An Unexpected Journey

Jeneva Sotello and her husband Vernon Kistler were surprised when they discovered they were expecting another baby. They hadn’t planned on welcoming a new addition, and they were initially stressed and worried about how they would manage with an already full household. But they soon embraced the idea and couldn’t wait for Baby Vernon’s arrival.

Because she had no problems during pregnancy, Jeneva decided to deliver Baby Vernon at CHIRSTUS Santa Rosa Hospital – Westover Hills. The couple didn’t anticipate needing access to a level IV neonatal intensive care unit (NICU) and weren’t expecting anything out of the ordinary. However, as soon as Baby Vernon was born, he would need to be transferred to The Children’s Hospital of San Antonio (CHofSA) because he had trouble breathing.

“I barely got to see him after delivery. The nurses took him immediately and then informed me that he would need to be transferred because he was in distress,” said Jeneva. “I got to give him a quick kiss, and then they whisked him away.”

Jeneva had to spend the night in the hospital because doctors wanted to monitor her after giving birth; she would have to wait until the next day to see Vernon again.

“As soon as I was discharged, I headed over to CHofSA so I could see my baby. The doctors had Vernon connected to a bunch of machines and were giving him lots of medication because he wasn’t responding to any of the other treatments,” said Jeneva. “It was a scary sight.”

Vernon had a condition called meconium aspiration syndrome. It happens when a baby breathes a mixture of meconium and amniotic fluid into the lungs right around the time of birth. Meconium is an early stool that a baby passes soon after delivery; sometimes, like in Vernon’s case, it happens when the baby is still inside the uterus. If not immediately addressed, meconium aspiration can make a baby extremely sick and even cause death. Meconium stain amniotic fluid occurs in one of 10 pregnancies, with 5 percent of these infants developing meconium aspiration syndrome.

Because Vernon had meconium aspiration syndrome, he was at risk of developing hypoxic-ischemic encephalopathy (HIE). A neonatal brain injury, HIE occurs when a baby’s brain does not receive oxygen and can cause brain impairments, including epilepsy, developmental delays and motor and cognitive skill problems.

Dr. Maria Pierce, medical director of the Neonatal Intensive Care Unit at The Children’s Hospital of San Antonio, used a whole body cooling technique to lower Vernon’s body temperature.

Dr. Maria Pierce, a neonatologist at CHofSA, initiated a procedure called whole body cooling to help lower Vernon’s body temperature. The process helps slow down the brain’s metabolism to prevent further damage. His care team also placed Vernon on an extracorporeal membrane oxygenation (ECMO) watch. ECMO is a heart and lung bypass machine that pumps and oxygenates blood outside the body allowing the heart and lungs to rest until they have time to recover. CHofSA is one of only a few centers in the region that can perform ECMO to support these babies.

Thankfully, Vernon never needed ECMO because as soon as Jeneva arrived and was able to be near Vernon, he started to turn a corner. His breathing and other vital signs steadily improved.

“It was like Vernon knew his mom was near and could relax,” said Jeneva. “From there, he just continued to get stronger and better.”   

Vernon spent 40 days in the Neonatal Intensive Care Unit at The Children’s Hospital of San Antonio. Doctors monitored him closely and were ready to use ECMO as a life-saving measure. Fortunately, his condition improved and ECMO was not needed.

Jeneva and her husband were relieved that Vernon was improving. They had never experienced anything like this with their other children, so everything was somewhat chaotic.

“We just didn’t know what to expect, and it was overwhelming going back and forth to the hospital while managing our other kids and our home-based business,” said Jeneva. “And not knowing how much longer he would have to stay in the NICU was hard, too.”

Vernon was born on January 28 and spent 40 days in the NICU at CHofSA before being discharged on March 9. 

Since he’s been home, Vernon has been doing really well. He’s been growing and is always hungry.

Jeneva says Vernon is always smiling, and the other kids love to play and talk to him. He has reached several milestones, and doctors expect him to grow into a normal, healthy child.

Although Vernon’s experience was stressful for their family, Jeneva and her husband know they were in the right place at the right time.

“All of the nurses and the doctors who took care of Vernon were incredible, especially Dr. Pierce. She would always keep me updated no matter what,” said Jeneva. “I couldn’t always be at the hospital because I had other kids to take care of, but I know Vernon was always in good hands, and I didn’t have to worry constantly.”

When asked about what Jeneva would say to other mothers facing similar circumstances, she said she would tell them to lean into prayer and leave it in God’s hands.

“The whole time we were going through everything at CHOSA, I just kept believing that everything was going to be OK, and it was. I had every faith in the doctors and the rest of the care team and knew in my heart that everything would be all right,” she said.

To learn more about the Level IV NICU at The Children’s Hospital of San Antonio, please visit: https://www.christushealth.org/childrens/services-treatments/nicu.

A Prayerful Journey for Jonah

Sylvia and Matt Arismendez were thrilled when they heard they were pregnant with their fifth child. They were looking forward to a new bundle of joy to love.

All of Sylvia’s other pregnancies were normal in that neither she nor her babies experienced any major complications. But this pregnancy was shaping up a little differently. Not only did Sylvia have gestational diabetes, but she had an excess amount of amniotic fluid, which can lead to pre-term labor and other issues. In addition, they also learned that their unborn baby had a condition known as right-sided congenital diaphragmatic hernia or R-CDH.

CDH occurs when the diaphragm, the muscle that separates the chest from the abdomen, doesn’t close during prenatal development. The baby’s abdominal organs push (herniate) through the defect into the chest cavity impacting the baby’s developing lungs.

“Along with learning all the aspects of this condition, we also discovered that it’s extremely rare,” said Sylvia. “And the chances of survival, especially for a right-sided diaphragmatic hernia, are extremely low.”

CDH has a prevalence of about 1-4 per 10,000 births, of which approximately 85% are left-sided (L-CDH), 13% are right-sided (R-CDH), and 2% are both sides. At first, Sylvia and Matt were told that their baby – who they would eventually name Jonah – had a 30 – 40% chance of survival. But, as they met with more specialists, that survival rate dwindled to only 5% – something Sylvia and Matt were not prepared to hear.

“At this point in our journey, we were being told that Jonah’s only option would be palliative care and that there was nothing that doctors could do to save his life,” said Sylvia.

They were determined to find another way to help Jonah and weren’t going down without a fight. So, they prayed and began exploring other possibilities.

 When they learned about a hospital in Houston that delivered CDH babies, they decided they would pursue that route and then discovered that The Children’s Hospital of San Antonio (CHofSA) provided the same services. It was right in their own backyard.

“I had a 2-year-old, 4-year-old, 6-year-old, and 8-year-old enrolled in homeschooling, and my husband was working full time. So, it was not ideal for us to pick up and go to Houston,” said Sylvia. “At the same time, we wanted to give Jonah a fighting chance and decided to inquire about what CHofSA could do to help him.”

As soon as she made the call to CHofSA, Sylvia knew they had made the right decision. That was on a Friday. On Monday, she met with Dr. Cody Henderson, neonatologist, and Dr. Katherine Barsness, Jonah’s surgeon.

Dr. Cody Henderson was among the first doctors to meet with the Arismendez family to discuss Jonah’s condition before he was even born.

The minute they walked into the hospital, Sylvia said she and Matt felt a sense of peace. Since they were devoted Catholics, the couple was comforted by all the images of Mary, Joseph, and Jesus surrounding them. 

Once again, they heard the odds were not in their favor and that Jonah had a slim chance of survival. So, they and the doctors both relied on the power of prayer. Sylvia remembers Dr. Barsness telling them the care team would pray before Jonah’s procedure, during and after. She also told Sylvia that they would do everything in their power to keep Jonah alive.

The Arismendez family were relieved to know that the expertise of surgeons like Dr. Katherine Barsness are available in San Antonio. They thought they needed to uproot their family and move to Houston to be closer to the kind of care he would need.

At this point, Sylvia was about 35 weeks into her pregnancy. To help Jonah have the best possible outcome and allow his little lungs to grow, they decided it would be best to try and get Sylvia as close to 40 weeks as possible.

Doctors scheduled Sylvia to have her C-section at 38 weeks on November 2, 2021. To the surprise of her physicians, her level of amniotic fluid reduced and went back to normal right before Jonah was born. It rarely happens and perhaps would help Jonah have a positive outcome.

“I remember the room was full of nurses and specialists ready to assist as soon as Jonah was born,” said Sylvia. “I had prepared myself for the idea that they would not give him a chance to cry. They needed to get him intubated as quickly as possible.”

Sylvia and Matt had a minister on hand to baptize Jonah right away, just in case things took a wrong turn. It was not until that evening that she was able to visit Jonah in the Neonatal Intensive Care Unit (NICU) and lay eyes on her newborn baby. She learned that he had been immediately intubated and placed on extracorporeal membrane oxygenation (ECMO). The ECMO machine is similar to the heart-lung by-pass machine used in open-heart surgery. It pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest.

Jonah stayed on ECMO for six days. Sylvia and Matt later found out that it’s a regular practice for CHofSA to keep babies on ECMO for a maximum of two to three weeks because it thins their blood and increases the risk of having a seizure or stroke. Jonah did experience over 30 seizures and had a significant stroke while he was on ECMO. He wouldn’t have survived if the doctors had taken him off too early.

Jonah was off ECMO and had reached a major milestone. His next milestone would be surviving surgery.

When he was seven days old, Jonah had surgery to repair the CDH. Dr. Barsness explained to Sylvia and Matt that there was a chance that when they moved Jonah’s organs to the right cavities that his intestines may not fit, and they would have to create a pocket outside of his body until everything settled into place.

“It sounded scary, but the doctors assured us that it was normal,” said Sylvia.

Sylvia and Matt once again turned to prayer and asked everyone they knew to pray for baby Jonah. At one point, thousands of people were lifting Jonah in prayer. People from all across the world – people Sylvia and Matt didn’t even know – were praying for their baby.

Matt held his son Jonah as he recovered from surgery in the Neonatal Intensive Care Unit at The Children’s Hospital of San Antonio. The family relied heavily on their faith in God and confidence in the medical staff who cared for Jonah.

Once again, Jonah defied the odds. Doctors were able to make sure all of his organs and intestines fit. It was yet another miracle, and another prayer answered.

 “We felt God’s presence every step of the way. We knew that He was taking care of us, and we needed to trust that He was providing all the resources we needed. He had guided us to the right people when we needed them, and he helped us make the right decision for Jonah,” said Sylvia.

Jonah was turning a corner but had a couple of challenges ahead of him. First, he needed to be weaned off morphine, something Sylvia said was tough on him. After all, Jonah had been on the drug for the first two and half months of his life. He also would need a tracheostomy, a small, surgical opening through the neck into his windpipe to help him breathe better. He also was going to need a gastrostomy tube to help him eat. Despite developing multiple infections, including a bout with pneumonia, Jonah recovered and eventually was able to go home.

After four months in the NICU, Jonah was finally ready to go home with his parents Sylvia and Matt.

In total, Jonah spent four months in the NICU.

Sylvia and Matt were grateful for the physicians: Drs. Pratik Parikh, who became his main neonatologist, Dr. Barsness along with a team of other neonatologists, our occupational therapist, physical therapist, respiratory therapist and the nurses who took such great care of Jonah every step of the way.

Dr. Pratik Parikh was Jonah’s primary neonatologist during the four months that he spent in the NICU.

“Our two main nurses were Madison and Rachel. They were so wonderful with Jonah and became familiar faces to him. You could tell they cared a lot about him, which meant a lot to me,” said Sylvia.

Every time they hit a bump in the road with Jonah’s care, everyone prayed: Sylvia, Matt, the doctors, and the nurses. Sylvia said everyone on the care team was so compassionate and caring, but what impressed her the most was how they relied on God to lead them.

Now that he is at home, Jonah has progressed quickly. Sylvia says he’s active, and when he goes to physical, occupational or speech therapy, they are blown away by his development.

“They can’t believe that he was in the NICU for so long and yet is so strong and is picking up on many things,” said Sylvia. “Overall, he’s doing exceptionally well, and the doctors expect him to be a normal functioning child as he continues to grow.”

After leaving the hospital, Jonah has continued to thrive with the help of physical therapy.

It was believed that Jonah’s right lung may never function. But, once again, Jonah has defied the odds – his left lung is completely inflated, and his right one is functioning. Sylvia believes it’s the result of fervent prayer and the care he received at CHofSA.

“My hope for Jonah is that he will become a strong man physically, mentally and emotionally,” said Sylvia. “I want him to be able to share his story and serve as a beacon of hope to others.”

To learn more about the general surgery department at CHofSA, please see: https://www.christushealth.org/childrens/services-treatments/surgery/pediatric-general-surgery. To learn more about the NICU, please see: https://www.christushealth.org/childrens/services-treatments/nicu

An unexpected miracle

For as long as she can remember, Rebekah Jowers knew it would be difficult to get pregnant. In 2017, she was diagnosed with Polycystic Ovary Syndrome (PCOS), a hormone imbalance disorder that causes small cysts to form on the ovaries. It was normal for Rebekah to skip her periods for several months or even years. If she was pregnant, a missed period wouldn’t be a clear indicator.

While Rebekah and her fiancé, Logan, were eager to start a family, they knew their dream may not happen, but they clung to hope even though they were hanging by a thread. Rebekah’s biggest dream was becoming a mom. Little did she know, things happen when least expected.

“A few days after my fiancé and I went out for dinner, I started feeling very ill,” said Rebekah. “I couldn’t keep anything down. At first, I thought I had food poisoning. When my symptoms persisted for several days, I went to the emergency room. They gave me IV fluids and a pregnancy test which I didn’t think much about. To my surprise, the nurse told me my test came back positive! I was like, ‘What? Are you sure this is right?’ And she said, ‘Yes, you are pregnant. Congratulations!’ It took me a few minutes to process what I just heard. It was a jaw dropping moment for me because I thought I could never conceive a baby. I have PCOS and the chances of me getting pregnant were slim to none. When I told Logan the news, he was as surprised as I was! It was an amazing moment for us.”

Rebekah and Logan were surprised to learn she was pregnant, but happily anticipated their baby’s arrival.

While Rebekah had frequent bouts of morning sickness during the first three months, her baby was growing and developing normally. Her obstetrician, Dr. George Cajas at the Women’s Center at Westover Hills, requested weekly ultrasound visits and her baby was very active and loved to stand up and dance in her belly.

“I love dancing so my baby picked up on that,” said Rebekah. “During my second trimester, Logan and I found out we were expecting a girl. As my pregnancy progressed, I noticed she wasn’t as active, so I went to the ER to make sure she was still breathing.  And sure enough, when we saw and heard her heartbeat on the ultrasound monitor, we knew our baby was fine. Since I’m a physically active person, the doctors told me I basically rocked my baby to sleep in my belly. I put her in a deep sleep and that is why she wasn’t moving as much. They told me to lay down in a dark room and drink lots of cold water to wake her up. Sure enough, it worked. She started moving again.”

When Rebekah was 37 weeks pregnant, she began having Braxton Hicks contractions. She was doing everything possible to alleviate the contractions. She’d walk, perform breathing exercises, and move back and forth on a bouncing ball. While it seemed to calm down the contractions, she began having more frequent contractions several days later. At 39 weeks, she was put into the hospital and labor was induced. Her nurses evaluated her progress and noticed the baby’s heart rate was dropping. Whenever Rebekah rolled over to her left side, the baby’s heart rate would go down and so would Rebekah’s blood pressure. But, when Rebekah rolled over to her right side, the baby’s heart rate would go up again, and Rebekah’s blood pressure would return to normal. Her nurses were a bit concerned and monitored Rebekah and her baby more frequently.

“My labor wasn’t progressing well,” said Rebekah. “At that point, I was given medicine to speed up my contractions. As I was going through labor, my nurses checked the ultrasound monitor and they noticed that my baby had ingested meconium (her first stool) which can lead to serious breathing problems after birth.  As a result, my obstetrician determined it was best to deliver my baby right away.  As I was being prepped for an emergency C-section, my fiancé and I were so nervous. Up until this point, I had an uneventful pregnancy. We tried to stay positive and basically roll with the punches.”

On November 12, the couple welcomed their daughter, Paisleigh, who was born at 39 weeks, and weighed 8 pounds, 4 ounces. Immediately after she was born, Paisleigh was transferred to The Children’s Hospital of San Antonio (CHofSA) since they had a level IV neonatal intensive care unit (NICU).

“As a new mother, it was heart-breaking to see my baby in an incubator hooked up to everything you could imagine,” said Rebekah. “She was on oxygen and connected to different machines. My daughter wasn’t moving, and it was hard to see her in this condition. I was glad she made it here.”

When Paisleigh arrived, she was put under the care of neonatologist Dr. Cheryl Motta and Dr. Maria Pierce, a neonatal medicine physician who provides care for infants with persistent pulmonary hypertension and those in need of extracorporeal membrane oxygenation (ECMO). CHofSA is one of the only children’s hospitals in the region providing this advanced life-saving treatment for infants.

Paisleigh was treated for meconium aspiration, which occurs when a baby ingests amniotic fluid containing meconium (baby’s first stool) into their lungs. When these particles stick to the lungs, it can prevent a baby from breathing properly resulting in respiratory distress. In Paisleigh’s case, she developed persistent pulmonary hypertension, or high blood pressure in her lungs, due to the meconium build-up which restricted the flow of blood into her lungs where it normally picks up oxygen.

Paisley was transferred to The Children’s Hospital of San Antonio Level IV NICU to receive expert care including ECMO treatment.

“When treating pulmonary hypertension, our primary goal is to increase oxygen flow to the baby’s organs to prevent further complications,” said Pierce. “Severe meconium aspiration and pulmonary hypertension can be fatal. Our team responded quickly and gave Paisleigh the care she needed. To help her lungs recover and heal, we placed her on ECMO for several days, which is a heart-lung bypass machine that takes over the baby’s heart and lung functions and delivers oxygen to the brain and other parts of the body. ECMO is the highest form of life support that can be provided to a critically ill infant. We are fortunate to have the resources available to be able to offer it here at CHofSA.”

Paisleigh spent 18 days in the NICU under the care of Drs. Maria Pierce and Cheryl Motta.

After 18 days in the NICU, Paisleigh was discharged on November 30, just weeks before Christmas, which is what Rebekah and Logan had hoped for. Rebekah says if it weren’t for the wonderful doctors and nurses who took such great care of her baby, her outcome could have been completely different.

“I had the greatest team of doctors and nurses,” said Rebekah. “They were amazing since the first day my daughter was transported to the NICU. If I had a question or concern, it was never hard to reach them. As a first-time mother, I had so many questions to ask them. I credit the NICU care team, including Dr. Pierce and Dr. Motta who were Pasleigh’s primary physicians, for saving my daughter’s life. Despite everything we’ve been through, I am grateful my baby is alive and with us.”

Today, 2-month-old Paisleigh is doing remarkably well. She can breathe on her own and acts like any other healthy baby. She is a miracle to her parents, and her personality is beginning to show.

Rebekah is grateful for the life-saving care Paisleigh received in the NICU at The Children’s Hospital of San Antonio.

Rebekah credits the ECMO program at The Children’s Hospital of San Antonio for helping her daughter survive during a critical period. The ECMO program at CHofSA is the most active, comprehensive, and experienced neonatal, pediatric, and cardiac ECMO center in South-Central Texas since 1989, providing ECMO treatment to critically ill infants and pediatric patients. Additionally, the program has been internationally recognized as an Extracorporeal Life Support Organization designated “Center of Excellence.” Click here for more information about the ECMO program at our children’s hospital.