Tracy McManamonContact a Case Management Specialist! Call Today at
(877) 549-1212 or Email Us!

Medical Tourism – World Class Physicians & Facilities

Chronic Cerebral Spinal Venous Insufficiency


There has been a great deal of advances in the field of multiple sclerosis management and in particular Chronic Cerebral Spinal Venous Insufficiency over the last decade. Of these, a large amount of research has been conducted in analyzing the cause for multiple sclerosis.

In the recent past, a specific area called chronic cerebral spinal venous insufficiency, sometimes called CC SVI, has been described. In this article, we shall take a brief look at this concept and discuss its applications in the management of multiple sclerosis.

What is CC SVI?

CC SVI forms a part of a group of malformations of the venous system within the brain. Various pathologies can affect these veins, particularly the ones close to the internal cervical veins and the azygos vein.

The relationship between CC SVI and multiple sclerosis

Multiple sclerosis is a neurological condition that is characterised by the loss of the protective myelin tissue around the nerves. In other words, it is a demyelinating condition that affects the nerves resulting in alterations in conduction of nerve impulses along the spinal cord. As a result, patients can experience varying degrees of motor weakness which can eventually be rather debilitating.

With regards to the relationship between CC SVI and multiple sclerosis, a theory called ‘liberation treatment’ was proposed by Prof Paulo Zamboni in 2008. There have been a number of different contradictions and issues raised regarding this treatment. Be that as it may, it has been proposed that in patients with CC SVI, the internal jugular veins and the azygos veins are significantly narrowed. This results in a high deposition of iron in the brain which ultimately triggers a series of reactions that can result in the loss of myelin from the surface of the nerves.

Application of CC SVI in the management of multiple sclerosis

The principle of CC SVI in the pathogenesis of multiple sclerosis is now being utilised in treating this condition. Initially, tests are performed to determine the exact point of narrowing within the veins. This test is called a venogram and involves the injection of contrast into the veins and imaging using a specialised x-ray equipment. In some cases, intravascular ultrasound may be used.

Once the narrowings have been determined, stents can be inserted into these narrowed veins or balloon angioplasty may be performed. It is believed that doing so can slow down the process of demyelination and the ultimate development of multiple sclerosis. The procedure is performed under local anaesthetic and guidance of an x-ray machine. The balloon is guided in with the help of a catheter and once in place a metallic stent is put in place to keep the vein open. The procedure takes a few hours to perform and has very good results. Risks are low especially when this procedure is performed by experts.

Procedural costs

Unfortunately, CSS VI treatment is not being performed in United States. However, it is performed by experts for a very reasonable cost in places such as Costa Rica. It is worthwhile making a visit if you have multiple sclerosis or have just been diagnosed with it to obtain this rather remarkable treatment.

Costa Rica’s Thriving Medical Tourism

Costa Rica’s Thriving Medical Tourism:

Though Costa Rica’s Thriving Medical Tourism has been around for many years, it is only recently that the industry has found itself in the spotlight. In the last several years, rising health care costs and long wait times for elective surgeries in developed countries have caused individuals to seek quality health care outside their own country. The phenomenon has been an incredible opportunity for countries who have long since provided high quality medical care at affordable prices to their own citizens to open their doors to these foreign patients in need of the services they provide.

Costa Rica is one of these nations. Since 1941 the country has enjoyed quality and affordable health care through their universal health care system. This system of care allows for health services to flourish under a performance based model as opposed to many developed nations’ for-profit based model. Costa Rica is noted for having the best Children’s Hospital in Latin America, as well as the most efficient state-owned hospitals in the region. Not only are their facilities top-ranked, but more than 70% of the country’s doctors have completed their training in the United States, Europe or South America, meaning that many of them are board certified in these countries as well.

The year 1990 saw the birth of Medical Tourism in Costa Rica when a few dental clinics and plastic surgeons saw an opportunity to offer their high quality facilities and services at affordable prices to Americans and Canadians. Now, over twenty years later, the country welcomes some 40,000 medical tourists per year. With three JCI (Joint Commission International) accredited hospitals and ninety AAAASF (American Association for Accreditation of Ambulatory Facilities) dental, surgical and outpatient clinics it is clear to see why Costa Rica has become a top choice for Americans seeking quality health care at more affordable costs.

Ask us today why Costa Rica may be your best option for your up and coming medical care needs

Hot Trends for Borderless Healthcare/Medical Travel

Medical Travel opens new doors of possibilities for patients internationally

Borderless Healthcare – the practice of traveling away from home for treatments and care – has created a new landscape of opportunity in today’s global marketplace. As an industry, medical tourism is flourishing and expanding on world-wide scale and creating new and significant revenue streams for companies, healthcare providers, and countries prepared to respond to the demand.

The Opportunity

The number of consumers traveling abroad for treatment is soaring. Whether termed Healthcare Travel, Medical Tourism, Medical Travel, International or Global Healthcare, or Borderless Healthcare, the bottom line is that patients are traveling outside their home country more and more for health care and treatment.Estimates of worldwide medical tourism place total projected global revenue at $40 – $60 billion per year currently.1 Some sources project the growth of medical tourism will be 20% per year,2 while leading consultancy Deloitte & Touche predicts 35% or higher growth per year as the global economy recovers.3 While most Americans are new to this concept, the number of Americans taking advantage of medical tourism is expected to rise: an estimated 1.6 million Americans will seek medical care by traveling abroad this year. 4

Additionally, some seventy-six million baby boomers are now arriving at an age where their healthcare needs will be increasing; thus, the practice of medical tourism is likely to expand dramatically over the next few years.Patients are traveling to destinations around the world and are spending an increasing amount to access the superior healthcare they want or need. Millions are seeking elective procedures such as cosmetic surgery and cosmetic dentistry. U.S. Consumers spend $12.4 billion a year5 on elective cosmetic surgeries and treatments alone.

During the depressed global economic climate of 2008-2011, medical/health travel was the only significant sector of the travel and tourism industry that was experiencing growth, even as other sectors have declined.

In particular, there has been growth in upscale medical tourism in recreational locations, due to a number of factors and trends, including:

  • Comparatively high wealth in U.S. and other Western nations combined with a desire for more health treatment options
  • Comparatively low costs, offering saving of as much as 60% – 90% on treatment
  • The appeal of being able to recuperate in a private, resort-like destination
  • Shorter waiting times for treatments and surgeries
  • Desire for a high level of service and personal attention
  • The ability to combine treatment and recovery with a vacation with friends and family.

Market Drivers

Significant drivers in the healthcare travel market include Cost/Affordability, and Accessibility.

Cost/affordability: The significant appeal of medical tourism is the opportunity to obtain high quality medical treatment at a significant saving over what it would cost in the patient’s home country. Healthcare costs in the U.S. are quite high. In fact, the World Health Organization ranks the U.S. as number one in healthcare expenditures and yet their healthcare system ranks 37th in the world for quality of care. Many consumers find that paying for care at home (even with insurance covering some of the cost) is more costly than seeking care abroad, even when factoring in the cost of the treatment, travel and accommodations.Locations that can offer outstanding value due to differences in economic markets have a distinct advantage for attracting patients. For example, a November 2007 study found that U.S. accredited hospitals in India typically charge just $10,000 for heart bypass surgery that would cost between $95,000 and $200,000 in the U.S. Hip-replacement surgery that would run between $31,000 and $75,000 in the U.S. can be had for as little as $12,000 at a JCI-accredited hospital in Singapore.5

Another study in 2008 found that hernia repair – which typically costs $4,500 in U.S. hospitals, is only $1,800 at foreign hospitals.6

Health plans such as Aetna and Blue Cross Blue Shield of South Carolina, as well as, self-funded corporations such as Kraft Foods and Hannaford Supermarkets are looking at medical tourism as a way for their companies and their insured patients to save money.

Accessibility: Healthcare is extremely expensive in the United States, and in Canada there are often long waiting periods to get non-emergency care. These factors lead patients to look for options abroad for care. For example, in the area of liver transplants, in the U.S. a patient must reach a certain MELD7 score to qualify to go on the waiting list for a donor organ, thus often leaving a patient in a very weakened state of health for a long period of time.

These reasons alone are enough to drive North American patients to look outside of their home countries for low-cost, high quality healthcare. The growth in medical tourism is also due to a number of additional contributing factors and trends, including:

  • Lack of timely access to elective procedures due to cost, rationing, or other restrictions.

For example, in Canada, physicians cannot privately treat their fellow Canadians if those treatments are covered by the government health plan. In a number of countries, nationalized health systems sometimes deny treatment to particular patients (for example, because of age or physical condition), and some treatments may not be available to any patients (for example, because of cost).7

  • Increasingly high expectations of consumers with respect to health care and growing “medical consumerism” (patients’ desire to have more control over decisions affecting their health and medical care).

Increasing Acceptance

North American consumers are increasingly willing to travel to obtain care that is both safe and less costly. In fact, two in five survey respondents said they would be interested in pursuing treatment abroad if quality was comparable and the savings were 50% or more.

Consumers aren’t the only ones interested in medical tourism; the practice is gaining acceptance with employers and insurance companies as well. In the past year, a number of big employers have promoted medical travel to the employees they insure to
offset soaring health costs. In 2008, the World Medical Tourism & Global Health Congress noted that more than 100 employers and insurance companies had already implemented medical tourism programs and had started sending employees overseas for healthcare.8

With the new United States instituting The Patient Protection and Affordable Care Act (aka “ObamaCare”) on January 14, 2014, American patients and insurers/payors will be looking for cost effective healthcare solutions. Those solutions will need to include state-of-the-art treatment that is equal to or better then that currently available in the United States. Traveling abroad is the one of the most cost effective and reasonable ways to find such solutions.

1 ITB World Travel Trends Report, ITB Berlin and IPK International, December 2012

2 As reported by Horowitz, Rosensweig and Jones, “Medical Tourism: Globalization of the Healthcare Marketplace.” NIHMedscape General Medicine,

3 Deloitte & Touche, Medical Tourism: Consumers in Search of Value, market research report issued in 2008 and updated in 2009

4 Ibid.

5 Modern Healthcare, May 2008

6 Deloitte & Touche, Medical Tourism: Consumers in Search of Value, market research report issued in 2008, updated 2009.

7 MELD = Model for End-stage Liver Disease, a numerical scale to rate how gravely ill a liver patient is and thus set priority for a transplant

8 Medical Tourism Association, June 2008. As a demonstration of the rapidly emerging nature of the medical tourism industry, 2008 was only the second year that the Medical Tourism Congress was held.

© Copyright 2013 Michael R. Brown & Michael Brown Communications/Healthcare- Proprietary

Is Medical Travel Our Answer to Obamacare?


Now more patients now than ever before are realizing the tremendous benefits of travelling outside of the United States for world class medical care which can mean survival as well as recovery for some patients that would otherwise be living on borrowed time while waiting for treatments here at home.

Nigeria is without oncological care, and so cancer patients are forced to go abroad for care. An average of 50,000 Canadian patients flock to the US each year to avoid waiting four months for non-emergency care. These are just two small examples of not only the accessibility of health care globally. The situation in the US is predicted to become similar in some respects with the implementation of Obamacare. The US is expected to begin to see physician shortages beginning in 2014 and worsening in the next few years.
As Obamacare is gearing up to take effect in 2014, and with the baby boomer generation approaching retirement age, an unavoidable healthcare shortage is looming. With that in mind, more and more Americans are looking to other countries for less expensive, high quality care in a reasonable time frame.

The medical travel industry is exploding, creating many new opportunities for patients to obtain large discounts on everything from heart valve replacement to dental work at World Class facilities.

With the changes coming to the United States growing more evident every day, international governments around the world are heavily investing in infrastructure as well as promotion in order to label their countries as prime medical travel destinations.
However, countries such as Poland, Malaysia, Costa Rica and other nations, are already able to compete with the United States in the cost of health care because the majority of in-country patients who seek treatment pay out-of-pocket but are treated in the finest facilities in the world, and they are therefore more pressured to keep their costs down.

A hip replacement that costs on average $50,000 in the US runs about $6,900 in Poland and treatments such as HIFU, which are still considered experimental in the US, can be performed on patients suffering from prostate cancer.

NewWarsawImageWith health care’s globalization, countries are beginning to specialize in specific types of care. Costa Rice and Hungary are becoming known for high quality dental care and Poland is in fact, one of the leading centers throughout Europe for Medical and Dental Care.

Other countries are not the only ones seeking to take advantage of the recent boom to the medical travel industry. A number of American physicians are looking to relocate to avoid the excessive restraints from the government, increasing Medical Mal Practice costs.

Patients are also looking to other countries for procedures and treatments that are not covered by their insurance companies, such as dental care, weight loss reduction, cosmetic surgery and treatments such as HIFU (High-Intensity Focused Ultrasound) and CCSVI (Chronic Cerebro-Spinal Venous Insufficiency) that are still considered experimental in the US.  Additionally patients are looking for a speedy way in which to receive non-emergency care, an issue that is becoming more prevalent as January 1st approaches. In addition to this, there is nothing stated in the laws of Obamacare that forbids insurance companies from encouraging their clients to go to foreign physicians for their care.

Even with the unavoidable hurdles, medical travel will become more of an option for thousands of Americans as the quality of the care continues to rise and the prices are steadily 60%-70% less than in the US. These competitive prices are going to become a greater force in the U.S. health care system and how Americans choose to obtain treatment in the coming months.

Bariatric Sleeve Surgery: How it Works and What to Expect

Bariatric Sleeve Surgery

Weight loss is an art as well as a science. All efforts employed towards shedding off any extra pounds either use art, science or both. Technological advancements have seen the emergence of superior scientific weight loss procedures. Bariatric surgery is all about promotion of weight loss by restricting food intake and decreasing food absorption in the stomach and intestines.  There are different types of bariatric surgery and the gastric sleeve procedure is one of them. It is also known as vertical sleeve gastrectomy. Gastric sleeve bypass surgery cost differs from that of the other bariatric procedures, it also differs in indication, technical approach, outcome and complications.

Gastric sleeve procedure is recommended for obese patients who cannot undergo the other three types of bariatric surgery.

This is because the surgical procedure is irreversible. It permanently reduces the size of the stomach. Also, most of these patients have co-morbidities, which increase the risks of undergoing the other forms of bariatric surgery. Patients with body mass index of 35kg/m2 – 40 kg/m2 or greater and who have co-morbidities like heart disease, diabetes mellitus and obstructive sleep apnea are eligible for this procedure.

The surgical technique involves removal of almost 75% of the stomach along the greater curvature (the bigger curve of the stomach). This results in a small tube-like or ‘sleeve’ stomach and surgery can be open or laparoscopic. The former has to do with making large incisions through the skin in order to manually remove part of the stomach. The latter uses very small incisions through which a laparoscope is passed and the stomach visualized via a computer monitor. The procedure takes about 1 hour with expected hospital stay of 2-3 days and recovery occurs within a span of 2-4 weeks. Therefore, gastric sleeve bypass surgery cost is worth the simplicity of the procedure and the expected positive outcome.

Following gastric sleeve surgery, one is able to restrict their food intake because with a small stomach, satisfaction is experienced faster.

Digestion is reduced hence less calories are absorbed into the body. Within 12 months a weight loss of 50%-80% should be experienced. Complications are few especially when procedure is performed laparoscopically. In the immediate post-operative period, the patient may experience nausea, vomiting, gastroparesis and abdominal pain. Despite such complications gastric sleeve surgery is deemed safe and effective.