QUINCY, MI - Payton Morris is mild mannered with bright, exploring eyes and tousled hair.
She sleeps better than many and complains about little other than her meals, which she demands with typical, desperate urgency.
Monday, Feb. 9, the 2-month-old wore a onesie with pleated sleeves and a pithy saying about being genetically cute.
It was not until her mother pulled down the collar of her shirt, exposing the start of a pink scar running vertically down the center of her chest, that it became clear little Payton had ever been anything but a normal, healthy baby girl.
Last month, Payton underwent a successful heart surgery, scheduled before she became inevitably sick, because doctors knew of a congenital defect within about a day of her Nov. 22 birth at Hillsdale Community Health Center.
Payton was among the first in the state to benefit from a newborn screening test made mandatory last year in Michigan hospitals, according to a statement from the University of Michigan Health System, which is raising awareness during Michigan's Congenital Heart Defect Awareness week. The university has done the newborn screening since 2003 and advocated for the requirement.
The university collaborated with the state Department of Community Health and others to implement "pulse oximetry screening" in April, adding the test to a 50-year-old screening program that checks for 55 disorders.
The two-minute test, administered by attaching sensors to babies' hands and feet, showed Payton had abnormally low oxygen levels. She immediately went by ambulance to the university's C.S. Mott Children's Hospital in Ann Arbor.
Within hours of her arrival, her parents, Holly and Rob Morris of Quincy, knew their daughter had total anomalous pulmonary venous return, a congenital heart disease affecting the pulmonary veins that is difficult to detect before birth. Payton's pulmonary veins, the veins coming back from the lungs, returned to the incorrect side of her heart, said Dr. Richard Ohye, the head of pediatric cardiovascular surgery at the children's hospital.
"Since we knew about it, we didn't have to wait for something bad to happen," said Ohye, co-director of the Michigan Congenital Heart Center.
He performed the operation Jan. 13. By Jan. 24, Payton was home.
"We are very grateful and very blessed," Holly Morris, 29, said Monday as she sat with Payton, her husband, and their 4-year-old son, Eli, at the Jonesville McDonald's, where Rob Morris, 32, is the manager.
Miah VanSickle
In contrast, Andrew and Tanya VanSickle of Jonesville, who know Rob Morris through their work at McDonald's, had a baby girl, Miah, in May 2011, before the testing was required.
Miah, coincidentally, had the same rare condition - it accounts for about 1 or 2 percent of all congenital heart disease - but it was not immediately discovered.
Though Tanya VanSickle thought Miah looked a bit blue at birth, she was assured all was well until a follow-up appointment at her doctor's office revealed 3-day-old Miah had a heart murmur.
About 2 1/2 weeks later, tests at the U-M hospital determined she had total anomalous pulmonary venous return.
Miah underwent an identical surgery when she was 2 months old and is now an active 3-year-old attending preschool and trying to keep up with her three brothers, her mother said. "She's healthy as can be."
While the results were uniformly positive with Miah and Payton, they might not have been.
Undetected at birth, some more critical heart conditions can cause an infant to become seriously ill, go into cardiac arrest or die, Ohye said.
Payton and Miah's disease, when untreated, is not likely to be fatal, but it would cause growth and other issues and progressive over years and decades, the doctor said.
"I was kind of furious that I didn't find out at the hospital," said Tanya VanSickle, who used to work with Rob Morris as an assistant manager in Jonesville. "I was kind of frustrated with that, and I really didn't get all the answers."
Knowing sooner would have made difference, she said. For weeks, VanSickle said she stressed about her daughter.
"I wouldn't let anyone touch her, wouldn't let anyone come around her because I didn't want anything to happen to her," she said.
Rob and Holly Morris' experience was not free from worry - they called it "nerve-racking" - but the period of not knowing was far shorter.
All had initially seemed fine. Holly Morris had regular prenatal care, no pregnancy complications and a natural birth. Payton weighed 7 pounds, 15 ounces. Her coloring was good, she seemed to be eating well and her parents were prepared to take her home from the hospital. Their vehicle was already packed. Holly was ready for discharge and Rob Morris was sleeping in a recliner when he suddenly learned his daughter was to go to Ann Arbor.
"It was a shocker," said Holly Morris, who, with her husband, praised the staff at the children's hospital for their competency, care and attention.
It was comforting to know what was "a big deal" for them was routine for the doctors, Rob Morris said.
Congenital heart disease is the most common birth defect, affecting 1 to 110 or 1 to 125 children, Ohye said. One in 500 children has heart surgery. "I always tell parents it is the most common heart defect you've never heard of," Ohye said.
With most boys and girls, their classmates will never know they had an operation, he said.
Payton, admirably stoic through some painful procedures, healed "remarkably well," Holly Morris said.
She still takes a medication and will have follow-up visits, but Ohye said she will grow up, have kids and do "all that good stuff."
By looking at Miah, it would be impossible to know she underwent open-heart surgery, VanSickle said.
Failure to identify defects early, however, puts babies at risk and can require emergency care. "When they are really sick, that is not the time they want to have a big heart surgery," Ohye said.
Reinforcing the screening efforts are worthwhile, he does not remember the last time he had an ill patient from Michigan whose disease had escaped detection at birth. He used to see such patients at least once a month.
"I don't know what we would have done without it," Holly Morris said of the testing. "I'm glad it's out there for other mothers and other families."