MANIKARNIKA
I do not forget this patient; not because I did a miracle surgery but because she is an ultimate fighter. She has come to a long long way, experienced life & death at very young age, tolerated a very difficult time bravely and now she is back to the life.
So, Nidhi (name is changed) is a 17 year old girl, studying in the Arts, falls in love with some one. Parents did not agree but she was firm and committed. She was studying in fashion designing. She left the study for her love, left the city and married to him. After some times, turbulence started in her marriage life. One day the turbulence got converted into the tsunami and she ingested toilet cleaning acid. It burnt her whole throat, food pipe and stomach, she was serious.
The treatment was given, she was stabilized but she could not swallow anything, not even saliva because her food pipe and stomach were gone. Some one put a small pipe in her abdomen into the small intestine through a small operation, so she can be fed through that tube directly into her intestine and she was discharged. Treatment was done by her parents.
It had been 2 years, she could not even swallow her saliva; she has to keep spitting, nutrition was given via that feeding tube on her abdomen. She was losing weight. All this treatment was done somewhere else.
So, when first time she came to me, 4 years ago; a beautiful small little girl, smiling face but deep inside a lot of pain. She was brought to me by her parents. I have never seen her husband or anybody from his side during the treatment. I investigated her and found that her throat, food pipe and stomach were completely damaged and were never going to work again. She asked me whether she could ever be able to eat through mouth!
Now, if you look at the anatomy, wind pipe and food pipe are common in initial part but nature has made such a beautiful mechanism so that when you breath, the air goes into the wind pipe and when you eat, the food goes into the food pipe, any aberration means food into the wind pipe and that can lead to even death. her injury was so high at that common passage of air and food and so practically it was difficult to preserve both routes safely, so if I do surgery and make a new food pipe she needs a hole at the front of her neck and a tube through it in her wind pipe and she has to life time breath through that small tube in her neck (tracheostomy) or she can breath normally and lifetime fed through that tube on her abdomen. Tracheostomy means she can’t speak as well. Choice was hers. It was two years she had tasted anything. She agreed for the food pipe. She selected food over voice. She agreed to the risk of death during the treatment.
I made a new food pipe using a part of her large intestine, brought that new food pipe into the neck through chest, joined it to the remaining part of throat behind the tongue, and a separate hole was made in the neck for breathing. It was a 6 hours surgery. She did well, on 5th day after surgery it was a time for trial of water though mouth. I asked her father to give her sips of water, Nidhi requested me to give the first sip with my hands. She & her parents wanted me to give water. It was an honor for me. I gave her sips of water but she was coughing because that natural mechanism of swallowing was gone, so she needed to re-learn the new way now. I taught her how to re-learn and asked her keep on trying to take water, than gradually increase as she tolerates. The smile on her face was privilege to watch as she started taking orally.
After 3 months of surgery, she was comfortably taking oral food and was gaining weight, she was very happy. But she had a small tube visible from front in her neck for breathing. Can we remove that!! I said her to learn the swallowing well, will think after another 3 months.
After another 3 months, she was fantastic, now there was a time for a trial tracheostomy removal. There was a risk, if she swallows food inside her wind pipe it can lead to death as well. If she cannot swallow safely without tube in her windpipe means that tube would be back and would remain for life time. We kept her in hospital, removed the tube from wind pipe, she was under close watch, she gradually started taking food orally again, she was breathing normally; occasionally she was coughing, that means still something is going into the wind pipe. But within a brief time she re-re-learnt the swallowing and her tracheostomy was out. And now she can speak as well after 6 months! The smile on her face was privilege to watch.
It has been 4 years now, she occasionally visits me. She re-joined the fashion designing course, finished it and now she has started her own work. She occasionally whatsapps me. I occasionally used to annoy her that when is she going to give me some good news. She was back to the normal life. Just 3 days ago, got a call that she has found her soulmate and going to get married soon. I was one of the first person to get informed out of her family.
She fought the whole journey very confidently, and never appeared weak. She is a Manikarnika.