Patient Name: Kimberli Gaither
Two weeks after Kimberli Gaither underwent in-vitro fertilization she started to bleed. She and Fred cried all day fearing the loss of their babies. They had waited thirteen years to have children – first medical school, then the residency program, and then Mother Nature prevented them from being parents. Their elation had been high when they learned they were pregnant, their disappointment devastating at the thought of loosing their little ones.
Fred accompanied Kimberli to the doctor’s office for another ultrasound that afternoon. “The babies are fine,” the doctor explained, “The blood came from implantation.” Tears of joy filled their eyes. They could see tiny little hearts beating. But not just three, one sac had two heartbeat – identical twins. “We cried all day because we thought we were losing the babies. Then we cried all weekend because we were having four!” Kimberli remembers. How will we do it?
“I feared I could not carry four babies. I knew the pregnancy was high-risk, but on top of that, I had my own medical conditions that complicated things. I was scared,” she says. To keep her fears at bay, her doctor performed a weekly ultrasound. The babies continued to thrive.
The quadruplets were eighteen weeks along, when an ultrasound revealed one baby had a two-vessel umbilical cord. “There is an 8-12% chance your child could have heart problems,” the doctor explained. Six weeks later and after a day of continuous ultrasounds trying to see the baby’s heart, the cardiologist said that it might be Tetralogy of Fallot – a series of heart defects that limits the amount of blood oxygenated. Their little baby boy would likely need heart surgery. As the obstetrician and cardiologist presented the options, Kimberli and Fred knew that they wanted to travel to Arnold Palmer Hospital for Children & Women. Equipped to handle the delivery and neonatal care of quadruplets as well as the skilled surgeons of the Congenital Heart Institute for their son with heart defects, Arnold Palmer Hospital provided the Gaithers with the confidence they needed.
At twenty-seven weeks, Kimberli’s contractions began. She traveled to Arnold Palmer Hospital where obstetrician Stephen Carlan, MD, examined her and immediately admitted her. He began carefully monitoring her so the quads could go full-term, thirty-two weeks. The following day, pediatric cardiologist Aykut Tugertimur, MD, saw Kimberli and confirmed her son had Tetralogy of Fallot. “He is so wonderful,” Kimberli says in appreciation. “He checked on the babies and me every few days.”
After five weeks of bed rest, four growing babies, and intense swelling, she could not move. “I just couldn’t function anymore,” she admits. But it was almost Friday and Friday would be thirty-two weeks. Dr. Carlan scheduled to take the babies by Cesarean section and Fred arranged to fly in from their home in Panama City as usual on Thursday. However, on Wednesday, April 13, 2005, the quads were ready to be born. Kimberli’s contractions quickened and intensified. “I was really impressed at how they pulled together the delivery so quickly,” Kimberli shares. During the C-section, Dr. Carlan looked over the screen, and asked jokingly, “Now, you did know you were having six today?” His sweet manner helped comfort Kimberli when her husband could not be at her side. Twenty-nine people filled the operating room. As each boy was born, a nurse walked by holding him out for Kimberli to see, saying, “Hi, Mom,” and placed him in an isolate before taking him on to the Neonatal Intensive Care Unit (NICU). Grayson 3 lbs 5 oz, and Graham 2 lbs 15 oz (identical twins); March 3 lbs 7 oz, and Miles 3 lbs 12.5 oz.
Before taking Kimberli to the recovery room, nurses took her to see her sons. Still lying on the stretcher she looked in at her babies; they were all fine – even Graham. “He was so perfect. He was doing so well.” Nurses placed baby Graham in her arms. “We had worried for months about him. I had been so scared, but there he was looking up at me as if to say, ‘Life is good, mom.’ He was even breathing on his own – it was a moment of great joy.”
Dr. Tugertimur ran tests on Graham and found that he had a mild form of Tetralogy of Fallot. Though he would still need surgery to repair the hole in his heart and a few other defects, his heart would enable him to grow a little bigger and stronger to handle the surgery. He did not seem worried; a great comfort to Fred and Kimberli.
“It is different as a parent than it is being a nurse. You lose all your knowledge. I was so nervous because they were mine. I would watch as the monitors would show their heart rates dropping or their oxygen saturation levels too low and I would not know what to do,” Kimberli shares. “But everyone in the NICU was calm and gave the babies a chance to recover on their own, to make them stronger.” The Gaithers saw their neonatologist, Michael McMahan, MD, daily. “There was always a neonatologist walking around the NICU,” Kimberli shares. “I felt so comfortable with my babies in their hands. I knew if something went wrong, they were right there. The NICU was wonderful to my sons. They did everything I would want as a mom,” she says.
As the Gaither boys are able to leave Arnold Palmer Hospital, they will join their mom at the Hubbard House until they are all able to travel back to Panama City. Graham’s surgery will take place before he is six months old.