Tiny but tough twins born under 2 pounds each ‘doing well’ after treatment at Deaconess NICU

A year ago, Samantha “Sam” Williams was airlifted to MultiCare Deaconess Hospital 24 weeks into her pregnancy. She had early signs of labor, but never expected her twins would arrive that day.

Lorenzo and Layla were delivered by an emergency cesarean section on April 16, 2022.

“I just thought I probably would have to do bed rest or something like that,” Williams said. But a doctor said her babies had to be delivered immediately, and Williams’ fiancé was already in scrubs. “It was so fast; they pushed me into the next room.”

She didn’t get an initial glance at first-born Lorenzo, who weighed 1 pound, 11 ounces, because a nurse whisked him away to resuscitate him. Williams briefly got to see Layla, at 1 pound, 9 ounces, before her immediate care.

Both premature babies needed breathing support. Their home for nearly five months was the Neonatal Intensive Care Unit at Deaconess. Lorenzo’s complications also required a one-month stay during that time at Providence Sacred Heart Children’s Hospital, until he stabilized to rejoin his sister.

Today, the babies’ overall health is generally good, Williams said, although they regularly see specialists for ongoing care. Last week, she took the twins into Deaconess for a reunion with their longtime NICU nurses, just two days after they marked their 1-year-old birthday.

The Deaconess Level III NICU is donor-supported through the MultiCare Inland Northwest Foundation to offer supportive, low-stimulant care for babies born weighing under 1 pound, 12 ounces or before 26 weeks gestation.

In 2022, 399 babies received care in the Deaconess NICU.

Through multiple health scares, Williams said the Deaconess NICU nurses gave her the support and information she needed to grasp medical complexities. Most of her relatives are in Baltimore, where she lived until moving to Spokane in 2015. Her fiancé and mother-in-law are here, but she drew close to the nurses during daily visits.

“They became like a little family to me where now, I miss them,” Williams said. “I’m not saying I’d want to do that again, but I really miss them because of the relationships I built with them.”

Williams bonded with nurses who include Erica Ziemer, Debra Mort, Nate Cates and NICU nurse manager Sarah Hurley.

“Every day I came in there with the nurses who were taking care of them, I would sit in there for hours – and that’s how we really got close, where you’d have conversations about the babies and get information you don’t know. They teach you how to change diapers when they’re that small. With Sarah, every time I came there, we spoke to each other. We laughed together.

“It was a rotation of nurses taking care of them at first, and then it started to be the same nurses caring for them. I’m pretty sure I met everyone in there.”

During early days, Williams said she felt afraid most of the time because of the babies’ fragile health. She watched nurses swiftly handle equipment, such as one time when Layla had a tube fall out. Other times, they held her hand, offered hugs and constantly reassured her.

Premature babies, especially before 32 weeks, have underdeveloped lungs and are susceptible to early chronic lung disease. The twins struggled with lung complications, she said, and had to be on breathing machines.

“They had brain bleeds as well,” Williams said. “They had to get a lot of blood transfusions, and at one point they thought they caught meningitis, and one did. Lorenzo got meningitis.”

Her son’s health issues further cascaded. He ended up with necrotizing enterocolitis, or NEC, the most common and serious intestinal disease among premature babies, when tissue in the small or large intestine are inflamed.

“They caught NEC kind of early and had to transport him to Sacred Heart just in case he had to have bowel surgery,” added Williams, although that surgery wasn’t needed. “Once he got there, it was a course of antibiotics he had to be on. He couldn’t eat, and he was also having problems with his liver.”

Both twins had a condition called PDA, for patent ductus arteriosus, as an opening between the aorta and pulmonary artery. For most infants, the pathway seals shortly after birth. In primarily babies born prematurely, the PDA fails to close and can make it difficult for babies to breathe normally due to increased blood flow to the lungs.

Layla’s PDA is small, and while being monitored today, it didn’t require surgery, Williams said. Her son’s opening was much larger and required surgery at Sacred Heart to install a “piccolo,” a self-expanding wire mesh device smaller than a tiny pea. Williams said Lorenzo also had an inguinal hernia operation at the same time.

Lorenzo’s overall health improved drastically after getting the PDA device, and Deaconess nurses prepared a celebration for his return.

“Once they said he was clear to go back, Sarah at Deaconess asked me, ‘Do you want me to start asking if they could transfer him back?’ Of course I wanted that, because I was going to two different hospitals for a month. Once they got the OK and he was sent back, they put him back with his sister in the same room, in the same spot.”

His return also meant Williams got to hold both her babies, simultaneously, for the first time.

“It was very welcoming with signs, decorations, balloons. Their theme was Mickey and Minnie, so the whole side of their room was decorated with Mickey and Minnie.”

Her babies continued to recover, then thrive, so Layla came home Aug. 3, a day before Williams’ original due date. Lorenzo was discharged on Sept. 16.

“They both came home with oxygen, and as of right now they’re only required to wear oxygen when they’re asleep,” said Williams, who described their current development as closer to 8 months. “They’re teething, they’re smiling, playing, laughing. We won’t see if there are any delays or anything until maybe they’re 2 or 3.

“They do have a high risk as far as cerebral palsy, but we don’t see any delay right now. They’ve just started to sit up, to roll over, so they’re not walking right now, but generally, they’re doing very well.”