(MENAFN- The Peninsula) The Peninsula
Doha, Qatar: Sidra Medicine, a Qatar Foundation Entity, took a multidisciplinary and innovative approach to care, to save a young Kuwaiti girl's life.
A harrowing start
Fatima was diagnosed with intrauterine growth restriction, indicating that she was not growing as expected while inside her mother's womb. Just three days after she was born, she developed a life-threatening bowel infection called Necrotizing Enterocolitis (NEC), requiring doctors in Kuwait to perform an emergency ileostomy1.
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At seven months old, Fatima developed short bowel syndrome and complications like failure-to-thrive and life-threatening sepsis. The sepsis lead to necrosis, where the tissues in her feet and finger tips started to die.
As a result, Fatima became malnourished and needed specialized nutritional support and immediate surgical intervention to prevent the necrosis from spreading further. She was at increased risk of losing all her limbs. She also needed bowel surgery to treat her short bowel syndrome including the closing of her temporary ileostomy. Time was of the essence.
Multidisciplinary approach to care
With the help of Sidra Medicine's International Patient Services, Fatima's parents rushed her to Qatar from Kuwait. The international patient services team prepared all the paperwork and worked with the clinical teams to ensure Fatima received an individualized treatment plan to address her unique needs as soon as she arrived at the hospital.
Jenny Sacree, clinical nurse leader, pediatric specialty clinic for international rehabilitation at Sidra Medicine said:“Fatima's care required access to many of our specialist services, including several different surgical disciplines, therapists, nutritionists, rehabilitation physicians, pediatric intensive care and surgical ward care. Her care with us, showed the strength and depth of our expertise as we pulled together a core team to save her life and to ensure she received the right support throughout her journey, including follow up care and consultations.”
Plastic and Orthopedic Surgery
A combined team of plastic and reconstructive surgeons (Dr. Graeme Glass) and orthopedic surgeons (Dr. Farhan Ali) were mobilized to address Fatima's damaged limbs.
Dr. Graeme Glass said:“Fatima needed urgent surgery so that we could save her feet and hands from further wasting away from necrosis. Within hours of her being admitted to our hospital, we removed the necrotic tissue from her feet and left her with as much of each foot as was viable.
“We also removed the necrotic tissue from her finger tips and were able to save all her fingers from amputation. We then performed a skin graft from her thigh to close the wounds. It was quite a complex and delicate process as it was imperative we save as much of her limbs as possible.”
Short Bowel Surgery
Following limb surgery, Fatima was getting readied for the second phase of her healing - to ensure she received the right nutritional support to prepare for her short bowel surgery.
Sidra Medicine is the only specialist hospital in the GCC region with a comprehensive Advanced Intestinal Rehabilitation (AIRS) program for young patients with short bowel syndrome. The program includes physicians, surgeons, dieticians and pharmacists, who developed a customized therapy plan for Fatima.
Dr. Mansour Ali, Executive Chair of Surgery, who also established the AIRS program at Sidra Medicine said:“Upon Fatima's admission under the AIRS multidisciplinary team, we immediately initiated intravenous nutrition and adjusted Fatima's oral feeding regimen. It took two months, until we were confident that Fatima had gained the right amount of weight. We then successfully closed her ileostomy and then performed the short bowel surgery to reconnect her intestines.”
“Children afflicted with short bowel syndrome are often dependent on long-term intravenous nutrition. In the absence of a synchronized treatment strategy, many of these children face grim futures marked by infections and liver failure. However, with the implementation of advanced intestinal rehabilitation, we can proudly claim a staggering 90 percent survival rate and a life free of continuous intravenous nutrition and without having to undergo an intestinal transplant. We were very proud to see Fatima's growth and development and moving on to the next and final stage of her treatment program,” continued Dr. Ali.
A novel approach to a unique problem
With her surgeries out of the way, it was important Fatima gained the correct weight-bearing therapy to prepare her for future prosthetics for her feet.
Kurt Thompson, from the Physical Therapy unit said:“Fatima was now on the final stage of her care journey with us, which required a comprehensive rehabilitation program. We were keen for her to bear weight on her legs and gain normal development from sitting, standing and walking. It was important to her physical and mental development. The challenge was that Fatima did not like any weight being placed on her residual limbs while standing, even if it was for a short amount of time.”
“This is when we applied a bit of innovation. Together with our orthotist, Abdullah, we created a completely bespoke pair of feet to help Fatima stand on her own and that could fit into shoes. This was a temporary measure before she gets prosthetics. And our first attempt with the bespoke feet was a success. Over the course of three weeks, with our help, Fatima was happy to stand for up to 20 minutes, without complaining!”
Standing Tall: steps to a new future
Fatima's parents said:“Our beautiful daughter is truly standing tall today! She showcased such courage and strength from the minute she was born and throughout her ordeal. We are extremely grateful to the fantastic team at Sidra Medicine. They pulled all stops to give our daughter the best in surgery, rehabilitation and follow up. We uprooted our entire family to be here for her, and not once did we feel out of depth. The team were with us every step of the way, ensuring we were equal partners in doing what was best for Fatima. Thanks Sidra Medicine, you have played a key role in changing the course of Fatima's health and well-being for the better.”
Fatima has since been discharged from Sidra Medicine and is currently at home in Kuwait. Thanks to the innovative solution, her family have decided to wait for her to gain some more weight and grow further before she gets her prosthetics.
Sidra Medicine will continue to provide follow up consultation over the next few months via video conferencing to support her home exercise and total parenteral nutrition programs.
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