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Inside special units within Springfield’s two major hospitals, battles are waged every day to keep the most fragile of human beings from slipping away. KSMU’s Jennifer Moore went to visit those units to find out more.
REPORTER STANDUP: "Right now, I’m in the Neonatal Intensive Care Unit, or NICU, at CoxSouth Hospital in Springfield. Surrounding me are about 10 tiny babies in incubators, most of them hooked up to various monitors and tubes. Right next to me is a mother reading her baby a book: that baby, nurses tell me, weighs one pound, four ounces today. New research shows that parents like her can experience trauma long after they leave the hospital."
"It’s a very frightening environment," says Cheryl Blevins, a clinical nurse educator at Cox, who has helped babies and parents through the NICU experience for 26 years.
"There’s a lot of equipment. Alarms. A lot of staff. A lot of voices. A lot of procedures," she says.
This is where Bilirubin lights, probes, monitors, IVs, wires, and hand sanitizers are the norm...not to mention the constant threat of looking death in the face with setback after setback, and sometimes, months of “close calls.”
SOUND UP: Newborn crying
Some of these babies’ cries sound like a tiny kitten rather than a human: others open their mouths to cry, but don’t even have the lung-power to emit any sound.
A new study from the Stanford University School of Medicine showed over half the parents whose babies were in the NICU for an extended period of time either had Post Traumatic Stress Disorder (PTSD), or were at high risk for developing it. PTSD, of course, is best known as the disorder soldiers develop after trauma in combat.
A separate study carried out by Duke University graded parents on three PTSD symptoms: hyperarousal, avoidance, and flashbacks or nightmares. 30 parents were interviewed; 29 of them had two out of three of those symptoms, and 16 parents exhibited all of them.
Those findings aren’t at all surprising to Tracey Brown, who lives in Springfield now. She was 24 ½ weeks pregnant with twins in Arkansas when she began hemorrhaging.
With four months to go before her due date, doctors determined that her babies would have a better chance of survival outside of the womb than in it. She delivered twin boys Austin and Dylan via Cesarian Section: they were 1 lb 7 oz and 1 lb 3 oz, respectively.
“They called them 'micro-preemies,' because they were so small,” Brown says.
Both boys were on full life support: a few decades ago, they wouldn’t have had any chance of survival. Their lungs had not yet developed any surfactant, which is the soapy substance needed to breathe. So, they received artificial lung surfactant, which was discovered through research funded by the March of Dimes.
"We were scared to death. It all comes so fast, and you’re reliant upon the Neonatologists to tell you, ‘This could happen.’ Or, ‘We need to do this, or this will happen.’ And, ‘Do you consent to this?’ And you want to do what’s best for your children,” Brown said.
Three days after their birth, the larger of the twins, Austin, developed a brain hemorrhage on both sides of his brain, which is not uncommon for babies born that early. Tracey and her husband were told by a team of Neonatologists that even if Austin survived, he would have no quality of life. Tracey says, upon hearing that, she and her husband knew they had no choice but to say 'goodbye.'
"And so, that evening, we held him…and sang him lullabies as he passed away. And he was just so tiny…you couldn’t even tell you were holding anything, you know? He was so tiny," she recalls through tears.
Tracey says she can see a direct correlation between having a baby in the NICU for several months, and being on a battlefield. More than once, Dylan’s breathing tube became disconnected from the ventilator. She watched his oxygen levels go down to almost nothing as the NICU staff scurried to bag him manually. Many parents have seen their preemie babies turn blue.
“You get used to, while you’re in the NICU, hearing all of these alarms going off. And sometimes, I would hear them in my sleep. I would wake up and it was a phantom alarm,” she said.
She also found herself jumping at the sound of the beeps of a supermarket scanner, or feeling her heart rate pick up at the sight of a hospital scene on TV.
SOUND: St. John's NICU
At St. John’s Hospital, Dr. Melinda Slack oversees the NICU, and has been a neonatologist here for nearly three decades. She says part of the stress comes from seeing what’s happening to other babies around you: the most privacy a NICU family usually gets is a thin curtain.
Although hospitals try to reduce that stress, the experience is so traumatic for some parents, they tend to block the worst parts of it out.
"A common thing I find is, as we’re nearing discharge, I sit for a casual visit with the mother. She says, ‘It’s hard for me to remember how small my baby was.’ And I say, ‘Yes, that’s maybe a good thing,’” Slack says.
She says many NICU parents get hyper-anxoius about germs, buying packs of scrub brushes at a time, and vowing to not have visitors over for years. The trauma also can have a lasting effect on relationships, she says.
"Unfortunately, the divorce rate is much higher among people who have had a chronically ill baby in an intensive care nursery. And we try to offer them the opportunities for counseling," Slack says.
Slack says for parents who have been through several months in the NICU, counseling is not just ‘okay,’ it’s imperative. St. John’s has a weekly support group for NICU parents, and both CoxHealth and St. John’s have NICU social workers ready to offer advice and resources. Also, there’s the local March of Dimes office, which says it's ready to help parents in any way it can.
Cheryl Blevins of CoxHealth says there’s a movement across the country to give NICU parents more comfort in the form of solitude, so that they’re not around more disturbing sights and sounds than necessary. That’s hard to do, however, with babies who have to be monitored around the clock.
"NICUs have recognized that that’s part of our environment that we need to modify. Parents are exposed to unending stresses. It’s not just, ‘What’s going on with my baby?’ It’s, ‘What’s going on with the other babies on my row,’" she says.
Tracey Brown’s surviving son, Dylan, was in the NICU for four months and on oxygen for almost a year. He’s now a thriving two year old, and has just started attending daycare part-time.
Tomorrow, he’ll stand tall on the stage with his parents and older sister at Springfield’s March of Dimes, where the Browns will act as the Ambassador family, honoring both Dylan and their lost son, Austin.
The March of Dimes will be at Jordan Valley Park in downtown Springfield tomorrow. Registration begins at 10:00 a.m.
For KSMU News, I’m Jennifer Moore.
LINKS and Relevant Phone Numbers:
YouTube Video of Joe and Tracey Brown's Story
St. John's Hospital NICU Website
CoxHealth NICU Support: (417) 269-3000
St. John's NICU Support: (417) 820-3303
March of Dimes, Springfield: (417) 889-9397