Dominic Andersen is an alert and seemingly content toddler. He likes to dance, watch cartoons, swing and play outside. He is quick to laugh or smile. He also is extremely lucky to be alive.

Dominic was born 16 weeks premature. He weighed 1 pound 10 ounces at the time of his birth and had not yet developed fingernails, ear cartilage or eyelashes. His skin was nearly transparent.

Jennifer Andersen holds her son Dominic on the balcony of her Lynden apartment.

Dominic, who will be 3 on May 5, has health problems that require constant care. On Dec. 31, 2003, Dominic's single mother, Jennifer Andersen, received a call from her insurance company notifying her it would no longer pay for Dominic's in-home nurse. Andersen said the company left her with no option but to resign from her job and become Dominic's primary nurse. She said she is afraid she may lose her home if she cannot fund Dominic's in-home care.

Andersen, 30, said Dominic's doctors gave him a 10-percent chance of surviving through the winter when they released him into Andersen's care six months after he was born. Dominic overcame the odds of his survival with the support of his family, as well as an in-home nurse and various doctors and therapists.

When the doctors sent Andersen home from the hospital, she transformed her apartment into an at-home version of a hospital, with medications and monitoring equipment lined up around sterilized counters. Doctors told Andersen that if Dominic stopped breathing, he could not be resuscitated because of his poorly developed organs. They told her what to expect if Dominic stopped breathing -- a gasp of breath after a prolonged absence of breathing was normal before death. The thought of taking care of such a fragile child was daunting at first, but she quickly learned how to act as a mother and nurse, Andersen said.

"I didn't know what I was going to do," Anderson said. "I knew I was going to hold him a lot and sing to him a lot.  It's not very common for doctors to send you home with a death plan."

Anderson said the insurance company discontinued payment for in-home care because it believed she could receive financial help through a state program.  It gave her a week to find alternative care, Anderson said. With no way to pay the $60-an-hour fee for full-time, in-home nursing assistance, Andersen informed her employers that she would have to leave without notice. The program the insurance company suggested could not provide financial help until insurance payments reached their limit, but they did not, in Dominic's case, because the insurance company cut off payments prematurely. In 2003, Andersen said she spent approximately $10,000 on Dominic's substantial health care, and insurance companies paid approximately $2 million.

Dominic Andersen swings on the apartment balcony of his Lynden home.

"Insurance said it was purely custodial care, but the fact of the matter is he needs it," Andersen said.

Dominic receives food through a tube attached to his stomach 14 hours a day because his stomach valves do not function properly. The tube is attached to a machine that provides a constant flow of nutrition. It makes walking difficult for the energetic toddler. Andersen picks up Dominic's machine and trails him from room to room. They stop to examine lines painted on the wall and continue through the apartment to his bedroom.

Andersen said Dominic's recent diagnosis as autistic explains his energy as well as his interest in seemingly unimportant items. She said she spends a lot of time watching the cracks in sidewalks with him. Dominic no longer needs an oxygen tank, which is a major improvement, Andersen said, but his kidneys have not grown recently, and he slowly is working his way back to the 29 pounds he weighed before a dramatic weight loss of six pounds in September. Andersen said that in 2003 alone, Dominic had 139 out-of-home trips to the doctor's office.

"We've not once (gone) to a doctor's clinic and (not heard) we're done," Andersen said. "There's a lot of unknowns."

Michele Unrau, 23, worked as one of Dominic's in-home care providers from September 2002 to March 2003. She said Andersen is a fun and outgoing mother who offers full support to her son.

"The most important thing is to not give up on your child," Unrau said.

"With people supporting you, amazing things can happen."

Andersen said activities that used to matter to her before Dominic was born do not seem as important anymore. From September through June, Dominic is not allowed to leave his house, except under controlled circumstances, because of the trauma a common cold could do to his body. Andersen said she spends most of each day taking care of her son. When Andersen has spare time, she talks to many of the doctors, caregivers and organizations that fill a Rolodex sitting on her counter. Finding the best possible care for Dominic is a constant struggle, Andersen said.

"I admire Jennifer's strength, from the minute to hour to week caretaking," Dominic's maternal grandmother Julie Andersen said. "She's conquered it. But humanly, you can't do it for long."

In a recent care conference in which people who work with Dominic met to discuss his progress and needs, doctors told Andersen that Dominic is one of the most medically fragile children in Whatcom County. Andersen said hearing that was reassuring -- she sometimes forgets that she is facing a different and trying experience raising Dominic.

"I won't lie, sometimes you get so tired," Andersen said.

Dominic's paternal grandmother, Stephanie Miller, said she is upset that Andersen has faced so much difficulty in finding financial help. Miller said she sees a lot of unnecessary setbacks and lack of funding in organizations Andersen needs to go to for help.

"I saw on a TV station where they were asking for money for a dog for surgery, and I thought, 'Oh, this is just killing me,' " Miller said.

Valerie Veltkamp worked with Andersen for several years at Homestead Farms, a hotel and resort in Lynden where she lives. With help of other Homestead Farms employees, Veltkamp started the Dominic Andersen Care fund to help Andersen financially. Veltkamp said she admires Andersen for how she has triumphed, but that Andersen needs more time for herself.

"I see her as the most wonderful mom I have ever seen," Veltkamp said. "She is a remarkable person, very caring."

Dominic attracts his mother's attention by tapping on her arm and pulling her in the direction he wants to go or pointing at an object he wants. He knows where to find his favorite movies and dances in front of the television when Andersen plays them. Andersen said she is working with speech therapists to help Dominic enhance his communication skills. Dominic cannot speak or use traditional sign language.

Dominic likes being read to, and often is relentless in his requests for her to read his favorite pages over and over, Andersen said. She said she is working on creating an album with pictures of Dominic's favorite activities so he can tell her when he wants to swing or go to the park. Julie Andersen said watching Dominic grow gives her an unusually broad perspective on humanity.

"They're their own identity," Julie Andersen said. "In the healthy environment, our identities are much more universal, but in the medically fragile world, you're much more of a minority, an individual."

Andersen said Dominic's premature birth was unexpected and inexplicable. The day before she went into premature labor, Andersen had a routine checkup with her doctor, who said the pregnancy was progressing normally and that she was healthy.

Andersen said she sees Dominic's premature birth as a mixed blessing. Because Dominic's medical condition is so fragile, Andersen said she does not have the opportunity to take him for granted, but she also has much more to worry about than the mother of a healthy child.