Sri Lanka: Long Term Medical Support and Growth Hormone Treatment for Children

Fazeer Ahamed

Age: 13

• July: 4 vials of growth hormone
• August: Neither Fazeer nor his family member attended the monthly meeting in August. Thus, Fazeer did not receive his 4 vials of growth hormone therapy for the month of August.
• September: 4 vials of growth hormone
• Fazeer’s dosage is 10 clicks at night, daily.

Fazeer is now in grade 13, and he attends Wayamba Royal College in Kurunegala, where he lives while continuing his studies. Economics, information technology, and accounting are the subjects he is studying in the Advanced Level, and he will be sitting for the examination in the year 2016.

For the convenience of his studies, Mr. Nishantha Sandakelum and Mrs. Stephney Minerva Fernando decided to allow Fazeer’s mother to attend the monthly meetings with all of Fazeer’s information. This decision was made at the monthly meeting in January 2015, and Fazeer was very happy and thankful to us.

We instructed Fazeer to attend a meeting every 3 months.

Madura Madushanka

Student

• July: 4 vials of growth hormone
• August: 4 vials of growth hormone
• September: 4 vials of growth hormone

He had attended school and private classes, and completed the Advanced Level Exam. At the moment, he is taking a computer course too. His mother is very much concerned with his progress, and * the medical authorities at Karapitiya Teaching Hospital are very satisfied with his progress and with her.

Gayan Madushanka

Student

• July: 2 vials of growth hormone
• August: 4 vials of growth hormone
• September: 4 vials of growth hormone
• Gayan’s dosage of growth hormone therapy is 10 clicks each night.
• An injection of Testoviron was administered on July 7th, 2015, August 4th, 2015, and September 8th, 2015.

Gayan had started to attend school again, and he is very happy about the school. Gayan is a developmentally delayed child, and this school provides education for such children.

Tharindu Hasanga

Continued Treatment

July – September:

• Tharindu’s increased medication had to continue. He visited the Karapitiya clinic with his new blood profile on July 23rd, 2015. No change in his medication. Tharindu has to attend the clinic with his new blood profile after 3 months.
• Senior medical consultant, Dr. Arosha, had instructed Tharindu to do more exercises to decrease his weight. Tharindu’s weight is 75 kilos.
• Professor Sujeewa Amarasinghe, the senior pediatrician at Karapitiya Teaching Hospital in Galle, Sri Lanka, had referred Tharindu to Dr. Arosha.
• Tharindu takes Rosuvastatin (40 mg) and Ezetimibe (10 mg) each night. He also receives a food parcel with more grains and a packet of fat-free milk powder. He is well now.

Madumekala Ubeywarna

Age: 22

• July: 4 vials of growth hormone
• August: 2 vials of growth hormone
• September: 4 vials of growth hormone
• Madumekala is continuing sex hormone medication: Climen, 1 tablet daily.
• As Professor Sujeewa instructed, Madumekala’s growth hormone therapy was increased again from 12 clicks to 14 clicks. We plan to meet with Professor Sujeewa to get his decision about Madumekala continuing the therapy, as there has been little progress in her height for the last few months.

Discussion with Madumekala
Dr. Martina C. Fuchs requested that we have a small, private discussion with Madumekala regarding her future plans. We spoke with Madumekala and found that she has no plans. Unfortunately, she behaves like a 4-year-old girl. She does not attend to any housework to help her mother. We had to put forward the same question many times about what she would do and what she would like to do as an adult, but Madumekala could offer no specific answers. She seems to have no idea for her life, and depends on her mother for everything.