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]

Under the Weather

Thien Nhan isn't feeling well today, slept badly last night and has a poor appetite. A storm is brewing in Hanoi and changes in weather typically cause Thien Nhan's leg stump to ache.

On the surgical front, we're waiting for some pioneering reconstructive surgeons in Washington DC to review Thien Nhan's case. If this lead doesn't pan out, we'll likely send him somewhere closer to home for urethral dilation--the first, relatively simple procedure that he needs. While he definitely needs urethral dilation within the next few months, at this moment he isn't in pain, so we've decided to wait and see about Washington...

When Thien Nhan was first adopted (and prior to that), peeing was a nightmare for him as he often had urinary tract infections, was severely dehydrated, and was unused to being offered a lot of liquids. By keeping him very clean and ensuring that he drinks loads of water, his new parents are helping to make peeing less uncomfortable for him.

In the first weeks that they had him, in order to obtain urine samples and monitor his urine output, family members would take turns following him around the house with a plastic cup, which rarely worked! They were so desperate to get a sample at one point that when he piddled on the floor they used a teaspoon to try to collect it...

Testing

Thien Nhan needs surgery on his urethra as soon as possible. His small, exposed penile opening makes urination painful and leaves him prone to infection. The doctors he's been seeing in Hanoi recommend that he go elsewhere to see a specialist, so we're looking into hospitals in Bangkok (a center for genital plastic surgery). He needs tests and x-rays to determine the extent of the internal damage to his penis.