08:41am Sunday 20 October 2019

Parents of Triplets Thank Physician “Dream Team”

The Coral Springs couple, who already have a 20-month-old son, Ayden, appeared at a news conference Monday to thank the team of doctors and nurses who over the summer finally diagnosed Andrea as having a rare autoimmune disorder and, just this month, as suffering from a placental abruption. “When all is said and done, I want everyone to know,” said Anthony Temperino, “you saved her life twice.”

The Temperinos, who used in vitro fertilization for both of Andrea’s pregnancies, described how their harrowing journey began early in June, soon after learning that Andrea was carrying triplets. The 34-year-old mom, who had a problem-free first pregnancy, began having difficulty swallowing and breathing. She also was unable to lay flat to rest and had an odd numbing sensation around her lips.

Concerned about Andrea’s rapid decline, the couple went to a hospital in Broward, where she was admitted into the ICU for 10 days. Doctors told the couple “something is clearly wrong,” but could not offer a diagnosis. One internist suspected Myasthenia Gravis, but neurologists could confirm nothing, as Andrea’s condition deteriorated.

Desperate for an answer, Anthony drove Andrea to Jackson’s emergency room, where a team of doctors and nurses began conducting tests. Within hours, Miller School doctors determined that Andrea was indeed suffering from the rare autoimmune disorder, Myasthenia Gravis with antibodies to muscle-specific tyrosine kinase (MuSK), a condition that weakens the muscles and affects swallowing, speech and breathing.

Ashok Verma, M.D., D.M., M.B.A., professor of neurology and Director of the Kessenich Family MDAALS Center, and Kristine H. O’Phelan, M.D., associate professor of neurology, Chief of the Neurocritical Care Division and Co-Director of the Neuroscience ICU at Jackson, admitted Andrea to the neurocritical care unit, where she spent eight days on a ventilator.

Five weeks later, Andrea was well enough to go home, but the Temperino family was not out of the woods. On November 1, 30 weeks into the pregnancy, Andrea and Anthony came back for a check-up with Andrea complaining of abdominal pain. Salih Yasin, M.D., associate professor and vice chair of obstetrics and gynecology, quickly determined she had suffered a life-threatening placental abruption, when the placenta separates from the wall of the uterus. Blood was gushing into the amniotic sac.

Andrea was whisked into an operating room for an emergency Cesarean section, where all three babies, Ashton and identical twins Alexander and Austyn, were born within one minute. A team of neonatologists at the University of Miami at Holtz Children’s Hospital was in the operating room and immediately took over care for the pre-term infants. “Luckily we have people and a system in place to handle this type of case,” said Yasin. “That’s the beauty of life and how it comes to be.”

Baby Ashton had inhaled and ingested blood, but eventually responded to treatment led by Shahnaz Duara, M.D., Medical Director of the Neonatal Intensive Care Unit at Holtz. The couple hopes to take the babies home by Christmas, but Duara said doctors want the infants to continue to develop in key areas before that happens.

On Monday, for the first time, the Temperino triplets were dressed up and held at the same time by their proud mom and dad. “How do you say thank you for your life?” asked Anthony, a commercial pilot. “I have gratitude beyond words.”
Feeling “very blessed,” Andrea said, “I can’t wait to take all of my children home. We’re very grateful.”

Miller School Departments, Centers and Institutes

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