As written by River’s mother, Angie:
The night before River’s birth was pretty ordinary until I awoke around 3 am. Once I realized my water had broken, I arranged for my dad to come stay with our son Finn, packed my bag and showered. We finally made it to the hospital around 5 am.
My nurse mentioned I could go for a walk to help labor progress. After many laps, an epidural and pushing for roughly an hour and a half, the doctor said I needed a C-section.
The C-section process was a lot different than how I remembered it with my first baby. The doctors were talking about how it wasn’t going as planned. There was desperation in their voices, but I tried to be brave and pretend I didn’t hear it.
I knew something was extraordinarily wrong when the nurses shouted, “Get the NICU. We need help NOW.” I started asking anyone who would listen if River was okay. Why wasn’t he crying? When the NICU team arrived, they quickly held River up for us to see and took him away, just like that.
The next couple hours were hard. We didn’t have any answers.
When my doctor came in she told us, “That was the scariest and most difficult C-section of my career.”
My uterus had a lot of scar tissue from my first C-section. Because of that, it made getting River out extremely difficult. He was pulled out feet first, blue and not breathing.
Hours later, when we were finally able to see River in the NICU for the first time, we were informed he was just coming back from an MRI.
I asked, “An MRI? For what?”
“He has a little indentation in the side of his head. We just wanted to get it checked out,” the nurse replied.
I peered over the side of the isolette at my baby. There were so many wires measuring different things, and a feeding tube had been placed to help him get ample nutrition. I was not able to hold him, but I gently stroked his silky, dark red hair – already so different from his brother’s. I did not yet understand the enormity of the situation; what a “little indentation” actually meant.
A doctor then explained that the reason for River’s MRI was to see if and how the indentation impacted his brain. He also told us that it would require a separate set of doctors – doctors who weren’t available at our current hospital, doctors who were neurosurgeons. He arranged for a transport to Children’s Hospital of Richmond at VCU, where River could be seen by these experts.
Treatment at CHoR
River was seen by Dr. John Collins, a pediatric neurosurgeon. He told us that River had a depressed skull fracture that was obtained during labor and delivery. It was the first time anyone had used the words skull fracture. River would require a few days of observation to make sure he didn’t have any seizures. He was also jaundiced, so he needed time under the lights to help his bilirubin levels.
When River was deemed clear, Dr. Collins was ready to discuss treatment options to fix the fracture. I had been experiencing medical challenges of my own and was still in the surgical ICU at this point. My husband and Dr. Collins called on speakerphone so I could be a part of the discussion. We were presented with four options.
It seemed like a no-brainer to try the least invasive procedure first, which was the “pop-out” procedure where they use a hand-held vacuum to suction the skull back into place. Dr. Collins made it very clear that results were not guaranteed. Still, we felt it was the best option for our five-day-old baby.
The following day, River underwent the successful procedure.
Seeing my baby
After my discharge, I went straight to River to hold and feed him for the first time!
Dr. Collins told us he had read all the medical journals he could, and reached out to another doctor who had performed a similar procedure with success. He said that infants born with depressed skull fractures were incredibly rare, but he was happy with the results. As were we. When you looked at River, you could never tell his head had been fractured.
When River was ready for discharge, we scrubbed up, signed in, and went into his NICU room one last time. We were finally able to bring our littlest love home to be together as a family of four.
One month later
A month later we returned to see Dr. Collins for a follow up. One of the nurses marveled at how well he was doing and told us that since River’s procedure, Dr. Collins had used the vacuum to fix a skull fracture in another infant. Our River was a pioneer!
Even more incredible is knowing our little boy has NO neurological effects. We can never fully express our gratitude and thankfulness for Dr. Collins and the entire NICU team that took care of River at CHoR. We may have had a rough start, but we’re ready to spend the rest of our lives loving our little red-headed miracle.
River recently celebrated his first birthday and continues to thrive, meeting all of his developmental milestones and playing with his big brother.