A 12-year-old girl with idiopathic scoliosis was diagnosed in 2006 and followed up at the Specialized Unit in Vertebral Columna (VCU) of the reference hospital.
In the last year, there is evolution of the scoliosis curve, evolving the Cobb angle from about 35o to 77o in a period of time of approximately one year.
In view of the evolution, the UCV team raises to the family the possibility of performing surgical arthrodesis, providing the corresponding IC document.
1.
It is a family composed of the mother, widow and affects a mental handicap, with a cognitive level that we could define as borderline, and her daughter, the patient in question.
The circumstance is that the child's father died in an operating room during surgery.
The child is a 12-year-old adolescent with normal cognitive level.
After reading the IC document and receiving the corresponding information from the surgical team, both mother and child decided not to accept the proposed surgery, visiting their pediatrician of the health center (HC).
The consultation shows a high level of anxiety and awareness of performing the above mentioned surgical intervention.
After analyzing the data, the pediatrician considers that the surgical intervention is indicated, given the evolution of the scoliosis presented by the child.
However, it is very difficult to speak with either of them, so it is decided to postpone the interview and grant a time for reflection.
After several clinical interviews, carried out with both the family and the social worker, and together, it is observed that there is still a high level of anxiety and anxiety due to both.
The pediatrician asks the mother to show her the IC document and proceeds to explain the details of it, as well as the complications that could arise and the options both to perform the intervention and not to carry it out.
He was advised to talk again with the UCV team.
After evaluating the situation, it was concluded that the best option was for the social worker of the HC to accompany the mother and the child in her visit to the doctor of the UCV.
The child was also asked to write down her fears, including the following briefly:
Fear.
• Very serious doctors
• I don't want to walk.
• I want to be a normal child.
• How much help will I need from mom?
• Will I go to rehabilitation?
• Will I have some years to recover?
• Will someone come home to help me with the duties?
• Can I die if I operate?
• What if I don't operate?
• What will happen if I operate?
• What plan does my mother have if I die?
• My father stayed in the O.R., can I stay?
• Can I have a handicap?
I don't want someone else's blood to me.
• Time in the hospital
• Scarring, staples, etc.
• Will you put me plaster in half the body after surgery?
Did you feel like a wheel?
I won't pick up a walker?
• The doctor said they would do as possible not to touch my lung, but what could happen?
• How long bedtime after the operation?
• Will I have any breathing problems?
What about drips?
I don't want to fix anything.
• I don't want to grow up with a rod and touch.
• Every day I get more scared.
Finally, the interview was conducted with the UCV team and the social worker of the CS, who was much more positive than expected.
The intervention was pending the evolution of the curve in the following six months and the mother and the child began to face positively the whole process.
