Saturday, November 26, 2022

When your patient reminds you of your own son!

It was a usual clinic day when the next patient entered the room. 

A young couple carried their 6 year old boy, in the fetal position and placed him on my examining table. He looked scared as most children do when they come to my office. Seeing a surgeon is scary ordeal for a child and he had reason to be scared as this was his fourth visit to a so called “surgeon.” 

When I asked what was wrong, the parents immediately uncovered the abdomen of their malnourished son. Protruding from his lower abdomen was fungating, friable tumor larger than the size of a softball. It had the stench of urine and necrotic tissue as urine leaked from around its base. He laid frozen in the fetal position perhaps from fear or perhaps due to pain. He had not walked in some months. 

As I looked at him, I was reminded that he was the same age as my own son.

The parents explained that they had spent most of their money trying to get this tumor treated. Upon further questioning, I discovered it was neither treated properly nor adequately. Tragically, this is not unusual. 

It is cases like this that break my heart. The family admitted they didn’t have much money left (having spent it on the prior treatments, none of which was a biopsy, nor a definitive operation) and they inquired how much it would cost. I knew it would be beyond their capacity, so I encouraged them to let us treat him and we would discuss payment later.

Edmond was admitted to hospital and started on a malnutrition protocol. He was anemic and required multiple blood transfusions before we could consider taking him to the operating room. His body was in a state of just trying to survive the perpetual attack of urinary infections from this resource sucking tumor that had plagued him for several months. The tumor, which engulfed his entire bladder and a significant portion of his abdominal wall, would need to be excised in its entirety, leaving him without a bladder. He would need a urinary stoma (meaning he passes urine from a small hole in his abdomen into bag) at least till we could get him better nourished to do something more definitive. 

He underwent a several-hour surgery where we delicately removed the tumor, which engulfed his entire bladder, and reconstructed his abdominal wall to fill the large hole. He was then admitted to our new ICU for post-operative care. 

Our new ICU has been a game-changer for patients like this. Our visiting anesthetist and ICU doctor (Dr. Joel you rock!) was able to give him an epidural for pain and he did awesome post-operatively.

In most mission hospitals, each patient must have a 24hour care provider who is responsible for patient laundry, food and waste disposal. Most mission hospitals do not have the resources to provide this, and it is all done by the caregiver, usually a family member. His mother, his caregiver, stayed at his bedside during his recovery.

Three weeks after his operation, he came smiling AND WALKING into my clinic. He gave me our traditional fist pump. His incision is almost healed his family is learning out how to live with a urinary stoma without running water & electricity. This is no small feat.

Though our surgery may cure him, the lack of available chemotherapy and his delayed presentation makes his prognosis guarded….but for now he has new lease of life. 

Mark 6:13 When the Lord saw her, his heart went out to "him" and he said, "Don't cry." 

I totally get this verse!! Unfortunately, I can't heal by just a simple touch as in the subsequent verses of Mark 6 but... 

We are so grateful to those who financially support our surgical ministry to help care for families and patients like Edmond.

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When your patient reminds you of your own son!

It was a usual clinic day when the next patient entered the room.  A young couple carried their 6 year old boy, in the fetal position and pl...

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