Joe

When Joe was pregnant with her third child her daughter was diagnosed with an exomphalos* at her 12 week scan. After she was born she was also found to need heart surgery for a rare condition. She was 16 months old at the time of the interview.

When Joe was pregnant with her third daughter, it was discovered that it was a triplet pregnancy, but she miscarried two of the babies leaving just her daughter. At the 12 week scan an exomphalos* was detected. Joe was warned by doctors that she might need to stay in hospital for a few weeks after the birth as her daughter would be cared for in neonatal intensive care (NICU)*.

Her daughter was born at 39 weeks and taken to NICU immediately for assessment. Joe suffered a post-partum haemorrhage* and needed a blood transfusion. So she was not able to see her daughter properly for a few days, although the nurse did bring her baby to her for short visits. When her daughter was 5 days old, it was discovered that in addition to her exomphalos, she also had a rare heart condition for which she needed open heart surgery. She had to wait several weeks to put on weight before surgeons felt she was strong enough for the surgery. She was transferred from NICU to a specialist heart unit, which Joe found very distressing. Her daughter was covered in wires and there were many very sick babies around her. She didn’t put on much weight, but at 6 weeks her condition was so serious that surgeons decided that they had to operate, come what may.

The surgery was major, but a success. One of the side effects of her heart surgery was that she was left with a left vocal chord palsy, which means that at the time of the interview, aged 16 months she was not able to talk, and needed regular speech therapy. She was fed by NG tube* for over 14 months and now receives feeds through a peg* in her stomach. The period of time in hospital was very stressful and challenging for Joe and her husband. It was 8 weeks before she could hold her baby without wires and tubes.

Joe’s daughter was discharged at 4 ¬¨¬®≈í¬© months old, which was a great day. But it was also very stressful and scary for Joe to be home with a 12 year old, toddler and baby with such complex medical needs. She needed several specialist visits daily from various healthcare professionals (including physiotherapists, dieticians and a speech therapist). Her daughter developed gastroesophageal reflux disease which made her recovery take longer, although she was much better once she could sit up. Building the confidence to look after her baby at home was a steep learning curve for Joe, and she said she was a hermit for the first few months while her daughter was really vulnerable to infections. She had the closure operation for her exomphalos at 14 months.

At the time of the interview Joe’s daughter was 16 months old, still fed by a peg in her stomach and not able to eat properly or talk yet. She was receiving regular follow up with dieticians, speech language therapists, paediatricians, and every few months has surgical, respiratory and cardiology reviews.

But Joe felt she and her family are managing to find glimpses of normal family life, albeit one with complex medical needs. Joe was planning to go back to work part-time soon.

*Exomphalos
An abdominal wall defect, that occurs when the baby’s tummy wall does not develop fully in the womb. Some of the baby’s intestines and sometimes other organs such as the liver, develop outside the tummy and are covered by the umbilical cord.

Neonatal Intensive Care (NICU)
A unit for critically ill newborn babies and infants who need the highest level of nursing and medical care. Babies in NICU often require support for their breathing. Those undergoing major surgery will often be looked after in a NICU.

*Nasogastric (NG) tube
A tube placed through the nose into the stomach. This may be used to drain the stomach contents after surgery or to provide milk when babies are not able to feed fully by mouth.

*Post-Partum Haemorrhage
This is excessive bleeding following the birth of the baby. Most commonly it occurs within 24 hours of the birth and greater than 500mls (approximately one pint) of blood is lost (primary PPH). Secondary PPH can also occur where there is abnormal bleeding from 24 hours to six weeks after the baby is born.

*Peg
A type of gastronomy feeding device, which is inserted into a surgical opening in the stomach.

Joe’s message was that sometimes mum knows best, and you should trust your instincts. And that you have more strength than you realise.

Age at interview 36

Age at diagnosis 34

Joe found a parent who lived close by whose daughter had also had an exomphalos a few years earlier. She had met her online, where she felt people knew her better than her actual friends.

Age at interview 36

Age at diagnosis 34

Joe was frustrated that health professionals were dismissive of knowledge she had gathered online.

Age at interview 36

Age at diagnosis 34

Joe said that although the family were traumatised by everything they had been through with their baby, it has brought them a sense of togetherness they didn’st have before.

Age at interview 36

Age at diagnosis 34

Joe found it difficult having her toddlers visit her in hospital, but also hard to leave them at home if she visited.

Age at interview 36

Age at diagnosis 34

Joe described bringing her daughter home. The first week was awfully hard, and she felt very isolated.

Age at interview 36

Age at diagnosis 34

Joe said her health visitor and GP had been amazing. They have suggested counselling but she doesn’st have the time, she is too busy caring.

Age at interview 36

Age at diagnosis 34

Joe feels her identity has been lost along the way.

Age at interview 36

Age at diagnosis 34

Joe describes the day when the respiratory consultant gave her the green light to take her daughter out and about, but she still needs several appointments a week.

Age at interview 36

Age at diagnosis 34

Joe felt her daughter wasn’st ready for her surgery and lobbied the surgeon to leave the operation for a few more months.

Age at interview 36

Age at diagnosis 34

Joe’s daughter had exomphalos. Early scans after she was born showed she had a rare heart condition as well that hadn’st been picked up in pregnancy. They were taken to the bad news room.

Age at interview 36

Age at diagnosis 34

Joe said some of her friendships have survived, and others haven’st. She didn’st like people treating her children like juicy gossip’s.

Age at interview 36

Age at diagnosis 34

Joe held her daughter without wires for the first time. She took her to the window to show her the stars.

Age at interview 36

Age at diagnosis 34

Joe wanted to make a happy surprise for her whole family. She asked the sonographer to write her baby’s sex secretly in an envelope and the card shop to pack a box of surprise balloons in the right colour.

Age at interview 36

Age at diagnosis 34

Joe’s daughter had exomphalos*. She had not anticipated how hard it would be to feel a bond when she was separated from her.

Age at interview 36

Age at diagnosis 34

Joe had a postpartum haemorrhage after her daughter was born and was in intensive care for several days. Staff were able to bring her daughter to see her.

Age at interview 36

Age at diagnosis 34

Joe described about how hard it was talking to her daughters about needing to be away after the birth, and preparing them for the possibility of their baby sister not making it home.

Age at interview 36

Age at diagnosis 34