Karien Pieterse

 

Karien Pieterse is die baba dogtertjie van Pieter en Ansie Pieterse wat woonagtig is in Port Alfred.

Karien is gebore op die 23ste Desember 2010 met  ‘n malformasie bekend as  Kloaka. (“Cloaca” in engels)

Reeds met die aand van haar geboorte was daar al soveel probleme. Sy het ‘n maand te vroeg in die wêreld gekom omrede daar amper geen vrugwater om haar was om haar te beskerm nie.

Haar onderontwikkelde longetjies  het twee keer opgehou funksioneer. Al haar afval stowwe en urine het in haar baarmoeder opgegaar. Die buik was so geswel dat dit die longe vasgedruk het.

Die dokters het min hoop vir haar herstel gehad en daar was vir die ergste gevrees.

Na baie intense sorg en gebede het sy wel bly leef.

Die volgende aand het sy en haar pappa van Port Elizabeth met ‘n noodvliegtuig na Kaapstad gevlieg waar sy opgeneem is in Vincent Pallotti Hospitaal.

Haar longetjies was erg verswak en sy was op ‘n respirator gekoppel. Op pad na die hospitaal het sy geweldige asemhalings probleme ondervind en is daar gevrees dat sy nie die hospitaal lewendig sal haal nie.

Deur die Genade het sy wel oorleef.

Sy is Kersoggend, die 25ste Desember 2010 geopereer om die geweldige swelling in haar buik deur ‘n kateter en ‘n kolostomie te dreineer.

Elke dag het sy eie eise en vrese opgelewer en sy het vir drie weke in intensiewe sorg deurgebring.

Sy is ontslaan en saam mamma en pappa huis toe, Port Alfred toe.

Daar is ook vasgestel dat Karien net een nier het en dit veroorsaak nou op ses-maande groot probleme - Karientjie groei nie .

Sy het tot op vier maande gegroei en het toe slegs 4,7 kilogram geweeg.

Sy tel sedertdien geen gewig op nie en groei in lengte glad nié.

Na nuwe mediese toetse is vasgestel dat haar niertjie baie siek is en moontlik tot nier versaking kan lei.

Gedurende 11 en 15 Julie is Karien vir 'n tweede keer in die Vincent Palletti Hospitaal, Kaapstad opgeneem.

Na intensiewe toetse is vasgestel dat haar enigste niertjie wel funksioneer maar onderontwikkel is.

Die nier verkeer egter onder druk as gevolg van die malformasie. Die ekstra druk op die niertjie sal verlig word deur die beplande rekonstruktiewe chirurgie wat nou al hoe meer noodsaaklik word.

Om sake te vererger is Karien traag om gewig op te tel en moet die risiko gebonde aan die chirurgie opgeweeg word teenoor die toestand van haar nier. Die chirurgie moes noodgedwonge uitgestel word tot op 'n staduim wat die risiko aanvaarbaar sal wees met inagneming van die nier se toestand.

Karien is verder gediagnoseer met Craniosynostosis, 'n toestand waar die skedelbene van die baba se koppie voeer heg. Volgens die dokters moet hierdie toestand deur chirurgie reggestel word verkieslik voor nege maande.

Volgens Karien se Pediater in samewerking met 'n Genetikus word daar vermoed dat Karien moontlik ly aan 'n raar sindroom genaamd "Baller-Gerold sindroom".

Ons kan net bid en glo dat Karien gou sal herstel en 'n normale lewe kan lei.

Gedurende September 2011 het spesialiste en chirurge Karien se geval bespreek en die gevolgtrekking gemaak dat die dreinering van urine verbeter moet word met ‘n prosedure om te help met die voorkoming van herhalende urienweginfeksies.

Hulle sal dan moet vas stel waar in die ureter van uit haar nier dreineer (hoewel dit na die blaas moet dreineer, is dit moontlik dat dit nie die geval is nie en dit dreineer na ‘n ander struktuur).

Hulle het op die volgende vir Karien besluit.Hulle sal prosedures, sistoskope, vaginoskope en kateterisasie van die Urogenitale strukture onder narkose in teater by die Rooi Kruis Oorlog Gedenk Kinder Hospitaal op October die 3de doen.

Sodra dit gedoen is, terwyl sy steeds onder narkose is sal 'n MRI van haar onderlyf geneem word in die MRI-eenheid het.

Na haar herstel van die narkose en die bestudering van die MRI beelde en interne ondersoek sal hulle  besluit op die beste roete om die urinêre stelsel te dreineer.

Dit sal lei tot 'n tweede narkose en ‘n chirurgiese prosedure, waarskynlik in dieselfde week, en waarskynlik by die Vincent Pallotti Hospitaal .Professor Fieggen, die neurochirurg sal haar dan ook sien ten opsigte van die operasie op haar skedel.

 

 

 

 

Karien Pieterse

 

Karien Pieterse was born on the 23rd of December 2010 with a malformation / condition generally referred to as ‘Persistent Cloaca’.

Already during the night of her birth, it became evident that there might be some serious complications due to the fact that she was born a month premature as a direct result of the absence of almost all amniotic fluid in the womb at the time of her arrival.

Aggravating the circumstances was the fact that her (underdeveloped) lungs ceased with normal functioning at least twice within the first hour after birth as a result of huge amounts of pressure (exerted on the lungs) created by an abnormally swollen abdomen.

Although so many prayers have already been answered, the medical staff had little hope for survival and although Karien did indeed manage to pull through, the situation was still critical indeed.

It was, therefore, necessary for Karien to be transferred to the Vincent Pallotti Hospital in Cape Town so, the night of the 24th of December ’10, she was accompanied by her father on an emergency air ambulance flight bound for Cape Town.

During the early hours of Christmas morning, the 25th of December ’10, Karien underwent surgery in an effort to reduce the swelling of her abdomen by means of insertion of a catheter & colostomy.

She spent the next 3 weeks in the Intensive Care Unit at Vincent Pallotti Hospital after which she had been discharged .

Accompanied by mom & dad, she travelled back to Port Alfred soon after.

In the mean time, Karien had been diagnosed having got only one kidney which resulted in additional complications after about six months in that Karien did not grow in size.

Preliminary medical tests determined that the kidney was under stress and as a result, may very well fail.

This lead to another admission to Vincent Pallotti Hospital in Cape Town from the 11th July ’11 to the 15th of July ’11.

Additional tests confirmed the initial diagnose as it determined that the sole kidney had been literally under pressure due to the malformation (persistent cloaca), just like the lungs had been earlier in her life.

It is, therefore, essential for reconstructive surgery to commence as soon as possible – the sooner the planned surgery is completed, the sooner will the pressure be relieved from the kidney which will then enable it to function normally.

However, due to the reluctance of any gain in overall body mass by Karien, the risks associated with the reconstructive surgery had always been weighed up against the risks which an underdeveloped kidney could have to her overall health.

This resulted in a postponement of the reconstructive surgery to a point where it became acceptable, considering the overall deterioration of the kidney.

Karien has also been diagnosed with Cransiosynostosis, a condition which (present at birth) causes one or more sutures in the skull of a baby to close prematurely which impedes with brain growth / expansion – the developing brain has simply no space to develop in.

This condition needs to be corrected surgically as well – preferably within the first nine months after birth.

Due to the culminating circumstances of all of the above mentioned conditions, it is believed that Karien may be suffering from a rare genetic syndrome called Baller-Gerold syndrome.

During September 2011 deferent specialists and surgeons discussed little Karien’s case an derterment that drainage of urine should be established with a procedure to help preventing recurrent urinary tract infections.

They will need to establish where the ureter is draining into from her single kidney (although it should drain to the bladder normally, it is possible that this may not be the case and entering into a different structure).

They have made the following arrangements for Karien to try to establish this.

They will be doing an examination under anaesthetics, and cystoscopy, vaginoscopy and catheterisation of uro-genital structures in theater at Red Cross war Memorial Children's Hospital on October the 3rd Monday.  

Once this is done, while she is still under anaesthetics she will be taken to the MRI suite to have an MRI of her abdomen.

She will than recover from the anaesthetics and we will review the imaging and decide on the best route to drain the urinary system.  This will mean a second anaesthetic and a surgical procedure, most likely in the same week, and probably at Vincent Pallotti hospital.

Professor Fieggen, the Neurosurgeon will be seeing her regarding the surgery on her scull.