Patient profile (1/24): Zuber

Zuber is a 15-year-old, Oromo-speaking boy from Welega province. He has moderate scoliosis and increasing incontinence. We hope this will improve after surgery. His dad is a farmer.

He is #1 in his class and wants to be a doctor.

Twenty-four patients sent to Ghana for life-saving spine surgery

Dear Friends:

On December 30, 2017, we sent 24 patients to FOCOS Hospital in Ghana for spine surgery.

We will be posting their individual stories over the next several weeks. Please consider a donation to support their life-saving surgery.

Thank you!

Rick

Rick Hodes, MD, MACP
AJJDC Spine and Heart Program, Addis Ababa

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Moges and the Hidden Miracle

Recently a friend said to me: “Rick – there are no coincidences. Instead, there are hidden miracles. It’s really God running the show.”

In 2016, I was in Lalibella, about 400 miles north of Addis Ababa, visiting the rock churches with a visiting delegation. An hour after we arrived, my cell phone rang. Who was calling? A patient named Moges – who lives in Lalibella! Moges had no idea I was nearby.

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Moges has been waiting for surgery since 2012. He is a tough case – severe scoliosis – over 180 degrees by some measures, and quite stiff. He had lost 70% of his lung capacity. His remaining lung capacity was .93 liters – that’s less than 3 cans of Coke – at 8,500 feet above sea level. That means he’d need traction for months to help correct this. He had a “tabletop” spine, a term which we have coined to describe our patients with flat backs on top which can hold a pen or glass of water.

“Hay Moges,” I said in Amharic, “Amazingly I’m actually here in Lalibella. Come to the lobby of the Mountain View Hotel at 4PM.” As we drank tea in the lobby, he asked me if there was any hope of him getting surgery.

A member of the delegation, a San Diego woman named Judy, was taken by Moges, his optimism, dignity, and courage, despite a severe deformity. Moges had graduated from university and works for the Ethiopian government. He was the sole support of his family.

She went home and decided to try to raise $22,000 for his surgery. She had some doubts about whether this was possible though. Judy contacted friends and relatives, her community and outsiders.

A few months later I got an email: “Mission accomplished!”

This success reminded me of a quote I use in graduation speeches from St. Francis – “First you do what you must, then you do what you can – and soon, you’re doing the impossible!”

In April 2017, our friend John Ward and I flew Moges and 21 others to FOCOS Hospital in Ghana. We attended an Easter party with him, and I went to a bookstore and purchased 6 books for him to read – “Moges, you’re going to have a lot of time.”

Moges was admitted to FOCOS hospital on the May 9, 2017. He was placed in halo traction for 20 weeks. Dr. Oheneba Boachie-Adjei and team did his surgery in 2 stages. The first surgery was done on October 24th followed by another surgery two weeks later.

He was discharged to JB Guest House on November 30, 2017.

In writing this I came across a quote from Rabbi Menachem Schneerson: “If you see what needs to be repaired and how to repair it, then you have found a piece of the world that God has left for you to complete.”

Judy did not come to Ethiopia saying “Let me find a kid to help.” But once she ran into Moges, she turned it into an opportunity to save his life. Thanks to these efforts – all spurred by a “coincidental” phone call, Moges now has a new life, with expanded lungs.

I smile as I write this. I await another coincidence as soon as it comes along.

Please support us to continue this work. We can’t thank you enough!

All my best,

Rick

Rick Hodes, MD, MACP
AJJDC-Ethiopia

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2017 Annual Report

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Dear Friends and Supporters,

We’re at the end of another amazing year, and we’d like to thank you for all of your incredible support! We simply couldn’t do this work without you. I encourage you to take a look at our 2017 Annual Report, which highlights both our successes and the help we’ll need moving forward.

We’re making one last fundraising push before the end of 2017 to help the 100+ patients we have in line for complex surgery. Please donate to help them.

With appreciation,

Rick

Rick Hodes, MD

 

 

We can help Solomon walk for the first time!

DSC00242Friends – we need YOUR help to change Solomon’s life.

Solomon had polio as an infant and has always been in a wheelchair. He has a very twisted spine and has lost over half his lung capacity.

Solomon is from a town in S. Gondar called Debre Tabor. He was a solid high school student and has just registered to study computers and database management in college, a good field for someone confined to a wheelchair.

Solomon reports that his classmates were helpful and friendly, and he was never teased. We see amazing kindness here. He is the 4th of 6 kids. His dad is a government worker, and his mom a housewife.

The family assumed there was no treatment, and he never consulted a doctor. However, Solomon’s niece was born with a cleft lip and came to Addis Ababa for surgery. They asked if there is any spine doctor in Ethiopia and were referred to our clinic.

On exam, we were happy to see that while Solomon has the thin legs of a patient who has survived polio, he does have some working muscles, and he’s able to lift 1 leg against gravity and move the other side-to-side.

We immediately saw that this is a kid we can really help. What he needs – and has needed for a decade – is to spend a couple of months in ambulatory traction and then have corrective surgery.

He has good upper body strength and is very flexible, a good sign that his traction will be easy and short – about 2 months – and then have surgery.

Because he has upper arm strength and some leg motion, there is at least a possibility that they can put braces on his legs (making them inflexible) and he could walk for the first time in his life with crutches or with parallel bars. Walking with straight legs and crutches takes a lot of energy, but it may give him mobility which he does not have now.

Certainly, even if he can’t walk after surgery, he will be better because his back will be straight and his lungs expanded.

One of the problems which polio patients face in the second half of their lives is post-polio syndrome which weakens the muscles. If this happens, then having his back straight and lungs expanded may well save his life.

I am excited to be able to send him for surgery. Now we need your help to raise funds for him!

This is a kid whom we can really help and completely turn around his life. Wouldn’t that be amazing – walking upright for the first time at age 18?!

We need your help to send Solomon to FOCOS Hospital in Accra for traction and surgery by the great Dr. Boachie and his team. We need to raise $20,000. Every gift helps, please join in.

All my best,

Rick
Rick Hodes, MD, MACP
AJJDC-Ethiopia

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Huge News: Mushida went from paralysis to walking!

17In medicine, things don’t always work out as planned, we all know that.

On the other hand, sometimes we simply feel like we hit a home run.

In early January of this year, Mushida showed up at our clinic, carried in piggy-back by her mom. What unfolded was an unexpected story.

Mushida is the youngest of 9 children in a rural Oromo Moslem family from Jiru, north of Addis Ababa. She lives a 5-hour bus ride away, followed by an hour on a donkey. Her dad is a farmer, they grow maize and some wheat. All 9 children were born at home, delivered by local women with limited knowledge of childbirth. All are alive and healthy, except for Mushida.

The family lives in a mud home with no electricity. They wake when the sun comes up, work in their fields, and return as the sun is going down. They eat dinner to “kuraz,” oil lamps, at 8PM. They pray at a local mosque 5 times a day. Their diet is based on injera made of maize and shiro (beans). They eat meat twice a year, on holidays.

As a child, they noted that the lower part of Mushida’s body was darker than the top. Because she had not been to a doctor, nobody knew that this was the sign of a genetic disorder, neurofibromatosis. Her back began deforming as a young girl and was getting worse.

One day in July 2016, Mushida woke up paralyzed. They prayed for health and waited several months, but there was no improvement. The family had no extra money, but her caring dad made a tough decision – to rent half his land, for 3 years, take this money and bring her to Addis Ababa for medical care. He found a taker and rented the land for a total of 4000 birr – about $175. They took a bus to Addis Ababa and went to an orthopedic doctor. They were told she could be treated for 40,000 birr – over $1700. This was impossible. They asked around and were directed to AaBET Hospital where we see patients.

Dr. Rick was out of the country at that moment, so they waited 5 days, sleeping on hospital benches until he returned. On January 11 he drove her to a CT scan and MRI. They noted that she had a terrible spine deformity they nickname a “gamma,” – it has a Z-shape with a right spine, a middle spine, and a left spine. Technically this deformity is classified as “complex multi-planar transpositional deformity, alpha type.”

Though she had been paralyzed for 5 months, she still had some bowel and bladder function, and she still had a great spirit.

15A few days later, Rick brought her and another patient to FOCOS Hospital in Accra, where she went into traction, 23 hours a day. After several months of traction, she underwent a 6-hour surgery led by Dr. Oheneba Boachie-Adjei. She had spinal fusion from T3-L4. She had 3 vertebrae removed (VCR from T9-11) with a cage placed. She had bone grafting and instrumentation. She now has 4 rods and 18 screws.

This was followed by physical therapy. Amazingly, Mushida started walking again.
And walking easily! After 2 months of therapy, she returned to Addis Ababa. After a week in the capital, her brother came and they returned home this week.

Mushida is profoundly grateful for her health. Her goal: “I just want to go to school and finish high school, then I’ll figure out what I want to do.” Mushida – we know you can make it!

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Semegn has a big tumor and needs our help!

Semegn is a 16-year-old orphan with a benign tumor, a tumor which will kill him. But he can still be cured. We need your help.

Sem has been my patient for several weeks. Yesterday, I sat with Sem to take a long history. He is from Wello, 10 hours away by bus. He never knew his mother, she died when he was a baby. His father died when he was 5, and he moved in with his grandmother. Together they do basic farming to support themselves. They live in a mud home with no electricity or running water.

Sem was a top student. But he has a 3rd-grade education. He stopped school several years ago because he was getting severe headaches and his head was expanding. He came to the outskirts of Addis Ababa 2 years ago to go to a holy water site, seeking a cure. He moved onto the site and would shower in holy water in the morning, and drink it in midday. They provided food and shelter to him and others. He saw others get better – mentally ill and patients with eye disease. But his head was expanding. Holy water was not helping.

He heard of someone getting treatment in Addis Ababa, so he sought care in a center for poor patients, where he met Dr. Rick. We sent him for x-rays and a CT scan.

Rick writes:
“I sent the CT scan to eight experts and got eight opinions about what it represented. Some felt it was likely to be bone cancer. Some felt that it was a tumor called fibrous dysplasia, which has a better prognosis. But all agreed that it was potentially fatal, and he needed urgent care.

Clearly, he needed a biopsy to be able to come up with a detailed plan. At that moment, renowned German facial surgeon Dr. Peter Cornelius arrived in Addis Ababa to operate on a patient with a facial deformity. Dr. Peter performed the biopsy, itself a difficult operation.

We sent the biopsy to the United States. After two weeks of analysis, I got the answer: it is a benign tumor called a meningioma.

Next step – I sought the opinion of the experts in how to approach this.

Some medical details:

Dr. Peter wrote: “Rick, this is really good news. It will need a tailored approach via a fronto-temporal craniotomy…the orbital walls (area around the eye) will need reconstruction. …You’ll need a team of neurosurgeons, craniofacial and plastic surgeons, and oculoplastic surgeons. Reconstructive options include autogenous bone (split calavaria), titanium meshes, or a specifically designed alloplastic implant.”

And an academic department of neurosurgery in Washington had a meeting to discuss this and send their advice: “It will take a lot of work to accomplish the needed surgery: Before surgery, he will need an angiogram and embolization of the feeding vessels. The operation itself would be a tour-de-force, requiring neurosurgery, ophthalmology, ENT, and plastic surgery.”

Here is a summary: this is an area with a lot of blood vessels. He’ll need to have the blood supply to the area cut down (embolization) a day before the surgery. And then a team approach with a 12-hour operation which has a very good chance of success.

After removal, he should be fine.

But this cannot be done in Ethiopia. Ethiopia does not yet have the surgical expertise, or the technical ability to embolize the area. We can’t get all the pre-surgical studies done.

Dear readers, WE NEED YOUR HELP! In the USA, a surgeon estimated this would cost a half million dollars. But we have a fine hospital in South India, with superb surgeons, which will do it for about $10,000. I have seen their embolization in another patient of ours with a bone tumor. He had a superb result and is back in school.

I sat with Sem and asked how he feels. “I worry all day long about my future,” he said. “Will I die? Is there treatment?”

But Sem still has hope. Learning that he does not have cancer was a great morale boost. And now that he has hope for surgery, he is ready.

I asked what he wants to do once his surgery is complete. “First, I want to go back to school,” he said, “it’s been too long that I can’t go. Next, I want to study the bible and become an Orthodox priest. But I don’t want the church to support me, I want to do business and support myself.

Please start by supporting Sem’s surgery!

Thank you all!

Rick Hodes, MD, MACP
AJJDC-Ethiopia

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