Fanning a tiny spark into a steady flame

Baby John Metaxiotis has already lived through more than many adults ever will. Born at Mercy Hospital for Women at just 26 weeks and a tiny 395 grams, John has undergone countless medical procedures and defied staggering odds to not just survive, but thrive. He's a fighter, but he hasn't had to fight alone.

From the day John opened his eyes, he has been surrounded by devoted care from his parents and the team the Neonatal Intensive Care Unit (NICU)."There's a massive team of people involved in the delivery and care of such a young baby,"explains Kelly Elliott, one of the unit's Associate Nurse Unit Managers. "There were more than fifteen people inthe theatre, from across the perinatal, neonatal, obstetric and NICU teams."

While John's story is just one of many incredible journeys witnessed at Mercy Hospital for Women, he was remarkable on many levels. "John was one ofthe smallest babies we've ever had," remembers Kelly. "He's probably the smallest I've seen in eleven years in the unit. The main challenge initially is just to survive. Everything's underdeveloped so the first few days are critical."

John's mother Paula felt every minute of that time, but her own gruelling journey � and that of the team who cared for her �began long before. "John was our 16th attempt at IVF, with three miscarriages along theway," reveals Paula. "Everything was going fine with this pregnancy until we discovered John wasn't growing, so his gestational age was two weeks behind due to the placenta not functioning properly."

Concerned, Paula's obstetrician rang Professor Sue Walker, Sheila Handbury Chair of Maternal Fetal Medicine at Mercy Hospital for Women. "Sue was amazing. She confirmed there was a problem, then looked at research into why it might be happening, including links to sleep apnoea which I was found to have. So I was put on a machine which helped a lot.

"We just did everything wecould to keep things going." Throughout the following months, the Mercy Hospital for Women's team gave Paula their undivided attention and support.

"Sue was very honest with us. On the first visit she said, 'You need to realise you're going to have a small baby'. I said 'Oh okay' and she said 'No, I mean really tiny. I'm hoping for about the 500-gram mark'.

"In the week before John's birth, Cathy, my senographer, did ultrasounds every day. The amazing thing was that John was very active! At night lying down he would just kick and kick � he was already fighting."

At Paula's 26-week scan, the moment Paula, husband Con and the team had been waiting for arrived. "Even though I tried to keep the pregnancy going to 27 weeks, my body wouldn't let it. Sue came in, looked at the ultrasound and said 'Happy birthday'. My husband and I looked at each other and said 'It's not either of our birthdays'. Sue said 'No, it's your son's birthday � you're going in"'.

"I'm really surprised at how calm I was, partly because the staff were so fantastic. There just aren't enough words to say. Everything they had to give me, they gave."

Paula and Con were going to need all the support they could get.

"When I finally saw John, I knew what tiny meant. He weighed less than a tub of butter. "It's very daunting, I won't lie to you � seeing him with wires and everything in the humidicrib. The first week was hell: he actually lost weight � he got down to 330 grams. Then we were toldhe has lung issues due to their underdevelopment. You just think it's never going to end."


Paula Metaxiotis with John

Thanks to the skilled and compassionate care of the NICU staff, with whom the Metaxiotis family have spent every day ofthe past four long months, John has blossomed to 1.8kg and continues to progress well.

"Paula had help from thelactation team to get her breastfeeding going, which has helped John enormously," notes NICU Graduate Nurse Keryn Hutchison, one of the dedicated staff nursing John and Paula.

"She was also offered help from the social work and pastoral care teams, particularly in the first few days when everything is so hour by hour. "As well as offering support, we tried to keep Paula and Con involved in John's care. Not only is having a baby new to them, having to cope with everything else on top of thatcan be overwhelming."

Keryn clearly feels pride in John's progress. "He's been too small even to bathe, but now he's almost ready. Paula and Con are really excited, they've bought him his first outfit."

It's the personal connection between staff and patients that give comfort and reassurance to long-term NICU parents like Paula. "The staff become your family. When the nurses come past they'll ask if they can havea cuddle. This place has been our home away from home."

Ultimately, John's story is a tribute to the limitless love and faith of the Metaxiotis family. "I'd tell John 'this is your goal for today' and then we'd work towards it. You have to think of all this as a job. Your mindset has to be positive so your baby can feed off you, feel safe and grow."

"Now, with the treatment he's had here, his heart is good, his brain is good. The lungs will catch up with age and growth. "At the end of the day he's our perfect little boy."

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