Times of India
28 April 2011
By Dipti.Barve

3 London docs failed to see what a local doc saw in one sitting – that baby Raphael’s cough and breathing problem was not due to an infection but a piece of eraser stuck in the windpipe
Baby Raphael Pointon will always have a special connection with Pune because he was able to breathe free again here. If it wasn’t for a local doctor, the two–yearold British boy would have had to suffer much more because his windpipe was making life difficult for him.

Raphael’s parents took him to a paediatrician in London after they saw that their baby had trouble breathing. The doctor thought it was a respiratory tract infection and prescribed a course of antibiotics. However, Raphael’s cough and breathing problems persisted.

His parents consulted two more doctors but their baby did not get any relief, despite the inhalers and cough syrups. Raphael’s ordeal went on for three weeks, till his parents decided to come to Pune as they had some onsite work, the baby’s mother Seera Pointon said.

Once in Pune, Seera and her husband went to the Aditya Birla Hospital in Thergaon and consulted Dr Sachin Shah, a paediatrician. That is when the true picture came to light: a foreign body was stuck in little Raphael’s windpipe. None of the three English doctors they consulted suspected this.

Dr Shah carried out a few tests and found out, to the parents’ surprise, that a piece of eraser measuring 8 mm was lodged in the windpipe. Dr Shah along with paediatric surgeon Dr Dasmit Singh performed a bronchoscopy on Raphael and successfully removed the piece of eraser.

Seera’s gratitude for the timely and accurate diagnosis is clear from what she told this reporter after the operation. "We were shocked when we came to know that a piece of eraser was stuck in the windpipe. We also wondered why the paediatricians in London were unable to diagnose the problem. Three weeks went by but Raphael’s condition showed no signs of improvement. He became cranky due to the pain. I really thank the Indian doctors for their timely diagnosis and treatment."

Dr Shah said that he had a gut feeling the baby’s breathing problem was due to a foreign body in the windpipe and not due to an infection of the respiratory tract. "When the patient came to me, I thought the possibility that a foreign body being stuck in the windpipe was very high. An X–ray and a CT scan proved my fears were not unfounded. A tiny object was stuck on the right side of the windpipe.

Since there was a swelling in the affected area we decided to perform a bronchoscopy immediately," he added.

Dr Shah later elaborated that parents must not reject the possibility that something may be stuck in the windpipe if their baby has a persistent cough and is unable to breathe normally. He also said that to minimise such risks, the environment where a toddler plays should be clean and free of objects that may break into tiny splinters.

Dr Dasmit Singh, the surgeon who performed the bronchoscopy, said the procedure was not risk free. "Bronchoscopy is potentially dangerous and requires skill. In Raphael’s case, the affected area had swollen up a lot because the piece of eraser was stuck for three weeks. We decided to perform the operation immediately to ensure he did not catch any lung infection."

Finally, all is well because the Pointons’ ordeal ended well. One crucial observation to be made here is that cases like Raphael’s are responsible for making our city a rising star in the field of medical tourism.

In bronchoscopy...
An instrument called a bronchoscope is inserted into the airways (food and windpipe), usually through the nose or mouth. This allows the practitioner to examine the patient’s airways for abnormalities such as foreign bodies, bleeding, tumour or inflammation. A persistent cough and breathing problems could be an indication that a foreign object is lodged in the windpipe