Tot, born prematurely, has rare laser surgery

By JOHN STANG/Daily Inter Lake

Caleb Williams is a 5-month-old boy in a 1-month-old body.

His mother's weakened cervix led to Caleb trying to force his way out of the womb at 25 weeks (15 weeks early).

Twenty-five weeks is almost the absolute minimum time of pregnancy for a child to survive.

So mom Rolanda Goodsell, now 26, was zipped from her Columbia Falls home to North Valley Hospital and then to Missoula Community Hospital for a Caesarean section.

Born at 1 pound, 13 ounces, Caleb spent two months in Missoula before his mother and father, Calvin Williams, took him to Kalispell Regional Medical Center's relatively new neonatal clinic for another month.

That set the stage for a first-of-its-kind surgery in Flathead County.

Caleb suffered from an ailment called retinopathy of prematurity.

Retinas in eyeballs develop while the fetus is in the womb. A premature baby can have underdeveloped lungs that shortchange the oxygen going to the eyes, which can hamper the development of retinas.

Essentially blood vessels inside the eye will clump together instead of spreading out.

The retina is the part of the eye that captures an outside image and begins translating it for the brain.

Retinopathy of prematurity can lead to blindness plus increased chances of eye problems, including detached retinas, throughout life.

This ailment's most famous victim is the blind musician Stevie Wonder.

The cure is laser surgery.

"It was really scary," Goodsell said of when she learned that laser surgery was needed.

However, that specific laser surgery would not have been possible in the Flathead until this year.

One reason is that Kalispell Regional opened its neonatal nursery in February and recruited neonatologist Dr. Cindy Edstrom from Boise.

That meant Caleb could be cared for in Kalispell instead of Missoula.

A three-months-premature baby's body has a lot of catching up to do,

"His whole development process was interrupted by being born early," Edstrom said.

Muscles are tight and weak. His organs need to finish maturing. His brain has to develop enough so he breathes automatically outside the womb.

So the neonatal nursery's staff kept a constant eye on Caleb to ensure he received oxygen, and he was rolled routinely to develop his muscles.

The other reason that this surgery could be performed in the Flathead is that Glacier Eye Clinic recruited an ophthalmologist from Omaha, Neb., Dr. Aaron Alme, who performed neonatal eye surgery there.

On Sept. 10 at Kalispell Regional, Alme donned a laser on his head just above the nose. His eyes aimed the actual beam, which was triggered by foot pedal.

Alme's concentration had to be intense and focused.

He nudged one of Caleb's eyeballs, then the other, into position with something that looked like a pencil with a swab on the end.

The laser bursts lasted a tenth of a second each.

There were likely from 600 to 800 laser bursts to clear up interior eye scarring and to break up blood-vessel clumps over 1 1/2 hours.

"It's a challenging procedure," Alme said.

While laser eye surgery has been around for at least 20 years, its use is increasing with premature babies - now being used in 10 or 11 percent of premature births.

Correspondingly, the frequency of eventual retinal detachments from premature births has dropped significantly in recent years, Alme said.

Caleb, now nine pounds, will still go through routine checkups, including keeping tabs on his eyes.

"He's growing pretty well for being premature," Edstrom said.

But it is too soon to tell what the long-term effects of his premature birth will be, she added.

Goodsell had to leave her job as a Dairy Queen assistant manager to become a full-time mom for Caleb and her 6-year-old daughter Autumn. Medicaid pays a large chunk, but not all, of the medical bills.

Goodsell said: "He's a lucky little guy."

Reporter John Stang may be reached at 758-4429 or by e-mail at jstang@dailyinterlake.com