Three-year-old Jayden Gentzyel takes his time placing a broom up between his "Cars" kids table and his toy work bench. He looks over the structure and contemplates if it will hold his weight. He then climbs to the top of the table and surveys his newly formed bridge before getting ready to take the first step.
His mother intervenes before the high-wire act plays out. Jayden is a daredevil his mother, Desiree Gentzyel explains.
"When he was a year-and-half old he had a toy with wheels," she explains. "I told him not to stand on it and of course he did. He hit the corner of a fire pit and had to have his head glued"
Jayden has provided plenty of adventures for his mother in just three years, starting with his decision to come three months early.
"He was supposed to be a Valentine's Day baby, but he was stubborn and decided he was coming on Nov. 19, 2010," Desiree says with a laugh.
On Nov. 18, Desiree had an appointment with her OB/GYN, who determined that she was in labor. She was taken by ambulance to Geisinger Medical Center in Danville in an effort to stop her labor. Doctors were unable to do so and, to complicate matters, the always adventurous Jayden decided to flip around and was positioned as a footling breech delivery -- or feet first.
Doctors performed an emergency c-section and sent 2-pound, 3.7-ounce Jayden immediately into the Geisinger Janet Weis Children's Hospital Neonatal Intensive Care Unit, where he was placed on a ventilator for two weeks.
"Jayden's course was slightly more difficult than we expected," Neonatologist Edward Everett, D.O. said. "He had a little bit worse lung disease than your typical baby born at 27 weeks."
Jayden lost a little weight during his NICU stay and required a feeding tube to assist in his nutrition. He also had two hernia repair surgeries during his stay. Before leaving, the cardiology team also discovered a couple of heart defects: patent ductus arteriosus or PDA and a Ventricular Septal Defect.
The ductus arteriosus is the blood vessel that every human fetus has that connects the aorta and the pulmonary artery. During pregnancy this blood vessel is a vital part of blood circulation, but shortly after birth, the vessel normally closes. In many premature infants and in Jayden's case, the vessel remained open. The VSD is a hole between the two pumping chambers of the heart. Both defects cause the heart and lungs to work harder and make the infant ill.
"We treated his PDA with medication that closed the vessel . The VSD first appeared fairly minor and did not seem to be giving him major problems," said Robert Mangano, M.D., Director of Pediatric Cardiology at Geisinger Janet Weis Children's Hospital.
Jayden continued to improve following a few minor setbacks in the NICU and by Feb. 12, two days before his original due date, he was able to go home with his mother.
Due to his prolonged time on the respirator, Jayden developed bronchopulmonary dysplasia or inflammation or scarring in the lungs. He was sent home on oxygen and an apnea monitor and a car bed designed for premature babies. As the lung disorder was improving, the hole in his heart started to show itself to be more problems than originally expected.
After being home for about a month, Jayden developed what his family doctor thought was pneumonia.
"He was given antibiotics and they didn't work," Desiree said. "A week later, he got worse, and he was admitted to the local community hospital for a week. Against my better judgment, I allowed him to be discharged. They sent him home with four times the oxygen he needed prior to going into the hospital."
Once again he was given antibiotics again but was beginning to vomit when he took them and when he tried to eat. After visiting the family doctor again, they stopped the oral antibiotics and started him on antibiotic injections instead. The situation was a difficult one for Desiree to watch.
"My poor baby at a month and a half old was getting these painful shots," she said.
A few days later on May 4, Jayden had a follow up appointment with neonatology at Geisinger Janet Weis Children's Hospital for his apnea visit and monitor check.
"His growth had kind of slowed after he had gone home," Dr. Everett said. "During his visit he exhibited some suspicious symptoms that indicated his heart defect may have been causing problems with his breathing as well as his growth.
"It is tough sometimes for babies to eat when they are working very hard to breathe," he said. "We were a little concerned about how things were progressing, so we brought him into the hospital for further testing."
Desiree, who was working as a nurse in Lock Haven, had to travel more than an hour every day to be with Jayden at the hospital. She traveled back and forth and stayed at the Ronald McDonald House in Danville® when she was able.
"I got to the hospital one day and they told me they had called in pulmonology and cardiology because his oxygen saturation level had dropped very low," she said. "They had performed an echocardiogram on him, and the cardiologist said they did not like what they saw. He told me Jayden needed a cardiac catheterization to get true picture of how bad his VSD was."
On May 11, Desiree's 28th birthday, Jayden had the catheterization in the Pediatric Heart Catheterization Lab at Geisinger Janet Weis Children's Hospital.
"Following the examination, we found that the VSD was quite significant," Dr. Mangano said. "He was in congestive heart failure."
Jayden was scheduled for open-heart surgery to repair the defect. After a little more than a 3-hour surgery and a couple more weeks in the hospital, Jayden was able to return home, this time without oxygen or an apnea monitor. He started eating better and gaining weight. Desiree noticed an immediate difference.
"When he was on oxygen, I couldn't allow him to cry because it would drop his heart rate. After the surgery he was able to be a normal kid," she said.
Because of her medical background, Desiree knows how dangerous the situation was for Jayden.
"If he would have been born 10 to 15 years earlier, he would not have survived," she says. "If he would have been born 10 years earlier, he wouldn't have survived the congestive heart failure. Dr. Everett basically saved his life twice, the day he was born and the day he admitted him back in the hospital.
"I love all the NICU folks. They didn't talk down to me and, knowing I was a nurse, they involved me in everything," she said. "If I ever have to go through that again, I would go to Geisinger. Between the doctors knowing what they were doing and their taking the time to explain it and work with you, Geisinger is hands down the best place you could ever take your kid."
Dr. Everett acknowledges that the case was very up and down for Jayden and his mother and credits Desiree for her poise, patience and attention to detail.
"This is an amazing story, because she had a very strong background in medicine and had a really good understanding of the challenges Jayden faced. She was very sensitive to his needs and attentive to his care and played a critical role in recognizing that he needed some extra attention following his discharge from the NICU, " he said.
Equipment used for Jayden's care and diagnosis in the NICU was made possible by donations to Children's Miracle Network at Geisinger. Children's Miracle Network funds also were used to provide pediatric cardiology equipment used in Jayden's care, as well as, the Pediatric Heart Catheterization Lab.