A typical NICU patient
I love to think about this one baby boy patient of mine. He was born into my care nineteen years ago. His mother came into L&D with premature rupture of membranes, without any fever. She was given antibiotics and steroids to mature the baby’s lungs. Despite being given other meds to stop her premature labor, it continued in earnest. Within six hours her son was born weighing two pounds at 27 weeks gestation. He was thirteen weeks early!
After giving mom a quick peek at her baby, my NICU team admitted Luke to the NICU. There he was placed on a ventilator and given artificial surfactant. His response was not good, and his x-rays showed pneumonia and severe respiratory distress syndrome. He responded slowly to treatment. We did see some lowering of oxygen requirements and ventilator settings in those first weeks.
A challenging NICU stay
However, he then developed a patent ductus arteriosus, a congenital heart defect that flooded his lungs with too much blood. Medical therapy to close his ductus was not successful. Later this required surgical closure, which created another setback onto higher oxygen and ventilator settings. Afterwards, this little guy developed a central venous line infection. That required intravenous antibiotics and was treated successfully.
His mother, bless her heart, in addition to visiting Luke every day in the NICU pumped/expressed her breastmilk for us to feed to him. Luckily, he tolerated his mother’s milk feedings very well, but his growth was slow. She enjoyed doing something for him that none of us could do.
His mom was a NICU mom extraordinaire. She was brave, calm, and thoughtful. She got to know her son’s nurses and seemed to feel adequately informed (by them and by me). If she was scared throughout his NICU stay, she never showed it to me. Some NICU moms are traumatized by the experience and take a long time to adjust. Others hide their fear and remain dutifully, but quietly present at their child’s bedside. Many NICU mothers feel guilt, as if something they did caused their child’s preterm birth. (This is almost never the case.)
Little Luke had other complications – a small hemorrhage into his brain and another bout of infection. His progress coming off the ventilator was agonizingly slow. He was one of a group of patients that NICU nurses call “wimpy white boys.” He developed what is called chronic lung disease, or bronchopulmonary dysplasia (BPD). Many medicines were used to help him wean off the ventilator, but ultimately, he needed intravenous steroids to hasten his recovery.
The steroid treatment worked, but it was not without risks. At that time, we were concerned that babies who required steroids might be at an increased risk of cerebral palsy. His parents and I were willing to take that risk to get him off the ventilator, and it worked.
Chronic lung disease in the NICU
This tough little guy remained in the NICU for over six months. The first few months were spent keeping him alive and weaning him off the ventilator. The next few months were spent getting him to grow adequately and weaning him off his supplemental oxygen. It took quite some time for him to learn how to oral feed, from a bottle and at the breast. Can you imagine expressing your breast milk for over four months before you ever get to nurse your baby?
My little patient slowly accomplished everything he needed to do to go home. His mother was there every day at his side throughout everything. She and his primary nurse became close friends through all his ordeals. After Luke went home from the hospital, mom kept in touch with this nurse, who would relay to me how he was doing.
Fast forward nineteen years to his high school graduation this past May. His primary nurse shared with me the senior picture his mom sent her. Luke had grown into a handsome and fit-looking young man. Having become proficient on the guitar, he was going to a music school in Colorado for college. Hearing that update really made my day! Wow, to see such amazing progress in this child, now a man, made my heart so full.
An update on his progress at home
But there is more. One day this summer I was in Nordstrom shopping for some jeans. While I was checking out, this lovely middle-aged woman came up behind me, tapped me on the shoulder, and asked, “Are you Dr. Landers?” I turned around and said, “Yes,” but did I not recognize her. She told me that she was Luke’s mom, and I gave her a big hug. When I asked about Luke, she told me all about his music and the college he planned to attend. I could easily tell how proud and happy she was.
As I reached for my credit card, she said to the sales lady, “This doctor saved my son’s life!” My heart almost burst with love, joy, and gratitude. It was one of those moments in my life that I will never forget. Luke’s mom allowed me to feel truly worthwhile and amazingly fulfilled.
I hope that one day someone will say something that causes you to feel truly fulfilled in your work. It is pure heaven.