Robyn Nachtigall-Hill has known she wanted to be a sonographer since she was 12 and undergoing cancer treatment. In a unique twist of fate, the woman who helped save her life as a preteen is the same woman who would someday become her sonography mentor and then help save her daughter’s life.
Joy Guthrie was part of Nachtigall-Hill’s cancer care team at Valley Children’s Hospital. Guthrie performed echocardiograms to make sure her chemotherapy treatments for bone cancer weren’t damaging her heart.
A decade after that first meeting, Nachtigall-Hill encountered Guthrie again when she applied to the sonography training program at Community Regional Medical Center. Joy Guthrie PhD, ACS, RDMS, RDCS, RVT, is the director of sonography training at the downtown Fresno hospital and an assistant professor of medicine at UCSF Fresno in Echocardiography.
There were 84 applicants and only 14 spots in the cohort Nachtigall-Hill applied for so Guthrie asked a crucial question: Why do you want to train in ultrasound technology?
“Medical imaging was a huge tool in the diagnosis of my cancer. It inspired me… I want to be part of something that had helped me and I want to give back,” Nachtigall-Hill replied and then she smiled.
Guthrie said she immediately recognized the crooked grin of her former patient and knew she was someone who could persevere during tough times. Nachtigall-Hill had survived Ewing’s Sarcoma, a rare cancerous bone tumor, and amputation of her leg as a preteen.
“She lost her leg but not her drive,” Guthrie said. “I think anyone who goes through cancer has a certain internal resilience. And she certainly excelled in our program.”
Guthrie gave her a spot in the training program and then later hired Nachtigall-Hill as a pediatric sonographer at Community to perform echocardiograms on the hospital system’s tiniest patients.
Sonographers are in short supply
“Sonographers are a hard-to-fill position and it takes a lot of one-on-one and hands-on training to produce one sonographer,” said Guthrie. Currently half of Community’s sonographers and ultrasound techs are graduates Guthrie helped train.
The need for trained diagnostic medical sonographers, cardiovascular technologists and ultrasound techs continues to grow, with a projected need of 12% more sonographers by 2029, according to the U.S. Bureau of Labor.
That need is especially acute in Fresno which has high rates of premature births. Nachtigall-Hill trained to do ultrasound scans on those tiny pediatric patients and applies that expertise in Community Regional’s neonatal intensive care unit.
Lucky for her she could get that training close to where she grew up and attended college. Community Regional’s 18-month program is unique in the Central San Joaquin Valley. The nearest hospital-based training programs in sonography and ultrasound technology are in the Bay Area and Los Angeles. (Find out more about qualifications and how to apply to the sonography program.)
One-of-a-kind sonography training here in Fresno
Sonography uses high frequency sound waves (ultrasound) to produce images of organs, tissues or blood flow inside the body. It's used to examine many parts of the body and is increasingly used to detect and treat heart and vascular disease.
Community Regional’s sonography training program is the only one in the nation currently accredited in all five sonography disciplines – General Diagnostic Sonography, Adult Cardiac Echo, Pediatric Cardiac Echocardiography, Vascular Sonography and Advanced Cardiac Echocardiography.
Community Regional was also the first in the nation to be accredited to train advanced cardiac sonographers, who are able to extend the care of cardiologists, much like nurse practitioners do for physicians.
And it’s the only program in California accredited to teach ultrasound techniques needed to detect anomalies in the tiny hearts of premature babies. It was that expertise Nachtigall-Hill would be grateful for when it was needed for her daughter.
Sonography expertise spots pregnancy problem
After working side by side with her mentor, Nachtigall-Hill has come to rely on Guthrie’s 30 years of sonography expertise. It was expertise she turned to when she started feeling off half-way through a high-risk pregnancy. After a busy Friday afternoon, she confided in her boss and mentor about unusual fluid leakage. Guthrie was concerned and asked if she could take a quick look.
Nachtigall-Hill’s first pregnancy had been textbook perfect, but when she tried for a second child, she had a couple of miscarriages before becoming pregnant again. “I had the honor to scan her at about 18 weeks,” Guthrie said. “It was a little girl! I looked at her fetus, up and down, and the anatomy was absolutely perfect.”
But two weeks after that perfect ultrasound Guthrie saw something else. “To my surprise, her cervix – you know what keeps the baby inside the uterus – to our shock and our dismay it was totally open,” Guthrie described.
Guthrie quickly called one of the hospital’s perinatologists to ask what to do next. “I explained the gravity of the situation and got her into a wheelchair. We didn’t want her to stand up since that might make her go into labor. She was at a point that if she went into labor, then there would be no chance of saving the baby.”
Guthrie wheeled Nachtigall-Hill over to the hospital, where she was assessed, stabilized and sent home for bed rest. Two weeks later she was readmitted because she was having contractions. At 22 weeks and 6 days’ gestation, baby Regan was born weighing 1 lbs., 7 oz.
“The minute I saw her I just had this hope, and I knew that God was going to take care of her,” Nachtigall-Hill said. And she knew her daughter was in expert hands at Community Regional, which delivers the more micro-preemies – newborns weighing less than 3 lbs., 5 oz. – than any California hospital. “The doctors and everyone did an amazing job taking care of her,” she added.
Guthrie agreed: “I have never witnessed such a collaborative effort in trying to save this tiny miracle baby. Our neonatologists, nurses, respiratory therapists, a surgeon and the entire NICU staff worked tirelessly to save our little Regan.”
Nachtigall-Hill asked her mentor to be part of the effort and do all of the ultrasound procedures and echocardiogram scans that Regan might need. “I washed my hands a million times and prayed every time I touched her,” described Guthrie, who said as a premature infant herself she felt a special bond with her tiny patient. “That first echo, she reached out and grabbed my finger. I knew that little Regan could fight and survive.”
Regan not only survived but has thrived. At 18 months, Regan is developmentally where she is expected to be. “She’s at home with us, and she’s really active and just a happy girl,” said her mother. “She is taking steps right now. We were concerned because she had a little brain bleed in the hospital, but she’s hitting the milestones she should. She’s starting to say things like ‘Daddy.’”
Guthrie’s thrilled her quick thinking and a team of experts were able to give Regan a fighting chance to grow into an active toddler with the same crooked smile as her mom. “But to me the real hero in this story is Robyn,” Guthrie said. “She’s just grace under fire and you can put any obstacle in front of her and she just rises above.”
Nachtigall-Hill said she’s been lucky to have Guthrie there during the crises in her life: “We were meant to be together and work together.”
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