Paz Wasserman never imagined that the stir-fry meal he prepared could be life threatening. After a few bites, he felt a burning in his throat and lost consciousness. After examining him at Rambam Health Care Campus (Rambam) in Haifa, Israel, his physicians say it is a miracle the young man survived.
Paz Wasserman during his hospitalization at Rambam. Photography: Rambam HCC.
Before their mandatory army service, Paz Wasserman (19) and his friends lived together in a hostel as volunteers in a year-long community service program. Wasserman’s mother, Sigalit, recalls, “It was Paz’s turn to cook for his friends, and he made a stir-fry. After taking a few bites, he felt a burning sensation in his throat, and seconds later, he fainted and lost consciousness.” Realizing it was an emergency, his friends immediately called Sigalit.
For the next two weeks, Wasserman complained of a sore throat. He had a cough and it was difficult for him to swallow. He used throat sprays and ate cold food to alleviate the pain and discomfort. “We never imagined his condition was serious—people always eat hot food, and sometimes their throats burn a little. Then he called me and said he wasn’t feeling well; he couldn’t breathe and was lying on the floor. I will never forget that evening,” says Sigalit.
Emergency services rushed Wasserman to Rambam’s ER. After being diagnosed with severe pneumonia and respiratory failure, he was transferred to one of the hospital’s intensive care units. Recalling the difficult moment, Sigalit adds, “I felt like this was it; everything was over, and my child was going to die.”
The day after, while sedated and ventilated, doctors performed a gastroscopy, which involved inserting an endoscope with a light and camera into his upper gastrointestinal tract. The procedure confirmed the physicians’ suspicions; there were burn holes in Wasserman’s esophagus and trachea—caused by the hot food. “This is rare, and it’s the first time I’ve seen it. Only a few cases have been reported in the medical literature,” explains Dr. Amit Katz, director of Rambam’s Department of Thoracic Surgery. “We don’t know why the food remained in the thoracic part of the esophagus, causing the burns. Some of the tissue died, and created small burn holes, which we call a ‘fistula.’”
To promote the fistula’s healing, the doctors placed a stent into Wasserman’s esophagus. He was then transferred from the ICU to the hospital’s Department of Thoracic Surgery. “We left the stent in for the maximum time—six weeks, hoping the tissue would heal and the fistula would close. Unfortunately, it didn’t, and there was no improvement,” explains Katz. “The only other option was complex surgery to repair the fistula and remove the esophagus. We hoped this would save his life.”
“I feared for Paz’s life,” says Sigalit. “I kept asking the doctors if there was an alternative,” but eventually realized that surgery was the only option. “The night before, I couldn’t sleep, and I used every moment to check on my son.”
Dr. Katz explains the three-stage surgery, “First, we cut off the esophagus and left a small section to create a new tracheal wall to close the hole. In the second stage, we created a gastric tube to replace the esophagus, and in the final stage, we reconstructed Paz’s digestive tract using the gastric tube. The tube extends to the neck and connects to the esophageal stump.” Wasserman was critically ill and needed help breathing. However, standard intubation was not possible, so he was connected to an extracorporeal membrane oxygenation (ECMO) device, which oxygenated his blood during surgery. This is not common practice, and it can cause complications like bleeding and infection.
The surgery was successful, but recovery would take time. Dr. Assaf Miller, director of the Medical Intensive Care Unit, reported that the first few days after surgery were dramatic, and the patient’s condition took time to stabilize. Two weeks later, Wasserman was weaned from the ECMO, and returned to the Department of Thoracic Surgery for further treatment and rehabilitation. “His rehabilitation did not progress as expected, and his cognitive function was poor,” adds Miller. “He was breathing on his own—we had reduced his medication, but he was still sleepy, confused, and not communicating as expected. His case was extreme, and we didn’t know if there was a more serious, underlying condition.”
The physicians felt that Wasserman would be better off at home, where he could recover in a familiar place, surrounded by his loving family. “It wasn’t easy, and he had to relearn everything,” says his mother. “We cried over his smallest achievements, like drinking a glass of water without help or holding a spoon on his own.” She adds that her son has made giant strides; he is no longer confused and speaks clearly. “Now, he is back to being the boy I always knew.” She points out that his rehabilitation is complex, and he will have to get used to his new diet and repaired digestive system. “But, that is small compared to the fact that he’s alive and with us.”
Dr. Katz says that Wasserman’s case is rare but inspiring, “Paz is an example of the power of hope; you can recover from a difficult situation even if you think there is little hope.”
This story ends happily—Sigalit reports that her son has returned to exercising at the local gym and is spending time with friends. Wasserman dreams of becoming a doctor and saving lives, just like the Rambam physicians who saved him.
Comentarios