Hello to you all and Happy Mother's Day to all you moms!

Xavier has been very well-behaved today; he even brought his mommy flowers and a cute card. His gifts, strangely, matched with the colors of his nursery, which Rebecca and I only decided upon yesterday.

Let me back up a bit, because I don't want you to miss some of the exciting news (at least I hope you will find it exciting). Rebecca had difficulty getting to sleep yesterday. Whenever she would doze off, Xavier would escape his monitor or the monitor would slip. The rhythmic drum of his 140ish bpm heart beat would go silent and Rebecca would wake up. Her "Mother's Hearing" has started!

The exciting news I mentioned is this: late last night, the doctors decided Xavier was doing well enough he only needed to be monitored the standard three times a day. All of the wires and gizmos attached to Rebecca's tummy were removed. Praise God! Xavier's marathon NST of 29 hours ended and he crossed the finish line like a champion! All the chaos which began Friday night has settled down as the doctors grow more comfortable. For that, we also praise God!

With the monitors quiet, Rebecca could sleep without distraction. Also, the results of Rebecca's 24-hour urine came back negative. This is the test looking for pre-eclampsia protein markers. Further, the blood tests done on Friday's blood draw all returned negative.

Xavier has had two of his three hour-long NSTs today. Both of them look really good. I can't speak for the morning run, but his afternoon's run only showed one variable decel. Nothing to get concerned over.

His Doppler exam today was interesting. What we noticed was one of his two umbilical arteries did not have any absences about 70 percent of the time. This was not the case yesterday; both arteries showed consistent absences. We asked about this and the doctor agreed with what we were seeing. She stated he did not show that yesterday. The lack of absences in his Doppler means Xavier is not having to work as hard against the placenta, at least in one of his umbilical arteries, as he was working yesterday. We will be looking closely to see if those absences remain absent (and we pray that they will!). No reverse flow observed, also wonderful to see and hear. Xavier was doing well.

After reading Xavier's goal list from yesterday, so many people wrote to us or spoke with us to tell us they are pulling for Xavier to go full term! Thank you all for your encouragement and faith! That would be the ultimate "your baby continues to prove me wrong" action.

Always, we thank you for your prayers.

Mom's flowers. The yellow vase came from Xavier. He chose the colors to match with his nursery color scheme. The purples and reds were a gift from a friend who stopped by to visit. Behind, Rebecca glows on the day set aside for her honor (actually, she is being gracious as I take a photo for which she was unprepared)

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Posted by Michael Ogden on May 12, 2013 at 5:16:00 PM MDT #

Hello to you all.

As I titled today's entry, I found it somewhat ironic that this is day 61 of our hospital saga. Our first visit to the hospital prior to this was just after we learned we were pregnant. That morning, a Friday, Rebecca was spotting. Being new to all of this, and terrified by the Internet reports, we went to the emergency room at PVH. There we saw our child for the first time and he was then 61 days old.

To continue from yesterday's entry, after yesterday's ultrasound, Dr. Yong had Rebecca admitted to the hospital. We asked if we could check in later in the day. I'm thinking "We drove here in two cars. I need to get to work." and several other thoughts. Rebecca had thoughts of her own. Based on the good results of our scheduled NST (which followed the ultrasound), we were allowed to check in later. Xavier did well on the NST.

I headed to work and Rebecca headed home to pack, find a place with a patio to enjoy a lunch, then get a pedicure. At 3:30 I packed the car and drove Rebecca to University Hospital.

Upon arrival Rebecca was beset by nurses and hooked up to monitors, oxygen, blood pressure cuff; the doctors even (after much persuasion) tapped her with an IV (the persuasive reason that the sterile water drip would help hydrate her and help Xavier with his decels (explained later)). At one time we had no less than six medical staff in the room, two doctors, an anesthesiologist, and various nurses. During the hooking up of monitors, blood pressure cups, and a host of other circus attractions, we were briefed on C-section procedures and probabilities (all this while the anesthesiologist was fitting Rebecca with a catheter in her hand). We also got the low-down on all the anesthetic possibilities. If you haven't realized it, the doctors, based on the NST graphs pumping out over the past hour, were thinking a C-section last night was a high probability (one doctor turned to me and said, "I wouldn't go home any time soon if I were you"). Around 6:00, Rebecca was given a steroid injection to help "jump start" Xavier in the event he needed to be delivered. (this is what they did as we transferred from PVH so many weeks ago). Rebecca had blood drawn through another "poke" and started a 24-hour urine collection (to test for pre-eclampsia markers).

We sat for many hours watching Xavier's NST chart thrash. We learned new terminology like "decel" and "variable" or "variable decel". These refer to deep drops in Xavier's heart rate which persisted for twenty or thirty seconds. These decels were the center of concern for the doctors and the nurses. Every time Xavier demonstrated a decel, a nurse instantly showed up in the room. We were living literally hour by hour, and the "hour-long" NST is still on-going as I type (25 hours now). Rebecca was not allowed to have any dinner because a delivery of Xavier was so close; she was not allowed to even drink water (though she did have a sterile water drip bag draining into her arm). She regrets her 1:00 lunch choice was a couple of Lamar's cake donuts.

We made it through the night, and Xavier's NST graph grew more stable (the nurses kept coming in to have Rebecca change position to see if that would help. It did, once we found the magic positioning). I left the hospital about 10:30 PM to go home and let the dog in the house, feed her, and find something to eat for myself. I returned to the hospital about 12:30. Rebecca was asleep and Jenny, our night nurse, was working to get Xavier back on the monitor (he has been very good about slipping under the radar). Through the night Xavier's NST graph maintained a good, steady, healthy rhythm, though I got little sleep because the drip-feed alarms kept going off for various reasons.

About 10:00 this morning, we met with the team of doctors who came in at the same time as we were getting Xavier's daily Doppler test. Dr. Rick, whom we have seen several times already, once again mentioned how little Xavier continues to prove him wrong. (to which I say, "Go, Xavier, go! Keep it up!"). Today's dopplers look the same as yesterdays, which is good. Dr. Rick checked another artery in Xavier, and one we have not seen checked before. It is the artery connecting the liver to the heart (I have forgotten what they called it, so much information was flying around the room one could not catch it with a butterfly net!). It looked really good, a healthy, strong flow. As a sign of the doctors' comfort, Rebecca was allowed clear liquids.

With Xavier looking good on his Dopplers and his NST graph putting the doctors' nerves at ease, Rebecca and I visited with Father Mark, who drove down to give Rebecca communion, then Rebecca returned some of the phone calls which came in during all of this. I left to let the dog out into the yard for her "business" and to feed her. I also needed (quite desperately) to mow the Southern Outpost's lawn before it started eating people.

I returned in the late afternoon to find Rebecca watching "The Jungle Book 2" and Xavier's NST graph looking good. I spoke with the nurse (Bethany) on my way in to ask her how "my girl and my boy are doing." She gave a glowing report. Xavier has continued to show some variable decels, but nothing alarming.

Currently, Rebecca is doing well. We made another goal tonight. Twenty-four hours after yesterday's steroid injection, Rebecca got the second one (it takes two doses to jump-start things, although one is better than none). The "jump start" is good for two weeks, but is best served if Xavier has another 24 hours to absorb the dose. That is our next goal. After that, our goal is always one more day and one more ounce. We really want to make it to June, and that is not out of reach, but it will be day by day and NST/Doppler by NST/Doppler. I have written on the room's white board Xavier's longer-term goals of 7 ounces and 3 weeks. Rebecca really wants him to make 2 pounds (which is another 3 ounces away) and another 10 days.

Rebecca was allowed solid food and wasted no time ordering an omelet. She requested, and was granted, time away from the monitors and all the hoses and wires to shower and clean up. We are awaiting pizza, broccoli and chocolate cake from the kitchen. One of our friends who wrote back to us this morning cited a wonderful scripture, one I thought was Spirit-led, timely and right on the money: Now all glory to God, who is able, through his mighty power at work within us, to accomplish infinitely more than we might ask or think. Ephesians 3:20

Great is our God! Today (and yesterday) have been a ride, though not like the "Space Mountain" of last week. His hand has walked us through it. We even saw a miracle: Rebecca let an anesthesiologist insert a catheter!

Responses[1]

Posted by Michael Ogden on May 11, 2013 at 7:30:00 PM MDT #

Hello to you all and always, thank you for your prayers.

Sorry to those who follow the blog for your daily updates; I did not have an opportunity to update things in a timely way. Everyone was expecting the growth news and today was a big day. As it turns out, this day offered even more excitement. This blog entry will be split into two parts, this and the one which follows because that's kinda how today has gone: it's been one big blur across two days.

Rebecca and I arrived at the hospital in separate cars. The plan was that I would attend the ultrasound, schedule the June ultrasounds, then head off for work (which is a mere :15 minutes down I-225). Rebecca would head off to Xavier's NST and call me with the results. That was the plan. Here is what actually happened:

Rebecca and I arrived at the hospital in separate cars; I parked in a nearby lot, she used the valet service. Our sonographer was Jean, a petite RN with three and a half to four years experience. Reading the orders, she told us this morning was just a Doppler checkup. "Oh no it's not!" thought I. I'm quite sure Rebecca was thinking similar thoughts. We told Jean that was not correct, so she called the doctor to clear things up.

Coming back, she was not given the go-ahead to do the growth exam (which does extensive probing) and only did the Doppler.

I know I have mentioned the Doppler frequently as it is a vital measurement for the baby's health. I will describe it in more detail. The Doppler is a measure of the blood flow in the two umbilical arteries and the blood flow out through the umbilical vien. Each of the three cords comprising the umbilical are measured. The arteries have a pulsating flow like a pulse, and the vien a more even drain. The arterial measurements are graphically displayed on the machine and appear like a sawtooth wave something like: /\_/\_/\_/\_/. Notice that there is no part of this curve dropping below the "baseline"; dropping below the baseline is not a good thing. A ratio is taken between the peak value and the trough value and that is called the Resistance Index or RI. Xavier's placenta is resisting blood flow when his heart rests (the beat which does not pump blood). An RI ratio approaching 1 means the placenta resistance (which is abnormal in a pregnancy) is strong enough to stop the baby's blood flowing back to the placenta on the "rest" beat. At some point after an RI of 1, blood flow will be in reverse, as if the placenta becomes a competing heart. In essence this means the placenta can no longer deliver to Xavier effectively and at some point further becomes dangerous to him.

Xavier's RI this morning was 0.99. There is no reverse flow yet, but there are what are called absences. In the graph above, that is the flat bottom line. I will note at this point that the absences can persist for days or weeks before any reverse begins; there is no guarantee of this longevity, however. At this point, it is necessary to watch Xavier much closer, with daily Doppler tests and frequent NSTs. That, of course, cannot be done at home. So, the doctor, Dr. Joyce Yong whom we first met at the Platte Parenatal and who sent us to the hospital originally, sent us to the hospital once more. We have been expecting the re-admittance to the hospital because the weekly Dopplers have been trending this way, but we hoped to make it into June.

Dr Yong amended the orders and we did get our growth exam. Here is a summary of this morning's growth exam:

1. weight: 1 lb, 13 oz. This is not the 2-2 1/2 we were hoping for, but still Xavier averaged a little more than 2 ounces a week, which has been his growth curve since his 23rd week
2. Percentile: 2%. He is still growing at a consistent rate, just behind the curve. He is still on the curve, I will point out!
3. S/D blood pressure ratio: 85%
4. Amnio fluid: 7.4 cm (had to use the 4 quad method today). This is a little lower than last week; the lower fluid levels made some of the ultrasound measurements difficult, fuzzy or not possible today, but this is no cause for alarm.
5. organs: all looking good, heart pumping proudly at 139 bpm; bladder partly full, brain good; stomach OK.

I will continue today's events on tomorrow's entry. To be candid, we feel we are still living one, very long day

Here is today's profile shot from the ultrasound.

Out monographer, Jean, took this 2D of Xavier's face; there was not enough fluid today to get a 3D image. His eyes are to the left.

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Posted by Michael Ogden on May 10, 2013 at 4:08:00 PM MDT #