‘Riding the roller coaster’ of the NICU

After four and a half years trying to have a baby, Andrea and Todd Brommelkamp were completely caught off guard when an at-home pregnancy test came back positive in January.

They were even more caught off guard, though, when their son was born at just 25 weeks on July 13 - 15 weeks shy of their Oct. 23 due date.

According to the Centers for Disease Control and Prevention, preterm birth is the biggest contributor to infant death. The final weeks of gestation are crucial in growth and development, and a premature birth can lead to long-term intellectual disabilities, cerebral palsy, respiratory problems, visual problems, hearing loss and feeding and digestive issues.

Still, the Brommelkamps said they were 'super lucky.”

At 20 weeks, they went to their doctor for an ultrasound to determine their baby's sex, but the nurse noticed something was off.

She couldn't get a good picture of the baby's foot and thought it might be clubbed. At 24 weeks, they did a follow-up ultrasound and a 'look came over the nurse's face,” Andrea said.

She knew something wasn't right.

Although the baby's feet were normal, Andrea's cervix was not.

When pregnant, a woman's cervix gradually will soften, decrease in length and open. At 24 weeks, the average cervix measures around 3.5 centimeters. Andrea's was less than a half a centimeter, putting her at risk for preterm labor.

She was given two shots of betamethasone - a steroid - to speed up the development of her son's lungs and told to go home, rest and try to avoid giving birth as long as possible. The goal was to hold off until 28 weeks, but doctors warned it was only a matter of time.

The couple celebrated each day they grew closer to their goal, they said, but just a few days later, on July 11, Andrea woke up 'feeling terrible.”

'I tried to push through, but something didn't feel right,” she said, describing an uncomfortable and 'intense tightening of the stomach” that led her to reluctantly call the doctor. She was told to come to the hospital immediately.

Two days later, Andrea sat in her hospital bed chatting with a nurse when the baby kicked and her water broke. Twelve hours later she gave birth to her son, Thomas, by cesarean section. He was just one pound, eleven and a half ounces - so small the Brommelkamp's wedding rings fit around his legs.

Since then, Thomas has been in the neonatal intensive care unit at UnityPoint Health - St. Luke's Hospital, battling the challenges of a premature birth.

In 97 days, he's been weaned off oxygen, feeding tubes and gained quite a bit of weight, now weighing in at just over seven pounds. The Brommelkamps hope to bring Thomas home Saturday for Andrea's birthday.

'It's all she wants for her birthday,” Todd said. 'We don't want to get our hopes up, but we're optimistic. We see the light at the end of the tunnel, and it's a pretty good feeling.”

But the road to get Thomas in good health was not easy, Andrea said.

'We rode the roller coaster with him,” she said. 'We've had good days and bad days. It's not all sunshine and rainbows. It sucks. It really sucks. But you have to celebrate the milestones because there's nothing you can do to change it.”

According to the CDC, predicting and preventing preterm birth - which affects about 1 in 10 infants in the United States - can be challenging because the causes are 'numerous, complex and not always well understood.”

However, there are some preventable risk factors, such as avoiding smoking, drinking and using illegal drugs while pregnant. Other risk factors include a previous preterm birth, a pregnancy with more than one baby (twins, triplets, etc.), problems with the uterus or cervix, and chronic health problems in the mother, such as high blood pressure, diabetes, infections during pregnancy and clotting disorders.

For Trisha and Justin Bressler - another family whose now two-and-a-half year old daughter, Jaelyn, spent her early days in St. Luke's NICU - the cause of preterm birth was pre-eclampsia, a potentially life-threatening condition in which the mother's blood pressure rises after the 20th week of pregnancy.

Jaelyn was born at 28 weeks, when Trisha's pre-eclampsia had become so severe that it was threatening her life and Jaelyn's.

'We were very scared and overwhelmed,” Trisha said. 'There were a lot of what ifs.”

They spent 11 weeks in the hospital and although they had trouble weaning Jaelyn off oxygen, she now is a healthy, normal, highly-energetic two and a half year old.

Although medical advances have improved the chances of survival for infants born prematurely, precautions such as healthy diet and habits should be taken to avoid early delivery as much as possible, the CDC said.

'There are so many stresses involved in an extended NICU stay,” Andrea said, giving examples such as finances, work and even stress on their marriage. But having been in the NICU so long wasn't all bad.

Over the past 97 days, the Brommelkamps have developed close relationships with Thomas' doctors and nurses, so much so that they feel like extended family, Todd said.

'We're very thankful for everybody here,” he said. 'This is not something I want anyone else to go through, but I can't say enough about the people here. I can't imagine going through this without them. It's very clear just how much they care - they take care of these kids like they're their own children.”

'You develop a great deal of connection,” agreed Dr. Dennis Rosenblum, a neonatologist at St. Luke's. 'It's very gratifying to send families home with healthy babies. I feel privileged to take care of these kids.”

The Brommelkamps said they look forward to the day when they can bring Thomas back to the NICU when he's older to meet the doctors and nurses who cared so much for him.

In an effort to reunite families who've 'graduated” from the NICU, St. Luke's will host a reunion on Sunday Oct. 23 from 2 to 4 p.m. in the Nassif Heart Center classrooms. All former St. Luke's NICU patients and family members are invited.

IF YOU GO

What: UnityPoint Health - St. Luke's Hospital NICU family reunion

When: 2 to 4 p.m. Sunday, Oct. 23

Where: UnityPoint Health - St. Luke's Hospital, 1026 A Ave. NE, Cedar Rapids, Nassif Heart Center classrooms, third floor

Who: Former St. Luke's NICU patients and family members - no formal invitation needed

Cost: Free

Details: Former NICU families are invited to join doctors, nurses and staff for a reunion at St. Luke's. Refreshments, games and activities for children of all ages are included. Families are welcome to dress in Halloween costumes.