One thing that is always difficult about clinic day is determining what surgeries we can realistically do for the patients, especially if they have more than one condition. Here you’ll see a picture of Carlos, the cutest little boy who came in with his parents for a cleft palate and deformities of his hands and feet. Carlos is 18-months old, and has difficulty eating because of his wide open palate. His hands have multiple fingers fused together (syndactyly), but his right hand is more serious because of fusion between his thumb and forefinger, which is causing a major deformity of his fingers. Without correction, Carlos won’t be able to write, play baseball, or comb his hair. Because of his multiple anomalies, he will require numerous reconstructions of his palate and hands in the future. So Carlos was scheduled for surgery immediately.
Unfortunately, Carlos’s surgery was cancelled because of severe iron-deficient anemia, making surgery very risky. His parents told me that because of his cleft palate, it is very difficult for him to eat solid foods, so he still drinks milk for the majority of his calories. And, at his age, this is not enough for him to get the iron, vitamins, and calories he needs. But, our pediatrician counseled his parents about nutrition, and how they can introduce more substantial items into his diet. He will be scheduled again next year when the team returns (Interplast comes to Cusco every year around the same time), so hopefully he will be strong enough for surgery next year.
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