Nawaz opts to travel abroad on ‘his own risk’

LAHORE: Former prime minister Nawaz Sharif has opted to travel abroad for his medical treatment on ‘his own risk’ due to unavailability of required diagnostic facilities in Pakistan to ascertain his mysterious blood disorder cutting down his platelets count.

“As Nawaz failed to respond to conventional first line treatments of ITP (I.V. Gamma globulin, Systematic Steroids and Revolade) and his co-morbidities have worsened because of his treatment, the board agrees that he may be allowed shifting abroad to a centre of excellence of his choice on his own risk,” ruled the 14-member Special Medical Board headed by Prof Dr Mahmood Ayyaz, principal SIMS/SHL, along with 9 members and four co-opted members.

The doctors said Nawaz Sharif’s condition had been deteriorating significantly as he had developed steroid induced behavioural changes.

“He had a transient episode of amnesia due to TIA, and therefore was unable to sleep due to nocturea because of glycosurea, and his empagliflozin had to be stopped,” observed the doctors in view of the updates provided by a private medical board of the Sharif Medical City headed by Dr Adnan Khan.

The doctors administered a high dose of steroids in addition to necessary medication to increase and stabilize his platelets count around 40,000 to enable him for a long flight. Nawaz Sharif is headed to Boston, USA, for treatment of his mysterious ailment after going through a detailed checkup in London.

“The administering of steroids to increase platelets triggers blood sugar and blood pressure, besides affecting renal and cardiac functioning,” a source informed, adding that it was a huge challenge for doctors to maintain his platelets count to a reasonable level without disturbing other vital indicators to enable him to travel abroad through air ambulance.

Earlier, Nawaz remained admitted to the Services Hospital for 17 days for treatment under the supervision of a high-powered multi-disciplinary Special Medical Board, constituted by the Punjab government.

The Medical Board, also assisted by Prof Dr Tahir Shamsi – a renowned Haematologist from Karachi – diagnosed Nawaz Sharif to have been suffering from autoimmune blood disorder known as Idiopathic thrombocytopenic purpura (ITP), but had fallen short of identifying the cause of disorder that caused severe and sudden drop in the patient’s platelets count.

Therefore, the Medical Board advised the patient’s genetic tests to ascertain the cause of drop in platelets count abroad and treatment accordingly.

The doctors, at best, had been doing management to increase and stabilize his platelets count in relation to his co-morbidities, for Nawaz Sharif’s multiple ailments reacted in conflict to medication for each complication and needed a delicate balance to manage his multiple pathologies simultaneously.

On November 6, Nawaz was discharged from the Services Hospital and shifted to a makeshift High Dependency Unit (HDU) set up at his Jati Umra residence, where he remained under treatment of the private medical board of the Sharif Medical City until his departure abroad on Tuesday.

Dr Adnan Khan, Nawaz Sharif’s personal physician, said the former prime minister was on heavy doses of steroids and massive immunomodulation.

“It was not advisable for him to stay in hospital as hospital acquired infections could even be fatal in impaired immunity,” he said, adding that doctors had advised the patient to be managed in isolation in an HDU facility.

He said the Sharif Medical City managed one such facility at his home providing whatever was necessary. “Round the clock specialized doctors and nurses provided the care supervised by the Medical Board,” he added.

Dr Adnan Khan informed that, post-CABG, Nawaz Sharif suffered NSTEMI (heart attack) twice during incarceration in Adyala Jail in July 2018 and then during admission under custody in the Services Hospital as sub-jail in October 2019. “Stress of incarceration is life threatening,” he believed.

Nawaz’s medical files were handed over to the team of doctors and paramedics, headed by an Intensivist, traveling with the ex-PM in a high-end air ambulance equipped with a fully functional and staffed Intensive Care Unit (ICU) and Operation Theatre (OT).

The air ambulance made a brief stopover at Doha, Qatar, where Qatar Amir Sheikh Tamim Al-Thani’s personal Chief of Protocol received him and took him to the Royal Terminal lounge during refueling and change of medical staff at the Doha Airport before taking off for London, UK.