MANCHESTER — This Clay County town is about 100 miles from Lexington, but for many patients at Willowbrook Women's Center it is a world away.
"There aren't a lot of reasons for the patients to go to Lexington," said Laura Bates, UK HealthCare outreach sonographer. "A lot of them are scared to death."
Navigating the sprawling University of Kentucky medical campus can be a frustrating puzzle, and even getting from Manchester to Lexington often involves finding a car to make the trip and scraping together money for gas. And, for Willowbrook patients, driving those long miles worrying about the health of their babies creates stress that is not good for them or their unborn children.
But because of UK HealthCare's Blue Angels program, Mary Sizemore, pregnant and diabetic, didn't have to go to Lexington. She got an expert prenatal checkup via an Internet connection recently.
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The 20-year-old's pregnancy is being monitored carefully because of her illness, as is the size of her baby. A large baby can pose health risks for the infant and mother.
Sizemore is among a growing number of women connecting with Dr. John O'Brien, director of maternal fetal medicine at UK HealthCare, through the Blue Angels program. O'Brien reviews ultrasounds in real time via an Internet connection using a specially designed portable ultrasound machine with a specially trained sonographer.
The goal is simple: Provide needed services to patients with serious complications who live in rural areas.
Care often is best delivered close to home, O'Brien said.
With her mom and sister standing nearby, Sizemore looked at the monitor that sat about a foot away and saw her baby's scrunched face appear in the monitor, a tan shape against a black background in the darkened room.
For the next 20 minutes or so, Bates smoothly moved the camera across Sizemore's gel-covered belly, zooming in and out on the heart, lungs, feet and fingers as O'Brien, back in Lexington, quietly talked the expectant mother through the exam and results.
It's hard to tell whether Sizemore was nervous; she remained stoically silent.
Dr. Ian Sink, a physician at Willowbrook, is the first to see women like Sizemore. He uses standard ultrasound equipment to check on the progress of their pregnancies and health of their babies.
Previously, an abnormal ultrasound required Sink's patients to drive to Lexington to get a second opinion, often a daylong trip filled with apprehension and challenges.
"It is really a struggle for them," said Sink, "Even to make the trip 20 minutes to get to the office can be a real struggle."
Clay County is one of the poorest counties in the state, but O'Brien said the Blue Angels program gives residents access to advanced maternity care.
Bates, who lives in Eastern Kentucky, carries a suitcase-size, specially designed ultrasound machine to Willowbrook and other rural clinics. The machine, and O'Brien's expert review of the ultrasound, can help a mother avoid a trip to Lexington.
If everything appears well, the mother continues regular visits to Willowbrook. If there is potential for a problem, the mother goes to Lexington to meet with a pediatric specialist and set up a plan of care for the pregnancy and beyond.
In the case of a defect like an infant's malformed heart, the proper care can be available immediately following birth, Sink said.
That was the kind of help, thankfully, Bransen Roberts didn't need.
Before he was born, doctors discovered through ultrasound that he had hydronephrosis, a rare condition where urine backs up in the kidney as a result of an obstruction in the ureter or backward flow of urine from the bladder.
While the condition sometimes is not detected until the child is older, it is dangerous and can result in the loss of one or both kidneys without proper intervention.
In Bransen Roberts' case, the long-distance ultrasound consultation resulted in an in-person review of his case at Kentucky Children's Hospital and the reassurance that he would be born healthy and monitored closely as he grew.
His parents, Becky and Jason, were relieved to hear the news and glad they could get a consultation before their son was born.
UK's program is modeled after a similar effort in Arkansas, which has 20 sonographers traveling the state. But the portable and digital connections were created at UK specifically for the Kentucky program.
The Blue Angels program has been in operation for about a year. O'Brien said he would like to see it available to moms across Kentucky.
Right now, Bates visits Manchester, Hazard, Morehead and Middlesboro.
As for Mary Sizemore, O'Brien gave her and the baby a clean bill of health, and a gentle, repeated caution to keep track of her sugars.
Upon hearing the good news, she smiled shyly.