| Anna
was born with a huge Exomphalos in May 2005 and it was treated
conservatively.
I was sixteen weeks pregnant with my second child when I discovered
that there was a major problem when the results of my ’16
week’ blood tests came back. My 12 week scan had looked
fine, but I felt peculiar and was convinced that the blood tests
would be positive. I remember apologising to the baby for having
them! Three days before Christmas 2004, my midwife called to
ask me to go to the Royal Victoria Infirmary (RVI) in Newcastle
as the tests had come back with some worrying results and the
baby could possibly have Spina Bifida.
The midwife called at 4pm and our appointment at the RVI was
at 9.30am the next morning at the Fetal Medicine Unit. My husband,
Andy, and I met with our consultant. Following a scan, he told
us there was indeed a serious a problem with the baby. We were
told that the baby had Exomphalos – something we had never
heard of - and that he/she could also have the chromosomal disorder
Edwards Syndrome. We were offered a CSV test immediately to
check for this and we decided to go ahead. The test took place
within an hour or so and was painless. The fact that things
happened so quickly that day was an enormous help to us as there
was no time to get really anxious.
From the start we were treated with enormous kindness and sensitivity
by the team at the RVI and I will always be very grateful for
that.
Unfortunately because of the Christmas break we had to wait
longer than usual for the results of the CSV test. The normal
two days became six and they were the longest of our lives.
We spent the period between Christmas and New Year investigating
the implications of Edward’s Syndrome and finding out
more about Exomphalos. Thankfully the results for Edward’s
Syndrome were negative.
The first few weeks following diagnosis were really difficult.
Expecting a baby is normally such a happy time, but we had to
tell people about the Exomphalos. Being able to direct people
to the GEEPS site was a great help as that covered ‘the
science bit’.
We eventually decided to find out the sex of our baby as it
seemed weird that all the RVI team knew what we were having
from the results of the CSV, but we didn’t. Knowing that
we were expecting a little girl gave us a real boost and a little
‘person’ to focus on.
We attended the RVI every three weeks and as time went on more
was discovered about our baby. Her Exomphalos was huge, but
before she was born the Foetal Medicine team were pretty certain
that her heart and lungs were good. I felt such mixed feelings
during the scans as I felt enormous love for my baby mixed with
real fears about how long she would be with us. I was also very
concerned about my eldest daughter and how she would feel if
her sister died.
Anna was born by C-section at 38 weeks. Our consultant had been
encouraging about trying for a vaginal delivery, but because
of the position of Anna’s liver in the sac he finally
opted for surgery and carried out the operation himself. I found
the whole experience quite surreal. I heard Anna cry (my mum
could hear her down the corridor her cry was so loud!), saw
her for a few moments, held her hand and then she was whipped
off to Special Care with Andy following close behind. We had
decided that I would have my mum with me - so that Andy would
concentrate on Anna - and that worked well. The Special Care
team took some instant photos of Anna for me and Andy was also
armed with our digital camera.
Some hours later I was well enough to get into a wheelchair
to visit Anna in Paediatric Intensive Care. She looked dreadful,
but was breathing for herself and I managed to breastfeed her.
To feed her and cuddle her on that first day was incredible
as it was so unexpected.
Unfortunately, the good times did not last. That night I was
taken back to my room (midwifery had very kindly given me a
private room, so that I didn’t have to listen to other
people’s babies crying), but Andy had to go home to see
our eldest daughter. I couldn’t sleep and just wanted
to be with my baby. At 2am a midwife rang PICU to be assured
that Anna was fine. However, when Andy and I went down to the
ward early the next morning Anna was very unwell and making
some awful grunting sounds. All day the medical team tried to
get her breathing back in line, but eventually they told us
that they would have to put Anna on a ventilator. We were relieved
as she was clearly getting worn out. Anna remained on the ventilator
for eight long days during which time she was fed mainly on
expressed breast milk.
The nurses on PICU were wonderful. They really encouraged us
to get involved with Anna’s ‘cares’, so we
changed her nappies, wiped her eyes and so on. She was very,
very swollen during this period and could barely open her eyes
most days. It was heartbreaking to see her cry - unable to make
a sound because of the tube in her throat.
Anna had to lie on her side as her Exomphalos put so much pressure
on her chest. Her dressing was changed daily and the nursing
staff suggested using a surgical stocking to hold the dressings
on to contain it a little. All we could do was spend as much
time as possible with Anna and give her some comfort. The nurses
were very tender with her.
We met with her surgeon who told us that he had decided to
take a conservative approach with Anna. No surgery would take
place until she was at least 12 months old and that she might
be in hospital for at least six of those. The Exomphalos would
be bathed daily and treated with a burns cream called Flamazine
to encourage skin to ‘heal’ over
Anna came off the ventilator at nine days old and came out
of PICU five days later. She still needed oxygen 24 hours a
day, but she was much less swollen and, to our delight, we started
to see that she looked just like her gorgeous big sister.
We moved into the Paediatric Surgical unit where we were really
able to get hands on with Anna. She started to have a daily
bath with disinfectant solution and then her Exomphalos was
treated with Flamazine and dressed. Over the next few weeks
I gradually took over the lead in this from the nurses. Anna
did really well and, bar some nasty infections, she thrived
from this point on. Her Exomphalos started forming ‘skin’
over it and began to reduce in size which in turn helped her
breathing to improve.
When she was six weeks old we were told that we could nurse
her at home with the support of the Community Nursing Team.
We were very worried about this, but were persuaded that things
would be fine and they were. It took me some time to get my
head around ordering oxygen canisters, prescriptions etc, but
all the difficulties were worthwhile as we were able to start
living as a family again. It was wonderful to see my eldest
daughter every day and my mum (who had stayed to look after
her and Andy) was finally able to go home.
Initially, a paediatric nurse came in daily to help me with
her bath, but as Anna’s Exomphalos shrank in size this
went down to twice a week. The nurses were all lovely people
and it was a pleasure to see them. Anna’s dad was very
hands on and always took care of her baths every weekend. We
visited the out patients clinic at the RVI every couple of months
and were thrilled when we were told that Anna’s organs
had gone back into her abdomen of their own accord. Anna’s
surgeon also said that as she had confounded all expectations
and was doing so well he might look at operating at six months.
Anna went into the RVI for her closure operation at the beginning
of December 2005 – at the age of just over six months.
I expected to feel very nervous, but by this stage I had developed
such faith in the team at the RVI that I was strangely calm
about the whole process.
Anna took the operation in her stride and came down from theatre
with a wonderful flat tummy. She was well enough to come home
within two days. She is catching up on sitting up, rolling over
and so on, but has some problems gaining weight. She will need
another operation before she goes to school as the muscle covering
her tummy isn’t quite strong enough. However, she looks
wonderful and loves nothing more than having raspberries blown
on her tum.
Our youngest daughter is an absolute joy to us and we still
can’t quite believe that she is here. Reading this story
you may think that the past year has been very grim, but we
have met some truly inspirational people who work for the NHS.
We also had wonderful support from friends and family, which
made all the difference in the world.
|