Aric: We've always wanted to have a family of our own. It was always our desire to have
kids.
Megan: It took us a long time to get pregnant. It took us three years for Eva. Two years
later we have Macy. Aric was working out of town six days a week and was only home
basically on Saturday and Sunday nights and Blake happened on one of those nights. The
first trimester was normal. Everything was great on May 10 we went in for our 20 weeks
scan ultrasound. I've had two other kids, I've had other ultrasounds so I know they
can have fun with it and they kind of watch more and there was none of that so I kind
of knew something was off and that's when my doctor came in and said, "I don't know
how to tell you this but there's something wrong with your baby."
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Megan: That's when he went on to tell me about that he has spina bifida and that there is
fluid on the brain. His brain is being pulled back, terms like this that I've never heard
of before. I just sobbed and cried.
Dr. Teich: Once the fetus is diagnosed with a problem what happens is that the coordinators
from whatever referring hospital will call Children's and setup an appointment for us
to be seen by the appropriate specialist.
Dr. Governale: They're different people who know a lot about those different things. So
by working as a team you get that high level of knowledge across all those specialties
that can be involved in something with wide reaching implications like spina bifida.
Dr. Teich: And they can also decide where they want this baby to be delivered, how they
want to be taken care of, I think it really helps knowing ahead of time. And we give them
a tour of the hospital we show them where they're going to be. We really want the family
to be comfortable.
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Megan: I felt better. I felt like we could do this. I felt like this is something we
can overcome. There's still a lot of question of what does this mean for our lives? How's
this going to impact us? How's this going to impact our family? What do we need to do?
Lots of questions still but we left feeling hopeful.
Dr. Governale: I want the spinal cord forms during development in the womb very early
in the womb. It forms as a tube which rolls up from skin and then detaches from the skin.
Myelomeningocele is spina bifida is when that bottom part of the tube doesn't break free
from the attachment and stays open to the skin.
Megan: There're four levels of your spine and his is the lumbar level. Most commonly
with this type of lesion level we see kids that don't have feeling from waist down. We
don't really know exactly what type of care he'll need and a lot we won't know until birth.
His room's ready, clothes are brought, diapers are ready. Eva is very excited she will tell
you that he has spina bifida. That's him.
Aric: There he is, there's the spine.
Eva: He has B bone in his back.
Aric: Where is he right now?
Dr.: So today we are going to deliver Megan's baby by cesarean.
Megan: Just waiting and waiting patiently.
Aric: A little nervous, it's kind of intense, it's getting more real but we'll get through
it.
Nurse: That's when we're going from the OR to the NICU maybe we'll be able to have family
come and see him and I'll have you guys sign consents for Children's Hospital, they need
consent to transporting.
Aric: Just see you later.
Nurse: We're going to go right out around this way.
Aric: There's still kind of unknown factor of not knowing what to expect once he goes
to Children's. I know they're in good hands so there's not too much to worry about.
Dr. Melillo: When they have spina bifida you do not want them to be delivered vagially
because you don't want to disrupt the defects. Right now the baby is breached we're going
to probably have to do a classical C section which is safer for the baby and probably better
for Megan as well. Our job is to deliver the baby safely and then the baby off to the people
here they stabilize the baby, get everything set and it's seamless, it's one of the great
things about working here and being hooked up with Children's here is that we do our
job and then it goes right down the line everybody does theirs and you have a baby that gets
the best care possible.
Nurse: Nice and pink, breathing on his own always has. We'll dress him over his defect
and dads got to picture he can show you so we'll see you down there OK? Hey everybody
this is Becky Myer and we're bringing back this little boy Blake Mumford who is with
his mom Lucille and we'll be back to the NICU in a few minutes.
Aric: A cute little one too. It was nice for the family to be able to see him. He's
doing good and we're happy best possible outcome.
Dr. Mohyeldin: He's scheduled for first case tomorrow morning. I'm going to talk to the
mom she's over at Riverside still? All his vital signs looks perfect to me we have really
72 hours to perform this surgery, close the defect up and protect his central nervous
system from infections and all the other possible problems that can arise from it. The advantage
that we have here is when we see mother's prenatally before and time everything properly,
have a healthy delivery. We can get them to our hospital, stabilize and ready to go to
the OR within hours and that would be the case for him.
Dr. Governale: OK so the neuro surgical aspect of closure of an open myelomeningocele is
identifying the open spinal cord which is attached to abnormal skin, separating it from
the abnormal skin, dropping it down into the spinal canal, trying to roll it together if
it will come close if not it's OK then defining the Dura the layer cover the entire brain
and spinal cord which is also stuck to the skin identifying that boundary, separating
it from the skin, dropping it down, bringing it together close and suturing it water tight
so that the spinal fluids stays in and doesn't leak out. From my perspective I think there
was a good border between a spinal cord skin and good layers. My perspective went fine
it was straight forward for me.
Aric: We're just ready to get our family started, get through all the hurdles we consistently
heard he's doing great. I really want to hold him bad.
Dr. Spaeth: Having the multiple layers closed, or having the spinal content back where they
should be but then also have them layers of muscle and skin over top will make that repair
more robust so it won't be as thin, it won't tend to break down, it will actually be stronger
all along. I think everything went really nicely and smoothly. It is always a pleasure
working with the neurosurgery team here. Gives our patients better care to have a multi-disciplinary
care.
Aric: Hi.
Dr. Spaeth: I'm Dr. Spaeth I'm playing the plastic surgeon. Everything went well as far
as the closure so if you kind of look at where your spine is you got muscles on either side
and then there was the skin and the middle part was stretched out. He's got an incision
that's about nine centimeters long, it doesn't sound very long on little guys. If there's
got a progress or anything that we'll be updating you guys.
Aric: Megan will be happy to hear it.
Megan: Hey.
Aric: Ok I'm with the plastic surgeon, said everything went fine, said he's going back
up to his room.
Megan: OK finally got to see him.
Aric: As soon as I get off the phone and you get up the elevator.
Megan: OK go do that.
Aric: Can't really ask for anything better. All the doctors said he did fine, he's doing
fine now, he's just recovering.
Megan: Discharge and he came straight here and got to hold him for the first time. It
was amazing we need it a long time. He's feeling really well, doing well, back seems to be
well and the nurses have been amazing, and awesome, and very caring, and informative,
and the care has been great.
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Dr. Richter: he's actually doing very well. He's recovering from both of his surgeries,
the cerebral spinal fluid is made in the brain and it typically drains out kind of the back
in the bottom of the brain but that drainage can become blocked. Just with spina bifida
so that's why we have to put the shunt into bypass that and allow it to drain a different
way. And so he has loops of tubing in his abdomen and that's where the fluid drains
in to his belly so that his body can just re-absorb all the fluid and the things that
are in the fluid that's actually good for him. He doesn't move his legs much for now
we're just waiting for him to gain some weight and do some of the things so that he's ready
to go home.
Hi mom how are you?
Megan: Good.
Dr. Richter: He looks good. I saw that he gain weight last night.
Megan: Blake's been here for two weeks now, I'm here just hanging out with him and cuddling
with him, and he's doing great. Nurse him for the first time yesterday, it was awesome.
Very excited to take him home.
The biggest thing he'll need at home medical wise is cathing so we've been learning how
to cath him on our own, I practice a couple of times we're ready for him to come home.
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Aric: Seems doing a lot of the nurses and doctors. For most they treated Blake their
own kid.
Megan: Nurses have been awesome, they're like angels.
Aric: They're very encouraging as far as getting us involved in his cares and being
more hands on.
Megan: He's feeling really good, he looks great, his back's looking great.
Aric: Just glad to be getting home.
Megan: The whole family's coming over tonight.
Nurse: Congratulations.
Aric: Thank you.
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Megan: We're here at Myelo clinic at Nationwide Children's this for his first round of check-ups.
Margaret: Myelo clinic is kind of a long day but it's wonderful that we have a whole team
for the kids to see. When he comes he sees developmental pediatrician or urologist, orthopedist,
neuro-surgeon, occupational physical therapy, social work if needed, we also have nurse
psychology for when he gets older.
Megan: I've been excited for today just to make sure we're doing things right.
Aric: Today for me is more of getting to know the doctors, who they are, kind of build
that relationship. How you doing? Nice to meet you too.
Renee: I'm a hugger. Ok so I'm from neurosurgery and I'm a nurse practitioner, I work with
Dr. Governale and the whole team. My job is to work with the surgeon and if I see anything
that's wrong then I go and talk to them. This looks amazing, it does and I'm going to check
his shunt. He's at 1.0 see?
Margaret: What's nice about that clinic is when they come, they see other children, other
families that they can meet and it's very helpful to kids of different ages and different
function and I think that's really fun.
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Aric: Blake's four months old now, he's going through a couple of surgeries that do adjust
his shunt kind of monitor that in clinic to make sure that fluid doesn't build up to unacceptable
level. Now it keeps thing around it even feel so we can kind of concentrate more on the
baby and not his disability.
Megan: Some days are hard, some weeks are harder than others but the most part is has
been joyful and fun and enjoying him a lot. Blake right now really is the physical therapy
going to Myelo clinic every three months at this point. He's a lot of hip movement which
have been really encouraging to the doctors. His plastic surgeon doctor really didn't expect
to see that so we're all very hopeful that maybe he can walk with help, we're praying
for that.
Aric: Everybody around just loves on him as if nothing was wrong.
Megan: I think the support of the medicine group has been really great. I think it would
been all heard to go through the pregnancy and everything you're going through with all
of them because I felt like I really did feel like I can call them any time I had a question
and that's always answered right away.
Aric: They don't really miss a bit, it's kind of a seamless transition from doctor
to doctor.
Dr. Teich: It's a great thing that we do in Columbus, it's nice to have all the different
hospitals together because we actually will discuss cases and we can learn from each other.
Everybody benefits form this.
Megan: I just hope Blake's happy, I hope he's content with who he is.
Aric: Since he was born he's been having surgeries and he's been fighting it along
the rest of his life to continue to fight. His parents and sisters, and the whole family
to support him, come cheer him on. We wouldn't have any other one. It's very unique and you
know it's part of the reason why we love him even more.
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Aric: There's not another Blake anywhere.
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