On June 10, 2008, Caoimhghin (pronounced KEY-vin) was the first. Not the first child in his family — he followed three older brothers — but he’ll always be remembered at Children’s Hospital of Philadelphia because he was the very first baby delivered in the Garbose Family Special Delivery Unit (SDU).
Caoimhghin was diagnosed before birth with spina bifida, a birth defect in which part of the spinal cord and surrounding nerves are left exposed through an opening in the back. The continuous exposure to amniotic fluid can damage the spinal cord and cause a wide variety of issues, including bladder and bowel problems, orthopedic malformations such as club feet, paralysis, and weakness or loss of feeling below the lesion. The pregnancy would require close monitoring, and he would require surgery immediately after birth to repair the opening in the spine.
These needs were a perfect example of why the SDU was created — so that babies with prenatally diagnosed birth defects who would require immediate, specialized care after delivery could be born and receive that care all in one place. Mom and baby could stay close, and Caoimhghin would have access to all the pediatric specialists he needed before, during and after delivery.
Fast forward 10 years and, according to his mom and dad, Caoimhghin is an awesome "little big kid" who is excited to be turning double digits!
A familiar journey
Courtney and Marty weren’t strangers to high-risk pregnancies, having delivered Caoimhghin’s identical twin brothers 18 months prior, or to spina bifida, as Courtney grew up with a sister with the condition. When Caoimhghin’s diagnosis was confirmed, they were nervous but ready to tackle the challenges ahead.
The family’s maternal-fetal medicine specialist referred them to the Center for Fetal Diagnosis and Treatment (CFDT) at CHOP because of the team’s extensive experience with prenatal diagnosis and spina bifida treatment options, including fetal surgery. In fact, Center team members pioneered the prenatal surgical procedure. After the comprehensive, full-day evaluation and meeting with the team, Courtney and Marty knew they wanted Caoimhghin to be treated at CHOP, even though it turned out he wasn’t eligible for fetal surgery.
“They had done the tests, were familiar with him, and the team was very well-known for being on the cutting edge of diagnosing and treating birth defects,” says Marty. “It was where we felt most comfortable.”
Keeping families together
Another benefit that drew them to the Center was the brand new Garbose Family Special Delivery Unit (SDU), which was opening just in time for Caoimhghin’s arrival.
A transformative gift from donors Lynne and Bill Garbose allowed CHOP to create the world’s first birth facility specifically designed for healthy mothers carrying babies with known birth defects. Babies born in the SDU either have undergone fetal surgery to treat the birth defect before birth, or, like Caoimhghin, need immediate specialized care or surgery soon after birth.
The SDU brings together expert prenatal care, customized delivery plans and a multidisciplinary team with extensive experience caring for babies with birth defects and their moms, all in one place. This setup not only minimizes the risks of transporting fragile babies, but allows mom and baby to stay close after birth, making a difficult time easier on the family.
“It was a tremendous difference, versus my other deliveries; so much easier for me to be able to go downstairs and see him. It was almost cathartic. The SDU gives parents the ability to make decisions together. We’re tremendously grateful for CHOP being there, and for the SDU. It really kept us together, it truly did.” — Courtney, Caoimhghin's mom
Surgery for spina bifida
Caoimhghin underwent postnatal surgical repair of myelomeningocele (MMC) just a few hours after birth. Postnatal spina bifida treatment involves surgery to close the defect within the first 24 to 48 hours of life. A pediatric neurosurgeon removes the MMC sac, if present, and closes deep tissue layers and skin over the defect to protect the spinal cord and nerves. Often, a shunt is required to drain spinal fluid from the brain, but so far Caoimhghin has not required this.
“It truly is a miracle, the doctors being so excellent at what they do, to preserve so much of what he can do,” says Courtney. “He is totally mobile. He loves to play sports and dance, especially tap dancing — it's his seventh year.”
Persistence and progress
Today Caoimhghin is an active almost-10-year-old who loves to play sports, read (especially about American history, one of his favorite topics), play music on his recorder and sing. He continues to make progress and regularly returns for follow-up care through CHOP’s Spina Bifida Program, which offers long-term management for infants, children and teens with spina bifida and other spinal cord problems. Long-term care is an important aspect of spina bifida treatment as children can develop new health problems as they grow into adulthood.
Above all, Courtney and Marty want Caoimhghin to know that he can do whatever he sets his mind to.
“He approaches life with a great sense of humor,” says Courtney. “He’s also very bold. We tell him all the time his boldness is persistence — that comes right along with everything he’s been through. We want him to do whatever it is he wants to do, as long as he gives everything his all. We’ve never watched him shy away from anything.”
He certainly doesn't shy away from a little friendly competition: "I especially love to play basketball with my brothers and my dad. I play against my mom too, but she always wins!!!"
His parents also hope that he’ll be able to grow up in a world where people are more understanding of birth defects like spina bifida. For Courtney, whose sister passed away at age 17 after struggling with the condition, the progress that has been made in spina bifida treatment options, as well as advocacy, is encouraging.
Caoimhghin has taken this spirit to heart. "I want all kids to know that it is important to not think of yourself as 'handicapped' or 'disabled,'" he says. "Instead, think about how you are 'handi-capable' and have special abilities, and you will be able to do so much more than you think!"
The Williams family encourages other parents in their shoes to contact their local spina bifida associations for more information, and to meet other families going through similar experiences. They also talk about the importance of being an advocate for your child, even before he or she is born.
“Keep hope alive,” says Marty. “Take it one day at a time. There’s no sense worrying about it.”
Originally posted: July 2013
Updated: May 2018