Hemophiliac discharged after 11-year treatment

Phan Huu Nghiem, 37, was discharged from Cho Ray Hospital in Ho Chi Minh City on Tuesday after 11 years of treatment for an infection contracted after an injury 18 years ago.

The infection grew critical since Nghiem suffered from hemophilia A, a genetic deficiency in which the absence of a specific protein disrupts damaged blood vessels from clotting.

At 19, Nghiem fell and hit his side against a river boat while swimming in the Mekong Delta province of Vinh Long Province. Little did he know the incident had caused internal bleeding that would change his life.

Years later, Nghiem still suffered pain, though his family could not afford to send him for a proper health check.

Not until 2010, when he was 26, did Nghiem decide to visit Cho Ray Hospital for treatment after no longer being able to bear his condition, which had caused his stomach to distend.

Tran Thanh Tung, head of the Hematology Department at Cho Ray, said when Nghiem first arrived, the blood clot was still small, and that doctors had decided against an operation fearing excessive bleeding.

Instead, Nghiem received radiotherapy to make the clot shrink, traveling back and forth between Cho Ray and his hometown.

In time, the blood clot grew bigger.

"Hemophiliacs need only incur a small injury to develop a large hematoma," Tung explained.

In May 2014, Nghiem was admitted to the hospital suffering a high fever after the blood clot had developed into a tumor, exacerbated by gangrene of the hip, thigh, right abdomen, and continuous bleeding. The tumor covered the entire pelvic area, pressed on the ureter, and also caused pleural effusion.

Nguyen Truong Son, the then director of Cho Ray Hospital who is now working as Deputy Minister of Health, made the call to operate on Nghiem as his necrotic tumor had by then reached three kilograms in weight.

During the first large-scale surgery in 2014, doctors were able to remove around 2.5 kilograms of the tumor, though it was only the start of the journey.

Since then, Nghiem has undergone 25 additional operations.

Pham Thanh Viet, head of Cho Ray’s General Planning Department, said Nghiem has spent the longest time in hospital, had the most surgeries, and is subject to the highest medical fees ever, at VND40.8 billion of all patients.

Health insurance has footed around VND38.3 billion of the bill.

Do Thu Ha, deputy director of HCMC’s Social Insurance, said Nghiem is among a few to have enjoyed the highest health insurance coverage ever.

Le Minh Hien, head of the Department of Social Work at Cho Ray, said benefactors had helped Nghiem, with his family covering the surplus costs.

Ngo Duc Hiep, one of the doctors who directly treated Nghiem, said: "In addition to 26 operations and more than 10 sepsis treatments, we had to continuously encourage the patient, who had wanted to give up on many occasions."

Tran Thi Mai, Nghiem’s mother, said for the past seven years, doctors had only allowed Nghiem to return home for the Lunar New Year, Vietnam's most important holiday.

Though he has been discharged, Nghiem has to rely on a wheelchair for mobility.

"My biggest worry now is that once I’m gone, nobody would take care of him," his mother said.