By any yardstick imaginable, Debra Cassell went through a heck of a journey to motherhood.
It’s impossible to guess the number of tears she and her former husband shed, through at least eight miscarriages, invasive and expensive fertility treatments that proved fruitless, and one doctor’s prognosis Debra would never bear children because her uterus was too tiny.
But the special education teacher and her then-husband, Trip Kellam, didn’t give up. They badly wanted a family. So some 14 years ago, the couple embarked on a last-ditch effort — invitro fertilization — at a North Carolina hospital.
When Debra became pregnant with twins, years of frustration and heartache morphed to joy and excitement. Their little boy would be named Sam, their little girl, Allison. The expectant couple decorated a nursery — they painted Sam’s side of the room green; Allison’s pink.
“Being pregnant with a boy and a girl was the happiest time of my life,” Cassell said. “I felt like we had won the lottery. That God was rewarding us for all our difficult times trying to conceive.”
The couple didn’t take any chances. Debra, who’s now 50, began seeing an obstetrician who specialized in high-risk pregnancies. Both before and during the pregnancy, Trip had to give her daily and painful injections.
Other than that, the initial months of Debra’s pregnancy went perfectly, she said. That was a big change from the past. With most of the others, she miscarried around two to three months.
Then one day, at right around six months, Debra decided to do some shopping. That night she experienced pain that eventually subsided. The next might it came back and was unbearable.
Trip rushed her to the Carilion Roanoke Community Hospital, where doctors diagnosed her with HELLP syndrome, a serious complication that for expectant moms can be fatal.
The best treatment was an emergency C-section. Both Allison and Sam weighed less than 2 pounds when the doctors delivered them three months early, in June 2007. Both were in incubators in the neo-natal intensive care unit.
“It all happened so fast, it felt like a nightmare,” Debra said. “But once they were born, all we could do was keep the faith and pray.”
Within days of her birth, Allison, who weighed slightly more than Sam, fell victim to a grave inflammation of her bowel called necrotizing enterocolitis, or NEC. Doctors performed surgery to removed diseased sections of her intestines. But that didn’t save her. The tiny infant girl died 11 days after she was born.
“After she passed, I didn’t want to get out of bed,” Debra told me. Trip “was very strong and told me we had another baby still fighting for his life, so we needed to go [to the hospital]. The NICU moved Sam to another room so we wouldn’t have to go back into the room where Allison drew her last breath.”
Sam stayed in the hospital for the first three months of his life. After the hospital released him, he had to wear a head-shaping helmet for nearly two years; Debra stayed home caring for him. It was during that time that she conceived a children’s book about babies born prematurely.
“Sammie the salmon was the smallest fish anyone had ever seen,“ she hand-wrote on a legal pad. “He was so little, he was only the size of a lima bean.“ She wrote some more verses, too.
“The words for the book just flowed out of me one stressful day when I was so scared to leave him [and go back to work],” Debra said. Then she put that pad away for a decade.
The Kellams wanted more children. So Debra underwent invitro fertilization once again, using frozen embryos that remained from their first pregnancy. But she didn’t get pregnant the second time around.
By the time the couple decided to adopt, Debra was back to work, teaching special education at Oak Grove Elementary (she now works at Glen Cove Elementary). And in 2010, they found Emily, a baby girl in a South Korean orphanage who’d been born the previous March.
In late December that year, Debra and her then-mother-in-law flew to Seoul, South Korea, to meet Emily and bring her home. They returned with the 9-month-old baby girl in January 2011. Emily Kellam is almost three years younger than her brother.
Even by then, it was apparent that Sam’s medical challenges went far beyond a misshapen head.
“He was diagnosed with developmental delay and speech [problems] at a young age,” Debra told me. Then attention deficit hyperactivity disorder, sensory integration disorder, problems with fine motor skills and a learning disability in math.
Life had prepared Debra for such issues, however. When she was a child, her parents adopted a little boy, her brother Eddie, who had cerebral palsy.
“I remember growing up how he was picked on and treated differently because of the way [Eddie] looked. He was very smart and a wonderful person,” Debra said. “I became a special education teacher to help children like my brother feel good about themselves. He was so proud of me being a special education teacher. He would brag to all his friends.”
When Sam was in fifth grade, Debra recalls he began complaining his feet hurt.
“We took him to a doctor to do a full body X-ray and blood tests to try to determine what was going on. The X-ray showed that his upper spine wasn’t fused together properly,” she said. “This was because of his preterm birth.”
After many months and many tests, Sam’s doctors diagnosed him with juvenile arthritis. They prescribed weekly injections of an anti-cancer drug that’s also useful in treating psoriasis and arthritis.
But Sam was so sensitive to pain that neither his mom or dad could bear to give him the shots. So that task fell to Debra’s brother, a nurse. The couple would drive Sam to her brother’s house every week for the injections.
“Poor Sam would throw up before even getting the shot,” Debra said.
Sam’s developmental problems set him apart from other kids his age in middle school. He was allowed to use the school elevator; most of the other kids weren’t. Sam also got extra time in the halls to get to his next classes, and special physical education classes.
His peers noticed those differences. And “when he started sixth grade, he was being bullied on his school bus. He said they were making fun of him because of the way he walked and talked,” Debra said.
“This broke my heart for many reasons. To see him cry because kids were picking on him was terrible. It brought back all the memories of my brother being picked on.”
In the chronology of Sam’s life, this brings us up to last year. By then Debra and Trip, with whom she shares custody of Sam and Emily, were divorced.
It’s also when Debra hit upon an idea that took shape on two parallel tracks. It went back to those verses she had penned in 2010 on the legal pad, about the little fish named Sammie who was tiny as a lima bean.
“I wanted him to be proud of his book and see how wonderful he truly is,” she said.
In the short-term, Debra figured, the book would help rebuild Sam’s self esteem that had been eroded by other kids’ bullying. But she had a longer-term goal in mind, too. Such a story could teach tiny tots about the developmental challenges preemies like Sam face in life.
And just maybe, that would build a lasting understanding and ethic among small children about the differences between themselves and infants born prematurely. In the best case, that could lead to less bullying of “different” children in the future.
Debra found an artist, Lynda Farrington Wilson of Moneta, and hired her to draw illustrations for those verses. She’d go on to publish the book, “Sammie the Salmon,” through Amazon.com
It’s had an effect. Her story has been featured in the online newspaper, The Epoch Times. And on a website called Love What Matters, which bills itself as “real stories by real people far and wide, to celebrate the love, kindness and compassion.”
Debra was interviewed on WSET (Channel 13), for a segment of “Living in the Heart of Virginia.” And recently, she said, she’s been talking with employees of Sarah Ferguson — the Duchess of York — about a possible upcoming interview.
“Sammie the Salmon” has been selling slowly but steadily on Amazon since last year. A few bucks goes into Debra bank account for each book sold, but she’s not paying much attention to that dribble of dollars. Instead, she’s still trying to get word out about it.
Emily’s now 11. Sam is a growing and gangly 13-year-old who’ll celebrate his next birthday in June. He loves history, golf, fishing, and like most boys his age, online gaming. He and Emily are close.
“Their bond is closer than most siblings,” Debra said. “Both Sam and Emily are very empathetic to others. I always tell them it’s more important to be beautiful on the inside.”
Happy Mothers Day.
Contact metro columnist Dan Casey at 981-3423 or firstname.lastname@example.org. Follow him on Twitter:.