Thursday, October 06, 2005

Oya and Hydrocephalus

Hilly Bogor

At the weekend I motored over to St Francis Hospital to meet a Dr Alex who had by then examined the little girl. I wanted to hear from him the details of Oya’s illness.

"It’s Hydrocephalus. Water on the brain," said Dr Alex. "An abnormal accumulation of cerebrospinal fluid within the ventricles."

"Hence the massive head." I said. I had no idea what ventricles were.

"And symptoms such as headache, vomiting, lethargy and loss of memory."

"So what’s to be done?" I asked.

"The treatment is to implant something that diverts fluid from the brain into the abdominal cavity. There’s a tube and a valve and a catheter."

"Is it necessary to have the surgery?"

"In this case, yes."

"Is it expensive?"

"Yes."

"Does the mother want the child to have the operation?"

"She does."

"OK," I said, "if you’re sure it’s necessary."

~

Min was having one of his depressed days. He didn’t want to talk.

"It’s day about with Min," said Wardi, as we sat in the front room of their little brick house.

"One day happy, one day sad."

"What about some music?" I said.

Wardi turned on the radio and found a music channel. Min began to smile just a little. Then he stood up and swayed to the music. He still looked as if he might have a migraine.

"And how are you?" I asked Wardi. "Missing your wife?"

"She’s back." He gave a big smile.

"I’m pleased."

"How’s the little girl with the big head?"

"Oya’s in hospital for her operation," I said. "Do you know the mother?"

"I’ve seen her around," said Wardi, frowning.

"What about the father?"

"Oya’s mother has a new boyfriend."

Naively, I hadn’t thought enough about possible complications. What sort of person was the mother? Would the new boyfriend want to look after Oya? Would there be any complications from the surgery? Would the mother keep in touch with the hospital as the years went by? Should we have gone ahead with the operation?

After leaving Min, I went to see Dr Handoko at the Kuningan Medical Centre.

"You know there is no cure for Hydrocephalus," said Dr Handoko. "These people usually die young."

"What about surgery?"

"It’s not a cure, but it should prolong the life of the patient a bit and it should reduce the suffering. I know one gentleman with Hydrocephalus who’s now in his thirties."

"Is the implant necessary?"

"If the symptoms are serious, such as enlarged ventricles, the patient must be treated. Otherwise there will be a further deterioration."

"What are the complications?"

"Same as with any surgery. Infection, malfunction of the implant and so on."

I went to see Oya at the St Francis Hospital. She had had her operation and was attached to tubes. There was no sign of the mother. A woman, who was one of Oya’s neighbours, was sitting at the bedside.

"How’s Oya?" I asked the nurse.

"Fine. Had her operation."

"The head still seems large," I said.

"Yes. The operation reduces pressure on the brain but it’s not a cure. There is no cure."

"I see." I supposed Dr Alex hadn’t promised any miracles. He probably hadn’t told me enough.

"The mother," whispered the nurse, "has not been in here once. A lot of the time the child has been on her own. Not been in even once."

No comments: