When new-born, Marley Gentleman, would not settled at night, Katie’s gut told her something wasn’t right.
Marley was just 11 days, when Katie decided to ring her midwife, hoping it was not just her worrying as a firsttime mum.
The mid-wife told her to trust her gut, and it turned out to be the best advice she could have had.
The following few weeks turned the Rangiora family’s life upside down.
Marley, who was born in May last year, had a blocked ureter, and he had developed ureteric reflux. A blockage occurred, trapping E. coli from his nappy.
This resulted in sepsis, which nearly claimed his life.
But today, Katie and Ryan Gentleman say they have a ‘‘happy, bouncing boy, full of beans’’, and like ‘‘nothing had ever happened’’.
The Gentleman’s GP could not see Marley until the afternoon when Katie rang for an appointment, but suggested she take Marley to the afterhours clinic in Madras Street, Christchurch.
Her husband Ryan had left early in the morning for work, so Katie’s mum drove them in.
As they prepared to leave Katie noticed Marley’s skin was turning mottled.
‘‘I didn’t know what mottled meant, or how bad it was.
‘‘When the nurse at the after-hours clinic called us in, and asked us what was wrong, I unzipped his onesie and showed him (the nurse).
‘‘We were sent straight to ‘resus’, and straight from there to Christchurch Hospital.’’
Truck driver Ryan was on the road when he received the call. He parked his truck on the side of the road, and took an Uber straight to the hospital.
Clinicians at Christchurch Hospital tried to figure out what was wrong, and later that evening suggested Marley might have a twisted bowel.
‘‘I thought, ‘great, finally an answer…so what do we do’? They told us there was nothing they could do if that was the case.’’
Doctors performed an exploratory surgery to figure out if Marley did have a twisted bowel.
‘‘It was the longest few hours of our lives,’’ says Katie.
They discovered Marley didn’t have a twisted bowel, but they weren’t sure what was wrong. Marley was sent to ICU for three nights.
‘‘His paediatrician and surgeon were amazing. I could not love those two women any more. They were so supportive, and they gained access for my whole family to see him, in case this was going to be ‘goodbye’.’’
Meanwhile, clinicians at Christchurch had identified Marley could need highly specialised care, so they involved Starship from the start.
‘‘After 3 nights, Starship said they wanted him up there because it was the best place for him, so they came and fetched him. Our doctor told us they were the best of the best.’’
Katie remembers feeling ‘‘overwhelmed’’ when the flight team arrived.
‘‘The amount of equipment they had, they looked like they’d prepared for absolutely everything. I wondered how my baby could be attached to all those things.’’
There was a doctor, a nurse, and a loadmaster. With no room for Ryan he took a commercial flight to Auckland and when they arrived at Starship, the Pediatric Intensive Care Unit (PICU) team immediately wrapped support around them.
‘‘I was worried something would happen while we were in the air, but no matter what, they always looked after me. They were so reassuring, they really made me feel like Marley was in good hands.’’
‘‘I cannot rave more about how well we were looked after.’’
At Starship, the family received a diagnosis from blood cultures taken earlier. Marley had developed sepsis due to ureteric reflux, caused be a pre-existing kidney condition.
His left kidney was abnormal, but it wasn’t picked up on pregnancy scans. The midwife and paediatrician from Christchurch double-checked Katie’s scans, one of which was at 38 weeks, and both concluded there was nothing obvious to see.
They said the blockage must have developed late in Katie’s pregnancy. His ureter had a blockage, so he’d developed ureteric reflux – e coli from his nappy had managed to find its way to his kidney, which couldn’t drain, causing the life-threatening health condition he now faced. The early days were fraught, but one special moment stands out for Katie.
‘‘We hadn’t held Marley for five days,’’says Katie. That’s when a PICU Nurse helped Katie hold Marley.
‘‘I just broke down, because I didn’t know if I was ever going to hold him again. I will never forget that Nurse’s face and how caring she was. She gave us wet flannels to clean him, and gave us the freedom to look after our baby so we could feel like parents again.’’
They inserted a stent at Starship to drain the kidney and gave Marley two lumbar punctures.
After a week in PICU, they went back to the wards for another week as he grew stronger. They then flew back aboard Lifeflight to recover further in Christchurch Hospital.
For about another eight days Katie and Ryan went into Christchurch Hospital every day, until he was finally allowed home.
A speech language therapist was needed to help Marley learn to suck again, due to being fed through a line for two weeks. But after a general anaesthetic to insert a central line, he woke up sucking his binkie (dummy).
When Katie thinks back to the staff at Starship, she has fond memories.
‘‘Ryan and I are so incredibly grateful for all the care we had with Marley. We have never felt more looked after, understood and safe. We are beyond grateful for what we experienced.
‘‘It was a hard time, but we do have some fond memories in spite of it.’’
As of January 11, 2023, Marley has had his stent removed and the blockage in his kidney appears to have disappeared. He’ll have a MAG3 scan soon to check his kidney function and confirm his blockage has cleared.
‘‘He was back to his happy self the day after he had the stent removed.’’ Í A final scan has shown Marley now has no blockage. He has a lot of scarring in his left kidney, which his surgeon and paediatrician expected, and a small amount still needing to be drained from his kidney. Marley will now be monitored regularly for high cholesterol and any cardiac issues, as he is at risk due to the condition of his kidneys. Í Marley was one of 27 children retrieved from Christchurch by the Starship Air Ambulance last year, and flown to Auckland for urgent medical treatment.
Today Marley is thriving thanks to Starship clinicians and his local Christchurch care team.
Help Starship answer the calls of children like Marley. Donate today at www.keepstarshipflying.org.nz .
