• December 13, 2019

Premature births are common - Odessa American: Ector County Hospital District

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Premature births are common

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Posted: Tuesday, November 26, 2019 11:30 am

November is Prematurity Awareness Month and Hughes said the main idea is to bring awareness to premature infants in general. The March of Dimes website says each year more than 22,000 babies die. “And about every 12 hours, a woman dies as a result of complications from pregnancy,” the site said.

“We have a lot more born here than we think we do. We have two level three NICUs (neonatal intensive care units) here. We are one of them and then we have a level II NICU in Midland,” Hughes said. “Out of those three units, we’re able to service the Permian Basin and provide services for the premies, so a lot more are born than we think and they survive and do well.”

The other units are at Odessa Regional Medical Center and Midland Memorial Hospital.

She added that they provide the services the babies need when they need them and can’t go home.

“We give them the warm environments that they need when they aren’t with the mom. We give them the nutrition they need to help them grow and then as they start growing and get big and get off oxygen and we get them home. They start here as teeny, teeny tiny and leave here as roly polies,” Hughes said.

Erika Quezada had a daughter that needs the care offered at Medical Center’s NICU. Her daughter Kamila was born premature on Oct. 25 weighing 3.5 pounds. She was 16 inches long.

They are now out of the NICU, Director of Public Relations Trevor Tankersley said Nov. 26.

“The care has been wonderful. It’s been an experience,” said Quezada, who is a registered nurse at Medical Center.

Quezada said her doctor encouraged her to have her daughter a little early.

“I was having a lot of trouble with my blood pressure … so we were afraid it was going to affect her long term, even though so far to the 34 weeks, we were doing really well. They did more ultrasounds to make sure that everything was safe and ready for her. At first, we had thought about me just being in the hospital being with the machines and keeping her in utero, but when they ran the exams they said no it would just be safer to have her early instead of having kept her inside. It was an elective induction that turned into an emergency C-section. It was a very long experience for sure, but we’re here,” she said.

Due to Quezada’s blood pressure, Kamila had had intrauterine growth restrictions, so it did affect her growth. Kamila would have been a little bit heavier at the 34 weeks, but Quezada said the doctors made a good decision.

Although she works at MCH, Quezada said she had never been to the NICU and it was a little overwhelming, but the staff was very good and informative.

“… They make sure to come in and keep me to up to date of what changes might have happened, or what doctors decided to make changes of. Since I had the C-section, I do go home every so often just to care for myself, (take) showers and so forth but I’m here at least more than half the day for sure. My husband had been with me. Today’s (Nov. 13) his first day to go back to work. I will stay here the rest of the time,” Quezada said.

Her husband works in the oilfield. He was with her and their daughter until Nov. 13.

“He still has more time off, but since we wound up here and still got a couple more weeks to go it was best just to go back to work. Then when she goes home, he can be home with us,” she added.

Originally, doctors told her she would be at MCH until her due date, which was Dec. 6.

“But since she’s been doing so well, we’ve been progressing so good they’re hoping, and we’re hoping and we’re pushing for before Thanksgiving,” she said.

She praised the staff for their helpfulness and knowledge.

“There’s been times in the very beginning when I didn’t understand what was going on. I would just tell the nurse and within minutes I had a doctor here. I had the nurse practitioner here. The nurses for sure, they’re easily to be found. I’ve never had any issues of finding answers. It’s overwhelming to come in and see your baby attached to certain things and not know,” Quezada said.

“I didn’t get to meet her for the first 24 hours of her life because I had my own issues, so when I came in, they saw that I was being wheeled in they had doctors and nurses and everybody trying to explain to me at least what was going on and what they felt and what they saw from the moment that I didn’t get to see,” she added.

“Since I had the emergency surgery, I had to have general anesthesia so … we didn’t know what gender she was. I didn’t even know anything about her,” she said. But the nurses talked to her and told her about the baby and how she was doing.

“Even when I was up there, I was still not clueless. I knew what was going on. My nurses communicated with these nurses very well and I was informed,” Quezada said.

Hughes has worked for MCH since 2008.

The NICU takes and resuscitates babies from as early as 22 weeks all the way up. Their weight varies, but it’s usually at 1 pound, sometimes under.

“… Even just 10, 15 years ago you weren’t going that low with their age, so it’s amazing those teeny tiny ones the fight they have and the will to live that they have. You see it in them, the little personalities they have,” Hughes said.

Hughes said the nurses take the babies from delivery and put them in isolettes, like incubators.

“That kind of mimics, as best we can, mom to help them grow (and) stay warm. All of our isolettes have humidity to where it gives them a very humid environment to help their skin and help them not lose all that water weight that they’re full of at that time. And so it gives them all the heat, all the humidity and everything. It gives them a nice quiet environment,” Hughes said.

They use several different ventilators, depending on how small the baby is and what’s going on with them.

“It’s amazing. Even I can tell just in 15 years that I’ve done NICU the difference in how long those little ones are on the ventilators. Years ago, they would be on them for months and months and months where now we get them on and sometimes within a few days we take them off. They may have to go back on for a little bit, but … in a matter of hours and days we’re taking them off. We try not to leave them on for those months on end like we used to,” Hughes said.

MCH has all private rooms, which isn’t necessarily the case nationally, she added.

“… All the babies get their own little room and the parents can stay 24 hours a day. They can sleep in the rooms … and then as long as the baby’s stable, we try to let them get them out if they can tolerate it and let them hold. We try to help them when they’re really small. We do a lot of kangaroo care, skin to skin. It just helps the babies stay warm. They do a lot better being stable in that position and the moms can kind of cozy up and cuddle with them and the babies love it,” Hughes said.

There are many factors that cause premature birth. Hughes said it just happens sometimes and other times it can be related to infection, or other risks to the mother’s health if the mother has any type of underlying issues.

“Sometimes mom’s cervix and uterus just can’t hold on to the baby all the way to term, so they deliver early. The babies sometimes have complications that they need to be delivered early. If things aren’t going good and babies aren’t stable, they’ll deliver them early,” Hughes added.

Term is 37 to 40 weeks. The closer they get to that 34-35 weeks, the shorter their stay if they eat “really well, do really well (and) stay warm,” she said.

Complications seen in premature babies mainly are breathing problems. Initially some of them may go home on a little bit of oxygen and then slowly as their lungs heal, they get off. But when they are older, they may have things in asthma, get sicker more easily during the winter or have more respiratory issues.

Some of the babies that are carried to term come to the NICU for breathing problems and stay a few days.

Depending on how premature they are, some babies may also have developmental delays and others may have vision problems.

“We usually have them follow up with therapies when they leave here — speech, occupational, physical therapy — and make sure they don’t fall behind, especially as they get close to starting school and make sure they’re caught up in all those kinds of things because that can be an easy thing to miss,” Hughes said.

The NICU is licensed for 30 beds.

“We typically run an average of 20, so it can get a little hectic. I think some people don’t realize how many premies really are born out there. A lot of people think oh I’m going to have a baby. It’s going to be term. We’re going to be good and move on. And even the ones that are just barely a little pre-term can still have so many issues,” Hughes said.

She added that she and her colleagues do become attached to the babies.

“The longer they stay, the more they’re ours. Most of us, at least nowadays with social media, all of us in here we have so many moms on there or they’ll text us pictures. They’ll tag us on Facebook. It makes you feel good, too. Sometimes they’ll show up at the door,” Hughes said. “They feel like they’re part of your family. ...”

Hughes always knew she wanted to be an NICU nurse practitioner and now she’s getting her doctor of nursing practice.

“I feel like I love babies in general. Then I also love the critical thinking and all of the craziness that goes with that. Then you do get to see them thrive. I think that’s what makes NICU a little more special. … Everybody has that same common goal. They want to see the best for the baby and they want to see the baby do the best they’re going to do with what they’ve been given. I think everybody puts their whole heart into seeing these babies run and play …,” Hughes said.

She said the job can wear you down because it is emotionally driven.

“We work longer shifts, so it can get to be very wearing when you’re here and things are crazy. But I think we all try out best to keep each other going. That’s part of the team thing. On the days that are rough and the days that aren’t as good as others, when we may lose a baby or things just aren’t going as good for a baby, you can just feel it in the unit. The whole environment is very quiet, very down. That’s when everybody gets a little more supportive. … There’s always those days, but there’s way more good days than bad,” Hughes said.

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