Twelve days after Rogers Ssembatya was admitted to St. Vincent Healthcare, the Ugandan youth was sitting in a wheelchair with a smile on his face.
Now an outpatient, he and his American guardian, Terry Fettig, met Wednesday morning with Dr. Timothy Dernbach at the St. Vincent Wound Healing Center. Rogers, 15, will soon begin a series of treatments in one of the center’s hyperbaric chambers to help speed his healing.
The ailing Ugandan teen, who had returned to Billings from Africa after being granted humanitarian parole, spent a week in the hospital while doctors pinpointed his diagnosis and began treatment.
He and Fettig arrived in Billings on Oct. 16, with Rogers sweating and shivering by turns, although his temperature was normal. The paraplegic had three pressure ulcers on his bottom, two superficial and one very deep.
“The deep one, unfortunately, has penetrated into the ischium, which is part of the pelvic bone, and it’s infected,” Dernbach said in a separate interview. “And those are very, very difficult to deal with.”
But new technology and cutting-edge medicine will make the treatment much easier than it might have been in the past. And it’s doubtful either would have been available to Rogers in Uganda.
Dernbach, a vascular surgeon and medical director of the Wound Healing Center, had a short answer when asked what would have happened to Rogers if he hadn’t come back to the U.S.
“He would have died,” the physician said. “Not next month or two months, but probably a year from now, of sepsis.”
Instead, Rogers talked on Wednesday about what he’s looking forward to now that he’s starting to feel better.
“I’ll be happy to see my friends again,” the soft-spoken youth said. “I’m excited.”
He’s already seen one friend, Zach, a few times, and he’s looking forward to getting back into school. But first, he needs to heal.
This is the second time Rogers has come to Billings for the highly technical medical care he requires. He came for the first time in February 2010 and spent nearly 2 ½ years here.
At a young age, Rogers was struck with tuberculosis of the spine. The untreated illness gradually made it impossible for him to walk and very difficult for him to breathe.
Fettig and Nadine Hart, a physician assistant at St. Vincent, worked together to eventually bring him to Billings for care. Hart is a founder of the Billings faith-based Hope 2 One Life, which works in Uganda, and Fettig also has worked with a Christian ministry there.
Dr. Gregory McDowell, an orthopedic surgeon with Ortho Montana, diagnosed him with post-tubercular kyphosis.
The spinal deformity caused Rogers’ spine to bend about 160 degrees. It compressed his spinal cord, causing near paralysis and restricting his breathing.
Rogers underwent delicate surgery performed by Dr. Oheneba Boachie, a renowned spinal surgeon from New York City, and McDowell. A portion of the spine was removed, and the spine was realigned and fused.
The surgery went well, and while Rogers would never be able to walk, he could breathe easier and have a much better quality of life.
In summer 2012, Rogers accompanied Fettig to Uganda where he went to work on a construction project. It also gave the young boy a chance to see his mother, who was ailing and who died while he was there.
The expectation was that the youth would return to Montana to continue his medical care. But his visa application was denied.
Finally, more than two years later, with the help of Shepherd immigration attorney Christopher Flann, Rogers was granted a humanitarian parole to return for medical treatment. An application can be made to extend his stay a second year.
The original plan upon his return was to do treatment on an outpatient basis. But Rogers’ symptoms led physicians to admit him to St. Vincent on Oct. 17, where his pressure ulcers could be treated.
The good news, Dernbach said, is the hardware installed during his spine operation was not infected. Further tests were needed to pinpoint the source of his infection.
“In the past, we would take these patients to surgery and we’d open the wound up and cut out all the infected bone, and it’s a really, really big deal,” Dernbach said.
Instead, a bone biopsy was performed, and, once the bacterial infection was identified, Rogers was put on a new, potent antibiotic that only has to be injected once a week.
The next step will be for Rogers to be treated in a hyperbaric chamber daily for two hours, for about six weeks. The problem with treating a bone infection with antibiotics, is “the bone is essentially dead, so the antibiotics don’t get in there,” Dernbach said.
“So even though you treat him appropriately, it just doesn’t get the job done,” he said.
The hyperbaric treatment causes the body to grow new blood vessels in the infected area. To boost the treatment, Dernbach will use a new drug called Epifix, donated by MiMedx.
“I can inject it into the wound, and it will really hasten the healing,” he said.
The combination of hyperbaric, the Epifix and the antibiotics give a 90 percent chance of healing the infection, Dernbach said.
He added that not only is he optimistic about Rogers’ healing, he has high hopes for the youth.
“I don’t know him very well, but he’s got a great attitude and he’s got a can-do approach to life,” Dernbach said. “So I think he’s going to do very well for the long term.”
Fettig said things are going much better than they were when the pair flew into Billings.
“He’s so much happier than before because he wasn’t feeling good,” Fettig said. “He still has the infection, but the antibiotics are working, and we’ll continue those for three more weeks.”
He added that McDowell looked at the X-rays of the hardware from the first surgery, “and he said they look very good. All the screws are tight, and everything’s in place.”
Fettig said once Rogers’ health is stable and he is able to sit up for more than a few minutes, he’ll be home-schooled. He also possibly will take electives at a nearby Christian school, which will also give him an opportunity to be with other kids.
Rogers, for his own part, admits that he misses his brother and the girlfriend he left behind. But he’s looking forward to the future, and maybe becoming a lawyer.
It’s one way, he said, he might make a difference in someone else’s life.