Toledo health community comes together to help Algerian boy with rare birth defect

[Al-khiyal]

Toledo health community comes together to help boy with rare birth defect

April 14, 2009 -- Imagine having such severe pain that you’re not able to lie on your back. This is what Ayoub Hamdi, a 14-month-old boy from Algeria, had to go through until he came to Toledo in March for free treatment performed by UT Medical Center surgeons.

Ayoub was born with a physical defect that left his spinal cord exposed under the skin near his buttocks, resulting in a baseball-sized tumor.

Dr. Azedine Medhkour, associate professor of surgery and a UTMC neurosurgeon, saw Ayoub’s story in the newspaper and on a YouTube video in which the boy’s mother, Dalila, asked for help.

Medhkour, originally from Algeria, said the people there are extremely poor.

“Ayoub would not have had a chance to keep his leg function and may have contracted an infection and died after surgery had he had the procedure done there. For these reasons, I offered my services free of charge,” Medhkour said.

“Since we don’t have an inpatient pediatric service at UTMC, St. Vincent Mercy Medical Centers’ agreed to allow me to operate there and waived the costs,” he said. “They were very kind and helpful throughout the whole process.”

After Medhkour performed the closure of the spinal cord defect and covered it with its natural layer, the plastic surgery team — composed of UTMC plastic surgeons Drs. Marlene Welch, Timothy Janiga and resident Brian Smith — performed a skin closure flap, which led to excellent healing.

According to Medhkour, the surgery took seven hours and went better than expected. Ayoub is already flexing his knees better than before the operation. With the use of crutches and physical therapy, he should eventually be able to walk.

Dr. Dinia Medhkour, Azedine’s wife, has been the translator throughout this process since Ayoub’s mother does not speak English. “My wife was a huge help, as well as Brigitte Odenthan, another very nice person from the Ronald McDonald House,” Medhkour said.

Through Dinia, Ayoub’s mother, Dalila, said, “I am very thankful to God and everyone who participated and donated their time and effort for Ayoub’s treatment and care. I am thankful for the hospitality and kindness of the Ronald McDonald House staff and volunteers. I am also thankful to St. Vincent’s and UT Medical Center staff … from the doctors and nurses to anyone who came near my son. Thank you all for everything you have done. You will always be in our hearts and prayers.”

Ayoub is staying at the Ronald McDonald House in Toledo with his mom and will remain there for two more weeks until he returns to Algeria. Medhkour plans to bring him back in a year for a follow-up visit.

[Al-khiyal]

UTMC doctor treats Algerian boy

April 30, 2009 -- After the click of a mouse on the YouTube video, thousands of miles of vacation time and support from unknown people around the world, a sick Algerian boy named Ayoub Hamdi was able to receive the treatment he needed.

Dalila Hamdi, Ayoub’s mother, said she and her husband were shocked when they found out their son had a rare birth defect known as spina bifida.

Azedine Medhkour, associate professor of surgery and chief of the division of neurosurgery at the UT Medical Center, said spina bifida occurs once in every 1,000 births within Third World countries because of diminished medical services and poor diets. Many people living in developing nations may not be healthy, and women may not have a proper diet during pregnancy, factors which could contribute to the increase in birth defects such as spina bifida, Medhkour said.

“It occurs mainly because of the lack of folic acid,” Medhkour said.

Folic acid is an important vitamin during the first months of pregnancy, Medhkour said.

According to Medhkour, the disorder causes the spinal cord to be exposed at the skin level, causes weakness in the legs and can lead to paralysis in some cases.

Medhkour said Ayoub’s birth defect should have been treated immediately after birth.

“It needs to be repaired within 48 hours,” he said.

Hamdi said her son was in severe pain.

“He never lay down on his back,” Hamdi said.

Ayoub always had to be sitting upright, and she could never put him down for long periods of time, she said.

Hamdi said there was nowhere in Algeria that could provide the care Ayoub needed.

Medhkour said Ayoub was already seven months old when they first met, and the area where Ayoub’s spinal cord was encased in a sac about the size of a grapefruit.

The major risk would have been the rupturing of the sac and the leaking of spinal fluid, Medhkour said. The rupturing of the sac could have infected the boy with spinal meningitis, which may have caused mental disabilities, paralysis or even death, Medhkour said.

Hamdi said she put an ad in an Algerian newspaper asking for help. Soon after, an Algerian who was living in London saw the ad and came to their family with the idea to put her testimony on YouTube, she said.

If it weren’t for YouTube, Medhkour said he would have never even come in contact with Ayoub. Medhkour said his colleagues in the Algerian-American Association of Greater Washington knew about Ayoub and his situation, so they wrote Medhkour an e-mail with a link to a YouTube video showing Ayoub’s parents’ plead for help.

“There was an appeal on the YouTube video that was heartbreaking,” Medhkour said.

Due to Ayoub’s condition the family was forced to send him back and forth to the hospital for appointments; knowing that his condition should have been treated within two to three days.

“They kept giving him the appointments four to five months later,” Medhkour said.

Since Ayoub was nearly 4,000 miles away, Medhkour said he decided to use his vacation time to travel to Algeria and assess the boy’s condition.

“I thought I would first try my vacation time to see him,” Medhkour said.

Initially, he went to Algeria to see three other children as well, but 20 other children were also in need of his services, he said.

Medhkour said he examined all four of the boys and determined Ayoub was the best candidate for surgery.

“Mentally, he was all there, and he had some movement in the legs, which is also hopeful because he could flex his hips,” Medhkour said.

At first Medhkour said he tried to do the surgery in Algeria, but he knew he wasn’t going to be able to do any follow up treatments.

“Then I decided, I cannot do it in Algeria, [so] I will do my best to bring him to America,” Medhkour said.

Although UTMC personnel were willing to perform the surgery, the hospital does not have adequate pediatric services, so Medhkour said he looked to St. Vincent Mercy Medical Center, an affiliate of UT.

“I spoke with the administration, and after a few weeks of discussion, they agreed to allow me to do the surgery at St. V’s for free,” Medhkour said. “They began donating the hospital time, the [operating room], the nursing, the pediatric services, the critical care unit service, everything for free.”

Medhkour said when word got out Ayoub’s surgery would be done for free, an anonymous person in Algeria who was not of the boy’s family bought the airline ticket to America.

Once Ayoub arrived, Medhkour began working on the boy’s unique condition.

Medhkour said he had to free the spinal cord from the skin that was attached to it.

“I then covered the spine with the natural layer of skin that comes with it,” Medhkour said. “Once I covered the spine and buried it under the normal skin, my assistant moved more layers of skin over it, eventually covering the spine completely. We then brought everything together and closed it, and now the wound is healed perfectly.”

Ayoub now shows more movement of the hips, he’s able to use his knees and stand on his knees every now and then, Medhkour said.

“He has shown some progress,” Medhkour said. “Life will be better, but for him to walk normally like a normal child ... no.”

Medhkour said with assistance Ayoub will have all the possibilities to use his knees with splints, and hopefully he will be able to move up to crutches.

Hamdi said Ayoub is able to sit down and lay down normally, and he can also use a car seat and stroller.

“I used to be able to only put Ayoub on my lap, and that was it,” Hamdi said.

Medhkour said he is very thankful for all the help of friends, colleagues, St. V’s and the community at large.

“I thank those people at St. V’s very, very much for their agreement,” Medhkour said.

Medhkour said he and his team at UTMC had to find somewhere for Ayoub to stay while in Toledo, and St. V’s had room at the Ronald McDonald House. The Ronald McDonald House donated the room and board, and Ayoub and his mother have been staying there since March 7 and will fly back to Algeria on May 4, Medhkour said.

“The mother was so ecstatic, she was crying,” Medhkour said.

Hamdi praised everyone involved with her son’s care and said they are very dedicated. “They do their work, they care and they are very kind,” Hamdi said.

“We were all overwhelmed by the support we got from everybody, even unknown people. When we asked who was going to donate a wheelchair, we got the wheelchair; who’s going to donate the walker? We got a walker,” Medhkour said.

Medhkour said Algerian community members in Canada are also sending Hamdi a check for “a few thousand” dollars to follow up treatments.

“That’s another gesture that’s unbelievable, and all this started from a YouTube video,” Medhkour said.

[amalgamate]

ooh, another Mounib episode

[Bent_Bladi]

Allah ya3teehon el 3afyeh <3