Richmond toddler makes great strides since being born 14 weeks early

Callie Gauker has the kind of smile that melts hearts.

Her big, blue eyes look wide at you when you meet her for the first time. This is a toddler who's taking in every ounce of the world. When Callie enters a room, you can see her mind racing.

"She makes new friends everywhere we go," said her mom, Jodi Gauker of Richmond Township. "When we're at a restaurant and she's in her high chair, everyone has to come over and tell her how cute she is."

At Good Shepherd Rehabilitation Hospital in Bethlehem, the staff takes turns saying hi to Callie. They remember what she was like when she came to the pediatric unit in March 2015, so small and fragile.

"Oh my gosh, Callie," they say. "You're getting so big."

At 20 months old, Callie is not talking yet, but she claps for everyone she meets, and Jodi and her husband, Lee, can't wait for those first words to come. They can tell Callie has a lot to say.

The Gaukers are at the age where their friends are having babies, but they've learned not to compare Callie to others.

And that makes sense, because few babies have started life the way Callie has.

"It was not always this easy," Jodi said, laughing as her baby woos the crowd inside the Bethlehem rehabilitation hospital. "Not at all."

Born at 26 weeks

Callie was born at 26 weeks and a day, about 14 weeks ahead of schedule. The 26-week mark is significant, because babies born just a week earlier face much longer odds of survival, Jodi said.

Jodi was admitted to Lehigh Valley Hospital for a pregnancy complication before Callie was born. It turned out she had preeclampsia, a complication marked by a sudden spike in blood pressure that can lead to other issues such as liver failure, which happened to Jodi. She said it felt like a car was parked on her chest.

"It didn't hurt to breathe, but it did take a lot of effort," she said.

Lee and Jodi are a natural fit. Jodi is the talker, and Lee the strong, silent type.

She remembers the birth, and how crazy her daughter's Oct. 27, 2014, arrival was.

It was the middle of harvest at Gauker Farms. Jodi knew not to call her husband because he wouldn't be able to hear the phone's ring on the farm. Instead, she sent a text or two indicating a baby was coming. It'd be a good idea for him to get to the hospital, she said.

Lee arrived and joked that his wife could have given him a bit of a heads-up as they prepared for delivery.

"We will have this conversation later," she said, pointing her finger for dramatic effect, "but I gave you all the time I had."

Two roads

Callie was born via C-section. At 13.5 inches long, she was about the size of your typical Barbie doll, and she weighed 1 pound, 9 ounces. Lee said her thigh was about the size of his index finger.

After birth, Callie was placed into an incubator and required a breathing tube, ventilator and feeding tube. It took 27 days before she could be taken out of that incubator and held.

At the hospital, they learned she had a problem with her airway and needed to be transferred to the Children's Hospital of Philadelphia for specialty care. Callie weighed just 740 grams, slightly more than her birth weight, and had to get up to 2,000 before she could be moved to the Philadelphia hospital. That took two months.

She had a tracheostomy at CHOP in February due to narrowing in her airway. A thin tube was inserted into her neck to allow her breathe.

"Whatever needs to be done, you just do it," Jodi said. "Sometimes, it felt like you come to the road and there are two scenarios and the worst one always seems to happen, but we make it work."

Rehabilitation

Callie was pretty weak and sick when she arrived at Good Shepherd in March 2015. She had a respiratory infection that complicated matters. She still had the ventilator and breathing and feeding tubes, and she needed significant help from the breathing machine.

"She needed a lot of care," said Dr. Kimberly Kuchinski, Good Shepherd's medical director for pediatric physical medicine and rehabilitation. "She needed a lot of medical monitoring of her fluid load, her feeds."

Taking care of a baby so fragile is its own balance, said Sheri Luther, respiratory therapist at Good Shepherd. You try to gradually lower her settings on the ventilator, but any setback, such as an infection or illness, could derail a few weeks of progress.

It took weeks and months to build up her therapy from a few minutes in the day to longer sessions.

There were setbacks, but the milestones eventually started coming.

She smiled at 4 or 5 months old, and then she started batting her toys and interacting more with the people around her, following their movements, Kuchinski said. With therapy, she needed less and less support from her ventilator.

All along that process, Jodi and Lee were getting their own education about what they would need to do to care for Callie when she came home. Kuchinski said Jodi could teach a class for other parents in not sweating the small things.

Jodi admitted the last 20 months have tested her patience at times.

"As a parent you think I can just get my child out of bed, but we couldn't do that until we had some training with how to get her out of bed with a ventilator," she said. "I was so mad I couldn't even get my kid out of bed by myself."

After nearly three months, Callie was ready to continue her rehab at home in May 2015.

"On top of seeing where Callie has come from the beginning to discharge, it's also seeing how far the parents have come," Luther said. "Jodi, she would be so nervous when we would say today is the day you're going to do the trach change. The growth in the parents was such a neat thing to see."

Next milestones

The time at home has continued the curve of progress and patience. It's also reordered priorities.

The emergency room staff at Lehigh Valley Hospital knows the Gaukers by name. There was a surprise bout with bocavirus, a much-needed medication adjustment and an emergency tracheostomy tube change that the Gaukers handled just fine.

Callie has been weaned off her ventilator, but she will likely need surgery to correct her airway so she won't need her breathing tube.

"The road is not over," Jodi said." You hope things go according to plan. Not really much has gone according to plan so far. But everything that's happened we've had help though and it's worked out."

Callie has already caught up when it comes to growth, and the words and steps will come with time and more therapy. The Richmond Township dairy farmers said they will be excited when she gets to eat her first cheeseburger.

"I don't think there's any limitations about who she can be or what she can do," Kuchinski said. "Really, the sky's the limit."

Jodi and Lee are ninth-generation farmers at Gauker Farms in Richmond Township, where they raise steer and grow corn, soybeans, wheat and hay on about 250-acres.

"She's the 10th," Lee said of Callie.

Jodi looks at her daughter, and those wide eyes stare right back at her. Her hopes for Callie are simple and pure.

"I always hope she stays this happy kid," she said. "I hope you always find what makes you happy."