Saving Gage — How MVH NICU team and parental touch saved gravely ill newborn
Few gave little Gage Anderson Conger much of a chance.
He and his twin sister, Kennedy Eve, were born 17 weeks early, after all, right on the cusp of viability outside the womb. So when Gage’s health started failing seven days after his June 2012 birth, the medical staff of the Neonatal Intensive Care Unit at Miami Valley Hospital felt the end was near for this struggling, 1-pound-5-ounce infant.
First-time parents Jessica and David Conger of Miamisburg braced themselves. As a hospice nurse, Jessica knew death all too well, what it’s like to comfort and care for dying patients in the final hours of their lives. She had seen in her career how prolonging a patient’s care could also prolong the patient’s agony. So she and David requested Gage be given a “DNR” (Do Not Resuscitate) status, meaning no extraordinary measures would be taken to save Gage’s life once he went into cardiac arrest.
Then they prayed for a miracle.
Healing touch
Jessica remembers telling the NICU staff she wanted to hold her son, that she didn’t want Gage to die alone in the controlled, sterile environment of his Isolette, a modern-day incubator. “I want him to be with his mom or dad because that’s where he’s supposed to be,” she told Gage’s nurse, Kay Hirst, RN.
Hirst, a 17-year veteran of the NICU, suggested Jessica hold her son on her chest, “skin-to-skin.” The practice is believed to provide a psychological and physiological benefit between a mother and baby immediately after birth and later, especially if the baby is pre-term. It’s believed the contact promotes attachment and bonding, helps stabilize the infant’s temperature and heart and breathing rates. Babies seem happier, more relaxed.
“We do a lot of skin-to-skin, we encourage it all the time,” says one of Gage’s doctors, MVH neonatologist Prakruti Jambula, MD. “There was really nothing else we could offer Gage and his parents at that time, though we continued to do what we could medically. We just wanted the family to have some happy memories of what we thought were his final days.”
Gage, in acute renal failure and respiratory distress, looked ashen and puffy on his mother’s chest. He stayed connected to his lifelines — a ventilator to help him breathe, IV tubes that delivered medicine and a nasogastric tube that provided nutrition — while blankets and his mother’s body heat warmed his little body.
Hirst went home at the end of her shift and cried, certain Gage would be gone by the time she returned the next morning.
Saying goodbye
When nurse Debra Tankersley started her evening shift, she found an exhausted couple wracked by grief, drained physically and emotionally. She parked two rocking recliners called kangaroo chairs side-by-side, where Jessica and David, a middle school math teacher, took turns holding their son, always skin-to-skin.
“I just kept stroking him and telling him every minute I held him that I loved him,” Jessica recalls. “I was sobbing and praying, saying goodbye…”
Kennedy, meanwhile, remained critically ill but stable in her room next door, showing none of the troubles that were sapping the life out of her little brother, who was two minutes younger and two ounces lighter at birth. “She was fantastic,” Jessica recalls, smiling. “I think that was her way of helping us so we could focus on Gage.”
The hours ticked by. Five hours, eight hours, 14 hours. Friends, family and grandparents came and went. They prayed, they cried, they discussed funeral plans. “We were just waiting for him to pass,” Jessica says, “but he wouldn’t.”
‘I smell urine’
After 21 hours of skin-to-skin, nurse Kay Hirst was back on duty when she and the Congers noticed a strong urine aroma coming from Gage, strange for a baby in renal failure.
“Sure enough, he had a big, ol’ wet diaper,” Hirst says with a smile. “As soon as I smelled urine, I was happy, but I didn’t want to let on because it still could’ve turned out bad for Gage. I was cautiously optimistic.”
Soon after, Gage’s vital signs started perking up, too, and his blood urea nitrogen level, a measure of how well one’s kidneys are working, began falling to normal levels. Still, the Congers clung to Gage, and for another 15 hours they hoped, prayed and caressed their tiny son as a baffled medical staff watched him climb back from what seemed like certain death just a day earlier.
Finally, after 36 hours on his parents’ chests, doctors determined Gage was well enough to go back to his Isolette and get on with his life.
“It was a bit of a shock to all of us,” says Dr. Jambula, adding that she nor her colleagues had ever seen such a turnaround. “We definitely did everything we could medically, but something more than medicine helped in this case.”
Says Tankersley, the second-shift nurse: “I’ve done this 30 years and I’ve never seen anything like it. I’ve never seen a baby that close to death pull through the way he did and be as healthy as he is today. I truly believe it was the skin-to-skin contact that brought him back.”
Hirst, who still gets a chill thinking about it, calls Gage “a miracle.”
“Medicine didn’t save Gage,” she insists. “His parents did.”
Gage and Kennedy lived in the NICU for nearly five more months. Kennedy went home Nov. 3, followed by Gage on Nov. 19, three days before Thanksgiving.
“As we walked out of the NICU as a family, we had so much to be thankful for,” Jessica remembers. “Most of all, we were thankful that we were able to do just that — leave as a family.”