With two babies in the neonatal intensive care unit at UW Health’s American Family Children’s Hospital and two young boys at home, Jackie and Zach Westrick, of Madison, are managing a parental juggling act.

At least Hendricks, their premature twin with a heart defect, is being cared for in Madison — not in Milwaukee, where he likely would have been sent before American Family Children’s Hospital opened a specialized NICU in 2014.

“I don’t know how we’d do that,” said Jackie Westrick, holding Hendricks, who along with brother Hudson was born July 20, about two months early. “This way, we can still be a family together.”

The level IV NICU, which soon will nearly double in size, is one of several programs at American Family Children’s Hospital that didn’t exist in Madison or have significantly expanded since the hospital opened 10 years ago next week.

Pediatric heart surgery and cancer care, including a powerful radiation treatment provided in a room lined with lead bricks, are among the hospital’s other hallmarks.

UW Health previously housed its children’s hospital on the fourth floor of UW Hospital, built in the 1970s and designed for adults. In August 2007, it opened American Family Children’s Hospital, with six floors, separate from but connected to UW Hospital, and designed for children.

More than half of the $78 million cost of the children’s hospital, and more than a third of the $45 million cost of an expansion that added two floors in 2014, came from fundraising, said Jeff Poltawsky, a UW Health senior vice president who oversees the children’s hospital.

“The generosity of this community really made this children’s hospital possible,” Poltawsky said.

Another $11 million project will take shape this fall. The universal care unit, for children who need special monitoring for conditions such as diabetes and epilepsy, will move in October from half of the eighth floor to all of the seventh floor, which was left vacant for expansion.

The NICU, on the other half of the eighth floor, will take over all of that floor, adding 12 beds to its current 14, likely by January.

Dr. Jamie Limjoco, medical director of the NICU, said the expansion will allow the unit to accept more referrals from around Wisconsin and northern Illinois.

Limjoco said the additional beds will also help the unit prepare for an expected increase in births starting next year at UnityPoint Health-Meriter, a partner of UW Health, which provides deliveries for both health care systems. Group Health Cooperative of South Central Wisconsin is switching to Meriter from SSM Health St. Mary’s Hospital for deliveries.

“We’re constantly full,” said Limjoco, who noted that two of 12 rooms in the existing NICU have two beds, meant for twins but typically needed for unrelated babies.

Hendricks, the Westricks’ son with a heart defect, has been at the children’s hospital’s level IV NICU — equipped for the most serious cases — since shortly after birth.

The other twin, Hudson, was at Meriter’s level III NICU until this week, when he joined his brother at the children’s hospital’s NICU. Hudson doesn’t require the higher level of care, but doctors said keeping the twins together, and letting Jackie more easily breast feed both of them, would be helpful.

Surgeons plan to fix Hendricks’ heart defect, which causes increased pressure in his lungs, once he’s closer to his due date, Sept. 26, or the date on which he was scheduled to be delivered early by Cesarean section, Sept. 1.

He’ll likely stay in the NICU for a few weeks afterward, said Zach Westrick, who continues to work as a chiropractor while Jackie, a nurse in UW Hospital’s burn unit, is on leave. Their other sons are ages 3 and 5.

“If we had to go to Milwaukee, we wouldn’t be able to do it,” he said. “It would separate us all.”

Mending hearts

When Larissa Mikelbank, of McFarland, was born with multiple heart defects at St. Mary’s in 2003, she was sent to Milwaukee for a complex open heart surgery to reroute her blood flow, which doctors at UW Health couldn’t provide.

Today, the situation has changed, with two UW surgeons doing about 150 pediatric heart surgeries a year, up from about 20 a year a decade ago, according to Dr. J. Carter Ralphe, chief of pediatric cardiology.

When Larissa, 14, needed another open heart surgery this May, she went to American Family Children’s Hospital. In a 13-hour procedure, doctors installed a mechanical valve to replace a damaged aortic valve.

Larissa, who will be a freshman at McFarland High School this fall, stayed in the hospital for nine days. Her parents appreciated the close proximity to home, which allowed them to cook much of their own food, sleep at home many nights, bring movies to their daughter and watch as her friends visited her.

“That helped us get through it,” Diane Mikelbank said.

The growth in pediatric heart surgery could spur another project at the hospital, Poltawsky said. The sixth floor, which has been kept open for future expansion since the hospital opened, may be needed for heart surgery patients, he said.

“Probably in the next two to three years, we will have to finish it out,” he said.

Combating cancer

Kaylee LeGrande, 17, of Sun Prairie, has tried many kinds of treatments at the hospital for neuroblastoma, a stubborn type of childhood cancer.

After her diagnosis two years ago, she had six rounds of chemotherapy. Then she tried two rounds of MIBG therapy, in which a radioactive chemical binds to tumor cells to kill them.

That treatment, which wasn’t available in Madison before American Family Children’s Hospital opened, requires patients to be isolated for three to five days until their radioactivity wears off.

Kaylee also had a special kind of stem cell transplant, receiving cells from her father, Chuck, and infusions of an immunotherapy drug. But complications required her to take steroids, which temporarily gave her diabetes, and her neuroblastoma remains.

She’s had a “rocky course,” said her oncologist, Dr. Ken DeSantes.

Still, Kaylee and other patients with cancer have been able to try new kinds of treatments — such as CAR T-cell therapy, an immunotherapy recommended for approval by the Food and Drug Administration committee last month — because DeSantes and his colleagues are part of a pediatric cancer “dream team” at the children’s hospital.

The designation came in 2013 from Stand Up to Cancer and the St. Baldrick’s Foundation, co-founded by journalist Katie Couric.

Karen LeGrande said that, despite her daughter’s continuing struggle with cancer, she’s glad Kaylee has been able to get cutting-edge treatment so close to home.

“It’s great that we have it here,” she said.

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.