SINGAPORE - What most people take for granted, Mr Pang Poi Wong has had to fight for his whole life to get: a clean bill of health.
Born 19 years ago with four heart defects that conspired to deprive his body of oxygen, he faced death on countless occasions, turning blue in the face, lips and nails whenever he was exhausted.
Madam Lim Lye Kiaw thought the birth of her youngest child had gone normally until the doctors came to her and told her something was wrong with the baby. He had a bluish cast to his skin. She recalled in Mandarin: "My mind went blank and I could only ask myself repeatedly why my child had to be ill."
The 49-year-old sales promoter, whose husband died 13 years ago, has two other sons aged 25 and 22 who were born healthy.
Doctors put the tiny baby through an echocardiogram, or ultrasound examination of the heart, and determined he had pulmonary atresia.
This means that his pulmonary artery, an important blood vessel which carries oxygen-poor blood to the lungs to receive oxygen, was not properly developed.
To make things worse, the three branches of the artery were not joined, as they should be.
He also had a hole in the wall (septum) separating the right and left ventricles of the heart, so blood that had been depleted of oxygen kept mixing with blood that had been enriched with oxygen.
His aorta, which was supposed to carry oxygen-rich blood from the left ventricle, also received oxygen-poor blood from the right ventricle because of the hole in the heart.
Most babies now pull through complex heart conditions like his, but Mr Pang's journey was especially difficult.
Associate Professor Quek Swee Chye, head of the division of paediatric cardiology at the National University Hospital (NUH), said congenital heart disease occurs in eight out of every 1,000 live births.
Of these, about 3per cent will, like Mr Pang, have pulmonary atresia with a ventricular septal defect. More boys than girls have the defect.
At two days old, Mr Pang had an operation to create a pathway for blood to reach the lungs. As he grew, alternative pathways had to be created to meet his oxygen needs.
Due to his heart condition, he never had a single physical education lesson in school. When his brothers played basketball with other kids, he stayed on the sidelines.
For his mother, no sacrifice was too great. Every time he fell sick, she would rush him to a clinic before the infection could exacerbate his condition and make breathing difficult.
Finally, his doctors scheduled the major operation to repair his heart defects after his Primary School Leaving Examinations.
But catastrophe struck just after his first paper. He came down with dengue fever and had to take the rest of his exam in hospital. The operation was delayed by half a year.
His mother said she was so worried during the repair operation that she could neither sit nor stand.
She said: "I rallied all my family members to come to the hospital to support me round the clock."
He was in hospital for close to a month. When he returned to school, his teacher asked other students to take turns to carry his schoolbag.
Another blow: Down with H1N1
Down with H1N1
But Mr Pang was elated. He could feel his body was on the mend. He had more energy and no longer needed his eldest brother to carry him piggyback when they went out.
He also started playing basketball regularly with his friends in school, going for 20 minutes at a stretch.
Still, his problems were not over.
Five years later, the conduit, which was put in his heart when he was 13 to take over the job of his underdeveloped pulmonary artery, had to be replaced.
Dr Terence Lim, a consultant at the division of paediatric cardiology in NUH said such grafts have to be replaced periodically because of the calcium deposits on the walls.
But again, the operation, scheduled for the beginning of 2010, faced a hitch when Mr Pang was infected with H1N1 - an influenza virus - followed by acute transverse myelitis, a neurological disorder.
The operation was finally performed a year later. Doctors also replaced a faulty valve with an artificial one.
Each surgery a higher risk
Each surgery a higher risk
Prof Quek said that each subsequent surgery Mr Pang goes through carries an incremental risk as the operating time gets progressively longer.
Madam Lim said her son was a "very brave child" because he never cried and would take the initiative to learn about his condition and surgical procedures from the Internet.
Mr Pang's final operation resulted in complications that led to a hospital stay of 53 days.
After a year-long hiatus, the first-year Ngee Ann Polytechnic student is back in school now, where he studies logistics and supply chain management.
He said: "I'm really lucky and grateful to the doctors. Despite my condition, I was never bullied or teased in school."
Prof Quek said Mr Pang's repaired heart will never "be as pristine as a normal heart", although he can now do many things just like his peers.
Dr Lim said Mr Pang has a higher risk of arrhythmia (abnormal heart rhythm) and infective endocarditis (where the heart valves become infected by bacteria) as compared to a healthy person.
Mr Pang's last two operations cost about $45,000, of which $7,000 was covered by the NUH Kids'
Heart Fund, that provides financial support to children with congenital heart disease.
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