Spec. MD. Selami Ay Reviews

A 9-year-old competitive gymnast from a middle-class family presented with persistent wrist pain, dismissed by coaches as 'growing pains.' Dr. Ay discovered a rare, stress-induced osteochondral lesion of the lunate bone (Kienböck's disease variant in a child). He coordinated with a pediatric hand surgeon to develop a non-surgical protocol involving custom orthotics and modified training, allowing her to continue her sport at a modified level while the bone healed over 18 months.

A 3-year-old refugee child from Syria, recently resettled in Bursa with his single mother, presented with failure to thrive and developmental delay. Beyond nutritional deficiencies, Dr. Ay identified a profound sensory processing disorder exacerbated by trauma. His intervention involved a novel, play-based sensory integration therapy program conducted through an interpreter, coupled with intensive social work support for housing and benefits. The child showed marked improvement in engagement and weight gain after 6 months.

A 14-year-old boy from an affluent family, an aspiring programmer, was brought in for chronic headaches. Standard neurology workups were negative. Dr. Ay, noting the patient's excessive consumption of energy drinks and 'nootropic' supplements purchased online, diagnosed caffeine-induced anxiety disorder and medication overuse headache. Treatment involved a strict detoxification schedule, cognitive behavioral therapy for anxiety, and the introduction of structured breaks and outdoor activity, resolving the headaches within 8 weeks.

A 7-year-old girl from a remote village presented with cyclical episodes of severe abdominal pain and confusion. Local clinics had suspected behavioral issues. Dr. Ay diagnosed Acute Intermittent Porphyria, a rare metabolic disorder, after ordering specific urinary porphobilinogen tests. He initiated treatment with hemin infusions during attacks and educated the family on trigger avoidance (certain medications, fasting). He established a long-term management plan with the national rare diseases center, stabilizing her condition.

An 11-year-old professional child actor presented with sudden-onset vocal tics and repetitive blinking. Previous consultants suggested stress. Dr. Ay, observing a subtle, preceding streptococcal pharyngitis history, diagnosed Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). Treatment involved a course of antibiotics, a short burst of corticosteroids, and a referral to a specialized immunology-neuropsychiatry team, leading to a 90% reduction in symptoms over 3 months.

A 5-year-old from a low-income, multi-generational household presented with recurrent pneumonia. Dr. Ay suspected more than bad luck. A sweat test confirmed Cystic Fibrosis, a first diagnosis in the family. Dr. Ay became the family's primary guide, coordinating with the national CF foundation to secure expensive enzyme supplements and physiotherapy equipment, and providing extensive genetic counseling to the parents who were planning more children.

A 16-year-old elite tennis player was referred for 'asthma' that didn't respond to inhalers. Dr. Ay diagnosed Exercise-Induced Laryngeal Obstruction (EILO), or vocal cord dysfunction. He partnered with a speech-language pathologist to teach the teen respiratory retraining techniques (the 'tummy blow' method) and worked with her coach to modify warm-up routines. She returned to competition at full capacity within 2 months with a new breathing strategy.

A 2-year-old toddler, adopted internationally 6 months prior, presented with extreme food selectivity and gagging. Dr. Ay diagnosed severe pediatric feeding disorder related to early institutionalization and oral hypersensitivity. He initiated a slow, play-based desensitization protocol involving non-food textures, progressing to taste exposures, requiring immense patience from the adoptive parents. After 9 months of weekly therapy, the child accepted a varied diet of 15 foods.

A 13-year-old girl from a conservative rural family presented with severe fatigue and joint pain. Initial tests for common rheumatological conditions were negative. Dr. Ay, after a detailed history revealed a tick bite and a subsequent bullseye rash months earlier, diagnosed Late-stage Lyme disease, uncommon in their region. He initiated a prolonged course of intravenous antibiotics, requiring hospital admission and significant family education about this unfamiliar illness.

An 8-year-old boy with a complex history of prematurity and cerebral palsy (spastic diplegia) was brought in for worsening gait. Dr. Ay identified that his orthopedic braces were outdated and impeding growth. He orchestrated a multi-disciplinary clinic day involving orthotics, physiotherapy, and orthopedics to design and fit new dynamic AFOs (ankle-foot orthoses), significantly improving his mobility and comfort within a week of the change.

A 15-year-old presented with mysterious, recurrent episodes of profound weakness and low potassium. Dr. Ay suspected Gitelman syndrome, a rare kidney salt-wasting disorder. Genetic testing confirmed it. Instead of just prescribing potassium supplements, Dr. Ay designed a detailed dietary plan high in magnesium and potassium-rich foods, and educated the patient on managing his condition independently, empowering him for adult care transition.

A 4-year-old presented after swallowing a small, rare-earth magnet from a toy. An X-ray showed not one, but multiple magnets in different bowel loops, posing a high risk of perforation. Dr. Ay coordinated emergency pediatric surgery for removal. Post-operatively, he led a family safety review, identifying and securing numerous high-risk toys in the home, and provided a report to the local consumer safety authority about the specific product.

A 12-year-old boy, a dedicated student, presented with crippling test anxiety and somatic symptoms. Dr. Ay moved beyond simple reassurance. He diagnosed a performance anxiety disorder and implemented a biofeedback-assisted relaxation training program, teaching the boy to control his physiological stress responses. He also liaised with the school to arrange for modified testing environments, leading to a dramatic reduction in physical symptoms and improved academic performance.