Child with yellow eyes and white stools from birth - A case of Biliary Atresia who survived seven surgeries and a liver transplant.....
Sarah, elder among two siblings, was born on 9th Dec, 2012. She was born to the couple who had a consanguineous marriage.
Sarah had yellow eyes, and passed white stools which were noticed by Dr. Farooq when she was taken for immunization. Sonography at the age of two months revealed Biliary Atresia - a condition characterised by a fibrotic bile duct.
Sarah's parents brought her to Dr. Santosh Karmarkar - Pediatric surgeon at Wadia hospital, who performed the Kasai operation when she was two and a half months of age. Sarah was put on nutritional supplements as she was not taking feeds properly. After this operation, she developed internal bleeding which was controlled by conservative treatment.
Sarah started growing up but not at the pace at which children of her age grew. Though intellectually active, physically she was always weak. While her younger sister started standing and walking, Sarah still could not sit properly. She had to be hospitalized at least four times in a year says Sarah’s mother who managed her single handedly while her husband - the main breadwinner was away in Saudi Arabia for a living...
Dr. Karmarkar had suggested Liver transplant to be only option to improve Sarah health and in 2008, he emphasized that it was needed soon.
Sarah’s Mother says, “The support came from my younger brother, who stood by me, once I made my mind. Trust is very important virtue which we put completely in doctors. Rest all was in hands of God almighty. I never wanted to repent in my life by thinking that, I did not try enough.”
In June 2008, at six and a half years of age, Sarah underwent liver transplant at Jaslok hospital.
It was a live donor transplant, the donor being Sarah’s mother. At the time of transplantation, Sara was weak and malnourished that she could barely walk and was being repaeatedly hospitalised with recurrent attacks of cholangitis and ascites. Her nails were crumpled and turned black in colour from her chronic liver disease
The post transplantation course of Sara was stormy.. she was on ventilator for two days and developed repeated spikes of fever with abdominal distension, for which re- exploratory surgeries of abdomen were done. She had also developed neurological complications like psychosis, tremors and temporary loss of vision which were completely reversed, as the causative factors were controlled.
Sara had improved considerably at the time of discharge and was discharged with proper dietary advice. She was managed by a large team of doctors at Jaslok hospital including Dr Aabha Nagral, Dr Fazal Nabi, Dr Sanjay Nagral, Dr. J.D. Sunavala, Dr. M.M.Bahadur, Dr. Das, along with support of nurses, physiotherapists and dieticians.
Today, at the age of 10 yrs, Sarah appears like any other kid of her age. Happiness shines in her mother’s eyes and she mentions that, no one can make out that my daughter has undergone as much as seven surgical procedures including a Liver transplant. God almighty has given life to my kid, it was her destiny that was written by God, I trusted him, put my faith in doctors and took the decision of liver transplant. She recalls that from hospital she used to give emotional support to the family at home who were worried. Her brother was her source of strength at that time.
As a growing up kid, before Liver transplant, Sarah used to be worried about her yellow eyes; her nails had turned dark coloured almost black. All this completely reversed after Liver transplant.
Sarah, at present goes to a special school, where she has opened up, and is enjoying her activities. At regular school due to her physical weakness to compete with other children, she would feel neglected.
Sarah has developed her interests under the care of teachers from her present school. She is very good at drawing, dances in bharatnatyam dance form, and takes part in dramas. She is a bit shy with doctors, as she relates all her hospitalization and procedures to them and does not talk in front of doctors but is a chatterbox at home, says her mother Sumayya.
Family including her grandmother is extremely happy to see this young kid growing up, and never forget to mention gratitude towards the doctors who took care of Sarah.