Please log in, or sign up for a new account and purchase a subscription to continue reading.
✓ Unlimited website access 24/7 ✓ Unlimited e-Edition access 24/7 ✓ The best local, regional and national news in sports, politics, business and more! With a Digital Only subscription, you'll receive unlimited access to our website and e-edition. Our digital products are available 24/7 and are accessible anywhere, anytime.
As a current print subscriber, you receive 24/7 access to our website and online e-edition at no additional charge. All you have to do is activate your access. To activate digital access, you will need your account number. You can find your account number on any recent subscription notice or bill.
Sorry, no promotional deals were found matching that code.
Promotional Rates were found for your code.
Please log in, or sign up for a new account to continue reading.
Thank you for reading! We hope that you continue to enjoy our free content.
Welcome! We hope that you enjoy our free content.
Thank you for reading! On your next view you will be asked to log in or create an account to continue reading.
Thank you for reading! On your next view you will be asked to log in to your subscriber account or create an account and subscribe purchase a subscription to continue reading.
Thank you for signing in! We hope that you continue to enjoy our free content.
Thank you for reading! We hope that you continue to enjoy our free content.
Thank you for reading! We hope that you continue to enjoy our free content.
Thank you for reading! We hope that you continue to enjoy our free content.
Thank you for reading! We hope that you continue to enjoy our free content.
Thank you for reading! We hope that you continue to enjoy our free content.
Checking back? Since you viewed this item previously you can read it again.
Variably cloudy with scattered thunderstorms. Low around 65F. Winds SSW at 10 to 20 mph. Chance of rain 60%..
Variably cloudy with scattered thunderstorms. Low around 65F. Winds SSW at 10 to 20 mph. Chance of rain 60%.
Velerie Alvis, shortly after she was born. Velerie was born at 22 weeks 4 days gestation, weighed 1 pound 6 ounces and was just 11.5 inches long. She overcame impossible odds to make to her third birthday.
This chart compares the indicators neonatologists believe increase survivability rates among periviable infants and Velerie’s statistics. Miraculously, Velerie and her family met most indicators.
Velerie Alvis, shortly after she was born. Velerie was born at 22 weeks 4 days gestation, weighed 1 pound 6 ounces and was just 11.5 inches long. She overcame impossible odds to make to her third birthday.
This chart compares the indicators neonatologists believe increase survivability rates among periviable infants and Velerie’s statistics. Miraculously, Velerie and her family met most indicators.
As the Alvis family prepares to light three candles on their daughter’s Minnie Mouse birthday cake tomorrow, it’s hard to imagine the independent toddler as the micro preemie born at 22 weeks with less than a 30% chance of survival.
Beth Wrieden-Alvis wanted to be a mother, but after two miscarriages, a septated uterus diagnosis and corrective surgery, fertility treatments, and still no baby, she decided to put her dream on hold. “We were in the process of planning my wedding. I found the perfect dress that needed no alterations or adjustments,” said Wrieden-Alvis. Then, the news came that she was pregnant. “I was in shock,” she said.
Wrieden-Alvis, and her husband, Anthony Alvis, were married on July 6, 2019. On August 11, they found out their baby was a girl. A week later, Wrieden-Alvis woke up in the middle of the night with severe back pain. “I thought maybe I had a UTI or something,” she said. The couple drove to the hospital in Burlington. Upon arrival, doctors determined she had an infection. Moreover, her cervix was dilated, and her amniotic sac was bulging. They sent her immediately to the University of Iowa Hospital (UIH) in Iowa City.
“I was there for two days before my water broke. And out she came,” said Wrieden-Alvis.
Velerie Lois Alvis was born on August 20, 2019, at the gestational age of 22 weeks and four days. Less than the weight of two cans of soup, she weighed 1 pound, 6 ounces and was 11.5 inches long.
Currently, 22 weeks is the lowest threshold of human viability. Periviability is the stage of fetal maturity with a marginal chance of extrauterine survival. According to an article published in Hippokratia, the time window between 22 and 26 weeks of gestational age is considered the period of periviability. It is a gray zone for clinical and ethical decision-making.
At this point, most state legislatures have not enacted laws to regulate neonatal care and limits of viability. With advice from clinicians, parents have two choices; try to resuscitate the baby in a newborn intensive care unit (NICU) care or give the infant palliative care, a hospice for babies. With palliative care, the doctor delivers the baby and allows the parents to hold them until they pass away, usually within a few minutes. NICU care immediately gives the baby life-sustaining treatments based on parent and clinician consensus. The care either escalates or is withheld depending on the initial response of the infant and the parents’ choices.
Due to the gray area of periviability, most hospitals won’t attempt resuscitation for babies under 24 weeks. Hospitals that don’t offer parents the choice of NICU at 22 weeks are not unethical. Instead, they’re making a judgment call about what is best for the baby based on what they see as a low chance of survival balanced against the potential pain of intensive care.
“The two extremes, the ‘vitalistic’ approach (preserving life at any cost) and the ‘easy’ alternative of euthanasia, should be avoided to maintain the holistic view of the human person,” wrote Doctors Gkiougki and Chatziioannidis in a Hippokratia article. “The sanctity of life does not take precedence in all circumstances.”
Survival rates vary depending on location, and the interventions hospitals can provide. Smaller hospitals don’t have the resources to care for periviable babies in their NICU. Varying existing approaches across NICU units in medical, ethical, and socioeconomic issues may seriously impact the quality of care of infants and add an emotional burden to families and health care professionals involved.
Researchers have discovered several indicators that can influence a periviable baby’s prognosis. For example, if the mother had a singleton birth, if the baby is female, if the birthweight of the baby is high for its gestational age (GA), if the mother has been exposed to antenatal steroids, socioeconomic parameters, proactive intervention, willingness to intervene, and if the baby was born in a tertiary (specialized) center.
Velerie was a singleton female baby. Her birthweight was higher than the average weight of babies with a GA of 24 weeks! When Wrieden-Alvis was admitted to the hospital, the doctors gave her two corticosteroid injections 24 hours apart to help Velerie’s lungs develop before birth. At 22 weeks, the two steroid shots can double a baby’s chance of survival.
In 2019, the University of Iowa reported that, among 20 babies born at their children’s hospital at 22 weeks between 2006 and 2015, 70 percent survived, the highest survival rate at that gestation ever reported in the United States. Beth’s condition gave her time to transfer to UIH, where Velerie was born.
Considering her size and development, Velerie was very healthy. The doctors gave the Wrieden-Alvis family a 72-hour window. If she made it, there would be a good chance she would survive.
Wrieden-Alvis felt a spiritual optimism about Velerie’s prognosis. Her mother passed away in 2014 and was Velerie’s namesake. The nurse on staff assigned to Wrieden-Alvis’s room the night Velerie was born was named Valerie. At UIH, they were in the Pappajohn Pavilion. “My dad’s name is John,” said Wrieden-Alvis. “It just kind of felt like everything was going to be okay.”
Velerie survived the first 72 hours and kept getting stronger every day. “We didn’t have any downhill spells; it was all uphill,” said Wrieden-Alvis.
Velerie was in the neonatal ICU and connected to a maze of wires, tubes, and monitors. She had a picc line and oxygen. She was kept in an incubator to help stabilize her body temperature. Nurses changed her using diapers that could fit a Barbie. “When they’re first born, you can’t put your weight on them because of their nervous systems,” said Wrieden-Alvis. So she would sit next to Velerie and occasionally touch her hand. “I was so scared. I didn’t want to hold her and hurt her.”
When Velerie was about two months old, Wrieden-Alvis held her for the first time. “My dad and my husband left the room. They couldn’t do it; it was too stressful.”
After Wrieden-Alvis was released from the hospital, she returned to her home in Keokuk. She got in her car every day and drove 90 minutes to Iowa City to see Velerie. A social worker helped Wrieden-Alvis enroll in the Colette Louise Tisdahl Foundation, which gave her gas cards to subsidize the daily travel expenses to see Velerie. Foundations like the CLT Foundation facilitate opportunities (like travel expenses) otherwise impossible for families of lower socioeconomic status, which also improves neonatal outcomes.
“Every time the phone would ring, we thought it was something bad, but it was just them calling to let us know that they either had raised her oxygen a little bit, something along those lines,” Wrieden-Alvis said.
Wrieden-Alvis could not give enough praise to the doctors that kept open communication with her. “Every night, before I went to bed, I always called. They’d update me on everything. Dr. Rysavy (one of Velerie’s doctors) explained everything to me in street terms. All the other (doctors) used medical terms. I couldn’t understand it.”
The only hiccup was a valve in her heart that wouldn’t close. Failure of the patent ductus arteriosus (PDA) valve to close is common among premature infants. So the neonatologists gave Velerie medicine in an attempt to close the valve without surgery. The treatment worked initially, but the valve quickly reopened.
“So they had to do another round of medicine, and it was just scary thinking about it,” said Wrieden-Alvis. “The NICU journey is not for everyone. “God picks who He wants to go through that battle because you have to be strong to go through it.” Fortunately, the medicine worked the second time, and Velerie didn’t have to have corrective surgery.
After 144 days, Velerie graduated from the NICU and came home, just as the COVID pandemic began. Wrieden-Alvis was grateful for the timing, “They weren’t letting people come in and out. So, I’m glad that she was home before then.”
For six months, Velerie was on oxygen. “We had oxygen and an oximeter, and like, no matter how she moved, even if it was just a little bit, the machine would go off,” said Wrieden-Alvis. “So we lost sleep because we thought our baby wasn’t getting oxygen. It was really stressful for the first six months.”
Wrieden-Alvis attributes getting through the stress of the NICU and Velerie’s first year to a robust support system, “I always somebody was always with me when I went to see Velerie.”
Wrieden-Alvis made a local friend from Missouri named Tessa, who had twins on oxygen around the time Velerie was discharged from the NICU. “She was an amazing help,” said Wrieden-Alvis. “If I had issues, I called her. In the middle of the night, if she needed an oximeter cord because the company was closed, she’d call and come pick it up. We were there for each other.”
Velerie was officially released from the UIH Neonatal clinic in April. “I messaged them about a concern, and they responded, ‘You’re gonna have to contact her doctor because we no longer want to see her!’” said Wrieden-Alvis. “ No more testing on her or nothing because they think she is perfectly fine.”
While Velerie is an overall healthy child, premature birth is a chronic condition requiring long-term follow-ups. “I still worry when Velerie gets sick because she has premature lungs,” said Wrieden-Alvis. “Back in March, we were in the hospital for five days because she got the rhinovirus, and it caused her O2 levels to go really down.”
Some preemies need eye surgery and glasses. Velerie didn’t need surgery, but does wear glasses. In addition, she has braces on her legs, but only temporarily to help her feet develop arches. Growth and development are common concerns for preemies, but Velerie is right on track.
Today, soon-to-be three-year-old Velerie is pretty much just your typical threenager. “My daughter is full of sass like, it’s bad,” said Wrieden-Alvis, “It’s attitude, attitude, attitude. And she’s really smart.” But, of course, with the fight Velerie has shown the world since she entered it, a little sass is to be expected.
Variably cloudy with scattered thunderstorms. Low around 65F. Winds SSW at 10 to 20 mph. Chance of rain 60%.
Variably cloudy with scattered thunderstorms. Low around 65F. Winds SSW at 10 to 20 mph. Chance of rain 60%.
Mixed clouds and sun with scattered thunderstorms. Gusty winds and small hail are possible. High 79F. Winds SW at 5 to 10 mph. Chance of rain 50%.
Success! An email has been sent to with a link to confirm list signup.
Error! There was an error processing your request.
Get the latest local and national news.