From Excruciating Pain
The birthday party in the hospital cafeteria seemed like nothing out of the ordinary, with colorful balloons and a big vanilla-iced cake with pink and blue letters that announced, "Happy First Birthday!" But for the Errante triplets, being born at all was a miracle. The proud parents, Roseann and Joe Errante, both 37, counted their blessings: Samantha, the designated "gang leader" who fought so hard to make it into this world; Michael, known for flirting with the doctors and nurses who had worked tirelessly to save his life; and Joseph, the quiet one, who took everything in with his solemn, dark eyes.The Errante triplets were something of a miracle right from the start. Roseann, a stay-at-home mom, and Joe, a public school custodian in West Babylon, New York, had longed for a second child after their son Anthony was born. But they had almost given up hope after two years of trying to get pregnant and a devastating miscarriage. "When we first found out I was pregnant, we didn't want to get too excited because so many things can go wrong with triplets," Roseann explains. "After three months of everything going smoothly -- not even morning sickness -- it hit us that we had a lot to do to prepare for three babies, and we'd better get started."
Roseann and Joe both come from big Italian families, and everyone wanted to pitch in to prepare for the babies. Roseann recalls many mother-daughter trips to Babies "R" Us. She was having the kind of glowing pregnancy most women dream about. But that was about to change.
One night in August 2005, when she was seven months along, Roseann shot up in bed at 3 a.m. and clutched her chest. Excruciating pain radiated up through her neck, ears and head. "One minute, I was sound asleep," she says, "and the next, I was jumping out of bed with pain so bad, I couldn't speak. On a scale of one to ten, this pain was a fifteen. I was scared for my babies and for myself."
Something Wrong
The Errantes spent the next morning, a Thursday, in the ER at Stony Brook University Medical Center, where Roseann was scheduled to deliver her triplets in eight weeks. Doctors monitored the heart rate of the mother and babies, and measured the mother's blood pressure and ran a battery of blood tests. By noon, the couple had learned that all the test results were normal. Feeling somewhat reassured and thinking that maybe the pain was just the indigestion that can occur with pregnancy, they returned home. But Roseann's pain got worse.
Says Joe, "All during the pregnancy, I'd been the one researching everything that could go wrong, and I never told Roseann anything unless it pertained to her. She can be a worrier, and she has hypertension, so I didn't want her blood pressure to shoot up unnecessarily. Now suddenly, something was going wrong, and I couldn't help her."
By Friday morning, Roseann's chest was still throbbing with every breath. "My wife is not a complainer, so I knew it had to be something serious," adds Joe, who took Roseann directly to the Maternal Fetal Medicine offices at the hospital.
"I didn't know what was going on, but I knew whatever I was seeing was atypical," says J. Gerald Quirk, MD, the obstetrician who had also examined Roseann the morning before. He admitted her for more in-depth cardiology tests and general observation.
On Friday and Saturday, Roseann had more blood tests, EKGs to measure her heart rate, ultrasound exams of her legs to look for blood clots, as well as chest x-rays. Joe sat by her side as, one by one, the test results again came back normal. Outwardly, he was his usual jovial self, joking with the doctors, trying to keep things light so his wife wouldn't worry. But he was getting increasingly nervous: "They kept coming into the room, saying, 'Great news, it's not this' or 'Great news, it's not that.' But I knew it wasn't good that they couldn't find anything wrong -- and my wife was still in pain."
Meanwhile, Roseann was sitting up and watching TV and walking around. As far as the hospital staff were concerned, she seemed to be in great spirits. "I'm pretty good at hiding my pain, and if I kept calm and didn't breathe too deeply, it did help," Roseann recalls. "I kept my hand on my stomach and felt the babies kicking, or watched the fetal monitors the whole time. I was thinking, As long as the babies are moving, I'm okay. They helped to keep me calm, even though inside I knew something was terribly wrong."
A Time Bomb
On Saturday afternoon, Roseann was feeling well enough to walk down to the lobby with Joe to visit Anthony and more than a dozen relatives. "At this point, we were thinking Roseann was having pregnancy complications that would disappear once the babies were born. We certainly didn't suspect anything serious," Joe says. "We were talking and laughing like we always do when we all get together."
After two hours, Joe walked his wife back to her room. That's when things took a horrible turn for the worse. By 4 p.m., Roseann's pain was so fierce, she couldn't straighten up. Joe knew he had to do something more to help his wife. "I tracked down a labor and delivery doctor, and she could see I wasn't my usual upbeat and talkative self," says Joe. "Those past few days, all I could do was hold Roseann's hand. I couldn't do anything to make her feel better. I was desperate."
Finally, an echocardiogram, a test that uses sound waves to create a moving picture of the heart, was done. And by 8 p.m., the terrifying results were in: Roseann had a dissected aorta, a two- to three-inch-long tear in the inner lining of her main artery that provides blood flow to her heart and other organs. The tear formed a bubble of blood between the layers of the aorta, which could have either burst or blocked blood flow to other major arteries, including the one pumping oxygen to the triplets. It was a time bomb that threatened her life -- and the lives of her babies.
When Frank C. Seifert, MD, a cardiothoracic surgeon at Stony Brook University Hospital, learned of Roseann's condition, he knew he had to act fast. Half of all people with an aortic dissection die if it's not detected and repaired within the first 48 hours of the initial tear. "At any time after the tear began, Roseann could have ruptured her aorta and died," explains Dr. Seifert, who acknowledges that a dissected aorta can spread as fast as a run in a stocking. "Or, the tear could have spread to other blood vessels to the head or abdomen, including those that supply the uterus."
Not only was the ripped aorta life-threatening to the babies, but the surgery to correct it also posed risks. Roseann's body needed to be cooled to 52 degrees and her heart stopped for 90 minutes to repair the tear -- conditions that each could have decreased her blood flow significantly and killed the triplets. The babies needed to be delivered, even though they were eight weeks premature, before Roseann could undergo the open-heart surgery to repair the tear. The doctors were racing against the clock to save the lives of the babies and their mother.
Believing in Miracles
Within an hour, about 30 doctors and nurses had assembled for the rare double surgery. Three teams were needed: one for the delivery, one for the heart surgery and a neonatal team to care for the babies after birth. The C-section to deliver the triplets began around 9:30 p.m. on Saturday, while the heart surgery team stood by, ready to intervene if Roseann's aorta burst unexpectedly.
Joseph came first, weighing only 3.1 pounds, then Samantha, at 3 pounds, then Michael, at 2.5 pounds. The tiny babies had some breathing problems at first. But within ten minutes, they were all stabilized, breathing with the help of respirators.
Meanwhile, Joe and the couple's big Italian family filled an entire waiting room. Suddenly, the doors burst open. "We saw the babies fly by on carts in these little incubators," recalls Joe as he chokes up at the thought of his three newborn children fighting for their lives. "I still didn't know if the babies were okay or if my wife was going to make it."
He had to wait four and a half more hours to learn that Roseann's heart surgery was successful, though the doctors said they couldn't be sure Roseann was going to pull through for another 48 hours. But her recovery was quick: She awoke just six hours after the open-heart surgery.
After the drugs wore off, one of the first questions Roseann asked, of course, was, "How are my babies?" But for the first three days, she was too weak to get out of bed to see them, so she had to be content with her husband's descriptions and digital photos. "He kept telling me the babies all looked exactly like him, but he didn't tell me they were hooked up to machines with bells and alarms going off," she says. "When I finally saw them, on the fourth day, it was a shock. They were so tiny and fragile. We couldn't pick them up, so we'd poke our fingers through the incubator openings to hold on to Samantha's fingers or gently rub one of the boys' tummies."
Roseann checked out of the hospital ten days after her surgery, and by Thanksgiving, the entire family was home for a big Italian feast. "I have my bad days of feeling tired or having pain, but I feel blessed that all three babies came through this ordeal perfectly healthy," Roseann says now.
"Sometimes, when things are really crazy, I have to stop and look back a year to remind myself how lucky I am that my wife and all three of my babies are here," Joe says today. "I wouldn't wish this ordeal on anyone, but it's definitely shored up some shaky faith for me. I'm a real believer in miracles."