Her birth became a pivotal experience for the budding neonatal team at BryanLGH Medical Center East, which is building its program to compete head-to-head with the neonatal intensive care unit at Saint Eli
MARK ANDERSEN / Lincoln Journal Star | Posted: Thursday, March 20, 2008 7:00 pm
It wasn’t an emergency yet, but something seemed wrong.
Dr. Cory Friesen ordered a non-stress test for Marla Shelton, who was two weeks short of full term — and scared.
She hadn’t felt the baby move since at least mid-afternoon of the previous day, and her paranoia had grown to panic by 3 a.m., when she and her husband poked fruitlessly at her stomach.
Later that morning in the doctor’s office, the baby’s heartbeat was a normal 155.
“Thank you, God,” Shelton remembers saying out loud.
Still, something was not right.
Friesen, an ob-gyn, heard the ultrasound tech’s urgent page overhead and hurried in just in time to watch the fetal heartbeat drop from 130 to 50 in a matter of seconds.
Marla Shelton heard him swear, then say, “I don’t know if this baby’s going to make it.”
He called the BryanLGH delivery operating room in an adjoining building as he and the tech pushed and pulled Shelton on a surreal wheelchair trip through the hospital. Doors and people seemed to melt out of the way, Shelton recalled.
If there was a chance of success, Friesen told her on the run, they’d go in for the baby.
She called her husband.
“I’m going in for an emergency C-section, and they don’t know if the baby is going to make it.”
They hung up.
“Please, God,” she said as they raced through the halls.
“Please, God.”
Watching smiling, giggling 9-month-old Addison Shelton play on the floor of her parent’s southwest Lincoln home today, it’s hard to fathom that her first 16, 18 or 19 minutes were spent without a pulse or a normal breath.
Just how long she lay there limp and blue depends on the recollections of the storyteller. All agree it was more than a quarter hour.
Her birth became a pivotal experience for the budding neonatal team at BryanLGH Medical Center East, which is building its program to compete head-to-head with the neonatal intensive care unit at Saint Elizabeth Regional Medical Center.
BryanLGH will open its maternal/child tower this summer.
Dr. Albert Owusu-Ansah, the new program’s neonatalogist, saw a lot of infants in precarious health during his 13 years at what used to be called Cook County Hospital in Chicago, now called John Stroger Hospital.
That’s what a neonatalogist does, said Ansah, who came to Lincoln a year ago March 1.
Not all his stories end happily.
Medical protocols used to call for 15 minutes of lifesaving efforts once artificial breathing was begun, Ansah said, but many children were born with lifelong brain damage. New protocols say to continue lifesaving efforts for 10 minutes after adequate ventilation.
But this isn’t a story about hospital competition, pregnancy risks or even medical proficiency.
This is Addison’s story.
More than a dozen nurses, doctors and techs grabbed at Marla Shelton as she entered the operating room. Some stripped off her street clothes while others hooked up IVs.
“I remember Dr. Friesen saying, ‘Just pour it on,’” probably referring to germ killer, she recalls.
Then she heard him say something like: “We’re going in.”
As her world went dark, she focused on the slim chance her baby would be OK.
Friesen said he checked the fetus again with an ultrasound as hands swarmed over Marla, and he saw what looked like agonal heartbeats, a couple of seconds apart.
“We’ve at least got to give it a chance,” he thought.
Fewer than 10 minutes transpired from the moment the baby’s heart rate declined to the moment Friesen handed her off — limp, not breathing, no pulse — to Ansah and the team.
That was at 11:16 a.m., June 7, 2007.
Aaron Shelton, driving his pickup from a construction site to the hospital, called his wife’s cell. An ultrasound tech answered.
The baby girl is out. They’re working on her.
“So,” he recalls saying, “I have a girl.”
And his wife?
Fine.
He was at her side when she awoke from anesthesia an hour later. He passed on Friesen’s answer to the big question: “I don’t know.”
There must have been a heartbeat, Ansah said recently. “You can’t get the dead to come back to life.”
He had placed a tube down Addison’s throat and handed off the squeeze balloon. Every 30 seconds, he interrupted CPR to listen for a heartbeat.
“We just kept going,” said Laurie Ketterl, nurse manager of the maternal child center. At one point, she heard Ansah say he thought he heard a single heartbeat.
At least 15 minutes passed.
Ansah ordered a third shot of epinephrine into Addison’s cord.
And then, “Do you see what I see?” Ketterl recalls asking.
The bluish baby was beginning to pink up.
It was the first time everyone had worked with Ansah as a team, Ketterl said.
“We all felt like we had little guardian angels.”
To this day, Friesen said, nobody knows what went wrong before Addison’s birth.
It could have been any number of things, Ansah said. A cord accident. The placenta separating from the uterus.
“There are so many possibilities,” he said.
After the agonizingly long resuscitation, Addison’s heart was beating strong, and she was trying to breathe on her own. She remained on a ventilator.
At the time, there was no way to determine the extent of damage.
Sometimes, even for a child whose breathing has stabilized, Ansah said, enough brain damage has occurred that the baby cannot live off a ventilator. And some babies who make it this far don’t survive.
Marla and Aaron Shelton met their daughter briefly a few hours later, as she was being prepared for transport to the Saint Elizabeth NICU. At the time, Ketterl said, BryanLGH wasn’t ready for a baby with her complications.
The Sheltons agreed on a name: Addison Grace.
Addison didn’t move at all in those first few days, and then it was to twitch.
The family kept vigil. It was draining.
The doctors talked, but what did it all mean? On the third day, Aaron Shelton recalled, they finally asked: “Is she going to live?”
Yes. Based on her improvement since she first arrived, there was no reason to think she wouldn’t live.
Nine months later, nobody can provide all the answers to how she recovered.
“They don’t know,” Aaron Shelton said. “She’ll show us what she can do.”
The Sheltons wanted what all parents want for their children. They wanted Addison to be perfect and beautiful.
At first, Marla Shelton said, it seemed that wouldn’t happen.
When Addison opened her eyes, they rolled back into her head.
She had lost the instinct to suck and swallow. She made no sound. Her parents despaired.
And then the good happened.
“When she first started crying,” her mother said, “We were so happy.”
After 4½ weeks, they took her home.
“She’ll be perfect for who she is,” said her dad.
They celebrate the achievements they took for granted with their first child, 3-year-old Connor.
Drinking on her own from a bottle. Waving bye-bye.
Addison started playing patty-cake a few days ago. And raising her arms — so big.
“Ours is a happy story,” Aaron Shelton said. “She’s perfect for who she is.”
The constant therapy sessions, the muscle stretching, the special way they’ve been taught to hold her to help strengthen her neck, the eye patch she wore — it’s all routine.
Babbling, blue-eyed and blond, Addison bounces on Marla Shelton’s lap, the picture of a happy, healthy child.
“She’s a little miracle,” said her mother.
Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.