By Victor Greto
She’s beautiful.
Her large eyes roll toward you as she leans back in her mother’s arms and stretches her body and limbs. Her puckered lips hint at a smile, just before she grimaces in pain.
“It’s all right, Brianna,” her mother, Tina Diaz, coos.
But it’s not.
Brianna, 3, nearly drowned two years ago and suffered brain damage from lack of oxygen.
Neither Brianna’s nor Diaz’s lives have been the same since.
Official records are not kept for near-drownings, but Pam Santucci, an injury prevention coordinator for the Broward County Health Department, said that for every 10 children who drown, 36 are admitted to hospitals and 140 are treated in emergency rooms after near-drownings.
Drowning is the main cause of death for children up to four years of age in Florida. Broward County recorded 15 drownings in 1999, after averaging 11 per year during most of the 1990s. Miami-Dade County recorded six in 1998, down from 10 in 1997; and Palm Beach County recorded three drownings in 1998, down from five the previous year. No records for either county were available for 1999.
It only takes a few moments of inattention to change the course of a family’s life. For Tina Diaz, it meant a daily struggle to make ends meet and the end of a relationship.
For Nanette Cruz, whose son also nearly drowned, it meant a forced move of her growing family to the United States.
Minutes matter
On a hot day in May, 1998, Diaz and her boyfriend took out the garbage at a town house they were renting in Sunrise.
“The air conditioner was broke, so we had the door open,” said Diaz, 28. “We were gone, max, 4-5 minutes.”
It was enough.
The 24-pound, 13-month-old toddler climbed out of her crib for the first time in her life and crawled straight to the pool. “When I found her, she was already at the top of the pool.”
Brianna’s dad and a police officer performed CPR before paramedics arrived and took her to the hospital.
“They told me she wasn’t going to survive,” Diaz said.
But she did, even after Brianna was taken off a breathing machine at Diaz’s request.
“There’s a reason why Brianna is still here,” Diaz said. “Why did she live? It was Brianna’s choice. She fought the battle. That’s why I’ll never give up.”
Diaz’s boyfriend, father to Brianna and 1-year-old Marc Anthony, left after the accident.Diaz pays for medical services and two nurses a day through Medicaid and Children’s Medical Services, a state system of managed care for children with special health care needs. She works as a waitress two nights a week. She also sells “stuff that friends donate” at a flea market during the week.
The rest of her time is spent holding a writhing and whining Brianna in her small Plantation apartment.
Living with pain
“I bust butt,” Diaz said. “But you don’t sit and feel sorry for yourself. People keep asking me how I can do what I do. Well, I don’t have to live with all this pain,” she said. “And now I take nothing for granted.”
Because of her brain damage, Brianna has lost control of many functions, including digestion and bending her limbs.
She whines constantly and rarely naps. She is in constant gastrointestinal pain. She has had a surgical procedure to prevent acid from refluxing into the stomach, so she doesn’t regurgitate food and choke to death.
Over time, Diaz has gotten Brianna to swallow, so she feeds her some food through the mouth, but Brianna receives most of her nourishment through a syringe that injects nutrients directly into her stomach. When Brianna has too much pain, Diaz injects her with Maalox.
Diaz takes Brianna to Pediatric Therapy Associates in Plantation several times a week for therapy.
Because Brianna remains so stiff, many of her muscles have knotted. Her stretched position also blocks bowel movements, contributing to her pain.
Terry Klein, a physical therapist, has worked with Brianna for more than a year and said Brianna “has reached a plateau” in her development.
In other words, this will be life for her in the foreseeable future.
“There’s not a lot of compassion for this until it hits home, and you don’t want it to hit home,” Diaz said. “I worry about what she’s going to be like in five years, 10 years but, when I see her, it just doesn’t matter.”
`We’re believers’
Rafael Cruz neither whines nor writhes; the 2-year-old leans back stiffly in a car seat in an overstuffed chair in his home in Coral Springs.
Splints help keep his tiny legs, feet and hands in a normal functioning position. His eyes look up into their lids. He breathes shrilly.
A small machine is next to him. Attached to a syringe, the machine sucks saliva from the hole in his trachea. Rafael cannot swallow. His mother, a nurse or his stepsister help clear his throat throughout the day.
Rafael nearly drowned in May, when he crawled into a pool at his family’s home in Puerto Rico. Though the pool had a fence around it, his oldest sister forgot to close the gate after sunbathing.
Nanette Cruz, Rafael’s mother, was filling out forms for a summer camp when it happened.
“I was finished with the paperwork and went out to the living room,” Cruz said. “He was gone. I saw the back yard, then the open fence, and I saw him floating in the pool. I jumped into the pool to get him out.”
Her parents, who lived behind her, saw Cruz splashing in the pool and called 911.
By the time he reached the hospital, Rafael showed no vital signs. But the doctors brought him back to life. He breathed through a respirator for nearly three days before they did a test to see whether Rafael’s brain functioned. It did.
After a while, he began breathing on his own. But there wasn’t much else he seemed able to do, including swallow.
Before a month passed, Rafael went through a tracheotomy, which opened an airway through his windpipe, and a gastrotomy, which surgically penetrated the boy’s stomach, so he could be fed through a tube.
Because there are no pediatric rehabilitation centers in Puerto Rico, Cruz took Rafael to Miami, where she stayed with her son for three months.
Cruz’s family, which includes husband Miguel, their son, Miguel, 7, and stepdaughters Camille, 15, and Michelle, 19, decided to move to Coral Springs.
Since then, Miguel has flown weekly or bimonthly to Coral Springs from Puerto Rico, where he works. He just found a job in Miami and is trying to sell their house, which Cruz said no one wants to buy because of Rafael’s accident.
Cruz, who said she was about open a real estate appraisal business in Puerto Rico, has yet to get a license in Florida. She hasn’t found the time.
Each day the boy takes 10 milligrams of Baclofen, a muscle relaxer; half a tablet of Rubinol, which helps dry secretions; a tablet of multivitamins; 13 milligrams of Lasix, a diuretic; one tablet of Vasotec, for high blood pressure; 20 milligrams of Intal for asthma; and .63 milligrams of Xenopex, also for asthma.
Because of Medicaid, Cruz gets help from a nurse eight hours a day. They are able to pay for the rest of Rafael’s care.
“We’re believers,” Cruz said. “If God sends this to us, it’s because he chose us because he knows we can afford it. We accept it as God’s will. And we believe that some day he will be better.”
Safeguards proposed
One Florida legislator is trying to lessen the likelihood of near-drownings. Rep. Debbie Wasserman Schultz, D-Weston, has proposed a bill that would require safeguards around new pools.
“There’s a really good chance of it passing this year. We have assurances that the bill will reach both houses,” Wasserman Schultz said.
The first year she introduced it, the bill required that all pools be fenced.
Now, the bill requires pool fencing as one of four options, including safety pool covers and exit alarms.
These requirements are only for new pools.
Wasserman Schultz said she is confident it will pass.
Diaz also has taken action.
She is helping start a Parents of Near Drowning Children support group through Children’s Medical Services. A support group of the same name broke up about three years ago.
The new group probably won’t begin until June, said Phyllis Hudson, a social worker at CMS who is bringing the group together.
Diaz said she is proud that, through her influence, she’s gotten four of her friends to put up fences or barriers around their pools.
Both Cruz and Diaz acknowledge that their “victories” are small.
But the pain of their children — and their own daily solitude — is not.