Becoming a Family
By Emilia Jones
Erlanger turns a nightmare birth experience into a happy ending for one local family.
Irene Oster stared through the glass window of the operating room as a million thoughts, prayers and promises to God ran through her mind.
As a registered nurse in Erlanger’s neonatal intensive care unit (NICU), the hospital is like her second home. It’s where she has cared for the tiniest and sickest babies. It’s where she has given hope to so many new moms and dads. It’s where she has helped infants born prematurely or ill fight for their lives.
But this day at the hospital was different. On the other side of the window was her own daughter, Karlie, who was fighting for her life and the life of her unborn baby. “I don’t understand. I don’t understand,” Irene remembers her daughter Kera saying over and over again as they wheeled Karlie across the hall. “She was dead.”
Karlie Zimmerman, the youngest of Irene’s three daughters, had gone from respiratory arrest to cardiac arrest. Doctors and nurses swarmed the once vibrant mom-to-be’s side. She had no heart rate. They shocked her. They shocked her again and again—five times in all.
Fourteen minutes passed. Still no heart rate. Suddenly, a doctor performed a cardiac thump, an aimed blow with the fist to a specific part of the sternum. Karlie’s heart began to beat.
Less than five minutes later Mackenzie Grace was born by emergency cesarean section. It was a miracle.
But Irene couldn’t keep her eyes off her own daughter. How could she survive after her heart was still for 14 minutes? And if she were to survive, what would the damage be to her brain? Irene’s mind went places she didn’t want it to go.
“There was a window,” Irene recalls. “She looked gone. Then they brought the baby out. She looked pink. She looked great. She was chunky. I said to Matt (Karlie’s fiancé and Mackenzie’s dad), ‘We will raise this baby together.’ ”
Karlie and her fiancé, Matt Snyder, were thrilled to learn they were having their first child. The couple had just moved into a new home and had fun decorating the nursery. They were in love, and they couldn’t wait to meet their baby.
Thirty-one-year-old Karlie had a dream pregnancy. She never had morning sickness. Her ankles never swelled. She never complained.
At her 38-week prenatal appointment, her doctor decided to do a planned induction because the baby was getting big. On Monday, Jan. 16, the couple arrived at Erlanger, took pictures in the parking garage and then headed to triage. Soon after, Karlie settled into her room and was started on IVs.
It wasn’t long before her contractions began. But by the next day she still wasn’t dilating, and the baby wasn’t tolerating the Pitocin, a medication used to start the contractions. Her doctor decided a c-section would be best. The couple called Karlie’s mom and sisters, Kristiana Zimmerman and Kera Hughes, who are also nurses. Karlie later got an epidural.
Then, her oxygen saturation rates starting dropping. As she sat in bed with her mom and her sister Kera, she said she had to cough. Suddenly, her eyes rolled back, and she made a snorting noise.
That’s when she was wheeled across the hall and later miraculously brought back to life, minutes before her daughter was delivered. Matt aimlessly paced the hall. This had to be a nightmare, he thought. “Scared wouldn’t be the word,” Matt says. “It was unearthly. I felt like this couldn’t really be happening. This was not what I planned. It’s not what I thought having a baby would be like.”
Cooling, Healing, Thriving
Mackenzie was transferred to the NICU at T.C. Thompson Children’s Hospital at Erlanger, which is on the same campus as the adult hospital. It’s the region’s only Level III NICU—the highest level assigned by the state of Tennessee.
“I knew she was in good hands,” Irene says. She knew her newest granddaughter would thrive in the NICU at Children’s Hospital, surrounded by specially trained nurses, neonatologists and other staff. Irene herself had cared for many babies in similar situations there.
Mackenzie immediately began cooling therapy, or therapeutic hypothermia. The idea is to cool the baby’s body temperature so the brain will require less oxygen, slow her organs down and allow her body to heal. It’s a protocol used at Children’s Hospital and other leading hospitals for babies deprived of oxygen at birth. Irene knew it well.
However, what she didn’t know was that the same method would be used to minimize her daughter’s brain damage. Karlie was put in an induced coma while her body was cooled to 32 degrees Celsius for 24 hours. The next day, her body temperature was carefully and strategically warmed by around a half-degree per hour. Mackenzie’s body temperature was rewarmed slowly.
Nationwide statistics show that one out of six patients who undergo hypothermia protocol recover. Soon after coming out of the coma, Karlie gave her family an incredible gift. She opened her eyes for their newborn throughout the night while their baby’s vital signs are monitored at the nursing station.
A Miraculous Recovery
When Karlie awoke from the coma, she was happy to see her mom and her sisters. But she didn’t remember Matt, and she had no idea that she had just had a baby.
Karlie was suddenly 19-year-old Karlie instead of the 31-year-old woman, fiancé and new mother. It was hard on everyone, but especially Matt. “Everything upstairs with Karlie was drama and crazy,” Matt says. “The NICU was my little happy place.”
While Matt held, fed, diapered and loved on his daughter in the NICU around the clock, his thoughts and prayers never left Karlie. But he knew she was in good hands with her mom and sisters and the droves of people praying for all of them.
As Karlie’s body, heart and brain continued to heal, some days were good. Some were tolerable. Others were just plain awful. But, Karlie says, not remembering was the most difficult thing. Then the day finally came for Karlie to see her daughter.
As her mom sat with her holding one iPad, a nurse in the NICU held another. Using FaceTime video calling, Karlie saw the beautiful face and strawberry blonde hair of her daughter light up the screen. Soon after, Karlie was well enough to visit and hold her daughter in the NICU. And, as a family, Karlie and Matt wereable to spend the night in the NICU’s Care by Parent room, where they could feed Mackenzie, change her diapers and shower her with love while the baby’s vital signs were being monitored at the nursing station.
In fact, the night in the Care by Parent room would later become Karlie’s first real memory since leaving for the hospital more than a week earlier.
Happy to Be Home
On the 10th day, the family of three went home—together.
Because her brain hadn’t completely healed, Karlie had to take time to get to know her baby and her new life. “I carried her. I grew her,” Karlie says. “Then I was looking at her like, ‘Who is that?’ ” Fortunately, she has had plenty of help from her mother, sisters, Matt and a whole host of friends and family.
Karlie still doesn’t remember the days she spent in the hospital, but she does remember everything before and after. And she now knows her little girl better than anyone. “She’s happy,” Karlie says. “She found her smile, and it takes over her whole face.”
Karlie’s body still has to heal, but for now she and Matt are enjoying all the firsts that come with parenting. “Holding her for the first time without all the wires was like holding her for the first time again,” Matt says. “Now everything is how I imagined, plus a little bit more.”
"Mackenzie Grace is the biggest blessing I could’ve ever dreamed to receive. God chose me to be her mother, and I am honored. She brings joy and light into my life every day, and I hope she learns as much from me as I do from her. I love her more than life, and I am so thankful that we are alive and healthy and get to spend our lives growing together.”—Karlie Zimmerman
Special Care for Special Babies
T.C. Thompson Children’s Hospital at Erlanger takes care of the sickest and smallest newborns in the region’s only Level III neonatal intensive care unit (NICU), the highest level assigned by the state of Tennessee. The 58-bed unit is staffed with specially trained neonatologists, nurses and neonatal nurse practitioners. Plus, the young patients have immediate access to pediatric and surgical sub-specialists. And for parents, there’s a Care by Parent room. In this home-like setting, parents can feed and care.
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