The Preemie’s Prayer
Dear God, as you look down upon us,
We know that you might have to squint.
We’re located here in the NICU:
It’s the nursery that we rent.
There are many alarms and sirens,
Connected to condos and flats.
The nurses tape our booties on,
And dress us in funny hats.
We have a lot in common;
All of us were in a hurry.
For many different reasons,
Our storks came a little early.
Some of us don’t know why,
We bursted out from our bubbles.
We entered into this world,
Never meaning to cause any troubles.
Vickie Spencer 2008
On June 3, 2008 at 10:02 PM Ethan Russell Pacholski entered into this world weighing 3lbs 9oz. Today he is a happy, healthy 2 year old boy. Here is Ethan's story.
Ethan became a twinkle in our eyes in December 2007 just a week before Christmas. I was 7.5 wks pregnant. We were told that our beautiful baby was due on August 11, 2008. For the first 26 weeks everything was going great. We had a 20 wk ultra sound that showed us that we were having a boy. He was perfect he was growing like he should & everything was on track with his development. Then just before Mother's Day I came home from work craving Chinese food. So Matt went to our favorite Chinese restaurant for take out. When he got home something felt wrong, I felt wet. So I went upstairs to the bathroom thinking that the baby as laying on my bladder but when I got there I found myself in a puddle of blood. After a call to the Dr. we headed straight to the maternity ward at the hospital. By the time we got to the hospital (with in an hour of noticing the blood) it was already slowing down. I was hooked up to a monitor & there was his heartbeat going strong at about 150. The next day I had an ultrasound done & everything was looking great. I was sent home the day before Mother's Day feeling that it was the best Mother's Day present I could have because I was still pregnant. After a week of bedrest I was given the OK to go back to work. The next 4 weeks went by without a problem then on June 2 at about 10 in the morning I started to have back pain. I figured it was just from the long road trip we had taken to New York (I was given permission from my Dr). As the day progressed the back pain got worse. By the end of my day it was so bad I cried the whole way home. I tried taking a warm bath to help ease the pain but that didn't work. I took some Tylenol for pain relief but that wasn't any help. I didn't get any sleep and at about 4 in the morning the pain left my back & I began having contractions. I started timing them right away to see if they were regular & they were. We called the Dr & headed back to the hospital. This time I was told that I was done working & that I was going to be on bed rest until I delivered the baby. Later in the morning I began leaking fluid this is when I was told that I was going to be in the hospital for the next 4 weeks & they were going to keep me pregnant until I reached 34 weeks then they were going to have to deliver the baby. But at 6 that night my water fully broke & Ethan was on his way. A nurse from the NICU came in to talk to me. She told me that at 30 wks my baby was going to need to be on a vent for at least the first 48hrs of his life. She said that he was going to be about 3lbs & was at high risk of infection. Around 7PM I was about 3cm dialated and I asked for an epidural. They drew some blood & called for an Anesthesiologist. The pain meds weren't coming soon enough by 8 that night I was up to 7cm dialated and by 9:00 I was at 9cm. They rushed me to a delivery room & I started pushing a little after 9:30 and at 10:02 Ethan was here. He screamed at the top of his lungs & he didn't stop. About an hour after he was born they brought him to me so I could see my little boy. He was stable enough for me to hold him for a minute. He had 10 very tiny fingers, 10 very tiny toes, a head of thick black hair, & a little button nose. When the nurse handed him to me he opened his eyes & managed to wiggle a little hand out & he grabbed my finger. It was then that I named him Ethan Russell. He was so tiny & so fragile, the smallest baby I had ever held and I have to say I'm special because not many people can say they held a 3lb 9oz baby. Ethan defied all the rules. He was on CPAP for the first 6 hrs and after that he was breathing fine. The nurses were always telling us what a wiggle worm he was. He did not like to have his diaper changed & he was Houdini when it came to pulling out his NG tube. We were told to figure that Ethan would be in the NICU until at least his due date so it was going to be a long haul. When he was 4 wks old he was moved to an bassinet because he showed that he was able to hold his own body temperature. We also began trying to bottle feed him one bottle at a time. We started with a bottle a day for the first couple days. When he did well with that we moved up to 2 bottles a day and so on. On July 22 we were asked to bring in his carrier so they could do the car seat test the next day. They were getting him ready to go home. All he had to do was be able to take 8 bottles a day for the next 48 hrs with out dropping his stats and he would be out the door. On July 25 the NICU signed his release papers and at 3PM that day Ethan, Matt & I walked in the backdoor of our house for the first time as a family. After 52 days in the NICU Ethan was finally home with us where he belonged.
Today, at age 2, he has no complications from his premature birth. He is 27lbs, 33" tall & healthy. Ethan's favorite things to do is run, jump, climb, and watch Curious George. He loves to hear people sing, he is always asking me to sing to him & in the car I always sing to him with his playlist on my IPod. He has a lovey, a stuffed lamb that he named Moose after 18 months of us calling it Lambie, he has a strange obsession with garbage, & he is currently potty training. We were so lucky that he was born so healthy. Someday we will make Ethan a big brother and he will be a great big brother when the time comes.
Prematurity is not something to be taken lightly. There are so many possible complications that come with it. The earlier a baby is born the more complications they will most likely have. Once a baby reaches 25 weeks gestation it is considered viable. This means that the baby will be able to survive outside of the mother. Babies that are born between 23 weeks and 25 weeks are considered on the edge of viability.
Common complications from prematurity -
- Respiratory Distress happens when a babies lungs are not mature enough to breath on their own. Babies with RDS will need to be placed on a vent until they are able to breath on their own.
-Apnea is when the brain forgets to tell the lungs to breath. This happens because the brain is not fully developed. As babies get older it will gradually happen less & less.
-PDA (Patent ductus arteriosus) is when the lungs have too much blood flowing through them. It can cause chronic lung damage, puts a strain on the heart, & makes respiratory distress worse. It can correct itself, be corrected with medication, or through surgery if the medication doesn't work.
-IVH/PVL (intraventricular hemorrhage/periventricular leukomalacia), are brain bleeds. IVH has different levels known as grades (1 being mild 4 being the worst). Small grade bleeds don't normally leave any lasting damage but the larger bleeds can lead to complications like cerebral palsy, mental retardation, vision/hearing impairments, or death. PVL is what shows if the brain suffered any damage from the bleed from lack of blood flow to the brain.
-ROP is a condition where abnormal blood vessels develop in the eyes. Normally it can correct itself without and lasting damage. It can cause vision problems, the retina could detach & in a few cases leave the baby blind.
-NEC is inflammation of the intestinal tract. In mild cases it just leads to feeding intolerance, in moderate cases it can lead to infections, & in severe cases requires surgery to remove damaged intestine.
-BPD (bronchopulmonary dysplasia) is chronic lung damage babies who are still in need of help with breathing after 36 weeks gestation indicate this
Disabilities-
-Mild to moderate- respiratory problems that might require being on oxygen for months after coming home, mild cerebral palsy (difficulty controlling movement), vision/hearing problems, learning disabilities
-Severe- chronic respiratory problems (needing ventilator support), severe cerebral palsy (needing a wheelchair) blind/deaf, mentally retarded
23-25 weeks - A baby that is born at 23 weeks only has a 20% chance of surviving. The average weight for a baby that early is around 1.1lbs (498g) and the average length is 11.4" (29cm). A baby born at 25 weeks has a 65% chance of surviving. The average weight for a baby at this gestation is 1.45lbs (658g) and the average length is 13.5" (34cm). When talking about what their health will be in the long run roughly 33% will live normally, 33% will suffer from mild to moderate types of disabilities, and 33% will have severe disabilities. The lungs of babies born between 23-25 weeks are severely immature and they will more than likely be born with respiratory distress. These babies will most likely need to be on a ventilator to help them breath. How long the baby needs to be on the vent will depend on how immature their lungs are at birth and how quickly their lungs mature after birth. In some cases babies will continue to need oxygen even after they come off the vent and may even go home on oxygen. For babies this early 65% will have BPD that resolves by the age of 2. In babies born this early 40%-50% will have PDA, 10% of those babies will need the surgery to correct it. Babies this early have a 15%-20% chance of developing IVH (15%-20% will have a severe brain bleed). Most babies this early will develop ROP, less than 15% require surgery to prevent the retina from detaching & 5% may go blind from it. NEC will develop in 5%-10% of babies born this early. Of the babies that develop NEC 50% will require surgery and 60%-90% will survive it. When it comes to infection almost 50% of babies born between 23-25 weeks will develop one. At this gestations it can become a severe infection but they have about a 75% chance of surviving it.
26-29 weeks - Babies born at 26 weeks have a 75% chance of survival while babies born at 29 weeks have a 85% chance of survival. Babies born at this gestation have a reduced risk of developing complications. At this gestation babies have a better chance of living a normal healthy life, 40% will be normal, 40% will have mild to moderate disabilities, and 20% will have severe disabilities. At this stage the lungs are still too immature so they will have RDS & will need to be on a vent but they tend to come off the vent in a few weeks & may need oxygen after they come off the vent, only 50% will develop BPD. Of the babies born at this gestation 40%-50% will have PDA (only 10% will require surgery), small brain bleeds are common (only 5%-10% will have a large grade bleed), 5%-10% will develop NEC, 75% will have ROP (7% need surgery, 4% will go blind), and babies at this gestation have a 30% chance of developing an infection.
30-33 weeks- Babies who are born at this point do very well. They have a 90%-95% chance of survival. Of the babies born at this stage 65% will live normal lives, 20% will have mild to moderate disabilities, 15% will have severe disabilities. At this gestation most babies lungs are mature and they are able to breath on their own, only 25% will have RDS but will come off the vent within a week and 10%-15% will have BPD, in 40%-50% PDA will occur 10% will need surgery, 15% of these babies will develop an infection, and very few will develop NEC.
34+ weeks- Babies who are born at this gestation have a 95% survival rate and have little chance of any disabilities. By this point their body is almost as mature as a full term baby (37+ weeks) so any problems that may come up will most likely resolve within a week or so. Only a small percentage of babies born at this gestation have severe problems. Even though babies at this point are practically full term it's still important for them to stay inside mom as long as possible.
When women find out that they are going to become a mommy they picture watching their belly grow with each passing month, feeling their baby kick, preparing the nursery for the arrival of the newest member of the family. They never think that they will spend weeks in the hospital from pregnancy complications, that they will hear that their baby may not survive, and they certainly never think that they will have a premature baby. It's so important for people to be aware of what challenges preemies face. Even though many preemies go home there are so many others that never leave the NICU. At this time I would like to take a moment to honor some of those babies who lost their struggle.
Kayleigh Anne Freeman (June 23 2008 - May 11,2009)
Joshua Alexander Castillo Escobar (Oct 7, 2009 - April 22, 2010)
Gabriel Cole-Kosakowski (Oct 2, 2009 born @ 17 weeks)
Gabrielle Murphy (Aug 5, 2001 stillborn)
Charlie (January 2010 - Oct 2010)
Silent Child
by Kelly Lancor
My silent child
our precious baby,
Close to my heart
I'll keep you with me.
An important job
God has for you,
There is love to give,
and work to do.
He needs an angel
strong but small,
To shine light on many
and give love to all.
Before you go
I give you this,
half my heart
and one last kiss.
We'll miss you dearly
that we know,
But by God you were
chosen,
So to heaven, you must go
