Sunday, July 15, 2007

Maybe Michael Moore will Pick Up the Tab

He was born 11 years ago in Santiago de Cuba and had an uneventful infancy until he was 10 months old. One night the baby seemed more irritable and was clearly sick. His fever started to get worse and he began to have seizures, which frightened his mother terribly. They brought him to the local medical facility where a spinal tap confirmed that the baby had meningitis. He nearly died.

It took about a year for his family and the pediatricians to figure out that this toddler was having trouble hearing, and subsequent testing confirmed that the meningitis had deafened the boy. The only option, the family was told, was to wait until he got older, at which time he could get a cochlear implant. But when he got older, the surgeons in Cuba told his family they did not have the expertise to implant him. His cochleas had become filled with new bone and this would have to be drilled out. Somehow, a faculty member in a Public Health school in Florida became familiar with his case and began moving heaven and earth to get this child a cochlear implant.n Appeals were made via the Swiss Embassy in Cuba, in order to get a visa for offshore consultation. Then the child's chart found its way to my desk.

My gut feeling is it is too late for this boy. The surgeons in Cuba should have implanted the child when he was a baby, not "wait until he gets older". The audiologists and speech pathologists in Cuba do not have any expertise in providing the intense follow-up care and programming this child will need. The family will not be able to afford the little equipment replacement costs such as for cables and rechargeable batteries. That's if I perform the surgery, which is not likely because, a.) he's too old now, b.) patients with bone in their cochleas don't get as much benefit from implantation, c.) because of his age at deafness it is doubtful he has developed the brain connections necessary to process speech.

This boy's prospects would be a lot brighter if either a.) he were an American citizen, or b.) if the medical system in Cuba were up to snuff. We'll get the little guy a CT scan here on a REAL CT scanner and see if his cochleas really are all that bad.

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