Saturday, January 31, 2009

July 13

Well, Will didn't end up getting the ventilator removed today after all. He was anemic and not oxygenating well, so they gave him another transfusion (from the same donor) instead and they're going to wait and see if he's strong enough to try tomorrow but that also depends on a couple other factors. His heart murmur is back, and the doctors are considering whether to try another dose of the medication he was given before. We're not certain if the heart medication (which is a vasoconstrictor, causes veins to shrink down) caused the poor circulation in his legs and the black toes, so giving him enough to effect his heart may cost him his toes, feet or legs if he has a worse bad reaction to it. His other option is surgery, which sounds to us like it might be the safer option - a surgery that they consider pretty quick and easy (doc said it's about 20 minutes and doesn't bleed much), has a very high success rate and is pretty much guaranteed to permenently fix the problem, or medication which may or may not fix the problem and may or may not damage or cause the loss of his extremities. I don't like the idea of either one, but if something has to be done surgery is starting to sound safer than an unknown reaction to the medication.

His weight was back down to 2 lbs 12 oz, but still over his birth weight so that's good. Really nothing else to report, which at this point is good news. We didn't end up staying at the Ronald McDonald house tonight, since he was doing well we're comfortable coming home. I want to save my time for when he gets the ventilator removed or anything else major, they try to balance it so nobody gets an unfair portion of time in there.. I feel better about that too, someone who really needs it that lives further away than I do can have it. When he gets the ventilator removed though I'm not going anywhere, last time they tried that he coded (went into cardiac arrest) a few hours later. We're pretty sure it's unrelated, but that doesn't matter at all to me I'm going to be with him as long as I can after that just to make sure he's okay.

The swelling on my feet is almost gone today and I'm completely off the pain killers. Still in some discomfort but very little pain. We got a parking pass and meal vouchers, it took them 2 weeks to figure out we're going to be there all the time! Our social worker, who should have made sure we got those, went on vacation while I was in the hospital too so we fell through the cracks and didn't get the same quality service they claim to usually offer. Oh well, at least we got them! We didn't even know they were available, that saves us $3/day for parking and $4 each per meal at the cafeteria which helps.

July 12


Will did very well again today. No major drama. We didn't like the nurse he had today very much. She was more attentive than some of the others havebeen, but couldn't seem to get the leads (monitor attachments to him) properly placed so every time he moved it would say his heart beat was dropping dangerously low and set off an alarm when really everything was fine. She didn't really seem to care about the alarms either. She did get us a Ronald McDonald house room for tomorrow though, so we can stay closer to him and not have to face the hour each way drive for at least one night.


They're decreasing the percentage oxygen he's getting gradually, preparingto switch off the respirator and transfer back to the CPAP (pressurized airmask). We have some anxiety about that, since that's the only thing that had changed the day he coded, but we agree with the doctors that it most likely is a completely unrelated event, and realize the dangers of leaving him on a ventilator long term are higher than trying to put him back on CPAP since he's done so well with it before. They're saying they may try switching over again tomorrow or possibly soon after, and if he does well with it then we can try tube feeding a couple days after and then he should start really growing! He's also gained a bit more weight, another ounce! Up to 2 lbs 13 oz now! His coloring is looking great too, he's stopped being funky pink and starting to look like normal baby skin color.

July 11

Will did very well again today. You wouldn't know by looking at him, by his tests or anything that he came so close yesterday. The doctor told us today that we were much closer to losing him than we thought, they usually only try to revive a baby for 15-20 minutes and it took them 15 minutes to bring him back. They have no idea why he went into cardiac arrest and no idea what brought him back. The doctor didn't think that the epinephrine, calcium or anything else they did was what made the difference, it seems to have been a miraculous recovery. There is a test they do to monitor kidney function as a way to check for possible oxygen depravation since the body will prioritize and send oxygen to the brain & lungs first - so if the kidneys show no sign of oxygen depravation odds are the brain and lungs had plenty and his kidneys are doing great.

They think it may have been a blood clot that formed in his leg, the reason his lower extremities had a dusky color a few days ago, and may have broken loose and traveled to his heart or lung, but there is no way to find out for sure. We're almost certain it had nothing to do with the extubation (removal of the ventilator) and using CPAP yesterday since his oxygen stats and things looked just fine and he was crying vigorously right before he coded. The doctor thinks he was in pain and that's why he was crying like that, and that seems to support the blood clot theory. So we have no way to know if this was a one-time incident or if we may face future problems, but we're very lucky he's okay. Time makes all memories fade, but I don't think it will ever fade for me having the doctors call me in to be with him, entering a room of quiet people watching us and laying hands on my son not knowing if we were saying goodbye, having the chaplain say a prayer over him and feeling the world crumbling. I can't imagine how it is for parents who face that situation and don't get the miraculous recovery we got.

On the bright side his weight is awesome! He's passed his birth weight by 1 oz, up to 2 lbs 12 oz today! He also got his first taste of colostrum (first milk), not enough to eat but enough to make a taste since there is a belief that some of the antibodies and good stuff can be absorbed through the gums/mouth. I expected him to make a sour face like most babies do around weaning time when trying new foods, but he just kept licking the roof of his mouth interestedly. Think that's a good sign. And I'm milking like a cow. Pumping every 2-3 hours and about half the time I'm producing close to a full bottle (60 ML) on each side. I actually just had to swap out and get a 2nd bottle for each because I'd filled them up, was a little late getting home so closer to 4 hours between. Swelling on my feet is less too.

Some more of my family is showing support, I've had a few offers to donate blood so hopefully we'll be able to find a donor for him. He is A positive I think, that's what one of the nurses said. Justin and several other family members need to find out their type and get testing. Running on sugar, adrenaline and sheer will power so I think I'm going to go collapse a while, I've been sleeping in bursts, having nightmares, waking up in a panic thinking something has happened to him. His poor nurses have to reassure me every couple hours when I call that he's just fine. I also ran out of my oxy codone or whatever it is, my good pain killer. I'm not in much pain, but my body aches so it's probably good I'm done with that I think I was starting to get addicted to it if I'm this achy not taking it. Still taking way too many medications but most are short-term things that once I finish the course I can stop. So not a bad day today overall, exhausted and stressed as usual but Will is doing well and that's all we really care about.

Friday, January 30, 2009

July 10, Will's escape attempt

Note: This is one of the most emotional updates. It was a life changing day for us, and one we still think of often. I remember this day when Will is on my last nerve, and I'm glad he's here even when he's feeling 2.

Justin here,
I'm sitting in an overnight room at the NICU that Will is in. We had a very scary day. The docs decided he was doing well enough to extubate (remove his oxygen tube) and put him back on a CPAP (sp?) which is more like a snorkel over the nose, like he had his first 2 or 3 days on. He did well for about 3-4 hours and then he coded, which was cardiac arrest. April came back from pumping and found the nurse over him and he was grey. The nurse called for help and the NICU staff and docs rushed to him and worked on him for 15-20 minutes to revive him, just like on TV there was a wave of commotion, medications, people, chaos, while April and I sat on a couch some 10 feet away hoping for the best. We were doing ok until the chaplain came to us, which made us realize the gravity of the danger Will was in. The NICU staff called us in to come talk to him and touch him, I think April and I truly belived they had asked us in to say goodbye. He was on his back, but upside down- meaning his head was facing the foot of his incubator, he had been intubated but was moving around with his eyes open. We both placed a hand on either side of his head and watched him wiggle and look around the room and up at us ,as April and I both wept. At that moment I saw how beautiful he was and how important he is to me and April and how much I needed him to stay with us. The chaplain asked if we'd like him to say a prayer and I said yes. I don't remember what he said, but it was the most imortant prayer I've ever said amen to...Before the chaplain left he commented that his eyes (William's) looked so aware. Noone had told us they had stabilized Will until we had been by his side for half an hour or so. Looking back I suppose it was obvious by his moving around and looking up at us.

The Doc saw us a little later and was not sure what had happened, because all of Will's stats and numbers and tests were all looking good, and he seemed as strong as could be expected, the color in his feet and legs which had caused some concern days ago were perfect and pink like the rest of him, which is why they took out his breathing tube, leaving it in also has danger of lung scaring so they like to remove them when babies like Will are strong. Will is doing ok now, stats look good, blood gas tests are coming in nicely. So here we are in a little room, April is asleep next to me but I'm too awake, maybe I'll sleep when he is in pre-school. I never thought my baby would have a heart attck before me. This has been the scariest day as a parent, and the scariest thing I've ever been through.

If you have any loved ones that have passed away, please ask them to watch for Will and to shoo him back to us if he tries to make a break for it again.

Love you all
Justin

July 9




Good news again today! Will's toes are almost completely back to normal. The tip of his big toe is still a bit purple but not bad, and his other leg isalmost completely normal color. The doctor said he's getting another heart check, but they are going to wait and see regardless of what the results are. He thinks the PDA may have resolved itself with the couple doses of medication he got, or that it's minor enough not to require further treatment (we hope). He also may possibly be removed from the ventilator, possibly Tuesday.. did I mention possibly? Nothing certain there, but Ithink that's good news they think he's getting stronger enough to be considering that sometime soon. He also got a new hat today :) The nurse got him a cute set with booties and a hat, but that hat was too small and doc said he wanted his feet uncovered so he can't wear the booties heh, so the nurse had to remove them again... so he has a different hat that looks huge on his tiny head. He's been on his belly the last couple days so we can't see him all that well, but we did get a pic with his new hat and one of him just laying there. No weight change today, still 2 lbs 8 oz. Doc said he's doing better overall and looking good :)

July 7







So far the docs don't think he'll need heart surgery, it's common in pre-term babies to clip a valve, something called PDA. Still some discolor on his toes, the docs aren't sure what that is all about, they removed a PICC line (long term IV) from his foot in hopes of better circulation.






=-Justin

Thursday, January 29, 2009

July 6

Will recieved a blood transfusion last night after we'd left.

I'm a bit upset about that, it had been mentioned that transfusions are often needed for preemies that tiny, because they can't produce their own blood very well yet and they require frequent blood draws for tests that help keep him alive. It had not been mentioned though that he needed one, at least not yet, and we returned this morning and asked if anything interesting had happened and were told nothing had. Then this afternoon his doctor mentioned casually that he had a blood transfusion last night! I don't know about the rest of you, but I consider that a major thing and I've asked to be informed of everything happening to him so I'm pretty upset they didn't tell us!

If we'd known he needed one that soon we would have had the family try to donate right away when he was born so the blood would be ready and I'd told the doctors already we want to donate from within the family if possible. So he agreed to get us some paperwork to get family tested and hopefully one of us can supply it if he needs more. The doctor also agreed to try to use blood from the same donor if he needs more in the meantime, it should be available for another week, to minimize how many people he's exposed to. So at least that's something.

A couple of his toes have also turned black. They think it's because the IV line thing in his umbilical cord that they use to draw blood was causing problems, apparently that's not uncommon, and they usually place a line somewhere else and remove that one. They tried to place another in his arm today but couldn't get it placed so they will try again this evening and in the meantime they removed the umbilical one and he'll just be without a blood draw location for a while. They used a nitrous cream on them to dialate the blood vessels, hopefully that and the tube change will be enough to save his toes.

He's had 2 doses of the heart medication so far but no improvement on his murmur. He gets one more dose tonight and they'll re-evaluate him tomorrow. Hopefully there will be enough improvement to avoid surgery but we really don't know yet. The doc wasn't able to say how the odds look one way or another. Hmm what else..

He gained some weight! Only 1/2 ounce, but that's gain after he's been slowly losing weight since birth so I'm considering it excellent news.

I'm Exhausted, still weepy and having some issues from my own medical junk, saw my doc today who told me the doc who took care of me while she was away seriously under-prescribed my painkillers so she increased my dosage, ahhh.. so that's interesting news, I've been in a lot of pain for no good reason. Hopefully now I'll sleep a little better. I've been waking up gasping every time I shift in my sleep because moving around in that position hurts so much, fun stuff....

Milk has also come in well, doc says I need to start waking up at night to pump on a feeding schedule. Getting a nice supply stored at the NICU for when he's ready to eat, at least that's satisfying, I feel like I can do something for him, and the staff has been very supportive. Guess that's it for now. No new exciting pictures, he was mostly covered up today and nothing looks new.

July 5


I was discharged from the hospital on July 4. This is the first of many updates since!


We went to see Will again today. He had just been put on a ventilator. I've decided it's a good thing, he looked more relaxed and was resting more peacefully. He was working hard to breathe and it was making him too tired, this way he should be able to make some progress easier. That means the big CPAP tube was removed and he has a smaller tube in his mouth, so his nose is free. While we were there the top was off of his isolette and he had his hat and goggles off so we got to see his face and hair. He opened his eyes near the end of the visit and spent a while looking around after I got tochange his diaper, that really seemed to wake him up.


Results weren't back conclusively on his heart but the doctor told us they'll most likely be starting him on a medication which works in about 60-70% of cases, the remainder need surgery but he didn't seem to think it was a dangerous operation, pretty routine. His nurse gave us some things for his baby book,we got his tiny hat and some odds and ends, and a tiny little diaper his size. The diaper is so tiny it's about the size of my palm folded. The hat smells like him :) Anyway, here's a bunch of pictures, the light wasn'tgreat in all of them - he's not turning red again it's just poor lighting inthere and we can't use flash.

July 3

April and Will are both doing fine. She was moving around on her own, she was slow but able to do it. They let her shower with some help today. She visited Will a few times on her own (usually walking there and wheelchaired back to her room). April's breathing is still shallow so she may not come home for a few more days.

Will's color is less red today, turning more of a peach and pink color. The NICU Doc said he felt Will was still doing well. There is evidence of bleeding in the brain, which is considered normal this early. The NICU doc let us know he was not concerned about the location of the brain bleed, and they will ultrasound his head again in 2 days. William's heart rate was high and they're not sure what was causing that. He's on oxygen and IV's and too many meds to remember, but he is breathing on his own without a respirator. While I was there with April they put in an arm IV (we were asked to stepout when they placed it) and he did not like it at all. He was squirming around and attacking the tubes in his right arm with his left hand. Seeing him move and fuss around being helpless breaks my heart. Thank you everyone for being so supportive,



Aprils other boy,



Justin



Another update from Justin

Update on William, July 2


Today April was brought up to see Will. She was able to touch him but not hold or pick him up, He gave her some fussing noises and flayed around his little hands. April should come home Wednesday or so but she will basically be down for a long time. Right now we're just hoping Will's health stays strong. The NICU Doc told us he was as well as they can expect for this premature, even if healthy at this early they are considered critically ill. I've attached some new photos. Justin

Down the Rabbit Hole

This e-mail was sent by Justin to everyone:

April was taken off the Magnesium at around noonish today. After no labor progress and signs off possible infection (April's temp slowly rised to 100.7) the doc decided it was in Williams best interest to take him out by C-Section. William was pulled into this world at 5:13PM. I sat on a small metal stool and held April's hand and head and we stared into each other eyes until someone announced the baby was out. They placed him on a cart and he let out lots of angry baby noises, and continued to fuss all the way to the NICU. I was allowed to follow him up to his room and watch him for a few minutes and take a picture before I was asked to leave. I spent the next 3hours with April before I went back to see William with my mother-in-law. He had all sorts of machines on him by that time and was still fussing and pulling at all the cables and wires (he was not a happy camper). The NICU docs said he was better than they expected and are cautiously optimistic.

He is very tiny and pink. He was born at 27 weeks and 5 days. He is 2 pounds 11 oz and about 16 inches long.

I've included a picture of my own small sized adult hands (7in from my wrist to tip of middle finger) in front of a similar sized table he is on in the next photo for perspective.






B.C. - Before Children

I'll start this blog off by sharing our original updates, the e-mails sent to friends and family to keep everyone informed as our lives changed so much.

For it all to make sense, a little history is needed. I have PCOS (poly cystic ovarian syndrome), hypothyroidism and several other minor health issues. It was difficult for us to start a family, and I was told I may never have children. We were truly blessed to get pregnant with Will, with medical help, in spring of 2006.

I became very sick by 7 weeks along. I lost my job and spent most of my time at home in bed. At the worst of it I was losing about a pound each day and couldn't even keep down water. I developed hyperemesis gravidarum, HG. I had a PICC line put in, a long term IV line, to keep me hydrated and well enough to stay out of the hospital. I lived on Zofran and oatmeal.

As time went by my nausea got a bit better. I was finally up and around, though nowhere near being myself. I got about a month of being okay. We found out the baby was a boy!

I had several incidents of extreme pain while pregnant, that were misdiagnosed as a slipped disk or dislocated rib. Turns out they were gallstones. Not threatening at the time, but the stress and horrible degree of pain may have contributed to what came next.

I scheduled an appointment with my doctor thinking I had an infection and found out I was in early preterm labor instead, at barely 27 weeks along. I was already about halfway dilated, and was immediately hospitalized. My doctors put me on magnesium sulfate to stop labor. I hung in there 4 days on magnesium, though it didn't completely stop labor for me and did make me very sick. Breathing became difficult, my whole body was in pain from laboring so long and finally I'd had enough. I started showing signs of infection, and Will started to go into distress. Magnesium was discontinued to try to let him be born, but I failed to progress any further in the couple hours we tried. Will wasn't handling it well, so an emergency c-section was ordered.

I think of this as when we got dragged down the rabbit hole. A whole world we'd never considered being part of became ours, where we knew all kinds of medical jargon and spent days worrying about oxygen percentages and weight gains measured in grams. Preparing to welcome an unplanned micropreemie is surreal, wonderful, horrifying and confusing all rolled into one. We'd never considered that the outcome of our family would be anything but a fat, healthy term newborn, even after all the wrong turns we always thought that was something that happens to someone else. Not us. Not our baby. Obviously, we were wrong. But it all turns out to have a silver lining. Here's a window into our trip through Wonderland.