Ivy Martin

When Ivy was born after a normal pregnancy, she did what all newborns do: she cried.

But then something changed. Right after Ivy stopped crying, she stopped breathing and turned blue.

To Ivy’s mom, Stephanie, it seemed that within seconds, a whole team of doctors was in the room. And it would be 12 hours before she would see Ivy again.

A Difficult Diagnosis

“Nobody was 100 percent sure what was happening,” Stephanie recalled. “The doctors came in with a lot of different possibilities. Cleft lip. Cleft palate. Down syndrome. It was a lot of guesses and uncertainties.”

Finally, the doctors at WVU Medicine Golisano Children's were able to determine Ivy’s condition. She was born with the back of her nose sealed, a rare newborn breathing problem called bilateral choanal atresia.

“When you have nasal blockage at birth, it’s an emergency because children and infants automatically want to breathe through their nose,” Hassan Ramadan, MD, chair of the WVU Department of Otolaryngology, said. “They don't know how to open their mouth to breathe. These kids will go blue as soon as they're born because they're trying to breathe through their nose, but nothing is going in. So then something needs to breathe for them.”

In these situations, a surgeon inserts a tube into the windpipe (trachea) to keep the airway open. Or, babies may have a sucking nipple placed in their mouth with a hole in it so they can keep their mouth open and breathe through it temporarily until surgery corrects the nose.

A Complex Surgery

Ivy needed surgery to place stents in her nasal cavities to help her breathe more normally. It was a complicated procedure because a newborn’s nasal cavities are very tiny. The surgery required instrumentation that might not get through the nose of a four-day-old baby.

In the past, surgeons would enter the mouth by opening the palate to try to fix the nasal blockage. But that can cause problems with facial, mouth, and palate growth. The child could end up with significant tooth deformities.

Dr. Ramadan decided the best approach was to place the stents with endoscopic nasal surgery, which was a relatively new procedure at the time. He used a thin, rigid tube with a light and a camera to repair the nasal passages. The surgery was successful.

Ivy was finally able to go home after spending almost three months in the NICU.

More Surgeries as She Grows

Over the years, Ivy has thrived and is active in a variety of sports, including golf, air rifle shooting, softball, basketball, and volleyball. She’s active, independent, and determined, and pushes herself in sports and in life.

She continues to be tested regularly for such conditions as allergies and anything that might affect her breathing. And as her body grows, her air passages tend to narrow and need to be widened.

Growing up has required more surgeries to reduce her turbinates (shelves of bone inside the nasal cavity) and remove her adenoids. She will also have surgery for a deviated septum that her mother said came about because a ball hit her.

Ivy’s nose holes (not the nostrils, but the back openings of the nasal cavity) will remain the same size because they are artificial holes. As she grows, those may need to be adjusted surgically. Her care team continues to monitor those. She sees an ear, nose, and throat (ENT) specialist every six months to have her breathing tested. She’s also had a sleep study, and her family is thankful that clinicians didn’t find apnea.

Care That Feels Like Home

The surgeries have helped Ivy breathe better over time. Her family is grateful for the surgeons and care teams that have made Ivy’s progress possible.

Her mother said, “Being able to be two miles from home, right in your backyard, literally to have a top-of-the-line facility with doctors, nurse practitioners, nurses, everybody that specializes in these types of areas. It's a privilege. It's an honor to have this right here in West Virginia.”

When asked how she felt about her care at WVU Medicine Golisano Children’s Hospital, Ivy said, “Great!” She added, “I have a picture on my wall of the groundbreaking of this building [the current WVU Children’s Hospital]. I was so little when they started building this building. And I was one of the first people to see the inside of it, too. It kind of just feels like home.”