Hi Anu...i hv been reading ur expertise to solve the issues of people and am really impressed. We have been married for 19years now and have a son and daughter .From the start of the marriage my wife have been inclined towards her mother and her family paying less or no heed to us. Circumstances were also favorable to her and she always got the opportunity to stay close and visit her parents often which i did not mind.We lived in Mumbai and she is from Chennai.After marriage my mom-in-law used to continuosly interfere into our lives by calling her and she used to act as per her suggestions only which led to problems as she was a puppet in the hands of my Mom-in-law. Moreover since my mom-in-law was not in good health my wife tried not to over rule as she did not want her mom to feel sick as she doesnt like to be over ruled or by pass failing which she goes on hunger strike and stop taking tablets spoiling her own health. Due to this reason everybody has been appeasing her.Initially i thought to ignore but slowly it started to affect my family as well as my wife started to see things thru my mom-in-laws perspective and find faults in everything. We shifted to overseas to stay away from all these and we really had a good life for 10 years there but since i lost job during covid i had to shift base to India for my son's education but she chose to stay back there with my daughter as she is working there.I too felt that let her spend some time so that i could settle things in India and call her but it is more than 2 years now and she refuses to come back and dont even care for us and neither call us as family. I tried to involve my in-laws to convince her but they are also playing a diplomatic game and doesnt want to go against their daughter's wish.Due to this attitude of my mom-in-law their own daughter-in-laws have been staying away and since my in-laws stay alone my wife feels that she is the only support system for her parents but it has come on my life's sacrifice. She has been ignoring us and even i kept moving for the sake of my family and children instead of respecting my feelings she has become more adamant now.Her brother is also seperated from her wife and he also looks forward for a support system from my daughter and my wife and they seem close ignoring myself and my son.We have been trying to convince her thru all means but she is caring. Even i feel that it is futile to force someone into relationship but she unknowingly spoiling my family and deprieve my son the mother;s love and also depreive my daughter from affection and love.Due to this my son has also stopped expecting from her and my daughter treats me as a stranger due to long distance. Pls suggest the way forward. Shud i wait for things to improve or leave as it is.I am 47 now and she is 45..told her that let us enjoy the best things in life rather than regretting later but she does not understand.

Ans: First of all, I understand how overwhelming and frightening this situation feels. A second bone marrow transplant is not only a medical decision, it becomes an emotional and financial storm for the entire family.

Please take a deep breath. Right now, the most important thing is to move step by step, with clarity and support, instead of panic.

Let me guide you in the most sensible and practical way forward.

1. Do not agree immediately for a second BMT without full confirmation

Before taking such a high risk and costly step, it is extremely important to confirm whether this is truly relapse or graft failure.

Please ask the doctor urgently for these key tests:

Chimerism Test (this is the most important)
This will show whether the donor marrow is still functioning.

Hemoglobin electrophoresis or HPLC

Genetic confirmation of recurrence

Bone marrow evaluation

Full transplant summary from 2013

Sometimes what looks like “thalassemia again” may actually be mixed chimerism, which can sometimes be managed without a full second transplant.

Do not decide until this is clearly confirmed.

2. Take a second expert opinion within 7 to 10 days

A second transplant is a major step. A second opinion can completely change the treatment plan.

Some of the best transplant centers in India are:

CMC Vellore
Tata Memorial Hospital, Mumbai
Apollo Chennai
PGI Chandigarh
AIIMS Delhi

Ask your current hospital for all reports and records in one complete file and consult quickly.

3. Negotiate strongly with the hospital for financial support

Please remember this clearly:

Hospitals can reduce costs significantly under charity, CSR support, and welfare schemes.

You should immediately request:

Concessional package
CSR or charity quota support
Installment payment option
Government or NGO assistance

Go directly to the Patient Welfare Office or Medical Superintendent and say clearly:

“We cannot afford 25 lakhs. Please place us under financial assistance support.”

Many families get 30 to 50 percent reduction when they push firmly.

Ask for a written revised estimate.

4. Insurance roadmap that actually works

Do not just ask “Will it cover?”

Do this exact process:

Check your policy wording for:

Bone Marrow Transplant
Stem Cell Transplant
Day care procedures

Apply for pre authorization before admission

If rejected, file escalation immediately

Group insurance through employer usually has higher chance of approval

Even though thalassemia is genetic, continuous insurance often still covers hospitalization and transplant procedures.



5. Government funding options that work in real cases

Please apply immediately. Do not delay even one week.

Practical sources include:

Ayushman Bharat (PMJAY)
Karnataka CM Relief Fund
PM National Relief Fund (PMNRF)
Health Minister Discretionary Grant

Many transplant cases receive support through these funds.

Hospital social workers usually help with forms.

Start applications this week.

6. NGOs that genuinely help thalassemia patients

These organizations are active and supportive:

Sankalp India Foundation
Cure2Children Foundation
Thalassemia Patients Advocacy Group

They help with funding, donor support, and correct guidance.

Write to all three with reports and hospital estimate.

7. Crowdfunding is the fastest support route today

Many families are able to raise 10 to 20 lakhs within 2 to 4 weeks through:

Milaap
Ketto
ImpactGuru

You will need:

Doctor’s letter
Hospital estimate
Patient photo
ID proof

Hospitals also cooperate in documentation.

8. Legal action is not the priority right now

I will be honest with you.

A transplant functioning for 13 years is usually not treated as negligence easily.

Legal cases take years and will not solve today’s urgent need.

First focus on:

Correct diagnosis
Second opinion
Financial assistance
Insurance
Relief funds
NGO support

Legal route can be explored later only if clear malpractice evidence emerges.

9. Ask the doctor these 6 direct questions tomorrow

Please write these down:

Is this graft rejection or true recurrence?
What is the current chimerism percentage?
Are there non transplant options before a second BMT?
What is the success rate in his specific case?
Will the same donor work or is a new donor needed?
What is the minimum possible cost after concession?

Do not leave without clear answers.

10. Immediate checklist for today

Collect these documents urgently:

2013 discharge summary
Current reports and diagnosis
Doctor recommendation letter
Hospital cost estimate
Insurance card and policy copy
Income certificate (needed for relief funds)

These will be required everywhere.

Final words

Please remember, you are not helpless.
There are medical options, financial support routes, and real organizations that can help you.

Just do not take any rushed decision.

Take one step at a time:

Confirm diagnosis
Second opinion
Negotiate assistance
Apply for funds
Reach NGOs
Start crowdfunding if needed

Naveenn Kummar
Chief Financial Planner | AMFI Registered MFD
https://members.networkfp.com/member/naveenkumarreddy-vadula-chennai