Sunday, April 22, 2018
Health

Haitian teen with life-threatening tumor comes to Tampa for surgery

TAMPA — As a tumor continued to grow, eating away at Jacques Saintil's lower jaw, he never gave up hope.

Not after doctors in his hometown of Port-de-Paix, Haiti, told him there was nothing they could do. Not after a hospital in the capital of Port-au-Prince couldn't help. And not even as the swelling prompted people to ask the embarrassed student what was wrong with him.

Then an acquaintance told him about a dental clinic where Tampa orthodontist David Leever makes regular visits.

So in February 2011, the then-17-year-old made the 6-hour, 170-mile bus journey to the Christianville Dental Clinic, just a few miles from the epicenter of the devastating earthquake that struck a year earlier.

Leever examined him and knew his problem was far worse than embarrassing.

That visit kicked off a series of events that, 14 months later, have brought him to Tampa, where he will undergo the first of two surgeries on Wednesday at Florida Hospital Tampa to remove a tumor that, left unchecked, could kill him.

American doctors frequently do mission work in places like Haiti, where access to health care is poor and specialists are hard to find. What made Saintil's case unusual is that its seriousness and complexity required a trip to the United States and a lot of teamwork. Doctors, a hospital, medical companies and family members all were willing to chip in and help.

• • •

Around November 2010, Saintil began to notice that the right side of his face was swelling.

"People would notice and ask what was wrong," the soft-spoken Saintil said in Creole Thursday as his uncle Franck Salomon translated. "I didn't know."

Saintil said it didn't hurt or affect how he ate or talked. Mostly, he felt self-conscious.

In the United States, such tumors are usually detected early through routine dental X-rays and removed with simpler procedures.

But in a country with limited access to dental and medical care, people like Saintil — whose family is not wealthy — are more likely to do nothing, Leever said.

Saintil lives with his mother and father, and has two older brothers and a younger sister.

Though Saintil first noticed the tumor around November 2010, it likely started growing years earlier, said Dr. Patrick Abbey, one of two oral and maxillofacial surgeons who will operate on Saintil. It now measures about 3 inches in diameter, he said.

Leever said the Haitian dental clinic where he volunteers doesn't see many cases that are so serious. But Leever, who has been providing care to people in Haiti for more than 20 years, was confident he could find help for Saintil.

After a New Jersey oral surgeon who does work in Haiti couldn't get the right surgical team together for the job, Leever called colleagues in Tampa.

"It didn't take 10 minutes for them to say they were on board," Leever said of oral and maxillofacial surgeons Patrick Abbey and Barry Levine.

Abbey said he was more than willing to help out a colleague and friend he has known for more than 20 years.

"And it was about doing what is right for this kid," Abbey said.

Wednesday's procedure will remove the tumor along with a large portion of his lower jaw, and partially replace it with a bone plate made of titanium. If all goes well, Saintil will return to Florida Hospital Tampa in about three months, for another procedure to fully rebuild his jaw using bone from his hip.

The tumor, a mandibular ameloblastoma, is not cancerous. But if not removed, it would continue to grow, destroying his jaw bone and likely spreading to other parts of his skull, Abbey said.

"Eventually, it would kill him," he said.

The hospital, surgeons and implant vendor agreed to provide care — estimated at more than $100,000 — for free.

A pharmacy on the Florida Hospital Tampa campus donated the medications Saintil will need after surgery.

Saintil's uncle and aunt in Fort Lauderdale agreed to host their nephew and take him to and from Tampa. They and other relatives bought his plane tickets to and from Haiti.

"When people bring a good case forward, we do explore that," said Dr. Brad Bjornstad, vice president and chief medical officer of Florida Hospital Tampa.

Caring for indigent patients is part of the hospital's mission, and the fact that so many people stepped forward to help made Saintil's case particularly worthy.

"It all worked out," he said.

• • •

Saintil, who had never visited the United States before, has made a couple of trips to Tampa in preparation for surgery.

Those trips, plus the two surgeries ahead, will mean missing out on a large portion of the school year, which he'll have to make up next year.

On Thursday, Abbey went over the procedure for the last time with Saintil, his uncle and aunt, and answered their questions.

"What can he eat after surgery?" his aunt asked.

Soft foods for about a week, the doctor said.

"Will the tumor come back?" his uncle asked.

There's a less than 1 percent chance, the doctor said.

Saintil had just one question.

"Will both sides of my face look the same after the surgery?"

"The right side won't look swollen anymore," Abbey told the uncle. "Tell him he'll get just as many girlfriends afterward."

Richard Martin can be reached at [email protected] or (813) 226-3322.

 
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