Callista and Jason Puchmeyer received one of the best Christmas gifts possible this year: finally bringing home their newborn daughter, Vincenza, a month after she was born with a rare blood disease following her mom's high-risk pregnancy.

"All the stress is gone,” Callista said by phone from the family's Westlake home a few days before Christmas. “I'm just glad to have her home, and we can all be together. I know my heart would be torn in, like, millions of pieces if she had still been there on Christmas, and we were all here."

The Puchmeyers are Westlake natives who met in high school. They have been together for 21 years and married for 13. They have four other daughters: 11-year-old Annabella, 9-year-old Lucia, 8-year-old Cecelia and 3-year-old Francesca. They didn’t know they had the potential to have a child with Rh disease until they lost a baby from it four years ago. The disease prevented them from taking their newest daughter home for a month.

Rh disease is a rare condition in which the blood of the mother and the blood of her baby isn’t compatible. Callista, 36, has negative blood, and Jason, 38, has positive blood. Because of genetics, their babies will only ever have positive blood — the opposite of their mother’s negative blood.

Callista’s immune system produces antibodies that cross the placenta and attack the baby’s fetal red blood cells, which can cause anemia and ultimately death, said Dr. Melissa Mancuso, chair of Maternal-Fetal Medicine and director of the Fetal Treatment Center at Akron Children’s Hospital. The couple credit Mancuso with saving the lives of their two youngest children.

The RhoGAM shot given to pregnant women contains antibodies and is usually able to trick the immune system into thinking it doesn’t need to make any antibodies because it thinks the body already has them. The shot has also made Rh disease relatively rare.

But in Callista’s case, the shot didn’t work. Although the Puchmeyers didn't know it, Callista became sensitized to Rh disease at Lucia's birth and the disease was present but not diagnosed during her pregnancy with Cecelia.

They got pregnant again with a girl, Grace, who they lost 17 weeks into the pregnancy in April 2014. They didn’t know about the Rh disease that caused the loss until Callista was around 10 weeks pregnant.

After they lost Grace, doctors in the Cleveland area told the couple they wouldn’t take on their case or said they should consider not having any more children.

The couple found Akron Children’s Hospital and a chance to have more children through sheer luck. Callista’s mother-in-law, Judy, was watching television and saw a one-minute commercial for the hospital that featured a woman with Rh disease.

"I was so grateful to find that commercial,” Callista said. “Seeing that commercial honestly allowed us to have ... two more babies.”

Before conceiving again, they met with Mancuso.

"There was no point to get pregnant if no one was gonna help us save the baby,” Callista said. “She said that if I was willing to put my body through those treatments and go forward with it — and she couldn't make us any guarantees that it would work — she would be willing to help us.”

 

Different pregnancies

The pregnancy with their next baby after Grace, Francesca, was relatively easy, all things considered. Mancuso delivered her at 36 weeks. Francesca — Frankie for short — had to see a hematologist for nine months before being medically cleared.

Because the condition worsens with each pregnancy, and Callista has a severe case, Vincenza — Vinnie for short — was a different story.

The condition is treated before birth with in-utero blood transfusions. Vinnie started getting sick around 29 weeks, and she had her first transfusion then. She had a second at 30 weeks and a third at 31 weeks.

The transfusions ranged from 1½ hours to three hours long. The second transfusion was the most difficult — Callista started having contractions. After the third transfusion, Callista’s placenta started to separate, and it was time to get the baby out.

Vinnie’s due date was Dec. 31, but Rh babies rarely go full-term, so Callista went in to Cleveland Clinic Akron General the night of Monday Nov. 12 to be induced.

Vinnie was breech, so Mancuso agreed to wait to see if the baby could be turned. She was successfully turned, and Callista labored all day and night Tuesday.

By Wednesday morning, Callista was taken to the operating room to deliver her daughter.

"When they broke my water, she must have flipped, so she was coming out arm and shoulder [first],” Callista said.

At that point, Mancuso decided Callista needed an emergency cesarean section. Callista had to be put under anesthesia, as her epidural had worn off and she could feel everything.

 

New arrival

Vinnie was finally born at 33 weeks and two days weighing 4 pounds, 15 ounces at 4:53 a.m. Nov. 14 — which is also Callista’s dad’s birthday. She was transferred to the neonatal intensive care unit at Akron Children’s, and her mother stayed at Akron General until Saturday night.

Callista — a former private-practice lawyer turned deputy chief counsel at NASA in Cleveland — and Jason — who works in corporate finance for Akron real estate developer Cedarwood Cos. — came to the hospital every day for the month Vinnie was in the NICU.

"Obviously, it's tough. I just try to be a good support system and help with whatever help she needs,” Jason said of his wife. “You kind of feel helpless because she's going through everything, and you can't really do anything.”

Since her dramatic entry into the world and her release from the hospital Dec. 15, Vinnie has been doing well.

She had a blood transfusion in the hospital and a second one Dec. 22. At home, she gets a daily dose of caffeine and wears an apnea monitor any time she’s out of her parents’ sight to help with her breathing. She also has developed a milk allergy. As of Monday,  she weighed 7 pounds, 4 ounces.

Mancuso said although there could be some effects because she was born premature, there should be no long-term effects from Rh disease.

"She's like a rock star,” Mancuso said. “She's growing, she's eating well, she's doing everything else that she should be doing.”

Mancuso encouraged women to know their and their partner’s blood type. She also encouraged couples to meet with a doctor before getting pregnant to ensure they’re in good health and have a plan in place.

Callista said she wants anyone who develops Rh disease to know there’s a doctor and hospital in Akron that can treat it.

The parents are so grateful for Mancuso helping them with their "two miracle babies,” Vinnie's middle name, Melissa, is Mancuso's first name.

"She's just a wonderful human being.... You feel like you're talking to your really good friend,” Callista said. “She saved two of our babies.”

 

Beacon Journal reporter Emily Mills can be reached at 330-996-3334, emills@thebeaconjournal.com and @EmilyMills818.