The Shrapnel That Blasted Kayeng’s Face Was Huge!!!
The Countdown to Surgery
During the five days of intense examinations, Dr. Nattawut along with his colleagues Dr. Nuthida and Dr. Wissen performed a number of tests on Kayeng’s eyes to check whether there was a remote chance of sight. Sadly, the results indicated that he is 100% blind.
Kayeng had caught a cold. Surgery was delayed. Kayeng visited Bumrungrad pediatricians Dr. Somyod and Dr. Prasong every day for checkups, antibiotics shots, nebulizer treatments and brochi tube drains. After a week’s delay, Kayeng received a clean bill of health. He was ready for surgery, scheduled for Tuesday, February 5 at 6 pm.
There were many well-wishers who came by to wish Kayeng good luck before the surgery. The included the Bumrungrad’s Managing Director Dr. Num and his family. Ophthamologist Dr. Phetsamone from Oudomxay in northern Laos dropped by to see Kayeng. He examined Kayeng with Dr. Nattawut in Luang Prabang, Laos last December.
In fact, there were visiting doctors to see the surgeons and Kayeng in the operating room. We couldn’t quite tell who they were with their masks on.
Ten Bumrungrad doctors and surgeons will operate in unison and lockstep on Kayeng for seven hours. A host of nurses and administrators in the background assisted and anticipated. While the operation was a success, the adroit doctors altered their plans midstream. Kayeng was strong throughout the operation. He demonstrated his strength, his spunk and his love for his Dad during the recovery.
The original surgical plans involved the removal of both eyes and to prepare the eye socket for prosthetic eyes (for cosmetic purposes) in the future. The foreign materials would be removed. The cause of the incessant pain in his left eye would be addressed. They would fix his right sinus to rid Kayeng’s chronic infections. The plastic surgeon would reconstruct Kayeng’s right nostril and upper lip.
Eye surgeons Dr. Nattawut with Dr. Aree would perform the eye surgery and remove the foreign bodies with neurosurgeon Dr. Yod standing by in the event there was a threat of brain damage. ENT Dr. Vitchaphan and Dr. Sutichai would addressed Kayeng’s sinusitis and repair his sinuses, damaged and partially destroyed by the flying shrapnel. Plastic surgeon Dr. Somboon would reconstruct Kayeng’s nose and upper lip. Anesesiologist Dr. Thamabovorn would ensure Kayeng in ready and comfortable to be operated on.
(A day before the surgery, Dori returned home to Vientiane, Laos. Barbara traveled to Laos with Dori and then turned around, jumped on a plane back to Bangkok to be at Kayeng’s side during and after the surgery. Barbara was in Bangkok to continue Kayeng’s story.)
When the doctors began to remove the right eye, they found seriously infected scar tissue behind the eye. The infection was caused by the foreign matter, including a huge piece of shrapnel, dirt and rocks. We are so fortunate, so godly fortunate that we found Dr. Nattawut and the support of Bumrungrad. The seriousness of the infection untreated would have eventually spread to his brain and Kayeng would have suffered a slow, very painful death.
The shrapnel removed from Kayeng’s eye was HUGE. It was over one inch by one-half inch, larger than Kayeng’s eyeball. We couldn’t imagine what it must have been like for such a large piece of metal (along with the smaller shrapnel, dirt and pebbles found) flying into the boy’s face, piercing his face and lodging itself behind his eye and resting just under his brain. Imagine the pain and agony of having your face blasted open, let alone what it was like for a child not yet two years old.
We applaud and admire Kayeng’s enduring strength, passion to share and his charismatic personality, given what’s he gone through. We applaud his parents, grandparents and family’s patience and for their constantly talking and reassuring Kayeng during this past year of suffering, agony and slow recovery.
The shrapnel removal was challenging and successful. There was no indication of the infection spreading to the brain. They implanted a prosthetic for his shattered orbital ridge. In the future, the doctors will fit Kayeng with prosthetic eyes so cosmetically he will look more normal. The photo below is with prosthetics eyes in as a test during surgery. They constructed a new right nostril and implanted a stent (like a tube) to keep his right nostril formed and open. The stent will be in place for one year and his nose will be reconstructed.
Because of the unanticipated challenges with removal of the foreign bodies, the doctors cut short some of the planned steps in the surgery and deferred those steps for the future. While they completed some superficial cleaning and repositioning of the left eye and ridded the source of the pain in his left eye, the doctors will remove the left eye which has shrunk and is no longer functional, and continue their surgical plans. The nose and upper lip will be reconstructed in the future, as well.
After a five hour surgery, Bumrungrad staff bought Kayeng to his room. Vakoung, Thongchanh and Barbara were anxiously waiting for and ecstatic to see Kayeng. Separated for the first time but now reunited, Vakoung immediately began to gently caress and quietly comfort and reassure Kayeng that he is back with Papa and everything is ok. As Kayeng was slowly coming out from under the anesthesia he reached out looking for Papa and found his finger. He knew it was Papa.