Baby R was 13 weeks old when he was admitted to St Joseph’s late 2020. When he was born, a lack of oxygen resulted in brain damage and this affected his ability to swallow. He had a tube placed through his nose down to his stomach to help him get the milk that he needed to grow. The muscles and valves involved in keeping the milk down in his stomach were also affected, and as a result he has severe reflux which caused all his milk to reflux out almost immediately as he was fed. Despite receiving medication to help control this response, he struggled to grow and put on weight. The clinical teams of the tertiary hospital, St Joseph’s and his mother were concerned about Baby R’s failure to thrive and together with support from the speech therapist and dietician they were able to reposition his feeding tube when it dislodged, supply continuous feeds from a feeding pump when needed, and supply high calorie feeds to achieve the first weight goal of 5kg. This weight achievement was crucial because it would allow him to be at a safe weight to receive a percutaneous endoscopic gastrostomy (PEG) which is needed for long term tube feeding. Once he achieved his first weight target, Baby R continued to thrive under the care of the nursing team at St Joseph’s where he received small volumes of milk every 2 hours. He was approved for surgery and received his PEG early in April 2021 shortly before being discharged.
Cynthia Lakay is a former patient of St. Joseph’s and she never thought she would be visiting her son, Angelo, at the very same facility she once called home. Suffering from TB of the spine, Cynthia started treatment in 2001 for a year and attended St. Joseph’s Special School. Today she leads an independent life, enrolled for a business administration diploma and cares for her son.
Angelo was admitted to Red Cross Children’s Hospital after an accident and later referred to St Joseph’s. He was diagnosed with transverse myelitis, after minor trauma to his spine. Transverse myelitis is a condition in which a section of the spinal cord becomes inflamed. During an inflammatory response the myelin, or protective fatty coating on nerve cells, is damaged or destroyed, resulting in weakness or paralysis, pain, and sensory dysfunction. Autonomic, or involuntary activities such as breathing, digestion, heartbeat and reflexes can also be affected. Part of Angelo’s thoracic spine (middle of the spinal cord) was affected and resulted in paralysis of part of his trunk and legs, slight weakness in his upper limbs and has affected his bowel and bladder function.
On admission he was unable to sit without support and arrived in a buggy mobility device, which provided maximum support. He received regular Physiotherapy and Occupational Therapy to address his areas of weakness. His balance while sitting improved and he progressed to a self-propelling wheelchair and is now able to sit at a table, and engage in fine motor activities.
“Angelo is a charismatic and charming young man who is motivated to get better. His positive energy is contagious and is definitely his biggest asset in overcoming his physical limitations “said occupational therapist Asgeree Dalvie who treated him at the time.
Twin sisters Audrey and Nicolene (1-year-old), arrived at St Joseph’s in February 2019 after being referred from Karl Bremer Hospital where they were treated for pneumonia. They were born prematurely and had low body weight, iron deficiencies and weakened immunity, all of which made them prone to infections and required frequent hospitalisation.
Daily nursing care encompassed administration of oral medication, 2-hourly feeding sessions and bathing. It was complimented by daily body massages to comfort, develop relationship with nurses and build trust. Feeding sessions became a special time for nursing staff in the ward, especially when their increase in body weight became visible and the team was reassured that the twin babies’ health is improving. As time went by their need for medical and nursing intervention decreased as they started to show increasingly positive development. Audrey responded well to therapy sessions and started to react to sounds, make eye contact and vocalise small words, and her co-ordination improved. Nicolene could clap her hands spontaneously, make hand signs and participated in speech routine games. They were adored by all the staff in the ward and they adjusted well to the daily routine. Audrey started walking unexpectedly and it was a very proud moment for the nursing staff – the good news was shared with and celebrated by everyone at St. Joseph’s. Each baby’s weight gain of 3kg was an important milestone and after 9 months in our care they were discharged – in time to spend Christmas with their family!
A HAPPY ENDING
Makanakah, while playing with the other children at home, fell into an oval bath tub with boiling water. She sustained 80% hot water burns across her tiny body. After numerous skin transplants and weeks in Red Cross Children’s Hospital, Makanaka was transferred to St. Joseph’s in July 2015. At the time she had developed severe contractures at her shoulder, elbows, hands, hips and knees. She also had significant scarring on her face and body. She arrived bandaged and a little afraid of anyone in a uniform.
The physiotherapist that treated her remembers at the beginning how Makanaka would pretend she was sleeping, when she was collected for therapy. Stretching is usually painful, but is much needed to preserve function. She used to only allow scar massage and as soon as she was expected to do anything functional, she would scream and cry without end. She was unable to dress herself, do up buttons and zips and turn open door handles and taps. She struggled to hold a spoon and feed herself and needed to be fed. She struggled to hold a pen and activities requiring the use of both hands (e.g. cutting with scissors) were extremely difficult. She also struggled with socialisation due to the physical and psychological scars.
One day, they tried their luck and incorporated stamps into therapy. She loved the stamps and forgot that she was supposed to be sleeping and started playing with the different colour stamps. She has progressed so well that she is now able to dress herself, tie shoelaces and do up buckles! She has been attending school and her handwriting and cutting skills have improved significantly.
After about a year and a half of receiving Physiotherapy, Makanaka improved so much that she was discharged from St. Joseph’s. Up until this day, she still asks to come to therapy, even though she knows that she does not need it anymore.