Neurosurgery brings hope to parents By Iana Seales
Stabroek News
May 16, 2004

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One-year-old Delwin Mclennon has been given a new lease on life after neurosurgery operations at the Georgetown Public Hospital.

The toddler, who was born with `water on his brain', had a shunt surgery two months ago and is now on the road to recovery. He is one of 30 patients to have surgery since January under a new programme.

Signs of his condition surfaced six months after he was born, according to mother Bridget Mclennon. He seldom moved around and his head had appeared a bit abnormal. And as his first birthday came around he was unable to take a single step.

After doctors at GPHC diagnosed Delwin, steps were taken for early surgery. A CT scan was performed and on March 25 he was admitted to the hospital. Five days later, Delwin was back with his mother and moving around the home.

He is yet to walk like most children his age but his new-found agitated nature is more than what McLennon had hoped for in such a short period of time. And post-surgery has been so demanding that she was forced to leave her job.

Delwin was left with a plastic tube in his body that aids in draining fluid from his brain to the abdomen.

So Bridget has to closely monitor his actions and see that he does not fall and disrupt that tube.

According to her, several Day Care Centres were considered but none was ever decided on because of the fear that Delwin might not be watched all the time.

A team of visiting paediatric neurosurgeons and anaesthesiologists from the International Children Hos-pital (ICH), Richmond, Virginia, USA were on hand to perform Delwin's surgery in addition to six others.

Neurologist John Ward headed the team of doctors who performed surgeries to remove tumours and fix the condition called hydrocep-halus or water on the brain, during a three-day visit. The team comprised surgeons, Econ Dopppenburg and Gary Tye and anaesthesiologists, Jay Shiparo and Ruth Becker Kain.

Dr. Varun Bhargava, a neurosurgeon attached to the GPH said neurosurgery has come a long way there. In the past it was rarely attempted because of the lack of equipment and medical expertise.

Bhargava, who is here from India on contract, told Stabroek News that neurosurgery is a complex practice that requires high technology and precise skill.

At present, GPH is handling general neurosurgery, Bhargava said, and in the event of special cases such as deep tumours, patients would be referred to overseas hospitals.

Patients diagnosed at the hospital are referred to Woodlands Hospital for the CT scan. Some travel to Trinidad for the Magnetic Resonance Imaging (MRI) since no local hospital has the equipment installed. But St Joseph Mercy Hospital recently announced plans to install MRI technology. Bhargava said GPH could collaborate with Mercy Hospital and provide the service when the equipment is installed.

Bhargava pointed out that GPH is treating patients who cannot pay, the majority of whom have early surgeries.

The risk of delayed surgeries can result in patients having seizures which can be fatal if not treated immediately.

According to Bhargava, patients in a vegetative state are often not the first to have surgeries since the risk is much higher. He said that in several countries such patients are considered social burdens and never have surgery.

Despite the complicated nature of such operations, Bhargava said he would usually go through with it and bring hope to comatose patients and some recover.

With non-complicated surgeries, patients spend two to three days in hospital recuperating while those with complicated surgeries would have an extended stay of one month.

Three patients have succumbed at the hospital after 30 surgeries, according to Bhargava. He said that they were complicated cases since the patients were dying.

He pointed out that children sometimes require neurosurgery shortly after birth. Some are born with tumours and hydrocephalus. Often tuberculosis and meningitis are the main causes of infection in children and result in them facing neurosurgery, Bhargava said.

According to him, affected patients can go without surgery and live with tumours. But those with cancerous tumours have a life span of eight months if they are not treated right away.

Before neurosurgery, Simone Talikurdir, aged four, had trouble leading a normal life. She was diagnosed with `water on the brain' one year ago. But signs of her condition surfaced much earlier, according to mother Gangadai.

Three years ago Simone had a seizure. Gangadai explained that the attacks just started coming. Last August was the last time the child had an attack.

During the years of constant seizures, Simone's sight became blurred; she was unable to walk properly and also had trouble speaking. Her fourth birthday was celebrated with some sadness, the mother said.

Then the family changed hospitals and Simone started attending the clinic at the GHP. After doctors saw her, the family became aware of her condition. And they were advised to have an early surgery. At that time GPH had no neurosurgeon. However, the family was guaranteed an operation.

Then Dr. Bhargava arrived in January and a date was set. Gangadai said the family was considering taking Simone to Trinidad but decided on GPH after meeting the new neurosurgeon.

After the CT scan was done Gangadai took Simone to Trinidad to have the MRI done. According to her, there were suggestions that the child might have a brain tumour. The result was negative and they returned to Guyana for surgery.

Within three days of the operation, Simone was back at home and has started to come around. Like Delwin, she also has a plastic tube in place.

Gangadai said she is a stay-at-home mother so looking after Simone is not demanding. She said neurosurgery has given the family hope, adding that in a year's time Simone would be able to lead the life of a normal little girl.