Doctors waited as long as they could to deliver the pair, but when Karen arrived at Geisinger Medical Center for her appointment on April 16 – just 28 weeks into the pregnancy – maternal-fetal medicine specialists decided an emergency C-section also would need to be performed that day in order to give Christopher a chance. Both babies immediately would be admitted to the neonatal intensive care unit (NICU) at Geisinger’s Janet Weis Children’s Hospital, where they would receive specialized care: Christopher for the medical issues that started while in the womb and Caitlin for the complications of her premature birth. Both babies faced challenging fights for life. Unfortunately, Christopher’s difficulties and the growth restriction he experienced proved to be too severe to overcome. His body had not fully developed, and even with emergency medical treatment, he was not able to thrive. Two days after his birth, Christopher passed away. Karen and Paul had to say a difficult good-bye to their newborn son as they faced the possibility of losing Caitlin as well. The little girl weighed only 2 pounds. She was on a ventilator, suffering from respiratory distress, and was battling a number of complications from her early arrival, including both apnea and anemia of prematurity. Her odds of survival were good, doctors said, but it would be a long and uncertain road. “We knew we were in the NICU,” Paul says. “We knew that her life wasn’t guaranteed.” “With 28-week preemies, we look for two things,” says James Cook, MD, director of neonatology at Janet Weis Children’s Hospital. “The first, that their lungs begin to heal, which sometimes can take two to three days and sometimes can take two to three weeks. And second, that they are able to tolerate their nutrition through feedings instead of IVs.” Paul and Karen waited for signs of improvement with Caitlin. Even a weight gain of a pound seemed an overwhelming goal, and the list of diagnoses was extensive; she suffered from bronchopulmonary dysplasia, chemical rickets, hyperbilirubinemia that required phototherapy, a vitamin A deficiency, gastroesophageal reflux and retinopathy of prematurity, among others. Her resilience was especially tested near the fourth week, when she became very sick and, as Karen recalls, went downhill very quickly. That was when her parents’ fear peaked. But Caitlin was not ready to give in. She continued to battle medical issue after medical issue, and conquered each problem one at a time. After being in such a delicate state for such a long time, she finally was improving – and those improvements were happening more quickly than anyone had imagined. “After that fourth week, she started to get a lot better,” Karen says. “Then, right after Memorial Day weekend, she was able to go to Special Care. … Once things got on track, it happened pretty fast.” “It took Caitlin’s lungs a long time to get better, but she did do very well after that,” Dr. Cook says. “It doesn’t always happen quickly, but it did with Caitlin.” The move to the Neonatal Special Care Unit meant that Caitlin was improving and no longer needed the intensive care she had required for more than a month and a half. Karen and Paul say they knew at that point that their daughter was going to be okay. “It was like a parade from one room to the other,” Paul says. She continued to recover in the Special Care unit. Soon, she was discharged, and her parents were more than ready to take her home. A crowd of NICU staff members gathered outside as she was secured in the car, all wanting to say good-bye to the little girl. “We tend to hold our breath when babies are in the NICU because anything can happen. We’re always relieved when they can go home,” Dr. Cook says. Caitlin required a breathing monitor for a few months as a precaution, and she received early intervention services – both physical and occupational therapy – but now she is showing no signs of lasting effects. She is a thriving toddler who loves to be active, whether it’s having tea parties or playing at a nearby park, and she loves to show off her budding sense of humor to bring a smile to Mom and Dad. Paul and Karen remember Christopher fondly and keep him in their hearts and in their minds, celebrating his brief life. And as often as Caitlin brings a smile to both of them, they also are grateful to have her smile reminding them of how far she has come and how fortunate they are to have her. | 
