Forget golf courses and fancy spas. The hot amenity for second-home resorts in Central America these days is a medical facility.

“People are asking for it,” said Kevin Fleming, who has included a 40-bed clinic in plans for Seaside Mariana, a 923-acre, or 374-hectare, project he is building on the coast of Nicaragua. “We’ve seen a real shift in consumer response.”

With second-home sales sluggish, an array of developers in the region are planning health care tie-ins, from Botox clinics to assisted living centers for retirees.

“In every development we have a say in, we’re promoting the idea of including a medical facility,” said Bill Clover, president of Panorama International, a consultancy with headquarters in San Antonio, Texas.

One of those projects is Playa Secreta, a resort with a marina, cruise ship dock, golf courses and more than 2,000 residential units now under development in El Salvador. Plans call for a clinic or small hospital on the grounds. “Developers are looking for an edge to attract people,” Mr. Clover said. “They are also aware of the aging buyer in the residential market.”

This is new territory for developers of Central American properties. While many hotels in the region promote packages tied to health treatments and weight loss programs, only a handful include a medical facility on site.

That is a contrast to countries like Thailand and India, which have well-established medical tourism industries, primarily catering to Europeans. But the United States — the key driver in the Central American market for second homes — is only now embracing the concept.

With health care costs rising, 1.6 million Americans are expected to leave the United States for some form of medical treatment by 2012, up from 750,000 in 2007, according to Deloitte, which tracks the industry.

The cost of care in Central America and Mexico is at least 25 percent to 40 percent less than in the United States, says Paul H. Keckley, executive director of the Deloitte Center for Health Solutions.

But the trend could slow if more insurance companies decide not to cover procedures performed overseas, Mr. Keckley said. And there is little solid evidence that medical services can sell vacation villas.

“We haven’t been able to translate demand for health and wellness into second home demand,” said Chad Martin, global research analyst with E360, a North Carolina company that regularly surveys buyers of second homes.

Still, developers in Central America are embracing the concept, eager for any way to jump-start sales. Last year a discussion about how to integrate medical tourism into developments was one of the best attended sessions of the annual Central America Tourism and Hotel Investment Exchange, said James E. Burba, president of Burba Hotel Network, the California company that produced the event for developers and investors.

In the past, medical tourism did not surface as an opportunity for developers “because regular real estate was so strong,” Mr. Burba said.

In many ways, medical facilities are a natural fit for tropical resorts. Patients can convalesce in style; retirees can live inexpensively in an exotic location, without worrying about the availability of medical care.

From a business standpoint, a health care facility attached to a second-home project can attract local citizens and expatriate residents, serving as a hedge against the ebbs and flows of the tourism market. A health care component can also make a project more appealing to lenders, some of whom are wary of financing vacation-home developments.

Larry Foster, a consultant based in Mazatlán, Mexico, is helping developers convert projects once planned as second homes into assisted living centers. “There are a ton of condominium projects in Mexico that are half-finished that would lend themselves to retrofitting,” Mr. Foster said.

Developers are also trying to innovate, targeting different niches in the medical treatment market.

On the Placencia peninsula of Belize, managers at the Villas at Cocoplum are planning to build a clinic offering an experimental migraine headache treatment. Patients would pay a minimum of $5,000 per treatment and could rent condos in the project, which also offers waterfront units for sale at $300,000 to $400,000, marketing prospectus shows.

“It’s geared toward a higher-end client and a nice complement to a high-end condo project,” said Boris Mannsfeld, the developer of the project, who lives in Belize.

Mr. Mannsfeld has formed a new company, International Wellness Resorts, to develop “wellness centers” with resorts. “People are seeking these kinds of state-of-the-art treatments,” said Mr. Mannsfeld, who worked in real estate in Colorado before starting the Belize project in 2006.

Many of the planned medical facilities are designed to market treatments that have not been approved for use in other countries.

“Clinical trials in the U.S. are prohibitively expensive,” said Russ Allen, the chief executive of Empowered Medical, a New York marketing agency.

His company is helping to promote a clinic that offers an alternative cancer treatment in conjunction with Valle Escondido, a retirement development in the hills of Boquete, Panama. There, spa rooms are being converted into recovery rooms and construction of a standalone clinic is expected to begin in January.

“This is a very efficient way to do something like this,” Mr. Allen said.

In Nicaragua, Mr. Fleming hopes to form a partnership with a university or an established U.S.-based hospital to build his clinic in the Seaside Mariana project. It is planned for a parcel near the rear of the development, not far from the Jack Nicklaus-designed golf course and the hotel to be operated by the Wyndham Hotels and Resorts.

He expects the clinic to attract the type of older buyers who plan to live in the development for extended periods, not just short-term visits. “There’s a huge demographic out there and we can’t afford to lose them,” Mr. Fleming said.

Research has emerged casting doubt on a popular new theory that multiple sclerosis is caused or worsened by blockages in the jugular veins.

In separate studies from Germany and Sweden, to be published Monday in the Annals of Neurology, researchers report they found no such trend of blockages in patients’ jugular veins, which carry blood away from the brain back to the heart. The theory, championed by an Italian vascular surgeon and some doctors in the U.S., has inspired thousands of MS patients to get tested and, in some cases, to get treatment such as the insertion of metal stents in jugular veins to keep them open.

Heather Tuck gets an ultrasound exam in Washington in March as part of research on the role of blood vessels in multiple sclerosis.

“Our results challenge the hypothesis that cerebral venous congestion plays a significant role in the [disease process] of MS,” wrote Florian Doepp, a neurologist at Humboldt University in Berlin, and colleagues. They did ultrasound and other imaging exams on 56 MS patients and 20 normal control-group patients. “Our results suggest the cerebral venous drainage in patients with MS is not restricted,” they wrote.

A smaller study from Umea University in Sweden looked at 21 MS patients and 20 healthy patients and concluded, “We found no differences regarding internal jugular venous outflow.”

MS is generally thought of as an autoimmune disease, meaning that a patient’s body attacks its own cells. Symptoms vary widely but often involve progressive weakness and pain and can include speech disorders and spasticity.

The theory about jugular-vein blockage originated from Paolo Zamboni of the University of Ferrara in Italy. Dr. Zamboni’s reports have spread rapidly among patients through the Internet, propelling thousands of MS patients to get examined or treated.

At Stanford University in California last year, a doctor treated 40 MS patients with balloon angioplasty or stents to open veins. Some patients reported symptom improvement. After one patient died and another underwent emergency surgery for a stent that floated into his heart, the university shut down the program but says it is considering further research.

Currently, a study at the State University of New York at Buffalo is examining 1,000 patients after about 10,000 sought to participate in the research.

Dr. Zamboni said he stands by his findings. He said he hasn’t read the Swedish report, but he questions some methodology in the German research. He said his own multiyear survey of 500 MS patients has found that 90% have vein blockage, compared with only 2% of 1,000 control-group patients who are healthy or have other neurological diseases.

The reports from Germany and Sweden won’t be the final word. The National Multiple Sclerosis Society, along with its sister group in Canada, have funded more than $2.4 million in studies to evaluate the vein-blockage theory. However, these two reports from Europe have heightened the skepticism of some MS experts about vein-blockage underlying MS.

Stephen L. Hauser, editor-in-chief of Annals of Neurology and chief of neurology at the University of California, San Francisco, said of the European research that “these two papers tried to replicate” Dr. Zamboni’s findings, and that “the original concept hasn’t been confirmed.” Dr. Hauser had complained to Stanford after his patient had to undergo emergency surgery there after a stent in a vein floated into his heart.

International Health Care Providers Inc. (IHP) announced today that Indiana Orthopedic Hospital has joined the company’s healthcare provider partnership team bringing cutting edge surgical options for Canadian knee or hip replacement surgery patients. 

IOH has implemented a specialized Canadian patient advocate program within their already impressive patient centric environment.  Services provided by IOH will enable patients to return to a more active lifestyle, quicker and in most cases, with less pain.  Because of advancements in medical technology, many of the surgeries performed at IOH can be completed on an outpatient basis, consisting of patient stays lasting 23 hours or less. 

In 2009, IOH was named a Summit Award Winner by Press Ganey Associates Inc. for sustaining the highest level of customer satisfaction for three or more consecutive years.  For 2010, IOH is rated in the top five percent in the nation for joint replacement; 5-Star rated for joint replacement, total knee replacement, total hip replacement, spine surgery and back and neck surgery (spinal fusion); ranked among the top five in Indiana for joint replacement and spine surgery; and the recipient of the HealthGrades Joint Replacement Excellence Award.  For these reasons, coupled with IOH’s sincere passion for providing quality patient care, IHP embraces IOH as an excellent solution for Canadians confined to orthopaedic waiting lists.

IHP’s comprehensive research and integrated international patient program provides specialized concierge services, preferred pricing and immediate patient file review to ensure proper patient – specialist compatibility.   Canadian orthopaedic patients will have their pre & post treatment care arranged, travel arrangements secured, medical records transferred and the communication lines opened between their Canadian physician and the IOH surgeon.

Kelly Meloche, President of International Health Care Providers Inc. stated, “We are excited to have the proven excellence of Indiana Orthopedic Hospital as our stand-alone midwest US health care partner.  IOH’s direct focus on musculoskeletal care and complex surgical procedures including total joints and spines represent the answers to many Canadian Orthopaedic patients’ prayers.”

For more information contact:

Kelly Meloche, Windsor, Ont.  at 519-736-0189 or kelly[at]ihcproviders.com

Dr. T. Rand Collins, Duncan, B.C. at 250-732-6693 or drcollins[at]ihcproviders.com

Ms. Meloche is President and Founder of International Health Care Providers Inc. (IHP), a leading international medical travel company based in Windsor, Ontario with a branch office in British, Columbia. (www.ihcproviders.com)

Ms. Meloche created IHP to serve as a resource of choice for Canadians needing better options for their health care.  She dedicated years to establishing a framework built on ethics, compassion and commitment in order to ensure that each client of IHP would receive superior care in a family focused atmosphere.  IHP specializes in connecting Canadians to world class leaders in health care, technology and medical research outside of Canada.

IHP’s comprehensive research and integrated international patient program provides specialized concierge services, preferred pricing and immediate patient file review to ensure proper patient – specialist compatibility. The company has partnered with many of the most highly accredited medical institutions to provide immediate health care solutions for Canadians requiring medical and therapeutic procedures. Their professional team arranges pre & post treatment care, manages travel arrangements, supervise the transfer of medical records, and facilitate communications between health care providers, hospitals, and employer groups.

As the regarded expert in medical travel for Canadians, Ms. Meloche has spoken as the industry expert throughout Canada and the United States.  She has assisted in developing strategies for successful implementation of International Patient Programs as well as creating a business model that caters to the Canadian health care consumer. 

Steve Baker, President of International Wellness Resorts stated, “We are excited to have Kelly joining our business advisory board.  Her successful international experience along with her enthusiasm and creative ideas will be a great asset to our company and our growth.”

Baker added, “We look forward to adding dynamic leaders like Kelly to our business and medical advisory boards soon. Our professional team of trusted advisors is a key to our success; offering proven experience, sound judgment, objectivity and strong support for our company’s goals.”

International Wellness Resorts Inc. is being developed in beautiful Placencia, Belize.  Emphasizing its theme of ultimate personal wellness, the Wellness Center will offer a variety of proprietary pain management procedures as well as a full range of wellness, cosmetic and spa products and services.  These services will be complimented with luxurious resort accommodations for patients and guests during their stay.

Upon successfully attaining full scale operations in Placencia, Belize, International Wellness Resorts will replicate its business model at numerous resort locations across the globe to serve large population centers.  These locations will match the Belize center in maintaining world class wellness care with a resort experience.

For more information, contact:
Karl Dakin, Denver at (303) 916-8272 or Belize[at]karldakin.com
Steve Baker, Denver at (303) 854-8820 or steve[at]pushingwater.com
Boris Mannsfeld, Placencia, Belize at +(501) 610-0294 or bmannsfeld[at]yahoo.com
Dr. Shane Kraft, Calgary at (403) 605-1067 or shane[at]optimumwellnesscentres.com

While the use of PET/CT is not currently indicated for diagnosing breast cancer, it can make a difference in the following areas:

• PET/CT accurately stages axillary and mammary lymph node involvement. Axillary lymph node dissection is currently a routine part of breast surgery, since it is the only way doctors who don’t know about PET have of staging breast cancer.
• PET/CT may detect distant metastasis resulting in more accurate treatment.
• PET/CT is also used to evaluate the response to therapy. Treatment can be altered, if necessary, for better results. 

• PET/CT is also used when there is suspicion of recurrent disease. Finding recurrent cancer early prolongs lives and increases the chance of beating the disease.

(1)   Source: Clinical Positron Imaging Journal, the official Journal of the Academy of Molecular Imaging, Vol 3, Number 5, Sept-Oct 2000.

How does PET work?

PET (Positron Emission Tomography) is a non-invasive diagnostic imaging procedure that identifies abnormal glucose (sugar) metabolism. Since certain cancer cells metabolize glucose more than normal cells, which often occurs before changes in anatomy, PET may identify the presence of disease earlier than other anatomic imaging techniques. As a result, PET may offer important information to aid in more effective treatment.

Along with Breast Cancer, PET/CT is considered particularly effective include lung, head and neck, colorectal, esophageal, lymphoma, melanoma, cervical, brain as well as other less-frequently occurring cancers.

I just spent time with a client as he recounted his ordeal with prostate cancer over two years ago, and I was struck by the fact that there were treatment options of which he was completely unaware. I was also struck by the fact that the way that his treatment process was described to him was frequently inconsistent, leaving him confused by many different scenarios presented to him as he moved from step to step throughout the process. To this day he remembers feeling “…as if the ground was always moving beneath him…” and he continues to live in fear that “…they didn’t get it all…” or “…it will for sure come back…” I felt sad that he had been left so confused by his providers, and talked at length about the treatment options for prostate cancer. I vowed that no patient would leave my office without knowing all of the options available to him!

International Health Care Providers connects its patients with the most up to date therapies available today. Prominent among these is the three-dimensional technology found in the operating rooms of our hospital partners; employing robotic technology, these techniques take modern prostate surgery to new level.

Robotic technology figures prominently in the spectrum of therapeutic techniques at Henry Ford Hospital in Detroit, housing the Vattikuti Urology Institute. To date, the Institute has performed more than 2,000 cases in this manner, and continues to perform more robot-assisted prostatectomies than any other hospital in the world.

With this procedure, the patient’s pain and blood loss, together with the risk of incontinence and impotence are significantly reduced. Recovery times in the hospital and at home are much shorter with this technique. With traditional radical prostatectomies, patients are expected to be in the hospital for two or three days. With robotic prostatectomy, most patients can safely be discharged one day after surgery.

Speaking of Henry Ford’s new operating suite for robotic surgeries, Mani Menon, M.D., director of the Vattikuti Urology Institute, says,
“This operating room is going to change the way operations are done. It is light years ahead of anything else that exists in the world.”

If I should have cancer, I want my care to be the most modern available – and I want no less for our patients! Dealing with cancer is one of the most stressful life experiences that patients will ever have. They deserve a thorough understanding of their options and the knowledge that their care is a the forefront of medical therapy. With care of the caliber of the Vattikuti Institute, Canadian men can face the challenge of a diagnosis of prostate cancer with confidence. For Canadian men, the quality option is just across the border….without the wait!

Patients experience continuing pain and disability – and so do their families. One patient experiencing excruciating pain while waiting for a knee replacement expressed her frustration as “I couldn’t participate in my life. I did not want to turn my husband into a caretaker.” Patients tell stories of lives put on hold; in those months of waiting, a lot of life, and lot of memories, are left in the ‘what-could-have-been’ dust.

As they move from waiting room to consultation then back to waiting room, patient’s pain worsens and hope declines. Many needing a joint replacement have worked hard most of their lives to be able to live their passions in retirement. “Passions” means chasing your grandchildren, crisp mornings on the golf course, and sunset bike rides with your life partner. Rarely do “Passions” come equipped with crutches and pain killers.

With our partner hospitals, the wait is short, and life can begin again. Before and after treatment, many other modalities are available to aid recovery. We can connect our patients with physiotherapy, chiropractic treatment, massage therapy, and pain management. We are dedicated to ensuring that each of our patients has a care plan throughout the process, and ensure that every patient has complete aftercare arranged before they leave for the hospital.

Canadians have health care options. Our partnerships with U.S.health care providers are the product of long hours at board room tables, ironing out every detail of our client’s recovery. The IHP team has worked hard and passionately at creating these health care choices, allowing patients to safely and seamlessly evolve from ‘waiting patient’ to ‘willing medical traveler.’

To those Canadians on waiting lists for health care, there are superior resources and options for you to consider. Call our office today and allow us to help you in making health care choices that will bring you back to your passion.

The “Liberation Treatment” is based in the thesis that blockages in the cerebral veins (CCSVI, or chronic cerebrospinal venous insufficiency) are responsible for some, and possible many, cases of MS. This concept, and the possibility that clearing these blockages may represent an effective treatment for MS, offers hope for those who are dealing with the symptoms of MS. To date, medical centers in the U.S. and Canada have taken a very conservative approach to this treatment; most are not pursuing treatment until well-validated research studies can be completed and the relationship of these changes to MS can be better understood.

There is rarely a day that goes by that my email or phone doesn’t chime in with an interested party looking to obtain access to what MS patients so dearly hope is the magic bullet they’ve been praying for. IHP is very anxious to help these patients – but only when we can connect them to a treatment that is safe and of proven effectiveness.

You may have heard that other groups are pursuing this therapy more aggressively, and are now sending patients overseas for surgical treatment. Unfortunately, the relationship of CCSVI to symptomatic MS is not well characterized, and, although many patients appear to benefit from clearage of their venous blockages, it is not clear what proportion of MS is due to vascular problems. Therefore, we have elected to wait to refer patients until we are sure that the safety and efficacy of this approach has been fully and rigorously evaluated.

CCSVI occurs when blood from the brain has difficulty flowing properly from the brain back to the heart due to blockages or narrowing of the veins. This concept was pioneered by Dr. Paolo Zamboni, one of the best-known investigators in this area. At the moment, there are no research studies being carried out in Canada, nor is any diagnostic protocol available at any Canadian medical center. At present, active research on vascular treatments for MS in the United States is being carried out at the Buffalo Neuroimaging Analysis Center (BNAC) under the supervision of Dr. Robert Zivadinov.

In a recent conversation with Dr. Zivadinov, it was quickly apparent that he cares deeply about his patients, talking with cautious excitement about the preliminary successful results of the Institute’s studies. He is dedicated to waiting until the clinical trials are completed to offer this treatment to the public.

Although this understandably creates a ‘wait time’ stress for MS patients, please be advised that we are monitoring progress in this area closely, and will advise our clients as soon as a safe and effective treatment is available.

What is available now at BNAC is a complete diagnostic evaluation including the following elements:

MRI of the brain and neck
Doppler ultrasound
Clinical visit with a neurologist
Neuropsychological evaluation
Blood testing.

The availability of this evaluation is very important for MS patients for two reasons: First, because no multitest workup specifically designed to evaluate vascular changes in MS is available in Canada, and secondly, because these changes are subtle, and scans should be viewed by radiologists specifically familiar with MS-associated vascular changes. Even highly competent general radiologists may not be entirely familiar with all of the subtle venous changes occurring in multiple sclerosis.

If you are interested in being evaluated for MS-associated vascular changes, please contact us. We invite MS patients and their families to complete the contact form on our website so that we may continue to keep you informed of new developments..

International Health Care Providers is pleased to announce the appointment of Dr. Collins to the Board of Directors of the Cowichan Seniors Resource and Support Society.

Congratulations Dr. Collins.