The October trip was cancelled, in large part because of
Hurricane Norbert, which crossed the southern Baja Peninsula
the weekend of our trip. Fortunately, Mulege escaped any
Prior to the October trip, during the week of September 10-14, Aeromedicos was
involved in a very rewarding case of a young boy, Brandon, from San Juanico,
Baja California. Dr. Vallee had seen Brandon and his mom Elisabeth in the clinic
about three years earlier, when it was learned that Brandon was born with an
imperforate anus. That is a birth defect where the end of the colon does not
make the final connection to the exterior of the anus. At birth the child was
given a colostomy and tests were later done to see if it was possible to surgically
attach the colon and achieve a functional system. During this process, the father
left, the mother lost her job, and consequently lost the medical benefits that
could have helped Brandon.
Because we had not seen or heard any more about Brandon, it was assumed that
the young boy had been helped somewhere. However, this August, one of our volunteers,
Mike Nizec, found out that nothing had been done and that the colostomy was in
need of repair. Pictures taken by Mike showed the hyperplastic tissue around
the colostomy to be in need of some aid.
Dr. Vallee agreed to go down on a special trip to evaluate Brandon. Meanwhile,
contacts were made to try and find a suitable place where some sort of surgery
could be performed. Since passports and visas were not available and would take
too long to obtain, it was decided that a Mexican hospital would be the best
opportunity to fix the colostomy.
One of our contacts, Liga, a flying group that does great work in Sinaloa and
whom we have assisted in the past, emailed us that they were having a clinic
in Tijuana on Sept 13 at a Catholic hospital and had the anesthesiologist and
OR time but needed a surgeon. Brandon was evaluated by Dr. Vallee on the weekend
of August 29, at which time Dr. Vallee saw a normal, healthy young kid, ready
for a new directions. Meanwhile, Dr. Gayou asked Dr. Tamir Keshen, a pediatric
surgeon, if he would be interested in helping. Fortunately for all concerned,
the answer was, “ yes”!
The next step was to insure that the mother and child were in Tijuana prior to
the date of the surgery. To that end, several of our pilots volunteered to make
the trip. It was finally decided that Craig Arcuri would be the first pilot with
Peter Lewis as back up. As the date grew near, a tropical storm, with a predicted
landfall close to the Cadeje landing strip, threatened to wreck our plans. By
contacting Dave Steibel in San Juanico, we were able to get the mother and Brandon
to Guerrero Negro for pickup on Thursday before the surgery.
One last glitch, a leak in a fuel tank on Craig’s plane, meant that he
could not use his plane. After a quick conference with Craig I found out that
he had sufficient C210 time so I agreed to loan him my plane to make the trip.
We met at the hanger to go over the plane where I found to my chagrin that the
master switch had been left on and the battery needed charging. That problem,
fortunately, was an easy fix and Craig was off the next morning early with Bob
Nussbaum, whose job was to arrange accommodations and chaperone Elizabeth and
Brandon while in TJ.
Friday afternoon Dr. Keshen, Dr. McFarland, and I met at the plane and flew to
Tijuana. At the hotel, Dr. Keshen got his first look at the young boy’s
situation. As the discovery process progressed, it started to appear that maybe,
instead of just a colostomy repair, the pass thru of the colon to the anus could
be undertaken if an x-ray showed favorable positioning of the colon and the anus.
The next step was to meet at the hospital to evaluate the OR and find needed
instruments. A phone call to Mike Nizec in San Diego was made to have him stand
by to run down any essential surgical tools and deliver them, if needed, to the
hospital. To everyone’s relief, the hospital was well equipped with both
the needed surgical supplies and the x-ray capabilities.
Brandon was admitted to the hospital, with mother spending the night by his side,
and the surgery was scheduled, conditional on the outcome of the x-ray.
The next morning the x-ray showed that the colon was indeed in a favorable position
and the pass thru surgery was begun at about 9:30 am. After almost 5 hours in
surgery by Dr. Keshen, with Dr. McFarland assisting and a great OR team, the
first step was complete. The colon had been connected to the anus!
There was a follow-up appointment at the hospital 2 weeks after the surgery and
mom was been given instructions and dilators the help the muscles recover. If
all goes well, the closure of the original colostomy will be done at the same
hospital in January.
This has been a great experience and there has been fantastic support and teamwork
by a number of individuals, all working hard toward the same goal. The following
is a list of all involved.
Thanks and great job, everyone! John Grube DDS Director Aeromedicos of Santa
Pediatric Surgeon: Tamir Keshen
MDs: Eric McFarland
; John Vallee , Bob Gayou , Irlanda Diaz
Anesthesiologist: Mahfous el-Tawil (Tawil)
OR nurse: Donna
Interpreter: Lala Gutierrez
Pilots: Craig Arcuri, John Grube
Ground Crew: Mike
Nizec ; Dave Steibel ; Bob Nussbaum ; Frank Mora (Tijuana
The Entire Staff of Hospital Sagrado Corazon Tijuana
Mexico: A competent well run facility with a great
even a sense
of humor that
comes with a
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