Pennod 6 Ward Plant

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-Ysbyty Gwynedd is the first

-port of call in an emergency...

-..for the people

-of North West Wales.

-Hundreds of children come here first

-if they're having any problems.

-Some come here so often,

-they become part of the family.

-We know about the problems they

-have to deal with from day to day.

-You can't help

-but put yourself in their shoes.

-Tonight, we bring you the story

-of one little man.

-He's been in and out of hospital

-since he was born.

-The doctors tend to ask if we want

-to save Gwion or let him go.

-Obviously we know the answer

-straight away. We want to save him.

-Since the beginning of

-the first series four years ago...

-..we've seen hundreds

-of little patients.

-One of them has become

-very familiar.

-Good boy.

-I'm nearly finished.

-They're inserting an NG tube to take

-food straight into his stomach.

-He can't swallow very well.

-We're here four or five times a year

-usually.

-With his chest.

-When Gwion was born, everything was

-fine until he was two weeks old...

-..and then he had meningitis Strep B

-and was rushed to Alder Hey.

-He was on a life-support machine

-for nine weeks.

-As a result, he had brain damage.

-He has blind, he has cerebral palsy

-and he has fits.

-He'll be on medication

-for the rest of his life.

-Have you been a naughty boy?

-You take the oxygen

-out of your nose!

-You're not supposed to!

-He was in Alder Hey for a while

-and he now has a lot of problems.

-He's now epileptic.

-He has what's known

-as quadriplegic cerebral palsy.

-He has diabetes insipidus.

-He has feeding problems.

-That's all happened as a result

-of the damage caused by meningitis.

-His lungs are the biggest problem.

-When Gwion has a cold, it can turn

-to pneumonia very quickly.

-To stop food

-from going down his windpipe...

-..doctors at Alder Hey Hospital

-have inserted a tube in his stomach.

-That's how he gets his food.

-But this doesn't protect him

-from winter viruses.

-The weather makes a difference

-for Gwion.

-If it's damp and raining and cold,

-he tends to come in more often.

-Gwion can't walk or move around

-like we do...

-..which means he can't do anything

-on his own.

-Everything collects

-and sticks on his lungs...

-..which makes it difficult

-for him to breathe.

-He has to come in to have oxygen

-to help him breathe.

-When Gwion comes to the children's

-ward after the summer holidays...

-..everyone knows

-that winter's on the way.

-Paediatrics is a seasonal business.

-We're much busier in winter.

-In particular between October

-and the end of February...

-..when the viruses are around.

-Children with asthma

-come in regularly.

-Babies come in with bronchiolitis...

-..which is a specific virus

-that's around in winter.

-We're always busier in winter.

-But when Gwion has a cold...

-..he doesn't just

-have to come in for a few days.

-He's here for weeks.

-I'm here until tonight...

-..and my partner will be here

-tonight until tomorrow.

-We have a three-year-old at home so

-one of us has to be home with her.

-She also works in between.

-They can be quite difficult nights.

-Gwion doesn't sleep well anyway.

-We do it at home and in hospital.

-One of us is up all night.

-It can be quite difficult.

-Between work and caring for Gwion,

-we all struggle.

-After four years of coming here...

-..Dewi Ward is like home from home

-for Gwion's parents.

-The nurses are like a second family.

-I've nursed Gwion

-since he was a baby.

-I've really developed a relationship

-with Gwion...

-..his parents and the whole family -

-I'm very fond of them.

-You couldn't ask for a better family

-to look after their child.

-Gwion means a lot

-to everyone on the ward.

-We sometimes feel

-as though he's our child!

-We all love Gwion.

-It's so nice to see him go home

-with his parents when he's better.

-It is difficult for us as a family.

-We don't know what's going to happen

-from one day to the next.

-We've been home for a week now...

-..but maybe tomorrow

-things won't be so great.

-For his mother,

-this morning is like so many others.

-She wakes up to another day

-on Dewi Ward.

-We like to do everything for Gwion

-in the hospital.

-We do everything at home

-so we do it in the hospital as well.

-They give him his medication

-but we tend to sort out his food...

-..and anything else he needs.

-Sometimes it's hard being

-in that room seeing him suffer.

-That part is difficult

-from day to day.

-I'll put these in the wash for you.

-I can wash them.

-Are you sure?

-Are you sure?

-

-Yes.

-Before things get busy, Sister Mel

-has some organizing to do.

-Who's looking after who today?

-I'm going to find out who was here

-yesterday and who knows who.

-I try to allocate the same nurse

-to the same patient for continuity.

-I haven't been here for over a week

-so I don't really know anyone.

-So I'll find out who the girls know

-and then I'll allocate.

-But the doctors are here already.

-Gwion's condition has deteriorated

-so he's their first patient today.

-Hello. He's awake!

-Shall we have a listen

-to your chest then, please.

-Will he be better a bit upright

-with his oxygen levels?

-He's very hard to position.

-I think this is the best position

-Mum's...

-So he's got a bit more work

-breathing compared to yesterday.

-Can you see it recessing?

-Recession bilateral.

-Let's have a listen.

-Two minutes. Two minutes.

-Two minutes, Gwion.

-OK.

-I know. Sorry.

-OK. All done. Good boy.

-Just keep up the levels.

-The chest infection

-is getting worse.

-I think we will still

-withhold the x-ray.

-We should do repeat bloods, put him

-on clarithromycin, more physio...

-..and see where we go from here.

-They've been to see him.

-He's completed a seven-day course

-of antibiotics...

-..but because of how

-he's been overnight...

-..they don't think

-the infection has cleared.

-So we're going to try

-another antibiotics...

-..that works in a different way,

-starting from today.

-He doesn't have to be here

-for the seven days.

-What keeps him here

-is the oxygen requirement.

-His parents can do everything else

-at home.

-They can do the physio

-and give him his medication.

-The oxygen requirement

-is what's keeping him here.

-They don't have home oxygen.

-But they can do the physio, the

-nebulisers and everything like that.

-Gwion always gets over

-these episodes.

-Recently, he had a sleep study

-at Alder Hey.

-It showed that when he's healthy and

-doesn't have a chest infection...

-..the level of oxygen in his blood

-overnight is fine.

-It's a good thing that he doesn't

-need oxygen all the time...

-..only when he's not well.

-I sometimes think, "Why us?"

-We just want him to come home.

-We don't want money or a big house.

-We just want the four of us

-to be at home as a family.

-We want to be like normal people

-and have some time at home.

-You want to hope for the best

-for the future.

-But you're also scared

-to think about it too much.

-We don't know how long we have

-with Gwion.

-We don't know

-what will happen tomorrow.

-You don't want to be too confident.

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-Late afternoon and Gwion's condition

-is still causing concern.

-Gwion isn't quite as well

-this afternoon.

-His condition has deteriorated.

-He needs a lot more oxygen

-this afternoon.

-The chest physio has come to see him

-and he's had an x-ray.

-On the x-ray,

-the doctor showed me...

-..that the bottom of the lungs

-look white.

-That could be fluid collecting

-at the bottom of the lungs.

-It could be mucus or other fluid.

-In order to see that,

-he'd need a scan on his lungs.

-Gwion has pneumonia.

-With his life in danger,

-there's no time to waste.

-In order to have

-the best possible care...

-..he's moved

-to the intensive care room.

-Mind your backs!

-We tried a lot of things -

-more oxygen...

-..more pressure in the oxygen,

-physio and different medication.

-Despite everything we tried,

-he didn't get better.

-In fact, he's worsened.

-And again. More?

-Oh, good boy.

-So we made the decision

-to move Gwion to the resus room.

-Now the consultant is here.

-The physio is still here.

-They've called

-the anaesthetics team...

-..to take a look at Gwion.

-It's important that they assess him

-at the beginning...

-..because if he still doesn't

-improve or gets any worse...

-..we'll be looking at

-giving him general anaesthetic...

-..in order to insert a tube

-to help with his breathing.

-The intensive care team

-is on its way...

-..to put Gwion

-on a life-support machine.

-Sister Mel has to phone

-Darrel and Sara.

-There is a decision to be made

-about Gwion's future.

-They're phoning the anaesthetics

-team to have a look at him.

-OK, Darrel?

-Will you phone Sara?

-OK, mate. Bye.

-We've had this two or three times

-before.

-Every time, the doctors have

-to ask us as part of their job...

-..if we want to save Gwion

-or let him go.

-Obviously, we know straight away

-that we want to save him every time.

-They have to ask us

-as part of their job.

-It was hard.

-Like every other time, the chance

-of losing Gwion becomes closer.

-That's what we find difficult.

-We now know that there isn't a bed

-in the PICU at Alder Hey for Gwion.

-The North West transfer service

-we use...

-..is trying to find a bed elsewhere.

-They are also out on another job

-at the moment.

-So we're waiting to hear

-what's going to happen...

-..and where we'll get a bed

-for Gwion.

-The team has been working

-all night...

-..caring for him

-and keeping him alive.

-You look tired.

-No, I'm OK.

-How long have you been up?

-I went

-and had a little bit of sleep.

-I'm not as tired as I look!

-The doctors were concerned

-because they were at 100%.

-They couldn't do anything else

-for him.

-His oxygen levels kept coming down.

-They were very concerned

-we were going to lose him.

-He's much more stable.

-He still needs to go to

-an intensive care unit.

-But he's ventilating much better

-than when we started.

-Ysbyty Gwynedd staff

-have done everything they can...

-..but Gwion now needs intensive care

-in a specialist hospital.

-Last night,

-there were no beds anywhere.

-They didn't know if we'd

-have to go to Cardiff, London...

-..Sheffield, Birmingham or Stoke.

-But at the moment

-they're sorting it out.

-They think they might get us a bed

-in Alder Hey.

-That's what we hope. We've been

-there a few times so we know it.

-Hopefully that's where we'll go.

-They have to prepare everything

-and make sure he's stable.

-At the moment, I have to make sure

-his medication is ready to go.

-We can't forget anything

-because it's all so important.

-I went home this morning

-to pack his stuff.

-I saw his little pants

-and it was too much.

-We've done up his bedroom

-with his little bed.

-The thought of going home

-without him...

-I can't even think about it.

-He's only four years old. We know

-he's not going to live like us.

-But we hope to have

-as much time as possible with him.

-We hope to have much more time

-with him.

-We just have to keep

-everything crossed.

-NWTS, the specialist paediatric

-transport team in North Wales...

-..will be responsible

-for taking Gwion to Liverpool.

-Kate, our colleague,

-has done most of the work.

-We've just come along

-and we're just finishing off really.

-We'll just sort out here and then

-we'll move him on to our trolley...

-..so that we can get him

-on to the ambulance.

-Hopefully it won't be too long

-then.

-Just making sure

-the parameters are normal.

-Can I give him a kiss

-before he goes?

-Are you heading off?

-Are you heading off?

-

-No, we're following after.

-We're not moving quite yet.

-You've still got

-a little bit of time.

-We'll get him on the trolley first.

-Don't worry, we're not going to let

-you go without saying goodbye.

-I have a real bond with Gwion.

-I can't imagine life without him.

-It's difficult not to

-because we know how ill he is.

-Every second with Gwion

-is worth so much.

-Shall we move him down slightly?

-Yes, shall we move him down

-a little bit?

-Tell me when.

-Stop.

-Do you know if it comes off?

-I don't think so.

-That's alright, then.

-This part is difficult.

-Seeing him go and not being allowed

-to go with him.

-We just want to make sure

-he arrives in Liverpool safely.

-It's a very long hour.

-Who's driving who?

-Sara is going to drive.

-We're going after him.

-When they get to Liverpool, it takes

-two or three hours to set things up.

-There's no point in rushing. We have

-to go home to sort out our clothes.

-Then we'll follow.

-Even when we get there, he probably

-won't have been set up properly.

-There's no point rushing

-or panicking...

-..in case we have an accident.

-He's like a member of the family.

-He's part of the family.

-He likes to be naughty

-when I'm here.

-He loves it.

-Yes.

-People are so quick

-to criticize this place.

-But unless they know the nurses and

-the people here, they have no right.

-They don't know them.

-It's wrong.

-We expect a lot of children

-with chest infections...

-..at this time of year.

-Obviously, Gwion is in and out

-with his chest.

-We're in for a bad winter, I'd say.

-We're here to help

-as much as we can.

-Gwion always has to be

-the exception.

-Have you seen him this bad before?

-When he was in as a baby,

-he was really poorly.

-Three years running,

-we've been in this situation.

-We don't like seeing him like this.

-Normally, the Optiflow works.

-But not this time.

-It'll be good for him to have a rest

-as well.

-Let the machines do the work.

-See you in Liverpool, OK?

-It's only an hour. Make sure

-you behave! No funny business.

-Dad and Mam love you.

-Love you.

-Gwion is such a happy child.

-I wouldn't change him for the world.

-He's been through so much.

-It's a pleasure to be with Gwion.

-Despite everything.

-He's such a happy boy.

-He has his own little personality.

-That's what makes Gwion so special

-for us.

-You're not going to leave us,

-are you?

-You're not going to leave Dad,

-are you?

-Gwion was fighting for his life for

-four weeks at Alder Hey Hospital.

-He was on a life-support machine

-during that time.

-After two months in Liverpool...

-..he was allowed to come home

-to his sister.

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