Children waiting for heart surgery | Bangkok Post: learning

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Children waiting for heart surgery

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Thousands of very sick children with heart defects await surgery each year. 20% of them die within one year of their birth. 

heart defect

The picture above is of an Atrial Septal Defect (ASD), a hole between the two "atria" chambers of the heart allowing the flow of blood between the two chambers which causes health problems if not corrected with heart surgery.

Click button to listen to Surgery for Children with Heart Defects and rightclick to download

Heart-rending SCENARIO: State-run hospitals cannot cope with the demand from children who need cardiac surgery. A private hospital group has launched a fund to assist the most urgent cases by Sukhumaporn Laiyok


Each year, between 7,000 and 8,000 children are born in Thailand with heart problems. Doctors don't know what actually causes most of these defects, but think that heredity may play a role.

"In about 15% of cases we know the reason for the defect," [said Dr Kraisorn Juthacharoenwong, a paediatric cardiologist at Samitivej Srinakarin Children's Hospital] "For the rest, the cause has never been ascertained."

Children with genetic defects often have congenital heart defects, with Down's syndrome kids being a classic example. "Half of babies with Down's syndrome suffer from congenital heart defects."

There is also a link between congenital heart defects and the consumption of large amounts of alcohol and certain drugs by expectant mothers. Poorly controlled sugar levels in pregnant women who have diabetes are also associated with a high rate of defects. Mothers-to-be who contract rubella during pregnancy also run a high risk of giving birth to infants with heart defects.

"Street drugs, like amphetamines, can, of course, have a negative effect on unborn children, too," said Dr Kraisorn. "Pregnant women should receive good prenatal care. Screening and diagnostic tests are important. Women carrying babies suffering from serious heart defects may be advised to terminate the pregnancy.

Defects can be structural - a hole in the wall of a heart chamber, for instance, or a malfunctioning valve - or may be related to the way blood flows through the arteries and veins that connect the heart to the rest of the body.

Heart disease can occur in children after birth as a consequence of rheumatic fever, rheumatic heart disease, Kawasaki disease or a coronary aneurysm - a localised enlargement that causes the diameter of a section of artery to swell to more than 1.5 times the size of adjacent segments.

According to Dr Kraisorn, some infants and children with mild heart defects may exhibit few or no symptoms and so may not need treatment. Severe or complex defects that will require medication or surgery can give rise to symptoms such as shortness of breath, rapid heartbeat, sweating, fatigue or a bluish tint to the lips, skin and fingernails.

"Some infants with heart problem may not develop at a normal pace. "They may be smaller or thinner than other toddlers of the same age and they may start sitting up and walking much later than their peers," Dr Kraisorn said.

In many children, a hole in the heart will close by itself. A tiny one may not need an operation. Patients may need occasional check-ups with a cardiologist as they grow to adulthood.

Less serious heart defects can be remedied with medication or by inserting a catheter. Surgery may be the last resort for babies or toddlers with complex and/or severe defects.

"In many cases, a single operation can repair the defect completely. But some patients may require several surgeries over a period of time to fix the defect," the cardiologist explained.

The treatment options available to a child will depend on the types of defects and their severity. Factors also include the child's age, size and general state of health.

Each year, between 3,500 and 4,000 children in Thailand with congenital heart defects need an operation to prevent premature death or major physical underdevelopment. About 20% of them die within one year of their birth.

Due to limitations on medical personnel and facilities, state-run hospitals are only able to perform surgery on 2,000 to 2,500 of these cases. That means that 1,500 to 2,000 very sick children have to go on a waiting list.

Samitivej's Fund for New Life was created to help children in need," said Dr Chanika Tuchinda, chairman of Samitivej Srinakarin Children's Hospital and president of the Samitivej Heart Fund. "The paediatric heart project provides a good opportunity for needy children [both Thai and foreign].

Launched in 2009, the project is a collaboration between Samitivej Hospital and the Cardiac Children Foundation of Thailand. It has set itself a short-term target of helping 60 underprivileged babies and children. That number was chosen to mark the 60th wedding anniversary of Their Majesties the King and Queen. So far 17 youngsters have been operated on, with a 100% success rate

To successfully perform an operation on a young patient with congenital heart defects, we require a team of well-trained medical personnel and an anaesthetist and good staff on the ward, plus all the necessary equipment and facilities. We think we have the ability to do that," said Dr Surangkana Techapaitoon, deputy director of Samitivej Srinakarin Hospital.

Advances in diagnostic and surgical techniques mean that children with cardiac problems have a much better chance of survival than ever before. "Almost every single child with a congenital heart defect who undergoes surgery can grow to adulthood and lead an active life," said Dr Kraisorn. "Many complex congenital heart defects can be cured, but they may need routine or special medical care.

Most children with heart defects run a high risk of contracting bacterial endocarditis. Some may need antibiotics before medical or dental procedures that might allow bacteria to enter their bloodstream.

Regular brushing and flossing as well as visiting a dentist every six months are highly recommended.

Three days after he was born Nong Prin began to breathe more rapidly and his skin took on a bluish tint. It became difficult for his mother to feed him because he would have violent choking fits which would leave him exhausted. As a result of his condition, the infant was not gaining weight and developing as he should.

Chairat Sirikanon is 11 years old. He enjoys school but cannot take part in sports or physical education classes. Any sort of exercise - even playing around with his friends - wears him out. He often gets frustrated with his inability to lead a normal, active life.

These two boys were subsequently diagnosed as having a congenital heart defect.

"Sometimes, my son's heart makes a certain sound," said Ratsarin Saithongthanaphun, Nong Prin's mother.

I got a terrible shock when I was told that my son had a problem with his heart. It was very depressing to learn that he needed an operation to fix the defect. He was only a year and a half old. It was a catastrophe.

That "certain sound", Ratsarin spoke of, is called a heart murmur - a swishing or whistling that is very noticeable if listened to through a stethoscope. It is caused by a defect that changes the way the blood flows through the heart.

"But not all murmurs are a sign of congenital heart defects," said Dr Kraisorn Juthacharoenwong, a paediatric cardiologist at Samitivej Srinakarin Children's Hospital.

Symptoms of congenital heart defects can be detected in newborns a few weeks after birth, he noted. In severe cases, infants' hearts fail and they need urgent medical attention soon after birth. Less severe defects may not be diagnosed until a child grows older.

INFO FOR DONATIONS


You can help children with congenital heart defects by making a donation to the Fund for New Life. The account details are as follows.

Bank: Thai Military Bank Account name: Wachira Medical College Foundation under the Royal Patronage of HRH Crown Prince Maha Vajiralongkorn for Samitivej's Fund for New Life (Paediatric Heart) Savings account no: 196-2-08745-6.

Donations can also be made in person at Samitivej Sukhumvit Hospital, Samitivej Srinakarin Hospital and Samitivej Sriracha Hospital

(Source: Bangkok Post, Heart-rending SCENARIO, State-run hospitals cannot cope with the demand from children who need cardiac surgery. A private hospital group has launched a fund to assist the most urgent cases, 17/05/2011, Sukhumaporn Laiyok, link

Medical Vocabulary

defect - when something is wrong and not right (not put together or formed the right way incorr has a fault, imperfection)
heart defect -
the condition when the heart is not formed correctly
congenital heart defect -
when the heart was not formed correctly (before the baby was born, when they were still in their mother) (See Wikipedia)
Atrial Septal Defect (ASD) - a heart defect that allows the flow of blood between the two "atria" chambers of the heart (See Wikipedia)

heart chamber - the closed areas that the blood passes as it is pumped out of the heart into the blood vessels (See Wikipedia)

surgery (noun) - medical treatment in the patient's body is cut open and diseased or damaged part is repaired, removed or replaced การทำศัลยกรรม, การผ่าตัด (See Wikipedia)
surgical (adjective)

cardiac - related to the "heart"
cardiologist - a heart specialist; a doctor who treats heart conditions แพทย์ผู้เชี่ยวชาญโรคหัวใจ
cardiac surgery - "surgery on the heart and/or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease (for example, coronary artery bypass grafting), correct congenital heart disease [defects], or treat valvular heart disease caused by various things including endocarditis. It also includes heart transplantation" (See Wikipedia)

anaesthesic - a drug given to patients during surgery to prevent them feeling pain  
anaesthesia - the use of anesthetics by doctors during surgery (See Wikipedia)
anaesthetist - a doctor who is an expert in giving patients anesthesia during surgery (administering anesthesia)

heart-rending - when some bad event creates feelings of great sorrow and sadness
scenario - the way that a situation may develop in the future; a possible situation in the future

cope - to deal successfully with a difficult situation, deal with a problem (make it manageable, not always solve problem)  รับมือกับ (See glossary)
demand - the need and desire to buy some good or service by a household or business

launched
- started เริ่มต้นดำเนินการ
fund - a collection of money for some activity เงินทุน กองทุน
urgent - needing to be dealt with immediately ที่เร่งด่วน

heredity -
genetics, the process of children gaining certain features and characteristics from their parents (See Wikipedia)
role - the position, function or purpose that someone or something has in a situation, organisation, society or relationship บทบาท
X plays a
role in Y - X has some purpose or function in activity Y

reason - an explanation of an event, why an event happened เหตุ ; เหตุผล ; สาเหตุ
paediatric - the specialized treatment of the medical problems of children (See Wikipedia)

ascertain - determine, discover or find out what the situation or condition is
genetic - dealing with the genes and common characteristics that are passed from parent to child ทางพันธุกรรม

Down's syndrome - mental retardation, slanted eyes, a small mouth, flat face, short stature and a tendency toward obesity (See Wikipedia and Google Definitions)
classic example -
the example that has been traditionally (for a long time) used to explain some point
suffer - to experience physical or mental pain

link - connect or connection เชื่อม
consumption - using, eating or drinking something การบริโภค
pregnant - when a woman has a baby growing and developing inside the body ท้อง ตั้งครรภ์
expectant mothers - pregnant women
mothers-to-be -
also "pregnant women"
diabetes
- a serious medical condition in which your body does not produce enough insulin to reduce the amount of sugar in the blood โรคเบาหวาน a deadly disease in which you have abnormally high blood sugar levels (See Wikipedia)

contract - to become infected with a disease ติดเชื้อ
rubella - a contagious viral disease that infects the respiratory tract, characterised by a rash of pink dots, fever and swollen lymph nodes, is a milder form of the disease measles and lasts three or four days in children and is slightly more severe in adults; can be damaging to a fetus during the first trimester, also known as German Measles (See Wikipedia and Google Definitions)
pregnancy - when a baby is growing inside a woman
risk - the possibility that something dangerous or unpleasant might happen ความเสี่ยง
run a high risk - do some dangerous activity (in which you might be harmed)

amphetamines -
a synthetic, addictive, mood-altering drug, used illegally as a stimulant (See Wikipedia and Google Definitions)
negative - bad ที่เป็นด้านลบ
prenatal care - medical and nursing care for women before and during pregnancy (which should follow certain recommended guidelines) (See Wikipedia)
screening - testing for a certain condition
diagnostic tests - tests on the patients blood, urine, etc ordered by the doctor to determine the disease or health problem (diagnosis)
suffering - physical or mental pain or problems ความทุกข์ทรมาน
terminate - end or stop ทำให้สิ้นสุด

structure (noun) - the form and shape of something, the way it is built, the way it is put together with parts
structural (adjective) 

blood vessels -
the narrow tubes that blood flows through in the body (two kinds: veins, arteries)
heart valve -
a door or gate that controls the flow of blood entry into the heart and exit out of the heart and passage between chambers (atrium to ventricle), there are four valves in the human heart (See Wikipedia)
malfunction - not working correctly, not working in the right way
malfunctioning valve - a heart valve that is not working in the right way
arteries
- a blood vessel (tube) carrying blood away from the heart to the tissues and organs of the body and the lungs (See Wikipedia)
veins -
a blood vessel (tube) carrying blood back to the heart (See Wikipedia)

X as a consequence of Y - Y caused X

rheumatic
fever - a noncontagious acute fever marked by inflammation and pain in the joints, mostly affects young people, caused by a infection by streptococcal bacteria (See Wikipedia)
contagious -
a disease that easily passes from one person to another person
acute -
happening suddenly (not developing over a long period of time)
rheumatic heart disease -
worldwide rhematic fever is responsible for damage to heart valves which can have a permanent negative effect on the health of a person's heart (See Wikipedia)
Kawasaki disease - an autoimmune disease occurring mainly in young children, giving rise to a rash, glandular swelling, and sometimes damage to the heart (See Wikipedia and Google Definitions)
autoimmune disease - "diseases aris[ing] from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body actually attacks its own cells. The immune system mistakes some part of the body as a pathogen and attacks it" (See Wikipedia)

aneurysm - a weakening and widening (dilation) of a blood vessel wall (which makes the blood vessel more likely to split (burst, rupture)
coronary aneurysm - a coronary artery aneurysm (See Wikipedia)
coronary artery - the blood vessels that supply the heart muscle itself with blood (See Wikipedia)

localised enlargement - something growing bigger (enlargement) in one small area (local)
fever - an abnormally high body temperature ไข้
diameter - the length of a straight line that reaches from one point on the edge of a round shape or object, through its center, to a point on the opposite edge เส้นผ่าศูนย์กลาง
artery - one of the thick tubes that carry blood from the heart to other parts of the body เส้นโลหิตแดง
swell - to become larger than normal
adjacent - very near, next to, or touching ติดกัน

infant - baby

mild -
light, not severe, a very small amount
symptom - something that is wrong with your body that shows or indicates that you have a disease
mild symptom - a light symptom, not a severe symptom

treatment
- the process of providing medical care การรักษา
complex - when something is difficult to understand because it has many parts connected in many ways 
medication - a medicine, or a set of medicines or drugs used to improve a particular condition or illness

shortness of breath -
dyspnea, air hunger, when it difficult to get enough air through breathing, "a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations.[2] In 85% of cases it is due to either asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease, or psychogenic causes" (See Wikipedia)

rapid
- very fast อย่างรวดเร็ว
rapid heartbeat - when the heart beats very fast
fatigue - being tired, having no energy 
tint -
colour
bluish tint - bluish colour

pace - the speed at which something happens ท่างทำนอง ย่างก้าว จังหวะ ที่สิ่งต่างๆ ดำเนินไป (See glossary)
develop at a normal pace - grow at the normal speed
toddler - a baby that is just learning to walk
check up - a regular physical health examination, to make sure a person has no health problems, should have check ups more often as you grow older (See Wikipedia)
occasional check-ups - sometimes having a check (but not often)
operation - surgery

cardiologist - a heart doctor
adulthood
- the state of being an adult (either legally, biologically, responsibilities, etc), (opposite of: childhood) 
peers - people with the same age, job, or status as you เพื่อนร่ีวมสาขาอาชีพ people or organisations at the same level and position but in a different place
remedied - a cured health problem
medication
- medicine taken to cure a disease or relieve a health condition
catheter - a tube used to put liquids into the body or take liquids out
inserting a catheter - put a tube for liquids into the body
last resort -
the last thing done (after everything else fails)
severe - very serious and worrying ที่รุนแรง ที่น่าเป็นห่วง

repair - to fix something that is broken or damaged ซ่อมบำรุง
fix - repair  
options - choices ทางเลือก
treatment options - possible ways to treat a disease to cure it
state - condition สภาพ
general state of health - whether the whole body is healthy or not 

premature - happening too soon or before the usual time ก่อนเวลาอันควร
premature death - when a person dies before they would normally die (especially a child)
physical underdevelopment - not growing to the size normal for their age (height and weight below normal)

personnel - the people who work for a company or other organization
medical personnel - highly skilled and trained workers who work on different parts of medical treatment (doctors, nurses, physical therapists, Pharmacists)
facilities - the buildings, equipment and services provided for a particular purpose สิ่งอำนวยความสะดวก
opportunity - a situation when it is possible to do something that you want to do (See glossary)
needy - not having enough money, food, clothing, etc. ยากไร้

collaboration - when people work together to achieve a goal
target - a goal เป้าหมาย
underprivileged - not having as many advantages or opportunities as most other people ด้อยโอกาส
mark - to celebrate something ฉลอง (also to commemorate some event in the past)
anniversary - a date when you celebrate something that happened in a previous year that is important to you วันครบรอบ

patient - someone who is receiving medical treatment คนป่วย, คนไข้
staff - workers, employees พนักงาน
ward - a room in a hospital with beds for many people
deputy - a person who is given the power to do something instead of another person, or the person whose rank is immediately below that of the leader of an organisation รอง, ตัวแทน,ผู้รักษาการแทน

X diagnosed as Y (verb) - a doctor believes that patient Y has disease or medical condition Y 
diagnosis (noun) - the disease or medical condition that the doctor believes that patient has
diagnostic (adjective) 

techniques - methods of doing a task or activity เทคนิค
chance - what happens when you don't control events (example: gambling = games of chance)
active - working, operating, doing its job
routine - the usual series of tasks that are done as part or a job or work กิจวัตร

contract - contract a disease, catch a disease from another person  
bacteria (noun) - very small living things (some bacteria cause diseases in humans)
bacterial
(adjective)  
endocarditis - inflammation of the inner layer of the heart or endocardium (See Wikipedia)
antibiotics - a drug that kills or inhibits the growth of bacteria (See Wikipedia)
bloodstream -
all the blood that flows around your body

brushing -
brushing the teeth with a toothbrush

dental floss
(noun) - a piece of string used to clean between the teeth เส้นใยขัดฟัน
flossing - the activity of using dental floss to clean the spaces between your teeth
highly recommended - people say it is very good and you should try it

violent - involving the use of physical force, with the intention of causing damage to property or injury or death to people ความรุนแรง
violent - involving the use of physical force, with the intention of causing damage to property or injury or death to people รุนแรง

choke
(verb) - when air is blocked and can't pass into the lungs (will quickly result in death if it does not stop)
fit
(noun) - sudden uncontrolled movements (sometimes with loss of consciousness)
violent choking fits - sudden uncontrolled choking

leave him exhausted -
caused him to be tired and exhausted after it stopped
exhausted - extremely tired เหน็ดเหนื่อย, เหนื่อยอ่อน
condition - health condition (meaning: health problem)
infant - a baby or a very young child ทารก, เด็กอ่อน

take part in - join an activity, be part of an activity
take part in sports - join in sports activities (example: play football with friends, go jogging in the health park)
physical education - the subject in school in which children learn to play sports
frustrated - want something but cannot get it, feeling annoyed and impatient because you are prevented from achieving something ผิดหวัง,ท้อแท้ใจมาก, หงุดหงิดใจ
wears him out -
makes him tired 
subsequently  - later on, after a period of time passed

shock -
the bad feeling that you feel when something bad suddenly happens to you (including surprise, being upset, unbelief, etc)
got a terrible shock -
was very shocked by some bad event
catastrophe - an event causing great damage and suffering, a disaster 

murmur -
a very low soft sound (that is difficult to hear)
heart murmur -

swish - the soft sound something makes moving quickly through the air or water
whistle - a loud high sound ผิวปาก

noticeable -
very easy to see or hear
stethoscope -
the device that a doctor uses to listen to the sound of a person's heart and other sounds in the body when checking their health (check up) (See Wikipedia)
detected - noticed, discovered or found out จับได้ พบได้
need urgent medical attention - (medical problem) needs to have the doctor look at it right now (without delay)

donation - money or goods that you give to an organisation, especially one that helps people เงินหรือสิ่งของบริจาค
account - bank account, a place where a person or business deposits and keeps their money 

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