Episode 3

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0:00:03 > 0:00:06From headquarters just outside Barnsley in South Yorkshire,

0:00:06 > 0:00:09a dedicated team of doctors and nurses

0:00:09 > 0:00:12fights to keep some of Britain's sickest children alive

0:00:12 > 0:00:17long enough to reach the specialist care they desperately need.

0:00:17 > 0:00:20If a child needs a life-saving operation...

0:00:20 > 0:00:22Down to ten, please.

0:00:22 > 0:00:25..or a premature baby has to be moved to a neonatal unit,

0:00:25 > 0:00:28it's the Embrace team's job to provide intensive care

0:00:28 > 0:00:32in the back of a moving ambulance, plane or helicopter.

0:00:32 > 0:00:35I was shaken, thinking, I don't really want to let him go.

0:00:35 > 0:00:38His heart's so small, how is he going to survive?

0:00:38 > 0:00:40It just felt like the whole world

0:00:40 > 0:00:41had come down. We didn't know what to do.

0:00:41 > 0:00:45As the NHS concentrates specialist care for babies and children

0:00:45 > 0:00:50- in fewer and bigger hospitals... - Mick, will you pull over, mate?

0:00:50 > 0:00:53..some of the UK's most vulnerable patients

0:00:53 > 0:00:56will need to undertake longer journeys to get expert care.

0:00:57 > 0:01:00- All right? Tired? - He's so cute, isn't he? Look at him.

0:01:00 > 0:01:02They know what the problem is, it needs correcting

0:01:02 > 0:01:06as soon as possible. So let's get him over there as quickly as we can.

0:01:07 > 0:01:09I love you...

0:01:10 > 0:01:1524 hours a day, every day, Embrace is on standby,

0:01:15 > 0:01:18tiny lives in its hands.

0:01:18 > 0:01:20'Hello, Embrace, how can I help?'

0:01:32 > 0:01:35'Hello, Embrace, Rebecca speaking. How can I help?'

0:01:35 > 0:01:39The Infant and Paediatric Transport Service, known as Embrace,

0:01:39 > 0:01:42co-ordinates the transfer of sick babies

0:01:42 > 0:01:46and children to specialist centres from its base near Barnsley.

0:01:46 > 0:01:49Good afternoon. How can I help you?

0:01:49 > 0:01:52Thank you very much indeed. Are you a consultant or a registrar?

0:01:52 > 0:01:56Every year, it receives 3,500 requests for help

0:01:56 > 0:01:58from hospitals across Yorkshire.

0:02:00 > 0:02:03Embrace Transport Service. Stacey speaking, how can I help?

0:02:03 > 0:02:08Baby Zakaria was born three days ago at Bradford Royal Infirmary.

0:02:08 > 0:02:11Doctors suspect he may have a rare heart condition

0:02:11 > 0:02:15which is fatal if not treated early.

0:02:15 > 0:02:19- 'I've got a baby who needs an echo in Leeds.'- Right, OK.

0:02:19 > 0:02:23'I think he has unobstructive TAPVD...'

0:02:23 > 0:02:26I didn't expect anything like that. Nothing to do with his heart.

0:02:26 > 0:02:27I just thought he'd just be

0:02:27 > 0:02:29a normal baby, like my other two children.

0:02:32 > 0:02:35An Embrace team has been dispatched to transfer Zakaria

0:02:35 > 0:02:39from Bradford to the Children's Heart Unit in Leeds.

0:02:41 > 0:02:44You knew there was something definitely wrong.

0:02:44 > 0:02:46You just pray for the best, really.

0:02:46 > 0:02:49Although Zakaria looks healthy,

0:02:49 > 0:02:53the oxygen levels in his blood are very low, and when doctors

0:02:53 > 0:02:57scan his heart, the veins connecting his heart and lungs look abnormal.

0:03:03 > 0:03:07Zakaria may well have a congenital heart condition called TAPVD,

0:03:07 > 0:03:11but this needs to be confirmed by specialists in Leeds.

0:03:11 > 0:03:14Shh, shh, shh...

0:03:14 > 0:03:15He's all right at the moment.

0:03:15 > 0:03:18He's looking quite well. He's breathing by himself.

0:03:18 > 0:03:21He's needing a little bit of oxygen, so he's got some oxygen going up

0:03:21 > 0:03:24some nasal cannula, as you can see,

0:03:24 > 0:03:27and that's working well for him.

0:03:27 > 0:03:30He's actually quite a big baby and if we just put him

0:03:30 > 0:03:33into our incubator fully dressed, we'll cook him.

0:03:33 > 0:03:37He will get really hot on the way. So we're just taking a layer off.

0:03:39 > 0:03:43Him in the incubator, and your own child in there,

0:03:43 > 0:03:45and a lot of things go through your head,

0:03:45 > 0:03:47but you just compose yourself and think,

0:03:47 > 0:03:49it's going to be all right, it's going to be all right.

0:03:49 > 0:03:52We were more than shocked. We didn't know what to think.

0:03:52 > 0:03:53We just thought to ourselves,

0:03:53 > 0:03:55just take him.

0:03:55 > 0:03:59It's only 12 miles from Bradford Royal Infirmary to Leeds,

0:03:59 > 0:04:03but for an anxious parent, the distance seems vast.

0:04:05 > 0:04:07We will get him fed straightaway.

0:04:07 > 0:04:10He might wriggle around a bit while they're trying to scan.

0:04:10 > 0:04:13So while they're getting all their stuff together,

0:04:13 > 0:04:15we can feed him and settle him down.

0:04:15 > 0:04:19Baby Zakaria is being transported to Yorkshire's only children's heart centre.

0:04:19 > 0:04:23This specialist unit has been under threat

0:04:23 > 0:04:27because of NHS plans to reduce the number of centres around England

0:04:27 > 0:04:30which carry out heart surgery on children.

0:04:32 > 0:04:35And then operations were halted overnight

0:04:35 > 0:04:38after questions were asked about its mortality rates.

0:04:41 > 0:04:46It re-opened just two weeks before Zakaria was born.

0:04:46 > 0:04:47'Heart surgery on children

0:04:47 > 0:04:50'will resume at Leeds General Infirmary tomorrow,

0:04:50 > 0:04:54'after it was suspended over concerns about higher-than-usual death rates.'

0:04:55 > 0:04:58- One of the nurses explained the situation to us.- Yes.

0:04:58 > 0:05:01About the death rates, what's happening.

0:05:01 > 0:05:03She explained everything before we even asked,

0:05:03 > 0:05:05which put your mind to ease, knowing...

0:05:05 > 0:05:07- They're not hiding anything. - Exactly.

0:05:07 > 0:05:11So it's opened again for a reason. If it was that bad,

0:05:11 > 0:05:14it would still be closed. So it's open again for a reason.

0:05:14 > 0:05:18There is no history of congenital heart conditions in Zakaria's family.

0:05:18 > 0:05:21His two older brothers have no health problems.

0:05:21 > 0:05:24I'm looking, essentially,

0:05:24 > 0:05:27for the cause of why his oxygen saturations haven't been normal.

0:05:27 > 0:05:32We need to have a really detailed look and see if

0:05:32 > 0:05:34we can determine the cause.

0:05:34 > 0:05:38Just daft questions! Why? What's wrong? Can you please tell us?

0:05:38 > 0:05:41And you had to be quiet all the way through,

0:05:41 > 0:05:43- and it just felt like forever. - Mmm.- Yes.

0:05:43 > 0:05:46The news from the scan isn't good.

0:05:46 > 0:05:50Zakaria's mum and dad are told their tiny son will have to have

0:05:50 > 0:05:55open heart surgery before he is a year old, otherwise he will die.

0:05:57 > 0:06:01She just told us what's happened, and it was just a shock.

0:06:01 > 0:06:03Their baby's got a condition called

0:06:03 > 0:06:07Total anomalous pulmonary venous drainage, which means that

0:06:07 > 0:06:12the veins from the lungs don't drain back to the left side

0:06:12 > 0:06:14of the heart as they should do, which means that the pink blood

0:06:14 > 0:06:18coming from the lungs is going to the wrong side of the heart.

0:06:18 > 0:06:21He will need an operation to put that right.

0:06:21 > 0:06:25He's only quite little, he only weighs 2.5, 2.6 kilos,

0:06:25 > 0:06:30so it may be that we want to wait a little bit before we do the operation,

0:06:30 > 0:06:35to allow him to get to maybe three kilos. And he's very well, there's no sign of any compromise at all.

0:06:36 > 0:06:39It just felt like the whole world had come down.

0:06:39 > 0:06:42- We didn't know what to do. - You don't expect it at all.

0:06:42 > 0:06:46I mean, not my baby, that's my baby, he looks perfectly all right.

0:06:46 > 0:06:48No matter how much they told me,

0:06:48 > 0:06:51he'll be all right, he'll be OK, it's been done before,

0:06:51 > 0:06:53but you just don't know, do you?

0:07:01 > 0:07:04Hello, Embrace, can I start with your name, please?

0:07:04 > 0:07:06What makes Embrace different from the other

0:07:06 > 0:07:08patient transport services in England

0:07:08 > 0:07:13is that it moves any critically ill child aged 16 or under, including newborns.

0:07:16 > 0:07:19What I'm going to do now is pass you on to our consultant,

0:07:19 > 0:07:21who will take further medical details.

0:07:21 > 0:07:23When a call comes in from a hospital,

0:07:23 > 0:07:29a senior consultant decides if the patient needs to be moved to a specialist centre.

0:07:29 > 0:07:32He has presented today about 15:30 to A&E

0:07:32 > 0:07:36with acute, severe, life-threatening asthma, and seemed to respond.

0:07:36 > 0:07:42Usually, a trainee specialist doctor and a nurse will do the transfer.

0:07:46 > 0:07:48Hello, Embrace, how can I help?

0:07:49 > 0:07:52Today, a call is coming in from Grimsby Hospital about a baby

0:07:52 > 0:07:57born ten weeks early who has a suspected blockage in her bowel.

0:07:57 > 0:07:59Yes, and it's a boy or a girl?

0:07:59 > 0:08:02- 'It's a girl.' - And have you got a weight for her?

0:08:02 > 0:08:07Baby Amelia is four days old and she still hasn't had a bowel movement.

0:08:09 > 0:08:12They're supposed to poo within the first 24 hours, and she never did.

0:08:12 > 0:08:15Her stomach just kept getting bigger and bigger.

0:08:15 > 0:08:19If her intestine is blocked, she needs urgent treatment.

0:08:19 > 0:08:25Her tummy was swollen and she wasn't tolerating her feeds.

0:08:25 > 0:08:28Her X-ray showed that some of her bowel loops

0:08:28 > 0:08:31were dilated and swollen, and there was a concern that

0:08:31 > 0:08:35there was a blockage at some point along the bowel.

0:08:38 > 0:08:42Grimsby Hospital doesn't have the facilities necessary to carry out

0:08:42 > 0:08:44detailed investigations of Amelia's bowel,

0:08:44 > 0:08:46so the team has been called in

0:08:46 > 0:08:51to transfer her the 70 miles to a neonatal unit in Sheffield.

0:08:54 > 0:08:57Well, she looks quite well. She's lovely and pink.

0:09:00 > 0:09:02Not very impressed with me, are you, Miss?

0:09:02 > 0:09:04The concern from the team here is that

0:09:04 > 0:09:09the two larger areas of bowel look quite dilated,

0:09:09 > 0:09:13and the rest of the bowel loops look quite big as well.

0:09:13 > 0:09:18So whether there's something blocking the passage of the stool

0:09:18 > 0:09:23through the bowel is causing an obstruction at some point.

0:09:23 > 0:09:27Amelia is a twin and the transfer will mean

0:09:27 > 0:09:30she'll have to be separated from her newborn sister Arrianna,

0:09:30 > 0:09:32who'll stay in Grimsby.

0:09:32 > 0:09:35'That was the worst thing, cos obviously,'

0:09:35 > 0:09:38I wanted to go with Amelia because of her being poorly,

0:09:38 > 0:09:41but that left Arrianna, and Mark had to go back to work as well.

0:09:41 > 0:09:44She does seem a bit like she's going to be cheeky.

0:09:44 > 0:09:49She doesn't like all the things. But she seems really chilled out.

0:09:49 > 0:09:53I don't know whether that's because she's not very well,

0:09:53 > 0:09:57but, no, she looks like she'll be trouble.

0:09:57 > 0:10:00Come on, then, sweetheart. Are you ready?

0:10:00 > 0:10:01'I was frightened of them.

0:10:01 > 0:10:06'They were so tiny and so fragile, it worried me, picking them up.'

0:10:06 > 0:10:11And when the nurses said, "Would you like a hold?", I thought, I'll break her bones, or something!

0:10:11 > 0:10:17The twins' mum will travel the 70 miles to the Jessop Wing Hospital

0:10:17 > 0:10:20with Amelia, leaving her twin sister in Grimsby.

0:10:23 > 0:10:26Dad is a long-distance lorry driver and has to go to work.

0:10:28 > 0:10:31When we pulled off, Arrianna was obviously left there

0:10:31 > 0:10:34and Mark said, I'll just pop back and say bye-bye to Arrianna.

0:10:34 > 0:10:38And me and Amelia just left. I think it was more the unknown for me,

0:10:38 > 0:10:41because I didn't know where I was staying, what I was going to do,

0:10:41 > 0:10:44I'd had nothing to eat, and it was awful.

0:10:44 > 0:10:47Baby Amelia is breathing for herself,

0:10:47 > 0:10:50but she is very tiny and very sick,

0:10:50 > 0:10:53and like all babies, she has the potential to deteriorate rapidly.

0:10:55 > 0:10:58There was a problem with her bowel that, at some point,

0:10:58 > 0:11:02the bowel could perforate, so develop a hole in it somewhere.

0:11:02 > 0:11:07And that sometimes can make babies and children quite poorly.

0:11:07 > 0:11:11We have to be prepared for any eventuality, really.

0:11:11 > 0:11:15Thankfully, the journey goes smoothly.

0:11:15 > 0:11:18It's always nice to get to the receiving hospital

0:11:18 > 0:11:25and know you've completed a nice, smooth, uneventful transfer. Yes.

0:11:25 > 0:11:30The Jessop Wing hospital has a level-three neonatal unit,

0:11:30 > 0:11:35which means the most critically ill babies can be cared for here.

0:11:35 > 0:11:39Specialists will decide if Amelia needs surgery to unblock her bowel.

0:11:39 > 0:11:42If she does, it may be many weeks before she is reunited with

0:11:42 > 0:11:45her twin sister back in Grimsby.

0:11:52 > 0:11:55Hello, Embrace, Audrey speaking. How may I help?

0:11:55 > 0:11:58OK. Are you the main consultant for this patient?

0:11:58 > 0:11:59Every year, teams from Embrace

0:11:59 > 0:12:03transfer over 2,000 sick babies and children.

0:12:03 > 0:12:05900 of them are critically ill

0:12:05 > 0:12:09and are taken to specialist centres to get expert treatment.

0:12:10 > 0:12:12Steve, it's Anne, back at base.

0:12:12 > 0:12:15When you get in the ambulance, can you just ring me with

0:12:15 > 0:12:18an estimated time of your arrival at Grimsby?

0:12:18 > 0:12:20The majority of journeys they make are within Yorkshire,

0:12:20 > 0:12:23but occasionally, the team is drafted in

0:12:23 > 0:12:26to fly a critically ill child home from abroad.

0:12:31 > 0:12:34A thousand miles away from her home in Leeds,

0:12:34 > 0:12:39a baby girl has been born in the Spanish holiday resort of Alicante,

0:12:39 > 0:12:4113 weeks prematurely.

0:12:43 > 0:12:45Baby Ellizeah's parents were visiting family

0:12:45 > 0:12:48when she made her early arrival

0:12:48 > 0:12:50and she's been in intensive care ever since.

0:12:53 > 0:12:57They said that the intestines perforated. They need to do surgery.

0:12:57 > 0:13:01And then they said, if we don't do this surgery, she's going to die.

0:13:01 > 0:13:05And that's when your whole world just comes crashing down.

0:13:05 > 0:13:07You just want to die yourself.

0:13:07 > 0:13:10As well as her perforated bowel, Ellizeah has a heart defect

0:13:10 > 0:13:13and bleeding on her brain.

0:13:13 > 0:13:17She will need specialist care in hospital for many months.

0:13:19 > 0:13:23Ellizeah's mum and dad have spent the last seven weeks at the bedside

0:13:23 > 0:13:25of their tiny, desperately ill daughter.

0:13:25 > 0:13:30Now all they want to do is get her home to a hospital in Yorkshire.

0:13:32 > 0:13:34We need to get her back to her hometown,

0:13:34 > 0:13:37to where she should have been born, in Leeds.

0:13:37 > 0:13:39And I feel like I owe it to her as a parent to do that,

0:13:39 > 0:13:41just because of what she's been through now.

0:13:41 > 0:13:45I feel like it's the only thing that will make it

0:13:45 > 0:13:50a little bit better for her. The hospital here is absolutely brilliant

0:13:50 > 0:13:55and we owe her life to them, but as a family, we need to be home.

0:13:57 > 0:13:59Back in Barnsley, at Embrace Headquarters,

0:13:59 > 0:14:02a community midwife who knows the family has alerted

0:14:02 > 0:14:06Lead Consultant Steve Hancock to Ellizeah's plight.

0:14:07 > 0:14:11The team would be able to fly her back to the UK.

0:14:11 > 0:14:14However, the NHS can't cover the £12,000 cost

0:14:14 > 0:14:18of chartering a specially equipped private plane

0:14:18 > 0:14:21and Ellizeah's mum and dad don't have travel insurance.

0:14:21 > 0:14:26Small babies need looking after in a special environment. They need

0:14:26 > 0:14:28full intensive care monitoring,

0:14:28 > 0:14:30they may need to be on ventilatory support,

0:14:30 > 0:14:34so all of that requires specialist equipment,

0:14:34 > 0:14:38and you can't put that specialist equipment on a commercial airliner.

0:14:45 > 0:14:47Thank you. Good evening, on the first day of spring!

0:14:47 > 0:14:49A Yorkshire couple stuck abroad

0:14:49 > 0:14:51after their baby was born prematurely...

0:14:51 > 0:14:56Ellizeah's family is determined to raise the money necessary.

0:14:56 > 0:15:00Zowie's mum is spreading the word on the local BBC news programme.

0:15:02 > 0:15:05We're currently near £12,000.

0:15:05 > 0:15:09So, we can have Zowie's baby brought home from a

0:15:09 > 0:15:10Spanish hospital to an

0:15:10 > 0:15:12English hospital.

0:15:12 > 0:15:16I'm very nervous but she's my daughter, that's my granddaughter

0:15:16 > 0:15:22and if anything helps them to come home to an English hospital, I'm willing to do that.

0:15:22 > 0:15:25Well, joining us now is Carol Lyons, Zowie's mum

0:15:25 > 0:15:27and Grandma to baby Ellizeah.

0:15:27 > 0:15:28Erm, Carol it's your...

0:15:28 > 0:15:30My mum was on the ball.

0:15:30 > 0:15:32I don't even know how she did it or what went on,

0:15:32 > 0:15:36I just got phone calls saying, "Right we're going to a family meeting.

0:15:36 > 0:15:39"This is going on, we're doing this, we're doing fundraisers."

0:15:39 > 0:15:42It was just amazing how much effort they actually put in

0:15:42 > 0:15:44just to get us home.

0:15:44 > 0:15:48But even if they do manage to get the money together for the specialist flight

0:15:48 > 0:15:52back to the UK, Ellizeah will be heading straight for intensive care

0:15:52 > 0:15:55where she could face weeks or even months of treatment.

0:16:01 > 0:16:04Every year 3,500 calls come

0:16:04 > 0:16:07into Embrace headquarters with requests to transfer some of

0:16:07 > 0:16:09Yorkshire's sickest children.

0:16:09 > 0:16:13One of those patients is seven-week-old Eddie.

0:16:14 > 0:16:17Hello, Embrace, Becky speaking, how can I help?

0:16:17 > 0:16:20Oh, hello, my name's Amy Rushbrook, I'm one of the paediatric registrars

0:16:20 > 0:16:22at Bradford Royal Infirmary.

0:16:22 > 0:16:28Eddie stopped breathing at home but his parents managed to resuscitate him.

0:16:28 > 0:16:30His condition has deteriorated

0:16:30 > 0:16:32rapidly since being brought to A&E in Bradford.

0:16:36 > 0:16:40He went blue straight away. As soon as I saw that

0:16:40 > 0:16:41I just rang the ambulance

0:16:41 > 0:16:43and then he stopped breathing

0:16:43 > 0:16:47and literally, to be honest the ambulance team were there in minutes.

0:16:47 > 0:16:50And then we had to resuscitate him ourselves through the advice

0:16:50 > 0:16:51over the phone

0:16:51 > 0:16:54and the ambulance team took him to BRI

0:16:54 > 0:16:56and then throughout the day it's got worse.

0:16:58 > 0:17:00'He started grunting, erm,

0:17:00 > 0:17:02'he has these periods of just intermittently

0:17:02 > 0:17:05'looking like he's desperately going to expire

0:17:05 > 0:17:08'and then picking up and fooling us all and then

0:17:08 > 0:17:10'doing it again within the hour.'

0:17:10 > 0:17:13Let's erm...take that call.

0:17:13 > 0:17:17Eddie is especially vulnerable because he recently had heart surgery,

0:17:17 > 0:17:19so Lead Embrace Consultant Steve Hancock

0:17:19 > 0:17:22decides he should be moved to the paediatric intensive care unit

0:17:22 > 0:17:24at Leeds General Infirmary.

0:17:25 > 0:17:29This one has had heart surgery in Leicester, something called a TGA

0:17:29 > 0:17:32which is quite a major heart operation

0:17:32 > 0:17:35and, I think, recovered, fairly well from that,

0:17:35 > 0:17:38but has been represented unwell, but

0:17:38 > 0:17:43we are thinking it's more perhaps an infection rather than the heart problem itself.

0:17:43 > 0:17:47The trouble is with these little ones when they've had heart surgery they are quite fragile,

0:17:47 > 0:17:51and you don't want to sit on them too long before you intervene.

0:17:51 > 0:17:54I have my emergency sandwiches.

0:17:54 > 0:17:55Doctors suspect that

0:17:55 > 0:17:59Eddie may have a severe case of bronchiolitis, a viral infection of

0:17:59 > 0:18:03the lower respiratory tract which affects children under a year old.

0:18:04 > 0:18:07He's sort of classified as paediatric because he's been

0:18:07 > 0:18:08home following his surgery

0:18:08 > 0:18:12and Bradford haven't got a paediatric intensive care unit, Leeds have.

0:18:13 > 0:18:18It's Ann Jackson from Embrace Transport. Hello there, how are you?

0:18:18 > 0:18:23Ann Jackson is one of the most experienced critical care nurses at Embrace,

0:18:23 > 0:18:26but because Eddie is so sick, lead consultant Steve is also

0:18:26 > 0:18:27travelling to Bradford.

0:18:30 > 0:18:33With Eddie it was pretty clear he was very sick

0:18:33 > 0:18:36and I think it was an unpredictable situation so I decided

0:18:36 > 0:18:39quite quickly that I was going to travel to Bradford.

0:18:40 > 0:18:44He's a good size, but he's risky, he's fragile, and,

0:18:44 > 0:18:48you know, Bradford to Leeds is not a huge journey but it's long enough

0:18:48 > 0:18:50and you really don't want to take any risks.

0:18:50 > 0:18:53These children go off remarkably quickly.

0:18:54 > 0:18:57Dr Steve hits the road in the rapid response vehicle

0:18:57 > 0:19:01so he can react if another more urgent call comes in.

0:19:02 > 0:19:06Steve, who is following in our rapid response car rang for an update.

0:19:06 > 0:19:08SIREN WAILS

0:19:08 > 0:19:12Hopefully, the tube's down, the X-ray will have been done, it's just a case of making sure he's

0:19:12 > 0:19:15adequately sedated and we'll have a good look at him and make

0:19:15 > 0:19:18sure he's fit for transfer and then it will be a case of loading him

0:19:18 > 0:19:19and taking him to Leeds.

0:19:21 > 0:19:24Because Eddie is recovering from major heart surgery,

0:19:24 > 0:19:26any infection could prove fatal.

0:19:28 > 0:19:30We'll get handover and have a look at him

0:19:30 > 0:19:32and the plan is to take him to Leeds.

0:19:32 > 0:19:34All right? Tired?

0:19:34 > 0:19:37I know, I know, are you coming with us?

0:19:37 > 0:19:38- Yeah.- Yeah.

0:19:38 > 0:19:41'They're so traumatised by what's going on we have to build up

0:19:41 > 0:19:43'a relationship with them very quickly.'

0:19:43 > 0:19:46You know, we're going to move their baby, they may come with us

0:19:46 > 0:19:49or they may not so there's a lot of trust there.

0:19:49 > 0:19:52- Ann?- Yeah.- Can we agree a plan, then?- Yeah, OK.

0:19:52 > 0:19:53So...

0:19:53 > 0:19:57- Tube, tube's well secured and in the right spot.- OK.

0:19:57 > 0:20:00He's critically ill needing intensive care.

0:20:00 > 0:20:05He's just at that point where he could just continue to improve

0:20:05 > 0:20:08and have a relatively straightforward stay in

0:20:08 > 0:20:10intensive care or things could get complicated for him

0:20:10 > 0:20:12particularly with his blood pressure at the moment.

0:20:12 > 0:20:17That's my main worry. How much support is he going to need for that?

0:20:17 > 0:20:20Before Eddie can be moved into the Embrace intensive care cot,

0:20:20 > 0:20:23the team has to get his blood pressure up by giving him

0:20:23 > 0:20:25some drugs.

0:20:25 > 0:20:27So, it's six milligram per kilogram so...

0:20:27 > 0:20:29- We're going for peripheral... - To start with.

0:20:29 > 0:20:32- Dopamine.- Need to get this pressure up...- Yep.

0:20:32 > 0:20:34We'll swap to a central line if necessary.

0:20:34 > 0:20:35BEEPING

0:20:35 > 0:20:38..7.5, so there's just a chance we might be...

0:20:38 > 0:20:42The blood pressure is low, so we're just working on that at the moment.

0:20:42 > 0:20:46Er, but in the last five minutes it has improved again, so,

0:20:46 > 0:20:49I'm hoping we can just keep it to fine tuning

0:20:49 > 0:20:51cos all the major stuff's been done.

0:20:51 > 0:20:53All right.

0:20:53 > 0:20:56When you think of what he's had before and the surgery and

0:20:56 > 0:20:58that he's been on intensive care, at least they've seen

0:20:58 > 0:21:01him on a breathing machine before and they've seen all the tubes

0:21:01 > 0:21:04and all the wires so they've got quite a good understanding.

0:21:04 > 0:21:06It's not like it's the first time they've seen him wired up

0:21:06 > 0:21:09so I know they're still very stressed and very anxious,

0:21:09 > 0:21:12understandably, but actually visualising this is not as horrendous

0:21:12 > 0:21:14for them as it would be to a new family coming and

0:21:14 > 0:21:16seeing it for the first time.

0:21:20 > 0:21:22He's bigger than I thought, he just fits in.

0:21:22 > 0:21:23Does he just fit in?

0:21:23 > 0:21:26- He's bigger than he looks! - He is a big boy. - His knees are a bit bent.

0:21:26 > 0:21:29I'm just connecting him all up and making him

0:21:29 > 0:21:30look less like a bomb's hit him

0:21:30 > 0:21:33and then you can have a proper look at him.

0:21:33 > 0:21:35Just a bit of a plumbing exercise.

0:21:35 > 0:21:38Just 18 hours ago Eddie's parents saved their son's life when

0:21:38 > 0:21:43he stopped breathing at home - but their ordeal is far from over.

0:21:44 > 0:21:48So, were you doing the breathing and the heart massage?

0:21:48 > 0:21:51It was kind of between us.

0:21:51 > 0:21:53I started doing it and Charlie was on the phone

0:21:53 > 0:21:57and then Charlie just gave me the phone and I just did the breaths.

0:21:57 > 0:22:00ANN: Yeah, fantastic. It's a horrible experience to go through, isn't it?

0:22:00 > 0:22:03I just keep playing it in my head is that scene...

0:22:03 > 0:22:04ANN: Yeah.

0:22:04 > 0:22:07That image I can't get rid of, to be honest.

0:22:07 > 0:22:09ANN: It will lessen, it will stay with you

0:22:09 > 0:22:11but it's fantastic that you did what you did,

0:22:11 > 0:22:12it's made all the difference.

0:22:15 > 0:22:20The combination of infection and a fragile heart means Eddie's still in grave danger.

0:22:25 > 0:22:28If he's got bronchiolitis which we think he may have, OK,

0:22:28 > 0:22:30I was always tend to say to parents,

0:22:30 > 0:22:33have in your mind that he's going to be in for, perhaps,

0:22:33 > 0:22:35a week in intensive care.

0:22:35 > 0:22:37But particularly if it's bronchiolitis

0:22:37 > 0:22:39often they can get worse

0:22:39 > 0:22:41before they get better.

0:22:41 > 0:22:44But he's going to a unit where they deal with it day in and day out

0:22:44 > 0:22:47over the winter. All right?

0:22:47 > 0:22:51I've been nursing a long time, but I think, knowing the

0:22:51 > 0:22:53emotions of a parent with a poorly child

0:22:53 > 0:22:56helps you to understand.

0:22:56 > 0:22:58I think, part of it's nursing and the training and

0:22:58 > 0:23:01I think part of it is just life experience in dealing with

0:23:01 > 0:23:04lots of people over the years.

0:23:08 > 0:23:10All right, little man.

0:23:11 > 0:23:15If you could hop into your new bed I'd be very grateful.

0:23:15 > 0:23:18I know. He's so cute, isn't he? Look at him.

0:23:20 > 0:23:24He's had a good journey. Numbers on his monitor are better.

0:23:24 > 0:23:26The only thing that's changed is his temperature's gone up

0:23:26 > 0:23:30so indication that there is some infection somewhere.

0:23:30 > 0:23:31But his blood pressure's improved

0:23:31 > 0:23:34so one of the drugs that we've given him to keep

0:23:34 > 0:23:37his blood pressure up, we've managed to stop, so that's in his favour.

0:23:37 > 0:23:39He was in about 40% oxygen

0:23:39 > 0:23:43when we set off and he's now in air, so that's a good improvement.

0:23:43 > 0:23:44Yeah, he's pretty stable.

0:23:45 > 0:23:48Sweetie pie. But nice and settled.

0:23:50 > 0:23:54Not only does Leeds have a large paediatric intensive care unit,

0:23:54 > 0:23:57it's also home to Yorkshire's only children's heart centre.

0:23:57 > 0:24:01One, two, three. All right, that can just drop down. Come on, sweetie pie.

0:24:03 > 0:24:07- Got him?- Yeah, got him. - Yeah? Good lad.

0:24:07 > 0:24:10Eddie didn't have his life-saving operation here

0:24:10 > 0:24:12but at a similar unit in Leicester

0:24:12 > 0:24:16because, at the time, there wasn't a surgeon available in Leeds.

0:24:16 > 0:24:19Both centres have been fighting NHS plans

0:24:19 > 0:24:21to close their operating facilities.

0:24:21 > 0:24:24If Eddie's illness is due to complications

0:24:24 > 0:24:27arising from his heart operation then Embrace will probably

0:24:27 > 0:24:30transfer him to Leicester for follow-up surgery.

0:24:38 > 0:24:41At the Jessop Wing Hospital in Sheffield, baby Amelia,

0:24:41 > 0:24:45born ten weeks premature, is about to be moved by the Embrace team

0:24:45 > 0:24:48for the second time in two days.

0:24:48 > 0:24:53It's large, distended and full

0:24:53 > 0:24:57but not tense.

0:24:57 > 0:25:00She was brought to the neo-natal unit from Grimsby

0:25:00 > 0:25:03because doctors were concerned that she hadn't had a bowel movement

0:25:03 > 0:25:06since she was born five days ago.

0:25:06 > 0:25:10This baby's abdomen got more distended than it should be

0:25:10 > 0:25:14and it looks like when they've put some food down,

0:25:14 > 0:25:16it's not completely being absorbed.

0:25:16 > 0:25:18She's getting a lot of bile coming back up the tube

0:25:18 > 0:25:21so there is a concern that there's a bit of a blockage.

0:25:23 > 0:25:26Just based on this X-ray, we can't tell where the problem is

0:25:26 > 0:25:33but it certainly looks like there is an obstruction at some point.

0:25:33 > 0:25:37Amelia needs a more detailed X-ray and this can only be done

0:25:37 > 0:25:40in the radiology department at the next-door Children's Hospital,

0:25:40 > 0:25:44a short journey but still dependent on scrupulous preparation.

0:25:48 > 0:25:50It's pretty short. You sort of just get your seat belt on

0:25:50 > 0:25:52and you get everything up and then, "Oh, we're here.

0:25:52 > 0:25:55"Seat belt off." But they don't have a bridge,

0:25:55 > 0:25:58they don't have a tunnel so we've got to drive.

0:25:58 > 0:26:02But short or long transport, you need the same preparation

0:26:02 > 0:26:05and the same handover at the end,

0:26:05 > 0:26:07so they're the hardest bits, really.

0:26:08 > 0:26:11Amelia's mum also has the extra worry of knowing that her other

0:26:11 > 0:26:15newborn daughter, Amelia's twin, has had to stay in an incubator

0:26:15 > 0:26:1870 miles away in Grimsby Hospital.

0:26:21 > 0:26:24She has been ever so good with everything that they've done to her

0:26:24 > 0:26:28- so far, bless her.- Yeah.- So... - She's chewing on her fingers now.

0:26:28 > 0:26:31Oh, is she? Poor kid's had nothing to eat!

0:26:31 > 0:26:34We'll count her fingers when we get there.

0:26:36 > 0:26:39Just as Amelia and the team get to the Children's Hospital,

0:26:39 > 0:26:41they are joined by Dad.

0:26:44 > 0:26:50The contrast is like a dye which just shows up on plain X-rays

0:26:50 > 0:26:55so what he'll do is place a small tube in the back passage

0:26:55 > 0:26:59and then inject the dye just prior to taking the X-rays

0:26:59 > 0:27:02and we'll take a series of films which should give us

0:27:02 > 0:27:07some good pictures of exactly what's going on in the bowel.

0:27:08 > 0:27:10Mum can't bear to watch this bit

0:27:10 > 0:27:13so Dad is staying with his new baby girl while a test is done.

0:27:15 > 0:27:17I think it was because I didn't want to be in there

0:27:17 > 0:27:19and I just thought, "Oh," cos I didn't know what

0:27:19 > 0:27:23they were going to do and Amelia being so tiny, I just thought,

0:27:23 > 0:27:24"Oh, I can't. I can't stay in there."

0:27:24 > 0:27:26And he didn't want to leave her on her own

0:27:26 > 0:27:29so he stayed and that's very brave for Mark.

0:27:29 > 0:27:32Then something amazing starts happening.

0:27:32 > 0:27:36The dye that's put into Amelia's digestive system for the test

0:27:36 > 0:27:38appears to be unblocking her bowel.

0:27:40 > 0:27:42The radiologist explained there was a bit of a blockage

0:27:42 > 0:27:45just where the large bowel meets the small bowel.

0:27:45 > 0:27:47He feels that it's a plug of meconium

0:27:47 > 0:27:52and meconium is just the first bits of poo that baby produces.

0:27:52 > 0:27:56And just by pushing through some of the contrast

0:27:56 > 0:27:59and releasing that plug,

0:27:59 > 0:28:02it may be enough just to release everything

0:28:02 > 0:28:07and keep everything flowing, so the radiologist is just having

0:28:07 > 0:28:11a chat with the surgeon, explaining what he's found.

0:28:11 > 0:28:14We should just be going back as normal

0:28:14 > 0:28:18but it may mean that we avoid any further...

0:28:18 > 0:28:21having to do anything further but we'll just have to wait

0:28:21 > 0:28:22and see, really.

0:28:22 > 0:28:24And the radiologist is right.

0:28:24 > 0:28:26Amelia's blockage is cleared.

0:28:26 > 0:28:30As soon as the Embrace team gets her back to the Jessop Wing Hospital,

0:28:30 > 0:28:31she has her first bowel movement.

0:28:33 > 0:28:37When we'd opened the nappy, she'd pooed and it was everywhere

0:28:37 > 0:28:41and I thought, "Oh!" I'd never been so relieved to see a dirty nappy!

0:28:41 > 0:28:44And then she continued to do it so it was excellent, but I wasn't very...

0:28:44 > 0:28:46Obviously, inexperienced at doing the nappy.

0:28:46 > 0:28:49She put her foot in it, it was all over.

0:28:49 > 0:28:52And there's me trying to mop her up. But yeah, I couldn't moan at all.

0:28:52 > 0:28:53It was brilliant.

0:28:55 > 0:28:57Amelia doesn't have to have surgery.

0:28:57 > 0:29:01But because she and her twin Arrianna were born ten weeks early,

0:29:01 > 0:29:04the worry will continue for some time as there may be other

0:29:04 > 0:29:06undetected health problems.

0:29:10 > 0:29:13Back in Alicante, at the hospital intensive care unit,

0:29:13 > 0:29:17baby Ellizeah is recovering from her third operation.

0:29:18 > 0:29:22She was born 13 weeks prematurely and has a perforated bowel,

0:29:22 > 0:29:26a defective heart and a bleed on her brain.

0:29:27 > 0:29:30But now there's some good news for Mum and Dad.

0:29:30 > 0:29:35After three months in Spain, an anonymous donor has given them

0:29:35 > 0:29:38the final £5,000 of the £12,000 they need

0:29:38 > 0:29:41for the team to fly their tiny daughter home.

0:29:42 > 0:29:45They donated the rest of the money and obviously,

0:29:45 > 0:29:50when you need that extra kind of miracle to get you home,

0:29:50 > 0:29:53then your mum rings you and says, "You're coming home,"

0:29:53 > 0:29:56and you're like, "I'm not, don't be silly,"

0:29:56 > 0:29:58and then it actually hits you, it's a reality,

0:29:58 > 0:30:01you are coming home, you're bringing your daughter home.

0:30:03 > 0:30:08Now the funding is secure, Embrace advanced nurse practitioner Karen

0:30:08 > 0:30:11and nurse Ian are setting off from the UK to pick her up.

0:30:13 > 0:30:16Mobile phone, drugs, to go.

0:30:16 > 0:30:20The paperwork, all your fax forms are there that you need.

0:30:22 > 0:30:24This has been a very sick baby.

0:30:24 > 0:30:28She has been needing to come back since day one, really.

0:30:28 > 0:30:32Blue, red section, one, two, three bags.

0:30:32 > 0:30:35'The reason she hasn't come back yet has been a mixture of the medical

0:30:35 > 0:30:37'and the financial.'

0:30:38 > 0:30:42Just yesterday, really, was the coming together of the two,

0:30:42 > 0:30:46in that she was fit to fly and the money was available to fly her.

0:30:46 > 0:30:51The money raised by the family has paid to charter the plane.

0:30:51 > 0:30:52The intensive care equipment

0:30:52 > 0:30:57and the Embrace staff costs will be picked up by the NHS.

0:30:57 > 0:30:59That wasn't bumpy at all.

0:31:01 > 0:31:03No, but the stronger the wind...

0:31:03 > 0:31:05Because they take off into the wind, if you got a strong wind,

0:31:05 > 0:31:07they just go, woof!

0:31:08 > 0:31:10That's just...

0:31:11 > 0:31:13Er, invasive pressure monitoring kit.

0:31:13 > 0:31:18The team has transformed the plane into a mobile intensive care unit.

0:31:19 > 0:31:21We don't do many of these,

0:31:21 > 0:31:26because it's not a common thing for little babies to get stuck abroad.

0:31:26 > 0:31:29But it's important to us that when they come up,

0:31:29 > 0:31:33and when it is a Yorkshire baby, they are able to respond.

0:31:33 > 0:31:35We have got the longer route.

0:31:35 > 0:31:38We are doing all right.

0:31:38 > 0:31:40After four hours in the air,

0:31:40 > 0:31:43the team starts the descent into Alicante.

0:31:46 > 0:31:49Karen, you see how much it wobbles at this speed?

0:31:49 > 0:31:52So, when you're sitting with the incubator,

0:31:52 > 0:31:55you've almost got to put a hand on it, just to dampen it down a bit.

0:31:59 > 0:32:02HE SPEAKS IN SPANISH

0:32:02 > 0:32:05Upon landing, it's another 10 miles by private ambulance from

0:32:05 > 0:32:07Alicante Airport to the hospital,

0:32:07 > 0:32:11where baby Ellizeah and her parents are waiting.

0:32:11 > 0:32:13As soon as I seen them, I shouted,

0:32:13 > 0:32:19because I just noticed the English nurse uniform, it was great.

0:32:19 > 0:32:21I felt like I had won the lottery.

0:32:22 > 0:32:27She is quite feisty, but we're hoping she will have a sleep.

0:32:27 > 0:32:30She has settled down now, looks like she likes to be swaddled,

0:32:30 > 0:32:33she likes to be wrapped up.

0:32:33 > 0:32:36Ellizeah is leaving the hospital

0:32:36 > 0:32:40where she has been cared for for the whole of her short life.

0:32:40 > 0:32:43There's no question that the treatment she's had in Spain

0:32:43 > 0:32:45is as good as she would have had in the UK.

0:32:48 > 0:32:53The challenge, I think, for the family, is around the unknown,

0:32:53 > 0:32:55so it would have seemed very different.

0:32:55 > 0:32:58The language barriers, of course, and the isolation

0:32:58 > 0:33:01from the family, which I think was probably the biggest challenge.

0:33:01 > 0:33:03In only five more hours,

0:33:03 > 0:33:06Ellizeah will finally be in her home city of Leeds.

0:33:15 > 0:33:19Meanwhile, back in the UK, Embrace patient baby Eddie is

0:33:19 > 0:33:22fighting for his life after open-heart surgery.

0:33:24 > 0:33:27When he was admitted to Bradford Royal Infirmary six days ago,

0:33:27 > 0:33:31doctors thought he had a severe case of bronchiolitis,

0:33:31 > 0:33:33or that his heart was in difficulty, following an operation.

0:33:35 > 0:33:39Embrace moved him to Leeds, where tests carried out by cardiologists

0:33:39 > 0:33:43revealed that the arteries leading to Eddie's heart had collapsed

0:33:43 > 0:33:44and he was in heart failure.

0:33:46 > 0:33:49The thing they didn't want to find, they found,

0:33:49 > 0:33:53which was that the coronary arteries had narrowed, in a very unusual way.

0:33:53 > 0:33:58So, I think as soon as they established that had happened,

0:33:58 > 0:33:59it was a case of, it needs fixing,

0:33:59 > 0:34:01it's not something that is going to fix itself.

0:34:01 > 0:34:04This narrowing is a rare complication

0:34:04 > 0:34:06arising from an operation Eddie had

0:34:06 > 0:34:09at the Children's Heart Unit in Leicester

0:34:09 > 0:34:10to switch his arteries over.

0:34:12 > 0:34:15This was done six weeks ago, when he was just five days old,

0:34:15 > 0:34:17and had appeared to be successful.

0:34:19 > 0:34:22Well, they sent me the pictures of the coronary arteries

0:34:22 > 0:34:24and they were narrow.

0:34:24 > 0:34:26And I was quite surprised that they were,

0:34:26 > 0:34:29because the operation seemed to be so successful before.

0:34:29 > 0:34:32This is something that can happen after this surgery,

0:34:32 > 0:34:35but it's quite unusual.

0:34:35 > 0:34:37We always had the niggling feeling that it would be his heart

0:34:37 > 0:34:39that would be the problem.

0:34:39 > 0:34:43We wanted to kind of sideline that as much as we could, but ultimately

0:34:43 > 0:34:47there's no such thing as coincidence when it comes to a heart patient.

0:34:47 > 0:34:51The Embrace team was drafted in to move Eddie to Leicester

0:34:51 > 0:34:54to have his second major surgery.

0:34:54 > 0:34:56As they travelled the 100 miles from Leeds,

0:34:56 > 0:35:00the surgeon who did Eddie's original operation cut short

0:35:00 > 0:35:04a conference in America and was flown back specially.

0:35:04 > 0:35:07They know what the problem is and it needs correcting as soon

0:35:07 > 0:35:11as possible, so, let's get him over there as quickly as we can.

0:35:11 > 0:35:16As soon as the surgeon arrived, he made the decision straightaway.

0:35:16 > 0:35:19Didn't want to run the risk of him having a heart attack in the time

0:35:19 > 0:35:23that they were waiting, so he called the team in and they got to action.

0:35:23 > 0:35:28These pictures recorded by the surgeon's head camera show him

0:35:28 > 0:35:30opening up Eddie's collapsed arteries.

0:35:31 > 0:35:35It's quite an unusual operation, quite complicated, so,

0:35:35 > 0:35:38as the senior surgeon, I thought it was right that I came back to do it.

0:35:38 > 0:35:42Yeah, I think Giles is one of the five surgeons in the UK that

0:35:42 > 0:35:46could have done this operation, so, very lucky that he was here in time.

0:35:46 > 0:35:49His coronary arteries had reduced to pinhole size.

0:35:49 > 0:35:51If your coronary arteries are blocked,

0:35:51 > 0:35:54then you have a heart attack.

0:35:54 > 0:35:56The operation is successful,

0:35:56 > 0:36:00but three days later, Eddie remains critically ill.

0:36:00 > 0:36:03I think we are just worried that...

0:36:03 > 0:36:06- with his lungs, obviously, the heart could be the problem.- Yeah.

0:36:06 > 0:36:10That's why they are doing the echo, just to check that.

0:36:10 > 0:36:13Eddie's attached to an ECMO machine -

0:36:13 > 0:36:15a complex piece of equipment

0:36:15 > 0:36:18which acts as an artificial heart and lungs

0:36:18 > 0:36:22outside his body, giving his own fragile heart a chance to recover.

0:36:24 > 0:36:25Seeing her baby back on life support

0:36:25 > 0:36:27when he has been at home with her for weeks

0:36:27 > 0:36:30is of course traumatic for Mum.

0:36:30 > 0:36:33He's a kind of angry...little boy!

0:36:33 > 0:36:35SHE LAUGHS

0:36:35 > 0:36:37He likes to eat a lot.

0:36:37 > 0:36:39He likes bath time.

0:36:41 > 0:36:43You all right?

0:36:47 > 0:36:52If he was awake, he'd be letting us know he was hungry. He'd be starving.

0:36:52 > 0:36:56He hasn't eaten properly in days, really. What?

0:36:56 > 0:36:58- What does he do when he's hungry? - He does that...

0:37:02 > 0:37:04He does that. Yeah, he's cute.

0:37:05 > 0:37:08But no-one can say how long it will be before Eddie is back

0:37:08 > 0:37:10to his old self.

0:37:16 > 0:37:20A thousand miles away at the Spanish resort of Alicante,

0:37:20 > 0:37:24the Embrace team is preparing to fly baby Ellizeah home to Yorkshire.

0:37:27 > 0:37:29After 12 weeks of waiting, finally there.

0:37:29 > 0:37:34- Been a long time coming, but we are there.- But it's been worth it.

0:37:34 > 0:37:37I mean, she's got her health, so... it's worth it.

0:37:37 > 0:37:40Ellizeah was born prematurely while her parents were on holiday.

0:37:40 > 0:37:43She's spent three months in intensive care

0:37:43 > 0:37:45and is still very sick.

0:37:48 > 0:37:52We do international transfers about three to four times a year.

0:37:52 > 0:37:54It has become a regular part of what we do now.

0:37:54 > 0:37:59It's not always straightforward, follow a guideline and do things

0:37:59 > 0:38:03the same way in a regimented way - you have to be a bit more flexible.

0:38:03 > 0:38:05You know, be prepared to change things as you go along,

0:38:05 > 0:38:06depending on what happens.

0:38:06 > 0:38:09Ellizeah will be going straight to Leeds General Infirmary

0:38:09 > 0:38:11after landing.

0:38:11 > 0:38:14Like many premature babies, she has multiple health issues,

0:38:14 > 0:38:17some of which may cause her problems in the long term.

0:38:19 > 0:38:22She might have a limp, she could be dyslexic,

0:38:22 > 0:38:25she might end up in a wheelchair, she might not be able to walk,

0:38:25 > 0:38:29or use her little finger, that kind of thing.

0:38:29 > 0:38:30Literally, we don't know.

0:38:31 > 0:38:34She was just beginning to...

0:38:34 > 0:38:37wriggle about a bit, the incubator started rocking a bit,

0:38:37 > 0:38:39so I'm just steadying it.

0:38:39 > 0:38:42We're just going through the clouds, it's a bit windy in Yorkshire.

0:38:42 > 0:38:47So, hopefully she won't notice. She looks pretty settled now.

0:38:49 > 0:38:51And when the aircraft makes its final approach,

0:38:51 > 0:38:54the winds sweeping across the runway at Leeds Bradford Airport

0:38:54 > 0:38:59make for a very bumpy, but thankfully safe, landing.

0:38:59 > 0:39:01THEY CHEER

0:39:03 > 0:39:06Another Embrace team has come from Barnsley to collect baby Ellizeah

0:39:06 > 0:39:12and ensure she safely completes the final ten miles of her epic journey.

0:39:13 > 0:39:15She was better than we hoped.

0:39:15 > 0:39:19She was a little bit grumpy in Alicante, and we feared that

0:39:19 > 0:39:23would last five hours, but actually, she's been an absolute delight.

0:39:23 > 0:39:27What's the temperature in there? Perhaps leave her on it.

0:39:27 > 0:39:29It's bitterly cold,

0:39:29 > 0:39:34but the temperature in Ellizeah's incubator has stayed the same.

0:39:34 > 0:39:37Mum and Dad said she liked the top of her foot stroking,

0:39:37 > 0:39:40and as soon as I did that, she settled down and went to sleep.

0:39:40 > 0:39:42So, she's caused us no bother whatsoever.

0:39:42 > 0:39:47Within half an hour, Ellizeah is almost at her final destination,

0:39:47 > 0:39:49Leeds General Infirmary.

0:39:50 > 0:39:55Oh, hi, it's Karen here again. Hello. We are just driving an LGI.

0:39:58 > 0:40:03Landing! Right. Yes, we are landing, in the ambulance.

0:40:04 > 0:40:07It felt like she was home, it's the hospital that

0:40:07 > 0:40:10I wanted her to be born in, it's where I was born.

0:40:10 > 0:40:13Just to have that support as well, of the people, to say,

0:40:13 > 0:40:17"Welcome back home, I can't believe what you went through!"

0:40:17 > 0:40:19It's just nice.

0:40:19 > 0:40:22Hello! Thank you.

0:40:22 > 0:40:24But it's still a long road to recovery.

0:40:24 > 0:40:28Ellizeah's had surgery on both her heart and bowel

0:40:28 > 0:40:30and doctors are also concerned that she's not feeding well.

0:40:32 > 0:40:35These notes that were given us are a more detailed history

0:40:35 > 0:40:40of things like blood results, operation notes, that sort of thing.

0:40:40 > 0:40:43They are in Spanish, but they will get translated.

0:40:44 > 0:40:48I'm sure she'll get used to broad Yorkshire accents, being here!

0:40:48 > 0:40:50Yeah.

0:40:57 > 0:41:00For the next six weeks, Ellizeah remains on the neonatal

0:41:00 > 0:41:04high dependency unit at Leeds General Infirmary.

0:41:04 > 0:41:06It's OK. Shh, shh. Oh, dear!

0:41:06 > 0:41:09A feeding tube has been inserted into her stomach

0:41:09 > 0:41:12and she has had surgery to treat her persistent reflux.

0:41:13 > 0:41:17It's not quite the speedy recovery her parents were hoping for.

0:41:21 > 0:41:25But finally, after three months in a Spanish hospital and nine weeks

0:41:25 > 0:41:30in a hospital in Yorkshire, Mum and Dad can take her home.

0:41:32 > 0:41:34She's very cheeky.

0:41:34 > 0:41:38She likes to do fake coughs and fake cries.

0:41:38 > 0:41:41She's really smiley on a morning.

0:41:41 > 0:41:44She has a bit of a temper as well, so, if you don't give her

0:41:44 > 0:41:47attention, that's it, she'll go in a mood with you.

0:41:47 > 0:41:52I think it's just amazing, how big she has got.

0:41:53 > 0:41:56I mean, with all the milk that she's taking as well,

0:41:56 > 0:42:00she's getting right heavy, aren't you? Yes, you are!

0:42:05 > 0:42:06At Grimsby Hospital,

0:42:06 > 0:42:11another Embrace patient with bowel problems is recovering well.

0:42:11 > 0:42:13She says, "I'm not waking up!"

0:42:15 > 0:42:19Four days after she was born here, baby Amelia still hadn't had

0:42:19 > 0:42:22a bowel movement, so the specialist transport team moved her

0:42:22 > 0:42:28to the neonatal unit at the Jessop Wing Hospital in Sheffield.

0:42:28 > 0:42:32Are you going to open your eyes and have a look at everybody?

0:42:32 > 0:42:34- She won't have anything to eat...- I know.

0:42:34 > 0:42:37A test she had while she was there loosened a blockage

0:42:37 > 0:42:39in Amelia's bowel and three days later,

0:42:39 > 0:42:41she was able to return to Grimsby.

0:42:43 > 0:42:46But on the day that Amelia was travelling back, Embrace was

0:42:46 > 0:42:50called out to transfer her twin sister from Grimsby to Sheffield.

0:42:50 > 0:42:52So now, the twins have swapped hospitals.

0:42:55 > 0:42:56It was awful.

0:42:56 > 0:42:59I think that is anybody's worst nightmare, just for them

0:42:59 > 0:43:02to be separated again, and when you think, oh, great,

0:43:02 > 0:43:05Amelia's coming back, you didn't expect them

0:43:05 > 0:43:07to say that Arrianna was going. I really didn't.

0:43:07 > 0:43:11Arrianna also has a blocked bowel, but it turns out to be

0:43:11 > 0:43:15a far more serious obstruction than Amelia's was.

0:43:15 > 0:43:18Her digestive system didn't develop properly in the womb,

0:43:18 > 0:43:21and she will need surgery to remove a section of bowel

0:43:21 > 0:43:24which is stopping waste from passing through.

0:43:28 > 0:43:31The twins have been apart for more than three weeks,

0:43:31 > 0:43:34and Mum is struggling to spend time with them,

0:43:34 > 0:43:38especially Arrianna, who is in a hospital 70 miles from home.

0:43:40 > 0:43:4325 days, and I've seen her 12 times.

0:43:43 > 0:43:48So, she won't recognise me soon.

0:43:48 > 0:43:51It's really strange, because they both do this thing where

0:43:51 > 0:43:54they lift both of their eyebrows.

0:43:54 > 0:43:56I just said, for them not to be together,

0:43:56 > 0:44:00they've got very similar characteristics.

0:44:00 > 0:44:04But Amelia tends to laugh a lot more,

0:44:04 > 0:44:07she lifts her little lip up when you say something to her,

0:44:07 > 0:44:11she seems to be a lot more alert than what Arrianna is at the minute.

0:44:14 > 0:44:17Three months on and it's the morning of what's hoped to be

0:44:17 > 0:44:20the final operation on Arrianna's bowel.

0:44:22 > 0:44:26She's already had a section of damaged intestine removed.

0:44:26 > 0:44:29Today, the surgeon is hoping to reconnect her bowel

0:44:29 > 0:44:32so Arrianna will no longer need a colostomy bag.

0:44:34 > 0:44:38Worried sick. If it was straightforward it'd be an hour and a half.

0:44:38 > 0:44:40But because of all the scar tissues and adhesions,

0:44:40 > 0:44:45they've told us about three and a half hours. But they also know what Arrianna's like.

0:44:45 > 0:44:48So, it's the thought of her being under that anaesthetic

0:44:48 > 0:44:51when she's only just had one two weeks ago as well.

0:44:51 > 0:44:54But we can only pray that it goes according to plan, can't we?

0:44:54 > 0:44:57And you be a good girl. Yeah.

0:44:57 > 0:45:02Arrianna is now 18 weeks old and has spent nearly her whole life

0:45:02 > 0:45:06in hospital, separated from her twin sister, Amelia, and her parents.

0:45:09 > 0:45:12If Arrianna asks me, "When was my first smile?"

0:45:12 > 0:45:15I can't tell her that, because it happened in hospital.

0:45:15 > 0:45:17And although they do keep a diary for me,

0:45:17 > 0:45:21I can't tell you an awful lot about Arrianna's developments or anything.

0:45:21 > 0:45:25So that's upsetting, because you just don't feel you can bond with her.

0:45:25 > 0:45:29This operation is turning out to be more complicated

0:45:29 > 0:45:31than the surgeon first thought.

0:45:31 > 0:45:34He'll have to remove another piece of damaged intestine

0:45:34 > 0:45:37before he can join the bowel back up again.

0:45:37 > 0:45:40But I suppose we need to unravel it all to see.

0:45:40 > 0:45:43I never got down to...

0:45:43 > 0:45:47But the surgeon needs to make sure that he doesn't cut out

0:45:47 > 0:45:50too much of the intestine, otherwise Arrianna won't be able

0:45:50 > 0:45:53to absorb the nutrients from her food properly.

0:45:56 > 0:46:00This is where the problem is, so we need to take this loop off.

0:46:00 > 0:46:03So we're looking at how much length of bowel she has got.

0:46:03 > 0:46:09And this is all small bowel. It looks like she's has got ample small bowel.

0:46:09 > 0:46:13Approximately there is 90cm, which is good.

0:46:13 > 0:46:16This piece of bowel will now be tested to try and establish

0:46:16 > 0:46:19why it was damaged.

0:46:20 > 0:46:22Yeah, I don't know here, what's happening here.

0:46:22 > 0:46:27It's all... We'll have to look at it oestrologically when they take it out. OK.

0:46:28 > 0:46:31Basically we have disentangled all the bowel.

0:46:31 > 0:46:35And there's 90cm of small bowel.

0:46:35 > 0:46:39Someone her age should have about 200, 250.

0:46:39 > 0:46:41But that's not too bad.

0:46:41 > 0:46:46And then we're going to join these two ends together now.

0:46:49 > 0:46:55She has more than a 50% chance of feeding normally and growing.

0:46:55 > 0:46:59But she's in a grey area, so we'll have to see which way she goes.

0:46:59 > 0:47:03I suspect she is going to be in the hospital for a good few weeks

0:47:03 > 0:47:08while we get her to start feeding orally and bring the TPN down,

0:47:08 > 0:47:12which is the nutrition we gave her through a line into her heart.

0:47:12 > 0:47:15And we'll have to see how she goes.

0:47:15 > 0:47:18But I think she's got a much greater than 50% chance of doing well.

0:47:21 > 0:47:25We found some bit of the bowel was quite strictured

0:47:25 > 0:47:30and damaged, so we had to remove it. But we did manage to join the two ends together.

0:47:30 > 0:47:33- So she hasn't got another stoma? - No, she hasn't.

0:47:33 > 0:47:36So it might be a good few weeks before

0:47:36 > 0:47:39we can think about getting her home etcetera.

0:47:39 > 0:47:43What we need to do now is to get her to recover from this

0:47:43 > 0:47:47and then feed, and we'll watch her very closely.

0:47:47 > 0:47:50It's absolutely fabulous. I can't believe that

0:47:50 > 0:47:53they've actually managed to put it all back together

0:47:53 > 0:47:56without creating another stoma. Brilliant.

0:47:56 > 0:47:59I'll go and see Arrianna first of all, spend a bit of time with her,

0:47:59 > 0:48:02make sure she's all settled. and then we've got to go and pick Amelia up,

0:48:02 > 0:48:05who's been very, very naughty at my sister's!

0:48:05 > 0:48:11Apparently she's been resisting sleep and being a bit vocal.

0:48:11 > 0:48:17But never mind! So that's us spent time with both of them. Lovely.

0:48:17 > 0:48:20Arrianna will be prone to infection after this operation.

0:48:20 > 0:48:24And it may be several weeks before she can join her sister at home.

0:48:36 > 0:48:39Let's leave this trolley on just for the time being,

0:48:39 > 0:48:42because there's two options. I don't think this little one needs an incubator.

0:48:42 > 0:48:47Of the 2,300 children and babies the Embrace team transfers

0:48:47 > 0:48:51every year from hospitals in Yorkshire, it takes 200 of them

0:48:51 > 0:48:53to the children's heart unit in Leeds.

0:48:53 > 0:48:58In 2012, an NHS review recommended that it and two other

0:48:58 > 0:49:02specialist heart centres in England should stop operating on children.

0:49:02 > 0:49:04Supporters fought these plans hard.

0:49:04 > 0:49:07But then the Leeds unit suffered a setback

0:49:07 > 0:49:11when NHS bosses temporarily suspended children's heart surgery,

0:49:11 > 0:49:13while its mortality rates were looked at.

0:49:17 > 0:49:20It's now three weeks since operations resumed in Leeds

0:49:20 > 0:49:22after reassurances were given about safety.

0:49:22 > 0:49:28And two week-old baby Zakaria is about to have complex open-heart surgery.

0:49:28 > 0:49:32- I just want to check he's got his name bands on, OK?- Yeah.

0:49:32 > 0:49:35And his date of birth, 20th of April, yeah?

0:49:35 > 0:49:37Zakaria was brought here by the Embrace team

0:49:37 > 0:49:40when doctors at Bradford Royal Infirmary

0:49:40 > 0:49:43suspected he had a fatal heart condition called TAPVD.

0:49:45 > 0:49:49Cardiologists confirmed he needed urgent surgery.

0:49:49 > 0:49:54They said to us he needs to have it. It is dangerous what he's got,

0:49:54 > 0:49:57The wrong blood's going in the wrong place. It's not supposed to. So...

0:49:57 > 0:50:00So, as he gets older, summat's going to happen to him.

0:50:00 > 0:50:04So, the quicker we act on it, the better for him.

0:50:04 > 0:50:11Operating on a baby who's 13 days old and weighs just 2.6 kg is far from ideal.

0:50:11 > 0:50:14But surgeons can't risk waiting any longer.

0:50:17 > 0:50:20They said that because of his condition, he wouldn't grow

0:50:20 > 0:50:23any bigger, so it would be best for him

0:50:23 > 0:50:25to have the operation as soon as.

0:50:26 > 0:50:29We'd prefer this child to be a bit bigger

0:50:29 > 0:50:31but we're not going to get that luxury.

0:50:31 > 0:50:36This child will rapidly go into very severe heart failure and die.

0:50:36 > 0:50:38Simple as that.

0:50:38 > 0:50:42Now as soon as he goes floppy, I'm going to ask you to put him on the table for me.

0:50:42 > 0:50:46Now that pudding is his head ring.

0:50:46 > 0:50:48So his head goes there, toes go there.

0:50:49 > 0:50:53I remember putting him down. I was shaking, thinking,

0:50:53 > 0:50:55"I don't really want to let him go."

0:50:55 > 0:51:01So I just put him down and just said goodbye to him, just gave him a kiss goodbye.

0:51:01 > 0:51:04And it just makes you feel, when she said that, it just...

0:51:04 > 0:51:07I don't know, it just makes you feel...

0:51:07 > 0:51:10Is this, "Goodbye forever", or is it, "Goodbye, I'll see you again"?

0:51:10 > 0:51:13So, I mean, you just don't know.

0:51:16 > 0:51:20The surgery in this condition is at the back of the heart so

0:51:20 > 0:51:22we have to lift the heart up

0:51:22 > 0:51:29and find these abnormal blood vessels that are draining from the lung

0:51:29 > 0:51:33and they're draining into the wrong side of the heart.

0:51:33 > 0:51:36So we have to plumb them back in to where they should be.

0:51:38 > 0:51:41Before the surgeon can start repairing Zakaria's heart,

0:51:41 > 0:51:44he must be attached to a bypass machine...

0:51:45 > 0:51:48..which takes over the work of his heart and lungs.

0:51:49 > 0:51:51Down to ten, please.

0:51:54 > 0:51:56We cool the baby right down.

0:51:56 > 0:52:00We hibernate the baby, if you like, and that's to protect the heart,

0:52:00 > 0:52:02the brain and all the different organs, etc.

0:52:03 > 0:52:09His heart's just so small. How's he going to survive?

0:52:09 > 0:52:12It all runs through your head. You just don't know what to do.

0:52:12 > 0:52:17No matter how much someone tells you, "Oh, he'll be OK,"

0:52:17 > 0:52:19no, it's just not...

0:52:19 > 0:52:20It just doesn't register.

0:52:22 > 0:52:25This is a rare condition and surgeons in Leeds only do

0:52:25 > 0:52:29this type of operation three or four times a year.

0:52:31 > 0:52:34I asked him, "Have you done it before?" And he said, "Yeah."

0:52:34 > 0:52:37He was one of the few doctors that had and I asked him,

0:52:37 > 0:52:40"Was it a success?" And he said,

0:52:40 > 0:52:43"Yeah, you know, it was 100 per cent success."

0:52:43 > 0:52:44It went very well.

0:52:44 > 0:52:48He's doing very well. His haemodynamics are stable.

0:52:48 > 0:52:51He is very stable. It went very well.

0:52:52 > 0:52:57Baby Zakaria has been on the operating table for six hours.

0:52:57 > 0:53:00For Mum and Dad, it's been an eternity.

0:53:00 > 0:53:02I kept saying, "There's something wrong.

0:53:02 > 0:53:05"There's something definitely wrong cos they're not calling us.

0:53:05 > 0:53:07"If it was all OK, they would have called us."

0:53:07 > 0:53:10Gosh, getting through that last half an hour, it was horrible.

0:53:10 > 0:53:12I was just like, "We've got to go up.

0:53:12 > 0:53:15"Let's ring them." He kept telling me, "No, it's all right.

0:53:15 > 0:53:16"It's just protocol.

0:53:16 > 0:53:20"That's what they do." It was horrible, that last half an hour.

0:53:24 > 0:53:26Most importantly, the chest is still open.

0:53:26 > 0:53:29The skin is closed, the sternum is still open.

0:53:29 > 0:53:32What I would suggest is running some sedatives

0:53:32 > 0:53:35and I would paralyse him as well just until the chest heals.

0:53:35 > 0:53:38- Hello. How are you doing? You OK?- Yeah.

0:53:39 > 0:53:41Finally, the surgeon breaks the good news to Mum and Dad

0:53:41 > 0:53:44that their tiny baby has pulled through.

0:53:45 > 0:53:48So, Zakaria's back and he's fine. He's done well.

0:53:48 > 0:53:50- Everything OK? - Yeah, he's doing well.

0:53:50 > 0:53:53Then we knew he was going to be all right. Even when they said

0:53:53 > 0:53:56the next 24-48 hours are going to be quite critical,

0:53:56 > 0:53:58- we thought, "If he's done that, he's..."- Through the worst.

0:53:58 > 0:54:01- 'He's going to be all right.' - 'Little soldier.

0:54:01 > 0:54:02'He'll definitely pull through.

0:54:04 > 0:54:07'I touched him. I knew I couldn't pick him up.

0:54:07 > 0:54:09'I just wanted a cuddle but I couldn't.

0:54:09 > 0:54:11'I just put his little teddy bear near him

0:54:11 > 0:54:14'and, yeah, just stood there, staring at him.'

0:54:14 > 0:54:18After a major operation like this, it's impossible to predict

0:54:18 > 0:54:22how long it will take a child to fully recover.

0:54:22 > 0:54:23But baby Zakaria does

0:54:23 > 0:54:27so well that he's back at home in Bradford in just five days.

0:54:27 > 0:54:30Now, five months on, he's continuing to thrive.

0:54:32 > 0:54:36- He's...- Still likes his food. - Still, yeah.- He's really good.

0:54:36 > 0:54:39He's like my other children, like any normal baby.

0:54:39 > 0:54:43I mean, you wouldn't be able to tell he's had a heart surgery.

0:54:43 > 0:54:47I mean, the scar - apart from that, nothing. I mean,

0:54:47 > 0:54:52towards the start, when he did come home, I felt I didn't know how...

0:54:52 > 0:54:55I didn't want to pick him up in case I hurt him or anything.

0:54:55 > 0:55:00But after, within a week or so, it was no different.

0:55:00 > 0:55:03Like any other children and, yeah, bonded fine with him.

0:55:03 > 0:55:06Yeah, you think about, "What if?"

0:55:06 > 0:55:09In the future, every time there's an appointment or a scan,

0:55:09 > 0:55:11what will they tell you?

0:55:11 > 0:55:14But you try to just be positive cos thinking he's gone through so much,

0:55:14 > 0:55:15the rest is nothing for him.

0:55:17 > 0:55:19So, of course, he's a happy baby.

0:55:19 > 0:55:22You wouldn't think there's something wrong with him.

0:55:22 > 0:55:25He's smiling, he's always doing what he's doing now.

0:55:27 > 0:55:30He just wants to get down and explore everything.

0:55:33 > 0:55:37In Grimsby, six months after the Embrace team transferred her

0:55:37 > 0:55:40to Sheffield, baby Amelia is back home.

0:55:42 > 0:55:45BABY BREAKS WIND Oh, that was lovely!

0:55:45 > 0:55:49Amelia and her twin sister Arrianna were born ten weeks prematurely

0:55:49 > 0:55:51and both have had problems with their bowel.

0:55:53 > 0:55:55Standing up.

0:55:55 > 0:55:58But Amelia's bowel unblocked itself during a test

0:55:58 > 0:56:00and she's been home for five months.

0:56:00 > 0:56:05There she goes. She looks beautiful. Pretty lady.

0:56:05 > 0:56:07Come on, then.

0:56:07 > 0:56:08She's moving into three to six,

0:56:08 > 0:56:12whereas Arrianna's still in...she's in newborn and up to zero to three,

0:56:12 > 0:56:17so she'll have to wear them and just roll them up. Won't she?

0:56:17 > 0:56:19Got to accommodate you, haven't we?

0:56:19 > 0:56:24We can't squeeze you in small sizes. No.

0:56:24 > 0:56:26For the last few weeks, Amelia and her mum have had to

0:56:26 > 0:56:31travel 70 miles to Sheffield to visit Amelia's twin sister Arrianna.

0:56:37 > 0:56:40Arrianna's still in hospital after having three operations

0:56:40 > 0:56:42to unblock her damaged bowel.

0:56:43 > 0:56:44Where's Arrianna?

0:56:44 > 0:56:47'The nurses, they just can't do enough for you.'

0:56:47 > 0:56:50They do get them out and they do give them cuddles which, obviously, me

0:56:50 > 0:56:54being so far away, it's nice to know that they do care.

0:56:57 > 0:57:01- Thank you.- We've washed her, haven't we? Got you dressed.

0:57:01 > 0:57:05- Had some cuddles cos you were a bit sad.- Aw.

0:57:05 > 0:57:07And then she went to sleep about 11.

0:57:07 > 0:57:09She was awake quite a lot of the night.

0:57:09 > 0:57:13I said, you're going to be really chuffed with me waking her up now!

0:57:13 > 0:57:14Aren't they?

0:57:14 > 0:57:17Although Arrianna is improving every day,

0:57:17 > 0:57:20she weighs nearly three kilos less than her twin.

0:57:22 > 0:57:24I just hope that when she does come home that they have got that

0:57:24 > 0:57:30twin bond and that they do get along and don't...don't fight. Don't we?

0:57:30 > 0:57:32Eh?

0:57:32 > 0:57:34I hope they do remember that they are twins

0:57:34 > 0:57:37cos they've never been together, really.

0:57:40 > 0:57:42Come on, Tubbs.

0:57:43 > 0:57:45Who's that?

0:57:45 > 0:57:48Perhaps the best test of any twin bond is seeing

0:57:48 > 0:57:49if they can share a single cot.

0:57:52 > 0:57:55Oh, Amelia. Amelia, what's this?

0:57:59 > 0:58:02Hello, Arrianna. Hi, gorgeous girl.

0:58:03 > 0:58:07'Getting Arrianna home, that would be truly wonderful.

0:58:07 > 0:58:10'I can't wait to get them both out and running around together.

0:58:10 > 0:58:11'I really can't.

0:58:11 > 0:58:14'I think that's going to be the best feeling ever, just to see them

0:58:14 > 0:58:18'both and actually have them together all the time.'

0:58:18 > 0:58:22- I can't wait.- We're having a big christening, aren't we? Yes.