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Drs. Nattawut and Phetsamone examined two-year old bombie victim Kayeng Yang. They and other passionate ophthalmic doctors are giving Kayeng and his family priceless holiday gifts of answered prayers to remedy his many functional and physical issues, to give him an opportunity to go to blind school, to enable him a better quality of life.

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December 19, 2012

Today was a culmination of many emails, phone calls and SMS messages over the last three weeks between Give Children A Choice, doctors in the USA, Thailand, Laos, and the Yang family. There were unforeseen disappointments that were overcome with heavenly progress by the end of the day. We were overjoyed. While the journey has just begun, today ended on an upswing.

Dr. Nattawut (http://www.bumrungrad.com/doctors/Nattawut-Wanumkarng) and Dr. Phetsamone (Oudomxay Provinvical Hospital Eye Clinic) met us at the Luang Prabang Airport. Dr. Nattawut came with medicines, the necessary surgical equipment, temporary eyes as well as donated live eye sclera. (Dr. Phetsamone who has been working with Dr. Nattawut for the past few years on patients with incredibly serious eye injuries. Google “Udomxay Mission Dec 2011 by Dr. Nattawut Wanumkarng” and you’ll see an example of their work.)

We had lunch on the Khan River, then motored on to the Luang Prabang Provincial Ophthalmology Center to meet Kayeng’s family. They traveled 8 hours from their Xieng Khouang home village Ban Thong to Luang Prabang. The Mom seemed happy to see Barbara and me. We were familiar faces in an unfamiliar “big city”.

Drs. Nattawut and Phetsamone examined Kayeng. He is blind in both eyes. Sight cannot be restored. He has serious conjunctiva and corneal infections in his right eye as well as an atrophying left eye, caused by persistent exposure to the air and drying. There is a sharp-edged, 1½ to 2 cm long piece of shrapnel lodged in Kaying’s right eye that could shift and cause brain damage. His maxillofacial bone holding up the right eye socket is shattered, thus causing his right eye to migrate down on his face. A CT scan would help see what is left of this bone. His right nostril is closed and his breathing is severely hampered. A CT scan would tell them if his nasal cavity is crushed or not.

 

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Short-term, Dr. Nattawut gave the parents different eye drops to rid the infections and to keep the eyes moist. Continual moisting of the right eye will prevent the right eye from shrinking (as what happened with the left eye).

Our first disappointment. The doctors were prepared to operate on Kayeng to reduce Kayeng’s continuous eye pains, to replace possibly Kayeng’s eye(s) with temporaries, and to take out the shrapnel. They needed a CT scan to help them comfortably guide their operations. Unfortunately, the CT scan technician and doctor were away for the next six months?! Thus, the operation was called off.

Our second disappointment. We learned that the Dr Luc’s Lao Rehabilitation Foundation sponsored mission was postponed. Boston’s Dr. Bounmany (who offered to help open up Kayeng’s closed nostril to help him breathe better) would not be coming this February. Bureaucratic paperwork postponed the trip.

Fortunately, it got better from here. The heavens descended up on us to bring good fortune for Kayeng.

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When the disappointed doctors learned they would not be able to operate, Drs. Phetsamone and Nattawut caucused. Within minutes, Dr. Nattawut pulled his phone out and in rapid succession reached out to the Bumrumgrad International Hospital’s Head of Ophthalmic Surgery Dr. Yee and the hospital director’s chief of staff. We could hear his calm but passionate appeal in Thai. He hung up. He beamed. With confidence, he said that he could take care of Kayeng in Bangkok. He would assemble a team of maxillofacial, ENT and ophthalmic surgeons and plastic surgeons. It is proposed that Bumrungrad would donate hospital expenses. Give Children A Choice volunteered to cover logistics, administrative and other support expenses not covered by the Bumrungrad offer.

We turned to Kayeng’s grandfather Mr. Norpor and father Mr. Vakong about the good news. Dr. Nattawut described in detail what procedures would be performed. His priorities would be getting rid of his gnawing pains and infections, his functionals and then the cosmetics. The doctors indicated that Kayeng would have to stay in Bangkok for a month.

Mr. Norpor thanked the doctors and said he would like to discuss the doctor’s and Give Children A Choice’s offer with his family.

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As this was going on, the country’s 17 ophthamologists were just arriving to Luang Prabang, as Drs. Phetsamone and Nattawut, to attend tomorrow’s two-day workshop. They heard about Kayeng’s situation and were filing into the examination room to learn more about Kayeng’s case.

After dinner the two doctors accompanied us to the Give Children A Choice house to check on Kayeng. Imagine. Doctors making house calls! The grandfather and parents agreed to have Dr. Nattawut’s team work on Kayeng. The father will accompany Kayeng to Bangkok. Hooray!

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Our discussions then centered on logistics. How difficult and timely are the paperwork process? How will they handle the dizzying pace and the modernity of Bangkok? (Note: The parents did not know how to use a sit down toilets in the GCAC house. The father broke the water sprayer head off next to the toilet to get more water to flow into the toilet. He didn’t know how to push the handle on the toilet to flush the toilet. They are used to “flushing” their squat toilet with a bucket of water filled from a nearby tank of water. They live in a small remote village where there are no paved sidewalks and roads, no traffic lights, no trains, no 7-11s, no elevators or escalators, no traffic, no locks on homes, etc.)

So, the day ended on a high note. Free pro bono complex medical care by world class surgeons at a world class hospital. Logistics and administrative expense supported through Give Children A Choice.

December 20, 2012

We spent the morning taking Kayeng and his family around Luang Prabang. They were in awe of the “big city”. What will the father think, when he’s in Bangkok?

 

 

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After lunch, we attended the Fred Hollows Foundation-sponsored regional Eye Care Conference, organized by Dr. Phetsamone.

Dr. Khamphoua, Director of the Vientiane Eye Center and head of the School of Light for the blind introduced himself to Barbara and me. He knew about Kayeng. He confirmed his support to have Kayeng attend the school for the blind in the next year or two, when Kayeng reaches a practical age to live away from home. He invited us to visit the school anytime. Another Hooray!
Today, we focused on getting ID cards and passports. We called our friends at the Ministry of Foreign affairs office in Xieng Khouang to expedite the passport issuance. They were enthusiastically supportive. Dr Nattawut wanted to work on Kayeng in January, so planning time is short. Time is of the essence. The paperwork process can be onerous (not the forms themselves but the process), as we’ve learned during the past year living here. Ophthalmologist Dr. Kormoua (Deputy Director of the Xieng Khouang Provincial Hospital in the capital city of Phonsavan and) Kayeng’s physician in Phonsavan volunteered to assist us. Nurse Barbara will accompany Kayeng and his Dad to Bangkok.

Barbara and the doctors visited Kayeng after the conference to see how the eye drops were working. They provided short-term care instructions for Kayeng as well as instructions to prepare to travel to Bangkok. They gave an overview of what to expect in the hospital.

In the meantime, Kayeng was happily playing with his new toys and backpack that we purchased in Thailand. Given his blindness, we purchase musical toys, including a drum, xylophone, horn, maracas. Just as he offered us stools during our first to his home, he walked towards Barbara’s voice and shared his toys with her, asking her to play the instruments with him.

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It was another good day. Could it it get any better. We have our support in Phonsavan in place to secure the Lao ID cards and passports. Kayeng’s family is on board. Kayeng will have a place in the School of Light.

December 21st

Kayeng and his family took an 8:30 minivan back home to Ban Thong in Xieng Khouang. We took Dr. Nattawut to the airport, who dived deeper into what he is considering doing for Kaying. We had a departing dinner with Dr. Phetsamone.

Looking Forward

The beginnings of a path to recovery for Kayeng is taking shape very nicely. Immediate medical care from Xieng Khouang Provincial Hospital Dr. Kormoua is prepared to provide medical and logistical support for Kayeng. Dr. Nattawut is assembling a team of surgeons to operate on Kayeng at Bangkok’s Bumrungrad Hospital. Dr. Phetsamone is guiding and coordinating the Lao support we need for Kaying. Dr. Khamphoua is prepared to accept Kayeng into the School of Light, which was built by American Dr. Luc, who founded the Lao Rehabilitation Foundation.

 

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