100 days in the NICU: Micro-preemie twins survive with expert care
Lex and Lochlan entered the world screaming — and well ahead of schedule — born at just 24 weeks.Apr 29th, 2019
By Cheryl Reid-Simons
For some, the Neonatal Intensive Care Unit is scary and intimidating. But to Fircrest’s Savannah O’Malley, the MultiCare Tacoma General NICU is “an amazing, magical place” that gave the gift of life to her twin sons, Lex and Lochlan.
“Without the NICU, my sons would not have had a first chance for life,” she says.
Lex and Lochlan entered the world screaming — and well ahead of schedule — born at just 24 weeks gestation and each weighing 1 pound, 10 ounces.
But they were alive, and they were fighters. They would need every ounce of that fight — and more than a little luck — to make it past the challenges ahead.
“I was so optimistic,” O’Malley says. “I didn’t know anything about 24 weekers or the complications we were going to be facing.”
She would learn soon enough.
O’Malley, her husband Kyle, and her doctors knew she would probably deliver early. Not only are twins typically higher risk for premature birth, but O’Malley had been on bed rest for two months with her daughter, Poppy, who was born at 36 weeks. So the risk of preterm labor may not have been a surprise.
“But we were optimistic I’d be able to carry them a little longer than I did,” she says.
Things were going well until she began experiencing some cramping at 24 weeks. Despite every attempt to stop labor, Lex and Lochlan weren’t waiting.
O’Malley gave birth at MultiCare Tacoma General Hospital, which offers the only Level IV NICU in the South Puget Sound. A Level IV NICU offers the highest level of care for the most critically ill or premature newborns, something the twins would need.
“There wasn’t a lot of time to prep us,” she says. “We were just trying to stay calm.”
Once the boys were born via Cesarean section, O’Malley got just a brief glimpse before they were whisked off to the NICU. She didn’t get a good look at her sons until she was out of recovery and nurse wheeled her up to the NICU.
“The closer I got the more anxious I was,” she says.
In between all the monitors and tubes and wires, she spotted her first son.
“I saw this creature that didn’t even look like a baby,” she says. “I was so overwhelmed I vomited.”
The nurses asked if they would like a picture with the baby.
“I said, ‘No way. Absolutely not,’” O’Malley recalls.
But the nurse pressed.
“She said, ‘Let me take a picture of you and your husband with the baby and you can delete it if you want.’ That was the right thing to do.”
Today those first pictures of each boy are treasured mementos.
With micro-preemies like Lex and Lochlan, complications are almost inevitable.
“They had all the normal stuff micro-preemies have to go through,” O’Malley says.
That included numerous blood transfusions, infection, respiratory distress and feeding tubes, among other challenges. Both had a heart condition in which a blood vessel between the pulmonary artery and the aorta isn’t closed. Lochlan’s closed on its own but Lex had to have a ligation procedure within his first month, which did the trick.
Caring for babies requiring this level of care takes a team of experts.
Tacoma General Hospital shares a campus with Mary Bridge Children’s Hospital, which is an added benefit to families with babies like Lochlan and Lex who require extended, complex care to help them thrive. The NICU and Mary Bridge Children’s providers frequently partner in the care of premature infants like the O’Malley brothers.
The Mary Bridge Pediatric Complex Care Support Team helped provide a sounding board for the family in the NICU and after discharge.
Jennifer Kett, MD, who heads the team, describes the team’s role as keeping an eye on the “big picture” of what is happening and what the ultimate goals are.
“We make sure everyone is looped in and that is conveyed to the family,” she says.
Lochlan made it home first, discharged after 96 days. Lex came home after 101 days, about a week before their due date. Bringing them home wasn’t easy.
“When you live in the NICU you think it’s the hardest thing ever,” O’Malley says. “Then you get home and all the security is gone and it’s stressful. You’re always ready to throw them in the car and go to the emergency room.”
As the boys approach their second birthday on July 18, they are both doing well. Both are still small — but thriving.
Lex is still followed by a dietitian as part of his neonatal follow-up care. Other than that, he doesn’t require any therapies or specialists.
Meanwhile, after suffering two separate grade IV brain bleeds, Lochlan continues to deal with some developmental delays.
“Lochlan definitely had the rougher go of it,” O’Malley says. “His very turbulent neurological history has impacted him some developmentally, but it could have easily been so much more drastic.”
Indeed, a neurologist told her recently that “you’d never know you were looking at the same kid by looking at Lochlan’s MRI.”
He’s making progress every day.
“He is just taking the scenic route developmentally,” O’Malley says. “Everyone’s optimistic he’s going to catch up with his brother someday.”
O’Malley says parents of babies in the NICU should always try to stay in the present.
“When you start looking too far in the future, you get anxious,” she says. “If you go too far in the past, you’ll feel guilt.”
The other advice she has for those “riding the NICU rollercoaster” is to ask questions.
“You’re desperate for information and you don’t have a medical background,” O’Malley says. “Ask every question. If you don’t understand the answer, keep asking the question until you do.”
O’Malley hopes parents of micro-preemies like Lex and Lochlan can take comfort in how well they’ve done.
“Statistics are just numbers and miracles happen all the time in the NICU,” she says.
Both Mary Bridge Children’s and the Tacoma General NICU are used to working together to make those miracles happen. From the care the twins received in the NICU to the specialists from Mary Bridge, it’s a team effort that makes it happen.
“This is a NICU used to taking care of micro-preemies and that’s very important,” she says, citing the presence of specialists from Mary Bridge and a NICU staff that maintains the “meticulous, constant management” such newborns require.
“The NICU here is just excellent at taking care of such tiny babies,” she says. “I’m really in awe of those folks.”
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