Monday, March 24, 2008

'My second life'


By J.J. Huggins
Staff writer

Ioan Tomsa started hiding his face when he was 7.

It was at that age that doctors took out his right eye and the surrounding cheek bone during surgery to remove a benign tumor pressing against his brain. The Romanian boy was left with a face that appeared caved in on the right side, with a dark hole where his eye had been.

People gawked at him. He began to hold his right hand over his face and turn away from people. Tomsa describes the way he felt in one word: "Ashamed."

"This was the only thing they could do," said Rodica Lupu, a Romanian pediatrician. "They didn't think of the look and the aesthetic outcome."

Lupu did consider "the look," and she worked to bring Tomsa (pronounced TOM-sha) to the United States for surgery to reconstruct his face.

She needed to find highly skilled experts willing to work without pay and hosts able to take in a young Romanian who spoke little English. The cost of the surgery and a trip to the United States was far beyond the reach of Tomsa's poor farming family in Rozavlea, a village in northern Romania near the Ukraine border.

Lupu found what she was looking for here in the Merrimack Valley. In January, a "dream team" of medical specialists came together to perform seven hours of surgery at Caritas Holy Family Hospital in Methuen. Two families in Windham welcomed the young Romanian into their homes for several weeks as he prepared for the operation and recovered.

Tomsa, who turned 20 while here, no longer has to hide his face. He feels reborn.

"I am feeling excellent," he said in Romanian, with Lupu translating. "I live my second life."

From Romania to Valley

Tomsa's road to the operating table was long. It began six years ago when his family saw an advertisement for a free health clinic run by a group of American doctors in another Romanian town.

Tomsa and his father, also named Ioan Tomsa, rode a train for 12 hours to reach the clinic. The doctors could do nothing for Tomsa — he would need to go to the United States for facial reconstruction.

But it was at the clinic that Tomsa met Lupu, a doctor at a Bucharest hospital who was working with the Americans.

She made it her mission to get help for Tomsa. A contact in the United States eventually put her in touch with Healing the Children, an aid group based in Spokane, Wash.

Faye Barry, program director for the group's Connecticut-based Northeast chapter, contacted North Andover plastic surgeon George Chatson, who had been to Romania on a medical mission for Healing the Children.

"Then everything just kind of fell into place," Barry said.

Chatson assembled what he called a "dream team" to perform the surgery. All the members of the team volunteered their time and services free of charge.

"One thing I have observed in the course of doing this project — that people are very willing to help," Chatson said. "I asked my own dentist to help."

The dentist, Jonathan Schrader of North Andover, accepted, along with Ian Glick, another North Andover dentist. Gary Rogers, a craniofacial specialist at Children's Hospital in Boston, also stepped forward. So did Richard Mirra, an oral-maxillofacial surgeon, and Erin Donaldson, a clinical anaplastologist — a specialist who creates prosthetic devices to restore malformed or missing parts of the body.

Caritas Holy Family donated the use of an operating room.

Sacrifice and surgery

Meanwhile, Tomsa's father sold one of the family's two cows, raising $300 to pay for a trip from their village to Bucharest to obtain a visa for Tomsa. It was a significant sacrifice.

In rural Romania, many families rely on their own cows for milk. Tomsa's family — which also includes his mother, Maria, sister Maria, 16, and brother Nicolae, 10 — lives on a farm with one horse and two cows, growing apples, hay, potatoes and other vegetables they sell.

Tomsa said there are "about 1,000 chimneys" in his village, meaning 1,000 homes. There is one tractor and eight computers.

Tomsa arrived in the United States in January, accompanied by a doctor from Romania, Cristina Patru, who served as his translator and supporter. Lupu remained in Romania but was able to visit Tomsa when she came to the United States in February for the wedding of her daughter, who lives in Abington.

Before the surgery, Tomsa needed dental work. He had never had any done because he could barely open his mouth as a result of his facial deformity.

"A portion of the bony tumor could have involved that part of his cheek," Chatson explained, "or just the pain and recover from surgery (to remove the tumor) could have caused him not to move his jaw and his jaw got stiff."

Tomsa had such difficulty chewing that he ate mostly pureed and soft foods, like mashed potatoes.

When Chatson and Tomsa stopped at McDonald's before the operation, Chatson was amazed at his struggle to eat.

"It took him about 15 minutes to eat an Egg McMuffin," Chatson said.

The dentists recruited by Chatson cleaned Tomsa's teeth, did a root canal and removed a decayed tooth.

The surgery to rebuild the right side of Tomsa's face took place Jan. 25.

Over seven hours, doctors made an incision in Tomsa's scalp and reconstructed his eye socket and cheek bone, using a material called Medpor that was secured to his skull with small titanium screws. Medpor is a porous, high-density polyethylene that can be shaped into a variety of implants. It is commonly used in cosmetic plastic surgery to augment chins or cheekbones.

Porex, the company that manufactures Medpor donated the material, worth about $2,500.

Doctors then stretched the skin of Tomsa's face to cover the Medpor, leaving a scar across the top of Tomsa's head that is partially masked by his hair. His face now has an even contour and bears no sign of deformity, except for the missing eye.

But with his eye socket reconstructed, Tomsa can be fitted with a glass eye (actually molded plastic), donated by Jahrling Ocular Prosthetics of Boston. The eye is expected to be implanted next month.

Tomsa visited Chatson's Turnpike Street office recently for a follow-up.

He has picked up enough English to say "Thank you very much" to Chatson, though he mostly communicated his appreciation with a wide grin.

Chatson handed the young man a green envelope, which Chatson said contained money from Chatson's mother for Tomsa's family.

The staff at Caritas Holy Family is also raising money for the family, Chatson said.

"They wanted to take up a collection to pay for a new cow," he said.


Two Windham families have taken turns hosting Tomsa during his stay — Elaine and Edward Yourtee and their next-door neighbors, Richard and Beth Straub.

Elaine Yourtee is executive director of Nobody's Children, an international children's relief agency she and her husband founded after adopting a Romanian orphan.

Yourtee said Tomsa exudes newfound confidence since the surgery.

He looks in the mirror and says in English, "Total normal."

"He just kind of took his head and turned it a little bit like, 'I have nothing to hide,'" she said. "And then he's always touching his face and touching around the right eye orbit, which is new to him. He cannot wait to get home for his whole village to see his new face."

Thanks to the surgery, Tomsa can also eat normally again.

"He loves apples," Yourtee said.

They were too hard to chew until doctors cut scar tissue to allow Tomsa to open his mouth freely.

This is Tomsa's first time away from home. He had been dating a young woman back home and is eager to show her how he looks after the surgery. He could return home by the middle of next month.

Tomsa realizes how lucky he is — "What a big chance I had," he said — and how a new life awaits him in his native Romania.

He never finished high school because his school was in the next village — so far away that he would have had to stay overnight. His family couldn't afford room and board. But now that he's no longer ashamed of his appearance, he is considering resuming his studies and getting a car to become a taxi driver.

And when he returns, Lupu said, "he will keep his head up."

How to help

Nobody's Children is seeking donations to help others like Ioan Tomsa. They can be sent to:

Nobody's Children

P.O. Box 1076

Windham, N.H. 03087

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