No heartbeat. No breathing. No chance of life. Meet the three kids who defied the odds at birth.
No heartbeat. No breathing. No chance of life. Meet the three kids who defied the odds at birth.
‘‘I COULDN’T EVEN HOLD THEM"
Born almost four months’ premature at barely 700g each, twins Ethan and Emma Low battled a host of life-threatening complications. Their mum, AUDREY LIM, 39, shares her heartrending story with EVELINE GAN. Childbirth can be a nerve-racking experience. But what’s most horrifying for a mum in labour is learning that her baby might be dead at birth.
I was just 25 weeks into my second pregnancy, when the early contractions hit. By the time I arrived at KK Women’s and Children’s Hospital’s (KKH) emergency department, I was already 4cm dilated. Nothing – not even medication to slow contractions – could stop my babies from arriving 11 hours later.
At their very young gestational age, there was a chance they would not survive the birth, the doctor told me. I was traumatised. But I was still rational enough to ask for an epidural; I wanted to be able to catch a last glimpse of my babies – even if they were not born alive. The entire operating theatre was unsettlingly quiet when Ethan and Emma were born, each weighing just around 700g.
Are they alive?
Within minutes, the twins were whisked off to the neonatal intensive care unit (NICU). I didn’t know if they had survived the birth. I didn’t get to see what they looked like. I didn’t hear them cry. I was too afraid to ask questions as I did not want to distract the doctors, who were trying to ensure my babies’ survival.
I breathed more easily only when my husband returned from the NICU and showed me photos he had taken of them using his mobile phone. Miraculously, the twins survived! But the cruel reality sank in the following day when I saw them for the first time. I had never seen such tiny babies! I’d thought that their survival was the end of our problems.
How naive I was! The long and scary journey had just begun. In the photos that my husband showed me, our babies looked long and skinny. In real life, however, they had so little fat and flesh on their bodies that they seemed two-dimensional. Their skin looked so raw. Their tiny bodies were hooked up to many wires and tubes.
All I heard was the beeping of the machines that kept them alive. There was nothing I could do to help them. I couldn’t even hold my babies to comfort them. They had to fight their own battles. I felt so much heartache, I broke down and bawled. Trying to keep Ethan and Emma alive in the following months was a huge challenge.
For instance, Emma needed heart surgery to rectify abnormal blood flow when she was only a month old. I cried non-stop as I waited outside the operating theatre during her surgery. My husband, on the other hand, coped with the immense stress by eating nonstop. We were out of our minds with worry and fear.
Thankfully, the surgery was a success and Emma began to thrive after that. Ethan, the elder twin, had more health issues than his sister. Besides breathing difficulties, he also suffered some bleeding in his left brain, which is still unresolved. It isn’t causing him any problems so the doctor has suggested leaving it for now and monitoring his condition as he grows. We spent about $90,000 on their hospital and medical fees, despite heavy Class C Ward subsidies.
Every time one of the twins fell seriously ill, we’d ask the doctor: ‘‘Will our babies be fine?‘‘
Surviving the first year
Even when the twins were strong enough to be discharged after hitting the 2kg mark, breathing problems plagued the first year of their lives. Caring for them at home was an enormous challenge. Like many severely premature babies, they would sometimes “forget” to breathe.
We had to wake them up when that happened, so everyone was constantly on high alert. Despite our vigilance, they ended up being hospitalised rather frequently for low oxygen levels. KKH literally became our second home as we were there every other month. The frequent hospitalisations took a toll on my husband and me as we were both working – he in marketing and I, property.
My older son, Daniel, who was then three years old, also needed a lot of attention. We rotated the hospital shifts and caring for Daniel with our domestic helper. Sometimes, our relatives would chip in. Every time one of the twins fell seriously ill, we’d ask the doctor: "Will our babies be fine?”
But nobody could give us a 100-per-cent guarantee. So we lived from day to day, not knowing what would happen next. Still, I would say we are extremely fortunate to have good medical facilities and expertise for premature babies. I doubt the twins would have come so far if we weren’t living in Singapore.
While the whole experience was terribly stressful, something good came out of it: The struggles my husband and I went through together during that trying period strengthened our marriage. When the twins turned three and no longer had major health issues, I asked him if we could try for another child.
Unfortunately, I think the incident scared him off having more children. Now that they’re six, I’ll probably check with him again – I would really love to have a fourth child! “Something’s wrong. He’s very weak. We need to take him out, now.” It was pandemonium in the delivery suite.
The ultrasound detected a very faint, palpable foetal heartbeat. Two doctors were called in. My husband and I turned to each another, our faces stricken with fear. Unfolding before us was the same nightmare we had gone through two years ago when I gave birth to our first child, whose foetal heartbeat could barely be detected.
Kayla was delivered via emergency caesarean prematurely in week 32, and weighed 1.35kg. She had to be incubated at the neonatal intensive care unit (NICU) for a month until she weighed 2kg. During this period, she was discovered to have a ventricular septal defect (VSD, or a hole in the heart). Now we were told our second child might not even make it?!
‘‘WHERE’S HIS HEARTBEAT?!‘”
Her second pregnancy was going well – until LENA CHEW ended up in the operating theatre for yet another emergency caesarean. Her son, Ethan Mak, was given a grim prognosis: death or brain damage.
Code Green!
To ensure a smooth pregnancy and a healthy baby, I had taken every precaution possible – I even quit my job so I could have ample rest. As I had pre-eclampsia during the first pregnancy and the condition has a high risk of recurrence, this time, I consulted an obstetrician who specialised in maternal foetal medicine. I was put on aspirin as a preventive measure.
The doctor even had an ultrasound of my baby’s heart done, since my first child had a hole-in-theheart condition. My husband and I were anxious about every test; every time, we’d fear the worst, but we passed all the tests. We were jubilant! At 39½ weeks, my obstetrician noted during the ultrasound scan that my placenta showed white spots, which indicated an ageing placenta that would soon be unable to support the foetus.
“If you don’t give birth by Tuesday, you will have to come in on Wednesday morning for a caesarean,” he said. I was elated when the contractions started on Monday night, and determined to have a vaginal birth. The joy was short-lived, however. Unlike the usual pulling sensation of labour contractions with intermittent “rest” intervals, this pain was continuous and escalated in intensity.
By the time we arrived at the hospital, I could no longer walk, and had to be wheeled into the delivery ward. From then on, everything was a blur. My baby’s heartbeat could not be detected and I was immediately rushed to the operating theatre amid public announcements blaring: “Code Green! Crash! Crash!”
My fingers trembling, I could barely scrawl my name on the indemnity forms. Lying on the operating bed, my body stuck with needles and drips, I thought I was going to die. The catheter hurt badly, and the gas mask over my nose and mouth was too tight. I thrashed around in a frenzy before I blacked out.
When I woke up, I knew my baby had been delivered – the pain from the caesarean wound was searing, and I was bleeding profusely. I had suffered a placenta abruption, a serious condition in which the placenta partially or completely separates from the uterus, causing loss of oxygen and nutrients to the baby, as well as internal bleeding. Blood had, unusually, congealed inside my womb instead of oozing out, and worsened my condition.
Ethan was the chubbiest baby in the NICU at 3.3kg, but his life hung by a thread.
Hanging by a thread
Deprived of oxygen, Ethan was born unconscious and blue in the face. He had also lost a lot of blood and needed a blood transfusion immediately after delivery. The doctors feared he would suffer permanent brain damage – if he did survive at all. Although my husband and family members tried to reassure me, I found it difficult to believe them.
When we were alone, I told my husband calmly that I was prepared to handle the truth. It was then that he broke down as he recounted how my obstetrician had advised him to brace himself for the worst. In his over 30 years of experience, he had encountered several similar cases that ended with the baby either dead, or braindead and kept alive in a vegetative state.
"We have to gather up the courage to pull the plug and let our baby go,” my husband said softly, “rather than put him on long-term life-support machines if he is brain-damaged.” Ethan was the chubbiest baby in the NICU at 3.3kg, but his life hung by a thread. We spent the next 72 hours in vigil.
This was the critical period to ascertain the so-called “degree of damage”, so it was important that Ethan did not suffer from epileptic fits or seizures that indicated brain damage. But there was a blood clot detected in his brain. His liver and kidney functions were also compromised. Gazing at my precious child, who was surrounded by life-support machines and tubes running from various orifices, I could only pray for a miracle.
Alive and thriving
Ethan made it through that third day. The blood clot cleared up on its own. His urine output slowly increased and his kidneys and liver resumed normal function. As more tubes and medications were removed, his puffiness abated. He began to look like a normal, healthy baby. After three seemingly endless weeks, Ethan cleared the last rounds of his brain scans and a battery of other tests.
It was particularly poignant to gaze upon my husband, with tears in his eyes, cradle our son tenderly and kiss him on the forehead as we finally carried him home, much earlier than the doctors predicted. Ethan is now a shy, unassuming fiveyear- old. He was placed under the loving care of the same neonatologist who is still taking care of his elder sister Kayla, now aged seven.
He successfully hit all his development milestones and was discharged at age three. While he has failed his hearing tests since infancy and been diagnosed with bilateral high-frequency hearing loss, he has no speech problems and doesn’t require hearing aids or medical intervention.
Currently doing well in preschool, Ethan decided a few months ago that he wanted to learn the piano. Looking at how he plays his favourite music pieces with relish, sometimes sans score, we are glad we overcame our initial scepticism. In our eyes, we see a perfectly healthy, happy and intelligent boy who’s thriving under our love, and a caring brother to Kayla and his two-year-old sister, Jerilyn. Ethan is one boy who survived all the odds – and came out triumphant.
