Preemie Story – August 2023

Preemie’s Full Name: Giovanni Cascamo
Parent Name: Katherine or John Cascamo
Gestation at Birth: (weeks) 30
Days in the NICU: 56

“Giovanni’s bravery and courageous steps inspire others to overcome challenges and soar like a phoenix.”

Preemie Story:
In 2009, Katie and John received the exciting news of their first child, a son they named Giovanni. However, during this time, Katie was facing challenges in her corporate career in the insurance industry due to a major organizational change that created a toxic culture and climate. This situation caused immense stress and interpersonal crisis for Katie, as she had to navigate the fear of losing her job with three employees that were dependent on her. These factors contributed to toxic stress during her pregnancy.

On top of these work-related challenges, John and Katie also experienced external stressors. John’s basement office, his beloved Man Cave, was flooded, adding to their already mounting difficulties. Furthermore, Katie suffered a fractured hand due to an enchondroma fracture. Unfortunately, the emergency department’s new resident failed to listen to her concerns, exacerbating the situation.

To make matters worse, Katie contracted Swine Flu (H1N1) during a time when the World Health Organization reported global deaths from the virus. This illness further added to the hardships she was facing. Katie required hand reconstructive surgery, which brought attention to an underlying condition called pre-eclampsia.

On a freezing December night, with temperatures as low as -1 degrees, Katie had to be airlifted by a fixed-wing plane over a 5500-foot mountain to reach a regional medical center equipped with a Neonatal Intensive Care Unit (NICU). Four days later, at 30 weeks and 3 days gestation, Giovanni was born weighing only 2 pounds and 8 ounces (1130 grams).

Giovanni needed specialized care in the Neonatal Intensive Care Unit (NICU) as a “feeder grower”. Fortunately, he did not face any complications while in the NICU. Katie dedicated 56 days to caring for Giovanni in the NICU. Katie’s parents, Jim and Caroline, lived just 20 minutes away from the NICU and helped support Katie and John during this difficult time. On weekends, John, Giovanni’s father, would visit and spend Saturdays practicing Kangaroo Care, a technique that involves skin-to-skin contact, and learning how to care for his son. Meanwhile, Katie’s experience caught the attention of the local newspaper, leading to an interview that was featured on the front page. The story focused on the available resources for maternal-infant healthcare in the region. In addition to this, Katie was interviewed twice on the 5 o’clock news. These media appearances marked the beginning of Katie’s journey as a NICU Parent Professional.

Presently, Katie and Giovanni are at the helm of Courageous Steps, a social benefit entrepreneurship venture that utilizes their own experiences to improve the engagement, thriving, and overall well-being of healthcare providers. Research suggests that a toxic culture and moral injury impact staff engagement and turnover. This leads to poorer patient outcomes, adverse events, and reduced capacity of parents to care for their medically fragile infants. By providing workshops on topics such as burnout, moral injury, and the role of servant leadership in healthcare culture to mitigate negative health outcomes in maternal-infant health, Katie is helping clinical providers transform the way healthcare is delivered. Giovanni, who is now 13 years old, is becoming a part of Courageous Steps and gaining valuable knowledge about building a social entrepreneurship venture. As a young adult, he is starting to grasp the significance of showing appreciation and support to the healthcare providers who cared for him during his time in the Neonatal Intensive Care Unit (NICU) and throughout his therapies, including Early Intervention, Speech Therapy, Occupational Therapy, and Special Education.

Advice for Preemie Parents:
The NICU journey is undeniably one of life’s most challenging experiences. As NICU parents ourselves, we often encounter a defining moment that prompts deep reflection on the state of our lives and the path we wish to pursue. In light of this, I strongly recommend maintaining a journal, one that captures the story of your preemie, including significant milestones and heartfelt anecdotes that evoke laughter, tears, and celebration.

Furthermore, I encourage you to keep a separate journal for your own personal reflections. Document your thoughts, emotions, and experiences both during the NICU journey and in the days beyond. To record your NICU baby’s milestones, I suggest using the _______ app, specifically designed for this purpose. Additionally, I recommend utilizing the DayOne app ( for your personal journaling. While I have contemplated creating a dedicated journal for NICU parents’ self-reflective experiences, DayOne will provide you with a journal that can be cherished indefinitely, extending beyond the NICU phase and accompanying you throughout your entire life.

Preemie’s current age and milestones:
At 13 years old and in the 8th grade, Giovanni is a remarkable individual. Despite facing challenges with A.D.H.D., Sensory Processing Disorder, and Anxiety, he possesses a charming personality and a genuinely caring nature. Giovanni’s passions lie in video games, and he enjoys connecting with like-minded gamers through platforms like Discord.

Following his time in the NICU, Giovanni dedicated eight years to Early Intervention, Speech Therapy, and Occupational Therapy, which have greatly contributed to his development. Currently, he has an Individualized Education Plan (IEP) that provides behavioral support for his A.D.H.D. and helps him overcome food aversions.

Despite these obstacles, Giovanni approaches life’s difficulties with a fantastic sense of humor. Standing at 5’5″ tall and weighing 105 lbs, he is growing into his own identity. John and Katie, his parents, are thrilled to witness his continued growth and exploration of interests such as video game design. Giovanni also actively participates in the media team at his church and displays an avid interest in technology.