Expert care leaves a lasting impact on twins Charlotte and William

Almost a year after Emily and Dalton welcomed twins, Charlotte and William to their family, the parents have become a coordinated team managing little kids who are always in motion. And they wouldn't have it any other way.

As they look ahead to celebrating the twins' first birthday, they also look back to those first few weeks with gratitude for the Children's Health℠ teams who delivered expert care to both babies for entirely different conditions. From the fast-action providers in the Emergency Room to the experts in the Pediatric Intensive Care Unit (PICU) where they formed a special bond with a nurse, Cami Miller, RN, who stood alongside them through their scariest moments.

"Having a baby in the hospital is absolutely terrifying, but having both of these newborns battling for their lives is something no parent can prepare for," Emily says. "Thankfully, the Children's Health team is ready for anything and we are eternally grateful for the medicine and the gentle care they gave all of us."

Becoming a Plano family

After 36 weeks of carrying twins and running around after her one-year-old, Emily was more than ready for her C-section. Thankfully, it went exactly as planned. Although Charlotte was having a bit of trouble getting into a feeding rhythm, the twins were given the all-clear to go home just a few days after being born.

"We hadn't been home a full two days yet when William spiked a fever of over 100 degrees," Emily says.

The parents rushed William to Children's Medical Center Plano where doctors and nurses quickly got to work so they could fully understand his condition. Emily and Dalton's precautionary trip to the hospital quickly turned into a medical emergency.

"Newborns haven't had time to build up their immune system, so if they get sick it can be much more severe than it would be for an older child or adult. Many things could have caused William to have such a high fever but meningitis is always high on our list of things to diagnose and treat quickly," says Paige Volk, M.D., Medical Director for the PICU at Children's Medical Center Plano and Associate Professor at UT Southwestern Medical Center.

William's care team feared he had meningitis, an infection in the spinal fluid and the lining of the brain. They needed to do a spinal tap – inserting a needle into the lower part of the spinal canal and collecting a sample of fluid – to test for a number of illnesses, including meningitis.

"There are two types of meningitis, bacterial and viral. Bacterial meningitis has the potential to be much more severe, but both are serious and we needed to have a clear diagnosis to treat William quickly," Dr. Volk says.

Now, with her six-day-old newborn being prepared for a spinal tap, Emily reminded herself that Children's Health was the best place for her son to be.

"I'm a team member at Children's Health and I know that if I can trust anyone with my child's health, it's this team," she says.

Charlotte joins her brother on the Plano PICU

As William settled in, Dalton headed home to see Charlotte and big sister Eloise, who were being cared for by Emily's parents. Unfortunately, Charlotte's difficulties eating were getting worse. By the next morning, Dalton was rushing back to the hospital with a second baby in need of emergency care.

"Charlotte was spitting up so hard that she was choking and Dalton had to use a baby suction to clear her nose and mouth," Emily says.

By that time, the care team had diagnosed William with viral meningitis. As he began antibiotics, the family met Cassandra Stewart, M.D., who let the parents know she wanted to send dye down Charlotte's intestines, watch where it stopped, and hopefully see what prevented her from keeping food down.

Results from the dye test identified the root of Charlotte's symptoms: pediatric intestinal malrotation. This condition happens when a baby's intestines develop twisted, blocking food from being digested. The blockage can also cut off blood flow to the intestines. Charlotte would need emergency surgery.

That's when Emily and Dalton were introduced to Nathalie Brewer, M.D., Pediatric General and Thoracic Surgeon at Children's Health and Assistant Professor at UT Southwestern, and Lauren Lazar, M.D., Pediatric Gastroenterologist at Children's Health and Assistant Professor at UT Southwestern, who would lead Charlotte's surgery and post-surgical care.

"When we saw her after surgery, she was fully intubated. We talk about caring for the whole family, but once you become one of those families you understand the value of this team and what they do for families," Emily says.

Now that Dr. Brewer had successfully smoothed Charlotte's intestines, everyone began patiently waiting for her stomach to start working like it was supposed to and for Charlotte to poop on her own. And for a moment, everything seemed to be moving in the right direction. Feeling assured Charlotte was in good hands, the parents finally made it home to sleep and check on their toddler. Watching over Charlotte during those long nights in the PICU was Cami Miller, RN.

"I stayed with Charlotte through the night almost every night for a week. I really wanted to be that one point of contact for Emily and Dalton that they could trust to take care of Charlotte and make sure they understood everything that was happening," Cami says.

Back and forth – the twins' extended stay

Meanwhile, William's health was improving. He was eating and his fever was gone. He made enough progress that doctors told Emily and Dalton that he could go home.

"He hadn't been home a day when this time his temperature started dropping. All of the sudden it was 95 degrees, which meant he was septic so we rushed him back to emergency," Emily says.

Soon, doctors had William under warmers. Over the next couple of hours, his temperature finally began to rise. But William wasn't going anywhere. He'd be admitted to the PICU.

"These babies had completely unique needs. We designed this PICU to provide expert care for all types of neonatal conditions. We also wanted to give families a voice in the care and make sure they were present. We saw this vision become a reality in the way that Emily and Dalton were able to be there for both of their children," Dr. Volk says.

Finally, William's temperature stabilized.

Unfortunately, Dr. Lazar, who was monitoring every bit of Charlotte's progress was concerned. Charlotte stomach was pumping out too much bile and her bowel movements were so infrequent and minimal. Dr. Lazar needed to find out why – quickly.

An endoscopy revealed that in addition to being born with intestinal malrotation, Charlotte had an exceptionally rare condition called congenital duodenal web. This happens when there's a blockage at the beginning of the small intestine.

"The original incision had hardly started to heal before Charlotte was heading back into surgery. At this point, we had thought that both babies were on their way to getting better, and then both became even more sick," Emily says.

This time, Adam Alder, M.D., Chief of Pediatric Surgery for Children's Health Plano and Associate Professor at UT Southwestern Medical Center, would lead Charlotte's surgery.

A few hours later, Charlotte returned from a second successful surgery.

Seeing your baby so vulnerable is overwhelming, but we had Cami and this amazing team and we got through hour by hour," Emily says. "There were moments when you're so overwhelmed and that's exactly when the continuity of care would shine through. But Cami made sure we understood what was happening every step of the way."

Finally, Charlotte's health began to improve dramatically. She was ready to catch up to her brother who was also making monumental progress.

"Over the next few days, we ping-ponged back and forth on rounds with each baby," Emily says. "This is an amazing group of physicians and nurses from different specialties all working together to make life better for our babies. As a parent, they are your source of hope and they delivered."

It's a true party of five

Finally, William was released to go home and Charlotte was just a couple of days behind. In total, the two spent 14 days at Plano.

When Emily and Dalton finally brought Charlotte home, the family began settling in to get to know each other. But Children's Health was never far from their minds. The follow-up care both babies received ensured both stayed on track to meet their developmental milestones.

"What's special about dedicating your medical career to children is that we can focus our philosophy of care around the whole family, and in this case that meant coordinating our support for parents who were very scared for the health of two children," Dr. Volk says. "Our Plano campus will soon get bigger, and that means we will have more capacity to give that level of personalized care to even more kids and their families when they need us."

Even though they had left the hospital, the supportive care they continued to receive from Dr. Lazar who coached Emily on feeding Charlotte and the surgeons who made sure her incision was healing. More than anything, Charlotte and William's parents felt the personal connections with Cami, and the physicians are what made their connection with their babies and the hospital's mission even stronger.

"Charlotte and William are healthy and we have Children's Health to thank for the laughter, the tears and a lot of messy meals and we love every minute of it," Emily says. "You can't imagine loving someone more than you love your child. To have dozens of people working to save their lives gives you a gratitude that will never go away."

Learn more

The Children's Health Pediatric Intensive Care Unit (PICU) is ready to care for the most complex patients with illnesses or injuries that require close and constant watch by a team of providers who specialize in critical care. Learn more about our PICU experts and the conditions we treat.