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Expanding pediatric services help keep families at home

by Katheryn Houghton Daily Inter Lake
| June 24, 2017 7:50 PM

The soon-to-be parents went into their appointment excited to learn whether they were having a boy or girl. Then they saw the ultrasound technician’s face contort.

“He said, ‘Oh that’s not supposed to be there,’” said 19-year-old Abbie Broesder. “I asked what he was talking about, ‘Could you elaborate on this?’”

Her boyfriend, Tyler Bargas, squeezed her hand tighter, his eyes turning from her to the screen showing the outline of their baby boy.

The Conrad couple had planned their 18-week ultrasound around the traveling technician’s visit.

They learned there was an opening on the right side of their baby’s umbilical cord that didn’t finish closing during development. That hole, roughly the size of a quarter, allowed organs like the small intestine to begin to grow outside of the child’s body.

The birth defect is called gastroschisis. It occurs in about one out of every 2,000 live births. The baby boy named Paxton, now three weeks old, became the first child treated in Northwest Montana for the condition — from prenatal care to corrective surgery an hour after his birth.

OVER THE last year, Kalispell Regional Medical Center has developed a full line of pediatric intensive-care services. Those services offer around-the-clock pediatric and neonatal intensive care units.

“We can do just about anything but open heart surgery,” said Dr. Kristin Veneman with the hospital’s neonatal intensive care unit.

Veneman said shortly before Paxton’s birth, another family gave birth to a baby with the same condition.

“We had to stabilize the baby, then that baby had to be flown out to Seattle,” she said.

Dr. Federico Seifarth, a pediatric surgeon at Kalispell Regional, said in the program’s first six months, 21 children received treatment who otherwise would have had to find care outside of the valley.

“It’s not just the case that people don’t have to leave the valley anymore for prenatal care, it’s the whole package,” he said.

The new service is temporarily housed in the hospital’s former adult intensive care unit.

Beams revealing the outline of the hospital’s future pediatric center — a three-story, 190,000-square-foot building — rise above the hospital’s main campus. The first phase of the roughly $40 million project is scheduled for completion next spring.

“This has already been changing the demographics of medical care in Montana,” Seifarth said, listing patient visits from Cut Bank to Canada for pediatric specialty visits.

He said the expanded services are not intended to replace care elsewhere.

“This is designed to complement and help other providers with that care,” He said. “We do everything to keep mom and kids and babies as long as we can in their places and homes … and we are doing everything we can to send them back home.”

BARGAS said he and his girlfriend didn’t plan on having a baby. But when a pregnancy test showed that’s what was going to happen, “everything changed.”

“We began getting ready as soon as we found out,” he said. “Nine months go by fast.”

Bargas found a house that would work for the small family. Broesder said she began making the list of the appointments she would need throughout her pregnancy.

Registered nurse Rachel Fisherkeller said the young family is an example of “doing everything right” when it came to prenatal care. But she said many soon-to-be moms wait too long to tap into prenatal care or forgo it altogether.

“For many people, it’s distance to that care. For young moms in this area, you’re also more apt to keep the pregnancy a secret,” Fisherkeller said.

A hallmark of gastroschisis is that it tends to occur with younger moms during their first pregnancy. Seifarth said the majority of children treated for gastroschisis from their mother’s womb through the weeks following their birth go without consequences from the defect for the rest of their lives.

He said people who don’t know there’s an issue until delivery day have to go into emergency-mode to ensure the baby survives.

“We want people to know, you get specialized care within Montana,” Seifarth said. “Don’t just go nine months and deliver. Find that prenatal care, it could save your baby’s life.”

Reporter Katheryn Houghton may be reached at 758-4436 or by email at khoughton@dailyinterlake.com.