The Metz family: Jessica, with Bennett, Anthony and Bailey Jones.
Christmas this year will be extra special for Jessica and Anthony Metz.
For most parents, celebrating their son’s first birthday just days before would provide reason enough. Add lifethreatening complications that made their son Bennett’s premature birth anything but normal and you begin to understand the richer meaning of the upcoming holiday season for this Thomaston family.
With a due date of Feb. 2, 2013, Bennett’s premature birth on Dec. 21, 2012 required all the advanced skills of the Neonatal Intensive Care Unit (NICU) staff at the Bridgeport and New Haven campuses of Yale-New Haven Children’s Hospital (YNHCH). “Until then, it was a perfect pregnancy,” recalled Jessica.
The 35-year-old mom worked out regularly, ate organically and took vitamins recommended by a naturopathic doctor. “I didn’t even get a cold,” despite her job as a high school teacher exposed to the random germs of a student population.
All that began to change on Saturday, Dec. 15, 2012. “I started having contractions, so I called my doctor, who asked me to time them.” Not more than six minutes apart. Nothing to be concerned about. “But as the week progressed, I began to feel worse,” she said.
Jessica’s Ob/Gyn advised staying home and resting. But at 1 a.m. Friday, Dec. 21, Jessica’s water broke. “I woke Anthony and he called my doctor, who was already at Griffin Hospital and met us there,” said Jessica. Uncertain she was in labor, her doctor ran tests to confirm the liquid was amniotic fluid. But the tests were inconclusive. “Meanwhile, I continued to lose more fluid.”
The team at Bridgeport
Knowing she was only 29 weeks into her pregnancy, her doctor advised transferring Jessica by ambulance to Bridgeport Hospital, where the NICU is well equipped to care for a child under the normal 40 weeks full term. “Infants at less than 36 weeks are at risk of lung immaturity,” noted Harris Jacobs, MD, chair of Pediatrics at Bridgeport Hospital. “This can require specialized care, which we’re highly experienced in providing.”
Jessica arrived at Bridgeport Hospital around 4 a.m. and was brought to the Antenatal Testing Unit of Labor and Delivery where tests quickly confirmed the fluid was amniotic and her cervix was dilated. Epidural anesthesia, which blocks pain in the lower spine, was administered and an I.V. started.
Another complication: Jessica’s multiple collapsed lungs over the years meant “pushing” during normal delivery could cause another lung collapse. So, a cesarean section was scheduled. Obstetrician Peter Marcus, MD, performed the surgery. Cheryl Menzies, MD, a neonatologist trained in dealing with complications associated with premature births, was on hand to provide resuscitation, if needed.
“As they started prepping me for surgery, I was told what to expect,” she said. “I was also told the baby’s lungs were under-developed. It was scary.” The cesarean went without a hitch, then Jessica heard Bennett cry. “It was a good sign. The lungs were functioning.”
Bennett was brought to a room within Labor and Delivery to check his breathing and other vital signs. “We were told he was having some trouble breathing and they gave him oxygen through CPAP (continuous positive airway pressure). They also put Bennett in an incubator and rolled him to me so I could see him. But I couldn’t hold him.”
In 1992, Yale-New Haven Children’s Hospital (YNHCH) became the first hospital in Connecticut to provide ECMO to treat neonatal respiratory failure.
In 2012 and 2010, YNHCH received the “Center of Excellence in Life Support” award from the Extracorporeal Life Support Organization (ELSO) for its pediatric ECMO program.
ECMO (extracorporeal membrane oxygenation) is a special infant life-support system used for lifethreatening heart and/or lung problems. The ECMO machine adds oxygen to the blood and removes carbon dioxide, enabling the sick heart and/or lungs to rest and heal.
YNHH’s pediatric ECMO program is the only one in the state and one of just three ELSO-registered programs in New England. The program includes physicians, respiratory therapists and nurses specially trained in ECMO.
From there, Jessica went to recovery. Bennett was taken to the NICU, which is equipped to deliver the highest level of intensive care in Fairfield County with the most advanced technology, noted Dr. Jacobs, including highfrequency ventilators, inhaled nitric oxide to treat severe lung disorders in neonatal patients and total body cooling to reduce the risk of brain injury when the newborn is deprived of oxygen.
“We’re the first Fairfield County hospital to offer highfrequency ventilation, which provides oxygen to newborn infants with life-threatening lung disease,” explained Robert Herzlinger, MD, director of Neonatology at Bridgeport Hospital. “We can also provide onsite pediatric subspecialty support in pediatric cardiology, pulmonology, neurology and gastroenterology.” Other hospitals often rely on outside specialists.
To improve Bennett’s oxygen level, he was placed on a ventilator and given doses of surfactant, a chemical lacking in the lungs of some premature infants. But there was no improvement. Next, Bennett was placed on a high-frequency ventilator. He also required a chest tube to re-inflate a collapsed lung. Still no change in Bennett’s condition. Until Dec. 24.
Jessica and Anthony will always remember Christmas Eve, 2012, three days after Bennett’s birth, but more importantly the beginning of his slow but steady turnaround. That’s when Dr. Jacobs recommended extracorporeal membrane oxygenation (ECMO), which is partial heartlung bypass and available at Yale-New Haven Children’s Hospital. In early 2012, Bridgeport Hospital’s pediatric services – including the 42 pediatric and NICU beds – integrated with Yale-New Haven Children’s Hospital.
ECMO is just one of the many pediatric specialties and programs now available to Bridgeport-area pediatric patients as a result of uniting the state’s largest pediatric services provider (YNHCH) with the third largest (Bridgeport Hospital). “Providing easier access to these specialties and treatments is a major reason why Bridgeport Hospital’s department of Pediatrics integrated with YNHCH,” noted Dr. Jacobs. “Integrating them also enables the two staffs to build on the pediatric expertise of both hospitals and that will benefit our patients.”
Shekia Whitehurst embraces daughter Sage in the NICU.
“It’s total coordinated care, including surgery for high-risk cases such as premature infants,” added Dr. Herzlinger.
The team at New Haven
With the decision made for ECMO, Bridgeport Hospital arranged to transfer Bennett to YNHCH the same day.
Within 24 hours after arriving, Bennett met criteria for ECMO. Under the care of pediatrician Orly Levit, MD, he was sedated and began ECMO treatment, which circulates and oxygenates the infant’s blood. While ECMO filled Bennett’s body with desperately needed oxygen, it allowed his lungs to rest, so they could strengthen and heal.
“The first 24 hours of ECMO were critical as to whether Bennett would live or die,” recalled Jessica, who also was transferred to YNHCH, where she stayed the first night, then returned each day from her home in Thomaston. Christmas Eve and Christmas day passed with Bennett on ECMO. Then the entire week passed, painfully slow – until Saturday, Dec. 29, Anthony’s birthday. That day brought a special birthday gift – Bennett’s lungs were finally responding, one in a series of positive changes.
ECMO treatment was stopped and Bennett was back on a respirator. “We were told he could have been on the respirator for a month. But he was on it for only one day. Then they placed him on regular oxygen.” “One reason Bennett did so well was because he was transferred early, allowing ECMO to start as soon as it was needed,” explained Dr. Jacobs.
Pediatric care at Bridgeport Hospital
The Bridgeport campus of Yale-New Haven Children’s Hospital features:
- A 20-bed newborn intensive care unit
- A 22-bed pediatric unit that specializes in the care of infants through adolescents
- The Elizabeth M. Pfriem Children’s Emergency Center, Fairfield County’s only dedicated Children’s Emergency Center, which provides specialized emergency care for ill or injured children and includes a helipad to rapidly transport traumatically injured patients
While ECMO treatment proved the turning point, Bennett’s care was far from over. The next six weeks included reducing his sedation level and helping him learn to eat. That step began with breast milk fed first through a tube, then from a bottle until he was able to breast-feed directly. “I didn’t get a chance to hold Bennett until January 1. The only thing I could hold was his hand,” she explained, which Jessica and Anthony did faithfully, day after day. Although Bennett’s entire medical team offered daily encouragement and support, one doctor stands out to the new parents: Matthew Bizzarro, MD, director of the pediatric ECMO program. As Jessica recalled: “He would walk by, look in on Bennett and say, ‘You don’t know how amazing he is.’” Dr. Bizzarro was referring to how quickly Bennett was progressing. “They were all so impressed with him.”
Ironically, Bennett left YNHCH for home on Feb. 2 – Jessica’s original due date. Now, almost 10 months after his birth, “Bennett’s overall health is great and he is growing like a weed,” said Jessica.
And thanks to the timely decisions and expert care of the pediatric services staff at the Bridgeport and New Haven campuses of YNHCH, this holiday season for Jessica and Anthony will include a truly special gift – the gift of a lifetime.