asked to be given a score out of a hundred. I was delighted to get 100% on the Sunday morning.

Bala called in on the Sunday night and said I looked a lot better. I said 'I am going to give you a demonstration' and walked with my stick at very high speed down the passage. I kept expecting him to shout at me to slow down [as the nurses kept doing] but I got to the end of the passage without him saying anything. So I turned round and walked back towards him as fast as I could go. He was looking intently at my hip and as I drew level he just said 'now try without the stick'. I managed a few slow steps and he gave me the stick back.

On Wednesday Bala kindly organised a dental appointment for me and taxi excursion into the surrounding countryside, he also sent a porter from the hospital who could speak a smattering of English to accompany me. During this time we visited a Hindu shrine where there was a very long queue of people waiting their turn to enter. A priest noticed me and insisted that I be taken right to the very front via a locked gate and a different staircase. Inside the shrine another priest gave me the Hindu equivlent of a blessing and I was invited to pray and then given some green material to eat [ it seemed like parsly leaves]. One other interesting observation I noticed during the drive was the very small number of people who smoked. In fact I only saw one smoker amongst at least two thousand faces we must have passed in the streets. But everybody it seems has a mobile phone.

Bala took me out to dinner that night, my last, and the next day I met his next patient. This was a man from the Philipines who was on wooden shoulder crutches. He needed both hips doing and looked tired and frail. His wife was with him and was very worried about whether they had done the right thing in trusting Bala purely on the basis of his website. I did my best to reassure them.

The flight back in a business class seat was a good one and I felt confident enough to refuse the use of a wheelchair in Terminal three at Heathrow [where a lot of walking is required]

It is now six weeks after the operation. I can pull a sock onto my right foot in the conventional manner, I have been passed fit to drive and for the first time in over two years I can stand up straight when I walk. My hip is still very stiff when I first stand up and there is still a numb sensation at the top of the buttocks. However I am assured by Bala that this will improve and is quite normal. I am very pleased I took the decision to 'take the India option' ! As a bonus my left knee is much better. It no longer has to take the stress of my previous limp.

4. Squidge Davis

Dr.Bala is a masterful world class surgeon whose skill, dedication, graciousness and --- inspired confidence in me immediately and continued to do go throughout.

My surgery proceeded exactly as had been described and I was beautifully cared for before, during and after the procedure.

The Post –op time was deeply restorative and nourishing not only to my body but to my heart and spirit as well.

All - in-all , I was in the hospital for 10days ( I am 67yrs old woman and did not jump right back as I somehow fantasized I would) and in all that time I did not have a single cause for complaint or disappointment but rather a bousety of special exquisite care.

I recommend Dr.Bala and his support team without reservation. Please feel free to email me if you need further reassurance.

5. Mrs.Jayalakshmi

Dr. Bala performed a bilateral knee replacement on my mother in Dec. 2009. Over a period of five years prior to the surgery, my mother's (at the time of surgery, she was 74 years old) mobility was impaired to the point where even getting out of bed was a problem. Her repeated use of her arms to lift herself up due to her knee problems led to significant strain in the shoulder and the pain caused lack of sleep – overall, this was a vicious cycle where the pain caused so many other disorders, both physical and mental, which led to more pain and so on. Under the advice of my cousin's wife, we sought out Dr. Bala. With me living in the United States and my brother living in Australia, we only had a short window of time (about 4 weeks) in which to perform the surgery due to the demands of our respective careers and families as well. On evaluating my mother, Dr. Bala said that she would be a candidate for bilateral knee replacement. I was amazed by a number of things during this whole process – however, two things stood out:

i)  First was the professionalism displayed by Dr. Bala. He carefully examined my mother and described the pros and cons of unilateral and bilateral surgeries to us. Needless to say, we were extremely concerned at the prospect of performing such an invasive (in our minds) procedure on someone so old and fragile.

ii)  More important was the concern that he showed for the patient. His empathy for her and his ability to soothe her fragile nerves was truly outstanding. Without his constant encouragement, I doubt that my mother would have agreed to the surgery, or had the kind of recovery that she had after the surgery. He helped her through physiotherapy and was often the inspiration that my mom needed to get onto her feet in the first few days following the knee replacement surgeries.

We owe a debt of gratitude to Dr. Bala. The biggest difference we see in our mother is her ability to sleep peacefully through the night – something that was explained to us upfront by Dr. Bala. It is also quite amazing to us to watch our mother navigate flights of steps this is by a lady that had trouble stepping over a threshold about an year ago. Not only has Dr. Bala made a significant difference in my mother's life – he has touched and affected the life of the rest of us who care for our mother and made our jobs of ensuring her comfort and care in her waning years. Thank you Dr. Bala, and I wish you well in your pursuit to treat others in a similar manner as well.

Pradeep Subrahmanyan - pks@alum.mit.edu