Estimated read time: 7-8 minutes
IDAHO FALLS — It was a moment several doctors, nurses and other Eastern Idaho Regional Medical Center employees never imagined six months ago.
But on a recent afternoon, they were lined up outside the hospital newborn intensive care unit doors because of a baby, a mother and their unbelievable will to survive.
For that mother, Nancy Hernandez, it all started with a cough.
It was the end of March and Hernandez, a mother of six with one on the way, was feeling tired and thought she had a cold.
"My mom never really felt sick. She didn't have any of the regular major symptoms of COVID," says Paola Rojo, Hernandez's daughter.
Hernandez came home exhausted from her job as a chef at a local restaurant when a friend stopped by.
"She had an oximeter. We put it on my mom, and it was at 76 when at a minimum, it was supposed to be at 90 because she was pregnant," Rojo says.
Hernandez needed to go to the hospital. She was taken to EIRMC, diagnosed with a severe case of COVID-19 and admitted to the intensive care unit.
"She was in severe respiratory failure, and the uterine pregnancy complicated the situation," EIRMC ICU Dr. Kenneth Krell tells EastIdahoNews.com. "When you're that sick with COVID, we have to keep the patients deeply sedated and paralyzed, and she did require that degree of sedation."
Doctors placed Hernandez in a medically induced coma. It was March 26, and she wasn't due for four months. She couldn't breathe and was placed on a ventilator.
"She had what we call barotrauma, where the lungs are so stiff and the airways crack," Krell explains. "You get a lot of air in the lungs, requiring chest tubes and a lot of air through the skin."
Rojo, who is 17, was left to care for the younger kids at home. Medical staff called daily with updates on her mom, and visits were rare because of COVID precautions.
"We don't have any other family around us, and when they started giving me news that my mom wasn't doing any better, I didn't know what to think. I personally shut down," Rojo recalls.
C-section in the ICU
Although pregnant women with COVID have been hospitalized at EIRMC, the intensive care unit had never seen an expectant mother's condition as bad as Hernandez's. She was not getting better, and nine days after she was admitted, Krell made a big decision.
"Nancy deteriorated to the point where I was worried we weren't getting enough adequate oxygenation to the baby, and we had to have an emergency C-section in the room," Krell says.
A cesarean section in the ICU had never been done at the hospital before. Hernandez's baby was just 24 weeks gestation and on April 4, Krell, Dr. Jordan Simpson of the hospital's NICU, and others delivered a baby girl. Angelica Alvarez Rojo weighed 1 pound, 6 ounces.
"We definitely worried about the baby. We didn't know exactly what we were going to get when she came out, but luckily she did pretty well at first," Simpson says.
Still in her coma, Hernandez had no idea she had given birth but she vividly recalls having dreams. In one, her father, who died of COVID-19 in Mexico last September, visited, spent time with her and hugged her.
"He said, 'You have to get up, you have to be strong because you still have a lot of things to do,'" Hernandez says.
Doctors worked to get Hernandez better. She ballooned up with air trapped inside her body so large incisions were made to help release it. She "certainly came close a number of times" to dying, Krell says.
Coming out of the coma
But on April 20, nearly a month after being admitted to the hospital, Hernandez came out of her coma. Her brother was in her room at the time.
"He was like, 'The baby girl they took out of you — she is doing well,'" says Rojo. "At that moment, my mom touched her stomach and said, 'Baby girl?' She was really confused. That's when she was like, 'Oh yeah, I was pregnant.'"
Hernandez says she had no emotion when she woke up. She wasn't sad, happy, relieved, upset — she was dull. She didn't cry or laugh and had no desire to see her baby.
"The nurses would constantly ask, 'Do you want to meet your daughter? Do you want to meet your baby? She's really pretty. She's beautiful. Come and meet her,'" Rojo says. "Mom would be like, "No. It's OK. It's fine.'"
Herandez's health began to improve, but Angelica's soon took a turn for the worst.
"Twenty-four-weekers are at an increased risk for what we call NEC (necrotizing enterocolitis), which is a gut infection … and unfortunately she ended up having that and ended up having to have surgeries," Simpson says.
In the past, premature babies with this condition were flown to Primary Children's Hospital in Salt Lake City, but EIRMC now has a pediatric surgeon who was ready to perform Angelica's surgery.
It was risky, and the little baby needed her mom.
"My mom remembers a nurse barging into her room yelling, 'Nancy, Nancy — your daughter is really sick. She's doing really bad. You need to see her right now,'" Rojo explains. "One of the doctors told my mom to hug her, kiss her, just love her, 'cause in a couple hours, he didn't know what the outcome would be."
At that moment, Hernandez says it was like a glass case around her shattered, and her emotions "unlocked." She realized what was happening with her daughter and began praying that Angelica would survive the operation.
She soon received word that the surgery was a success, and her strong baby girl would go on to recover from other health challenges.
Recovery and going home
Hernandez also recovered. She was released from the hospital on May 17 — nearly two months after being admitted. Angelica couldn't go with her, so Mom continued to visit the NICU every day.
And that brings us back to the moment doctors, nurses and others stood outside the NICU doors last Wednesday.
After 177 days in the NICU, it was finally time for Angelica to go home.
"Definitely the longest one we have had so far that we are discharging home," Dr. Simpson says." I luckily got to be there for the delivery, and now I get to see her go home."
As happy as everyone was in the NICU, there was a little bit of sadness. Angelica had been there for six months, and the staff has helped raise her.
"It's work by a whole team of people from nursing and therapy, including housekeepers and cafeteria help — it takes a whole team," Krell says.
Angelica will go home on oxygen and have regular visits to her pediatrician, but doctors hope she will live a normal life like any other child.
Hernandez has been looking forward to this day. She feels emotions again, and while she's happy, she's a little sad and nervous too, but says she and her baby are alive and well for a reason.
"My mom does believe Angelica has a special purpose, and my mom has something to finish up here too," Rojo says. "She feels it's as if God sent her back so she can also finish taking care of all her kids and making sure they become good people."
As Angelica was placed in her car seat, EIRMC staff lined up outside. When the door opened, they burst into applause.
There were smiles, hugs and tears as little Angelica and her mom moved through the line to their car — ready to begin a new chapter in their lives.
"She's very thankful to God that he allowed both of them to still be here," Rojo says. "It's a miracle. She feels all the nurses and doctors were both of their angels."