by Bob Grawey
It does not take much to weigh out two pounds of grapes at the grocery store. Try it. Just a couple clumps of grapes should do it.
That is how much Karla and Kayla Koppendrayer weighed when they were born.
Actually, the twins, delivered in an emergency caesarean birth at 25 weeks, six days, weighed 2 pounds, 2 ounces each. Karla was a whopping 14.5 inches long while Kayla, born a minute later, was 14 inches in length.
In 1992, babies born this early in a pregnancy normally died, and if they did manage to make it, they would suffer severe developmental disabilities.
But these super (micro) preemies, as they are called, overcame many obstacles and will graduate May 27 from Spectrum High School in Elk River, Karla with a 3.93 grade point average (GPA) and Kayla with a 3.92 GPA.
Each will major in nursing. Karla wants to specialize in neonatology, or working with preemie babies in ICU.Kayla is choosing labor and delivery.
But for parents Barb and Randy Koppendrayer, those choices seemed far off and unlikely when their girls were born.
The couple had one basic thought when they found out Barb was pregnant. Will it be a boy or a girl? When the Koppendrayers found out they were expecting twins their excitement grew even more.
Not far into the pregnancy, though, events began to happen to alter those blissful expectations. Complications set in around week 21 of Barb’s pregnancy, causing preterm labor.
Admitted to Abbot Northwestern Hospital, the expectant mother was given medication to slow the contractions. Then her water began leaking. More tests ensued to monitor things. It became evident, however, that delivery was inevitable, so a medical team delivered Karla and Kayla July 25, 1992. Their due date was Oct. 31.
Barb recalls she and husband, Randy, could not spend time with their new little girls because they were whisked away into intubation and transferred by a portable incubator to Minneapolis Children’s Medical Center’s NICU.
“At that age they don’t cry,” Barb comments. “Randy remembers them making soft ‘meowing’ sounds like a baby kitten before they were intubated. Their skin was paper thin and they were so small that they fit comfortably in the palm of Randy’s hand.”
Doctors began administering surfactant, a new drug developed and released just the year before. It was supposed to help super preemie babies finish developing.
Even with the new drug, the Koppendrayers were told their baby girls had just a 40 percent chance of survival. If they did make it, the likelihood of them having long-term developmental-related disabilities was 60 percent probable.
That aside, more immediate attention was given to Kayla, who had a level II brain bleed, or a stroke at birth. She also developed a life-threatening blood infection. Both girls had patent ductus arteriosus as well, a condition where there is an opening between two major blood vessels leading from the heart. It can cause too much blood to flow through the heart to weaken it. Heart failure could result if not addressed.
Kayla’s multiple conditions were too severe to allow the opening to heal on its own as it did with Karla.
At just three days old, Kayla underwent open heart surgery. By then her weight had dropped to 1 pound, 10 ounces. A surgical specialist was flown in from Chicago to perform the delicate and risky surgery.
“Before she went into surgery,” Barb says, “I got a hold of a pastor friend who came to the hospital and baptized both of the girls.”
It was just the second time Barb was able to see her babies.
Kayla made it through surgery successfully, but there were other complications.
Both girls required eight blood transfusions during the first two months of their lives, due to liver and blood functions that had not yet developed.
Karla and Kayla each had retinopathy of prematurity, too, a condition where the blood vessels in the eyes develop too quickly. The condition can permanently damage a person’s vision. In gestation, this development normally occurs at 34 weeks.
Kalya also had lung and breathing issues and was given a 28-day steroid treatment to help her breathe better.
Barb recalls making the 76-mile round trip to Children’s Hospital every day for over two months while her daughters were in intensive care.
With the many obstacles and medical uncertainties, many people presented the twin’s needs heavenward.
“I watched other moms with bigger babies born at 28 or 30 weeks’ gestation develop life-threatening conditions that would eventually be too much for their baby to handle,” Barb says. “One day they would be there. The next day I’d find an empty incubator in their spot. It was dangerous to dream or plan for a future. We never knew from day to day if that might be their last day.”
The young parents were just as stressed away from the hospital. Barb says no books had been written yet to let them know what to expect or what to look for.
Instead of congratulations, people felt it easier to tell the Koppendrayers they were sorry, Barb says.
Mounting bills resembled a small phone book.
But then some good news came. Karla was released to go home Oct. 8. She still weighed just 5 pounds. Kayla followed two days later, weighing 4 pounds, 2 ounces. It was still three weeks before Barb’s original due date.
Before doctors would allow the girls to go home, though, Barb and Randy, Barb’s mother and a close friend had to take a course on caring for the twins which included CPR training for preemies.
Once home, the twins had to be kept on apnea monitors 24 hours a day, for 13 months.
And because Elk River did not have a pediatrician at the time, the Koppendrayers had to either find a physician who would be able to care for the preemie girls or pack girls, equipment and other apparatus for weekly check-ups at Children’s.
A doctor at Riverway Clinic agreed to step in and give the twins care, and after being interviewed by the hospital, the Koppendrayers were given the go-ahead to get their check-ups done in town.
The girl’s lack of immunity demanded extra precautions, such as using a sterilized room at the clinic. At home, catching a cold meant wearing a surgical mask to protect the babies.
“The twins were not allowed to be around anyone under 18 years old if they had not had chicken pox yet. That eliminated any day-care options,” Barb says. “I had to leave my job and stay home to care for the girls for the first two years of their lives.”
Kayla’s stroke required continued extensive physical and occupational therapy three times a week until she was 5 years old.
At just 2 years old, Karla says those trips were her first memories.
Other appointments included trips to see neurologists, ophthalmologists, neonatologists and pediatricians.
“During the first five years,” Barb reflects, “we made numerous middle-of-the-night runs to the emergency room at Mercy with breathing issues and fevers. A simple cold would turn into pneumonia in a matter of hours.”
By the time the twins started Kindergarten, they had overcome most of their health issues.
Weighing only 30 pounds, though, they were very small compared to their classmates even if they were at the same level academically.
In elementary grades, Kayla still struggled with the effects of her lung condition. In third grade alone, she had four or five bouts with pneumonia during the winter months.
“It was frustrating,” Kayla says, “because I had to stay inside all the time.”
For Karla, multiple ear infections posed the biggest problems.
Playing games with other kids was a real challenge during elementary grades.
“I was always the smallest one,” Karla says, “just a stick, so in games I would easily get pushed over by everyone.”
The girls achieved a major milestone in the sixth grade when they caught up in size to the rest of the kids in their class.
Continuing through junior high, Karla overcame problems with math, while Kayla overcame slower development of her motor skills.
Barb and Randy promoted more development more through various activities.
Karla played basketball and soccer, was involved in gymnastics and learned to play flute. Kayla chose piano, was involved in dance, cheerleading, gymnastics and twirled baton.
From junior high through high school, both girls have also been involved in Girl Scouts and each has excelled in 4-H, where they both won grand champion ribbons at county and state fairs. Karla has won “Superstar Showman” as well, the past two years.
In just days Karla and Kayla Koppendaryer will begin forging new paths. Looking back at the many obstacles and how they beat the odds of not only living, but of excelling in life, Karla offers this advice.
“Just stick through it and keep going,” She says, “Don’t give up. Don’t let your obstacle run you. When we were little and would say, ‘We’re too small. We can’t do it,’ our mom would say, ‘That’s not an excuse. You can do it.’ So, we would keep trying. We wouldn’t give up.”