Get Well Soon!

Talk about a rough month! A couple of days after getting back to Hanoi, Thien Nhan caught the flu from his big brother, Little Minh, who'd been bedridden for some days already.


"Thien Nhan had a high fever for three nights," reports the kids' mom, Mai Anh. "He was very well behaved even though he was sick. He didn't make a fuss and he took all his medicine."

Unfortunately, due to his high fever, he wound up in the local hospital, where he was given fluids via an IV (photo).

Get well soon, Thien Nhan!

The family is still waiting for the results of Thien Nhan's hormone tests, done during his recent trip to Texas.

Houston Zoo

The day before Thien Nhan left Texas, a group of his supporters took him to the Houston Zoo. "Thien Nhan was really excited to see so many animals," said his grandma, Kim Anh. "He had an excellent day."

Having spent three weeks in Houston undergoing medical tests, Thien Nhan, 3, is now in the middle of a 30-plus-hour flight back to Hanoi. "He will arrive tomorrow," said his mom, Mai Anh. "Both of his brothers had the flu but are feeling better now. They are looking forward to seeing him and I know that he will be very happy to be home too."

Waiting for Results

In this photo Thien Nhan, 3, is comforted by his dad as he receives the last in a series of injections that he needed in order to test his hormone levels.

"The shots really hurt. He was so brave but he could not stop crying," reported the toddler's dad, Nghinh. "I felt terrible but there was nothing that anyone could do to help him. He just had to go through it."

Having been in Houston, Texas for the past three weeks, Thien Nhan will fly back to Vietnam tomorrow.

The results of the hormone testing should be available in some days. If the tests indicate that Thien Nhan's undescended testicles are producing testosterone, he will return to Houston for major surgery in early 2010.

"He is very eager to go home," said his dad. "He misses home and especially his big brothers."

Water Fun

While much of Thien Nhan's stay in Houston has been spent in hospital, the tot has managed to have some fun too. Here's a picture of the little guy during an outing to a local water park.

Help in Houston

Many thanks to Kids Without Borders' volunteer Susan for helping to make Thien Nhan's stay in Houston easier and more enjoyable. Susan and her sister have helped the family with transportation, dinners, etc. Yesterday, a friend of Susan's drove Nhan to his doctor's appointment.

Here's a picture of Susan, Thien Nhan and Susan's friend, Vu. Cam on!

To learn more about the Seattle-based volunteer-run Kids Without Borders go to http://www.kidswithnoborders.org/Home.asp

Extended Family

Since Thien Nhan's mom, Mai Anh, had to return to work, she flew back to Hanoi last weekend. Unfortunately, upon arrival she learned that one of her other two sons, Little Minh, 4, was running a fever. "It was a 39-hour trip and Minh's fever was 39 degrees," said Mai Anh. "So I got home and was up all night."

Thien Nhan's dad, Nghinh, then flew from Hanoi to Houston to "take over". Luckily for Thien Nhan his wonderful grandma, the acclaimed poet Kim Anh, will remain in the States for Thien Nhan's entire stay.

On Monday, Thien Nhan had his first appointment with Dr. Karaviti, who is administering a complicated test to determine whether or not the boy's testes are viable. Thien Nhan received his first HCG shot. He will receive two additional shots this Wednesday and Friday and have a blood test on Saturday. The results should be available in one week.

[Photo shows Thien Nhan, in red, drawing with friends and his grandma, Kim Anh]

A Difficult Process

Thien Nhan, 3, is now in Houston, Texas waiting to begin a 2-week-long process to test his hormone levels. "The test is very complicated and uncommon," explains the tot's mom, Mai Anh. "It involves injecting a vaccine that we must get from another state. So the vaccine is from one state, the test is performed in Texas and then the results must be read in another state."

Unfortunately, the injections are painful and must be administered daily for 2 weeks. "This is the only way to know for sure whether or not his testes are producing testosterone," says Mr. Greig Craft, the American philanthropist who arranged Thien Nhan's treatment in Texas. "If they are, he will need major surgery to retrieve them and place them in a reconstructed scrotum. This would happen early next year."

For the last 2 days, Thien Nhan has been complaining of stomach pains and rushing to the potty a lot. "He hasn't eaten anything unusual so I think it's stress," says Mai Anh. "He is homesick and nervous. This is a lot for a 3-year-old to understand. He is tired."

Homesick in Houston

Having been in Houston for more than a week, Thien Nhan is homesick. "Me oi, I want to go home and play with my brothers," Nhan told his mother, Mai Anh, speaking about his brothers Big Minh, 10, and Little Minh, 4.

"All day long he begs me to phone home," says Mai Anh. "He misses home and especially his big brothers."

[Photo shows Thien Nhan (on stool) with his brothers and cousin, back in Hanoi.]

5-Year Plan

After examining Thien Nhan, urologists and plastic surgeons in Texas are optimistic that the reconstruction of a functioning penis can begin in just 5 1/2 years, when Thien Nhan is 9. The reconstruction should be made easier thanks to the fact that a portion of the boy's penis (now tucked under the skin) remains intact.

"Nhan just wants to be like his big brothers and the other boys in his class," says the toddler's mom, Mai Anh. "The older he gets, the harder it will be for him emotionally. We are very happy that these doctors are able to help him."

[Photo: Thien Nhan undergoing a pelvic exam at Texas Children's Hospital while his mom comforts him.]

Anxious for Help

Before Thien Nhan went to bed, his mom, Mai Anh, explained that he'd be going to hospital the next day to meet doctors who would help to fix his "willy".

"The doctor's appointment wasn't until noon but Thien Nhan woke up very early and started asking if it was time to go see the doctor yet," reports Mai Anh. "I felt sad for him but proud of him too. He is so smart and brave for a three-year-old."

To see a brief video of one of Thien Nhan's exam at Texas Children's Hospital, go to:

http://www.youtube.com/watch?v=HqiKFQfi0OQ

Report from Houston

Since hearing of Thien Nhan's plight some years ago, Hanoi-based philanthropist Greig Craft has worked tirelessly to raise funds and find surgeons willing to take on this challenging case. Making time in his very busy schedule as the head of an injury prevention foundation, Mr. Craft has accompanied Thien Nhan, his mom and grandma to Houston, Texas, from where he sent this report:

A medical team at Texas Children's Hospital led by Dr. Lars J. Cisek, a pediatric urologist and Thien Nhan's coordinating physician Dr.Tue Dinh, a noted plastic surgeon, conducted a detailed exam of Thien Nhan's pelvic area. Dr. Cisek's initial assessment is that what doctors in Thailand and Vietnam believed to be testes may in fact only be internal scar tissue from the original trauma. If true, surgeons can still enable Thien Nhan to become a fully functioning male, although he would be unable to father biological children.

To determine the existence and viablity of the boy's testes, a series of injections will be given to Thien Nhan in the US over the next 14 days, followed by chemical analysis of his blood. This is a painful but essential process for Thien Nhan.

If the outcome is positive, the surgeons will conduct a Laparoscopy (inserting a tiny camera under anasthesia) to locate the testes. Internal scar tissue could make this a complicated procedure. Assuming that the testes are successfully located, major surgery would be needed to extract them. Dr. Tue would operate on the groin area, create a new scrotum from skin tissue, and relocate the testes. If the testes are not functional, hormone therapy will be the solution.

We'll know more in coming days, and will keep you posted as soon we learn more. Thanks for your ongoing support and love.

[Photo: Greig Craft carries Thien Nhan in the hospital]