Wisconsin Magazine; No. 1016; Special Care

<v Dave Iverson>I'm Dave Iverson. Welcome to tonight's edition of The Wisconsin magazine. <v Wisconsin Magazine Speaker>The Wisconsin magazine, a weekly look at our state and our time. <v Wisconsin Magazine Speaker>Tonight's special edition, Special Care, a documentary on the care of premature <v Wisconsin Magazine Speaker>infants. <v Man>So hard to see 'em and all, all these tubes in them and <v Man>the nurses when they try to feed their I.V. <v Man>It hurts. <v Man>You know, you have some hopes on the good days and then you have the bad days and then <v Man>everything that you gain you seem to lose. <v Narrator>In a few short days, Gary and Vicki Buchholz have learned something about the limits of <v Narrator>parental power. Kristin weighs a little more than a glass of water, and yet <v Narrator>it is the parents who are powerless to help. <v Gary Buchholz>She's got a lot of ?healing? to do and she has to do it all on her own. <v Dave Iverson>Good evening. Early this morning, my telephone rang.

<v Dave Iverson>On the line was Mike ?Henneck?, our director. <v Dave Iverson>The man who is usually in charge during the broadcast in the control room. <v Dave Iverson>Mike called to tell me he wouldn't be here tonight. <v Dave Iverson>He was at the hospital, busy becoming a father for the first time. <v Dave Iverson>Most parents, like Mike and his wife Ellen, are prepared for that special moment. <v Dave Iverson>But that's not the case for the parents of premature infants. <v Dave Iverson>The sudden birth of a baby born two or three months too soon brings parents into a brave <v Dave Iverson>new world of shock and uncertainty. <v Dave Iverson>Not many years ago, many of those tiny infants would never have survived. <v Dave Iverson>But today, most do. <v Dave Iverson>Our story was taped at the Special Care Nursery at Madison General Hospital, one of <v Dave Iverson>several neonatal centers in our state. <v Dave Iverson>Following this evening's documentary, we'll talk with three physicians about this topic <v Dave Iverson>and we'll respond to your phoned in questions and comments as well. <v Dave Iverson>The number to call a little bit later on will be (1-800) 362-3020. <v Dave Iverson>That's (1-800) 362-3020. <v Dave Iverson>We'll be back in 1 1/2 hour to take your calls and comments. <v Dave Iverson>But first, tonight's documentary, Special Care. <v Nurse>The real critical time is the first two days.

<v Pastor>Megan McCarthy, the Christian community welcomes you with great joy in his name I claim <v Pastor>you for Christ our savior by the side of the cross. <v Nurse>They can change in 10 seconds. <v Nurse>Everything can change. <v Pastor>I baptise you in the name of the Father. <v Nurse>She has now changed diseases. <v Pastor>and of the Son- <v Nurse>She's now become a baby with chronic lung disease. <v Pastor>and of the Holy Spirit. [Music plays] <v Dave Iverson>It is called the Special Care Nursery, a place where the most advanced technology

<v Dave Iverson>and the most fragile of human beings are joined together. <v Dave Iverson>It is a place where life begins and sometimes ends amidst a tangle of tubes <v Dave Iverson>and monitors. A place where first breaths are drawn through a machine <v Dave Iverson>and first cries are only a distant dream. <v Dave Iverson>It is the beginning of human life tethered to an uncertain future. <v Dave Iverson>[Mother asks her baby, "Come on little guy. Yep, mom's here, aren't you gonna visit with me?"] <v Dave Iverson>They are the unexpected, born too soon or too imperfect. <v Dave Iverson>Born in need of special care. <v Dave Iverson>An arrival by definition is never planned. <v Dave Iverson>The location and time not predetermined for medical convenience.

<v Dave Iverson>Today, a child born 70 miles away is in trouble, born with his intestines <v Dave Iverson>outside instead of in. <v Dave Iverson>Unable to treat the baby in the rural hospital where it was born, the infant is <v Dave Iverson>transported first to an intensive care unit, then readied for one more journey. <v Dave Iverson>The special care nursery at Madison General will soon be its new home. <v Nurse>[Baby cries for a bit] Life hasn't been very kind to you yet. <v Dave Iverson>Life will eventually seem kinder to this baby, technology and transports will see <v Dave Iverson>to that. But life's tiniest participants still face an uncertain beginning. <v Dave Iverson>And technology still can't answer a parent's first questions. <v Dave Iverson>Will my baby live? Will it be all right? <v Dave Iverson>An expectant mother has ruptured her membranes too soon.

<v Dave Iverson>Doctors attempt to delay birth as long as possible to give the unborn time to develop. <v Dave Iverson>The attempt is unsuccessful. <v Dr. Robert Perelman>The high risk team attempted to suppress her labor with pharmacologic <v Dr. Robert Perelman>?means?, to buy time for the maturation <v Dr. Robert Perelman>of the majors. But she-the mom continue to <v Dr. Robert Perelman>break through the suppressive drugs. <v Dave Iverson>The result? Not one baby, but two. <v Dave Iverson>William's baby, number one and number two, premature twins. <v Dr. Robert Perelman>She underwent a cesarean section for the ?inaudible?. <v Dr. Robert Perelman>[Interviewer asks, "When did this occur?"] Two and a half hours ago. So these babies are about <v Dr. Robert Perelman>two and a half hours old. <v Dave Iverson>The babies suffer from the typical problems of the premature. <v Dave Iverson>Their underdeveloped lungs lack a lining fluid called surfactant, a deficiency that <v Dave Iverson>leads to hymen membrane disease or respiratory distress syndrome. <v Dr. Robert Perelman>At this gestational age, the fetus or neonatal delivered is

<v Dr. Robert Perelman>still at high risk for complications of prematurity. <v Dr. Robert Perelman>Foremost among those is immaturity of one of the biochemical <v Dr. Robert Perelman>systems in the lung. <v Dr. Robert Perelman>And is the first and foremost threat to premature's <v Dr. Robert Perelman>life after delivery. <v Dave Iverson>They seem at first too vulnerable for the world that awaits them. <v Dave Iverson>And yet they are here. Tom Williams is suddenly a father. <v Interviewer>Does it seem real to you yet? <v Tom Williams>Now it does. <v Tom Williams>When you can actually see them. <v Dave Iverson>And so life begins with hope and a question mark. <v Dave Iverson>The first miracle has been achieved, but now what? <v Dave Iverson>Dr. Virginia Houstead. <v Dr. Virginia Houstead>The real critical time is the first two days generally premature <v Dr. Virginia Houstead>babies at this age. If they make it through the first two or three days, they <v Dr. Virginia Houstead>make it. The vast majority of babies that are going to succumb <v Dr. Virginia Houstead>to infection or to respiratory illnesses do so in the first couple of days of life.

<v Dr. Virginia Houstead>It's sort of a race of time for these children. <v Dave Iverson>The odds for survival change almost minute by minute, breath by breath. <v Dave Iverson>But in these first few moments of life, odds clarify very little. <v Dave Iverson>In the end, it means only this: We don't know, we just don't know. <v Dave Iverson>Dr. Gary Gutcher. <v Dr. Gary Gutcher>That's tough to deal with as an individual. <v Dr. Gary Gutcher>But then you somehow have to explain that to the parents as well. <v Dr. Gary Gutcher>I saved your baby's life, I'm not patting myself on the back. <v Dr. Gary Gutcher>We-somehow your baby's still alive. <v Dr. Gary Gutcher>I haven't the slightest idea how this is going to turn out. <v Dr. Virginia Houstead>It's really impossible for me to give you real odds on what their survival <v Dr. Virginia Houstead>rate or survival expectation is. <v Dr. Virginia Houstead>It's definitely better than 50/50, but it's by no means 95%. <v Dr. Virginia Houstead>Somewhere in that range is about all I can say for them I think.

<v Dr. Virginia Houstead>Literally every day that they make it improves their survival chances <v Dr. Virginia Houstead>at this point. As we spoke earlier, we expect them to get worse before <v Dr. Virginia Houstead>they get better. The next two days are going to be very rough for them, and we're just <v Dr. Virginia Houstead>literally going to take it hour by hour. <v Interviewer>What's hardest do you think for-for parents, is it the obvious things, the uncertainty, <v Interviewer>the-the separation? <v Dr. Virginia Houstead>The hardest? Gosh, a lot of it's hard. <v Dr. Virginia Houstead>The whole thing is hard. It's overwhelming from the start. <v Dr. Virginia Houstead>Just physically, when they walk into the nursery and confront that, it's so overwhelming <v Dr. Virginia Houstead>with all of the machines and the lights and the buzzers and all the equipment. <v Dr. Virginia Houstead>I think the hardest thing is probably that it's-it's a long process for those babies <v Dr. Virginia Houstead>and they wanted their baby so badly to make rapid progress.

<v Dr. Virginia Houstead>And there's so many ups and downs. <v Dr. Virginia Houstead>And I think we all share a lot of pride when those children are doing well. <v Dr. Virginia Houstead>And on the other hand, we all share a lot of grief with them when they aren't doing well. <v Dr. Gary Gutcher>It is extremely rewarding when you have done everything you can <v Dr. Gary Gutcher>against all odds and you end up two years later with a little toddler <v Dr. Gary Gutcher>waddling down the homes perfectly normal. <v Dr. Gary Gutcher>And you go Yahoo! <v Dr. Gary Gutcher>And on the other end of the spectrum is doing the same sort of thing. <v Dr. Gary Gutcher>Against all odds and it doesn't turn out right. <v Dr. Gary Gutcher>And the toddler is not waddling. It's being wheeled now, it's in braces and is <v Dr. Gary Gutcher>obviously not going to have a very productive maybe not even a very <v Dr. Gary Gutcher>enjoyable life. <v Dave Iverson>The odds are that one of the babies in this room will later develop significant <v Dave Iverson>handicaps. Those are the odds and that's all they are. <v Dave Iverson>Just the odds. <v Nurse>Your first blood ?inaudible? 90 percent, FI24 is 7.14, the CO2

<v Nurse>is 62, PO 97. <v Dave Iverson>Megan Hoover, born 11 weeks premature, weight just <v Dave Iverson>under 2 pounds, length 36 centimeters, just a little longer <v Dave Iverson>than a Barbie doll, Megan's lungs aren't developed enough to breathe <v Dave Iverson>on her own. She, too, lacks the lining fluid surfactant a problem physicians <v Dave Iverson>here are currently researching. A special care staff is exploring new ways of treating <v Dave Iverson>children with respiratory distress syndrome. <v Dave Iverson>For now, babies like Megan Hoover need immediate support and attention, including a <v Dave Iverson>machine that breathes for her. <v Dave Iverson>Megan will soon face the catch 22 of most premature babies. <v Dave Iverson>The machine that is keeping her alive is also doing damage. <v Dr. Virginia Houstead>Indeed, we worry about the respirator itself. <v Dr. Virginia Houstead>It's sort of-it's sort of a race of time for these children in <v Dr. Virginia Houstead>when they have lung disease and they need to be on the respirator.

<v Dr. Virginia Houstead>Yes, that respirator saves their life by giving them enough oxygen into their bloodstream <v Dr. Virginia Houstead>and getting rid of the carbon dioxide that they can't do effectively on their own, but <v Dr. Virginia Houstead>at the same time that it's saving their life, it is damaging the lung also. <v Dave Iverson>The longer a baby stays on the respirator, the greater the incidence of chronic lung <v Dave Iverson>disease or bronchopulmonary dysplasia. <v Dr. Virginia Houstead>We know that children who stay on a respirator for a long period of time have a higher <v Dr. Virginia Houstead>incidence of a condition that's called bronchopulmonary dysplasia. <v Dr. Virginia Houstead>It's a chronic lung disease. <v Dr. Virginia Houstead>And we know that those children have troubles throughout early <v Dr. Virginia Houstead>childhood in terms of-of lung problems. <v Dave Iverson>Still, those are future concerns. <v Dave Iverson>And parents learned quickly to take life one worry at a time. <v Mother> ?that's on us? <v Mother>?God? made you the miracle. <v Mother>?inaudible?

<v Dave Iverson>Suzy Hoover has two normal, healthy children. <v Dave Iverson>The products of two normal healthy pregnancies. <v Dave Iverson>She never expected anything else the third time. <v Suzy Hoover>You just don't realize how lucky you are when you have a normal, healthy baby, <v Suzy Hoover>and people trying to tell me that with my first 2 and I just always assumed I would. <v Suzy Hoover>Well, it was so unreal, I never dreamed that anything like this could happen to me. <v Suzy Hoover>All of a sudden you're on vacation and next week, you're having a baby. <v Suzy Hoover>I don't even have baby clothes taken out yet you know. <v Dave Iverson>When her membranes ruptured 11 weeks early and labor began, Suzy Hoover's Beloit doctors <v Dave Iverson>quickly sent her to Madison general. <v Dave Iverson>An emergency caesarean section was performed. <v Suzy Hoover>You know, when we came to the hospital, they gave her-gave her no chance of survival. <v Suzy Hoover>Hardly any, I mean, yea, it's like a slap in the face. <v Interviewer>Tell me what you see when <v Interviewer>you look at her right now. <v Suzy Hoover>Well, a miracle, but I know that this place is <v Suzy Hoover>just a place for miracles to happen.

<v Dave Iverson>A place for miracles to happen, if only they could always occur. <v Dave Iverson>Ashley, a baby born with an open spine, paralyzed from the waist down,

<v Dave Iverson>suffering significant brain damage and unable to breathe without a respirator. <v Dave Iverson>Her present and future are equally grim. <v Dr. Virginia Houstead>Developmentally when you're a tiny embryo. <v Dr. Virginia Houstead>There are some ridges of tissue that are supposed to move up and form a circle, that <v Dr. Virginia Houstead>encases the spine front and back, the spinal cord. <v Dr. Virginia Houstead>And in her case, it didn't do that. <v Dr. Virginia Houstead>It laid open so that there is no spinal column, there's no bones <v Dr. Virginia Houstead>in the back of her spine and the spinal cord itself lays open. <v Dr. Virginia Houstead>And at birth was in fact, opened to the air. <v Dr. Virginia Houstead>And she has very minimal movements. <v Dave Iverson>But it is the inability to ever be free of the respirator that troubles doctors most. <v Dave Iverson>Ashley will never be able to breathe on her own. <v Dave Iverson>For now, she is a prisoner to technology. <v Dave Iverson>The parents of special care children must accept shock and uncertainty, but

<v Dave Iverson>they are also given hope. <v Dave Iverson>For Ashley, hope is not part of the prognosis, for Ashley and her mother, <v Dave Iverson>time is not an ally, and yet time is all they have. <v Dave Iverson>Perhaps true courage is not only grace under pressure. <v Dave Iverson>Perhaps true courage is simply facing the future and knowing you'll face <v Dave Iverson>it alone. <v Dave Iverson>[Indistinct conversation] As dependent and fragile as each infant seems, <v Dave Iverson>they are in fact, independent personalities. <v Dave Iverson>Special care nurse Debbie Hamlay. <v Debbie Hamlay>I think each one of them is an individual and they show it and you <v Debbie Hamlay>get to know them like this one is really going to fuss and get mad if you do this or this <v Debbie Hamlay>one doesn't like it so bright, you know open their eyes. <v Debbie Hamlay>This one doesn't like to have blood ?guesses? drawn and knows you're going to do it.

<v Debbie Hamlay>The minute you wrap and heal with a warm diaper to heal them up, they drop their <v Debbie Hamlay>heart rate or they drop their oxygen saturation. <v Debbie Hamlay>They-I think they can learn. <v Debbie Hamlay>I think they do learn what we're gonna do them. <v Debbie Hamlay>From our touch and stuff. <v Dave Iverson>Tonight Debbie Hamlay is monitoring Christin Buchholz, a baby born three months <v Dave Iverson>premature, a baby whose every breath is a struggle. <v Debbie Hamlay>She opens her eyes and she moves around and she acts like she really is in <v Debbie Hamlay>there and she's going to let you know it. And then even when she's so tiny, she's got the <v Debbie Hamlay>energy to fight. <v Dave Iverson>This evening, Christin Buchholz will need the ability to fight. <v Dave Iverson>Her blood oxygen saturation level is dropping. <v Dave Iverson>The amount of oxygen Christin receives must continually be turned up. <v Debbie Hamlay>They can change in 10 seconds. <v Debbie Hamlay>Everything can change. <v Dave Iverson>Quickly, the air Christin is breathing through the ventilator must be turned all the way <v Dave Iverson>up to 100 percent oxygen.

<v Dave Iverson>Something is wrong. <v Debbie Hamlay>Come on Christin. Jill could you find the trans illuminator? <v Debbie Hamlay>I think she may have popped a ?nerve?. <v Dave Iverson>Christin may have suffered a pneumothorax, a condition where air leaks between the lung <v Dave Iverson>and the chest wall form a cavity that collapses the lung itself. <v Dave Iverson>A device called a trans illuminator is used to examine Christin. <v Dave Iverson>If her chest lights up, it will indicate a pneumothorax. <v Debbie Hamlay>On the right side, the left side are all going to light up when I do it no matter what. <v Debbie Hamlay>But that's worse too I think. <v Debbie Hamlay>Than last night anyways, this is what-[Indistinct dialogue] Yeah, I think so because I <v Debbie Hamlay>think she needs an X-ray anyways. <v Debbie Hamlay>It's not normal for her to be at 100%. <v Dave Iverson>X-rays are quickly taken to confirm the diagnosis. <v Nurses>[Indistinct conversations]. <v Nurses>Oh my god, that is it.

<v Nurses>OK. Get a better- You guys- How well how is she holding <v Nurses>up now? No, no, no. <v Nurses>Go ahead. Let's just go in there. <v Nurses>This is going on which side? Left side?. Left side, move to the left. <v Nurses>That's our favorite-Our favorite side. I may not be enough for you Want me to set up the <v Nurses>test tube? <v Nurse>This is an extremely large pneumothorax. <v Nurse>You can see this is the lung right here and all that is air around it, in the lung <v Nurse>normally would go all the way out to the ribs, and so there's just less than half of the <v Nurse>normal lung size there to do its job. <v Dave Iverson>The pneumothorax has collapsed the lung and is also exerting pressure on Christin's <v Dave Iverson>heart. A tube must now be placed in Christin's chest to let the air out <v Dave Iverson>and relieve the pressure. <v Nurses>[Indistinct conversation] Tell me what pressure it's reading. <v Nurses>16 over. Oh, good. <v Dave Iverson>A small incision is made in Christin's chest. <v Dave Iverson>Then a tube is guided into place.

<v Dave Iverson>The tube will allow the lung to re-expand. [Nurses talk to Christin] <v Dave Iverson>The procedure works, Christin's blood oxygen saturation level improves, the ventilator <v Dave Iverson>can be turned down from one hundred percent, Christin Buchholz is indeed a fighter. <v Debbie Hamlay>Hi, Gary. Hi, this is Debbie, I'm taking care of Christin tonight. <v Debbie Hamlay>Well um, she have had a pretty good evening until about 6:30, 7 o'clock. <v Debbie Hamlay>She started needing a lot more oxygen again. <v Dave Iverson>Late night phone calls they are anxiety-provoking for anyone. <v Dave Iverson>But for these parents, the anxiety is constant and that much more intense. <v Dave Iverson> Dr. Virginia Houstead. <v Dr. Virginia Houstead>Babies make a lot of backwards steps in the overall going forward of getting better, and <v Dr. Virginia Houstead>I think it's that that's hard for the parents is sort of adjusting to the fact that <v Dr. Virginia Houstead>it might be months before their baby is well enough to <v Dr. Virginia Houstead>carry around and treat like a normal baby.

<v Dr. Virginia Houstead>And that's hard. <v Dave Iverson>Gary and Vicki Buchholz, Christin's parents. <v Gary Buchholz>Can we touch her? <v Nurse>Sure, open it up. <v Vicki Buchholz>How are you feeling this morning huh? ?inaudible? It's mommy's little girl. <v Gary Buchholz>It's so hard to see 'em with all-all these tubes in 'em and <v Gary Buchholz>the nurses when they try to feed her I.V.. <v Gary Buchholz>It hurts. You know, I have such hopes on the good days and then you have the bad <v Gary Buchholz>days and then everything that you've gained you seem to lose. <v Gary Buchholz>But I guess you can't get too high on the highs and too low on the lows. <v Gary Buchholz>In a few short days, Gary and Vicki Buchholz have learned something about the limits of <v Gary Buchholz>parental power. Kristin weighs a little more than a glass of water. <v Gary Buchholz>And yet it is the parents who are powerless to help. <v Gary Buchholz>She's got a lot of healing to do and she has to do it all on her own. <v Dave Iverson>Kristin Buchholz and Megan Hooper, two babies who began life too

<v Dave Iverson>soon. They were born just two days apart, but their lives will soon <v Dave Iverson>develop in two different directions. <v Dave Iverson>Megan Hoover is now 3 weeks old and a landmark event is about to occur. <v Suzy Hoover>This is the big time, Megan. <v Dave Iverson>Suzy Hoover is about to hold her daughter for the first time. <v Nurse>Sometimes it takes just a little bit to get. <v Nurse>[Suzy speaks to her baby]. <v Suzy Hoover>[Indistinct conversations between nurses] I love you so much, you <v Suzy Hoover>just gotta get better and get bigger

<v Suzy Hoover>you know, I'm your mom, do you know, I'm your mama? <v Suzy Hoover>Is that why you're so wide awake? <v Dave Iverson>Megan has progressed well after such an extraordinary beginning, it is hard <v Dave Iverson>to believe in an ordinary future. <v Dave Iverson>And yet that is precisely what parents and hospital staff hope for. <v Dave Iverson>The ordinary, the average. <v Dr. Virginia Houstead>But in general, children who have been-who have had respiratory <v Dr. Virginia Houstead>distress syndrome of a-of a premature baby and have been taken care of on a respirator, <v Dr. Virginia Houstead>they generally do very well. The long term research studies that have looked at that say <v Dr. Virginia Houstead>that those children are pretty much functionally normal at school age and <v Dr. Virginia Houstead>run around and can play games and do everything else that other children can. <v Dr. Virginia Houstead>It doesn't usually inhibit their-their ability to play and <v Dr. Virginia Houstead>to be normal children. <v Dave Iverson>Most will grow up to be normal children.

<v Dave Iverson>Most, but not all. Ashley. <v Dave Iverson>A decision must be made. Ashley cannot live ever without extraordinary <v Dave Iverson>life support. Finally, doctors, staff, mother and a special <v Dave Iverson>hospital committee all agree it's time to let Ashley go. <v Dr. Virginia Houstead>You have to live with those decisions for a long time and <v Dr. Virginia Houstead>they aren't easily made. <v Dr. Virginia Houstead>But I-you know it colors it. <v Dr. Virginia Houstead>It colors the way-I don't know it colors you as a-as <v Dr. Virginia Houstead>a person. It changes you after you've been through 10 or 15 <v Dr. Virginia Houstead>experiences with families of a child dying. <v Dr. Virginia Houstead>It affects your life. Each one, I think, affects you in a little way <v Dave Iverson>Outside, it is Autumn, a time of beauty, a time when things pass on. <v Dave Iverson>In autumn, Ashley passes away. <v Dave Iverson>It is a hundred and twenty miles roundtrip from Madison to Beloit, a

<v Dave Iverson>journey the Hoovers have made over 80 times since late August, a journey they won't have <v Dave Iverson>to make anymore. In late Autumn, Megan Hoover comes home. <v Suzy Hoover>Hi, how do you like your new bed huh? <v Suzy Hoover>Got lots of room in this, it's different than your incubator. <v Mr. Hoover>She always seemed like a regular sized baby. <v Suzy Hoover>Can you say hi to your newest sisters huh? <v Suzy Hoover>Can you say hi to your new sisters? <v Suzy Hoover>What do you tell her?[Molly <v Suzy Hoover>says, "Hi"] You scoot over that way, Molly, OK? <v Suzy Hoover>Make room for Sissy so she can say hi to Megan too. <v Suzy Hoover>[Sissy says, "My shoe is stuck."] That's okay, take your other shoe off. <v Suzy Hoover>Be careful, don't ?kick? her up. [Suzy continues to talk to Megan]

<v Vicki Buchholz> Hey pumpkin, can you smile pretty? <v Vicki Buchholz>Awww such a pretty baby. <v Dave Iverson>Born just two days after Meghan Hoover, Christin Buchholz is now nearly 100 days old. <v Dave Iverson>One hundred days of life that were never supposed to happen [Conversation becomes <v Dave Iverson>indistinct] <v Vicki Buchholz>We pretty much compared Christin with Megan because they were so close. <v Vicki Buchholz>And now there's nobody to compare with anymore, and I ask myself,

<v Vicki Buchholz>why does you know just two days make that much difference? <v Vicki Buchholz>I guess the respirator can do that. <v Vicki Buchholz>Gets harder to come up here every day, watching all these other babies, I just ?don't <v Vicki Buchholz>want? to be here. <v Dave Iverson>Christin has chronic lung disease, a consequence of lengthy mechanical breathing. <v Dave Iverson>She still requires oxygen, and a minor brain hemorrhage has put Christin at risk for <v Dave Iverson>later developmental problems. <v Gary Buchholz>Every baby, I think was here have all gone. <v Gary Buchholz>She's been here for a long time. <v Gary Buchholz>What the doctors and the nurses have said is she's quite a rarity, <v Gary Buchholz>too, for them to have appear in and to even <v Gary Buchholz>survive. They kept on saying, boy, she is really a fighter. <v Gary Buchholz>[Vicki says, "She's a miracle baby"], I <v Gary Buchholz>know, I never thought that she wasn't going to make it.

<v Gary Buchholz>You know, just-just my own opinion that <v Gary Buchholz>she was part of me. And I know I know myself. <v Gary Buchholz>And I don't think nothing like uh <v Gary Buchholz>God wouldn't let something like that happen to us. <v Dave Iverson>Before Christin can leave the special care nursery. <v Dave Iverson>Her parents must learn things most parents never do. <v Dave Iverson>Emergency CPR techniques, home oxygen monitoring and how to give special <v Dave Iverson>developmental exercises. <v Gary and Instructor>4, 5 blow. 1 ?inaudible?. <v Gary and Instructor>Start again? It's continuous. <v Dave Iverson>It will be years before all of the unanswered questions surrounding Christin's <v Dave Iverson>development are resolved, but she is creeping closer to the baby she was expected <v Dave Iverson>to be closer to beginning life on her own. <v Dave Iverson>A prospect that leaves parents like Gary and Vicki both eager and anxious. <v Dave Iverson>Dr. Robert Pearlman. <v Dr. Robert Perelman>A family has had a-a life event which they never expected, <v Dr. Robert Perelman>have made it through that event with somebody that now they has been incorporated

<v Dr. Robert Perelman>into a part of themselves. <v Dr. Robert Perelman>It's a real person now. It's not just a small baby that couldn't possibly be <v Dr. Robert Perelman>mine. <v Dr. Robert Perelman>And there is a need to assure themselves that nothing's gonna happen. <v Dr. Robert Perelman>Can we do it? Can we do it by ourselves? <v Dr. Robert Perelman>After all this, we're not going to let anything happen. <v Dave Iverson>December 14th, ready and reassured. <v Dave Iverson>Gary and Vicki Buchholz can finally bring Christin home. <v Dave Iverson>She is now nearly four months old, a survivor of chronic lung disease, several <v Dave Iverson>collapsed lungs and countless chest tube procedures. <v Dave Iverson>She still will need extra oxygen at home, but home she will be. <v Vicki Buchholz>We're going to take you away from all your new friends, <v Vicki Buchholz>you come home and be with your mom and dad and your 2 sisters. <v Gary Buchholz>We're here to say goodbye. [Nurses say "Bye Christin, bye sweetie, keep in touch"]

<v Gary Buchholz>We sure will, thank you so much. <v Dave Iverson>They are the unexpected. Born too soon and too imperfect, <v Dave Iverson>though saved by technology. They are finally a fragile reminder of the human condition. <v Dave Iverson>They came in need of special care. <v Dave Iverson>And special care is what they receive.