Tripler's NICU discharges smallest preemie

HONOLULU -- To the complete joy of his parents, baby Aidan, a premature twin, who spent 126 days in Tripler Army Medical Center's Neonatal Intensive Care Unit, finally joined brother Declan at home following his discharge April 20, here.

Chief Warrant Officer 2 James Klinkenberg, a geospatial technician with 70th Engineer Company, 65th Eng. Battalion, 130th Eng. Brigade, and his wife, Brandi, underwent successful in vitro fertilization at TAMC in July 2011. They were excited to find out that they were having twin boys, but the pregnancy didn't go exactly as they had hoped.

"We went in for our 20-week ultrasound to see how the twins were doing and found out I had a-typical preeclampsia, (a condition related to increased blood pressure and protein in the mother's urine)," Brandi said.

Brandi was able to carry the twins to 26 weeks when the doctors decided the babies needed to be delivered ahead of schedule. Brandi underwent an emergency cesarean section Dec. 16, 2011.

James said the whole situation changed very quickly.

"They said we wanted to (deliver) the babies now and we just kept thinking 'It's too early,'" he said.

Maj. Joseph Hudak, chief, Neonatal Intensive Care Medicine, TAMC, who has been involved in the twins' care since birth, said they were not developing normally and there was concern that the twins were under stress.

Aidan and Declan were delivered just a little over 3 1/2 months early. Aidan was born at just 14 ounces, while Declan, the older of the two, was born at 1 pound 10 ounces.

"Aidan, at 14 ounces, is the smallest birth weight infant to survive and be discharged from Tripler that we can identify," Hudak said.

Hudak explained that infants born as small Aidan and Declan run the risk for many complications after delivery.

"For infants that premature, being born is often too much for their bodies to handle," Hudak said. "The mother does a lot of things for the baby before it's born. (For example) the kidneys don't have to work well because the placenta is doing their work and the lungs do not do any work because they are not used before they are born.

"A stay in any ICU is a rollercoaster ride and it is extremely stressful for families," Hudak added.

As they faced many difficult decisions and situations with their babies, James and Brandi found that the NICU staff was there to support them during their difficult time.

"December 16 changed everything and all at once the doctors and nurses became our closest family and the people we relied on most," Brandi said, who spent every single day in the NICU that her sons were there.

"They became so important because we were looking to them to show us how to hold our children and care for them," James added.

Declan, who was discharged March 30, did not get to stay in Tripler's new single-room NICU like Aidan, but the parents were very happy with the renovations. They said they enjoyed the privacy and noise reduction that the new rooms offered.

Even though Aidan and Declan are at home with their family, they will still see their NICU family frequently.

"We have a follow-up clinic especially for the NICU babies every Monday afternoon," Hudak said. "They will be seen by their pediatrician, but we will follow infants like Aidan and Declan for months after they are discharged."

Hudak said his job is very rewarding but not for the reasons one might think.

"It's not rewarding that the size of the baby we have been able to discharge is smaller, it's more rewarding in the fact that this family had two infants that should never have been born as small as they were, but here we are seeing both of them going home and they are doing great," Hudak explained. "The part I enjoy is that this whole family, the family we started with, is still here and going home. James and Brandi get to enjoy their new babies."

"They are my miracle babies, from conception to birth," Brandi said. "They are just little miracles."