13. Aug, 2019

copy from his report - as going through hospital notes!

Summary of Melissa’s needs when she was aged 7

As written by her Paediatrician

Melissa has Trisomy 18 with a number of medical problems.

Congenital heart disease – she has never had congestive failure or definite central cyanosis but does have clinical signs of pulmonary hypertension, a systolic thrill and a pansystolic murmur without any mid diastolic murmur or 3rd heart sound. Previous ECG showed a VSD but the most recent echo suggested there was some over-riding the aorta. No surgery is contemplated because she is asymptomatic from the cardiac point of view and it would be hazardous.


Difficult feeding and slow weight gain (although satisfactory for children with Trisomy 18).

Developmental delays.

Recurrent coughing and choking episodes – it is hard to be sure whether these are mechanical, infective or related to allergies.  Melissa is difficult to cope with when she gets unwell as her food and fluid intake diminish.

We are happy for Melissa to be admitted to Ward 3 at any time but this isn’t necessarily helpful for Josie as she is much more skilled at giving the meticulous nursing acre that Melissa requires, than anyone else could be.