Chase Juergens came out blue. His mother, Alicia, had a caesarean section, and the nurses said that wasn't unusual. Sometimes c-section babies take a little longer to catch their breath. They took him to the nursery for oxygen. Her husband, Michael, went with.
"They were looking at his chest and it was almost concave," Michael recalls. "His oxygen levels just weren't getting up there."
"He came back upstairs really emotional," Alicia adds. "He was like, 'There's something wrong with Chase.'"
Chase had congenital diaphragmatic hernia, or CDH, a defect in which the diaphragm doesn't form fully during development. Abdominal organs float up into the chest cavity, and babies like Chase are born with tiny, stunted lungs that can't supply them enough oxygen to survive.
A critical transition for CDH babies
Within an hour, Chase was airlifted to Children's Hospital Colorado's Level IV NICU, where pediatric and fetal surgeon Rony Marwan, MD, was waiting for him with a team of experts.
"The most critical part is the transition from the womb to the outside world," says Dr. Marwan. "By the time these babies get a diagnosis and get transferred to a big hospital, things can really spiral."
It helps to have a prenatal diagnosis, which allows the family to deliver on a labor and delivery unit like the one at the Colorado Fetal Care Center, with specialists at the ready. Chase's case, however, had gone undetected.
The experience to treat CDH, no matter how severe
Luckily, The Juergens family had one of the nation's foremost CDH referral centers in their backyard. With more than 50 years' experience, Children's Colorado's dedicated CDH team has treated hundreds of kids with the condition. That extensive experience translates to some of the best CDH outcomes anywhere.
Michael drove across town to meet the team while Alicia, still recovering, stayed behind.
"It was a wild experience I wouldn't wish on any parent," Michael says, "but seeing the level of unity on that team, how everyone was just staged and prepared and ready, that brought a lot of comfort to me."
Timing the treatment of CDH
In the NICU, Chase's care team soon determined his left lung was nearly intact. They supported him using a ventilation strategy robust enough to get him the oxygen he needed, yet gentle enough not to do any damage to his lungs. When the time was right, they repaired his diaphragm, giving his lungs room to grow.
"At one point during our stay, while we were getting ready to go home, a nurse mentioned that about 99.9% of these babies go home on oxygen," Michael says. "It was almost like Chase heard that and went, 'Watch this.' They took him off oxygen the next day."
At 18 days old, he went home without it.
A "happy little miracle warrior"
"This is an excellent outcome, no matter the severity," says Dr. Marwan. "I credit our consistency and our team - not just the specialists, but the nurses and the ancillary staff. They treat the most complex cases, and that translates to more moderate ones. But just because it was a moderate case doesn't make it any less a success."
Now a year old, Chase continues to thrive.
"He's pulling up and crawling, putting everything in his mouth. It's fun," says Alicia. "He's the chunkiest, happiest little baby. You'd never know how sick he was."
"We couldn't have asked for a better outcome," says Michael. "We call him our happy little miracle warrior."