Catholic Medical Quarterly Volume 68(3) August 2018

Faith in Medicine

A Journey Through Faith

Dr Donna Ropmay

“Now faith is the substance of things hoped for, the evidence of things not seen.” Hebrews 11:1

In the wee hours of February 12th 2014, I went into a prolonged labour for the birth of our second child after a gap of eight long years. I experienced a normal delivery but the little baby girl did not cry at birth. She was resus­citated and closely monitored in the Neonatal Intensive Care Unit (NICU) of the mission hospital where I was admitted. She was put on oxygen and intravenous fluids to support her frail existence. One day, a junior doctor walked into my room on ward rounds and announced, “Your baby’s collar bone is broken.” I was too stunned to respond! When I got the chance to visit my little girl during her feed, I noticed that her right arm had been placed in a soft gauze sling on the advice of the ortho­paediatrician who had seen her.

A week later, when my husband and I had hoped she would be discharged from NICU, we were devastated to learn from the treating paediatrician that she had devel­oped neonatal sepsis with fever, abdominal distension and raised levels of C-reactive protein (CRP). She received combinations of antibiotics for about two weeks to treat her condition. On one occasion, when I had just breastfed her, I looked at the needles which pierced her tiny hands and feet and couldn’t hold back the tears. Fortunately, my husband was by my side, sustaining me all along and assuring me that things would be alright. He read a verse from Psalm 139 [1] which says,

“For You formed my inward parts;
You have covered me in my mother’s womb.
I will praise You, for I am fearfully and wonderfully made.”

These words gave me hope as I realized that life and all its circumstances are in God’s hands. All we need to do is trust Him to take care of our concerns.

As days went by, our little girl improved, but we were in for another shock when the paediatrician said, “I’d like to evaluate her cardiovascular system (CVS) and get an Echocardiogram (ECHO) done.” The investigation was arranged and carried out by a cardiologist at the govern­ment hospital where I served as Faculty. Sure enough, the scan revealed a 3mm Atrial Septal Defect (ASD), Ostium secundum type, which is a less serious form of what is commonly known as a ‘hole in the heart’. The specialist was of the opinion that it had a 95% chance of closing on its own in due course of time. Meanwhile, follow up visits would be required to observe the defect and its possible implications.

Our baby’s oxygen saturation had picked up, and within a couple of days after the investigations she was fit to be discharged on the 28th of February.

The homecoming was special, more so for our elder daughter, Wyona Grace, as she welcomed her new sibling to the family. We had several visitors, including friends and relations we hadn’t met for years. There were questions about what we were going to name our child. One day, as my sister-in-law and I were looking affectionately at the baby sleeping in her cot, she said, “How about naming her Azania, which in Hebrew means God listens or The Lord hears?” I instantly agreed-it was so touching.My husband and I mutually consented to naming her Azania Faith.

I had taken maternity leave for six months and during that period our baby’s milestones developed normally. Her right shoulder had healed completely. She received regular shots of vaccines as per the national immunization schedule. Her appetite was good and she was very sociable. On December 15th 2014, my husband and I took her to the hospital for her measles vaccination at the age of 10 months. We also got an appointment with the cardiologist for an Echocardiogram (ECHO) to check the status of her ASD. I held my breath as the scan was performed and heaved a sigh of relief when we were told that the defect had closed! Praise God!

Grace in Retrospect

When I look back at the diagnoses that were made soon after our baby was born, I thank God for seeing her through all of them. Although not life threatening with prompt medical attention, they are pretty grave conditions which I cannot take for granted – birth asphyxia, fracture right clavicle, neonatal septicaemia and atrial septal defect.

Birth asphyxia, if severe or prolonged, could lead to irreversible brain damage and long-term motor, sensory, cognitive, behavioral, neuropsychiatric and developmental disorders.[2]

A fractured clavicle in the newborn is an unavoidable event in spontaneous vaginal delivery. There are studies which show an association with prolonged second stage labour, oxytocin use, forceps delivery and low Apgar scores. It usually heals without any permanent sequelae. Rarely, it can lead to Erb’s palsy or brachial plexus nerve injury.[3-5]

Neonatal septicaemia of late onset, acquired from the nosocomial environment, is a serious condition with increased morbidity, mortality and extended length of hospital stay.[6]

Recent evidence shows that 100% of atrial septal defects <3mm close spontaneously by the age of 18 months, while >80% of those measuring 3-5mm in diameter are usually closed by 12-15 months. Surgical correction is an option in holes which do not mend on their own.[7]

But for the Grace of God, I don’t think I could have taken so much in one go. Not only did He restore healing to our child, but also gave us parents the strength to carry on through those moments of great anxiety.

Thanksgiving and Reflection

“In everything give thanks for this is the will of God in Christ Jesus for you.” I Thessalonians 5:18

Praise the Lord that in spite of the problems she had at birth, she is doing well today.

I’m thankful for His mercies, great and small. I’m glad I saw how hard the nurses in hospital work round the clock to ensure its smooth functioning. Their dedication and tireless energy really inspire me. The care, compassion and concern that they show to their patients surely makes the world a better place. It reminds me that the spirit of Flo­rence Nightingale, the Lady with the Lamp lives on. Thank you matrons and sisters – may your hard work done with love for the little ones be duly rewarded!

“All things work together for good to those who love God, to those who are the called according to His purpose.” Romans 8:28

In the autumn of 2015 we had a housewarming service at our new home to which we had invited our local pastor and close relations. My husband welcomed all the guests and reflected on God’s blessings upon our family and es­pecially His healing touch on Baby Azania. When it was the pastor’s turn to speak, he made a reference to Psalm 103 whose words never fail to encourage me:

“Bless the Lord, O my soul;
And all that is within me, bless His holy name!
Bless the Lord, O my soul,
And forget not all His benefits;
Who forgives all your iniquities,
Who heals all your diseases,
Who redeems your life from destruction,
Who crowns you with lovingkindness and tender mercies,
Who satisfies your mouth with good things,
So that your youth is renewed like the eagle’s.”

Dr Donna Ropmay, is Associate Professor, Department of Forensic Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India

REFERENCES

  1. The Holy Bible. New King James Version. Nashville, TN: Thomas Nelson Inc.; 1982.
  2. Ahearne C, Boylan GB, Murray DM. Short and long term prognosis in perinatal asphyxia: An update. World J Clin Pediatr 2016 Feb; 5(1):67-74.
  3. Chez RA, Carlan S, Greenberg SL, Spellacy WN. Fractured clavicle is an unavoidable event. Am J Obstet Gynecol 1994 Sep; 171(3):797-8.
  4. Perlow JH, Wigton T, Hart J, Strassner HT, Nageotte MP, Wolk BM. Birth trauma. A five-year review of incidence and associated perinatal factors. J Reprod Med. 1996 Oct; 41(10):754-60.
  5. Gilbert WM, Tchabo JG. Fractured clavicle in newborns. Int Surg 1988 Apr-Jun; 73(2):123-5.
  6. Clark R, Powers R, White R, Bloom B, Sanchez P, Benjamin Jr. DK. Prevention and treatment of nosocomial sepsis in the NICU. J Perinatol 2004; 24:446-453.
  7. Radzik D, Davignon A, van Doesburg N, Fournier A, Marchand T, Ducharme G. Predictive factors for spontaneous closure of atrial septal defects diagnosed in the first 3 months of life. J Am Coll Cardiol 1993 Sep; 22(3):851-3.