viernes, 7 de mayo de 2010

La luz al final del túnel...

Short Bowel; Infant; dob 08 April, 2010; Quito, Ecuador‏

De: Kim Sterneberg (

Enviado: Viernes, 07 de mayo de 2010 3:29:19
Para: Fernando Agama Cuenca (; Fernando Agama Cuenca
CC: Helen Salan (

Re: Short Bowel Syndrome Neonate—Quito, Ecuador

Dob 08 April, 2010

Dr. Agama,

Hello. I tried calling you this evening with a cell phone number (59398831967) that Steve Diamond gave to our director, but my Spanish is limited and a very nice lady on the other end didn’t speak English.

Thank you for your email with the list of weights and photos. I made contact today with Dr. Samuel Kocoshis. He is the medical director of the Small Bowel Transplantation Program at Cincinnati Children’s Hospital Medical Center. Your pictures were extremely helpful. He is interested and wants to present this case to his department. He said from the pictures it appears that there is a very good chance of “bowel rehabilitation.” He said that whether or not this is possible or, if a transplant is what is needed; either situation would require a lengthy stay and close follow up. But again, he was very encouraged by what he saw.

There is a department meeting at noon on Monday where he will present the case and has asked me to be present. I am happy to go to the meeting and address any of the concerns I can. Some concerns and questions he raised regarding the acceptance by the department are:

1. ‘social’ care for the baby while here (they wouldn’t want the baby to become the sole responsibility of the hospital or have a family member of the baby change their mind during mid-treatment),

2. gaining approval for the length of time the baby would need to be here by our two governments,

3. care for the baby upon return to Ecuador,

4. and, of course, financial.

To the points he raised:

1. ‘social’ responsibility—I assured him that HTC would provide a host family and any general pediatric care not related to the case. We assume that a family member would not be accompanying the child. We already have a very experienced host family that has agreed to care for the baby.

2. gaining government permission—Helen Salan (HTC director) is very experienced obtaining medical visas and government documentation. She will need a contact in Ecuador to complete paperwork on your end. Dr. Kocoshis was relieved that the hospital wouldn’t have to do this.

3. care for the baby upon return—I assume ‘yes,’ with the medical care and commitment you have already shown this baby. But Dr. Kocoshis said that they have had cases where the medical and financial support fell apart upon children returning to their home countries. I’ll also be able to tell them that Steve Diamond has a long term relationship with the medical community in Quito. Return would not be for 2+ years from now, but this is one of the concerns he wants me to cover at the meeting.

4. Financial—Is Ecuador still willing to finance the medical care of the baby? Steve Diamond and our director, Helen, will be talking about the financial details for the hospital care and medical transport. Unfortunately, this will be an important detail for the medical team to have this case accepted by the hospital administration. I will need input from you, Steve Diamond and Helen Salan about how to proceed here. The host family and all other general pediatric care are at no cost, but the hospital and procedures…

At least this case is moving forward at Children’s. I’m not sure what we’ll know after the meeting on Monday, hopefully good news.

Your last correspondence was very helpful; could you please provide an update on the baby over the weekend? Also, if you have anything to add or questions regarding the points above, please feel free to contact me by email or phone—or contact Steve Diamond or Helen Salan. We want to help make this happen. I’ll add contact information at the bottom of this email.

Again doctor, thank you for taking care of this infant.


Steven B. Sterneberg, M.D.