on a day that statistics will tell you will probably be a bad day, we received some great news! at noon, we found out that the hole caused by the patent ductus arteriosus (pda) had closed in response to the medicine they gave him over the previous 24 hours. so, at least for now, there doesn't appear to be any reason for him to get transferred to a different facility for surgery. he also has a greatly reduced risk for a class IV "bleeder" ( our neonatologist's term for a brain hemmorage ). one of the side-effects of pda is that it sends five times more blood to the brain than is actually necessary, which in turn stresses the brain vessels. he's still at risk for a bleeder, but much less so.
speaking of brain hemmoraging, when our neonatologist was explaining the effects of pda, he took the opportunity to launch into a discussion of bleeders. it turns out there are four classes of them, with 'class one' being not visible with the naked eye and not typically associated with negative outcomes and 'class four' being visible through the scalp and often fatal. in what was one of the many conversations we've had over the past few days that can be quite disorienting, we found ourselves listening to him calmly tell us that he probably wouldn't even bother telling us about class one or two bleeders, as he'd end up driving us insane with that much detail.
there are many other physiological consequences of the ductus arteriosis closing , the most notable being that they can reduce the percentage of oxygen that he's getting via the ventilator. we normally breath air that has 20 percent or so of oxygen. for the past few days, eric has been getting anywhere from 30-60% oxygen. after the duct closed, they were able to move towards a schedule of letting him breathe ambient air with occasional enrichments of oxygen. also, they have been actively managing his blood pressure with dopamine and his blood sugar with insulin and they've stopped both of those treatments. later in the day, they also told me that they stopped giving him antibiotics to reduce the risk of infection. these are all stupendously wonderful signs that he's stabilizing and setting himself up for the long haul. of course, he'll still have bad days and downturns, but things are looking positive.
as donna, eric's nurse today, was giving me an update about the pda and how good things were looking she stopped and laughed, "you know - he's not a wimpy white boy!" she went on to explain that, when compared to other races, white male micro-preemies ( a technical designation for preemies that are born less than 26 weeks in gestational age and weigh less than 1 pound 11 ounces ) typically get more sick, have more bad days and have longer hospital stays. "i've been doing this for over 20 years and i don't think i've ever seen an explanation for it. but lil' eric ain't no wimpy white boy. and that should make you very happy."
indeed.
unfortunately, kris is still not progressing as quickly as she'd like and she's three days post delivery, which means perfectly natural post-partum emotions are beginning. a bad morning was made worse when the nurses told her they didn't want to even try to see if she could make it down to see eric, given her current condition. she's still at an increased risk for a seizure if she has too much sensory stimulation, so they want her to have another day of quiet rest.
her blood pressure is still dangerously elevated even after starting an additional blood pressure management medicine; her platelets has also been down throughout the day, while her liver function is elevated, all of which are trends in the wrong direction. it's nerve-wracking to anticipate each new lab result and continually discover that she's not only not stabilizing, but technically getting worse ( although thankfully she's not in any pain ); however, the doctor reassured us that she's not atypical for cases of severe preeclampsia such as she developed. he expects her to have another day or two of trending in the wrong direction, followed by a gradual normalization process. first her kidneys will start working more efficiently, followed by better liver function and finally her platelets will go back up. he said her kidneys are looking better, so we'll patiently wait for the others to follow.
her doctor also gave us a little more information about the specifics of her case. about 10 percent of preeclampsia cases have similar etiologies and, as we discovered, if the baby isn't delivered immediately it will die and the mom will quite likely die. to highlight the point, as a consequence of the disease process, kris' placenta had become 30% calcified over a very short time ( possibly 24 hours ). had we waited even a short period of time to go to the ER, the placenta would have become completely calcified and eric would almost definately have died from a lack of oxygen. it's also more likely than not that an undiagnosed underlying condition will be found that is known to amplify the effects of the preeclampsia ( essentially "causing" the severe "10 percenter" cases ); so, after everything settles down, they will start testing her to see if they can find the root cause.
amidst all the disappointing lab results, kris is feeling better and making other important signs of progress. she's started to regularly produce milk with a breast pump, which is getting stored down in the nicu ( neonatal intensive care unit ) for when eric is stable enough to start feeding. she also had her first solid food today, after days of nothing but an IV and the occasional juice. she happily enjoyed what would have otherwise been a bland cheese sandwich. and she also had her catheter removed! if you've ever had a catheter, you'll understand why this made her very happy.
update: later in the evening kris finally got her first set of postive lab results and her blood pressure, while still high, seems to be gradually trending downward. her results are promising enough that they aren't going to pester her every few hours over the night to draw blood and it looks like she might have a realistic chance of seeing eric some time tommorrow.
I love my new Grandson! He comes from good stock, a wonderful mother who is so beautiful, smart, kind, fun, giving, and a wonderful part of our family and a Dad who is strong, loving, fun, kind, and part of a group of smart wise Erics. God does not make mistakes, he gives us our children. Sometimes we have them and sometimes they come from other sources. Eric the 4th is a sweet addition to our lives, a blessing to reminds us that life begins at conception, it does not get any better than this gift. SS
By 11:44 PM
, at
Thanks so much for the update Eric. It is nice of you to take the time to keep everyone informed - I'm glad you're enough of a computer geek to do so haha. I am keeping Kris in my prayers and hoping that she is allowed to see E4 soon. I almost think that being able to see him and possibly lay a finger on him would help lower her blood pressure, but I suppose the doctors know what's best. Just remind her that she is doing the best thing for E4 right now, which is trying to make herself better so that she is ready for the long struggle ahead. I am so proud of her for pumping too. I know a cold breastpump is not as fun as a warm baby, but it will be a valuable tool against infection for little Eric-- one that science cannot compete with... and it is a great way for Kris to feel a connection to the baby when she can't be near him. As a La Leche League member, I have access to lots of reference materials and I know several people who are experts on the subject of breastfeeding infants in NICU, so do email me if Kris has any questions or if she wants to double check anything the hospital's Lactation Consultant tells her. You can also contact your local LLL leader if you haven't already http://www.lllusa.org/web/GrandRapidsMI.html - all of their support and advice are completely free of charge and you do not have to be a member to attend meetings or get a leader visit at the hospital or to borrow materials from their library. I also have had a lot of online support over the past five years at breastfeeding.com's message boards. I would highly recommend them as there are enough "been there done that" moms on there to help ease any worry you may have - not just about breastfeeding, but really anything to do with babies. Response time is minimal too. Several dads post there as well. (My handle is CandyCane)
Anyway, I know all of this must be so hard for her - especially not being able to see him. I can only imagine how that would feel - when they took Adam for just an hour or two, I would start to feel a little bit empty. I would find myself going down to the nursery in my bathrobe to pick him up and bring him back to my room. I can only imagine the heartache of not being able to just get up and go to him whenever the urge strikes. It will hopefully happen very soon. I am keeping her in my thoughts and hoping that her recovery speeds up. Please give her hugs from me. Keep taking lots of pics for her to look at as it will surely help her to know that E4 is doing well (for a white boy - haha)
Love Ya - C
By 8:44 AM
, at
I'm not family or anything, but I've been reading and thinking about you guys and rooting for all of you. Thank you for sharing these updates with us!
(l.m.orchard of decafbad.com)
By 12:25 PM
, at
Eric, Thank you for keeping us updated. I know that it really helps family and friends feel more connected to you, Kris and E4 even when we cannot be there by your side. You all are in my thoughts. I know that Kris' recovery has been slower than expected, but I know that everything will work out in the end.
This was not quite what I expected when I arrived last week for my vacation, but I am so grateful that I was able to be here with you and the family during this difficult time. I firmly believe that everything happens for a reason. We may not always be sure what those reasons are, but we eventually will understand. For me, it has been about family coming together in a time of crisis. It has been about witnessing the miracle of life. To see my beautiful strong nephew doing so well and beating the odds puts so many things into perspective. I know that we can thank the science and technology that is helping E4. But I also have to believe that all the positive thoughts and kind words from around the world are playing their role as well.
Like we joked about earlier this week, someday E4 is going to be teasing about how he was a smaller preemie than his Dad. I bet he will also grow up to be the "big Eric" of the family too! I love you little brother :-) Give my love to Kris and Eric IV.
Monica
By 12:35 PM
, at“"it is hard to be brave," said piglet, sniffing slightly, "when you're only a Very Small Animal." rabbit, who had begun to write very busily, looked up and said: "it is because you are a very small animal that you will be Useful in the adventure before us."”
the complete tales & poems of winnie the poohthis site chronicles the continuing adventures of my son, odin, who was unexpectedly born on the fourth of july at 25 weeks gestation, weighing 1 pound 7 ounces.
he's quite a fighter and you can always send him a postcard to the most current address listed here if you're inspired by his adventures. see the postcard project/google maps mashup to see a map of the postcards.
if you're new, you can browse the archives to catch up. and don't forget to watch a few movies that i made while we were in the neonatal intensive care unit. or if you want the abridged version and you can find a copy, you can read about his adventures in the november 2005 issue of parents magazine.
daddytypes
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The Continuing Adventures of Super-Preemie
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