Bazian, Joshua

I thought I would let you know what has happened with my pregnancy and delivery. If you do not remember me, my baby was due to be born on March 7, 1998 and he was diagnosed with a diaphragmatic hernia at 29 weeks in utero.

Baby was born on March 2, 1998 at 6:34 a.m. He was immediately taken and intubated by the neonatology team that was waiting for him in the delivery room. From there he went through the honeymoon period of 24 hours. His second 24 hours was not as good. Fluid was beginning to pool in his belly cavity and the doctors were unsure as to what was happening and called the surgeon from the Childrens' Hospital. The surgeon and the neonatologist consulted and they decided to transfer him to the Childrens' the next morning and conduct the surgery that evening as the surgeon was concerned that there was something blocking the hernia and not allowing fluid to pass and thus the pooling.

Joshua did not tolerate the transfer very well but managed to stabilize enough to satisfy the surgeon that she could do the surgery. The surgery took place that night (day three). From there Joshua did extremely well. His mechanical corrections were many and his organs cooperated with the surgeon and went where they were supposed to. Two thirds of his diaphragm was missing and there was not enough of a rim for the mesh to be sewn to all around so therefore some of the mesh is sewn to the chest cavity. He lasted through a honeymoon period of about three days where they thought they could extubate him very soon (about at day 7). Then he relapsed. He was put on nitric oxide and was paralyzed again.

Since his relapse, however, he has made a steady recovery. One week ago yesterday, they tried to extubate him and he lasted about a half hour. He was not taking deep enough breathes which told us that his diaphragm muscle needed to be exercised. His ventilation machine was then changed to a fancy Cadillac of machine that has a number of different variables on it that allowed him to still receive support while he exercised the muscles that he needed to breathe.

Yesterday they extubated him again. He was extubated at 11:15 a.m. The doctors say that if he manages to stay extubated for 24 hours (only 3/4 of an hour away), he will probably stay extubated. They of course warned us that he may need support again if he gets an infection or if his x-rays do not look good. We feel that our child is a miracle as one lobe of his liver was in his chest together with his stomach, small intestine and a good portion of his large intestine. If he were born10 years ago, I wonder if he would have survived? It looks like he will have one full lung and one half lung, I am unclear about the lung situation at this point, but we know that he has one full lung for sure. He is tolerating his feeds well and is almost off the morphine (pain killer) and medazalam (sedative). These are the only lines that remain. They figure that they will start tube feeding him in the upcoming days.

When it came time to push him out, I wouldn't push. The doctor asked me why, I told him because our son would have to begin his fight for life. My husband told me he couldn't get his high school diploma in there so I might as well push. I am glad I pushed him out as we have a baby boy who has proven to be a very strong fighter. A side note, we named him Joshua because the biblical meaning is "saved by God". This boy was unquestionably saved by God. So many people have said so many prayers and we thank them all.



Written by Joshua's mom, Sandra Bazian (Canada)
1999