The little boy in the wheelchair squeals in delight as his father pushes him around the bike track.
It's a joyous occasion for Dino Cottle. Six months ago, he never thought he'd see his son leave hospital but the three-year-old boy is a fighter.
Elijah, from Hout Bay in the Western Cape, lost the use of his legs after he was diagnosed with acute flaccid myelitis (AFM) last year. AFM is a rare condition that affects the nervous system, specifically the area of the spinal cord.
“Elijah started school in April 2020. A few months later, he caught a virus called respiratory syncytial virus, which is quite common in creches," says his mom, Courtney Matthei (30).
Though most people recover from the flu-like virus fairly quickly, Elijah needed to be admitted to hospital for treatment.
"When you have a kid in creche, they pick up a lot of viruses, but his body's response wasn't normal. He had a tight chest and spent two days in hospital where he was put on a nebuliser. He was admitted to hospital twice more to treat a chest infection," Courtney says.
Even after he was discharged, Elijah battled a persistent cough and when he woke up one morning, his parents noticed that he had a strange gait and his right leg was buckling under him.
Dino (34) and Courtney wasted no time seeking medical attention. At first, their GP suspected he had synovitis, a medical condition that causes inflammation in the leg.
While the exact cause of hip synovitis is unknown, some theories include a history of trauma to the hip or a recent viral infection such as an upper respiratory tract infection, bronchitis or middle ear infection.
“We were told that it's very common for a chest infection to move to the hip, which causes stiffness in the joint and makes it difficult to walk,” Courtney says.
They were terribly worried when Elijah couldn't stand on his legs. Over the next few days, his condition continued to deteriorate. He could no longer sit up by himself and he had a persistent cough.
Doctors ran a battery of tests and ruled out synovitis.
In August, following another round of tests, he was diagnosed with AFM.
Though his parents were relieved to finally put a name to his illness, Elijah wasn't out of the woods yet. His diaphragm, which controls breathing, was severely affected and he was put on a ventilator for 10 days.
“The maximum duration to intubate a child is 10 days. Anything longer increases the risk of infection but doctors could tell that he was going to need help breathing for a little longer. They then decided to do a tracheotomy."
A tracheotomy is a hole that surgeons make through the front of the neck and into the windpipe (trachea) to help you breathe.
"Dino and I were very freaked out about it. We were told that it requires a lot of maintenance and care to keep it clean but at least he wouldn’t be in a coma anymore.”
There were days they feared they'd lose him, but Elijah pulled through.
“He was initially supposed to stay on the tracheostomy tube for a minimum of six to nine months. But thank goodness our boy is such a fighter; he stayed on it for three weeks.”
Once he was strong enough, the couple broke the news to Elijah that he wouldn’t be able to use his legs.
“We had no way to really to explain it to him. We told him his legs were tired and they were taking a very long sleep. We said, 'They got hurt but if you work really hard, they'll wake up soon',” Courtney says. “He does try to sometimes shake them awake. It's comical but heartbreaking at the same time.”
Elijah uses a wheelchair to get around. “He loved to run. He learned to walk and the next day he ran. He loved his bike and going to the beach. In the beginning it was tough for him to adjust," his mom says.
"But he learned how to use the wheelchair so fast. He can go forwards, backwards and move in-between things.”
Courtney quit her job as a receptionist to look after Elijah and the couple's younger son, Isaiah (1), but as any parent will tell you, it takes a village to raise a child, particularly one with special needs.
Elijah has two physiotherapists, a hydrotherapist, a speech therapist and he recently started hippotherapy, which involves activities with horses.
The couple also hired a caregiver to help them around the house.
Elijah has made big strides in just a few months. He can now sit by himself and move from lying down to sitting up. He can freely use his arms without assistance, and he can move his hips. He's also regained movement in his right foot, which he can move up and down and sideways.
“There are big things happening but as the doctor said, it's a long road to recovery,’’ Courtney says. “He's so young but he’s such a champ.”
His only hope of a full recovery is a doctor based in the US who's successfully performed nerve surgery on a boy with AFM. Dino has reached out to the doctor.
The family would like to take Elijah for a consultation to see if surgery is possible. They've already applied for his visa and hope to hear back from the specialist soon.
"He's a fighter and has shown great results," Courtney says.