In November 2020, Tyra Starnes was shocked when her primary care doctor diagnosed her with chronic kidney disease during a routine annual exam. Up until that point, the 25-year-old West Palm Beach elementary school teacher felt healthy.

However, as her kidneys continued to deteriorate, Starnes started feeling the effects of the disease. She often felt fatigued and had developed a metallic taste in her mouth.

In April 2021, her primary care doctor referred her to Giselle Guerra, MD, medical director of transplant services and medical director of the kidney program at the Miami Transplant Institute (MTI), an affiliation between Jackson Health System and UHealth – University of Miami Health System.

Dr. Guerra took over Starnes’ treatment, immediately putting her on peritoneal dialysis, a system to remove waste from her kidneys. Shortly thereafter, Starnes and the MTI team started discussing the possibility of a kidney transplant as the best course of treatment.

“Those at risk of high blood pressure, diabetes, or who have a family history of kidney disease can develop chronic kidney disease,” Dr. Guerra explained. “Tyra had none of those things. Her disease was a result of an acute immune response that rapidly deteriorated her kidney function.”

After starting peritoneal dialysis, Starnes was placed on the national transplant list. As her condition worsened, her family came together in her support. Many of her loved ones quickly signed up to be tested as potential donors.

As fate would have it, Starnes’ great-aunt and godmother, Lesley Anderson, was a perfect match.
“When asked time and time again if I was certain I wanted to be a donor, I never questioned my answer,” Anderson said. “Tyra is my goddaughter. I was meant to be her donor. I wouldn’t have had it any other way.”

After nine months of peritoneal dialysis and follow-up appointments with the MTI team, the date for the surgery was set for January 26, 2022.

“I remember feeling drained after my last dialysis session,” Starnes recalled. “I wanted to have control over my life again. I didn’t want to wait any longer.”

On the day of the surgery, Starnes felt both worried and relieved, although she knew she was in the best hands.

A multidisciplinary team led by Rodrigo Vianna, MD, PhD, MTI’s director of transplant services and chief of liver and gastrointestinal transplant programs performed the living kidney donor transplant on Anderson using the da Vinci Surgical System. Gaetano Ciancio, MD, MTI’s chief academic and medical officer and director of the kidney and kidney-pancreas programs, transplanted Starnes.

“Robotic surgery minimizes surgical complications for living kidney donor patients. It often lessens medical risks due to shortened hospitals stays. More than 95 percent of our donors who have undergone this robotic procedure stayed in the hospital for less than 24 hours,” Dr. Vianna said. “The surgical expertise of our MTI physicians with the most complex cases, particularly when paired with innovative devices, such as the da Vinci robot, will help catapult health care to the next level for our transplant patients.”

Starnes and Anderson’s surgeries were a success, and they were both discharged on the same day. The two plan to celebrate on January 26 every year to commemorate their transplant anniversary.

“I want to let everyone know they don’t have to be afraid of becoming organ donors and should consider it,” Starnes said. “It can one day help save someone’s life.”

For a few months, Juan Llanes felt some discomfort in his stomach. To ease the pain, he’d drink water and feel better.

The 63-year-old postal worker never suspected his stomach issues were a sign of heart failure. Then, on January 16, 2021, he suffered a massive heart attack at home.

“Until it happened, I felt like Superman,” Llanes said.

Llanes, who never had a history of cardiac issues before his heart attack, credits his wife, Rosie Llanes, for acting quickly and dialing 911 after noticing her husband in discomfort as he was standing up from their couch.

He was rushed to a nearby hospital, where doctors inserted a stent in his coronary artery to help restore his heart’s blood flow. Unfortunately, there were serious complications.

Llanes went into multiple-organ failure and cardiogenic shock – a life-threatening condition in which the heart suddenly can’t pump enough blood to support the body’s needs. He was referred to the Miami Transplant Institute (MTI) at Jackson Memorial Hospital.

Llanes was placed into a medically induced coma for two weeks and on dialysis for two months. He was weak, and his medical team at MTI, led by Anita Phancao, MD, Chief of Heart Failure, Mechanical Circulatory Support, Transplant Cardiology at MTI, had to stabilize him if he was going to survive.

Dr. Phancao and her staff determined that Llanes’ best chance to survive was to implant in his chest a left ventricular assist device (LVAD), a battery-operated, mechanical pump that helps the lower left heart chamber pump blood to the rest of the body. The LVAD minimizes risk and offers patients enhanced quality of life.

Dr. Phancao consulted with Matthias Loebe, FACC, MD, PhD, FCCP, a leading heart transplant surgeon and Chief of Heart and Lung Transplant and Medical Support at MTI, and Llanes’ surgery was scheduled for March 10, 2021.

“This operation was the optimal option for Juan,” Dr. Loebe said. “We surgically implant the LVAD in patients who have reached end-stage heart failure and are not organ transplant candidates.”

Dr. Loebe said LVADs are a great option that help save many lives.

“The survival rate with the newest generation of LVADs is getting close to actual heart transplants,” Dr. Loebe said. “You can have an LVAD and live 10 to 12 more years.”

Llanes’ LVAD was implanted through open-heart surgery. The procedure lasted about five hours, but the length varies from patient to patient depending on their cardiac health and history.

In the hospital, a multi-disciplinary team that included nutritionists and psychologists worked with Llanes and prepared him to go home and adjust to his new lifestyle.

“What sets us apart is that we can provide the full spectrum of support,” Dr. Phancao said. “We have all the tools available to us. We prioritize educating our patients so they have a positive transition to living with an LVAD.”

Given a second chance to live, Llanes hopes to return to the workforce soon and is enjoying time with his family.

“Because of the great medical team I had at MTI, I can see my grandchildren grow up,” Llanes said. “I didn’t know about LVADs, but that procedure saved my life, and I hope this information can help save many more lives.

Harold Jean never knew that he was born with a heart condition. He lived a normal childhood, played sports, and exercised. But in 2005, at the age of 23, he suffered a minor stroke.

He quickly recovered, but it was the beginning of a series of health problems. Ten years later, at age 33, Jean learned his heart was weak. He was diagnosed with congestive heart failure and needed a pacemaker to help control his heartbeat.

“Even with the pacemaker, I could run and exercise,” he said. “I used to ride my bike often and was part of the Brickell Run Club.”

However, that all changed on November 23, 2020.

“I was home alone when all of a sudden, I couldn’t breathe,” he recalled.

He immediately called for a ride to Jackson Memorial Hospital.

“When I arrived at the hospital, I fainted in the emergency department,” he said. “After I woke up, I was in a hospital bed. The doctors told me if I hadn’t made it to the hospital when I did, I would’ve died.”

Anita Phancao, MD, FACC, Chief of Heart Failure, Mechanical Circulatory Support, Transplant Cardiology at the Miami Transplant Institute, was one of the doctors treating Jean.

“When Harold arrived at the hospital, he was experiencing shortness of breath, and we quickly discovered he was in cardiogenic shock, which means his heart could not pump enough blood through his body,” Dr. Phancao said. “We started him on IV medication to help support his heart and put in a balloon pump and admitted him to the intensive care unit (ICU). He was very sick, and so we put in for expedited advanced cardiac therapy, including listing him for a heart transplant.”

Due to the ongoing COVID-19 pandemic, visitors weren’t allowed in the hospital, so Jean couldn’t have his family at his bedside. Luckily, the ICU nurses caring for him stepped in. They spent time talking with him and keeping his spirits up.

“I love my nurses,” he said. “They took incredible care of me and became my family in their absence. They were so important for my mental health.”

On his birthday, the nurses that Jean had begun to call family surprised him with a cake and a birthday celebration. Then came the greatest gift of all.

“My nurse surprised me with the news that I would be receiving a new heart,” Jean said. “I was so overwhelmed with emotion and began to cry.”

On December 14, 2020 – Jean’s 40^th birthday – Jean underwent a successful heart transplant.

“Despite everything going on in the world with the pandemic, our transplant team has remained steadfast and committed to performing these lifesaving procedures,” said Matthias Loebe, MD, PhD, FCCP, FACC, Chief of Heart and Lung Transplant and Mechanical Support at Miami Transplant Institute, who performed Jean’s heart transplant.

After his transplant, Jean remained hospitalized, undergoing physical therapy at the Christine E. Lynn Rehabilitation Center for The Miami Project to Cure Paralysis at UHealth/Jackson Memorial for six months as he slowly recovered and learned to walk again.

“It was a difficult challenge, but I trusted the process,” he said. “By practicing my rehab exercises each day, I was finally able to walk. Jackson is truly the best hospital in the world. They did a great job, and now I’m back to living my life.”

For Jean’s medical team, seeing him thrive is the best gift.

“Our number one goal when performing a transplant,” Dr. Loebe said, “is to help our patients get better and well enough to go back to living their life.”

Today, Jean has resumed the activities he used to enjoy, such as exercising and running. And just when he thought things couldn’t get better, Jean received a note from his organ donor’s family.

“They reached out to me first, and then I wrote them back,” Jean said. “That letter meant so much to me. As soon as I saw who it was from, I just started crying. It’s such a miracle. Someone I don’t even know saved my life.”

Jackson South Medical Center is equipped with a new, robotic surgical system that aids in making knee replacement surgery more precise and accurate.

The system provides live, 3-D models that help surgeons plan and perform knee replacement procedures with more precision because it allows them to personalize everything – from the size of the implant components, their fit, and the mobility of a new joint.

Jackson South is the only facility in Miami-Dade and Broward counties with a CORI Surgical System for knee replacement procedures. So far, the Jackson team has performed more than 100 knee replacements using this new technology.

We caught up with Jaime Alberto Carvajal Alba, MD, a UHealth – University of Miami Health System orthopedic surgeon who specializes in this type of robotic surgery at Jackson South. Dr. Carvajal explains how this technology works, who can benefit from this type of procedure, and what patients can expect after knee replacement surgery.

Tell us about the new robotic surgical system and how it works for knee replacement surgery.

The CORI Surgical System is a handheld, semi-automated robotic system. It creates a 3D model live during surgery of the patient’s knee anatomy and allows us to assess the person’s range of motion, stability and better understand how their knee behaves. This provides all the information we need to know to restore the person’s own anatomy and assure a knee replacement is placed in an optimal position.

With this particular technology, we see a live 3D model of the patient’s knee during the surgery, so patients do not need to go for CT scans and other imaging before the procedure, as is sometimes required with other systems.

The live, 3D model also helps us set up the surgical plan and adjust it as needed, and then perform the procedure in a very precise manner. It helps me adjust the size of the components, adjust the tension of the ligaments and, at the end of the procedure, ensure the knee is working as it should. The surgery typically takes about one hour.

When someone has knee pain, what is the process for undergoing a knee replacement?

When a patient comes to us with knee pain, we first assess their symptoms and see what conservative measures they’ve tried first. We always recommend conservative management first, such as physical therapy, oral medications, and sometimes injections to see if we can decrease inflammation and pain.

If these measures do not help or aren’t enough to get the patient back to an adequate quality of life, then we offer surgery. Surgery is an option for almost anyone, as long as they don’t have other serious medical conditions that could make the procedure a risk for them.

Who is a candidate for knee surgery using this new handheld robotic system?

This system works for anyone in need of a knee replacement. Using a robotic system increases the accuracy of implant placement, which leads to optimal outcomes.

What’s the recovery processes like after knee replacement surgery?

At Jackson, we’ve been pioneers of a rapid recovery protocol that gets patients back on their feet and back to living their life as soon as possible.

Two hours after the surgery, we help patients out of bed and back on their feet. A physical therapist will come by with a walker to help them begin putting pressure on the leg.

Our patients go home the same day as surgery, which is nice because people enjoy being back in their homes and recovering in their own bed. We send them home with oral medications to control blood clotting and to manage any pain. In most cases, pain usually diminishes within a few days when the inflammation goes down.

Patients have their first physical therapy session the day after surgery. Our goal is to take the walker away about one-and-a-half to two weeks after surgery. Then, they will use a cane for another week or two, as needed.

Most of our patients generally return to their full activity about four weeks after surgery.

Is there anything else a patient should know before considering a knee replacement surgery?

I highly recommend people seek out a team – with a surgeon and surgical support team – that specializes in knee replacement procedures. At Jackson South, we are a high-volume facility performing hundreds of these procedures each year with an entire surgical team dedicated to this type of surgery. This means we have perfected our procedures down to the tiniest details, ensuring the best experience and outcome for our patients.

For more information or to make an appointment at Jackson Health System for robotic knee replacement surgery, call 305-256-4334.

In May 2021, Pedro Grillo and his wife were working out when he started to suffer from a severe headache and extreme exhaustion. Grillo, who was confused at his sudden exhaustion, sat on the floor to regain his energy when he lost consciousness.

Gym staff called 911 as Lyannete Soca-Grillo tended to her husband.

Fire rescue rushed Grillo to the emergency department at Jackson South Medical Center, where he was diagnosed with a ruptured arteriovenous malformation (AVM), an abnormal connection between arteries and veins, which causes severe hemorrhaging in the brain.

Due to COVID-19 protocols restricting visitation, Soca-Grillo was not immediately allowed in the hospital, and by the time they allowed her in, her husband was already intubated. The doctors told her he had fallen into a coma, and his condition was quickly worsening. Grillo was transferred to Jackson Memorial Hospital, where Jacques J Morcos, MD, a UHealth – University of Miami Health System neurosurgeon, was on standby to remove the blood in his skull.

“When the doctors told me they had to transfer Pedro, they warned me that he may not survive the ambulance ride to Jackson Memorial,” Soca-Grillo said. “I was terrified. My husband was alone, unconscious, and didn’t have any idea what he was going through.”

At Jackson Memorial, Dr. Morcos and his staff stabilized Grillo and removed the hemorrhage. A few days later, Dr. Morcos performed a craniotomy – a surgery to open the skull – to remove the AVM. He placed a shunt in Grillo’s brain to drain the excess fluid in his skull.

“AVMs are usually present at birth and are typically only detected after they rupture,” Dr. Morcos said. “Brain AVMs, such as Pedro’s, are rare and affect less than one percent of the population. People living with AVMs can live a long and healthy life without it ever rupturing.”

Grillo spent the next four weeks in a coma at Jackson Memorial recovering.

“All those weeks without Pedro were difficult for me,” Soca-Grillo said. “I couldn’t remember the last good memory we had. I could only picture him in the hospital.”

In July, Grillo’s medical team slowly brought him out of his medically-induced coma. He was unable to speak, eat, or walk, and he suffered from short-term memory loss.

“The last thing I remembered was being in the gym,” Grillo said. “I don’t remember waking up in the hospital, and when I first heard about my injury, I just couldn’t believe it.”

The next phase of his recovery consisted of rehabilitation. Grillo and his wife met with physical and occupational therapists from Christine E. Lynn Rehabilitation Center for The Miami Project to Cure Paralysis at UHealth/Jackson Memorial to discuss his recovery plan.

Over the next month, Grillo underwent intense inpatient occupational and physical therapy sessions four times a week, eight hours a day. After his discharge in August, he continued outpatient therapy at Lynn Rehabilitation Center.

“During our therapy sessions with Pedro, we made it clear to him that we were working to help him regain his independence,” said Gemayaret Alvarez, MD, a UHealth physical medicine physician and medical director of neurorehabilitation at Lynn Rehabilitation Center.

Grillo took his therapy seriously – practicing the skills and exercises he learned daily. He knows that the first year post-surgery is the most critical time frame in his recovery, and he hopes to return to his old self.

“When I saw Pedro after his time at rehab, I couldn’t believe how much better he’s gotten,” Dr. Morcos said. “This was a man who was on the brink of death and is now back on his feet and talking, both of which he couldn’t do when I first operated on him.”

In December 2021, Pedro passed his simulated driving assessment at Lynn Rehabilitation Center and accomplished his goal of being able to drive. He now drives himself to and from his rehab visits. His next big milestone is returning to work at CVS Health.

Today, Grillo is able to walk and climb the stairs of his Cutler Bay home without the aid of a walker or cane. Grillo and his wife are excited to finally be together and resume their lives after missing so much time with each other.

“I’m incredibly blessed to be here today, and when I think back to my injury, it almost doesn’t seem real,” Grillo said. “I’m so thankful to the therapist at Lynn Rehab and the doctors at Jackson Memorial for saving my life.”

When Latevia Ward, a third-grade teacher in Miami, went to the hospital in August at 27 weeks pregnant, she knew something wasn’t right. She was recovering from a recent bout of COVID-19 but felt like she was experiencing early signs of labor.

Doctors at the Women’s Hospital at Jackson Memorial Hospital were monitoring her closely because Ward — a mother of 7 — had a history of preterm labor and preeclampsia, which results in dangerously high blood pressure during pregnancy.

Just one year ago, on August 6th, 2020, Ward delivered twins at 27 weeks. The twins, Aidan and Asia, weighed less than two pounds and struggled with many complications. Ward lost both within a matter of months — one-month-old Aidan on Labor Day and four-month-old Asia on Thanksgiving morning.

In 2018, Ward lost another baby girl, Miracle, who was also born prematurely.

With this pregnancy, Ward had been in the hospital several times already due to issues stemming from preeclampsia, which was frustrating because she only had high blood pressure when pregnant. And after losing her previous three babies, she tried to get as healthy as possible.

“You can’t be prepared for it,” Ward said of preeclampsia. “[Before this pregnancy] I had lost weight, was eating right and everything, and wasn’t even on high blood pressure medicine. But as soon as I got pregnant, preeclampsia came back.”

Ward continued to go to the hospital every three days for monitoring. Then, doctors checked her cervix and realized she was dilated, a sign her body was preparing for labor.

Ward was in the hospital on bed rest for seven days, and doctors gave her medications to try to slow or stop the delivery and to prevent complications in the baby if it was born early.

On September 14, Ward went into labor and delivered a baby boy via cesarean section. Aaron weighed 4 pounds. The moment Ward heard him cry, she knew something was different. She never heard her twins cry because as soon as they were born, they needed to be intubated to help them breathe.

“When I heard him cry, I started crying because it was a relief to me,” she said.

Aaron was whisked away to the Neonatal Intensive Care Unit (NICU) at Holtz Children’s Hospital, the largest Level III NICU in the region that can provide care for the sickest and smallest babies.

Within four days, Aaron was off the CPAP breathing machine, but Ward was still nervous. She feared something would go wrong.

“I was afraid about everything,” she said. “I was so sad all over again thinking about my other babies.”

The nurses in the NICU, especially those who know her from the previous year, have reassured her each day that Aaron is doing well and getting stronger. He is tolerating food and is learning to suck to be able to eat from a bottle. He is now 8 weeks old, weighing more than 5 pounds.

“He’s alert and doing better,” Ward said. “I’m able to relax a little. But I still have some bad days, [especially since] November is when I lost Asia.”

Despite her understandable fears after her unimaginable loss, Ward has faith that Aaron will pull through.

“You just have to stay strong. I’m spiritual, and I read my Bible to stay positive, and I have positive friends around me,” Ward said.

Ward’s original due date was November 25, and doctors believed he would be ready to go home by then, but on Friday, November 12, Ward received the much-awaited that her baby boy was finally coming home.

Ward is looking forward to that day.

“I’m thankful to God that my son has finally come home and now we get to spend time together as a family,” She said.

When Araceli Cantero Obregón was seven months pregnant, doctors in Nicaragua told her that her son Edgard Sequeira would have hydrocephalus, a condition in which excess cerebrospinal fluid (CSF) builds up within the ventricles of the brain. She was also advised that they identified spina bifida, which occurs when a baby’s spinal cord fails to develop properly in the womb.

Despite the heartbreaking news, Obregón was not going to give up on her first-born son, who she welcomed into the world on September 6, 2007. By the time Edgard turned one, he had undergone surgery for both conditions. The procedures allowed the family a sense of normalcy for a few years, but the young boy continued to face medical setbacks and personal hardships.

Throughout his childhood, Edgard was not developing physically or cognitively. He also was experiencing complications with his bladder and kidneys. Furthermore, Obregon began noticing her son was lacking energy. He was isolated from his friends and had occasional seizures.

In 2016, pediatricians in Nicaragua ran tests and gave Obregon frightening news — her son was diagnosed with chronic kidney disease (CKD) and would need to start dialysis immediately. Edgard was also suffering from high blood pressure. The diagnosis was an all too familiar red flag for Obregón, who had lost her husband to CKD two years prior.

“It was traumatic to hear my son was suffering from the same disease that took my husband,” Obregón said. “My whole world was falling apart.”

After years of attempts with no sustainable treatment, Obregón desperately sought the care of pediatric nephrologists at Holtz Children’s Hospital, leaving Nicaragua for the U.S. in February 2020.

When Edgard arrived at Holtz Children’s, he was malnourished, weighing 50 pounds at 12 years old. After a thorough examination, his team of nephrologists determined he needed intervention in urology, nutrition, and blood pressure care before he could be listed on the national transplant waiting list. He would also need to continue receiving dialysis four times a week while being monitored by the pediatric transplant team at the Miami Transplant Institute (MTI).

Due to the COVID-19 pandemic, the family was also faced with the decision of having to stay in Miami long-term. For Edgard to have a fighting chance, Obregón knew the best decision was to stay in South Florida and make sure her son completed his treatments.

Thanks to the help and financial support of family, friends, and Miami’s Corpus Christi Catholic Church, Edgar and Obregon were able to stay in the U.S. and continue with Edgar’s care.

Over time, Edgard, now 14, had breakthroughs in his health, and last October, he was listed on the national transplant list. Five days after her son was listed, Obregón received the call from MTI that they were ready to perform the life-saving procedure.

The successful kidney transplant was led by Mahmoud Morsi, MD, and a multidisciplinary team at Holtz Children’s.

“I am eternally grateful to everyone, the social workers, the nurses, the nephrologists, the Holtz team, the MTI team, and so many others who have become a part of our family,” Obregón said. “There is no way to repay them for giving my son a chance to have a better quality of life.”

For the care team, miracle stories like these also remind them of their life’s calling as medical professionals.

“It’s a gift for them, and it’s a gift for us,” said UHealth pediatric nephrologist Jayanthi Chandar, MD. “It gives us a sense of fulfillment and happiness to see our patients thrive and witness extraordinary changes in their mental, emotional, and physical state.”

When Patricia Fusco and Katrina Wegmann were in high school, Patricia shared that she would not be able to carry and birth her own children. Unbeknownst to Patricia, Katrina decided then that if she was able to when the time came, she would be a surrogate for her friend.

Little did they know that more than 20 years later, not only would they still be close friends, but their husbands would also be best friends. And when Patricia and her husband, Andrew, had trouble finding a surrogate, Katrina stepped up.

Katrina, who already had two children of her own, expected it would be “another easy pregnancy and it would be able to make them a family.”

The pregnancy turned out to be anything but easy. Twelve weeks into her pregnancy, Katrina’s blood pressure was high — something she’d never experienced before, causing the pregnancy to be considered “high risk.”

Turning to Jackson for High-Risk Care
As the pregnancy progressed, Patricia, a senior specialist for community outreach and events at Jackson Health System, asked Katrina to consider meeting with the Maternal Fetal Medicine team at Jackson Health System. Every year at work, Patricia plans multiple events, including the NICU reunion, where babies who were saved and cared for at the Holtz Children’s Hospital Neonatal Intensive Care Unit (NICU) are reunited with their medical teams.

“I know that Jackson treats over 50 percent of South Florida’s high-risk pregnancies and that the Holtz Children’s Hospital NICU is one of the largest and best in the nation,” she said. “Working at Jackson, I hear the miracle stories all the time. But you never think you’re going to be one of those miracle stories.”

Katrina and Patricia immediately felt comfortable and confident in the Jackson team. They were followed by Jackson Medical Group physicians, Dana L. Homer III, MD, FACOG, an OB/GYN, and Felipe Tudela, MD, FACOG, an OB/GYN and maternal fetal medicine specialist.

Patricia called Tudela “a gift to his profession.”

“He’s probably the best doctor I have ever had the pleasure of meeting,” she said. “Everyone on the team invests themselves wholeheartedly in each patient’s case.”

When Katrina was 23 weeks pregnant, she suffered from terrible headaches, and her blood pressure was extremely high. She was admitted to the hospital and told she would need to remain there on bed rest to try to prevent an early delivery. That meant a possible two-to-three-month hospital stay – a stressful complication since she had two small children at home. Later they would confirm she had preeclampsia, a potentially dangerous pregnancy complication associated with high blood pressure.

A Difficult Choice
Two weeks later, a routine ultrasound showed that the baby was not growing and there was concern with the placenta, which was no longer providing critical nutrition to the baby. Dr. Tudela told them to consider delivering the baby early because he did not know if the baby would survive otherwise. Patricia, Katrina, and their husbands came together to make the difficult decision.

“That was a terrifying day for us, probably one of the most emotional days,” Patricia said. “Ultimately, we trusted the Jackson NICU enough that we preferred to deliver him then, rather than seeing what could happen if we tried to keep him in utero.”

On May 27, 2021, at 25 weeks and five days gestation, Joseph Patrick, nicknamed JP, was born weighing just 1 pound 4 ounces. Quickly, doctors told the Fuscos that they made the right choice as there was no more amniotic fluid in the sac, and the baby would not likely have survived if they had waited.

As soon as the Fuscos saw their baby in the NICU, they felt more at ease.

“When we saw him, I thought, ‘they’ve got this,” Patricia said. “Once he was stable in the NICU, things began to feel safe. And every step of the way from that day forward, the doctors, nurses, therapists, everyone at every level always kept us abreast of what was going on.”

The NICU Village
JP thankfully had no brain bleeds and a fairly smooth ride in the NICU, with some breathing complications and an unknown infection during his stay. He remained in the NICU for 123 days.

“They say it takes a village [to care for a child], and I can wholeheartedly say there is no better village than the NICU village at Holtz Children’s,” Patricia said.

During JP’s stay, Patricia and Andrew said they were a part of every conversation regarding his care and the nurses became their friends, confidants, and teachers.

In addition to the expert and compassionate care that both Katrina and JP received, Patricia said she is grateful that everyone at Jackson treated their uncommon situation as if it were an everyday occurrence.

“We had a unique situation because we were high-risk. It was also unique because it was a surrogacy, and we were two friends going through this together,” Patricia said. “We know that our situation is not common. It definitely is not something they see every day. But every single physician, every single healthcare worker, never batted an eye at us. Everyone treated the experience with understanding and compassion. I don’t know if that would have been the case at another hospital.”

In September, after a nearly four-month NICU stay, JP was able to go home.

“It was a relief to finally be able to walk out of those doors with our son,” Patricia said. “It felt like an accomplishment.”

A Special Bond
JP continues to grow and thrive but is closely monitored by doctors and specialists to make sure he’s developing and that no more complications arise. Patricia and Andrew are now enjoying what they call a more “normal” stage of parenting.

“We’ve already seen him grow from a fragile 1-pound infant to a robust, beautiful baby boy,” Andrew said. “Now I’m looking forward to watching him hit those milestones, not only growth and developmental milestones but the little kid moments that define a childhood.”

And Katrina is happy that she will be there to witness it all. While they still need to be careful about visits due to the pandemic, the families are closer than ever.

“I talk to my kids about JP all the time, and they can’t wait to spend time with him. I look forward to them growing up together,” she said.

The experience “intertwined” the families forever, Patricia said.

“We are eternally grateful to her,” she said. “There are no words or ways we could ever adequately repay or thank her for what she has given us.”

In December 2020, Daniel Furlong, a former urology resident at Jackson Memorial Hospital, and his wife, Sarah, were packing for their babymoon trip – four months before the expected arrival of their first child – when suddenly, Sarah began to experience uterine cramps.

The couple immediately rushed to The Women’s Hospital at Jackson Memorial, where doctors determined Sarah was in preterm labor. She remained hospitalized for observation, but the baby just couldn’t wait.

On December 30, 2020, with the help of Rachel Franklyn, MD, Jackson Medical Group associate medical director of obstetrics and gynecology, Sarah gave birth to a baby boy at nearly 25 weeks. Ryder, who weighed just 1 pound, 10 ounces, was immediately rushed to the neonatal intensive care unit (NICU) at Holtz Children’s Hospital. He remained intubated in the NICU for two months and had to overcome several medical setbacks, including pneumonia and brain bleeds, which caused him to have several seizures.

Ryder was also diagnosed with a condition called patent ductus arteriosus (PDA), an opening between the two major blood vessels leading from the heart that normally closes shortly after birth. He underwent a PDA ligation procedure, performed by Eduardo Alfonso Perez, MD, a University of Miami Health System pediatric surgeon, to correct the birth defect.

“He had to overcome so many medical challenges in the NICU that his medical team began calling him ‘Ryder the fighter’,” his father, Dr. Furlong, recalled.

When Dr. Furlong wasn’t tending to his patients, he was at his son’s bedside. Due to COVID-19 visitation restrictions, he and his wife took turns visiting Ryder.

“As a physician, I struggled with knowing too much and trying to relay that information to my wife without scaring her while being honest with her about Ryder’s progress,” Dr. Furlong said.

Last May, after spending 125 days in the NICU, Ryder was finally able to go home. The Furlong’s family and friends had anxiously awaited for this moment to come.

“Having Ryder as a patient was a journey for my staff and me,” said Dianne Bennett, ARNP, director of patient care services at Holtz Children’s. “Seeing him finally reunited with his parents after all he had gone through was such a heartwarming moment.”

Dr. Furlong and his wife are happy to be settling in with their son.

“Hearing Ryder cry at home was such a relieving moment,” Dr. Furlong said. “My wife and I had waited months to finally be with our son. We were so overjoyed to have him with us.”

Ryder will continue to visit various specialists to make sure he’s progressing and meeting important developmental milestones.

“As a member of the Jackson family, it was encouraging to know that my son was truly in the best care possible,” Dr. Furlong said. “My wife and I are so appreciative and thankful to everyone who took care of Ryder, including all of the doctors, nurses, therapists, and ancillary staff who treated and loved him as their own child.”

In May 2021, Zac Yezzi found himself in a life-threatening situation after he suffered a stroke.

Yezzi and his fiancé were in St. Barts planning their wedding, when one morning, the 30-year-old began developing a splitting headache that lasted throughout the day. He then lost vision in his right eye, followed by function in his right arm and leg. Somehow, he managed to drag himself to the bathroom and splashed himself with water.

“I was not aware of how traumatic my injury was then, but I knew something was terribly wrong,” Yezzi said. “I asked my fiancé to dial emergency services and request an ambulance.”

Yezzi was rushed to a nearby hospital, where a CT scan revealed that he had a large, eight-centimeter hemorrhage on the left side of his brain, which controls speech. The average hemorrhage is measured in millimeters.

With no neurologist on staff at the hospital in St. Barts, Yezzi was flown to a larger hospital on the nearby island of Guadeloupe. He arrived alone, afraid, and in agonizing pain, unable to communicate with his medical team, who only spoke French.

In Guadeloupe, doctors performed additional tests on Yezzi’s brain, and the results revealed an arteriovenous malformation (AVM) –an abnormal connection between arteries and veins, which would require complex neurosurgery that the hospital was not equipped to perform.

The AVM was determined to be the cause of Yezzi’s initial stroke and hemorrhaging.

While this was happening, Yezzi’s family had contacted the Bee Foundation, an organization that raises awareness about brain aneurysms and hemorrhages. The foundation played a crucial role in getting him transferred by connecting his family with a French-speaking neurosurgeon to communicate with the medical staff in Guadeloupe.

After two days, Yezzi was medically evacuated to Jackson Memorial Hospital. He was accompanied by his fiancé and his father, who were finally able to arrive in Guadeloupe despite multiple flight complications.

“The days leading up to my medevac were two of the longest days of my life,” Yezzi said. “During the flight to Miami, the pressurized cabin was causing me indescribable levels of pain, but I was just relieved to have my fiancé at my side.”

Upon arriving at Jackson Memorial, Yezzi was immediately placed in the neurointensive care unit, where he and his family met with Robert M. Starke, M.D., a University of Miami Health System neurosurgeon and neuroradiologist.

Dr. Starke walked Yezzi and his family through his diagnosis and recommended surgical embolization of the aneurysm and AVM and a craniotomy to remove the aneurysm as the best course of action if they wanted to prevent any recurring brain bleeds.

“Zac should consider himself fortunate,” Dr. Starke said. “Normally, a brain bleed as big as his has the potential to squash the brain, which could lead to death or severe long-term damage.”

After considering his choices, Yezzi elected to undergo surgery.

“I owe everything in my life to Dr. Starke! He and his team saved my life,” Yezzi said. “He’s an incredible surgeon. I’m so lucky to have been transferred to Jackson Memorial.”

Yezzi and his fiancé are back home in New York City, where he’s resumed work. He has made a full recovery, regained his sight, as well as the function in his right arm and leg.

He’s working on promoting awareness and the importance of early detection of brain aneurysms and AVMs to prevent others from having to go through a similar injury.