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Melissa Spangler

Holding onto Hope. 

Keri Spangler. Melissa Spangler. Children's Hospital & Medical Center, Omaha, Nebraska. rare birth defect known as congenital diaphragmatic hernia (CDH). An abnormal opening in the diaphragm, the muscle that helps in breathing, was allowing abdominal organs to move into the baby's chest area and compress the developing lungs.Having given birth to three healthy children, Keri Spangler had no reason to expect her next pregnancy would be any different. But a routine ultrasound at 30 weeks proved otherwise.
Further testing confirmed her obstetrician's fear. The baby appeared to have a rare birth defect known as congenital diaphragmatic hernia (CDH). An abnormal opening in the diaphragm, the muscle that helps in breathing, was allowing abdominal organs to move into the baby's chest area and compress the developing lungs. The life-threatening defect would require surgery shortly after birth to repair the diaphragm and place the organs in their proper position.

Keri and her husband, Ryan, searched the Internet to learn more about their unborn baby's condition. The more they read, the more they feared. "Everything I saw about CDH was so negative," Keri says. "All I could do was hold on to hope."

The Bennington, Neb., couple worried they would need to leave the state to have a successful delivery and surgery. That worry was put to rest after they met with Shahab Abdessalam, M.D., a pediatric surgeon at Children's Hospital & Medical Center. "Dr. Abdessalam answered our questions completely and truthfully," Keri recalls. "We felt more comfortable with the situation and confident he would do what was best for our baby."

Dr. Abdessalam told Keri and Ryan that his surgical intervention would depend on how well the baby's lungs had developed before birth. Traditional surgery methods would require a 4-inch incision in the chest. Recovery can take weeks, and the incision would leave a large scar on the baby's chest. Well-developed lungs would allow him to do the surgery using a minimally invasive technique - a first in Nebraska - which would lead to less scarring and improved recovery time.

Weighing 6 pounds, 11 ounces, Melissa Ann Spangler arrived two weeks early on Nov. 11, 2007. She was immediately placed on a ventilator and taken to the Newborn Intensive Care Unit at Children's.

Five days later, Melissa had surgery to repair the defect. Her right lung was fully developed, and her left lung was 80 percent developed, making her a perfect candidate for minimally invasive surgery. Dr. Abdessalam repaired the defect and positioned the organs correctly through a tiny incision - 4 millimeters. This technique led to dramatically better recovery, minimal scarring and less time on the ventilator. Dr. Abdessalam expects her to develop normally.

Six days after surgery, Melissa went home to join her older brothers and sisters. Now at 17 months of age she gives her parents and siblings a run for their money. After a follow up with Children's neonatologist, Howard Needelman, M.D., she has been seen routinely by her family physician, Kenneth Blad, M.D., to chart her progress. Currently, although her height and weight shade her on the lower percentiles for growth, her gross and motor skills are right on target. Says Keri: "She's always the shining star at her check-ups. She makes the doctors look good!"

In addition to her robust health, Melissa has developed a great sense of humor and enjoys making her family laugh, whether donning a laundry basket for a hat or wearing her daddy's shoes. "You wouldn't have known that she's had problems," says Keri. "She's just a special spark in our family."

The Spanglers feel fortunate in their decision to choose Omaha as their home. "We had just moved here before the diagnosis. "If we hadn't moved here, we would not have had the convenience of location or the quality of care which we received from the doctors and staff at Children's," explains Keri. "We are so grateful for the miracle we have been given."

© Children's Hospital & Medical Center | In Affiliation with University of Nebraska Medical Center College of Medicine