You probably heard this in the TV or in class. In simpler terms hydrocephalus is a condition where the head is expanding due to the increasing fluid in the head. It is because of a blocked drainage in the pipe system of the brain or an increased production of the fluid. In this case a child should undergo surgery as early as possible. This is to avoid seizures, increased pressure or any developmental delay. The surgery entails placing a pipe from the head to the peritoneal cavity pleuralcavity or the gallbladder. It usually is a series of surgeries either because the pipe/shunt has become dirty (infected) or the pipe doesn't fit the growing child anymore and needs to be replaced.
Any rotation or OJT to National Childrens' Hospital, would open up your eyes to the condition of hydrocephalus. But this three encounters I have are encounters in the emergency room and in the out-patient department. Read on.
1. A two-year old.
I don't remember whether it was during my internship or clerkship that this happened. In the early hours of the pediatric-E.R. rotation a family came in with a 2-years old girl. The family with the child is not her immediate family. The main character is the Uncle. He decided to bring the child to the ER because of the enlarging head. There was no immediate or urgent problem to the child. The urgency was with the uncle. He wanted to know if the child was to grow up normal if the child underwent surgery now. What he wanted to say was will the child still be a retard even if she underwent surgery. Will they have to take care of her the rest of their lives? Short of answering his questions, the consultant that day gave him every possible explanation. In short, YES to all his questions. The very sad thing was what he said last... "Eh di kung ganun din pala, hayaan na lang naming ganyan sya kesa pag-gastusan namin ng marami." Honestly, I don't know their status in life. But to go all the way from a province to one of the most expensive hospitals in the country and this done when the child was two years old is something that boggles me. Hydrocephalus is not a condition that suddenly presents one day. To tell you the truth the tape measure we had that day didn't even fit the circumference of her head. I don't know what consults they did before us. What I know is that at that point in time, I wish I had the power to turn back time and all the money in the world to give to the child so that she could undergo the best care possible.
2. 1 month old.
This happened just 2 duties ago. It's not about the child per se but the circumstances around it. The emergency room is the melting pot of personalities. That early morning a mother of a 22-year old male came in to the ER because her child had fever and chills that morning. She gave the child paracetamol. And kudos to her for managing well the problem. Her concern was if there could be something done further. In other words, could this be dengue. Dengue is of a viral cause and usually viral symptoms would entail high-grade fever and non-specific symptoms. And as for dengue, the first bout of fever doesn't give you a picture of dengue, it's the when the fever disappears where signs appear and the medical world can give a more or less appropriate diagnosis of dengue fever. But the 22-year old child in question is okay. In his words. ("Ma, okay lang ako, wag na tayong magpatingin"). To allay the fears of the mother, I ordered another complete blood count, the initial results of his blood count was far from the dengue/viral picture, it was normal, nearly bacterial in picture.
While they were waiting for the result, in comes a family from a class lower than them. Mother, father and a one-month old child with hydrocephalus. They came from a province and was led to the institution for further management. They didn't know what to do, they were in a slight disarray. The child was crying for food and the mother had to sit down and feed the child. Picture this. While she was feeding the child (breastmilk) the mother-from a-upper-class was looking at her (she was also with a side-kick), all eyebrows were raised. I would dismiss that as something else but what they did when the mother was led to the pediatric area was what raised my eyebrow, they smirked and laughed.
I'll leave this story at that.
3. Aaliyah.
During my neurosurgery rotation as a clerk, I had this encounter with a newly born child. The mother and father brought the child immediately to the OPD (charity section), for evaluation. Hats off to the doctor of NCH for catching the diagnosis immediately and for leading them correctly to the right people. :). The neurosurgeon was in doubt at first. But latter tests proved the diagnosis to be correct. In short Aaliyah underwent surgery early on. My encounter with her didn't end there. Even now I see them on my way to the hospital. The father calls out to me most of the time and updates me on what Aaliyah can now do. Last I saw them she is able to count to 5. They religiously follow their appointments with the pediatric and neurosurgery departments. After all that they have been through, a series of surgeries, spending Christmas and the other holidays a the hospital, I can still see their delight with gift of life. Aaliyah's development is delayed but the mother and father don't mind that, they are just happy that she is alive. They are happy that she is able to smile.
Any rotation or OJT to National Childrens' Hospital, would open up your eyes to the condition of hydrocephalus. But this three encounters I have are encounters in the emergency room and in the out-patient department. Read on.
1. A two-year old.
I don't remember whether it was during my internship or clerkship that this happened. In the early hours of the pediatric-E.R. rotation a family came in with a 2-years old girl. The family with the child is not her immediate family. The main character is the Uncle. He decided to bring the child to the ER because of the enlarging head. There was no immediate or urgent problem to the child. The urgency was with the uncle. He wanted to know if the child was to grow up normal if the child underwent surgery now. What he wanted to say was will the child still be a retard even if she underwent surgery. Will they have to take care of her the rest of their lives? Short of answering his questions, the consultant that day gave him every possible explanation. In short, YES to all his questions. The very sad thing was what he said last... "Eh di kung ganun din pala, hayaan na lang naming ganyan sya kesa pag-gastusan namin ng marami." Honestly, I don't know their status in life. But to go all the way from a province to one of the most expensive hospitals in the country and this done when the child was two years old is something that boggles me. Hydrocephalus is not a condition that suddenly presents one day. To tell you the truth the tape measure we had that day didn't even fit the circumference of her head. I don't know what consults they did before us. What I know is that at that point in time, I wish I had the power to turn back time and all the money in the world to give to the child so that she could undergo the best care possible.
2. 1 month old.
This happened just 2 duties ago. It's not about the child per se but the circumstances around it. The emergency room is the melting pot of personalities. That early morning a mother of a 22-year old male came in to the ER because her child had fever and chills that morning. She gave the child paracetamol. And kudos to her for managing well the problem. Her concern was if there could be something done further. In other words, could this be dengue. Dengue is of a viral cause and usually viral symptoms would entail high-grade fever and non-specific symptoms. And as for dengue, the first bout of fever doesn't give you a picture of dengue, it's the when the fever disappears where signs appear and the medical world can give a more or less appropriate diagnosis of dengue fever. But the 22-year old child in question is okay. In his words. ("Ma, okay lang ako, wag na tayong magpatingin"). To allay the fears of the mother, I ordered another complete blood count, the initial results of his blood count was far from the dengue/viral picture, it was normal, nearly bacterial in picture.
While they were waiting for the result, in comes a family from a class lower than them. Mother, father and a one-month old child with hydrocephalus. They came from a province and was led to the institution for further management. They didn't know what to do, they were in a slight disarray. The child was crying for food and the mother had to sit down and feed the child. Picture this. While she was feeding the child (breastmilk) the mother-from a-upper-class was looking at her (she was also with a side-kick), all eyebrows were raised. I would dismiss that as something else but what they did when the mother was led to the pediatric area was what raised my eyebrow, they smirked and laughed.
I'll leave this story at that.
3. Aaliyah.
During my neurosurgery rotation as a clerk, I had this encounter with a newly born child. The mother and father brought the child immediately to the OPD (charity section), for evaluation. Hats off to the doctor of NCH for catching the diagnosis immediately and for leading them correctly to the right people. :). The neurosurgeon was in doubt at first. But latter tests proved the diagnosis to be correct. In short Aaliyah underwent surgery early on. My encounter with her didn't end there. Even now I see them on my way to the hospital. The father calls out to me most of the time and updates me on what Aaliyah can now do. Last I saw them she is able to count to 5. They religiously follow their appointments with the pediatric and neurosurgery departments. After all that they have been through, a series of surgeries, spending Christmas and the other holidays a the hospital, I can still see their delight with gift of life. Aaliyah's development is delayed but the mother and father don't mind that, they are just happy that she is alive. They are happy that she is able to smile.
