[Top: Shots of TNP report on Dora's experience.]

By Ng Wan Ching

SHE would have been dead within an hour if her parents had not taken her to hospital right then.

And even when she got there, she may not have survived if the right doctors were not at the right place at the right time.

But little Dora, 7, was fortunate, and eventually pulled through.

Her recovery was nothing short of a miracle, and she had to endure a long, hard fight for her life.

In doing so, she became the longest paediatric patient here to have stayed on the Extracorporeal Membrane Oxygenation (Ecmo) machine.

This is a heart-lung machine which gives the blood oxygen from outside of the body.

Patients usually stay on the Ecmo for between three and five days.

But Dora stayed on it for a record-breaking 502 hours, all of three weeks.

Dora's first words, after 22 days of sleep, were written.

The little girl's father, Mr Chan Chin Ann, 39, an air force officer, recalled: 'She could not talk immediately but she got us to bring her a paper and pen, and struggled to write, 'Later when you pray, tell God that He is very, very, very good. :D'.'

Ill for a week

Dora's illness had started with sporadic diarrhoea and loss of appetite for about a week.

She then developed a fever with some breathing difficulties and her heart was beating fast.

Mr Chan and her mother, Madam Annie Tan, 38, a housewife, took her to see a GP on 30 Sep.

Besides prescribing flu and fever medication, the GP, who felt she was weak, prepared a referral letter for the Chans to take to a hospital in case her condition didn't get better.

'We thought it was unusual of her to look so lethargic compared with how she was in the past when she was ill.

'She couldn't even lift her own hand,' said Mr Chan.

He and his wife decided to take Dora to KK Women's and Children's Hospital (KKH) the same evening.

It was a decision that saved Dora's life.

Dora was diagnosed with acute viral myocarditis, which causes the heart muscle to get inflamed.

At the hospital, she was quickly put on the Ecmo machine.

The hope is that the heart can be relieved enough for self repair and recovery, as there is no medication to counter the viral attack.

Dr Sriram Shankar, senior consultant cardiothoracic and vascular surgeon at KKH, recalled how he had walked into the intensive care unit that evening as he was about to go home.

'My colleague, head of KKH's cardiology service, Associate Professor Wong Keng Yean, said don't go away, there's a child coming up and her heart function is very poor,' he recalled.

Said Assoc Prof Wong: 'Her heart was contracting irregularly and there was destruction of heart tissue as her enzyme levels were very high.'

Dora was put in KKH's intensive care unit immediately.

Perfusionist (someone who operates the heart-lung machine during surgery) Anne Ho and a nursing team, led by Sister Teo Guat Leng, rushed to the hospital to help with putting Dora on the Ecmo.

'The response time of the team was incredible,' said Dr Shankar.

With their help, he inserted flexible tubes into the great vessels of Dora's neck and connected them to the Ecmo machine.

Within an hour, Dora's heart was flat.

'There was no pulse, no ECG, nothing at all,' said Dr Shankar. 'This was because all the stress hormones and adrenaline that were keeping her going evaporated, once her own heart and lungs were out of the equation.'

The next day, Dora's condition worsened.

Said Mr Chan: 'The surgeon told us that the chances of recovery for such cases were about 60 per cent.

'From past experiences, we should be seeing positive results by seven to 10 days if everything turned out well.'

But he and his wife were also told that complications due to using the Ecmo machine may cause damage to Dora's other organs.

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