Less than 24 hours after he turned 9, Mohammad Karime, of Iran, received an unusual present: a tear duct.
Marking his 19th surgery in his nine years of life, Karime has spent more than two years in waiting rooms and on surgery tables with surgeons from Iran to Binghamton, and now Latham, searching for medical ways to restore the face of a boy who was left with several impairments as a result of a craniofacial birth defect.
Karime’s story began when Dr. Mohammad Baghaei-Rad, a surgeon whose practice is run out of Amsterdam, traveled to Iran and met Karime as he was venturing through Nishad.
In one of my humanitarian trips to Iran, I came across this little boy, said Baghaei-Rad. `Unfortunately, all the plastic surgeons in Iran threw their hands up and said they couldn’t do anything for him.`
According to Baghaei-Rad, Karime’s face had looked similar to the way a cleft mouth may appear, only the defect encompassed Karime’s entire face, leaving him with only one eye, a mouth that had formed at a 45 degree angle, and the omission of a tear duct to control the dripping of tears to Karime’s only remaining eye.
`Literally, he didn’t have half a face,` he said. `And because of the complexity of his case, it was difficult for him to find treatment over there.`
As a member of Gift of Life, a division of the Rotary Club whose members assist children with life-threatening conditions, Baghaei-Rad had decided to bring Karime to America, where he could receive the proper treatment, at no cost to his family.
`Five years ago was his first trip [to the United States],` said Baghaei-Rad, speaking on behalf of Karime’s mother, who speaks little English and has used Baghaei-Rad as her translator while in America. `The first time we brought this kid here, I had made an arrangement with a craniofacial surgeon in Binghamton, who arranged the bones in his face to create an eye socket.`
After several surgeries in Binghamton, Karime returned to Iran to recuperate.
Allowing some time to pass in between surgeries, in September, Baghaei-Rad and Latham board-certified surgeon Lucy Capek decided it was a good time to bring the boy back to America to have a nose constructed.
`First of all,` said Capek, `he was basically born, among other things, with just a real tiny nubbin on his face instead of a full-sized nose. If you could picture that all you had was one nostril and one kind of notch over it, that was his nose.`
According to Capek, when she first met Karime, she could see that some work had been done to construct elements of his face that were not previously there, however, the work that had been done by surgeons in Binghamton needed to be updated, due to natural erosion.
`They brought in something called a forehead flap, which is bringing in a lot of skin and soft tissue and building it up with some bone grafts,` said Capek. `After a couple of years, it began to shrivel down to nothing again.`
Capek said that when she met Karime, `On profile [his nose] just looked completely flat. What we did was put in something called a tissue expander, that’s kind of like a balloon, and you blow that up over a series of weeks and you stretch the skin that is there.`
Capek said, unfortunately, because the skin surrounding the area that would be his nose was affected by so many previous surgeries, the skin on the area where Karime’s nose would have been was so thin that the expander actually poked through and needed to be replaced by a softer brand expander.
Next, Capek took some cartilage from Karime’s rib and built a nose from there.
`He still has just one tiny nostril, but we have to wait until the bone heals before we can do anymore,` she said. `The great thing is that the nose came out looking a lot like his mom’s.`
But in the midst of all his surgeries and procedures, Karime was beginning to have trouble with a specific area of his face: His one functioning eye.
While an artificial eye was placed in the socket that was structured by previous surgeons, Karime’s functioning eye lacked a tear duct to help control the tears that are produced around the eye.
According to Dr. George Stasior, a Latham ophthalmologist and surgeon, tear ducts are particularly important to the eye because without them, blurred vision and infections can result.
For a child with one eye, impairment to the eye could be detrimental to Karime’s overall sight, Stasior said.
A day before the surgery, Karime, whose family was staying in Amsterdam with Baghaei-Rad, was celebrating a birthday.
`It’s his birthday and we want him to be happy ` not thinking of surgeries,` said Baghaei-Rad.
At 8:30 a.m. Friday, May 23, Stasior performed the tear-duct surgery that would enable Karime to blink over and over again without fear of being blinded by the tears he could not control. By inserting a small Pyrex glass tube from the corner of Karime’s eyelid to his nose, Stasior was confident that Karime would be able to have the same functions as individuals born with tear ducts have, within four to six weeks.
Stasior said he had been performing `about 45 tear duct surgeries,` like this per year, but that cases like Karime’s come along rarely.
And for a case as unique as Karime’s, most of the doctors and specialists Karime has met with in his time in America have treated him without cost.
However, Karime’s surgeries would also not have been made possible without contributions from people in the community, like Peter Bulgar, chief operating officer of CL King and Associates Inc.
`Dr. Stasior indicated that there was a need to raise some money. I think between a few of us, they raised a few thousand dollars,` said Bulgar. `[Dr. Stasior] is a very caring, credible surgeon and he was just explaining the situation and it just seemed like a good thing to do.`
By 11:30 the morning of his surgery, Karime’s anesthesia was beginning to wear off. According to Stasior, who said the surgery was `a success,` Karime would be able to rest for a few days before returning to Iran, as he was issued a 60-day medical Visa.
After that, Karime will return in about a year for post-treatment care, and to discuss further ways American doctors can improve his quality of life.
But for Karime’s mother, who has traveled with him and listened hard through the translated words of the doctors who have been diligently working to help her son, Karime’s life has already improved vast amounts.
`Mohammad’s mom, you know, she doesn’t smile a whole lot, but after the surgery, she had a big smile on her face. That really made my day,` said Stasior. “