Haleh Badkoobehi:
Naira is a sweet little girl who came to us from Mexico with deformities of both of her feet, and she wanted both of her feet to be corrected so she could walk like all of the other little kids that she would see.
Haleh Badkoobehi:
When Naira was born, she was born with a condition where her spinal cord didn't fully form. And so due to that, she couldn't actually feel or move her feet. Over time, she developed deformities of her feet, where her feet were curved in, and she couldn't be put in braces, and she couldn't actually walk on them. She had been operated on multiple times in Mexico, and her deformity did not actually get corrected. And so instead of being able to walk, Naira had to walk on her knees, and in walking on her knees, she would drag her feet underneath her, and she developed a large sore on one of her feet that became infected. So when Dr. Cho accepted her to come to us, I was able to see Naira, and noted that she had a very bad infection that would make deformity correction not possible. So our first step was to treat her infection, and that took a team. Our pediatrics doctor, Dr. Raam, worked with our infectious disease affiliates to place her on antibiotics that would treat the infection.
Manu S. Raam:
Naira has a condition called spina bifida, which is a birth defect affecting her spinal cord and her spine. And one of the problems that can occur in spina bifida is that the nerves that carry sensation information back from her legs get interrupted on the way back to the brain. And so patients like Naira can't feel anything below the level of their knees. When this happens, they're vulnerable to problems like pressure ulcers, and that's exactly what happened with Naira. She developed a pressure ulcer on her right ankle. It became gradually deeper and deeper, to the point where the underlying bone was exposed directly to the air and the environment. Then the ulcer became infected, and that resulted in an infection of the underlying bone as well. And that's called osteomyelitis.
Haleh Badkoobehi:
Once the infection was clear, which took a long period of time, she was left with a skin defect on the side of her foot, from where she would drag her foot. So at that point, our plastic surgery team evaluated the patient and helped with planning for surgical repair of this defect. I then took Naira to the operating room and was able to correct her feet, so now she has flat feet that you can move and place in braces. Her skin defect is gone and her infection has been managed. And so she's with our physical therapists learning how to walk, and so she came to us with a really bad infection, unable to walk with a wound on her foot and deformities that weren't corrected by other people's surgeries, and we were really able to provide her with everything she needed to get back up on her feet and out playing with all the other little kids.
Haleh Badkoobehi:
Shiners has become her family, and her family away from her family. And because her care is multidisciplinary, many of us interface with Naira and her mother. And so she has a great relationship with many of us, and it's been delightful to see.
Manu S. Raam:
Because of her personality, she has very strong favorites and likes and dislikes, and so she's already identified many of the nursing staff that she likes very much, and she knows them on a first name basis. And so I think, it's no substitute for a real family, but I think she's really bonded very well with our staff here.
Haleh Badkoobehi:
I just feel very fortunate to work in an institution like this one, where we have the resources to be able to treat kids and really to be able to give kids back their feet, their life, some sort of normalcy. And it really took a team. While I'm her primary surgeon, it was absolutely imperative to have Dr. Cho be the person that accepted her to come in for plastic surgery, to manage her wound on her foot, for our pediatrics team to manage her medically, for both her infection in her foot and also her skin infection, and for our affiliates as well. And without an institution like this one with all of these different resources, this wouldn't be possible. So I feel as fortunate as Naira.
