‘It was opened for my little guy’

Five years after becoming one of the first patients in a new small baby unit, a Michigan kiddo is thriving.

‘It was opened for my little guy’

Jeremiah Young entered the world four months early.

Born in Traverse City on March 9, 2015, he weighed a mere 1 pound, 7 ounces.

That same morning, about 130 miles to the south, neonatologists celebrated the inaugural opening of the new small baby unit at Spectrum Health Helen DeVos Children’s Hospital.

The new unit—part of the hospital’s Gerber Foundation Neonatal Center—had been uniquely designed for babies born at 26 weeks gestation or earlier.

Babies just like Jeremiah.

“It gives me goosebumps when I think about the fact that it opened the day he was born,” said Anita Young, his mother. “If he had not been taken to Grand Rapids, then I am not sure he would be here today.”

Jeremiah is now a thriving 5-year-old gearing up to start kindergarten.

He loves to play outside and ride his bicycle.

He has one speed—fast.

Meanwhile, the small baby unit has solidified its place as a state-of-the-art facility that each year gives 50 to 60 of the community’s most fragile newborns a chance to not only survive but thrive.

“We are just completely overjoyed and so proud to know that we are a huge part of their journey from the very beginning,” said Krista Haines, MD, lead neonatologist for the small baby unit.

“It makes all the work we put into making this small baby unit the best (one) ever worthwhile.”

An early start

Jeremiah’s mother feels those early days in the small baby unit set him up to learn to fight hard battles.

“He really continues to blow my mind and amaze me. He’s pretty spectacular. He’s overcome a lot in life,” she said. “His resilience and his drive is amazing.”

Jeremiah was rushed from Traverse City to Grand Rapids immediately after his birth.

At the time, Anita and her husband, Cory, were licensed for foster care of older children. They were also raising three biological children—Jenna, Jacob and Jessica, who were 12, 14 and 18 at the time.

“We kept getting all of these calls for babies,” she said. “My husband was adamant we were done with babies. He said, ‘We’re done with diapers.’”

But when they saw the desperate need, they told their social worker they were open to a baby.

Very soon after, they got a call about an 8-month-old baby girl who needed a home immediately.

The social worker added that she had a newborn biological brother who had just been born prematurely at 24 weeks.

“I just remember calling my husband and saying, ‘Well, how do you feel about two babies?’” Anita said.

Love at first sight

When Jeremiah turned 4 weeks old, Anita and Cory drove from their home in Traverse City to Grand Rapids and stepped into the small baby unit for the first time to meet him.

“I loved him from the second I saw him,” Anita said.

She remembers the moment well.

“I remember just breaking down,” she said. “He looked so tiny and frail. You could see through his skin, and it was unbelievable to me that he could sustain life. I could not believe it was possible that they were able to do what they can do.”

They put their hands in Jeremiah’s isolette and gently touched him. They had to be very quiet because any noise could overstimulate him.

On her third visit, Anita held Jeremiah for the first time. He was 6 weeks old.

“That was another day that was just unbelievable,” she said. “The very first time they put him on my chest the tears would not stop coming. It was amazing. It’s a little terrifying too because you’re so worried about doing something to hurt him.”

She remembers the nurses who worked together to help transfer him to her arms safely.

“I have such a special admiration and love for all of those NICU nurses,” she said. “They are an incredible group of people. I will never forget.”

Providing parents and newborns with skin-to-skin contact—also popularly known as kangaroo care—as early and often as possible is a priority of the unit. And it’s no small task, Dr. Haines said.

It takes a team of nurses and therapists to do it safely.

“It’s not an easy therapy, but it’s one that we are really focused on,” Dr. Haines said. “We do a really wonderful job with skin-to-skin.”

The Youngs visited every weekend, while also caring for Jeremiah’s older sister, Joyce, at home.

During each visit, while Jeremiah rested on Anita’s bare chest, his oxygen levels would rise so high the nurses would have to adjust the ventilator.

“It didn’t take me long to figure out that it was so healing for him,” Anita said.

A gentle start

While the hospital’s NICU had always been able to care for babies born before 27 weeks, the small baby unit provided an environment specifically suited to their unique needs, Dr. Haines said.

This includes subdued lighting and sounds to help encourage healthy sleep and wake cycles for their rapidly developing brain and nervous system.

“We wanted to make their environment as quiet, stable and soothing as possible because they are so fragile and underdeveloped,” she said.

The unit employs specially trained doctors and nurses, as well as respiratory therapists, occupational therapists, physical therapists and more.

“We had all of those same players before, but with the small baby unit we were able to develop a cohesive approach to how we were going to take care of extremely premature babies with a special focus on neuroprotective and developmental care,” Dr. Haines said.

Thriving in life

Jeremiah underwent various procedures during his time in the NICU.

Heart surgery to repair a vessel. Two eye surgeries for retinopathy, an abnormal development of the retinal blood vessels. He also survived a sepsis infection and chronic lung disease that prevented him from ever bottle feeding, as well as other setbacks.

At 4 months old, around his due date, Jeremiah graduated from the small baby unit to the regular NICU. On Aug. 24—nearly six months after his birth—Anita and Cory brought him home.

He weighed 12 pounds.

The day before he came home, they had dropped their oldest daughter off at college in Illinois. On their way back north, they picked up Jeremiah and brought him home.

“It was a struggle,” she said. “We were hoping and praying this was all going to work out because it was all a juggling act for sure.”

But through it all, it felt right.

“It’s a calling,” Anita said. “And I sort of feel like it was part of our purpose on the earth. I really have a great desire and need to care for people.”

Jeremiah’s adoption, along with his sister Joyce’s, became finalized in June 2017.

He still faces struggles, including a slight vision impairment and mild asthma. He still has a G-tube for feeding, though that should be removed soon.

He participated in Early On Michigan, a system for helping infants and toddlers with special needs.

At age 3, he started preschool through a special education program.

“He loves school,” Anita said.

When schools closed during the COVID-19 quarantine, he missed his classmates terribly.

Now it’s impossible for Anita to imagine her family without all five of her J’s: Jeremiah, 5, Joyce, 6, Jenna, 17, Jacob, 19, and Jessica, 23.

“I really feel like they have rocked our world and blessed our lives,” she said.

And as for the small baby unit?

She’s pretty sure its opening day five years ago was meant to be.

“It was opened for my little guy,” she said.

Source : Health Beat More   

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COVID-19 Isn’t the First Pandemic to Affect Minority Populations Differently. Here’s What We Can Learn From the 1918 Flu

Black influenza death rates exceeded white influenza death rates in the years prior to the 1918 pandemic, but the opposite was true during peak pandemic months

COVID-19 Isn’t the First Pandemic to Affect Minority Populations Differently. Here’s What We Can Learn From the 1918 Flu

On a Monday afternoon in early October about 100 years ago, a special meeting of the Baltimore school board was held to decide whether schools should close. Some 30,000 children—more than 60% of the city’s students—had reported absent that day, along with 219 teachers.

It’s unknown how many students stayed home because they were already sick or because they feared getting sick. Either way, the 1918 influenza known as the “Spanish Flu” was to blame. Baltimore, like other cities and towns across the country, was grappling with overwhelmed hospitals and crippled industries. The city had something else in common with much of the rest of the U.S. at that time, too: it was racially segregated.

The school board ultimately decided to close the schools, but the decision wasn’t unanimous. Some members agreed with John D. Blake, the city health commissioner, who wanted schools to remain open. Blake—who was accused by some at the time of downplaying the pandemic in order to keep public spaces open and businesses operating—pointed out that, at one school for Black students, there was a 94% attendance rate. He used this statistic and other similar data to claim that “colored people are not, as a rule, subject to the flu,” according to an account of the meeting published by the Baltimore American.

This statement was a careless over-generalization, but it reflected a common perception of the time. White health experts of the era, as well as Black doctors and Black journalists who served their communities, generally believed that white people were more susceptible to the virus. They were working with real observations, but their suppositions about the reasons for those numbers were often misguided and in some cases based on racist pseudoscience. (It was a common belief of scientific experts at the time—and particularly white experts—that health disparities between the races stemmed from biological differences, even though such ideas are scientifically baseless.) As the world grapples with the coronavirus pandemic, which has had a particularly devastating impact on communities of color in the U.S. and abroad, that history stands out as particularly surprising. But those who have studied the 1918 flu say it still offers a lesson for today.

“It’s counterintuitive,” says Vanessa Northington Gamble, a history professor at George Washington University, of the idea that a pandemic wouldn’t affect Black Americans. Gamble has scoured historical documents to understand why Black people seemed to be less affected by the 1918 outbreak. “I might not believe it, but it was believed at that particular time,” she says.

Indeed, observational accounts of lower death rates among Black people are supported by the available data: one 1919 analysis of mortality statistics by race and sex from the Metropolitan Life Insurance Company found that Black influenza death rates exceeded white influenza death rates in the years prior to the pandemic, but the opposite was true during peak pandemic months:

Other historical statistics paint a similar picture. In November of 1918, an official from the U.S. Public Health Service reported that flu incidences were lower among Black populations in seven predominantly Black localities. Meanwhile, military records from World War I show that, among troops stationed in the U.S., white soldiers had higher incidences of influenza and other respiratory diseases like pneumonia in the fall of 1918 compared to black soldiers.

Gamble cautions that historical data have flaws. Public health agencies and insurance companies were operating under racist systems; statistics such as mortality rates are based on unreliable population estimates; and the pandemic struck so furiously that health agencies, hospitals and physicians could barely keep up with the stream of patients, let alone find time to compile thorough records.

Race data may be especially incomplete. Medical facilities were segregated, and the few Black-only hospitals that existed at the time were operating at capacity. Patients who couldn’t secure a place in the hospital and who subsequently died at home may not have been recorded, potentially resulting in under-reported fatalities—a phenomenon that’s sadly repeating itself with COVID-19.

Still, Gamble thinks that the historical numbers have some merit. “We have to use them,” she says, “But not in absolute terms. We need to put them in the context of the time.”

One way to consider the historical context is by looking at how people of different races fared in 1918 relative to a non-pandemic time period. A 2007 study of 14 cities from the Federal Reserve Bank of St. Louis, for example, shows that for the full 1918 year, Black populations’ influenza death rates were higher than that of white populations in all but one city. However, the uptick in deaths that year wasn’t as dramatic as it was with their white neighbors, because Black communities already had such a high influenza death rate prior to the pandemic. In other words, there were more excess deaths among white people than black people.

Take Louisville, Ky., where the overall Black influenza mortality rate in 1918 was slightly higher than the white rate. But while the Black mortality rate had increased 175% compared to pre-pandemic levels, the white rate soared 810%:

Statistics and anecdotal accounts suggesting that Black communities weren’t as pummeled by the 1918 influenza outbreak as white areas leave historians and health experts with a paradox: how is it possible that people who were forced by discriminatory housing practices to live in crowded and unsanitary conditions, whose medical facilities and doctors were barred from collaborating with white hospitals, and who, as a result of these racist policies, were more prone to underlying health conditions would fare better, relatively speaking, in a pandemic?

The question is especially puzzling in light of COVID-19’s disproportionate effect on racial minorities who are still dealing with inequities in the modern-day health care system—in today’s pandemic, over a century later, Black people are dying at more than twice the rate of white people in the U.S.

Theories explaining this phenomenon have evolved over time. During the pandemic, according to Gamble’s research, some white experts blamed scientifically baseless “biological” differences between the races. For example, some claimed that Black people were less susceptible to respiratory viruses because the lining of their noses were more resistant to microorganisms. This type of shoddy reasoning wasn’t unusual for the era; myths about physical differences were frequently peddled as fact to justify discrimination.

“Some data seems to suggest lower death rates in the Black community,” says Nancy Bristow, author of American Pandemic: The Lost Worlds of the 1918 Influenza Epidemic. “But that was not because of biological differences, but because of how they lived in the society. Race doesn’t exist biologically. It is a socially constructed concept.”

Modern theories are more firmly based in science and consider the socio-economic factors of the time. One hypothesis is that an initial milder strain of the influenza virus, which hit the U.S. in the spring of 1918, affected communities of color harder than white communities, allowing Black people to build up an immunity to the more virulent strain that swept the country in the fall. But some researchers say there’s little evidence that a spring flu hit the southern states, where most Black people lived at the time.

Another theory is that racial segregation may have limited Black people’s exposure to the 1918 virus. The military, which played a critical role in the transmission of the disease around the world, was entirely segregated at the time. Private establishments held a firm color line, as did public transit. In rare cases when Black people were admitted to white-only hospitals, they were treated in separate wards, often in the most undesirable areas of the building, like attics and basements. But this explanation has been questioned by researchers who note that discrimination didn’t shield Black communities from other infectious respiratory diseases like lobar pneumonia and tuberculosis, which were more prevalent in Black communities than in white communities.

Despite holes in all these theories, at least one fact about the 1918 pandemic is certain: Black communities were left to fend for themselves to get through the crisis.

Unfortunately, this situation is still all too common today, and the outcomes are painfully apparent in the COVID-19 era. Today, as the country is grappling with another pandemic, the human toll is higher among Black and brown people. Disparities in health outcomes between races—both today and a century ago—are indisputably tied to systemic discrimination and oppression of those communities.

“Germs know no color line,” says Gamble. “The 1918 influenza revealed racial inequities—where people lived, where they got their health care, what jobs they had. It’s parallel to what we’re seeing now.”

Source : Time More   

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