Baby Hunter: NICU ups and downs

Wednesday, April 9, 2008

NICU ups and downs

During my mourning phone call to the NICU the nurse reported that Hunter's ET tube (the vent tubes in her mouth) was changed due to it showing false readings on the monitor and when they tried to adjust it Hunter moved and it came out. This was good and bad news for me. Hunter's infection is in her lungs due to the tubes. Yesterday I ask the infection control MD to replace the tube with a new one to increase Hunter's chances of fighting the infection. The MD stated that they try antibiotics 1st, then if that doesn't work then they swap out tubes. Putting in a ventilator tube is so hard especially for a micro preemie like Hunter. So when they removed the old tube it was filled with yellow gunk. Hopefully this will give Hunter a new start with clearing her lungs. The bad part is it tired her out and she was given ativan to calm her down. Hunter was removed off of the HiFi machine that helps keep her Co2 levels down and she received new IV lines in both arms. Last night was very busy for Hunter so the nurses felt it was best to let her rest today and not kangaroo. I watched her sleep most of the day. She didn't open her eyes today not even when I changed her diaper. The culture results that came back today shows two out of three of the infections gone. This is great news. Hunter will be tested daily and she will stay on contact isolation until she goes home. If it was up to me every one would be in a sterile moon suit before they touch her. On a more positive side she is still doing well with her feedings and bowel & bladder. I see many changes in her daily. Her little body is filling out. She is having voluntary movement of her hands and arms. She is looking more and more like her dad and I every day.

1 comment:

Anonymous said...: Charles:

You folks are doing a great job - I will hold you and your family in my thoughts and prayers. I know God is watching over her!

Sincerely,

Deborah Hagar - ULV Professor; April 11, 2008 at 3:26 PM

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Hunter's Bio

We would like to start off by saying thanks to everyone for their prayers and support. Hunter Grace Thomas was born on Easter Sunday, March 23rd 2008 at 2:00 am. Her birth weight was 1 pound 6 ounces. She was 23 weeks and 5 days. A full term pregnancy is 40 weeks and usually the minimum age for survival is 24 weeks. Typically the 24 week mark is when the baby's lungs start to develop. Lungs are a necessity for any chance of survival. The baby’s lungs make it possible for her to survive outside the womb. She is currently being cared for at Rady Children Hospital in San Diego. Her vital signs are stable at the moment. She is able to breathe room air on her own and occasionally needs the ventilator when her body tires and needs assistance breathing. It looks like she has overcome the first obstacle and that is the ability to be able to breathe on her own. The next crucial element to her survival is not having bleeding in the brain. She is so young and under-developed and it is common for infants her age to have bleeding in their brain. These symptoms are not correctable and in order to combat this condition her head has to be slightly elevated to allow the blood to drain to her stomach. Another crucial element to her survival is the closing of her PDA located in her heart. Information of this condition can be found of the following site: (http://www.heartpoint.com/congpda.html ). We will try and keep everyone informed on her condition and again we have been overwhelmed by the response and support we have received from everyone. If you like like to leave a comment or prayer just click the title of the entry. Although the initial outlook looks good we still have a long uphill battle to fight in order for her to survive. We believe with everyone’s prayers and the blessing of God she will be able to overcome these obstacles and grow to be a healthy happy baby.

How Did We Get Here?

From the beginning we knew this was going to be a difficult pregnancy. One month into Tasha’s pregnancy she had what we thought was a miscarriage in her primary doctor’s office. She passed a very large clot and her and her doctor thought it termed her pregnancy. She went to her OBGYN and after doing an ultra-sound they discovered that she was still pregnant and the baby was healthy. The ultra-sound showed she had a sub-chorionic hemorrhage in her uterus. Her doctor saw cases in which other patients were able to have normal pregnancies despite bleeding. Typically the body heals itself and there is no bleeding. A few weeks later she had a similar event occur and again the ultra-sound showed that the baby was ok. However this hemorrhaging was above the baby’s sack and could dislodge the placenta from the womb. She fought a bout with the flu in mid December and they later discovered from doing a cure that she had streptococcus. It usually can lead to blindness when the baby passes through the birth canal if not treated. The worry for Tasha however was possible infection to the sack which could cause a rupture. So she received a cerclage at around the 16th week, which is a procedure that stitches her cervix closed to help prevent it from opening and letting bacteria in. After the surcloge she continued to bleed, usually going through 3 to 4 pads a day. If the bleeding didn’t stop there was a high risk for infection and irritation of the uterus that could lead to contractions. At about the 19th week the perineonatologist discovered that because of the cerclage the blood was puddling in her uterus. This puddling could lead to contractions. The ultra-sound showed her body was starting to contract even though she didn’t feel pain. If she went into contractions the stitches could tear causing more complication. We were stuck between a rock and a hard place. If we removed the stitches she risked introduction to bacteria, and if we kept the stitches in we risk the start of contractions or her cervix tearing. With all this turmoil around her the baby continued to grow at a healthy rate. Armed with this knowledge, Tasha to her credit ate healthy, took omega 3 vitamins that help develop the baby's brain, and was prescribed weekly progesterone shots. We saw either her doctor or perineonatologist every week. The specialist said she would only be able to carry the baby at maximum up to the 30 week mark. We knew the 24th week would be the critical date of the pregnancy. If she could hold on until then she would be administered betamethasone that would help the lungs mature. From the 21st week leading up to the baby’s birth we were in the hospital what seemed to be every other night. She started contracting and each trip that we took to the hospital they would give her medication to stop the contractions. The first time she stayed overnight and the doctor released her with a mild medication that could be taken at home if she started contracting. The medication didn’t work, the week before birth we were in the hospital every night. They would stop the contractions and then release her after a couple of hours later each time. We were now in a race for time. We needed to hold on one more week to have any chance for the baby’s survival. Her condition was so intriguing the head of Pomona Valley perineonatology wanted to examine her. We saw him on Friday March 21st and his theory was the bleeding was either being caused by the cerclage or worst case scenario an abruption on the placenta. The first was treatable but the later was a more serious condition. He prescribed her an experimental progesterone suppository. Usually progesterone is administered by injection but her bleeding was so severe he felt the suppository could be absorbed by her body. He also wrote a prescription for betamethasone to be administered at the hospital on Wednesday, the 26th and Thursday the 27th.

Mircle Birth

March 23, 2008 was the most surreal experience of our lives. On Saturday the 22nd Tasha complained about contractions about 10:30 pm. This had become a familiar site. What was different about this night is she started to bleed heavily and changed her pad 3 times in a 30 minute span. As I got her things ready to make our routine trip to San Antonio hospital in Upland, I noticed she had been in the bathroom for more than 10 minutes. I heard her faintly call my name. When I went the bathroom she was sitting on the toilet slumped over. She told me to call 911 because she had fainted. I frantically called 911 and was put on hold. When I went to check on her she had fainted again. She said she had lost a lot of blood and I knew it was serious. The operator finally got on the phone and she dispatched the paramedics who arrived in about 5 min. She was able to get up and walk and lifted herself onto the gurney. I told the paramedics her condition and what medications she was on. We were staying at her sister’s house in Corona who could watch over her while I was at work. The driver said they were taking her to Inland Valley Hospital in Weldamer. He assured me it was the closets hospital, even though Corona Medical Center was only 4 miles away. So I followed the ambulance to the Hospital which turned out to be pretty far away. We headed south past Lake Elsinore and one exit before Murrieta. When we arrived the doctors took her vitals. She was alert but her pulse was low and her blood count was 6. A normal blood count is over 10, and her count stayed around 9.2 because of her bleeding. The doctor feared for her life because of the amount of blood she was loosing. They gave her medication to try and stop the contractions to no avail. Each time she contracted she could feel blood seep from her uterus. Her sheets had to be changed 3 times because they were drenched. The doctor wanted to perform and emergency c section because she feared an abruption of the placenta that could lead to Tasha’s death. She ordered a blood transfusion and wanted to proceed with surgery. We had come so far and we wanted to be sure that we exhausted every possibility before surgery had to be performed. We had become so accustom to her bleeding that the site of blood had become routine. We tried to inform doctor Leho that she has always had an unusual amount of blood during the pregnancy and we thought that this was consistent with her pregnancy although she had never lost this much blood at once. Tasha was reluctant to perform the surgery because they informed us they had no NICU and we were only 2 days away from her 24th week. The doctor pleaded with us to let her perform the surgery. We asked to be transferred to a hospital with a NICU but she said she could not transfer Tasha because she was not in stable conditions. The doctor ordered an ultrasound to see if the blood was a mixture of embryonic fluid and her regular bleeding. If the fluid was caused by a rupture of the bag, than it would buy us about 2 more days just enough to receive the betamethasone injections. The injections have to be administered 24 hours apart. They gave her one injection while they waited for the ultrasound. Realistically we needed 2 more days for the steroid to take affect. The ultrasound showed the bag hadn’t ruptured. The doctors, based on clinical studies diagnosed her with a partial abruption of the placenta. She could not say if that was the case for sure but based on the amount she was bleeding it had to be the cause. What the ultrasound did reveal was the baby’s measurements measured that of a 24 week old baby which was very important. Tasha’s vital started to improve and she stabilized, she still had not received the transfusion she was waiting on. Again the doctor said we had to make a decision now. It was evident that she needed to have the c section. A full abruption of the placenta would lead to the baby’s death and possibly Tasha’s. If we choose not to have the c section than we would have had to sign a release form saying that we were refusing treatment. We were free against her recommendation to walk out and admit her into another hospital. Tasha’s biggest concern was there was no NICU at their hospital at that was the primary reason she wanted to be transferred. The doctor said she would call the two local hospitals in the area and see if they could send a NICU team that could administer immediate treatment once the baby was removed from the womb. They called Loma Linda which wasn’t equipped to handle a child that young. Riverside Community had a team that could drive there but the drive could be to rough for an infant that delicate. Finally Rady Childrens Hospital of San Diego said they could fly in and airlift the baby out after birth. Faced with this decision we called Tasha’s doctor and she got on the phone with the doctor from the hospital. She asked the doctor to get a second opinion, and she told me if the second opinion was the same than it would be best to listen. We got a second opinion from the perineonatologist and he agreed with the diagnosis. We talked and agreed that if this team was willing to fly out at 12:45 in the morning by helicopter than they would be the best option. We had to decide if the baby had a better chance to survive in the hands of specialist or waiting 2 days with the risk of death of the baby and more importantly Tasha. By waiting we would have no control over the fate of the baby. The doctor came in and gave us a last and final offer. She said the team was ready to hop on the helicopter and we needed to decide now. We decided to leave it in the hands of the team from San Diego.
As the doctors prepared for surgery, Tasha started to receive her transfusion. They gave me scrubs to change into and we both prayed. As we sat and waited we could hear the helicopter arriving. It was the most chilling sound I have ever heard. I have to hold back tears everytime I imagine the sound. I went into the bathroom to change and when I came out the team was at Tasha’s bedside. They were three women who all had cases and dressed like pit men from a NASCAR team. They were literally heaven sent being that they dropped from the sky. They briefed us on what was going to happen in surgery. They would be standing by as the doctors performed the c section and would immediately take the baby and try to incubate it. They said this would be a very difficult time and there was no guarantee of survival, but they would make every effort to try and save the child. They rolled Tasha into the OR and prepped her for surgery. They were going to give her an anesthetic through her spine. She would be up for the entire procedure and I would be able to be by her side. When they called me into surgery I sat down and they started the incision. She felt it, so they frantically put her under and asked me to leave the OR. I stood and watch helplessly from outside through a window in the door. I had Tasha in my sight and in the background I could see the team from Rady’s in the corner. As the doctors frantically worked on Tasha a group of Hospital personnel gathered around the OR window. It must have been about 20 people either in the OR or in the observation room. The next few minutes were critical. The anesthesia that they used to put her under could pass the placenta line medicating the child. A nurse kept me abreast of what was going on. She said that had to cut through layers of muscles to get to the baby. She came back 15 minutes later and said the team now had the baby. I heard a yelp and I could not help but tear up. The yelp meant the baby’s lungs had developed. The nurse came back and said they were able to incubate the baby. Tasha and I were proud parents of a baby girl. As they rolled the baby out of OR I was able to hold her hand. The tip of my pinky was the size of her hand. She was 1 pound 6 ounces. She was a good size for a baby born this early. She was breathing on her own and her heart rate was stable. I had never seen a human being so small. Her arms and legs were flailing all over the place. She was extremely strong. She had my calves and her mom’s nose. She is truly a miracle. The team briefed me on what was to happen next. They were going to insert a breathing tube down her throat, and nutrient tubes through her umbilical cord. They also inserted a small IV in her tiny veins for hydrations. We had three names in mind before the birth and we were going to make our decision on her birthday based on what she looked like. The three in mind were, Hanna, Hailey, or Hunter. As strong and feisty as she was Hanna, and Hailey seemed too delicate. She was strong, and a fighter, she definitely is a Hunter. So by the grace of good we were delivered a child on Easter, and her name is Hunter Grace Thomas. Tasha got to see her briefly then she was loaded onto a helicopter and flown out with three angles back to San Diego.

Baby Hunter

Wednesday, April 9, 2008

NICU ups and downs

1 comment:

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