A new lease of life for Grade 1 scholar

by Carol Aloysius

When 10-year-old W.A.D Shashith, a student of President's College, Embilipitiya received the news that he had won the distinction of the ninth highest position at the recent All Island Grade Five Scholarship examination, he wept for joy.

Little did he know that his dreams of getting transferred to a prestigious school in Colombo and becoming a doctor, would be shattered at the very gates of his own school where he would go the next day to collect his certificate at a special ceremony held in his honour.

Having collected the certificate and carrying it carefully in his hands, Sashith was crossing the road to reach his van which suddenly swerved into his path, knocking him over. The accident occurred in October 2015.

"His certificate was covered with his blood," his still shaken father said, showing us the blood stained certificate. The child was first admitted to the National Hospital in Colombo and was treated for a frontal fracture and foreign bodies with a CSF leak which was medically managed. Although he was discharged a week later, he developed complications that led the parents to admit him into the Embilipitiya hospital, where he was then transferred to the Neurological Unit at the Karapitiya Teaching Hospital. Where he was diagnosed with meningitis and subdural emphyema and underwent multiple surgeries. Upon getting discharged the patient was still not responding and had no limb movements. The child was then admitted to Asiri Central Hospital.

Equipped

" We brought him to this hospital which we were told had the best equipped Brain and Scan unit in the country for neurological disorders , only after being assured by friends and school authorities that our expenses would be met, as we didn't even have the money to channel the doctor we were told to meet", the father said.

Recalling that day when Sashith was wheeled into his clinic at the Asiri Central Hospital at Norris Canal Road, the long experienced Consultant Neurologist of the Brain and Scan Unit of the hospital, Dr Sunil Perera said that sight of that completely helpless young child had triggered him and his staff to immediate action.

"I was in my channelling room waiting for my next patient when this little boy was brought in. There was no movement in his body. His eyes were closed, his lips did not move and he appeared to have difficulty in swallowing. It was clear he needed urgent surgery," Dr Perera said at a media briefing at the flagship hospital.

The guest of honour was Sashith, whose nearly complete rehabilitation was due to the generous gesture of the entire hospital staff including the operating team which waived their fees and gave both in kind (medications) and cash to facilitate their favourite patient's recovery.

Miracle

Recalling details of the miracle surgery that helped restore the youngster to his now near normal condition, Dr Perera said, "What we first did was to do a scan. CT scans that were performed at the Asiri Brain & Spine Centre, revealed a large cyst in the right frontal region with severe hydrocephalous and a frontal craniotomy. In laymen language it revealed a large hole in front which showed a big gap filled with water which required immediate surgery to remove the fluid, Dr Perera explained.

He said, normally children of this age have around 150 mg of fluid. But Sashith had one whole litre of fluid which was putting an enormous pressure on his brain which controlled the body's movements. (The medical term for increased volume of fluid in the brain is Cerebro Spinal Fluid (CSF). In addition there was a large cyst also filled with water. We had to remove all this excess water and send it elsewhere in the body."

Explaining the six hour complicated surgical procedure, known as Ventricular Peritoneal Shunt (VPS) where an anaesthetized Sashith lay under the surgeon's knife, he said, "First we went into the cyst which had caused a big gap in the upper brain, and connected it to a shunt which could be controlled from outside, changing it according to the child's progress. This is one of the most sophisticated controlled shunt systems as there is no need to constantly probe into the body as we can control it from out."

Maximum

Asked if the shunt could be kept inside the brain for the rest of his life, he said it was an adult sized stunt which expands when the brain grows. "Children's brains develop quickly doubling after the first two years and doubling again after 15 years. So this child has still a long way to go before reaching the maximum level," he said.

"It's a once and for all operation guaranteed to last a life time", he reiterated.

The effects of that life changing operation were almost immediate, he recalls. "Even in the ICU we could see him making small movements, being able to swallow his liquid food. Now he can talk, walk and eat by himself which is nothing short of a miracle.

If he had been left at home he would never have been able to do anything, especially since he was also under nourished as his parents couldn't afford to buy him vitamins and foods he needed. So we decided to take a holistic approach and cure the body, and mind as well as he was also mentally very stressed due to the injuries and his fear of not being able to return to school".

Responding to a question on how long it would take for Sashith to recover completely and go back to school, he said, "The boy is currently undergoing physiotherapy. His recovery depends on his determination and will power which he has in plenty. I believe it won't be long before he returns to school".

The message which Dr Perera anwd his staff wish to covey to the public is simple:

"Sashith's case is by no means unique. We see children coming to us very often in this condition. The lucky few who can afford fees manage to get their children treated.

But less privileged parents have to endure the agony of seeing their children suffering and dying for want of proper treatment. It is our duty to help them obtain the maximum help they need."

Facilities

Group CEO, Asiri Central Mr. Manjula Karunaratne who welcomed the guests said Asiri Central Hospital is one of the best-appointed and technologically advanced medical facilities, offering international standards in healthcare, and is the flagship of the Asiri Group of Hospitals.

"It is a one stop medical facility that offers diagnostic, therapeutic and intensive care facilities by specialists of a diverse area from medical to surgical divisions. They are supported by a trained, energetic and dynamic team of in-house medical officers and nursing staff," he said.