NICU Patient Stories
Olivia Munoz earned her nickname, “Feisty,” in the NICU. Now a healthy and thriving two-yearold, the little girl was whisked away from her parents immediately after her pre-term birth, a tiny and fragile one pound, one ounce and just over 10 inches long. Her mother, Jasmine Brito, found out she was having twins a few months earlier, on Christmas Day. However, the news quickly turned tragic with a diagnosis of twin-to-twin transfusion syndrome and the news that, at just 23 weeks, one of the babies had passed away in utero. Olivia, the surviving twin, was delivered immediately. And what a survivor she proved to be. “Olivia was taken immediately to the NICU,” says Jasmine. “My husband didn’t even get to see her, and they had to resuscitate her. Then I had to say goodbye to Victoria, her sister.”
The first three weeks of Olivia’s stay in the NICU were harrowing. After spending 14 hours in the hospital with her baby, Jasmine’s phone would ring in the middle of the night with an urgent call to come back. “There were many times we thought she wouldn’t make it to the next day,” she says. “She developed pneumonia, had to have spinal taps, and was diagnosed with a hole in her heart—there were things going on that first month that were terrifying.” The tiny girl nicknamed Feisty made it though. “Because of the nurses and staff in the NICU, that rollercoaster ride was so much easier,” Jasmine says. “They were pretty much her parents for the first 127 days—they taught us how to take care of her.” That careful attention included answering the new parents’ every question, and helping them to understand the monitors and tubes and tests involved in the care of their baby. It also included securing a nearby private hospital room for Jasmine and her husband for the last two nights of Olivia’s stay at TGH, so that they could experience a “trial run” on their own with Olivia before taking her home but still have the security of the nurses if they needed anything.
Along with continuity in the level of care and attention, the NICU provides that privacy and sense of security in every room. “That’s one of the things I love about the new design,” she says. “They put every thought and consideration into it, and it’s wonderful—it makes the families feel safe and at home.” Today, Olivia is a happy toddler. Cleared by all of her specialists, she only needs to see her pediatrician on a regular basis. “We have a lot of catching up to do with her—so many things we want to see and do,” says Jasmine. “And now that she’s doing so well, the sky’s the limit.”
William Andrew Mueller, IV became a medical pioneer on March 4, 2010. He was less than six hours old. William was one of the first “total body cooling babies” at Tampa General Hospital, a procedure that saved his life. Meredith Mueller was 35-weeks pregnant with William when she developed a placental abruption that severed the lifeline to her baby. It can cause death or serious injury to both the mother and the baby. She underwent an emergency C-section at a local hospital. “Our Will came into this world pale, limp and unable to breathe on his own,” the infant’s father, Trey, said. The medical report was grim: doctors said Will’s brain had been deprived of oxygen, and if he did survive his first night, he would likely suffer brain damage.
Doctors referred the Muellers to Tampa General to undergo a “total body cooling” procedure. There was no time to waste. At 3.5 hours old, Will was whisked to TGH and the cooling therapy began. His father said his body was cooled to 92 degrees for three days, while he lay in a coma-like state. The day after he was born, Will became the patient of Dr. Terri L. Ashmeade, Medical Director of Tampa General Hospital’s NICU, and Associate Professor of Pediatrics, University of South Florida College of Medicine. She explained that total body cooling, studied for years before being used on babies, is designed to halt potential ongoing damage caused by the baby’s oxygen deprivation. Total body cooling has to begin by the sixth hour of life, so Will’s speedy transfer was vital. It has been exciting to participate in the process, Dr. Ashmeade says. “All of us in the neonatal community have been waiting and watching for this type of therapy.
For years, all we could do was watch and hope.” By the end of the third day, Will’s temperature was slowly warmed back up to 98.6 degrees. “Our family and friends prayed that God would protect and heal Will’s body,” his father said. “It seemed like the whole NICU team was watching and cheering him on, too.” Will’s grandmother, Sherrie Chambers Mueller, said the family was treated with utmost kindness and her grandson was clearly provided with top-notch care – for which they are all extremely appreciative. “It is very emotional to go through,” she says. “We cannot say enough about the wonderful way we were treated at Tampa General.” Today, the mother of two little girls can enjoy the growth of her third child. Will has met every developmental milestone to date. “He’s perfect,” she says.
She will be forever thankful for the support and kindness she and her husband were shown by the hospital in the anxiety-ridden days while they waited for his development to unfold – demonstrating that he was truly all right. They did not wait alone. “I was so amazed, because Will didn’t even open his eyes for about the first week of his life,” she says. “And then, on the day he did open his eyes, the whole NICU – everyone – was just as excited as we were.” Dr. Ashmeade says those are the moments that nourish the hearts of the medical community. “I think that’s what keeps you going,” she says. “When you have a family bring a child back and you see how happy they are, and how well the child is doing, that’s what it’s all about.”
Susan Robinson was just 19 weeks pregnant when a sonogram revealed the birth of her third child, Anna, would not be as smooth as her first two. This sonogram showed that a huge tumor had wrapped around the baby’s neck, obstructing her airway. This wasn’t a problem while the child was in the womb. The placenta provided the nutrients and oxygen she needed. But at birth, Anna would have to breathe on her own. For that to occur, she would require an innovative EXIT (ex utero intrapartum treatment) procedure. EXIT is used to deliver newborns with abnormalities that obstruct their airways.
During this procedure, only the infant’s head and shoulders are delivered through a cesarean incision. As the umbilical cord continues providing oxygen to the child, physicians open the airway with a breathing tube, then complete the delivery. The EXIT procedure is difficult; only about 100 cases have been documented in the United States. Fortunately for Anna, lead obstetrician Valerie Whiteman, MD, had performed two of them before joining TGH. As Susan’s pregnancy progressed, Whiteman assembled a team of about 20 physicians, nurses, and other health professionals to practice the EXIT in an operating room using a simulator dummy. “We wanted to make sure everyone on the healthcare team knew their roles. Everybody had to be at their own place and everybody had to be ready to act at the proper time,” Whiteman says. “Using the dummy, we simulated the baby’s head position at delivery, which is the most awkward position imaginable for intubation. One of our main concerns was that it would be a difficult airway to secure.” The EXIT took place on October 1.
Among those gathered in the operating room, pediatric surgeon Charles Paidas, MD, stood ready to surgically open the airway if the intubation was unsuccessful. Fortunately, Terri Ashmeade, MD, a neonatologist was able to insert a tube into Anna’s airway with little difficulty. Anna’s tumor was a benign mass that stretched from the base of her brain to her chest, affecting her ability to nurse and presenting a potential danger to her heart. A month after Anna’s birth, Paidas performed the delicate operation to remove the tumor surrounding her neck. Meanwhile, Anna has settled in at home with her parents, older brother and sister. She shows no sign of the ordeal she experienced, her mother says. “She’s a normal, happy, healthy baby. She has the calmest, sweetest disposition,” Susan says. “For that I thank Tampa General and the medical team. They made a difficult situation a lot less difficult.”