Alexia Khammanivong wasn’t conscious to know she had given birth.
She didn’t know that minutes before delivery she’d been flying over Tampa Bay in a helicopter at 120 mph.
She wasn’t aware Kyrie weighed 3 pounds, 9 ounces, or that he was breathing through the help of a ventilator, the same as she was.
Doctors sedated Khammanivong and connected her to the machine hours before the delivery, when COVID-19 dropped her oxygen dangerously low. Her son, on the other hand, was born two months too soon and needed more time to grow his lungs.
Khammanivong was not awake to name her partner Chris Blackwell Jr. as the father on the birth certificate, so Blackwell sat in his Nissan Rogue in the parking garage of St. Joseph’s Hospital in Tampa and prayed. He wanted to be as close as he could.
It was the first day of 2021. His young family was fighting for its life.
Blackwell, 26, and Khammanivong, 21, began dating nearly three years ago, but she’d noticed his smile from afar at St. Petersburg High School, where sometimes he assisted his father, the longtime basketball coach.
After high school, she recognized Blackwell on social media and connected. They’d take long drives together around the city listening to hip hop on WILD 94.1 and eating ice cream. She found him to be a sweetheart. He loved the way she listened with an open mind.
They moved in together in St. Petersburg six months later.
They found out they were pregnant in the summer. They weren’t trying, or not trying, but decided if it happened, it was okay.
“When I found out it was a boy, I was lit,” Blackwell said.
They revealed the gender to a few family members at a park in early December, holding each other under pink and blue balloons near a picnic table. Blackwell posted pictures of cool cribs. He captioned a video of an ecstatic dad running through a house celebrating his son making the middle school basketball team with, “this me.” He was imagining someday.
Khammanivong considered how even if a family isn’t rich, they can always provide their children the gift of happy parents and an emotionally stable home.
The COVID-19 pandemic was the backdrop, but they were cautious. They wore masks and stayed home and unwound with daily walks in the park. They were young with no health issues.
Khammanivong worked from home doing customer service for PetSmart. Blackwell delivered packages for UPS.
He started feeling sick with a fever in late December. Khammanivong felt fine, but they went together to get tested at Tropicana Field on Dec. 23. He had it, and she didn’t, the results said.
But as Khammanivong bought Gatorade and prepped a room for Blackwell to quarantine in, he started feeling better, and she started feeling weak.
An ambulance took her to Morton Plant Hospital in Clearwater on Dec. 29, her 21st birthday.
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Blackwell couldn’t go inside because of pandemic rules, so they texted. On New Year’s Eve, she wrote that doctors were telling her about something called “intubation.” He texted her at midnight, “Happy New Year. I love you.” She texted back after 1 a.m., saying she hated how the night nurse always stuck her with needles.
Then, she went silent.
Khammanivong’s blood-oxygen level continued to drop as her temperature went up. She was placed in a coma, so a ventilator could keep her failing lungs going.
Doctors at Morton Plant conferenced with doctors at St. Joseph’s Hospital in Tampa. They agreed that even though she was only 30 weeks along, the best chance for both Khammanivong and her baby would be an emergency C-section, and that Khammanivong likely needed an ECMO, a blood-oxygenating machine that essentially does the full work of a patient’s heart and lungs.
They loaded her into a helicopter that flew her 22 miles to St. Joseph’s.
New Year’s Day can be a little slow at the hospital, but Khammanivong’s airlift shattered that. It was unusual to get such a young woman in critical distress, but an intubated pregnant woman was a shock.
Amy Mattison, a registered nurse in the medical intensive care unit, noticed the settings on the ventilator were turned up higher than she’d ever seen. The intensive care staff, which had treated many older, more vulnerable patients, became resolute, Mattison said. “I wanted to fight so hard for her.”
To save her, the team decided, they’d be proactive with every tool available, and everything they’d learned since the start of the pandemic.
Doctors realized several months into COVID-19 that patients fare better when turned face down. The maneuver, known as “proning,” reduces pressure from the heart and diaphragm on the lungs, and has been credited in part with vastly increased survival rates.
Kyrie, eight to nine weeks premature, was delivered Jan. 1 at 7:58 p.m. He was moved next door, to the neonatal intensive care unit at St. Joseph’s Women’s Hospital. Khammanivong was then turned prone.
She seemed stable, but not long after, her heart stopped while Mattison and a respiratory therapist were moving her.
Mattison began chest compressions, and a “code blue” was called. Her blood-oxygen reading was 17 percent, dangerously low. Others rushed in, and breathed for her manually. Khammanivong was given epinephrine, and her heart began to beat again, seconds shy of permanent brain damage.
Mattison left the room in tears, reeling, she said. “Our now 21-year-old patient that was already intubated had now coded.”
She would never give up, but she knew the reality of working with the sickest COVID-19 patients. Once these episodes started, the odds were not good.
Three days after Kyrie’s birth, Blackwell, with the help of a social worker, nurses and Khammanivong’s mother, navigated the legal paperwork to visit his son.
He reached his hand into the incubator. Kyrie grabbed his finger and held it, for half an hour.
“Best time of my life,” Blackwell said. He visited every day after.
But those joyful days with his son were cut with moments that landed like a slap, remembering Khammanivong was a building over, fighting for life.
No one was allowed to visit her in the intensive care unit, so he called three times a day.
Mattison came to know him well enough that she texted him directly. He was so appreciative. But it’s hard to understand what’s going on inside the room if you’re not there, so she FaceTimed him from Khammanivong’s bedside.
Doctors, still looking to be proactive, started her on Aviptadil, a decades-old synthetic form of a natural peptide studied for use in erectile dysfunction and pulmonary fibrosis. It was being trialed as a therapy for COVID-19-related respiratory failure after showing promise in Israel. Khammanivong may have been among the first 100 COVID-19 patients in the U.S. to get it.
Infants born at 30 weeks gestation, like Kyrie, have a high rate of survival but are likely to have breathing and eating difficulties and are vulnerable to infection as their immune system develops.
Kyrie was tiny but got stronger. After a week, he breathed on his own without a ventilator. Blackwell held him. He sent Mattison photos that she showed the other nurses. It made her feel lighter on hard days.
As word spread about the young mother in a coma, friends, family and strangers showed support. Basketball parents from the high school, city officials, a famous baseball player. People dropped off diapers, a crib, a stroller, clothes. The gestures filled Blackwell with hope.
The only thing left to do when Kyrie came home, he thought, would be to take him on joyrides.
Blackwell was headed home from visiting Kyrie at the hospital Jan. 13 when he received a call asking if he could come back and spend the night.
Kyrie had developed an inflammation in his intestines called necrotizing enterocolitis, a devastating disease affecting premature infants. Blackwell watched the double doors for an hour and 15 minutes as his son underwent surgery to remove damaged tissue.
The surgeon finally came out with another doctor. When he saw them, followed by three nurses, he broke down. He’d seen enough movies to know, when that many people come to talk to you, it’s not good.
The surgeon shook his head.
Kyrie was on life support, but too far gone. Blackwell, not wanting his son in pain, told the doctors they could let him go. If the situation had been reversed, he knew Khammanivong would make the same choice.
Blackwell stopped sleeping.
It was always worse at night. Surrounded by baby clothes and diaper boxes, there were no hospital updates to distract him. His thoughts raced, and his skin crawled, and the one person who could understand what he was going through was in a coma.
Khammanivong dreamed vividly in the coma. She wandered hospitals and universities from Utah to China. She searched for Blackwell. She was desperate to communicate, but no one could understand her.
She dreamed she gave birth.
She dreamed Blackwell found her. She couldn’t see him, but she heard his voice.
The whole city was looking for you. We finally found you.
The day after her son died, she received her first visitors in the intensive care unit. Her mother and Blackwell came together. They were allowed 20 minutes, in full protective gear.
Blackwell sat, unable to speak, staring at his partner’s slack face, closed eyes, chest rising.
“I’m sorry,” he finally said to her. And he cried.
Less than 24 hours later came the first good news about her in weeks. Her oxygen level was improving, and her blood pressure was normalizing.
Mattison and the rest of the team had waited for this, even getting updates on Khammanivong on their days off. After all their work, it still felt “miraculous,” she said. She reported the oxygen numbers to Blackwell as they ticked up in the coming days, 65, 70, 90 percent.
Then Khammanivong woke up.
After almost a month in a coma, she couldn’t walk or drink or speak out loud, but she knew she’d given birth.
“The first thing I noticed,” she said, “was my stomach.”
No one was volunteering information, but at first, it felt safer to sink into the haze than to probe deeper about Kyrie. Everything was fuzzy and confused, but she sensed something wasn’t right.
When she strengthened a little, she finally phoned Blackwell. At first, he wanted to protect her. He told her Kyrie was still in the NICU.
When he arrived at the hospital, the nurses told him he needed to break the news. They could not lie to her.
He stood outside for a while, then went into Khammanivong’s room.
What he said that day remains between them.
Khammanivong is home now, healing.
She’s able to get out of bed on her own and doesn’t use a walker anymore. She can talk. She can smile and laugh a little. At her last appointment, the doctor said most of the fluid is gone from her lungs.
She did not meet her baby but attended his memorial Feb. 7. “He’ll always be our first son,” she said. They kept it small, and everyone wore masks. Mattison, the ICU nurse, was there.
Kyrie was not officially counted among the more than 500,000 Americans who have died due to the coronavirus. That’s okay with his parents.
“He’s at peace,” Khammanivong said. “Whatever happened happened. That won’t change anything now.”
They share their story in the hope people realize what’s at stake in the pandemic.
The Centers for Disease Control and Prevention say pregnant people are at a higher risk of serious illness if they contract COVID-19. The reasons could have to do with a weakened ability to fight infection, faster heartbeat or the uterus displacing the lungs in the third trimester, making it harder to breathe. A study published in JAMA Internal Medicine in January found COVID-19 leads to significantly higher rates of complications, including preterm birth.
Since March 2020, more than 75,000 pregnant women have contracted COVID-19, according to the CDC, and close to 13,000 have been hospitalized. Data on how many went to intensive care units is lacking, but 82 died.
The couple does not know where they contracted the virus. It could have been that one trip into Walmart, or walking past someone to go to the car, Blackwell said. There is no practical way to achieve 100 percent safety.
But they know there are those who take more risks. Those who believe less science and more rumor, go maskless, gather in crowds and downplay it as just a flu.
“I’ve heard it all, that it’s a conspiracy,” Blackwell said. ”I had two people, my family, fighting for their life. Just wear a mask. Wash your hands. Stay 6 feet back.”
“If you love yourself, your baby and your family,” Khammanivong said, “do everything you can to protect them.”
Still, their experience has left them with more faith in other people, not less.
Blackwell thinks about the surgeon who agreed to pray with him, the nurse who put together a scrapbook of him with Kyrie, the doctor who knelt with the couple and cried. He thinks of all those acquaintances and strangers who sent gifts, and the hundreds who donated to pay for Kyrie’s memorial.
Khammanivong thinks about the person in Arizona, a state where they don’t know anyone, who sent the framed words with Kyrie’s name beneath them.
Those we have held in our arms for a short while, we hold in our hearts forever.
She will hang it someday, when she’s ready to create a little area for remembrances.
When she came home, Kyrie’s unused things were everywhere. She watched Blackwell quietly pack up the crib, the stroller and the clothes and return them.
“That was really hard for us,” she said.
It’s still hard, and nights are the hardest.
But now, home together, that’s when they have each other.