Being a mother of six, there isn't too much that surprises Latoya Murray. With children age 13 to 2, there is very little that she hasn't seen or dealt with.
However when her twin boys, Matthew and Michael McGregor, decided to come 13 weeks early, Latoya was a little unprepared.
"My son Adam, 13, was premature, about 32 weeks gestation," she said. "It prepared me a little bit but the twins were far worse than his case."
Latoya had the boys at her local community hospital by emergency c-section. Before the surgery, the hospital staff contacted Geisinger Janet Weis Children's Hospital to seek immediate specialized care for the boys.
"We got the call from the hospital that they would be delivering the babies and would need to transport them to Danville as quickly as possible," said James Cook, M.D., Director of Neonatology at Geisinger Janet Weis Children's Hospital.
Matthew weighed only 2.8 pounds while Michael weighed in at 2.9 pounds. Both boys had very underdeveloped lungs and doctors at the community hospital worked to keep them stabilized until they could be transported.
Latoya was in recovery and, at first, was unable to see the boys, which made things more stressful for her.
"I did get to see them just before they left on the Lifeflight® Medical Helicopter," Laytoya said. "They were placed on ventilators and both boys were in the same incubator. They were so tiny."
Because Latoya delivered urgently, doctors were unable to administer an injection of steroids to help with the development of the boys' lungs before birth.
At Geisinger Janet Weis Children's Hospital Neonatal Intensive Care Unit, Matthew and Michael required a great deal of support for their breathing.
For Latoya, being away from her newborns was very difficult. Because of her emergency c-section, she was unable to leave the hospital with her boys. It was four days until Latoya was able to join her newborns in Danville.
"I remember calling when I was in recovery and the helicopter hadn't even made it there yet," she said. "I was just so worried about them. When they did make it to the hospital and were being shuttled in, they told me they were still having trouble but they were in good hands. It was a relief when I got there and saw what good hands they were in. The nurses and doctors were really good with the boys. They cared for them just like I would."
With their underdeveloped lungs, the boys needed specialized equipment to help them survive.
"Their lungs were very sick. They needed high frequency oscillatory ventilation, which is what we use when babies lungs are very stiff," Dr. Cook said. "Both boys were on high frequency ventilation for about a week. These specialized ventilators provide a more gentle way to assist babies' breathing."
Matthew and Michael were given doses of surfactant, which is a mixture of fat and proteins made in the lungs that coat the air sacs and prevent them from sticking together when exhaling. Most premature babies only need one or two doses, but the twins needed four doses.
"Michael had a much more difficult course than Matthew did. Michael's lung disease was a little more severe and he suffered problems with his digestive system," Dr. Cook said. "He had difficulty tolerating any kind of feeding, formula or milk, and needed surgery to help with that."
Michael was diagnosed with acid reflux which was starting to damage his esophagus. The gastroenterology team decided to treat the condition with fundoplication surgery, a procedure to strengthen the valve between the esophagus and stomach to stop acid from backing up. Gastroenterologists also inserted a feeding tube, or G-tube, to help Michael receive nourishment and get stronger.
After about a week the McGregor boys were removed from the high frequency ventilators and were placed on conventional ventilators for seven more days. After the ventilators were removed, the boys were placed on continuous positive airway pressure, or CPAP, for another two weeks.
Matthew recovered more quickly and was discharged the day before his original due date. With the combination of digestive problems and his lung disease, Michael's stay was prolonged, and he spent nearly 5 months in the NICU.
"I stayed at the Ronald McDonald House of Danville®," Latoya said. "My two oldest children were home with my mom and I would travel back and forth every now and then, but I mostly stayed in Danville. It is about a 2 ½ hour drive from our home to the hospital."
Before Michael could be discharged and because of the medications he was prescribed and the equipment he was going home with, the neonatologists asked that Latoya spend a few days in the NICU to learn how to care for him.
"Michael had several medications, oxygen and the G-tube after his discharge. Mom did an exceptional job learning how to care for him," Dr. Cook said.
The boys are now 9 and will turn 10 in July. Matthew has had no major medical problems since his NICU stay.
"Matthew is pretty much healthy," Latoya said. "He had RSV (respiratory syncytial virus) a few times when he was a baby and was admitted to the hospital for 7 days, but other than that, he really doesn't get sick much. He is close to 60 pounds and is much bigger than Michael."
Michael had some additional breathing and digestive issues after his discharge. He is currently followed at the Geisinger Janet Weis Children's Hospital Outreach Clinic in Towanda for asthma by Carlos Perez, M.D., pediatric pulmonologist, and for stomach issues by John Peters, D.O., pediatric gastroenterologist.
"He is on a few medications for his stomach and breathing, but he has recovered," Latoya said. "He developed dumping syndrome (in which his body had trouble absorbing nutrients)and had a hard time gaining weight. Because of the dumping syndrome, his blood sugar levels are unstable. He takes a medicine to regulate his blood sugar and he actually finally hit the 50 pound mark."
Both boys are in third grade and enjoy video games and playing outside. Matthew wants to be a fireman, while Michael wants to be a doctor "like Dr. John Peters," which pleases Latoya.
"I am so happy with the care we have received at Geisinger," she said. "I don't think they would have survived if it wasn't for all the doctors and nurses. After all they have been through and the great work that Geisinger has done, I think my boys are miracles."
Equipment in the Neonatal Intensive Care Unit such as respirators, ventilators and the high frequency oscillation ventilators used for Matthew and Michael's care were funded by Children's Miracle Network at Geisinger. Incubators, like the one the twins were transported in by LifeFlight®, also are purchased with donations.