Surgery 2, 3, and 4!

MARCH 2010: After much daily attention, it became clear that the large ulcer to Pika’s foot was not healing and the bones of an already badly formed foot had been too damaged by years of ignoring the infection. The doctors were saying “amputate the foot”!

Amputation was Pika’s first surgery. We gave her lots of support. We showed her youtube videos of kids playing football with prothetic legs like she would have later, even one of a horse with the same. She cryed, was afraid, and went into surgery holding… not her mother or fathers hand, but Putu’s hand (YKPA Founder). Putu was her new mother.

Before her amputation was healed, her neurologist was telling us he wanted to put her on the ‘urgent’ list for repair of her spina bifida lumbar mass. This should have been corrected as a baby, but the parents are poor and from a remote village, with no education. The parents told us later that they took her to the local village healer and asked him about her 15cm round mass, and was told to not do anything about it, because it was given to her by God. Sad that he didn’t know that these birth defects will slowly cause the loss of all nerve function to both legs as well as bowel and bladder function loss. When we found her she had already lost bladder function and both lower legs were numb… the cause of her getting the infection in her foot which caused her to loose the leg instead of having it surgically corrected as a young child.

APRIL 2010: Pika was into her second surgery for correcting her spina bifida, before her leg had healed. There are two main complications in this type of surgery that happen occasionally to some children. Pika ended up with both. First, because her body kept making enough spinal fluid to replace what was lost with the mass removed, she started leaking spinal fluid from the sutures… a lot! We found her sitting on the floor with a wet shirt and shorts, and as usual, not talking. This led to an outpatient procedure of resuturing the surgical wound. Unfortunately, this leak happened again and again, and finally resulting with infection setting in. The infection entered her spinal fluid tract and caused meningitis, for which she was hospitalized immediately for her leaking fluid, headache, and fever. This is the other of those complications that happen. Now she had both!

Quickly Pika was started on IV antibiotics and went in for surgery #3 to repair the leak again. It took only a few days for the neurosurgeon team to realize that she was going to keep leaking spinal fluid and that she needed what some 80% of kids with spina bifida require… a plastic tube ‘shunt’ ($1000 USD for that tube) placed into her skull to drain away excess

fluid into her abdominal fluid. She went into surgery #4, this time crying more. Her threshold of being ‘strong’ was passed.

Two weeks later, she was discharged to ‘home’ (the orphanage). She was to continue what was now almost 6 weeks of lying on her belly in bed to heal.

It is easy to forget Pika has parents, as the father has not returned for 4 months, and the mother only sometimes visits. However during the events around surgery #4, her mother visited the hospital once and the orphanage.

PHOTOS TOP: Putu YKPA Founder consoling Pika before her amputation surgery.
PHOTO BOTTOM: A fellow patient in the hospital came to give Pika some emotional support after she awoke from surgery in shock at having no hair.