PWS AND GAS­TREC­TOMY EX­PLAINED

Friday - - Real Life -

It was at this time that we met a rel­a­tive at a fam­ily func­tion, who told us about bariatric surgery. We had not heard of any child who had un­der­gone this surgery, but we were des­per­ate to save our son’s life and were will­ing to con­sider any op­tion. We also re­alised that we had no other way of sav­ing Rishi. He was slowly dy­ing and we had tried di­ets and failed.

In July last year we made an ap­point­ment at the Asian Bariatrics hos­pi­tal in Ahmed­abad, western In­dia, where doc­tors con­ducted a de­tailed check-up and con­cluded that Rishi’s con­di­tion was se­ri­ous and re­quired surgery. I had to dip into my sav­ings to pay for the surgery, which cost Rs300,000 (about Dh18,220).

“I do not sug­gest putting Rishi on a diet be­cause you have al­ready tried it, and it has not worked,” Dr Ma­hen­dra Nar­waria, the sur­geon, told us.

“Rishi is dy­ing be­cause he is putting on weight so dras­ti­cally. He is suf­fer­ing from sleep ap­noea and also ex­pe­ri­enc­ing se­vere prob­lems re­lated to breath­ing be­cause of his weight. There are risks in­volved when go­ing ahead with surgery, but he is in a se­ri­ous con­di­tion, so we have to take this ex­treme mea­sure.”

We were in a dilemma after we heard the doc­tor’s prog­no­sis. We were ter­ri­fied that we would make a wrong decision. At the back of my mind we were scared that the surgery might go wrong. We dis­cussed it with our friends and fam­ily, who were very sup­port­ive. They knew how much we’d tried to con­trol his eat­ing and to help him lose weight and that we had failed. They too agreed that we should go ahead with it.

Fi­nally, in Au­gust last year, we agreed to the surgery.

Rishi had no idea what was go­ing on. “Doc­tors are go­ing to drill two holes in your stom­ach and check where you are hid­ing all the jalebis,’’ we told him, so that he wouldn’t be wor­ried. But we were re­ally scared. We had to force our­selves to smile as Rishi was wheeled into the the­atre for surgery at the Asian Bariatrics hos­pi­tal last Septem­ber.

Dr Ma­hen­dra per­formed a twohour op­er­a­tion, where he re­moved Prader-Willi syn­drome (PWS) is a ge­netic disorder that can re­sult in a num­ber of phys­i­cal and be­havioural prob­lems. A key fea­ture of the con­di­tion is a con­stant sense of hunger that the pa­tient feels.

A gas­trec­tomy is done un­der gen­eral anes­the­sia. A cut is made in the ab­domen and part of the in­tes­tine re­moved. By mak­ing the stom­ach smaller, it fills more quickly. This may help the pa­tient eat less. How­ever, gas­trec­tomy is only an ap­pro­pri­ate obe­sity treat­ment when other op­tions have failed, say ex­perts.

Sources: www.may­oclinic.org, www.health­line.com 70 per cent of Rishi’s stom­ach. Those two hours dragged on. We tried to be strong and prayed that our lit­tle boy would sur­vive. “We’re do­ing the right thing,” I told Henna, who was in bits.

While the gas­trec­tomy would not cure his con­di­tion, it would help con­trol it to a cer­tain ex­tent, be­cause he would eat less and thereby lose weight. This would im­prove his life be­cause he would be able to ex­er­cise, play games and do all the things chil­dren his age do.

Fi­nally the op­er­a­tion ended. “He’s in re­cov­ery,” the sur­geon told us. “You can see him soon be­cause the op­er­a­tion went well.”

Rishi was in in­ten­sive care for three days. He was fine but se­dated.

On the fourth day, he was put on a liq­uid diet of fruit juices and nu­tri­tious smooth­ies. A week later he was back home and within the first month he lost 3kg.

Im­por­tantly, he did not com­plain of hunger and did not seem to be miss­ing his reg­u­lar large meals. There

Ini­tially we were ter­ri­fied that we’d made the wrong decision by go­ing ahead with the surgery, but now we know it was the right choice. I see my son swimming, cy­cling and run­ning and en­joy­ing life again. That is a won­der­ful feel­ing.

Rishi no longer tires eas­ily. How­ever, there are days when his crav­ing for his favourite jalebis kicks in. When­ever he sees other chil­dren eat­ing, he wants the same. We in­dulge him, but with very small por­tions.

Rishi has to lose at least 6kg be­fore he’s classed a nor­mal weight for a child his age.

Dr Ma­hen­dra ad­mits he be­lieves gas­trec­tomy is not al­ways the right op­tion for chil­dren so young, even though he en­cour­aged us to go ahead with the surgery. “Rishi suf­fered se­vere dif­fi­culty in breath­ing while sleep­ing where his oxy­gen sat­u­ra­tion lev­els dropped be­low 60 per cent leav­ing him gasp­ing for breath. Gen­er­ally, we would avoid bariatric surgery in such a young child, but his prob­lem could have been fa­tal,” he told us.

“I would say it’s bet­ter for such young chil­dren to be put on a strict diet and learn a healthy life­style. But in the case of Rishi, surgery was the only op­tion left.”

Doc­tors are also mon­i­tor­ing Rishi’s PWS and have told us that it is un­der con­trol.

We are so glad that ev­ery­thing has turned out well. We just hope that Rishi’s ap­petite doesn’t grow again as he grows older. We hope he won’t have to have any more surgery.

Newspapers in English

Newspapers from UAE

© PressReader. All rights reserved.