Sunday, December 21, 2014

Haiti Mon Amour Part III: The story of Dahicha

Click here for Part I
Click here for Part II


As I prepare myself to go back to Haiti on the 23rd of December, I am both excited and terrified. Ever since I stepped foot there, I’ve been addicted. I think about it all the time. It haunts my dreams and makes me smile at the same time. Still to this day the pink headband haunts my dreams. What I wrote about the first time I was in Haiti, I can barely talk about. Yet I keep going back. Looking back on my writings, I realize I have focused mainly about the bad things about my experience. Much of that reason is because negative experiences vastly outnumber the positive experiences. “Then why go back?” people ask. I go back because the small, good things that happen, make all the pain worth it. I ended my last post by promising to talk about that good thing; the baby our team desperately tried to save. So here is that story.

If you’re expecting a story full of sunshine and rainbows, you’re not going to find that here. This is still a story from Haiti. This isn’t a Hollywood movie and the fact is that 20 months before this story, this could have all been prevented with proper care. But enough about the negatives, this is a story of joy. On January 27th, 2013 an incredible gift to the world was born. This gift has been an inspiration to my life ever since I came into contact with her. It was the night of August 14th or 15th when Dahicha came into triage, suffering from an Upper Respiratory Infection. I had just returned from the UN for dinner and popped my head into triage to see if anyone needed help. What I saw was multiple people huddling around a tiny baby. I went over to see what was going on and what I saw was an incredibly dehydrated baby that needed fluids ASAP. This was a very sick baby and there was a good chance that if we didn’t get fluids into her very soon, she would die. In addition, there was no room to put her in the peds ward because it was full to capacity, so she’d have to stay in triage. She needed an IV in her, and she needed that IV hours ago. Unfortunately there was no way to get an IV into her because we couldn’t find her veins. We tried for hours to get an IV in with no luck. At least 5 different people tried on her arms, legs, hands, and even feet. We spent hours trying to find a vein. Finally, at around 2 A.M, about 4 hours after this fiasco began, we got flashback. We had found the vein. We were all so relieved and ready to go to bed but just as I began to flush (putting a little saline into the IV), we felt an edema begin to form around her IV. A sign that we had blown her vein, or in other words, we no longer had access to her vein. Sadly, we had lost access to her vein about as quickly as we realized we had access. I felt awful. Looking back on it, it wasn’t necessarily my fault we blew her IV as it is a very common thing to happen, but it was me that was flushing it so I felt responsible for us losing access. I was determined not to lose this baby girl. At this point, she was in such poor condition that poking her with IVs wouldn’t make her cry. We tried for another 2 hours to gain IV access, with no luck. At that point it was clear we were going to have to call it a night and come up with a new strategy in the morning. Grudgingly, I headed to bed, the only thing I was hoping was that she’d still be there in the morning…something that at that moment was no sure thing. I think it goes without saying that I had a rather restless 3 hours of ‘sleep’.

 Photo Credit: Marla Camapau Drowley. Facebook
                At 6:45 that morning I got up for my shift and quickly made my way out hoping that she’d still be there. To my relief she was sleeping very comfortably and her health hadn’t deteriorated any further during the short night. Now it was crunch time. It was time to come up with a new plan to save Dahicha. We again tried for a bit to get an IV in her, once again with no luck. It was at that point I decided I was going to look for an alternative option. There had been an idea floating around about starting an IO, which basically entails drilling into a bone just below her knee cap to get access to the bone marrow. This process, as gruesome as it sounds and is, can basically function as an IV. The only problem is that we couldn’t find a pediatric IO. We had searched almost everywhere and couldn’t find one. But it was our only chance. So I went on a mission to find one. After about 30 minutes of searching and asking just about everyone, I was about ready to give up. But thankfully I asked one more person. One of the Haitian EMT/translators was pretty sure there was one in the emergency room. My heart began to race as I thought this might actually be a chance to save this girl. We quickly went to the ER where, perched perfectly in the corner of the top shelf, was EXACTLY what we had been looking for. It was such a relief, but there was no time to celebrate. This was just the first step in a long process. I hurried back to triage where ‘Dr. Zeke’ started the IO. We had access! Finally, about 12 hours later we would be able to get fluids into her system. It may have been too late though. Her condition had worsened. At this point she was teetering on the edge. She had become completely unresponsive. Every time I checked on her, I was worried she wasn’t going to be around anymore. But she kept fighting. Every time I checked on her, she was still fighting.

                Later in the afternoon, I borrowed one of the Haitian nurses, who Dr. Sam (my dad) claims may be the “best IV starter he’s ever seen” to come try to start an IV on Dahicha. Finally, after an hour of trying, and 21 hours after getting to the hospital, we had started an IV through her jugular on her neck. We pushed fluids through her to rehydrate her and slowly she gained back her color and actually began crying again. The good news, we had started an IV and hydrated her. The bad news, we had spent a whole day trying to save her and get IV access so we were a day behind on actually treating the reason she was here, severe pneumonia.

                I monitored Dahicha as much as I could. Every free moment I could find, I would be in the pediatric ward, making sure she was alright. On multiple occasions she became low on oxygen so I would run around to find a new tank for her. They started her on antibiotics but her pneumonia was so severe that she still wasn’t out of the clear. In addition, due to incidents during and directly after her birth, she had a number of other health issues that required other medications.

                On Sunday, when I left she was still not out of the clear. She had definitely improved, however she was still in the Pediatric Intensive Care Unit (PICU). Saying goodbye to her was one of the most difficult things I’ve had to do. I had done all I could though. And she was such a fighter that as worried as I was about her, I knew deep down, she’d fight through this. Still, saying goodbye to someone you spent so much energy on, not knowing if you’ll ever see them again is always hard. I knew her for 4 days but I already loved her. For the next two weeks I went back and forth over whether I should contact the owners of the orphanage she lived at. I knew that if I did and she didn’t make it, I’d be beyond devastated. Ultimately though, I needed to know. So after 2 weeks, I added her on Facebook. And then I waited. And I waited. Finally, after a day or two, I got a notification that my friend request had been accepted. This was it.

                As I logged on, preparing for the worst, I was greeted with a wave of relief when I saw that she had been steadily improving and was actually having surgery soon to insert a tube into her stomach. This was incredible news and put a smile on my face for the rest of the day. A couple weeks later, I was greeted by an even better message. Dahicha had gotten a medical VISA to be seen in the US. It was an incredible turn of events and truly inspirational. To make things even better, I will hopefully be seeing Dahicha while I am in Haiti next week. I am convinced that had it not been for the incredible determination and hard work of our team as well as the Haitian staff at Bernard Mevs hospital, Dahicha’s outcome may not have been so great. I also would like to recognize in this post, the orphanage that she is at and the people running the orphanage. Never, and I mean NEVER did they leave her side during this entire time. Marla, Ken, and Jocelin, you are all incredibly inspirational. And for the people reading this, I’m not asking for you to donate money to any cause, but I have seen first-hand how much these people care for the kids at the orphanage and it is inspirational. If you are looking for a cause to donate to, consider this orphanage. Here is the website of the orphanage if you’re interested in learning more: http://ebenezerglennorphanage.org/#/welcome

                Below is the full story of Dahicha, from birth until now. A huge thank you to Mrs. Marla Drowley for writing her full story and sending it to me.


Dahicha Decius was born on January 27, 2013. She was two days old when brought to the orphanage. Uncle, brother to the dad, brought her; said the mother died during birth. Found out later that the mother had pushed for over four hours and finally collapsed as the baby came out. Dahicha did not cry so they thought she was dead too. They cut the umbilical cord with an unsterile knife and put the bodies to the side and began mourning. A couple hours later someone walked by and saw Dahicha moving. They immediately picked her up and came to EGO (Ebenezer Glenn Orphanage). After the paperwork was completed (receiving copies of mother's death certificate and baby's birth certificate) we had the uncle and witness sign the forms and we received her. I was away from the orphanage until 2:30 that afternoon, but when I got back I went looking for the new baby. I found her sleeping and all covered up. I undressed her and did a once over. When I came to the dressing around the umbilical area it stunk and the more I uncovered the worse it got. In the middle of my exam Dahicha went into a seizure. I immediately took her to the nurse we have from the orphanage; she cleaned the area around the umbilical cord, but when Dahicha had another seizure she felt that we needed to get her to the hospital. We took her to the closest hospital, but they were not equipped for peds. We got an IV started and kept her overnight until we could transport her the next morning to St. Marc. There was an American Doctor from Toledo, OH on staff who said she had Neonatal Tetanus and immediately began giving her prescription medication. She said the next 24 hours would tell whether she would live or not. She survived and was released 14 days later. She still had not cried up to this point and had not taken a bottle. After we got her back to the orphanage we began trying to get her to take a bottle. It was very tedious, but finally we got her to begin to suck. Three weeks later she came down with pneumonia - which would be the first of seven episodes of aspirated pneumonia. Each time she got worse and worse. In April of 2014 while she was once again hospitalized in Port-au-Prince they placed a feeding tube and told us we needed to see an ENT Specialist. Sure enough her adenoids were blocking her passage and had to be removed, but that didn't happen until May 19th.  Then on August 12th she was hospitalized once more for pneumonia, but by the time they admitted her she was unresponsive and gray in color. They ended up drilling into her leg and pushing fluids through in her bone marrow. Finally 21 hours later they got an IV started. Three weeks later they placed a G-Tube into her stomach and we were released. In October of this year we got a medical visa approved to come to Michigan where she saw a Peds doctor at DeVos Children's hospital. They ran a UGI-xray and a barum swallow test to determine how she was aspirating and found out that she was not refluxing, so no additional surgery was necessary. However, she would hold food in the back of her month for up to 19 seconds before swallowing; and any consistency thinner than honey was aspirated. So they saw us the following week and we received physical therapy exercises to do with her at home to help improve her swallowing. She continuing her g-tube feedings with new formula that has fiber and she has gained seven pounds since August.

 

During all of this Dahicha was seen by a Neurologist here in Haiti and he prescribed her on Pheonbarbital back in July of 2013; prior to that she had been on Tegritol 2%. They have no way of testing phenobarbital levels in the blood here in Haiti; so we had it tested while we were in Michigan. However, we came back to Haiti before getting the results. Dahicha spams several times in an hour, but only seizures maybe once or twice a day and some times can go a couple of days without a seizure. Her seizures are where she straightens her limbs, eyes roll around and she screams very loudly like she is in pain. She was finally placed on baclofen by the doctor last week, to help with her spasms. We are hoping to change her phenobarbital to something else non-brain inhibiting, such as Keprra or Onfi. But I don't know if we can even get these meds here in Haiti.

 

Recent photo of Dahicha in her new stroller/chair donated by a family in Texas.