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Five months into her pregnancy, Shelton resident
Tracy Nerkowski was enjoying her weekly
prenatal yoga class when she noticed that her
ankles were swollen. She called her obstetrician’s office and
was sent to Bridgeport Hospital to have her blood pressure
checked. Her OB/GYN, Emily Blair, DO, FACOG
(Fellow of the American College of Obstetricians and
Gynecologists), was already waiting at the hospital.
“I was so relieved to see Dr. Blair when we walked in that I
think my blood pressure dropped on the spot!” says Tracy.
“But it didn’t stay that way, so Dr. Blair prescribed a medication
to help keep it under control.”
The medication worked temporarily, but couldn’t maintain
Tracy’s blood pressure at a healthy level. “Dr. Blair was so
worried about me that she prescribed bed rest at home,”
Tracy says. “I was allowed to get up only to use the bathroom, so every morning I set up my laptop, books, telephone and
snacks within arm’s reach around our living room couch
and stayed there all day long. I knew it was what I had to
do to keep myself—and our baby—healthy.”
“Tracy would have walked on hot coals to stay pregnant,”
says Dr. Blair. “Whenever there is a problem during pregnancy,
parents are often stunned and it quickly becomes a
very intense situation for them.”
But despite following her doctor’s orders, and all those
hours on the living room couch, Tracy’s blood pressure kept
going up. “So Dr. Blair had me stay in the hospital
overnight so my protein levels and kidneys could be continuously
tracked for 24 hours,” says Tracy. “Tracy was hooked
up to so many monitors,” remembers her husband, Paul. “I
held her hand all night—and it was a long night. We werereally worried,” he sighs. Tracy was also seen by Chief
of Obstetrics, Steven Laifer, MD, one of Bridgeport
Hospital’s perinatologists (obstetricians who specialize
in complicated pregnancies).
After the testing, Dr. Blair confirmed that Tracy had a condition
called preeclampsia—high blood pressure and
excess protein in the urine (for a complete discussion of preeclampsia,
visit Healthy & Wise Extras).
Specialized Maternal Care
Because preeclampsia can lead
to kidney failure, stroke and premature
birth, Dr. Blair determined
that Tracy and her
baby—now at about 24 weeks’
gestation (out of 40) and about
10 inches long—would be
best cared for by the obstetricians,
perinatologists and the
specialized staff in Bridgeport
Hospital’s Special Care Maternity
Unit. “I wanted Tracy to be on
constant bed rest,” says Dr.
Blair. Bed rest lowers a mother’s
blood pressure and increases
blood flow to the placenta,
which provides the baby with
the oxygen and nutrients needed
for development, she adds.
“Deciding whether or not to
admit an expectant mother to
the Special Care Maternity Unit
depends on the seriousness of her condition as well as how
far along she is. Tracy’s condition was pretty serious, and
because she was she was still in her second trimester,
I knew this was the best place for her to be in case there
were any further complications.”
Along with daily monitoring to check the baby’s health, Tracy
also received medication to speed up the baby’s lung development
in case a premature delivery would be necessary.
“In the Special Care Maternity Unit, our job is to create a
warm, encouraging and comforting place for our moms,”
says Holly Lavery, RN, who has cared for expectant mothers
for more than 20 years at Bridgeport Hospital, including
Tracy. “We’re here for them. Working with their
doctors, we provide the best technology and medical care
to keep them healthy, along with the intense emotional
support they need during this very stressful time.”
Nurses work together to meet the needs of the expectant
parents. “The nurses really take a personal interest in the
patients,” says Dr. Blair. “They realize how difficult it is to
have a serious condition during pregnancy and how
stressed the parents are. They help parents get through, day
in and day out, with lots of distractions. Without distractions,
parents can’t help but worry what might happen.”
On move-in day for the couple, Paul brought in comforts
from home—to help take their minds off their fears.
“We brought in favorite clothes,
puzzle books and our laptops,
everything we’d need over the
next several weeks, because we
didn’t know how long we’d be in
the hospital,” says Paul. They
hoped it would be for weeks,
because each additional day
that Tracy was pregnant meant
another day of development for
the baby.
“We knew that we would
receive excellent medical treatment
in the Special Care
Maternity Unit, but we were
happy to find out that our ‘regular
life’ could continue for
both of us,” says Tracy. The 10
specially equipped rooms on
the unit provide family members
with wireless computer
access and are furnished with
TVs, DVD players, refrigerators and beds for dads-to-be.
“Between Tracy’s daily tests and ultrasounds, we worked
remotely,” says Paul. “My boss could get in touch with
me and I could answer questions from the office. We also
listened to books on tape and started a webpage about
Tracy’s progress.”
“We know how stressful the waiting and worrying can be
for expectant moms, so the hospital is delighted to offer
them massage therapy (after getting clearance from the
doctor), visits from hospital chaplains and consultations
with our childbirth educator and certified lactation consultant,”
says Holly.
Tracy and Paul also met regularly with Chief of
Neonatology Robert Herzlinger, MD, who is also
medical director of Bridgeport Hospital’s Newborn Intensive Care Unit. “Dr. Bob helped us understand
what to expect with a premature baby. We knew our
baby was going to be early, we just didn’t know how
early,” says Paul.
“We try to educate parents as much as possible before the
baby arrives so they are equipped with the information they
may need in terms of what to expect and what kinds of care
may be necessary for the baby,” says Dr. Herzlinger.
While in the hospital, Tracy was seen frequently by her
doctors, including perinatologists who checked the baby’s
status. Then, at the beginning of her second week in the
Special Care Maternity Unit, the baby’s heart rate and
ultrasounds were beginning to show that the baby was in
distress. “I remember looking at the baby’s heart rate
monitoring at the end of the day and seeing that it looked
more concerning than it had earlier that morning,” says
Chief of Maternal-Fetal Medicine and perinatologist
Robert Stiller, MD.
“My doctors and the perinatologists determined that the
time to deliver was now or it could be too late,” says Tracy.
“I remember how quickly Dr. Menzies [neonatologist
Cheryl Menzies, MD] appeared at my bedside to answer
my last-minute questions and prepare me for the level of
care the baby would require after delivery.”
Finally, it was time. “I was told to put on these special
scrubs while nurses prepared Tracy for the birth,” says Paul.
“I was so excited that I’d soon meet our baby, but I wasn’t
sure what to expect in terms of the baby’s health.”
Tracy was wheeled to a prep room where she received a
spinal block. The anesthesia was injected into an area below
her spinal cord. “I’ll never forget the nurse’s expressive eyes at that moment,” says Tracy. “Her caring nature came
through her eyes at that critical time. That will always be
etched in my memory.”
That evening, April 7, Tracy and Paul welcomed baby
Ethan into the world. Delivered at just 25 weeks’ gestation
via cesarean birth by Dr. Blair’s colleague, OB/GYN
Steven Cassell, MD, “Ethan weighed 1.5 lbs. and measured
11 inches long,” says Dr. Cassell. “He had gained an
inch and about half a pound in just one week—which are
very good things in terms of his health and strength.”
Tracy recalls the first few moments they officially became a
family. “When Ethan was born, I heard one little cry and
saw his arm from the elbow to his fist, which he was pumping
in the air as the doctors whisked him next door to perform
their preliminary check,” she remembers. “Shortly
thereafter, Dr. Menzies brought Ethan back into the room
and Paul and I had our first look at him, which lasted only
a minute or two. No touching, no kissing, no holding—
just looking at this tiny little child of ours and wondering
what was in store for him.” After that, Ethan was transported
to the Newborn Intensive Care Unit (NBICU), where he
would be cared for during the next four months.
“As parents of a premature baby, you experience different
emotions than during a typical birth,” explains Tracy.
“There is obvious joy that your child is alive, but that joy is
hampered by his condition and knowing that critical days
are ahead. You truly start living moment-to-moment, as
each moment is so important to the baby’s health.”
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Apart from being nearly four months premature, Ethan’s
health obstacles during the first 16 weeks in the NBICU
ranged from a collapsed lung to possible bleeding on the
brain. He was hooked up to a ventilator (to help him breathe), intravenous medicines, lots of monitors and a
feeding tube, because, like most premature infants, Ethan
had not yet developed the sucking reflex. “The goal was to
maintain adequate levels of oxygen, blood circulation and
nutrition while his lungs continued to develop,” says Dr.
Herzlinger. “It was frightening to think about the ‘what ifs,’
but we knew he was in the right hands,” says Paul.
Tracy and Paul went home about a week later, with Ethan
remaining in the NBICU. “He was still so tiny and fragile—
his diapers were about the size of four cotton balls—
but we were comforted knowing there was a team caring
for him,” remembers Tracy.
“Tracy and Paul visited Ethan every day, spending hours
singing to him, reading stories to him and talking to him,”
says Michele Covino, RN, BSN (Bachelor of Science
in Nursing), Ethan’s primary nurse, who quickly became
part of the couple’s new hospital family. “That stimulation
from his parents helped in his development,” she adds.
But because Ethan had help breathing with a special ventilator,
they still weren’t able to hold him.
Finally, on April 29—more than three weeks after his
birth—Tracy had the long-awaited opportunity to feel
Ethan in her arms. “I finally got to hold him,” says Tracy.
For a brief but momentous 90 seconds before he needed to
go back on the ventilator, the couple embraced their tiny
son, strengthening the bond already building among them.
“You know the saying, ‘It takes a village to raise a child.’
Well, at Bridgeport Hospital, it’s true,” says Tracy. “There
were so many people who took care of him. And during
each phase, people would step in to make us feel better,
especially Michele.”
“Our goal in the Newborn Intensive Care Unit is to plan
for the baby’s trip home,” says Michele. “Every day, our job
was to help Ethan get strong and healthy and to teach Tracy
and Paul how to take care of him—from bathing to feeding
to working his special equipment and knowing what to
watch for. Tracy and Paul are incredible people. They put
their trust and faith in us and were very eager to learn how
to care for Ethan.”
In addition to providing top medical care for Ethan,
NBICU nurses made lots of mementos for Paul and Tracy,
who were both back at work during business hours. (Tracy
decided to save part of her maternity leave for when Ethan
was home.) Nurse Amy Puffer, RN, BSN, took photos of
Ethan and created three-dimensional collages. Nurse Dawn
Serreti, RN, BSN, made prints of his hands and feet. Nurse
Connie Anderson, RN, BSN, made him tiny hats with the
name of Paul’s favorite hockey team written across the top.
Nurse Karen Carroll, RNC (Registered Nurse Certified),
always made sure Tracy and Paul laughed. “They made us
birthday cards, Mother’s and Father’s Day cards and a sign
with a photo of Ethan when he weighed 32 ounces,” says
Tracy. “I’ve saved everything in scrapbooks and memory
boxes to share with Ethan when he’s older.”
On August 12, Ethan, who weighed just over 7 lbs., was
finally ready to go home. After a tearful goodbye to
the team who cared for them during those four months,
Michele walked Tracy, Paul and Ethan to their car.
“Today, Ethan is developing well,” says his pediatrician
Richard Freedman, MD. “He’s off a few medications and
continues to gain weight.” Tracy and Paul are still in close
contact with some of Ethan’s former Bridgeport Hospital
caregivers. When Ethan is a few months older, he
will participate in Bridgeport Hospital’s Newborn ICU
Developmental Follow-Up Program. The only one of its
kind in Fairfield County, the program evaluates 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.
“We really miss the people and the other parents we
saw every day and got to know,” says Tracy. “We are so
grateful to the Bridgeport Hospital team for helping us
become a family. Without them, we may not have had a
son to bring home.”
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