Health A Toronto doctor promised to help this acid attack survivor. One year later, she’s leaving Toronto with a new esophagus

19:53  18 december  2017
19:53  18 december  2017 Source:   Toronto Star

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One year later , she ’ s leaving Toronto with a new esophagus . Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh. Earlier this year, surgeons at Toronto General Hospital reconstructed her throat and stomach, using skin taken from her arm.

A Toronto doctor promised to help this acid attack survivor . One year later , she ' s leaving Toronto with a new esophagus . As a result, she angled to cannibalize her new alliance and targeted Ben, an opportune moment

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Popi Rani Das came to Toronto because of a promise.

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One year later , she ’ s leaving Toronto with a new esophagus . 15th December, 2017 lifestyle. SOURCE: Toronto Star; Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

A Toronto doctor promised to help this acid attack survivor . One year later , she ’ s leaving Toronto with a new esophagus . Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

It was made nearly two years ago in a cramped hospital room on a top floor of the Acid Survivors Foundation Hospital in Dhaka, Bangladesh.

Das, then 27, had spent seven years in that room, in pain and often sick, after her husband gave her a glass of acid to drink.

The clear, odourless liquid — Das had thought it was water — burned away her entire esophagus and most of her stomach. She needed the electrical outlet in her hospital room to power a blender so she could squeeze pureed meals into a feeding tube inserted into her small intestine.

Since she could no longer swallow, it was the only way she could eat.

Doctors in Bangladesh said she had little chance of getting better.

In 2010, in her hometown in Bangladesh, Popi Rani Das took ill to her bed. Her husband gave her a glass of water to drink. It was not a glass of water, but a glass of acid, which burned away two-thirds of her esophagus, some of her trachea and most of her stomach. © Carlos Osorio In 2010, in her hometown in Bangladesh, Popi Rani Das took ill to her bed. Her husband gave her a glass of water to drink. It was not a glass of water, but a glass of acid, which burned away two-thirds of her esophagus, some of her trachea and most of her stomach.

But Das refused to believe them. One day, she knew, someone would walk into her hospital room and offer hope.

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A Toronto doctor promised to help this acid attack survivor . One year later , she ’ s leaving Toronto with a new esophagus .

One year later , she ’ s leaving Toronto with a new esophagus . 15th December, 2017 lifestyle. SOURCE: Toronto Star; Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

That person was Toronto plastic surgeon Dr. Toni Zhong. She met Das by chance while travelling in Bangladesh in February 2016 on a medical mission to help women injured in grease fires.

As director of the breast reconstruction program at University Health Network (UHN), Zhong knew Toronto General Hospital (a part of UHN) was one of the few places in the world that had the expertise to help Das.

“I promised her I would take her case to the best surgeons I know,” Zhong says. “I promised: ‘I will try to find a way to help you.’ ”

It took a year but Zhong kept her pledge.

Das arrived in Toronto on Feb. 15, 2017. Ten months later, on Dec. 14, she gathered at Toronto General with her medical team and her mother, Ajanta, for an afternoon celebration to toast their many successes — and to say goodbye.

Das will soon return to Bangladesh, healthy and happy and able — once again — to eat ice cream and cookies, her favourite foods.

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One year later , she ’ s leaving Toronto with a new esophagus . 15th December, 2017 lifestyle. SOURCE: Toronto Star; Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

A Toronto doctor promised to help this acid attack survivor . One year later , she ’ s leaving Toronto with a new esophagus 15 December 2017, 2:00 am. Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

“After I go back home I will always think to myself I had come to this advanced country and this is where my life started again.”

But the complex trio of surgeries, which were completed in August and included reconstructing Das’ damaged esophagus using skin harvested from her arm, could easily not have happened.

There were medical challenges and funding dilemmas and worries over whether Das would remain well enough to travel and undergo the risky surgeries. Success was never certain.

“We felt we had to try,” says Zhong. “She compelled me — she compelled all of us — to go above and beyond for her.”

Das was not supposed to survive her husband’s vicious attack.

He was angry at Das, then 21, for not bringing a bigger dowry to the marriage. The glass of acid was meant to kill her so he could marry again. Though Das filed a police report, her husband has never been charged with a crime.

According to the Acid Survivors Foundation, the prosecution rate for acid attacks in Bangladesh is about 10 per cent.

In addition to burning away her esophagus and stomach, the acid attack damaged Das’s airway, causing a buildup of scar tissue that made it difficult for her to breathe and, each winter, put her at risk of deadly pneumonia. Though the acid had injured her voice box, Das was still able to speak.

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One year later , she ’ s leaving Toronto with a new esophagus . 15th December, 2017 lifestyle. SOURCE: Toronto Star; Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

One year later , she ’ s leaving Toronto with a new esophagus . 15th December, 2017 lifestyle. SOURCE: Toronto Star; Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh.

Zhong knew Das could die at any time or become too weak to leave Dhaka.

Even before she returned home from her 2016 medical mission in Bangladesh, Zhong was working on her plan to bring Das to Toronto.

Former Star reporter Marina Jimenez and former Star photographer Melissa Renwick were with Zhong on that 2016 mission sponsored by the German-based charity Women for Women.

Zhong’s first step back in Toronto was to raise money to pay for the young woman’s travel, medical care and living expenses in the city. Ontario’s medical system will not cover costs for international patients — no matter how deserving.

In Canada, The Herbie Fund helps critically ill children from disadvantaged countries get life-saving treatment at Toronto’s Sick Kids Hospital.

Zhong was surprised to find no such humanitarian fund exists to bring adult international patients to Canada.

Undeterred, she decided to start one herself, calling it the Popi Fund.

She took Das’s story to several potential donors, who quickly agreed to help. That core group, primarily three Toronto families, in turn rallied friends and within months had raised $700,000.

In addition, the surgeons and anesthetists who would operate on Das waived their fees and Toronto General agreed to open an operating room during off hours, so as not to affect Canadian patients.

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A Toronto doctor promised to help this acid attack survivor . One year later , she ’ s leaving Toronto with a new esophagus . Holiday grief makes the lights shine less bright.

A Toronto doctor promised to help this acid attack survivor . One year later , she ’ s leaving Toronto with a new esophagus . Popi Rani Das was tricked into drinking acid by her husband in 2009 in Bangladesh. Earlier this year, surgeons at Toronto General Hospital

Members of a local Bangladesh community group offered to host Das when she arrived in Toronto. Funds even arrived from Munich, Germany. Inge Haselsteiner, a German anesthetist who worked with Zhong on the 2016 mission in Bangladesh, with her sister raised 27,000 euros to cover the cost of Das’ housing, food, transportation and medicines in Toronto.

It seemed everyone who heard Das’s story wanted to help.

Back in her Dhaka hospital room, Das patiently waited. She focused on her embroidery projects of colourful flowers stitched onto white cloth. Eight times a day she fed her herself by injecting a puréed meal into her feeding tube.

On hard days, during her darkest moments, Das thought of all the people working in a faraway country. She believed in Zhong’s promise.

And when it came time to fly to Toronto, Das felt as if she had wings.

One year after Zhong first met Das in Dhaka, the two women reunited in the arrivals lounge at Toronto’s Pearson International Airport.

It was Feb. 15 and snow swirled across the runways, a novelty to Das who had never before left Bangladesh.

Zhong was relieved to see Das walk slowly toward her, a small smile on her face.

She had made it to Toronto safely. But the hardest part of her journey was still to come.

Acid burns flesh the same way fire sears skin.

“It goes through your skin, it goes through your fat, it goes down to your bone,” says Zhong, adding roughly 75 per cent of people who swallow acid will die. “That Popi survived her attack is a miracle itself.”

Days after Das came to Toronto, surgeons began planning a series of staggered operations that would give her a new esophagus and stomach.

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One year later , she ' s leaving Toronto with a new esophagus - Toronto Star Fri, 15 Dec 2017 02: Toronto StarA Toronto doctor promised to help this acid attack survivor . One year later , she ' s

© Copyright 2000, Lanka Academic Network. Embargo to be lifted on First Day of the New Year .

The first, scheduled within weeks of her arrival, helped surgeons understand the extent of her injuries.

Dr. Ralph Gilbert, in charge of head and neck surgery at UHN, had never operated on an acid attack victim. But he knew that he could use techniques similar to those he had pioneered to treat patients with complex throat cancers.

Together with his colleague, Dr. David Goldstein, the two head and neck surgeons decided to build Das a new tissue structure at the top of her throat using an eight-by-10-centimetre patch of skin harvested from her left forearm.

On March 31, during a six-hour operation, Gilbert and Goldstein folded the skin patch into a 3-D tube — essentially a new swallowing apparatus that bypassed her damaged esophagus.

They then attached one end of the 3-D tube to the back of Das’s throat and the other end to an opening in the left side of her neck. This opening fed into a small plastic pouch that hung outside her body.

This way, the surgeons could monitor Das’s swallowing and ensure saliva and food didn’t go into her airway, leading to deadly infections.

Within weeks, Das was relearning how to swallow, something she had not done for eight years. It was a sign the surgery had worked.

Months later, on Aug. 25, Das had her third and final operation. It was a combined procedure during which Dr. Gail Darling, a thoracic surgeon at UHN, brought the top portion of Das’s small intestine up under her breastbone to her neck, where Gilbert then attached it to the new throat structure.

It is a risky procedure, and one that doesn’t always work. Prior to Das, UHN had performed only 10 such surgeries.

Though her recovery seemed promising, Gilbert was sure only that Das would be OK when, weeks later, he watched her happily eat a digestive biscuit.

“She has these memories of going for ice cream with her family on a warm day,” Gilbert says. “It was one of those things she always wanted to do again.”

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As a child, Das adored chocolate ice cream. Now, Kit Kat is her favourite flavour.

When Das was born, her grandfather told her mother that she was brave and filled with courage.

It was why he named her Popi, which means warrior in Bengali.

Das says this inner strength helped her through the long, lonely years in the Acid Survivors Foundation Hospital and buoyed her in Toronto when she was scared or in pain after her complex surgeries.

“I had this faith that everything would be fine,” says Das, speaking with a Star journalist before a recent December checkup at Toronto General. Tanazzum Kaiser, an interpreter who works at the hospital and who has helped Das throughout her stay, translates the conversation between Bengali and English.

Das, who weighed less than 80 pounds when she arrived in Toronto, has slowly relearned how to eat with the help of speech pathologists.

She now uses her tongue to throw small bites of food to the back of her throat. She then swallows hard to move the food down her new esophagus.

Each week she gains a little weight.

Registered dietitian Anthony Ng thinks it’s nearly time to take out Das’ feeding tube. By the look on her face, it is a momentous occasion.

On the days she has hospital appointments, Das walks between Toronto General and the downtown apartment she shares with her mother, Ajanta.

The two are almost always together.

“For all this time the thing that kept me alive was my mom’s love for me,” says Das as Ajanta, 50, looks on. “My mom used to think about me constantly, for every moment, and all she did was pray to God that I get better. This pain I suffered through my mom also suffered.”

Das smiles when she talks of her mom. She also smiles when she talks about Gilbert, who she has nicknamed “Doctor Magician.”

“What he did for me was like magic,” she says of the two surgeries Gilbert performed that allowed her to once again swallow. Scars from those procedures curve along her delicate neck, still visible behind her gold lace scarf.

But even more than Gilbert, Das is grateful for her social worker Shobha Sawh, one of the 20 members of her medical team.

This is the person who has helped Das process her husband’s violent attack and given her strategies to manage the post-traumatic stress.

“To me,” says Das, “Shobha is like medicine.”

Since Das’s arrival, the pair has met nearly every week. Sawh has explained the risks attached to her three surgeries, coached her through the frustrations of recovery and rehabilitation and created coping tactics for when she returns to Bangladesh.

At almost every step, Sawh has reinforced Das’ belief in herself as a survivor.

“We say that the past is done and now she has a clean slate,” Sawh says. “This is her new narrative to start life all over again.”

Early next year, Das and her mother will return to Bangladesh. She will not need any more care from Toronto General.

Das says she wants to become an advocate for survivors of acid violence. She wants other women with stories like hers to know they are not alone.

“For seven years, I just struggled in a hospital, in a bed, in one room,” she recalls. “But I have come through that now.”

Das will return to the Acid Survivors Foundation Hospital before making further plans for her and her mother. She is eager to see her friends and show them how far she has come since leaving for Toronto nearly one year ago.

That Das wants to become an advocate for survivors of acid violence is no surprise to Zhong. It’s yet more proof that bringing this young woman to Toronto for medical help was the right thing to do.

“We have never said: ‘Popi, you should go home and be a spokesperson for all that has happened to you,’ ” Zhong says. “We have never said that to her. But because of how many people who have helped her, she now believes her role is to go out and help more people.

“I think that is how goodness spreads.”

The fund that Zhong started in 2016 to bring Das to Toronto is now a permanent fixture at UHN. It will help other adult international patients in crisis get life-saving surgery in the city.

Officially, it is called UHN Helps. But those who started this journey with Das will think of it as the Popi Fund.

And that, like once again eating ice cream after so many years, is something that will always make Das smile.

UHN Helps, otherwise known as the Popi Fund, will officially be accepting new patients in spring 2018. To donate, go to uhnhelps.ca.

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