Three small incisions.
That’s what Alycia Stump heard the surgeon needed to make to perform a lifesaving surgery for Zayden, her baby boy she had known for only a matter of hours.
Dr. Jeff Dehmer would make a single 5-millimeter incision for a camera and a pair of 3-millimeter incisions for his instruments. The minimally invasive surgical technique avoided a larger incision to open the newborn’s chest.
Zayden’s surgery at New Hanover Regional Medical Center followed a hectic day for his parents.
Alycia Stump wasn’t expecting to meet her baby for another three weeks when she went to a doctor’s appointment, where they discovered Zayden’s heart rate was jumping up and down.
Her physician sent her directly to Novant Health Brunswick Medical Center, surprising Zayden’s dad, Steven Eury, who was just getting off work. He made it to the hospital just in time for her C-section.
Her baby boy was born 6 pounds, 5 ounces on Oct. 23, 2018.
His parents found out something was wrong right after delivery, when a tube was inserted down Zayden’s throat and did not pass into his stomach. The test revealed Zayden had a condition called proximal esophageal atresia with a distal tracheoesophageal fistula, also known as EA/TEF.
In the womb, the esophagus and windpipe begin as a single tube. By two months after conception, the tube typically divides into two passages. But Zayden’s upper esophagus did not connect to his lower esophagus and stomach. Additionally, an abnormal connection was present between his lower esophagus and windpipe.
Only one in 3,000 to 5,000 babies are born with the abnormality. Zayden was one of only four cases across the region in the 18 months since Dr. Dehmer has been practicing pediatric surgery in Wilmington.
Alycia and Steven learned Zayden would need to be transferred to New Hanover Regional Medical Center, where the Neonatal Intensive Care Unit would be his first home. A NICU transport team brought Zayden to Wilmington aboard a VitaLink ambulance.
“I was scared when they took him,” Alycia said.
By the next morning, Zayden was undergoing tests at NHRMC. He was in the operating room by the afternoon.
The condition Zayden was born with is not always diagnosed before birth, but surgical repair is usually necessary within the first couple of days of life.
Before surgery, the newborns are evaluated to see if any other associated problems would complicate repair.
Dr. Dehmer opted to use the scope because the smaller incisions reduce post-operative pain and scarring for the newborn. The technique was first successfully performed in 1999. While the scope is more technically challenging than an open incision, Dr. Dehmer learned the minimally invasive technique during his training.
That doesn’t stop him from reviewing a textbook chapter the night before the surgery, or watching videos to review key steps.
“Pediatric surgeons don’t go through all the extra training to do appendectomies and hernias,” Dr. Dehmer said, referring to the two most common types of surgeries he performs. “They go into it to do cases like this.”
Dr. Dehmer and Dr. Timothy Weiner came to Wilmington in 2017, joining NHRMC Physician Group – Pediatric Surgery, where they specialize in general and thoracic pediatric surgery. Together, they operate on between 500 and 600 babies and children annually.
Before their arrival, patients like Zayden would have been transferred farther from home for both surgical procedures and recovery, which can make life even harder on their families.
Alycia gently cradles three-month-old Zayden in her arms as she remembers seeing the tubes connected to her baby after his surgery.
“Mommy didn’t like that,” she says softly to her son.
About a week after his surgery, Zayden underwent a special X-ray to look for a leak where the ends of the esophagus were sewn together. During Zayden’s month of healing in the NICU, his parents drove about an hour back and forth from their Brunswick County home to see him.
As might be expected, Zayden had some adjustments after he went home. He suffered from reflux and was spitting up after every feeding, and alarmed his parents with some coughing spells.
He eventually got on the right formula and medicine and is eating 4-5 ounces at a time.
He had dropped to 4 pounds, 11 ounces after the surgery, but started regaining weight. The three-month-old has rebounded to 12 pounds, 3 ounces.
“They said his recovery was remarkable,” Steven proudly said of his son.
Now, Steven said it doesn’t seem like the surgery is fazing Zayden at all. The tiny incisions have healed, leaving only small scars behind.
Watching Zayden rest comfortably in his mother’s arms, they talk about the little details parents know so well. About how Zayden’s hair was dark when he was born and is lighter now.
“He loves to watch anything,” Alycia said, especially the fish moving in their tank at home.
“He’s fascinated by ceiling fans,” Steven said.
They know he will soon be interested in toys. “He’s growing up way too fast,” Alycia said.
As Zayden continues to grow, his parents will always remember the surgery that enabled Zayden’s little body to accept food and to safely breathe. They think of what they would say to the next family that gets the news their newborn needs surgery.
“He’s in good hands,” Alycia said. “That’s what I would say.”