Tag Archives: infection

Contractions

3 Jun

Very first of all, you should know that the whole reason for this blog has more to do with the comments section than anything I could possibly have to say.  We’ve been brought to tears again and again throughout yesterday and this morning by your wisdom, thoughtfulness, faithfulness and amazing autobios in the comments of previous entries (not to mention notes on Facebook and Twitter).  Carey was having a particularly difficult morning and it was your beautiful sentiments, read aloud to her by me, that carried her through.  Content yourself in knowing I used all my oral interp skills to represent you and I apologize for any mispronunciations.

I’ve said it before and I have to say it again: thank you.  We covet every message and I mean it. If we could reply to you individually right now, we surely would.

By way of updates, though:

Last night began on a positive note.  Carey was moved to a much nicer room, complete with windows and other amenities, which lightened the mood considerably.  The “Rain Man Suite”.  Dr. Chao stopped by with an ultrasound device and showed us Baby A.  To our delight, we saw that not only had he partially replenished some of his fluids, but he actually had enough room to move around a bit.  Carey was still losing water, but apparently not as fast as it was being replaced.  “He’s bouncing,” Chao told us.  “You can’t bounce without fluid.”

This was good news.

And the hits kept on coming.  We enjoyed a little dinner and a nurse brought in a cot for me, so that I wouldn’t need to ride a chair for the third night in a row.  Carey popped a sleeping pill and we began to drift off to dreamland.  We weren’t out of the woods, but, for the first time in days, things were looking a little better.

Matters took a turn, though, around 2:45 AM.

An uncomfortable itching and some cramps were keeping Carey awake and we called in a nurse.  She hooked up a monitor and confirmed it: some minor contractions.  Temperature was fine, fluid leakage was next to none… everything was looking good except for that little wavy line on the contraction printout.

Over the course of the next several hours, what began as a mild irritation turned int0 what appeared to be full-blown labor pains.  We ordered up the contraction medication and no effect.  Hours later, Carey wound up calling Dr. Chao on her personal cell to petition for a different contraction medication and Chao relented.  This one helped, but by no means fixed it.

Everyone was getting concerned that Carey might be going into labor.  The pain had intensified to a startling degree and even though it was the last thing anyone wanted, we were forced to order up Morphine.  It helped for a half hour or so, but wore off quickly.  We were doing our best to avoid being shipped off to Labor and Delivery.  Delivering these babies at 22 weeks (as of yesterday), as the doctors keep reminding us, more or less means Game Over.

A NICU doctor paid us a visit for a quick consult, wearing a “I lost the rock-paper-scissors tourney in the hall, so it looks like I have to break the bad news” expression the whole time.  He gave us a lot of odds and statistics and some genuinely helpful insights on our post-partum infants.  Most of it we’d heard before, but I suppose the medical community isn’t really doing their job if somebody doesn’t come in at some point each day and remind us our kids are a cough away from the Grim Reaper.  And likely brain damaged or disordered if they do happen to hang in there.

It wasn’t an all-bad-news day, though.  Fluid and blood leakage: next to none.  Blood work: good.  Temp: normal.

Dr. Chao eventually came in with a much-needed post game on the day.  The contractions are real, but it’s Baby A that’s amplifying them.  Specifically, his lack of a filled sac is causing him and the other two to apply pressure to the pelvic nerve and uterine ligaments, which is excruciating.  Also, the issue was keeping Carey from emptying her bladder.  A catheter meant more infection risk, but what had to be done had to be done.  After the catheter, she’s feeling significantly better.  And no, she doesn’t seem to be in labor.

So, we’re at 22 +1.  I wish I could say our odds are better than yesterday, but they’re not.  In fact, the only difference between our situation today and our situation yesterday is we’re a day closer to 24 weeks, without infection.  So far, anyway.

Which is something.

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“We Can Hope”

2 Jun

Needless to say, we’ve been waiting in the eye of a mighty whirlwind since Carey’s water broke a couple of nights ago and she was admitted to the BirthCare unit at Long Beach Memorial.  We’ve spent all of our time in the hospital since then and, as you’d imagine, our OB warned us that we were in for a very long night and day to to follow.  And, of course, she was right.

Yesterday morning, we met with Dr. Chan to “discuss options”.  Truthfully, we met with several doctors, but it was Dr. Chan who told us where everything stood.  (Apologies if I get some of these details wrong.  When you begin hearing terms like “viability” or “termination” or “sepsis” in relationship to your wife and three children, the world starts to strobe and details get fuzzy.)

Chan looked at our ultrasound and described what’s happening.  Baby A, who’s lowest, next to the cervix, is the baby whose sac ruptured.  By yesterday morning, the amniotic fluid had drained more or less completely, causing the sac to, in Chan’s words “shrink wrap” around him.  What fluid is left is in the pockets around his body and Carey continues to leak amniotic fluid throughout the day and night.

The biggest problem with this isn’t necessarily that Baby A has less fluid or that he’s all scrunched up in a ball (those things are big problems later down the line, but it’s not the immediate concern).  A fetus is able to survive in those conditions and A’s heart continues to beat just fine, but it’s the risk of infection that worries everyone here at Memorial.

Carey was experiencing minor contractions when she was admitted (so small that she couldn’t even feel them), but they put her on medicine to counteract it during the first night.  Eventually, Chan made the ruling to take her off the contraction-blocker, as it was only serving to mask infection.

The trouble with infection is that it begins as perfectly safe bacteria that’s either introduced into Carey’s body from the outside or already exists there to begin with.  Our bodies are accustomed to it and our immune systems keep everything in equilibrium, but the game changes during pregnancy.  Hormones make gestating fetuses extremely susceptible to any sort of infection and the barriers between our children and certain disaster are the cervix and the sacs.  At one centimeter dilated and the bottom most sac ruptured, that’s very bad news.

A lot of people have asked if it’s possible to save the other two if something happens to Baby A and Chan explained that, with infection, it doesn’t exactly work like that.  Any direct, invasive action taken to address the situation introduces more bacteria and increases risk of infection.  It’s not really a matter of taking one baby out to save the other two.  There are definite exceptions, but in most cases, if one becomes infected, it’s likely the infection will progress to the uterine lining and other placentas.  And if that happens, it becomes a matter of saving Carey’s life instead of the babies.

We asked what the chances are for all three to make it and Chan was straightforward: about 30%. And, of course, the likelihood of the kids living with motor-neuro deficiencies or spending their lives in wheelchairs due to CP is now extremely high.  I asked him if it was at all possible for us to have three healthy, fully-functioning  children at this point.  He shrugged: “we can hope.”

Now, I’m a realistic guy.  I know that “we can hope” is doctor-ese for “extremely doubtful and you need to prepare yourself for some very cold realities.”

He discussed Options with us.  He warned us that to continue down this path could make it very difficult for Carey to get pregnant in the future.  He said that the odds weren’t with us and there’s a strong possibility of handicapped children, even if things begin moving in a positive direction.  He mentioned that we’re still a couple of weeks away from 24 weeks, the Age of Viability, and that’s the point where he’s no longer allowed to treat termination as an option.  He asked if we would object to any termination discussions from here on out.

Carey and I weren’t exactly sure what to say.  We’re Pro Life people.  Carey in particular is a hard and fast believer in the sacredness of all life, including-but-not-limited-to human beings, born or unborn.  We’ve agreed that nature is better at deciding these sorts of things than we are.  But, like that annoying instigator who throws up his hand in the midst of every college Ethics course discussion and plays the devil’s advocate, life is testing what we believe by introducing an extreme scenario.

We finally said we want to wait and see.

“There’s a phenomenon,” Chan told us, “where a ruptured sac can seal itself back up.  It happens very rarely and we can’t explain it, but I’ve seen it.  The sac heals and fills again with amniotic fluid.  After a few days and weeks, well, we’re back in business.”

“How often does that happen?” we asked.

“I don’t want to get your hopes up for that.  It’s rare.  I’m tempted to say it’s a 1% chance, but even that is being too generous.”

“Have you ever seen it with multiples?”

“Ah… I’m not sure how to answer that.  I think probably only singletons, but I can’t recall.  It’s unexplainable.  A miracle.”

Later, Carey and I were discussing what we thought.  What should we be praying for?  Is there any hope left for our boys?

“What do you think?” Carey asked me.  “Be honest.”

I wasn’t sure what to say, so I just laid the truth on her, as I see it: “Well, less than 1% isn’t 0%.  And it’s got to happen to somebody.  So why not two people who are right now being prayed for by hundreds of people all over the world?”

She agreed.  So that’s our prayer.

It’s Thursday morning, just before lunch, and Carey is still losing amniotic fluid.  Miracles are called miracles for a reason, though, and we’re taking Chan at his word: “we can hope.”

People have been absolutely astonishing with their prayers and encouragement.  To anyone who says blogging and social media is a waste of time, I say, respectfully, that Twitter, WordPress, Facebook and txt messaging have been our saving grace and anchor throughout this impossible time.  All over the world, we’ve received emails and txts, wall posts and blog comments, tweets and retweets from dearly loved family and friends and also Tweeters and Bloggers we’ve never met with encouragements, prayers and soothing words that have given us smiles and hopes in our darkest hours.

Several times a day I’ve pulled out my iphone and read Carey the latest, wishing we could reply to each person with hugs and heartfelt thanks.  “Good thoughts and vibes from me to you,” people have said.  “We’re praying.” “We know someone in a similar circumstance and they came out of it with a healthy baby.”  “We love you, we’re praying now and all through the day.”

“Praying.” “Praying.” “Praying.”

It would be impossible to describe all the encouragement we’ve received, but I want to mention one or two.

Marisa Palma: thank you for bringing meal after meal to the hospital.

Jerry and Pat Giles: thank you for getting out of bed at an ungodly hour to come and pray for us and give us a desperately-needed Psalm.

Mom, Dad, George, Shannon, Kelley, Erin, Lauren, Schwyzen, Danielle: thanks for crying with us on the phone and asking and listening.  It’s okay that you’re not sure what to say.  Being there for us is enough.

If you’ve txted us or posted something on your wall or commented or tweeted or retweeted: thank you.

If you’ve had a life long faith and are praying, or if you’ve told us, “I’m not a praying sort of person, but I’m praying for you,” or if you’ve simply wanted to send us good thoughts or vibrations or love or care or anything at all: thank you.

Thanks also for being understanding about what Carey and the boys need most.  It’s entirely possible that we’re unable at a given moment to take your call or receive an in-person visitor, particularly if you’re getting over a cold or something that could be dangerous.  Please don’t hesitate to ask if it’s an okay time, though.  If we’re able to talk or see you, we certainly would love to.

Most of all, please continue to lift us up.  It’s a difficult time and it’s far from over.  We’re trying our best to stay positive and get sleep when we can (I’ve gotten pretty used to this beside chair at this point).

I’ll continue to update Twitter when I can.

We’re going to keep hoping.  Hope with us, would you?

June 2, 2011