Isla was due to have her 29th EUA in Melbourne (probably her last in Melb) on the 22nd of July 2020. Our baby was due on the 18th of July. Since bub number 2 appeared to be even more ginormous than Isla (4.14kg), we knew I was probably going to be induced 2 weeks early (around the 4th of July). While the COVID crisis remained under control in SA, Victoria’s second wave was just starting to ramp up. On the 7th of July Victoria recorded 191 new COVID cases and the premier announced that metropolitan Melbourne, along with the Mitchell Shire would re-enter lockdown for a minimum of 6 weeks from the 9th of July. We knew this made it very unlikely that Garreth would get any sort of isolation exemption, as was previously suggested by the SA Health exemptions team. With case numbers growing in Melbourne by the day, we weren’t particularly excited by the idea of having to travel to Melbourne at all!
Bubs was due to be induced on the 4th of July and we arrived at Hospital at 7pm on Friday the 3rd of July to start the induction. Garreth and I both still had slightly lingering sore throats after getting over a cold that Isla brought home from childcare. We told the COVID screening lady this, thinking it should be fine as we were just at the tail end of a cold, no fever or any other symptoms. We really should have thought about it more during the week and got tested, as of course my obstetrician wanted to make sure we were clear before she could induce me. So we were sent away (still pregnant!😩) to get COVID tested and await the result. Most of the screening centers closed at 8pm, so luckily we got in to the Women’s and Children’s just after 7.30pm. There weren’t many people there and we were in and out in about 1/2hr. They said they would try to rush the results due to my planned induction, but being a weekend they weren’t sure how quickly we would get them. We then had to self-isolate at home while we awaited the result. Luckily Garreth’s parents were in Adelaide anyway to take care of Isla while we were in hospital with baby #2, so they were able to run any errands for us while we were isolating... AGAIN!
We got the results the following afternoon, so that was very quick. They were negative and I was hopeful that we might have been able to come back in to hospital on the Saturday night, but my obstetrician asked us to come back Sunday night, planning to have the baby on Monday. So, we headed in again on Sunday night. After being rear ended at the lights on the way to the hospital, we finally arrived in one piece and little (not so little) Zac entered the world on Monday the 6th of July. Weighing a hefty 4.53kg and 53cm long.
Isla's new baby brother, Zac
The hospital were restricting visitors due to COVID, but Garreth was allowed in the hospital with me at any time and Isla could visit for ½hr per day during certain hours, so she got to meet her baby brother in hospital.
Since there was a very small (less than 1%) chance that Zac may also inherit the retinoblastoma gene, Zac’s cord blood was taken at birth, along with a second blood sample on day 3 and sent off for urgent genetic testing (7-10 day turn around). It was our understanding that an ophthalmologist would also be visiting us while in hospital to do a visual assessment of Zac’s eyes. The appropriate paperwork was sent to the Women’s and Children’s to notify them of his birth. Our hospital received an email back asking us to call them to make a time for Zac to have an examination under general anaesthetic. We were under the impression that the urgent bloods and visual assessment was to hopefully avoid having to anaesthetise him. I spoke to the eye clinic at WCH and explained this. I believe there was just a bit of miscommunication between the eye clinic and our geneticist and perhaps the eye clinic didn’t know that genetic testing had been arranged and/or didn’t realise it could be done urgently. Genetic testing usually takes about 8 weeks and the eye clinic probably thought that was too long to wait should Zac have retinoblastoma. We knew however, from our original genetic testing with Isla that tests marked urgent do actually come back pretty quickly.
So after a bit of back and forth it was understood that Zac’s genetic testing should come back in a few days, our paediatrician would have a good look at his eyes every day while we were in hospital and once we were discharged we would bring him into the eye clinic at the WCH for one of the senior registrars to put some drops in to dilate his pupils and just have a look at his eyes while he is awake.
We returned home from hospital on Friday the 10th of July and we were due to take Zac into the WCH eye clinic on Monday the 13th of July. On Monday morning I received a call from the eye clinic to say the Dr we were due to see was off sick that day and we were rescheduled to Wednesday the 15th of July. Later that afternoon (7 days after Zac’s birth) we received a phone call from the genetics department confirming they had Zac’s blood results back and he did not carry the Retinoblastoma gene mutation, so that was a huge relief and a super speedy turn around, which was fantastic. I spoke to the eye clinic again and confirmed that Zac did not carry the gene mutation and we believed this meant it was no longer necessary for anyone to see him in person, but we were more than happy to still bring him in if they thought it was worthwhile. They agreed it was no longer necessary and Zac’s appointment was cancelled.
Next hurdle.......Isla’s EUA in Melbourne on the 29th of July. Melbourne’s second wave was continuing to worsen with face coverings becoming mandatory while in public from the 22nd of July. As much as we would have liked to have been seen by the eye team in Melbourne, we really didn’t want to have to travel into Melbourne at that time. I spoke to Sandra (Royal Children’s Hospital Retinoblastoma Care Co-Coordinator) and she asked what we wanted to do. I told her our concerns and she agreed that if we were happy to be seen in Adelaide, that was probably the safest thing to do. She said currently in Melbourne all kids being admitted to the hospital must be screened for COVID 2 days prior. Restrictions were tight in Melbourne and there was a much higher risk of contracting COVID there than there currently was in Adelaide.
Through my conversations with the WCH regarding Zac, I knew that the ophthalmologist had a list running on Thursday the 23rd of July that Isla could easily be added to. I told Sandra this and she said she would put it to the team in Melbourne and get back to me. Sandra called back to confirm that the Melbourne doctors were happy for us to been seen in Adelaide under the current circumstances. Sandra said she would contact the WCH and make arrangements for Isla to hopefully be added to the list on the 23rd. So she was booked in for an EUA at the WCH Adelaide on Thursday the 23rd of July with an admission time of 11am.
- A couple of days later news broke about some confirmed COVID cases at the Royal Children’s Hospital, so we were definitely happy with our decision to avoid Melbourne for now.
Isla had a bit of a cold from childcare and seeing as we had learnt our lesson from Zac’s induction I called the WCH on the 20th to see if she would need a negative COVID test to be admitted for day surgery on the 23rd. They confirmed that she would, so Garreth took her into the WCH that afternoon to be screened for COVID. The screening center was A LOT busier than when Garreth and I went in a few weeks earlier. Since the COVID explosion in Victoria, travel exemptions for South Australian’s had become a lot stricter. Anyone returning from interstate had to self isolate AND be COVID tested at the start and end of their isolation period. So, there were a lot of interstate travellers in there getting screened and they were all the first priority. People just kept coming in the door and jumping the queue, so Isla and Garreth were in there for about 4-5hours. After her test Isla had to self-isolate, which effectively meant I had to self-isolate, while we awaited her results.
Waiting, waiting, waiting....
We received Isla’s negative COVID result on Wednesday morning and Garreth took her to her EUA on Thursday the 23rd of July at 11am. Isla was first on the list and went through fairly quickly. Garreth spoke to the anaesthetist about what we had been doing in Melbourne with a pre med, but they thought they would try without it and she was fine. Isla was back in day surgery by 3pm and took a while to wake up. Dr Sia (our new Adelaide eye Dr) came over to introduce himself to Garreth in day surg. He said that he had been in theatre with Isla and that everything went well. Garreth was over the moon to see him there! We thought he wasn’t able to start working in Adelaide yet; but he mentioned he was able to come in for Isla's EUA and he got some good images to compare with the ones from Melbourne. There were no new tumours and all previously treated tumours appear inert. He mentioned the area that the Melbourne team have been closely watching for several months appears unchanged.
We were so happy to have had Dr Sia there for Isla’s EUA as we felt like we could be jeopardising her treatment by choosing not to go to Melbourne. The ophthalmologist in Adelaide was not trained in treating retinoblastoma and also didn't have access to the same equipment that both Melbourne and Dr Sia do to take images of her eyes. Dr Sia said that he would see Isla again in 2 months time for another EUA in Adelaide and she would also start having more regular vision tests with the orthoptists in Adelaide as well.
Isla took a little while to wake up, but after a drink and some snacks she perked up again. They were on their way home by about 5pm.
© Alison Davey 2021
Comments