To Karen, with live from U.S. Family ordeal: A Cuban girl's mysterious symptoms sent her parents on a desperate search for help that led them to Baltimore -- and to the care she needed.

February 11, 1996|By Ernest F. Imhoff | Ernest F. Imhoff,SUN STAFF

One way to look at the Karen Vazquez story is that she's an 8-year-old Cuban girl who faced death but lives happily today because of good-hearted Marylanders -- a hospital, four doctors, a social worker, a minister, three charities and many new Hispanic friends.

Another way is that the American medical system saved her after the Cuban medical system tried and didn't.

Still another is that Karen, an evangelical Christian, is the beneficiary of Sinai Hospital's practice of tsedakah (pronounced sedaka), acts of righteousness in daily life as dictated by the Torah and Jewish law.

In any case, Karen and her parents, Lino and Laly Vazquez, are eager to praise God, George Washington and Maryland.

The story starts in October 1994 when Karen was a healthy second-grader who got straight A's in school and danced at the national theater in Havana. Her parents ran a tropical fish business. Mr. Vazquez, a marine biologist, also taught Russian.

Karen's health began to change. Her face became puffy, her abdomen grew, she tired easily, she lost some hair. She was not in physical pain, but other children made fun of her when her face took on the shape of a full moon.

The normally happy child often retreated in tears to her mother's arms. School became a nightmare.

The family doctor dismissed the parents' worries, saying Karen's heaviness was normal growth. Unconvinced, her parents took Karen to another doctor. Tests began. Karen was taken from one doctor to another, to six Cuban hospitals in all.

Some doctors suspected Karen had Cushing's syndrome, a metabolic disorder caused by too much cortisol, a naturally occurring steroid that regulates blood pressure, inflammations and other functions. If a growth on the pituitary gland is the cause, that's Cushing's disease, rare and potentially fatal. Cuba had little experience in treatment.

Karen's condition deteriorated. She could hardly walk. She entered a hospital March 27 and would not leave hospital care for months.

"We thought Karen would die," Mr. Vazquez said. "In the spring of 1995, we started to write letters."

Saving Karen's life became the family's obsession. They sold most possessions to pay for medicine and for travel to doctors. The father wrote to the Cuban government, President Fidel Castro's brother Raul, the Red Cross, other doctors, other hospitals. Letters went unanswered or responses were discouraging.

'Let's see'

"I started researching the medical problem," Mr. Vazquez said. "I wrote to doctors who had written papers on Cushing's, asking for help to save our dear daughter."

One such letter went to a Baltimore doctor. He asked for help from a friend, Dr. Annabelle Rodriguez, a Sinai endocrinologist who speaks Spanish.

Dr. Rodriguez said, "Let's see." She met with Nancy Swartz, the Sinai pediatric oncology social worker and with Paul Umansky, community relations director. Institutions don't assume such cases lightly, needs are so great.

Two years earlier, Sinai took on another critically ill foreign patient, a Russian girl with leukemia. She eventually died.

Sinai Hospital administrators, who approved $7.5 million last year in uncompensated charity care mostly in the Baltimore area, agreed to take on Karen free of charge. Dr. Rodriguez told the Vazquezes the good news by telephone and letter.

dTC Dr. Karen M. Armour, a Sinai pediatric endocrinologist, received pictures of the bloated Karen and with others concluded that the little girl probably had Cushing's syndrome. Many tests were needed.

Ms. Swartz called two Baltimore nonprofit agencies, the Ronald McDonald House and Roads to Recovery Inc., on whose boards she served. The McDonald house, 635 West Lexington St., lodges families of critically ill children during treatment. Roads to Recovery is a nonprofit agency run from a Wilkens Avenue living room by Mike and Della Polk, who lost their 9-year-old son, Christopher, to leukemia in 1990 and set up the charity for transportation expenses in similar cases.

The groups agreed to pay for the Vazquezes to fly and stay here.

Dr. Rodriguez contacted the U.S. Interest Office in Havana to begin preparations to request permission for the trip. The Vazquezes applied for visas, which eventually were approved.

'She didn't improve'

Meanwhile, Karen's doctors in Cuba apparently decided she did have Cushing's disease. Her condition worsened. A resident in general surgery rather than a neurosurgeon operated on Karen June 27 in a Havana hospital, the parents said.

"The hospital told us Karen was cured," Mr. Vazquez said. "But she didn't improve. She stayed in intensive care in July, August and September." She was too sick to travel.

In late September, Cuban doctors corrected the electrolyte imbalance that was keeping Karen from traveling, Dr. Rodriguez said. Having few possessions left, the family sold their air conditioner to buy clothes for the trip to Baltimore.

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