A gift of time

Social worker Nattasha Charania (left) and neonatologist Ann Critz with a preemie at Emory University Hospital Midtown.
Social worker Nattasha Charania (left) and neonatologist Ann Critz with a preemie at Emory University Hospital Midtown.

 

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Pregnant with twins, Sunny Jones kept every doctor appointment and took every vitamin that her Medicaid pregnancy benefits would cover.

I know we sent this baby home with a better chance to be happy and function normally. That's worth a lot to us and to society."

Those babies were in a hurry, however. At 24 weeks, Jones underwent emergency caesarean at Emory University Hospital Midtown (EUHM). First to arrive was a girl weighing just 21 ounces. She was silent and unmoving, her heart barely beating. Neonatologist Ann Critz was present at the birth. The second twin, even smaller, his lungs and kidneys even less ready for life outside the womb, died that night.

A barrage of tests uncovered one problem after another with the surviving twin. Placed on a ventilator, with round-the-clock nursing care, baby Marisha was given surfactant to keep her undeveloped lungs from collapsing. Emory pediatric cardiac surgeon Paul Parker repaired her walnut-sized heart, operating at EUHM instead of Children's Healthcare at Egleston so she would not have to be transported. A pediatric ophthalmologist performed laser surgery for retinopathy of prematurity, the abnormal growth of blood vessels in the eye that can cause blindness if untreated. After almost four months in the neonatal ICU, Marisha "graduated" from ventilator to CPAP, the continuous positive airway pressure machine often used for sleep apnea, and portable oxygen delivered through tubes in the nostrils. A feeding tube ensured she would keep growing. Medically, she was ready to go home.

"With preemies like Marisha," says Critz, "the outcome from here on depends on the family."  She believed Jones was up to it. For months, Jones had cleaned apartments all day, brought expressed breast milk to the hospital, held her daughter as long as she could, then took a long bus ride home to her other two children. Social worker Nattasha Charania worked with vendors to get Marisha the oxygen and other medical paraphernalia she would need at home, and the nursing team educated the mother on how to operate it and care for the still fragile infant. Charania also helped Jones apply for continued Medicaid coverage (Medicaid pregnancy benefits had expired after 60 days, and Jones had no other insurance) and connected her with medical and support resources in her community, for herself as well as the baby.

"As clinicians," says Critz, "we never know patients' financial status or if Emory Healthcare will be reimbursed for all or any care. But in Marisha's case, I know we sent her home with a better chance to be happy and function normally. That's worth a lot to us and to society."

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Community Benefits Report Cover 2012