First published on Parent24.com:

A virus killed our baby

After a successful heart operation, our baby’s illness was a cruel twist.

After Zaan had his heart operation, he started to recover very nicely. We found out that he was allergic to cow’s milk and had to be placed on soya milk. This cost us a trip to the hospital over Christmas.

With his check-up in January at the cardiologist she was so impressed with him. He was able to sit with support and  generally catching up to his twin brother Tristan. At their 6-month check-up at the paediatrician, Zaan was half a centimeter shorter than his twin and one kilogram lighter.

When Zaan was 7 months old he started drinking less. On Monday, 10 March 2008, he only drank two whole bottles during the day and I took him to the paediatrician, who diagnosed bronchiolitis.

Because of Zaan’s history the doctor had him admitted to hospital and placed in High Care. He shared a room with two slightly older babies that had the RS Virus. We were unhappy with the hospital’s care and took him to another hospital. Unfortunately by then he had already caught the RS Virus and was getting sicker by the day.

On Saturday, 22 March, Zaan was again transferred this time to the PICU at Unitas. We arrived there to find the paramedic, doctors and nurses in a panic. Zaan had crashed in the ambulance and had to be bagged with adrenaline to stop the bronchiospasms.

He was intubated and sedated before transfer, but the nurses at Unitas couldn’t find a vein to place a drip. Eventually a doctor from the emergency rooms was able to place a drip in his knee. But every time he let go, the drip would stop flowing and Zaan was waking up from the sedation.

An anaesthetist was called out and a direct line was put into his main artery with an arterial line in his arm. After what seemed like hours Zaan was stabilised on the ventilator. The next day while we were visiting Zaan, his colour turned all splotchy. The nurse did a blood gas panel and immediately called a doctor. Again my husband and I stood out of the way watching the doctors struggling to save Zaan’s life. Zaan was bagged again with adrenaline. It was obvious that every time he was bagged his lungs were taking strain. At the end of the crisis Zaan had only 20% lung function and his oxygen level was at 47 when normal is above 90.

Over the next few days Zaan’s oxygen level slowly started climbing. Eventually he was well enough to be weaned from the ventilator. He was looking a lot better, although he was very thin. On Saturday 5 April, he managed to eat 5 spoons of porridge, something that I had been unable to get him to do before he got sick. The Monday he was very unhappy that I couldn’t hold him for longer. He was getting tired of lying there.

On Tuesday the 8th of April Zaan was well enough that the doctor started talking about discharging him before he picked up another virus, although he was very tired and fell asleep in my arms. We quickly arranged for take-home oxygen to be delivered the next morning. That night just before 11 o’clock we got a phone call from the doctor. I heard my husband ask the doctor if she was joking. The next thing he said was that we were on our way.

Zaan had died. His heart just stopped beating. He was happy and chatting to them before the alarms suddenly started screaming. It was over so quickly that they couldn’t even phone us before he died. We drove to the hospital knowing that it was to late. He was lying in the isolation room wrapped in blankets. That was the last time I could hold my baby.

First published on Parent24.com:

Baby Zaan’s heart

Two months old and in heart failure – my baby needed an operation.

My third son, Zaan, the smaller one of twins, was diagnosed with a heart defect two days after birth. To put it in layman terms, he had a 1cm hole between the left and right side of his 3cm heart with a single valve in-between instead of two. This type of atrioventricular canal defect has to be corrected surgically between 4 and 6 months.

Zaan spent the first 3 weeks in Neo-Natal ICU. When he came home, he had a feeding tube for milk, a saturation monitor to check his oxygen levels and oxygen for when he slept. At the age of 6 weeks he needed oxygen all the time. We went for weekly check-ups at the paediatric cardiologist. Our aim was to get him as close to 5kg as possible by mid November. He would have been 3 and a half months old then, and he needed to have the heart operation before the doctors and staff went on annual leave.

However, Zaan was 2 months old when he went into heart failure. He was stabilised in the Paediatric ICU for a week and his operation was moved up to a week later. On Monday, 22 October 2007, Zaan was admitted to the PICU. He weighed 3.5kg and was only 2 and a half months old. One of the smallest babies to receive this type of operation.

We were given a booklet, made by a mother whose son had undergone the same operation, with photographs of what to expect afterwards. We were also told not to get a fright if our baby was blue. The procedure was explained by the cardiologist, as well as the recovery. Because of Zaan’s age and oxygen dependency his recovery could take longer and the risks of the operation were higher. Even with all of this information we still received a huge shock when we saw our son for the first time after the operation.

Six o’clock on Tuesday morning we were at his bed, his operation scheduled for 7:30. The nurses prepped him and we walked with him to the theatre. There we were able to kiss him one last time before the anaesthetist and theatre staff started with their work. Opposite the theatre was a small waiting room. That room terrified me! We couldn’t sit there and wait so we went for a walk.

Zaan came out of the theatre at midday. As soon as we walked into the PICU you could feel the charged atmosphere. All the staff were hyper alert and ready to react to the first sign of an emergency. Everyone was hushed. The machines beeping next to Zaan’s bed was constantly checked and changes were made as soon as one of the 13 alarms went off. More medicine was connected to the arterial line and drainage bags were monitored. Notes were made every 15 minutes of his stats.

Today I wish that I had taken a photograph of Zaan right after the operation. It’s almost impossible to explain his colour. I took one the next day when his colour had returned to normal. My baby looked like he was swollen to double his size. His whole body was the colour of a purple-blue bruise. Zaan had swollen so much from the by-pass during the operation that the surgeon was unable to close his chest. The chest cavity was left open with a covering of synthetic skin. On Friday the swelling had gone down enough for them to close his chest and stitch him up.

He was on the N2O ventilator for seven days. Another 3 days to wean him of the oxygen ventilator and by 3 November, he was taken of the ventilator completely. He still received oxygen, but with a box covering his head instead of a machine. On 22 November Zaan came home. He still needed regular check-ups at the cardiologist, but his operation was a success.

This was first published on Parent24.com

Special needs: you can do it!

Children with Down syndrome have special needs, but don’t despair. Here are some of the things you can expect.

In the beginning your baby will have the same needs as any other baby. They need to be fed, bathed, changed, loved and played with. Treat your baby the same as you would your other children. A loving family will cause them to thrive.

As your baby grows, he or she may be slow to react to you, but don’t be discouraged. You will find that the more you hold and cherish your baby, the reaction to your love will follow. Plus you will both benefit from the contact.

However, as your baby grows older, you will have to help him reach his developmental milestones.

What about my baby’s health?

Health varies from baby to baby, but Down syndrome babies are more prone to certain medical defects and problems. Most of these are treatable.

  • Most children with Down syndrome suffer from a weakened immune system. They are more susceptible to colds and flues, infections and stomach upsets than other babies.
  • The probability of heart defects is high. Although the mildest cases can get better with time, surgery is usually needed. These surgeries are often very successful.
  • Children with Down syndrome often have thyroid problems and it is a good idea to have the thyroid function tested regularly. Routine tests should be done at birth, six months and thereafter every year.
  • The nasal passages are narrow and block easily. Keep the nose open to prevent mouth breathing. The nose, throat and chest are particularly prone to infection.
  • Partial hearing loss is common, usually because of repeated ear infections. Any suspicion of a eye or ear infection should be seen to as soon as possible.
  • Dry irritated skin and sore lips are common. If your baby’s skin is dry or sensitive use a moisturiser like aqueous cream, baby oil, lanolin cream, vitamin E oil or olive oil. Babies with Down Syndrome usually have bad circulation so use a towel to rub him down after bathing and then moisturise with cream or oil.
  • Bad eye sight happens often and eye tests are recommended during the first year. Should your baby’s eyes become full of mucus consult your doctor immediately.
  • Gastrointestinal problems may occur with birth and can be corrected with surgery.
  • Babies with Down syndrome have trouble regulating their temperature and don’t handle changes in external temperature very well. So keep your baby warm and well covered in winter and cool in summer. Bath your baby daily, but keep the bath temperature mild. One solution is to let your baby sleep in a warm babygrow without blankets, or to make him a sleeping bag to sleep in. Keep your baby out of the wind.
  • Some children with Down syndrome tend to become overweight as they grow older, thus it is a good idea to start with a healthy balanced diet from early on. Try to avoid too much starchy food and sweets.

No one with Down syndrome has all of these health problems, but a good prevention plan is necessary for each child. With accurate diagnosis and the correct preventative measures most of these medical problems can be handled easily.

Teamwork between the family and the health care practitioners is necessary to diagnose and treat medical problems. A complete check up every six months is advised for at least the first 5 years.

You will soon have a healthy, happy toddler giving you lots of love and smiles.

 

The Down Syndrome Association can be contacted on (021) 919 8533 or info@downwc.co.za

This was first published on Parent24.com

Down syndrome myths

Time to face the facts. Here they are.

Even though my son has Down syndrome, when I was asked about the myths of Down syndrome, I had to really think about what those were.  We live with so many preconceptions that to get the facts right you sometimes need to consult the experts. With a bit of checking I realised that I shared some of those mistaken beliefs. The most common misconceptions are the following:

Myth: Down syndrome is a rare condition
Truth: Actually it is not rare at all. With approximately 400 000 people living with Down syndrome in the USA alone it’s the most commonly occurring genetic condition in the whole world.

Myth: People with Down syndrome don’t live very long
Truth: Although this used to be true, it was mainly due to the associated medical problems faced by people with Down syndrome. But with medical advances the average life span of a person with Down syndrome has increased to 50 years.

Myth: The parents of children with Down syndrome are older than average
Truth: It is true that older women are more prone to giving birth to children with Down syndrome, however since more younger women give birth than older women, the bigger percentage of babies born with Down syndrome have younger mothers. It might also have to do with the screening tests that are recommended to all pregnant women over 35 years of age.

Myth: People with Down syndrome are severely “retarded”
Truth: Most people with Down syndrome have only mild to moderate intellectual disability and can, with support and a modified curriculum, attend normal educational institutions.

Myth: Most people with Down syndrome need to go to a home
Truth: Unfortunately this used to be true many years ago. Today people with Down syndrome enjoy normal lives at home with their families.

Myth: Children with Down syndrome must attend special schools
Truth: The educational system in South Africa has made provision for children with Down syndrome to be educated with a modified curriculum in mainstream schools.

Myth: There are no jobs for people with Down syndrome
Truth: People with Down syndrome are quite capable of holding down a job. They do their jobs with enthusiasm, reliability and dedication.

Myth: People with Down syndrome are always happy
Truth: They go through all the same emotions that we do. They also get angry, sad and unhappy.

Myth: People with Down syndrome cannot get married
Truth: They are quite capable of experiencing love and getting married.

 

The Down Syndrome Association can be contacted on (021) 919 8533 or info@downwc.co.za

This was first published on Parent24.com

What is Down syndrome?

With specific characteristics, and affecting all races and classes, this condition is worth knowing about.

What is Down syndrome?
About one in 600 babies are born with Down syndrome in developing countries and one in 1000 in developed countries. It is caused by an abnormality in the genetic material. More specifically, the most common type of Down syndrome is an extra number 21 chromosome and is called Trisomy 21.

How does it happen?
Each person’s cells contain 23 pairs of chromosomes. When an egg or sperm cell is formed, only one half of the pair is contained within. Once conception takes place the fertilised egg again contains 23 pairs. In the case of Down syndrome the split of the chromosomes takes place incorrectly and the egg or sperm cell ends up with 24 chromosomes. With conception the fertilised egg will contain an extra chromosome, resulting in Down syndrome.

The most important thing to remember is that nothing that the parents did or didn’t do is responsible for this condition.

Down syndrome characteristics
Babies with Down syndrome look different from other babies and can therefore be identified at birth. Some of the typical characteristics include the following:
•    Eyes that slant upwards
•    Small folds in the inside corners of the eyes (Epicanthic folds)
•    Small white spots on the iris of the eye (Brushfield spots)
•    A small nose with a broad flat bridge
•    A small mouth, and tongue that looks too big
•    Small ears situated low on the head
•    A single fold in the palm of the hand
•    Short fingers and hands
•    Pinkies that turn in towards the hand
•    A bigger gap between the big toe and the next
•    A slightly flat appearance at the back of the head

Other signs include:
•    Unusually loose joints
•    Low muscle tone (Hypotonia), that makes the baby feel floppy
•    Loose skin at the back of the neck
•    Heart defects in approximately 50% of all cases
•    Eye defects in about 60% of cases
•    Hearing problems may occur and can affect speech
•    Developmental delay (intellectual disability can be mild to moderate)

Not all of these characteristics will be present in all the children. Like other kids, children with Down syndrome look like their parents, for example hair and eye colour, but they will also have some of the above characteristics.  Each child is a unique individual and can differ greatly in appearance, temperament and ability. Remember that appearance doesn’t have anything to do with intelligence. This means that if someone has more of these characteristics it does not mean that they are more intellectually disabled.

Down syndrome is diagnosed with more than just these characteristics. A chromosomal analysis is done in a laboratory before it is an accepted fact.

Where does the name “Down syndrome” come from?
Down syndrome is named after Dr Langdon Down, who described the characteristics of the condition for the first time in 1866. The word ‘syndrome’ means the collection of specific characteristics and symptoms that are found in combination.

Source:  Step by Step into the future. An Introduction to Down syndrome, Published by the Department of Health.

The Down Syndrome Association can be contacted on (021) 919 8533 or info@downwc.co.za