This is no ordinary birth.
Owen is no ordinary child.
And Riley is no ordinary place.
It’s dress rehearsal time, only the stage is not in a theater — it’s a Riley Children’s Health operating room.
The team is rehearsing how they will save Owen Lower’s life during his birth. Once his dramatic delivery begins they will have only precious minutes to give him a way to breathe and a chance to survive. Calm and confident, dozens of skilled specialists step into their places, rehearsing precise choreography. Focused. Determined. Prepared.
A Rare Diagnosis
Katy Preidt and her husband Dustin Lower had no idea anything was unusual about her second pregnancy until a 20-week ultrasound revealed something alarming: There was a large growth on her baby’s neck. The family was soon referred to the Fetal Center at Riley Children’s Health, the only program of its kind in Indiana. The Fetal Center brings a comprehensive team together to manage complex pregnancies, from fetal imaging specialists, to Maternal-Fetal Medicine Specialists, to neonatologists, to every kind of pediatric subspecialist. Fetal Care Coordinator Emily Phillipy, BSN, RN-OB, guided Katy and Dustin through the entire process as their “go-to” contact while they learned more about their son’s rare tumor and the plan to save his life.
Typically, a family with a complex pregnancy meets with their team of caregivers for a care conference in the Riley Fetal Center outpatient clinic, where they look at the fetal images and discuss the game plan.
However, Katy had to be hospitalized several times during her pregnancy to manage excess amniotic fluid, so the care conference came right to her room in the Riley Maternity Tower. “Making those connections while I was pregnant, it was just so lovely,” she said. “We had established a relationship and trust that was just amazing.”
The fetal imaging revealed the growth on Owen’s neck, called a cervical teratoma, was bigger than Owen’s head and impacted his airway. Riley maternal fetal medicine specialist David Streitman, M.D., explained to the family how the team would need to perform an EXIT procedure, which stands for ex-utero intrapartum treatment. As Dustin explains, “It’s a C-section where they deliver his top half, his head and one shoulder, to establish an IV, then they work on intubating him while he’s still getting oxygen through the placenta. They said typically they would get 20-25 minutes max to be able to intubate him.”
Fetal Center Director Melinda Markham, M.D., was a key member of the care team and was impressed with how well Dustin and Katy collaborated. “The thing that really struck me was how calm they were — how much they absorbed that information and were prepared for whatever the outcome might be,” Dr. Markham said.
The EXIT procedure was scheduled for November 1, 2023, at 37 weeks gestation. To give Owen’s care team a chance to practice exactly how to intubate him quickly, Dr. Streitman used fetal images to have a 3D model of Owen’s anatomy created. Katy and Dustin remained hopeful as everyone planned for their son’s unusual birth. “We chose the name Owen for our sweet boy because it means ‘little fighter’ or ‘young warrior,’” Katy said in a CaringBridge journal. “We knew that this kid was going to be a fighter and that, frankly, he had to be.”
A Twist in Timing
Owen’s care team had rehearsed and prepared for their roles — but they also knew there was a chance his birth could happen earlier than the scheduled date. Backup specialists were looped in to make sure they were prepared for any scenario.
That preparation paid off. Katy’s water broke at 3:30 a.m. on October 18, 2023, two weeks before Owen’s birth was scheduled. Dustin called the triage department and the plans kicked into high gear. “They had a phone tree set up, Katy’s info was in all the nurses’ stations,” Dustin says. “That was a big piece, how prepared everyone was.”
Schedules were quickly adjusted. Colleagues stepped in for those who were unavailable. Two operating rooms were cleared, and the team gathered for one last “dress rehearsal,” practicing the steps they were about to take to save Owen while also taking care of his mother. Specialists with the Riley Pediatric ECMO (extracorporeal membrane oxygenation) team were on standby. This type of life support would be the only option left if Owen could not be intubated within that tight 20-25 minute window during which oxygen flowed through the umbilical cord.
Katy entered the operating room and the team began surgery. With Owen halfway delivered, Dr. Streitman carefully monitored his health. “I’m holding his head in my left hand…I’m watching his heart rate stay very steady, that tells us that the placenta is still attached, still giving him oxygen,” Dr. Streitman explained. Meanwhile, Riley otolaryngologist Lauren Sowa, M.D., began working against the ticking clock to intubate Owen. Within 19 minutes, the effort was successful. “It was quite the feeling,” said Dustin, recalling the moment when he first heard the good news that Owen was intubated. He said it felt “like weightlessness after everything we had been worried about and gone through.”
Removing the Tumor
Owen spent two challenging weeks in the RIley NICU, as specialists helped him become stable and strong enough for tumor removal surgery. On November 1, 2023, Riley otolaryngologist Diane Chen, M.D., performed the surgery and removed the large mass. It took less than two hours. “As a pediatric head and neck surgeon with a surgical oncology background, I had a thorough understanding of his tumor’s position to his airway, major neck vessels, skull base, and spine,” said Dr. Chen. “Fortunately, his tumor was well encapsulated and did not seem to invade any critical structures.” Dr. Markham called the tumor removal surgery “amazing.” “Dr. Chen and her team did a wonderful job taking the whole thing out — what a huge success that was,” she said. The tumor was sent in for pathology testing.
A week later, Owen gave his mother the best birthday gift possible: He took his very first unassisted breaths on Katy’s birthday, after Dr. Markham successfully removed him from the ventilator. “He did great. That’s what we were all hoping for,” said Dr. Markham. Katy described how special it felt that Dr. Markham was the doctor who extubated Owen. “She has been there with us through everything. I don’t know what we would have done without her,” said Katy. That gratitude also extends to their large team of Riley experts, as Katy expressed in her CaringBridge journal: “We can’t say enough good things about our doctors we met and the many doctors who were involved behind the scenes that played a role. I am truly at a loss for words to show our gratitude to them.”
During Owen’s recovery, the family also received a happy update, which Katy shared in her CaringBridge journal: “Big update, pathology came back and there is no cancer in the tumor! We are all so relieved to hear this news!”
Donors Make a Difference
Throughout Owen’s journey, his family felt the impact of donors’ generosity. Riley’s donor-funded Child Life Specialist team provided support to Owen’s older sister, Lyla. “That did wonders for my mental health,” said Katy. “It was obviously a really tough time for me. Having coloring books, being at a children’s hospital with a young child was perfect — she was able to play and have fun.”
Philanthropy also has a direct impact on the care mothers and babies are now able to receive all under one roof at Riley. “We could not have opened the Riley Fetal Center program without Riley Children’s Foundation support,” said Dr. Markham. Dr. Chen adds that donor support is essential in providing the level of expertise, technology and multidisciplinary collaboration it takes to care for children like Owen. “Your support for Riley will continue to enable our pediatric hospital to be the best in the state, providing the same level of care as other high-ranking institutions in the U.S.,” said Dr. Chen.
Little Warrior’s Bright Future: “He has everyone rooting for him.”
Owen went home from Riley just before Christmas 2023. Since then, he has been readmitted several times to manage breathing issues and respiratory infections. He is a huge source of joy to his family and loves playing with his older sister. “His path will continue to have bumps along the way, but there is no doubt in my mind that he is going to thrive,” said Dr. Markham. “All of us have this hopeful and optimistic view, because it has been amazing how well he has done so far. He has everyone rooting for him.” Katy and Dustin are planning to incorporate a Riley fundraiser into Owen’s first birthday celebration in October. “We could never be quite grateful enough,” said Katy. “We owe our life as a family to Riley.” As Dustin puts it, “We had the best of the best.”