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Sunday, January 8, 2006
Surgery completed on Baby Noor
The Atlanta Journal-Constitution
The surgery on three-month-old Noor al-Zahra of Iraq went better than expected, her doctor said Monday afternoon.
Baby Noor, as she has come to be known, may have a second procedure Wednesday if fluid builds up in her brain, as is common in similar cases of spina bifida, said Dr. Roger Hudgins of Children’s Healthcare of Atlanta.
“She just radiates good feeling,” Hudgins said. “We’ve gotten to the point where we love this child.”
Hudgins and a colleagues operated on Baby Noor Monday morning. He said he hopes Noor will be developmentally and mentally normal, though she will require a wheelchair and have limited control of her bladder and bowels.
The surgery was undertaken to repair a portion of 3-month-old Noor al-Zahra’s spinal cord that did not fully form during her mother’s pregnancy. They also hope to remove a mass of skin that has grown up around the cord.
The doctors predict success but envision Noor spending her life in a wheelchair with limited control of her bladder and bowels.
“Our best scenario is that she will be a paraplegic,” said Dr. Roger Hudgins, the hospital’s top neurosurgeon, who will perform most of the surgery.
Yet, her future has brightened immeasurably since Georgia National Guard soldiers in Iraq discovered her on a raid last month. Iraqi doctors told Noor’s family they could not help her and that she would likely not live long.
Soldiers from a Gainesville-based unit of the 48th Brigade Combat Team made connections that led to today’s surgery.
“She’s as personable as any 3-month-old I’ve ever seen,” Hudgins said. “She’ll grab your finger. She coos and does all the right things.”
He said he has explained the surgery to Noor’s father and grandmother, who accompanied her to Atlanta.
“The questions they asked were very thoughtful and insightful,” he said. “They got it as well as any parent would get it.”
Hudgins said there is “a 99 percent chance” Noor will survive. He planned to repair the damaged spinal cord, put it in its proper place and remove a mass of skin about 5 inches long and 3 inches wide.
“That skin makes the surgery technically difficult,” he said, “but it’s probably what saved her life.”
Noor suffers from a severe form of spina bifida, an ailment that caused part of her spinal cord to protrude through her back. Hudgins said he believes the skin that encased her cord helped prevent infection.
Intense follow-up needed
Hudgins said doctors and nurses will monitor Noor for signs of a fluid build-up in her head and back, which happens in roughly 90 percent of similar spina bifida cases. If fluid does accumulate, Hudgins plans to perform a second surgery Wednesday to insert a shunt, a type of drainage tube.
At some later date, Hudgins said, doctors at Children’s Healthcare probably will perform a third surgery to reposition Noor’s bladder and let urine empty through an opening doctors will create below the baby’s belly button.
Children’s Healthcare of Atlanta, which is donating its medical services to Noor, keeps tabs on several hundred spina bifida patients at any given time. Noor stands out because she suffers from a severe form of the birth defect and because she will need intense follow-up care after returning to war-torn Iraq.
Someone will have to monitor the shunt Hudgins expects to insert in Noor. If it clogs and fluid builds up, Noor could die, Hudgins said. In Iraq, she will need access to a neurosurgeon able to unclog the shunt if problems surface. In addition, she will need to see a urologist to deal with whatever bladder issues may arise, he added.
Her family, like relatives of anyone with paralysis, will have to keep an eye on Noor to make sure she has not accidentally hurt her legs, where she has no feeling. Doctors at Children’s Healthcare have treated paralyzed patients who were accidentally cut or burned but did not immediately know it.
Noor also is at risk as she gets older of developing scoliosis, or curvature of the spine, Hudgins said.
“This child is going to have a long, hard road,” said Jim Okula of Atlanta, past president of the Spina Bifida Association of Georgia. “What is the health care going to be like in Iraq?”
Malady gets attention
Though precise figures have proven elusive, Okula said, the association estimates that 1,100 to 1,700 people in Georgia suffer from spina bifida. Parents with affected children often have trouble paying medical bills. Those who live far from Atlanta may have a hard time reaching a spina bifida clinic held several times a month at Children’s Healthcare.
One positive aspect of the Baby Noor case, in Okula’s view, is that more people are hearing about spina bifida, which occurs in roughly one of every 2,000 live births in the United States, according to the March of Dimes.
Baby Noor’s case has given the association a chance to tell people how to prevent spina bifida — women who plan to become pregnant should take folic acid in a supplement or by drinking orange juice or eating oranges, dried beans and legumes, or leafy green vegetables.
“This is indeed helping us raise awareness,” Okula said.
‘Hard road’ for Baby Noor
The Atlanta Journal-Constitution
The Iraqi baby who just last month seemed consigned to die in a slum near Baghdad is to undergo what surgeons call a life-saving operation this morning at Children’s Healthcare of Atlanta.
Doctors hope to repair a portion of 3-month-old Noor al-Zahra’s spinal cord that did not fully form during her mother’s pregnancy. They also hope to remove a mass of skin that has grown up around the cord.
The doctors predict success but envision Noor spending her life in a wheelchair with limited control of her bladder and bowels.
“Our best scenario is that she will be a paraplegic,” said Dr. Roger Hudgins, the hospital’s top neurosurgeon, who will perform most of the surgery.
Yet, her future has brightened immeasurably since Georgia National Guard soldiers in Iraq discovered her on a raid last month. Iraqi doctors told Noor’s family they could not help her and that she would likely not live long.
Soldiers from a Gainesville-based unit of the 48th Brigade Combat Team made connections that led to today’s surgery.
“She’s as personable as any 3-month-old I’ve ever seen,” Hudgins said. “She’ll grab your finger. She coos and does all the right things.”
He said he has explained the surgery to Noor’s father and grandmother, who accompanied her to Atlanta.
“The questions they asked were very thoughtful and insightful,” he said. “They got it as well as any parent would get it.”
Scheduled to begin at 7:30 a.m., the surgery probably will last two to three hours. Hudgins said there is “a 99 percent chance” Noor will survive. He plans to repair the damaged spinal cord, put it in its proper place and remove a mass of skin about 5 inches long and 3 inches wide.
“That skin makes the surgery technically difficult,” he said, “but it’s probably what saved her life.”
Noor suffers from a severe form of spina bifida, an ailment that caused part of her spinal cord to protrude through her back. Hudgins said he believes the skin that encased her cord helped prevent infection.
Intense follow-up needed
If today’s surgery goes well, Hudgins said, doctors and nurses will monitor Noor for signs of a fluid build-up in her head and back, which happens in roughly 90 percent of similar spina bifida cases. If fluid does accumulate, Hudgins plans to perform a second surgery Wednesday to insert a shunt, a type of drainage tube.
At some later date, Hudgins said, doctors at Children’s Healthcare probably will perform a third surgery to reposition Noor’s bladder and let urine empty through an opening doctors will create below the baby’s belly button.
Children’s Healthcare of Atlanta, which is donating its medical services to Noor, keeps tabs on several hundred spina bifida patients at any given time. Noor stands out because she suffers from a severe form of the birth defect and because she will need intense follow-up care after returning to war-torn Iraq.
Someone will have to monitor the shunt Hudgins expects to insert in Noor. If it clogs and fluid builds up, Noor could die, Hudgins said. In Iraq, she will need access to a neurosurgeon able to unclog the shunt if problems surface. In addition, she will need to see a urologist to deal with whatever bladder issues may arise, he added.
Her family, like relatives of anyone with paralysis, will have to keep an eye on Noor to make sure she has not accidentally hurt her legs, where she has no feeling. Doctors at Children’s Healthcare have treated paralyzed patients who were accidentally cut or burned but did not immediately know it.
Noor also is at risk as she gets older of developing scoliosis, or curvature of the spine, Hudgins said.
“This child is going to have a long, hard road,” said Jim Okula of Atlanta, past president of the Spina Bifida Association of Georgia. “What is the health care going to be like in Iraq?”
Malady gets attention
Though precise figures have proven elusive, Okula said, the association estimates that 1,100 to 1,700 people in Georgia suffer from spina bifida. Parents with affected children often have trouble paying medical bills. Those who live far from Atlanta may have a hard time reaching a spina bifida clinic held several times a month at Children’s Healthcare.
One positive aspect of the Baby Noor case, in Okula’s view, is that more people are hearing about spina bifida, which occurs in roughly one of every 2,000 live births in the United States, according to the March of Dimes.
Baby Noor’s case has given the association a chance to tell people how to prevent spina bifida — women who plan to become pregnant should take folic acid in a supplement or by drinking orange juice or eating oranges, dried beans and legumes, or leafy green vegetables.
“This is indeed helping us raise awareness,” Okula said.
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