Sunday, 8 May 2011
In the two weeks since she arrived, Sarah has been treated for pneumonia, septicemia, and electrolyte imbalances. She has had some miserable days. Her most challenging crisis for us to manage in the NICU at GLA occurred when Sarah developed an irregular heart rhythm and muscle spasms.
We have no access to rapid laboratory services. 'Urgent lab work' in the developed world, means the lab processes the tests that are ordered as fast as they possibly can, often within the hour. In Haiti, it takes a minimum of 24 hours to get 'urgent' lab results back. Our Paediatrician and I could only take note of the signs and symptoms we saw, and use this information, together with the very limited medical history we had about Sarah, to diagnose and treat her.
Sarah was born prematurely, and she had not grown well in her Mother's womb. Her Mother showed signs of malnutrition, as did Sarah, who, hadn't been fed during the first five days of her life, while she was in hospital, but had instead been given IV fluids, that in all likelihood, only contained sugar and water. Low calcium levels are fairly common among babies in Neonatal units, especially in babies like Sarah. Low calcium levels affect the body's electrical conduction system. This can cause, abnormal heart rhythms,'jitteriness' and muscle spasms. We reasoned that Sarah probably had low calcium levels and that we could not wait a day or two for laboratory confirmation of this, but that she needed to be treated immediately.
I rarely get nervous about the limitations of clinical services or medical technology in Haiti. I have gotten used to making do with what we have. I have to admit though, I was anxious about Sarah, as we began treating her with IV calcium. She 'should' have been on a heart monitor. The calcium 'should' have been infused continuously. We had no working heart monitor or infusion pump, though, so we did the best we could. Thankfully, our best efforts were enough to get Sarah's body out of crisis.
On Friday, she was stable enough to come off of CPAP. Yesterday, she completed her course of antibiotics. Last night, she developed cold symptoms and today, she needs suction to clear the secretions from her nose, and oxygen to support her breathing.
At almost 4.5lb, she has grown significantly since she arrived at GLA, but Sarah is still very small and very fragile and she still needs your prayers. I believe that there are angels close-by her, and others above, advocating for Sarah directly before God.
Posted by Susan Westwood at 15:26