Separate medical emergencies for toddlers and toddlers require care at a Montreal hospital

MONTREAL – A couple from Montreal and their two young children are recovering from a whirlwind of recent health challenges and credit the MUHC for going to great lengths to provide them with care under one roof to keep their family together.

Stefanie Cortina was 37 weeks pregnant when she was sitting in the emergency room at Montreal Children’s Hospital on a Friday morning in September last year.

She was waiting for a doctor to see her two-year-old son Alessandro, who had taken a small tumble and hit his head several days earlier.

To increase stress, Cortina had just packed a hospital bag for herself because she was scheduled to be induced the following week at Saint-Mary’s Hospital. Her doctor who was concerned about the baby’s growth.

She could never have imagined that within the next six days, her son would have three surgeries performed by two different surgeons, and she would give birth to her baby – not at Saint-Mary’s, but at the Royal Victoria Hospital with an obstetrics team she was . meet for the first time.

“Definitely a roller coaster,” Cortina said.

“It’s not what you prepared for, you planned,” she said. “There was even just too much emotion to process.”

MORE THAN A Concussion

The cascade of medical barriers began to unfold as Cortina and her husband sought help earlier in the week at other emergency rooms. They were told three times that Alessandro had a concussion.

On the surface, that diagnosis made sense to them, but when they observed their little boy, it felt bad.

“It was kind of just his behavior. He was tired, he was tired. He was irritable. He was not himself, ”Cortina said.

It made them try again to get some answers three days later from the children, where the emergency team ordered a CT scan.

It showed that Alessandro did not bleed but had “excessive fluid on the surface of his brain and cerebellum,” according to Dr. Jean-Pierre Farmer, senior surgeon and neurosurgeon at the orphanage, who was called in to consult.

“In retrospect, he had probably fallen six months ago, and he may have created a small tear in one of the membranes covering the brain,” Farmer said, with another fall likely to cause fluid retention.

The toddler was anesthetized for an MRI scan, and while he was still asleep from the scan, the neurosurgeon immediately continued to drain the fluid to release the pressure, leaving a drain in place.

“STRETCHED BETWEEN TWO HOSPITALS”

With about a week of recovery in the hospital ahead of Alessandro, and with the date of Cortina’s planned birth just a few days away, Farmer suggested a way for her and her husband to stay by her boy’s side as much as possible.

“We said it could be better if we organize the transfer to obstetrics here and that you give birth here,” he said, because if not, “the family will be stretched between two hospitals.”

Cortina did not have much time to think about it. An action plan had to be drawn up.

There was a sense of relief at knowing that they would be in the same building at Glen Place if she could be transferred to the Royal Victoria Hospital (RVH) to have her baby.

“But at the same time, it’s like, wait, do they need to know my file? Do they want to know why I’ll be induced early?” she said.

Looking back now, “it was the absolutely right decision,” Cortina said.

“We were very happy to be able to accommodate the family,” Farmer said, adding that the way everyone at MUHC managed it despite several difficulties says a lot about the way the care at the institution is organized.

“I think the reason for telling this story,” Farmer said, is not because of its medically unique nature, but rather “it’s about the art of medicine, the ability to help the child, and help the family when the situation becomes a bit more complex. ”

TWO OPERATIONS AND ONE BIRTH

As his wife was now accepted as a patient at RVH, Salvatore Lee-Giulione breathed a sigh of relief knowing that he did not have to leave any of the family members alone in their hospital rooms for too long.

His speed-walking skills were quickly put to the test as the plan for an induction was disputed after Cortina’s labor pains began naturally while she was sitting by Alessandro’s bed with the children.

The couple walked together the short walk through the hospital building to RVH, where nurses examined her and confirmed that she was in active labor.

“So I stayed there. He went to prepare my son to get him up for an MRI scan while I got a contract. My husband came back just in time for me to get the epidural,” Cortina said.

“The treatment was absolutely fantastic. We never had to explain our story again, ”said Lee-Giulione as they bounced back and forth between the children’s and adults’ hospitals.

Their second son, Adriano, was born healthy and well. His birth brought the couple much joy, but not the total peace they wanted.

“As soon as my wife gave birth, we found out that Alessandro needed another operation,” said Lee-Giulione, the installation of a shunt to prevent fluid from accumulating in the brain.

“I was trying to do my best for my wife and Alessandro, so I kept going back and forth to reassure my wife that he’s okay and that everything will be fine,” he said.

The couple then informed Farmer that Alessandro was also on the waiting list for a bridge repair, which added another layer of complexity to the medical picture. Farmer suggested another solution.

“We thought it would not only be practical if Alessandro could have his shunt inserted and hernia repaired at the same time,” Farmer said, it also made good medical sense.

But that put Dr. Sherif Emil, Alessandro’s general surgeon, in a dilemma when he was home and recovered on the couch after sustaining a nasty knee injury the week before.

“I had already seen Alessandro, I did not really feel like I wanted my parents to meet another surgeon for the first time,” Emil said.

However, it was difficult to find a time the following day when both surgeons had not scheduled other appointments or surgeries.

“It was all very short notice. So it was really a challenge. But you know, we were still working on all the pieces we had and were able to assemble it,” Emil said.

“I could just imagine what it’s like to have a child who is acutely ill when just having another child, so my heart really hurt the parents.”

So less than 24 hours later, Emil arrived at the nursery with crutches, and he and Farmer merged through two different surgeries, saving Alessandro a return trip to the operating room and another anesthetic.

‘BOTH MY BOYS, HAPPY, HEALTHY’

Brothers happy and healthy

Alessandro and Adriano are happy and healthy after spending some time together in the hospital, both with unique medical conditions that require care. SOURCE: Natasha D Photography

Only a week after Alessandro was hospitalized, and with at least four medical missions completed, the family was discharged – but not without one last important meeting.

They had to introduce Alessandro to Adriano.

The tears come quickly two months later as Cortina remembers the moment.

“We just went in for a quick pick-up [with the baby]. And again, these would mean that you have to spend for these processes. It was just amazing. I could not be more grateful in a moment to see both my boys happy and healthy. ”

“Alesandro, the smile he had on his lip when he realized we were all going home and he saw his little brother … It must have been good for him because he figured, oh, we were all here,” she said .

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