Today

Today, I spent a sobering afternoon visiting two private hospitals.

My unborn nephew, due early next year, was diagnosed yesterday with hydrocephalus, and the parents-to-be are understandably distraught.

We sought second, third and fourth opinions from various paediatric and ob/gyn specialists at both hospitals, and with each progressive consultation, one of the burning questions that kept bubbling to the surface was: shouldn't this have been detected much earlier by the first opinion? The last specialist consultant we visited appeared to be sorely tempted to drop hints about possible malpractice, but would not say it outright. J was particularly unhappy about how the first conducted himself.

Q: What is the prognosis?

The prognosis for patients diagnosed with hydrocephalus is difficult to predict, although there is some correlation between the specific cause of the hydrocephalus and the patient's outcome. Prognosis is further complicated by the presence of associated disorders, the timeliness of diagnosis, and the success of treatment.

Thankfully, scans so far show that my nephew doesn't seem to have any other disorders associated with hydrocephalus. The less to worry about, the better.

... Affected individuals and their families should be aware that hydrocephalus poses risks to both cognitive and physical development. However, many children diagnosed with the disorder benefit from rehabilitation therapies and educational interventions and go on to lead normal lives with few limitations.

There is a very real chance of development retardation - the accumulated fluid in the ventricles would put pressure on his brain mass and potentially hamper its growth. So the sooner the fluid gets drained away, the better.

At this stage of the pregnancy, unfortunately, my nephew's lungs are far from mature. To take him out of the womb now would guarantee at least a month in intensive care - a burden that would probably bankrupt the couple. The ob/gyns also advised that the chances of survival are higher if the foetus remains in the womb longer; ICU time (and hence charges) would also probably be lower.

But the killer question, then, is whether to leave the foetus inside and risk further damage to his development, or take him out early to get the shunt procedure done ASAP while risking the plethora of complications (and costs) associated with severely premature births? There's no easy answer to this one.

The case was referred to KK by one of the private ob/gyns, since in his opinion, their (KK's) multi-disciplinary team would be better equipped to handle the situation in case multiple complications arise. Also, the savings due to government subsidies will ease the financial burden substantially.

I pray that my nephew will be all right.

Today, I turn thirty, and I am very thankful for what I have been blessed with.