When Kim Hirado and her husband, Judson Feder, decided to have children later in life they knew they might run into complications. At 43-years-old, Hirado underwent successful in vitro fertilization, which resulted in her becoming pregnant with twins. As is the case with many twins, Hirado and Feder’s babies were born prematurely, at just 25 weeks.

Although they both had their issues, the baby with the most complications was Kelli-Jain. At 1-week-old,
Kelli-Jain was treated for patent ductus arteriosus (PDA). In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart. In order to correct this issue Kelli-Jain was treated at another area hospital with an Indocin injection, which works by causing the PDA to constrict and closes the blood vessel that causes the abnormal blood flow. Having been treated with Indocin, Kelli-Jain experienced a side effect that damaged her intestinal tissue and was causing her small intestine to become inflamed. Because of this, her intestine could no longer hold waste, which caused bacteria to enter
her bloodstream.

Not being able to treat this gastrointestinal issue at the hospital she was at, Kelli-Jain was transferred to
Miller Children’s & Women’s Hospital Long Beach, and put under the care of Barry Steinmetz, M.D., pediatric gastroenterologist, associate medical director, Pediatric Gastroenterology, Hepatology and Nutrition Center, Miller Children’s.

“From the moment we arrived at Miller Children’s we were treated with the most amazing care,”
says Hirado. “From the doctors, to nurses, to the pharmacists, to the pulmonary technicians and everyone else – they were all wonderful.”

To correct Kelli-Jain’s intestine problem, Dr. Steinmetz enlisted the help of pediatric surgeon,
Dean Anselmo, M.D., who performed surgery to remove the damaged section of her intestine.
In addition to removing the damaged section of intestine, Dr. Anselmo performed an ileostomy,
a surgical procedure which creates an opening where intestinal waste passes out of a stoma
(surgical opening on the abdomen) and is collected in an artificial external pouching system which
is adhered to the skin.

However, after having gone through all of these treatments Kelli-Jain was unable to take food by mouth or in the intestine. She was given nutrition intravenously via total parental nutrition and intralipids. Three months later, Kelli-Jain was released from the hospital and sent home. A couple months later she had surgery to reconnect her intestines, but her troubles didn’t end there.

For an unknown reason, Kelli-Jain’s intestines became obstructed. Dr. Anselmo performed another ileostomy and surgery to remove 2/3 of her small intestine. Removing such a large section of intestine has left Kelli-Jain with borderline short bowel syndrome, a condition in which nutrients are not properly absorbed because a large part of the small intestine is missing or has been surgically removed.

To ensure that Kelli-Jain was receiving the nutrients she needed Dr. Steinmetz and his team fitted her with a gastro-jejunal feeding tube (G-J tube). A G-J tube is a tube placed through the abdomen directly into the stomach that passes into the small intestine. This tube is used to vent the stomach for air or drainage and to provide patients with an alternate way to take in food and fluid because he or she is unable to take enough by mouth. For three years Kelli-Jain and her parents monitored her G-J Tube every day.

Once she was able to produce enough fluid on her own Dr. Steinmetz and his team graduated Kelli-Jain to a gastrostomy tube (G-tube), which delivers nutrition directly to the stomach. Kelli-Jain is now
6-years-old and able to take food through her mouth. She has been able to successfully transition all feeding to the gut and is now off all intravenous nutrition.

“I can’t stress enough the impact that Dr. Steinmetz and his team have made on Kelli-Jain’s life,”
says Hirado. “She’s got big plans. She wants to be a doctor just like Dr. Steinmetz when she grows up. That’s in the long term of course. Right now she’s focusing on finally being able to go out and enjoy a normal day at Disneyland® or Chuck E. Cheese’s® with her sister, something she wouldn’t have ever dreamed of doing if it wasn’t for the care provided at Miller Children’s.”