Meet the Joy Boys!

It almost seems like 22-month-old daredevil Nathan Joy is preparing to climb Mount Everest this spring. He loves the challenge of scaling the sides of his crib or climbing up and over the living room couch. His twin brother, Lucas, no slouch himself, is always game for another round of hideand- seek or a 500th reading of Green Eggs and Ham.

When Mom and Dad—Aleksandra Dobkowski-Joy and her husband, Christopher Joy—watch the boys play, it’s never far from their minds that these two spunky youngsters were born at just under 3 lbs. apiece and, thanks to Bridgeport Hospital’s highly experienced Newborn Intensive Care Unit (NBICU) team, overcame serious cardiac and lung problems. Today, they are right on track and inspire everyone they meet.

More than two years ago, when Aleksandra and Christopher visited the obstetrician’s office for her first ultrasound, their only question was, "When is the baby due?" Looking at the monitor, the parents-to-be were stunned to see two babies.

Aleksandra’s obstetrician, Leslie Goldstone-Orly, MD, knew this pregnancy would now require additional expertise. She sent them to the Antenatal Testing Unit (ante=before, natal=birth) at Bridgeport Hospital, where Aleksandra saw Chief of Maternal-Fetal Medicine Robert Stiller, MD.

Dr. Stiller answered all of her questions. "We talked about the increased risks of preeclampsia (a condition involving dangerously high blood pressure), diabetes of pregnancy and pre-term delivery," Aleksandra recalls. "I listened and took notes, but all the while I was thinking, 'This isn’t going to happen to me!'"

Everything was fine until Aleksandra’s 22nd week of pregnancy. Then—"I started having mild contractions, but because this was my first pregnancy, I didn’t know they were contractions," she says. Luckily, soon after the contractions started, she had one of her regular appointments with Dr. Stiller at Bridgeport Hospital.

"Aleksandra’s cervical length had decreased dramatically," says Dr. Stiller. "This is an early sign that the cervix is beginning to dilate." In other words, Aleksandra could deliver any day. As Christopher raced to the hospital, Aleksandra was whisked down the hall to Labor & Delivery and was started on medication to stop the contractions.

After two days, the contractions slowed, and Aleksandra was moved into The Birthplace at Bridgeport Hospital to take part in the hospital’s Special Care Maternity Program for high-risk mothers. Here, physicians from the Perinatology Team (doctors with specific expertise in caring for high-risk pregnancies) and specially trained nurses kept close watch over Aleksandra and her babies. Robert Herzlinger, MD, Chief of Neonatology (the care of very small or critically ill newborns), visited her. He talked about what might lie ahead for the babies, such as brain, heart and lung problems that are common in premature infants.

During the next five weeks in the hospital, Aleksandra took her prescription for bed rest very seriously. "I got up only to use the bathroom, and every other day I was allowed to take a shower," Aleksandra says. "And we talked about names!" She was seen daily by Dr. Stiller or another member of the Perinatology Team (Gina Dunston-Boone, MD, Gary Kleinman, MD and Steven Laifer, MD), and had near-weekly ultrasounds to monitor the babies’ growth. "It seemed like a long time," says Aleksandra, "but I reminded myself that each day I spent in The Birthplace meant another day of important development for the babies."

At 28 weeks, the contractions started up again, but this time they couldn’t be stopped.

Ultrasounds showed that both of her babies were lying sideways in the womb. Aleksandra and her doctors decided to go with a Cesarean birth.

The surgical team sprang into action, and Dr. Goldstone- Orly delivered two boys: Lucas, the older, weighed 2 lbs., 11 oz., and Nathan, 2 lbs., 13 oz. It was November 4, 2005. "We were relieved but terrified," says Aleksandra. "Of course, we feared the worst: Would they be able to breathe? Would they develop normally?"

Bridgeport Hospital’s NBICU was waiting with open arms for those tiny bundles of Joy. The team included neonatologist and Associate Director Cheryl Menzies, MD, resident physicians, physician assistants and neonatal nurse practitioners skilled in the care of premature infants. "As we observed the NBICU team’s obvious commitment, skills and tenderness toward our babies-and toward us- our fears were put in perspective," says Aleksandra.

"Like many premature infants, Lucas and Nathan had underdeveloped lungs. At first, they needed respirators to help them breathe," explains neonatologist Richard Freedman, MD, who is the boys’ physician. "They had episodes of apnea—interruptions of breathing that are common in pre-term infants—and Lucas needed treatment for a partially collapsed lung." Treatment with a surfactant (medication that helps the lungs develop) and oxygen therapy steadily improved the twins’ breathing.

The boys also experienced cardiac problems caused by immature heart vessels common in premature babies. The expert NBICU team quickly identified nonsurgical solutions.

A few days later, Aleksandra was well enough to continue her recovery at home, but Nathan and Lucas were still too small to leave the hospital. Going home without her two newborns was something she never imagined would happen. But her heartache was eased when she realized how seamlessly the NBICU team could provide a sophisticated level of care in a nurturing environment.

After Aleksandra left the hospital, Dr. Freedman called her at home early each morning—including weekends and holidays!— with updates from the NBICU. "These daily calls reassured me that the boys were in good hands," she says. She and Christopher visited the boys every day, and learned from the caring NBICU nurses how to delicately hold, swaddle, burp and change such tiny infants. On January 9, 2006, at nine weeks of age, both Joy boys were finally ready to settle into their own home.

And still the staff kept a vigilant eye on the boys’ progress: Neonatologist Christine Butler, MD, carefully observed and examined their development through Bridgeport Hospital’s Follow-Up Program, seeing them every six months.

The only one of its kind in Fairfield County, the Follow-Up Program is critical to a child’s entire life. The program monitors the mental and physical development of at-risk NBICU graduates to determine early on if these infants might benefit from interventions to address any of their special needs. The examination tool Dr. Butler uses to evaluate child development is called the Infant and Toddler Developmental Assessment Test. "This test helps us evaluate a numbe