U.S. Army doctors give Haifa Street baby hope

BAGHDAD, IRAQ

05.31.2005

Courtesy Story

DVIDS Hub       

Staff Sgt. Raymond Piper
4th Brigade Combat Team PAO

BAGHDAD -- A coincidence has given a 4-month-old child a shot at living, thanks to an operation that 86th Combat Support Hospital doctors performed May 4. The surgery reduced pressure created by fluid build up in the brain, a disorder known as hydrocephalus.

During a 4th Battalion, 64th Armor Regiment medical assistance program on Haifa Street, the child's mother brought the baby to the U.S. Army doctors and asked if there was anything they could do for him. Local Iraqi doctors had told her that there was nothing that could be done and the child would most likely die within the next year.

Capt. Daniel Green, a Family Practice Physician and the battalion surgeon for 4/64 Armor said he went to see the child himself so he could evaluate the situation. "The prognosis was dismal at best," he later said.

The child was born without one of the ducts that regulate the flow of cerebral spinal fluid, so with nowhere to go, the fluid built up.

Despite the prognosis, Green went to 86th CSH doctors and asked if there was anything that they could do.

"Through my medical training I knew of a shunting procedure and have seen it done several times. Usually, it's done in the first two weeks of life, not in the first four months," Green said.

The U.S. Army neurosurgeons just happened to have the exact shunt, a specially-designed rubber tubing with a valve that opens and closes under the right amount of pressure.

Green's fellow doctors scheduled a day for the mother and a couple of the relatives to come to the 86th CSH with a translator and conducted a clinical evaluation of the child.

"We evaluated the child's motor skills, learning skills, functioning â?¦ and did a CAT scan," Green said.

The child's brain damage on the CAT scan was extensive, he said. "There was so much fluid build up in the brain, it compressed all of the brain tissue to a five millimeter thickness to the edge of the skull. It had pushed the bones and stretched the skin as far as they would possibly go."

But at the same time the surgeons felt that there might be some benefit to helping the child. The direct benefit to the child would be pain relief as the pressure of the fluid decreased..

"You can't ask the child if he is in pain, but it seemed quite evident to the mother and anybody who looked at him. The pain is from the fluid compressing the brain tissue," Green said. "The sheer relief of pressure from the brain might drastically reduce the pain.

If he didn't live a day longer, at least whatever days he continued to live would be pain free or would be with reduced pain."

There was an added benefit to attempting the procedure. If it was successful, it could continue to foster good relations with the Iraqi people and help instill trust that the Americans are here to help.

"Obviously that is not the reason to do surgery or risk a child's life but it was an added benefit to the pain reduction and therefore further encouraged us to offer the surgery to the family," Green said.

After the evaluation, the family had a very tough decision to make. If something went wrong on the table or the surgery wasn't successful, it could hasten the child's demise.

Meaning that if the child was left untreated, he would live six months. There was an increased possibility that he might not have survived the surgery or something could happen after the surgery a week later.

"The family was willing to do it â?¦ even just for the pain control," Green said.

There is always the chance for a miracle, of course. The shunt could relieve so much pressure that he will actually begin to develop normally.

"He will never be a normal child; however, there will still be moderate to severe brain damage and lower extremity paralysis, but we might buy him six more months to a year of life so that further medical opportunities might come available so that we might prolong his life further. That's the long shot," Green said.

Two U.S. Army neurosurgeons operated on the child in unison.

"In this child you have taken a simple procedure and have taken it to the extreme of dangerous because the anatomy was so badly destroyed over the past four months by the destructive behavior of both his malnourishment and the hydrocephalous that the complications were absolutely extreme," Green said.

Despite the difficulties of the operation, the shunt was operating properly while the child was kept under observation after the surgery to watch for infection.

He was released from the hospital, healthier than when he came in, and given a shot for a miracle.

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• Date Taken: 05.31.2005
• Date Posted: 05.31.2005 11:22
• Story ID: 1962
• Location: BAGHDAD, IQ