Saving lives and improving futures, one preemie at a time
October 10, 2008
If you’ve heard that the number of premature births in this country is skyrocketing, you’ve heard right. The number of preemies has shot up by 30 percent since 1981. However, as with most statistics, the numbers don’t tell the whole story. For that, you’d have to go to someone like Roger Faix, M.D., a Parkite and board-certified neonatologist and professor of pediatrics.
Faix earned his title after 14 years of rigorous academic schooling and training in the field. The education component of Faix’s resume is impressive. He spent his undergrad years at Dartmouth, followed by medical school at Cornell, a 3-year pediatric internship and residency at the University of Michigan and a neonatal-perinatal medicine fellowship at Duke. In 2001, he moved to Park City and joined the Division of Neonatology at the University of Utah, which provides 24/7 neonatal intensive care (NICU) patients at the University Hospital, Primary Children’s Medical Center and the LDS Hospital.
Neonatology wasn’t a tough choice for Faix. "I felt like it was my niche," he says. "I am faced with life-threatening and challenging situations every day, but I’ve never woken up Monday morning dreading work."
Faix acknowledges that the frequency of premature births in the U.S. is increasing, but says that the phenomenon goes beyond the usual suspects of fertility drugs, stress and lack of adequate prenatal care. True, the age of women eager to become mothers has escalated in recent years, which has led to a lucrative market for assisted reproduction techniques such as in-vitro fertilization. With the upswing in technology used to facilitate conception, the incidence of multiple births — which are more likely to deliver prematurely — has soared. According to The New York Times, in the past two decades, the incidence of twins has increased by 50 percent and triplets by 400 percent. But another major factor in the preemie boom, says Faix, is the reevaluation of what is considered premature.
Faix says there’s a common misconception that all preemies are born tiny enough to fit in the palm of your hand. In reality, the term "premature" encompasses all babies born before full-term gestation, which is 37 weeks. The youngest babies that survive are born at 22-23 weeks; at 24 weeks, they have about a 50/50 chance. In the past, only extremely preterm babies were labeled premature. However, in recent years, the medical world has included close-to-term births under the "premature" umbrella, which has skewed people’s perception of the dramatic increase in preterm births.
Premature babies are at high risk of a number of complications including anemia, respiratory problems and infectious diseases. In most cases, doctors aren’t able to pinpoint the cause of prematurity, but some of the known causes are certain lifestyle choices during pregnancy, poor prenatal care, hormonal imbalances and structural abnormalities.
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The preemies that Faix works with generally stay in the NICU from birth to their scheduled full-term due date. Many are ready before that, but it’s quite variable, he says. Sometimes the babies’ health improves throughout their stay and sometimes it declines. Ultimately, the family decides whether they wish to offer all the support possible or withdraw support because they feel that such a precarious situation is not the life they want for their child. "Each set of circumstances offers its own unique challenges," says Faix.
About 30-40 percent of Faix’s time is devoted to clinical care, which involves attending high risk deliveries, resuscitating babies who are not breathing or have no heart rate, and caring for babies with anomalies such as down syndrome, heart problems or bodily defects that require long-term care. This part of the job also entails invasive procedures such as inserting vascular catheters, positioning tubes in the windpipe and performing spinal taps. The remainder of Faix’s time is spent researching and teaching. He has taken a special interest in researching infectious diseases and has published several articles in medical journals.
One of the greatest challenges in neonatology is the absence of patient communication, says Faix. Infants can’t tell the doctor what hurts or even point to the problem area, for that matter. This leaves the babies’ parents and families to speak and make decisions for them. Faix says he finds it especially satisfying to help a family deal with the complex medical and social circumstances and sort out what’s right for them. "My job is to educate them in order to facilitate the decision-making process," he says. "Sometimes it the same decision I would have made in their situation, and sometimes it’s not, but that’s their choice."
Interacting with the family can also be the hardest part of the job, especially in circumstances where they wish to withdraw support. "It’s never an easy thing to do," says Faix, who is a father of two daughters himself. "There is always some degree of attachment to the babies and their families."
The Division of Neonatology is comprised of 22 neonatologists, plus a number of fellows and staff members. Faix says he enjoys working with a team of individuals with different interests, areas of expertise, skills and talents. He says he’s encountered territorialism among pediatricians, surgeons, obstetricians and others in different parts of the country, but in Utah he was relieved to observe an atmosphere of respect and collaboration toward common goals. "There’s more recognition that by interacting and making each other aware of developments early on, we can improve the future of that infant as well as many others," he says.
The neonatologists on the University team work for 3-week stints, 16 to 20 weeks plus 40 to 50 night shifts per year. That way, they become familiar with certain babies’ needs and also develop close relationships with their families. When he’s not working 8 a.m. to 6 p.m. day shifts and consecutive night calls, Faix says he enjoys doing things outdoors. He loves downhill skiing and visits all of Park City’s ski areas with regularity. He appreciates winter and says that, unlike those of us who are dreading the imminent snowfall, he is looking forward to the return of Jack Frost.
Favorite things to do:
Downhill skiing, hiking, watching movies
Favorite book topics:
Mountaineering adventures, polar exploration, literary classics
Independent flicks at the Broadway Cinemas in Salt Lake, subtitled Korean and Japanese films
Blind Dog Grill in Park City