A 17-year-old teenager received a second chance at life after an international group of doctors and specialists collaborated together to successfully operate on her at the Rambam Health Care Campus in Haifa.
The lifesaving operation was also credited as a success because of a new model of treatment, called “Bring the Patient, Bring the Surgeon” – which assures that the patient’s ongoing care will be administered by doctors who were present at the surgery.
The patient, Jummana, had been suffering from a serious endocrine problem. Her physicians in the Palestinian Authority (PA) initially referred her to Rambam. She arrived in Haifa wheelchair-bound because of extreme bone pain due to severe hypophosphatemia (extremely low phosphate levels).
Rambam doctors turned to colleagues at the National Institutes of Health (NIH) for help. They discovered that Jummana had a rare tumor only one half a centimeter in size in her palette that was consuming massive amounts of calcium and phosphorous from her bones. Rare in adults, such a tumor in a teen was virtually unheard of.
Next, Professor John A. van Aalst, Director of the Division of Plastic Surgery in Cincinnati Children’s Hospital, was contacted for advice regarding the best qualified hospital to perform the surgery, made complicated by the patient’s age and the need for complex endocrinologic follow-up.
“Why did we choose Rambam? Because of all the connections here, it was simpler for the family, and in the end safest, because she had a major endocrine problem that would be quite complicated to treat once the tumor was removed,” he said.
Dr. Omri Emodi, Deputy Director of Rambam’s Department of Oral and Maxillofacial Surgery, set up the multidisciplinary team needed for Jummana’s surgery, which included the patient’s endocrinologist, a hematoncologist, and the preplanning to create the necessary prosthodontics as well as bringing her doctors from Nablus to Rambam to observe the procedure and learn more about her condition. The Palestinian Authority doctors would now be able to better follow-up with her in Nablus, and just as important, gain valuable knowledge for treating similar problems if diagnosed there.
“Now that the tumor has been removed, we hope to be able to restore the calcium and the phosphate to her bones. Given that her bone density is extremely low (minus 8 Z-score), building her bones up again is the real challenge. This will be a long journey, but we are on track,” said Professor Dov Tiosano, Director of Pediatric Endocrinology in the Ruth Rappaport Children’s Hospital.
Tiosano said Jummana’s ongoing care is important for medicine in general.
“There is a huge interest in Jummana’s recovery. Because of the rarity of the case, one of the NIH Rehabilitation experts will also be visiting during follow-up to see how she is doing and to learn how our intervention is helping her to return to normal bone density and function,” he said.
Rambam officials said Jummana will soon be released home to Nablus. “She still must undergo follow-up at Rambam for her ongoing condition, but her hope for the future is much brighter due to the collaboration and good will of doctors who live and breathe their Hippocratic oath,” according to a hospital statement.