Isabel Garcia wasn't due until Valentine's Day.
Her mother, Silvia Garcia, had only gone to a couple of doctor's appointments before she faced a mother-to-be's worst nightmare -- she went into labor after only 25 weeks of pregnancy.
Isabel was born at Mercy Medical Center Merced. She weighed only 1 pound, 10 ounces. She was extremely premature and very sick. Because she was so tiny and so early, she was transferred to Children's Hospital Central California in Madera, where a Level 3 neonatal intensive care unit, or NICU, set up to take care of the sickest and tiniest of infants, could give the little girl a chance at life.
"They let me see her for about 15 minutes," Silvia Garcia said. "I put my finger in with her, and she grabbed my finger. Then they took her away."
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That 15 minutes seemed like only seconds to Garcia, but she knew that Isabel's best chance was in Madera, where she would get the best care possible.
After eight weeks in Madera, undergoing heart surgery and seven weeks on a ventilator, Isabel is back in Merced. She's not home yet, and isn't expected to be home with her mom and her 10-year-old brother until closer to her original due date in February.
Isabel is at the Level 2 NICU run by Children's at Mercy. The highest acuity unit in Madera, Level 3, takes care of the sickest babies. The Merced unit, which can take care of six babies at a time, is one of three satellite NICUs in the Central Valley run by Children's. The other two are in Hanford and at St. Agnes Hospital in Fresno.
Andree Soares, a registered nurse and the supervisor of all three satellite sites, said the little room packed with lifesaving equipment has been at Mercy for 12½ years.
"Most of the babies that come in here are typically premature, or have respiratory problems," Soares said. Other reasons that babies may spend time in the NICU at Mercy are that they have been exposed to drugs during pregnancy or were born with an infection.
Soares said that many of the babies who spend time in Mercy's NICU first go to Madera. This can be hard on parents, who may have other family members to take care of in Merced.
Silvia Garcia was one of those parents. "I had my son to take care of," she recalled. "If Isabel hadn't come back here I couldn't have gone back to work."
Once a baby is big enough or strong enough to go to a less acute unit, Mercy's NICU nurses are ready to take care of the infants. There are at least two registered nurses in the unit at a time, along with a respiratory therapist.
Many times the nurses in the NICU are alerted to a baby being born needing help, so they are in the delivery room.
If a baby is very sick or very premature, a transport team comes from Madera to take the infant to their NICU.
Garcia said the team, along with all the doctors and nurses both in Madera and in Merced, were wonderful to her and her baby.
"They have the best nurses and the best doctors," Garcia said. "They take their time to explain things and answer any questions or concerns I have."
Madera's children's hospital serves an area encompassing 45,000 square miles, according to Stacie Venkatesan, a clinical nurse specialist at Madera's NICU.
"We receive all the high acuity babies from about 50 hospitals in the area," Venkatesan said.
Getting the babies back to their families is important to the nurses and staff at the NICUs. "It can be such a hardship for families," Venkatesan said. "We get the babies back closer to their mommies and daddies as soon as we can."
That does more than remove a hardship from families. Helping moms and dads learn how to take care of their infant can help the baby get home faster, Soares said.
"We teach parents about feeding and any problems the babies might have," she said.
Lupe Saucedo, a registered nurse at Mercy's NICU, is taking care of Isabel these days. The baby came back to Merced at the end of December, and she is now doing well.
"Her weight is up to 4 pounds, 4 ounces, and now she's learning how to eat," Saucedo said. Because the infant was so premature, she was on intravenous feedings for a while, and now is fed through a tube into her stomach. Saucedo is helping Isabel learn to eat from a bottle, so she can go home soon.
Garcia visits her daughter every day, and she's fairly sure that Isabel knows who her mom is.
"When I talk to her, she opens her eyes," Garcia said.
Like Isabel, most of the babies who come through Mercy's NICU end up going home with their families.
"A lot of moms and dads go through some high stress times in the beginning with these babies," Soares said. "But most turn out to have happy endings."
Reporter Carol Reiter can be reached at (209) 385-2486 or firstname.lastname@example.org