Overview

So many people have asked what was wrong with Jackson in the first place. I thought it would be helpful to post an overview of where we have been and what has happened to Jackson. I might repeat some things, but I will try to be clearer about what has happened.

The first thing to understand is what happened. I want to stress that Jackson was fully developed and perfectly healthy. Jackson had an accident in the labor process. Though it is not clear when, at some point during labor, Jackson had three things happen. First, Jackson was posterior. This means that Jackson was faced toward Becca’s front, like the image suggests. This caused Jacksons head to be forced up against Becca’s pubic bone. Second, during labor, the umbilical cord became wrapped around Jackson’s neck. Third, Jackson pooped during his stay inside Becca. This poop is what is called meconium, not marconium, like I thought it was spelled. Jackson aspirated, or inhaled, a large portion of meconium. 

During labor everything went smoothly until about 2:00 to 3:00 in the morning. Becca had dilated to 9 cm and worked for hours to dilate yet was not able to dilate fully. At about 6:30 on Sunday morning Jackson’s heart rate began to fall dramatically. The doctor tried to do a vacuum delivery but failed, because Jackson was stopped by Becca’s pubic bone, as mentioned earlier. At about 7:20 in the morning they took Becca for an emergency C-section. They were able to get Jackson out; however, he had trouble breathing and was transported to the NICU at EIRMC, Eastern Idaho Regional Medical Center. They tried to use several drugs to help Jackson to breath, but it didn’t work. It was decided that he would have to be transported to PCMC, Primary Children’s Medical Center.

So out of the three things that went wrong, only the meconium aspiration continued to be a problem after birth. The umbilical cord and Jackson being posterior don’t matter after you get the baby out of the mother. So, why the heart and lung bypass? Why couldn’t Jackson breath? To understand why meconium aspiration is such a problem, you first have to understand how the lungs and heart work.

Most people know that the lungs gather oxygen and expel carbon dioxide; however, in order to do this the lungs produce surfactant which acts as a lubricant for the lungs and decreases surface tension allowing gas to exchange from the air to the blood and the blood to the air, as shown in the picture. In order to for lungs to work properly they need blood and air to pass through them carbon dioxide needs to leave the blood and enter the air and oxygen needs to leave the air and enter the blood.

The heart works as a pump for the blood of the body; however, it is a very complex pump. There are four chambers to the heart. Blood from the body enters the heart depleted of oxygen because it has delivered the oxygen to the cells of the body. It enters the heart in the right atria and then is pumped into the right ventricle. From the right ventricle it is then pumped into the lungs to get oxygen and then into the left atria of the heart. From the left atria it is then  pumped into the left ventricle and pumped to the rest of the body. It then goes in another cycle.

Before babies are born, they have a hole from there right atria to their left atria. This causes most of the blood to bypass the lungs and just pump through there body. This works because the mother provides the oxygen to the baby so the baby doesn’t need to breathe while in the mother’s womb.

When Jackson aspirated meconium, it caused several things to happen. First, the meconium compromised the surfactant in his lungs. This stopped exchange of carbon dioxide and oxygen in his lungs. It also irritated his lungs to cause the blood vessels in his lungs to constrict and this lung tissue to become inflamed. The constricting of the blood vessels is called pulmonary hypertension and the inflammation they called chemical pneumonia. This didn’t allow blood to flow through the lungs because it was easier for the blood to shunt through the hole from the right to left atria instead of flow through the lungs. There was also a lot of junk in his lungs that stopped air getting into the lungs in the first place.

Because Jackson’s lungs didn’t work it caused the carbon dioxide to pool in his blood and caused his blood to get more acidic. Jackson also couldn’t get enough oxygen to his blood and his heart wouldn’t pump through his lungs because it was easier to go through the hole from atria to atria. His heart then tried to compensate by pumping his heart harder until his body became tired and his blood pressure started to drop. These were the symptoms that he was fighting at EIRMC. This is the point where we weren’t sure whether Jackson would make it.

During his stay at EIRMC, Jackson was placed on several medications. I can’t remember them; however, when he was at Primary’s he was placed on dopamine, and dobutamine to control his blood pressure. He was also placed on a medication to make his heart pump stronger. He was placed on heprin to cause his blood not to clot. He was placed on verced and morphine to sedate him so that he wouldn’t move. They also gave him a lot of fluids to help his blood pressure by giving him transfusions and fluids.

When he was at primary children’s, he started on those medications and was suplimented by the ECMO machine, which is a type of heart and lung bypass. As a result, Jackson has been given good blood with oxygen and no acidity while his lungs recovered from the trama they were placed under. He has done amazing. He has surprised the doctor and nurse in his recovery and is looking good for a full recovery.

If anyone has any questions just post them in comments and I will do my best to answer them.