My wife having had cervical cancer approximately five years before her pregnancy, we thought it may be a good idea to have an ultrasound to rule out any complications. On our second routine scan at 16 weeks were given the devastating news of our newfound challenge. I resorted to hibernation for a few days while trying to educate myself through various sites on the internet. I must add that I found many of these sights to be rather depressing. We are very fortunate to be seeing, in my opinion, one of the best teams in the world. The foetal assessor, Dr Linnie Muller, the paediatric surgeon, Dr Rob Brown and the paediatrician, Dr Alexander are based at the Panorama Clinic where both the C Section and Gastroschisis operation took place. They have a very advanced neonatal clinic where babies with various challenges are monitored 24 hours a day.

We were guided with realistic information by the team who have devoted much of their life to Gastro children. Besides various hospitals around the world where Dr Brown has performed these operations, he has successfully undertaken twelve such operations at the Panorama Clinic and all twelve children are leading perfectly healthy lives today. Although they also rely on parent’s intuition they are also very determined that their success rate is based on certain rules and regulations that need to be followed.

The team firmly believe that the little one needs to come out a month premature. In the last month the organ tends to start swelling and the amniotic fluid levels drop considerably.

They also firmly believe that a C Section is the only way to go to prevent any further trauma to the little one and the organ. The little one is removed and within the first hour the organ is pushed back through the opening and the little opening is then sewn up. In most cases no cutting is required due to minimal dilation of the bowel. Dr Rob Brown successfully “moulded” a little belly button for Tate. The Gastro babies are normally in I.C.U. for a period of four to six weeks. The longest stretch has been the recent case of Tristan where he was hospitalised for approximately ninety days. Obviously the determining stage is the length of time they spend on TPN while everyone waits for their bowel “to wake up”.

Our little girl Tate, was born on the 2 August 2004 at 9h30am. She was three days short of thirty four weeks and weighed 1.8 kg’s. I was present throughout the entire C Section as I took photo’s on a digital camera in order to show my wife, Tabera, progressive pictures while Tate was being taken out. Having done a little studying I knew that a healthy bowel would be free on any dark blue and purple areas which indicate atresias. Tate was then wheeled to the Neonatal Room for the re-insertion procedure. The bowel was inspected for atresias and size. Dr Rob Brown took a full forty five minutes to re insert the organ. We were able to see Tate about an hour later. I managed to get Tabera into a wheel chair that evening to take her through to see our daughter. The following morning Tate was taken off the ventilator.

Up until Thursday the 12th the fluid being aspirated from the stomach was still very green, thick and far too much. However very little was aspirated on the 13th and the fluid was light yellow to clear which indicated that the bowel was moving the fluid. 2ml feeds of expressed breast milk were introduced every three hours. Unfortunately dark fluid was again aspirated in high volumes the following day so Tate was taken off her milk feeds. On Tuesday the 17th a small dark stool was found in Tate’s nappy! This was great. I never thought anyone would look so forward to seeing a dirty nappy! Another stool was found in Tate’s nappy yesterday and so progress continues. Tate is now on 4ml feeds every three hours and she seems to be absorbing the food.

We now hold thumbs that her stools will become more progressive thus increasing her feeds. If things go on as they are Tate should be out at the end of next week. I do believe that Rob Brown and his team are perfecting the treatment of Gastroschisis as one should always compare the term of hospitalisation of their little patients to that of other cases. It is very difficult for the mother to leave her child each evening for the duration of the hospital stay and becomes very traumatic for the mother, however in hind site it is now easy to say that when one sees the other challenges that face babies that are born without defects such as Gastroschisis in the Neonatal Care one is very happy with the small challenge we have to put up with for those few weeks. The chances are so very high of our little one never having to return to hospital for the same challenge. The only reminder is her slightly distorted belly button which will go on to tell many a tale when wearing her bikini!!!

Hey, nice belly button!

21 December 2004

Our little Tate is growing steadily, developing her little personality and attitudes. She now weighs 4.7kg’s. She is still on breast milk which I encourage all mothers to continue with for as long as possible. We have recently started to introduce small amounts of rice cereal. One would never have guessed that our little girl was born with a challenge. Although her little belly button will tell many tales when wearing her bikini, Dr Brown has done a great job in moulding a new one during the insertion operation.

We now hold a very special place in our hearts for the great team at Panorama Clinic and could never have enough energy in this lifetime to express our continual gratitude for getting our miracle Tate through the first part of her little challenging life.

14 March 2005

Tate now weighs 6.1kg’s and is growing steadily. Although we have introduced solids, Tate is still on breast milk as her staple diet. We have learnt that this is so important for these little ones as their lives started out with a bumpy ride on what I call the “silent killer” which ironically kept them alive, TPN.

Both the Paediatrician and the surgeon are extremely happy with Tate’s progress and they are very passionate about sharing their findings with the medical world.

Tate with Mum Tabera

My findings on the internet were very disturbing and negative. After meeting up with our team we knew every expectation in detail however felt tremendously lifted since the first day we found out. We have also found the need for education to be provided to the clinics that offer foetal assessment as we were devastated at the first news and soon thereafter having to discuss termination. In our opinion termination is absolutely out of the question regarding Gastroschisis! As mentioned, each and every case done at Panorama Clinic has been successful with minimal hospitalisation! Again I emphasize that the only traumatic part of the Gastroschisis challenge was having to leave our little girl each evening. This is were us husbands need to find copious amounts of patience and loving tender care for our wives!!!

Should there be any other “gastro parents” to be out there that need some support and questions please do not hesitate to contact me on the below email address.

Thank you for your time.

Kindest Regards

Troy, Tabera and tate troy@alternate.co.za

see Tate’s story and pictures on Dr Linnie Muller’s website www.fetalmedicine.co.za