3 Sep 2006 - A battle won

On Wednesday night our little man was hit by a really bad infection which caused his stomach to blow up like a balloon. This in turn impeded his breathing resulting in a big desaturation in his oxygen levels and us coming in on Thursday morning to find an ashen baby with a hugely distended tummy in need of resuscitation. Up to then his previous two weeks of life had been relatively calm and, apart from a minor infection the week before, there was much to indicate that he was making good progress. So seeing him in this state rocked us to the core and a chat with our paediatrician (Paul) made it quite clear that his life was in the balance.

Suddenly we were taking big steps backward. Having coped valiantly on the CPAP (continuous positive airway pressure) for four days up to that point Sam had to return to full blown ventilation. Paul upped his antibiotics from one to four – the big guns as he called them. The precious drops of breastmilk that were going in had to be stopped, sedatives were restarted, another transfusion of packed blood cells and then praying that his gut did not start to die (necrotise) and perforate which would be very bad news. A thick dirty yellow paste was constantly emerging from the pipe in his throat that led to his gut. The C-Reactive Protein (CRP) level, one of the measures of infection levels was at 70 (7x the norm) and his platelet count was right down. His whole body starting swelling up. All we could do was wait and pray.

Friday and Saturday were much the same with at least no further regression but still no clear sign of the infection abating with CRP more than doubling to 150. It was a bit scary when we heard that. Thankfully his vital signs (oxygen levels, blood pressure, heart rate) had stabilised and the ventilator was doing all of his breathing for him allowing him to focus his energies on fighting the infection. The paediatric surgeon visited twice over the two days to assess his condition and whether it would be necessary to operate on his gut. Yesterday afternoon he decided it would not be as Sam had been pooing for Cape Town the night before and throughout the day which meant that his gut was still intact. Paul’s assessment yesterday was that little Sam was in the middle of the woods but at least he had an axe and was using it.

Today (Sunday) finally Sam seems to have won the 3 day battle with his CRP levels halved to 70 and platelet count up again. He still looks pretty awful, his arms and legs are riddled with holes and bruises where the venus lines have gone in and his belly still looks like a sunburnt Blue-Bulls supporter’s but we are overjoyed to still have him. Infections like this hit one unawares and are something that all the staff continually warn us of but it’s impossible to convey the pain as a parent to watch your precious child’s life sinking away then sitting on the brink, not knowing whether the drugs that are slamming into his tiny body are going to work.

But we rely not on medicine alone. We know that people (I’ve realised thousands of individuals) across the world have been praying for little Sam and we are again so thankful that his Creator holds him in his hands. We watch in awe as prayer networks are set up here and in the UK and complete strangers meet us at the hospital and tell us how much they have been thinking of and praying for us.

For those who do pray we ask you to lift up:

• Paul, on whom we rely for medical decisions. It’s astounding how hard this man works, his

dedication to Sam and the honesty and care with which he deals with us. The nurses who attend to Sam for 12 hours at a stretch surviving on coffee and love for these tiny babies

• Matt who is starting to become pretty restless at night

• Mich and me. We’re still looking at being at least another 6 weeks in NICU and Paul has made it quite clear that once Sam is released that he can only be exposed to people on a very limited basis for the following 9 months unless we want to see him back in hospital. We have to do a CPR course prior to his release. A long hard road lies ahead and we cannot manage it in our own strength. I’m also involved in running two organisations so need energy for the extra hours needed to keep all the balls in the air and spend enough time supporting my wife and sons.

For Sam, please pray:

• Against infection. We’ve seen what it can do now and are exhausted by the prospect of having to go through this many more times.

• That tomorrow he can be weaned off the ventilator onto CPAP again.

• That feeding can commence again to keep the stomach active once the current infection has died down sufficiently.
• For veins - unfortunately the veins in one so small disintegrate pretty rapidly so Paul is continually having to find new ones for the lines that provide intravenous food, drugs and blood products. This again highlights the need to move as rapidly as possible onto stomach feeding as much of the food and drugs can then be administered that way.

• For his brain to be shielded from haemorraging

• Mostly though that little Sam will feel protected and comforted. He’s been so distressed for the past three days, crying away silently with no air passing his larynx and his tears remain behind his fused eyelids. (We’d love to be the first people he sees when he eventually opens his eyes). It’s difficult to know how to comfort him – so mostly we rest a hand on his head and read to him. We’ve finished two books so far, so if nothing else, by the time he leaves the NICU he will have an encyclopaedic knowledge of Narnia.

Sam's ventilator