Dr. Bijay Prabhakaran Nair

Role in Care

Oncologist managing Ishamma T M's Aml treatment alongside Ashwin V Nair (Hematologist/Oncologist). Primary ordering physician for the majority of lab work at KIMS Health. Actively communicates with family (Sameer) via WhatsApp regarding treatment decisions, lab results, and cycle planning.

Key Clinical Decisions (Documented)

• 2025-11-27: Received flow cytometry report from Sameer. Discussed case via 31-min voice call.
• 2025-11-28: Performed second bone marrow biopsy (Bone Marrow Biopsy 2025 11 28). Obtained 2 good cores, aspirate hemodilute. Noted hemoglobin dropping — transfusion threshold Hb <7, but patient not very symptomatic. Planned CBC repeat on Monday.
• 2025-12-04: BM biopsy results available. Discussed with Sameer via 22-min voice call. Shared report (7 pages).
• 2025-12-05: Follow-up questions from Sameer. 4-min voice call at ~1:35 AM IST. Noted his availability: "After 1-2 pm Indian time is usually lighter for me."
• 2025-12-08: Shared karyotype results — "Normal karyotype."
• 2025-12-09: Coordinated port placement and Cycle 1 start. Port delayed for platelet transfusion. Confirmed central line not needed for Aza-Ven. Wanted to speak with patient for informed consent before starting treatment: "I wanted to talk to her one more time before we started treatment just to make sure she understood everything." Discussed start timing — "Medically there is no difference between starting tonight and tomorrow morning." 10-min voice call with Sameer.
• 2025-12-10: Recommended meropenem as alternative to Zosyn (piperacillin/tazobactam). Responded to transfusion reaction (patient had sudden chills and breathing difficulty) — 2-min voice call.
• 2026-02-25: Reviewed labs (KIMS Health, Bill No L01S608426, billed 25-Feb-2026 9:25), noted platelets improving. Recommended proceeding with Cycle 3: "Platelets are better. We could proceed with cycle 3 of chemo next week starting Monday and monitor cbc closely. Best not to wait too long."
• 2026-03-30: In-person visit with patient. Discontinued Pegfilgrastim due to significant bone pain. Discussed subcutaneous vs. IV Azacitidine route preference with patient. CBC noted as "very good." Patient fatigued — gave week off, planned chemo for the following week.

Visit/Order History

• Multiple CBC and chemistry panels ordered (2025–2026)
• Longitudinal monitoring of pancytopenia and AML treatment response
• Regular WhatsApp communication with family regarding treatment planning

Facility

KIMS Health, Trivandrum, Kerala, India

Updated automatically during ingest.