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Under tumor, a baby's face

Eight days after Jordan Jamal Smith was born in March, his mother still couldn't see his face.

The bulbous, 1.8-pound mound of liquid and tissue protruding from the newborn's mouth covered his eyes and nose, his cheeks and forehead.

It had nearly killed him in the womb and threatened his life during his birth.

But two University of Miami doctors executed a carefully crafted plan, preventing the tumor from killing baby Jordan in the womb or during his birth.

And in the weeks that followed, Kimberly Robinson was able to hold -- and eventually see -- her son for the first time, an experience she later called her baby's continuous "rebirth.''

"The first time I saw him, I was only able to see his chin,'' she said Wednesday, carrying in her arms a healthy 2-month-old boy without a blemish on his radiant face.

ABNORMAL ULTRASOUND

It was late October, during a regularly scheduled doctor's appointment, when Robinson and the ultrasound technician next to her noticed something odd on the screen. The 17-week-old fetus inside Robinson had an abnormal shape on its face.

"I thought he was sucking his thumb,'' Robinson recalled.

Doctors soon discovered it was a rapidly growing tumor, which sprouted out of the baby's mouth like a large, inflated balloon. It would soon prevent him from swallowing amniotic fluid, which could cause Robinson's uterus to swell and give birth prematurely.

She was told the tumor, an epignathus teratoma, would likely suffocate the baby after birth. If the child was lucky enough to survive -- and he would probably not -- he would likely be mentally disabled. Abortion, doctors told her, would only expedite the inevitable.

Robinson, a Miami-Dade Public Schools bus driver who transports disabled students, was stricken with grief.

"Seeing what those parents go through, I didn't think I could do it,'' she said. "But they suggested I kill my baby ... I was looking for a ray of hope.''

KEEPING THE FAITH

Her husband, James Smith, advised her to trust in her doctors' expertise.

Instead the mother of three turned to Jackson Memorial Hospital, her family, friends and Pentecostal Christian church pastor. Each one repeated what her 13-year-old daughter, Kimeisha, told her the day she got the news.

"He's going to be OK.''

Each week, Robinson returned to the hospital, where doctors would insert a six-inch-long needle into her belly to drain a liter of amniotic fluid building up inside her.

"Oh my God, I hope he doesn't touch the needle,'' she would think while staring at the ultrasound screen nearby, watching the needle float by her baby's head.

Dr. Elvire Jacques, a UM obstetrician/gynecologist at Holtz Children's Hospital, stayed at Robinson's side for months, reassuring her the unpleasant process was vital to the baby. But on her own, the supportive doctor was astounded as every one of her doubts was dissolved.

"I can't believe we're getting this far,'' Jacques recalled telling herself almost every week until March.

GETTING HIM TO BREATHE

By the time Jacques and her 20-person team of doctors and nurses performed the Caesarean on March 25, pediatric otolaryngologist Dr. Ramzi Younis was ready to do his part. He kept the baby connected to his mother's placenta after birth, meanwhile finding a way to get the baby to start breathing, despite the tumor covering the baby's face.

The outlook was not good: 70 similar cases of the rare condition had been reported from

1953 to 2004. Of those, most of the babies had suffocated soon after birth.

Seconds after baby Jordan left the womb, he was whisked off by hospital staff. Robinson didn't even catch a glimpse of her son. The baby had no visible face, only a red mound the size of two adult fists.

"Thirty-five percent of his own weight was sitting on his face,'' Younis recalled.

The doctor lifted the heavy tumor and found what he was looking for: a mouth. The tumor, growing out of the child's mouth, had left a small opening large enough to insert a breathing tube. Doctors wrapped the baby's head and tumor in a large mask.

UNDER TUMOR, A FACE

After another week at the hospital, Younis performed a second operation, this time cutting away at the tumor itself.

"I was determined,'' Younis said. "We could have easily lost him.''

What he found after the six-hour procedure astonished him: Beneath the heavy red mass was Jordan's face, untouched and unaffected.

Although Jordan's facial bones and jaw had been pushed back and out of place, they were perfectly healthy. And like most babies, his bones were malleable. During the following weeks, his face slowly readjusted.

Ever so slowly, Robinson met her son. After the second operation, the mask and tumor were gone. By week three, his eyes were open for all to see.

And by Wednesday, the wound at the top of the Jordan's mouth was already closing on its own.

Holding him in her arms at Jackson's Neonatal Intensive Care Unit, Robinson said her baby should be home by next week.

"It's a miracle. It was God,'' she said. "Every day is like, wow.''


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