Friday, April 16, 2010

Trauma, tears . . . and guarded joy

Sarita and I were on the way to the airport this morning to visit our eldest daughter, son-in-law, four grandsons and semi-foster granddaughter in Virginia when we received the phone call:

"Jonelle is on her way into surgery for an emergency C-section. The baby (which we had been told was 26 weeks along) measured only for 22 weeks. It looks really bad. We will probably lose the baby. . . . And it appears there is some kind of cyst or something on Jonelle's uterus which means she will probably have to have a hysterectomy. . . ."

"Turn around! Turn around!" said Sarita.

We weren't going to Virginia.

Background: Late last week, the prenatal care doctor had warned Jonelle that she appeared to be suffering from pre-eclampsia (formerly known as toxemia). By Tuesday this week, the doctor confirmed the diagnosis, gave Jonelle a prescription for a blood pressure medication, and said, "Let's have you lay really low and see if we can keep things going for a couple of more weeks. If we can get you to 28 weeks, that's way better than 26 . . ."

Wednesday, Jonelle's blood pressure had come way down. Oh, joy!

But Thursday: Not so good.

A little side note: Knowing we would be out of town this weekend, and knowing of Jonelle's potentially precarious state, Jonelle's mother-in-law arranged to fly in last night to "be there" for Dave and Jonelle over the next 10 days.

Well, last night, Jonelle could not sleep. Her entire body was spasming and giving her terrible pain.

Finally, at 4:45 this morning, she woke Dave: "Dave, I can't stand it anymore!"

Dave called the Kaiser number and a nurse answered. "It sounds as if you're dehydrated," she said. "Please drink a lot of liquid . . . and I'll call you back in half an hour."

Half an hour later, Jonelle had drunk 40 ozs of water and promptly thrown it all back up.

Off to the hospital . . . with gratefulness that Grandma Lilly was there to take care of Natalia.

We got a call at about 5:40: "We're at the hospital . . ."--and the story of the rough night.

"Should we go to Virginia?" asked Sarita. "Should we stay?"

I suggested we go. "What can we really do, here? Jonelle is in good hands."

But then, at about 8:30, we got that call I mentioned up top . . . as we were on the way to the airport.

We turned around. Sarita and I took a while trying to undo what we could of our travel plans (see if we could salvage some of the expenses) and sent news to our prayer networks. And we made arrangements to pick up Grandma Lilly and take Natalia to her cousins' house, about five miles up the road and, more or less, on the way to the hospital. There was pleasant talk and smiles while Natalia was in the car. As soon as we dropped her off, however, tears began to flow. Crushing emotion. . . .

--All this trauma and no baby to show for it! . . . And with a hysterectomy, no more opportunity for any more children (or grandkids)!

--Why, Lord, do you give people who don't even want kids multiple pregnancies only so they can abort them . . . and then those of us who want them lose the babies or lose the ability to bear them? . . .

As the three of us checked in at the hospital (about 45 minutes from home) we were told that "the baby is born" but momma is still in the operating room. . . .

No word on how anyone was doing.

We waited about 10 minutes in the hallway outside the OR, tears, praying. And then a team of about four or five nurses and orderlies came out of the OR with a wheeled infant carrier.

"Is that the Lilly baby?" we asked as we sprang to our feet.

"Yes," they said--it seemed they were almost beaming. Someone said, "Grace Lilly."

The parade stopped and they let us get a very brief look at her tiny head under a blanket beneath the gentle hand of one of the orderlies.

Then they moved on.

Dave had been at the end of the train. I didn't recognize him with the full surgery scrubs he was wearing.

Hugs all around and then he was off behind the hospital staff.

"She looked good!" someone said. "Nice color!"

"Oh! She is so tiny!"

"Did she have any breathing tubes?"

"I don't think so!"

"Can it be? Is she okay?!?"

"They wouldn't have been so casual, would they, if she had been in critical condition. . . . Would they? . . ."

Longer story shorter:

It turns out the mass that had worried the medical staff before surgery was within the placenta itself . . . and may have been what caused Gracie to be so small (about half the size a normal 26-week-old intra-uterine baby should be). The mass may have been stealing most of Gracie's nutrients. Jonelle's uterus appeared perfectly fine.

The doctor made one of those comments that "says more" than she may have known: "We will need to watch you even more carefully with your next baby. . . ."

After everything had settled down, we were able to talk with the doctor. She explained that the abnormal placenta itself could have caused the hypertension (high blood pressure) and pre-eclampsia. Possibly.

We can hope.

Still, if there is to be any future pregnancy, Jonelle will be considered in the very high-risk category.

Momma Jonelle is doing fantastically. She looked better after a couple of hours following the C-section this morning than she did after days and days following the birth of her elder daughter in July 2008. . . .

Gracie: Born at 10:05 MDT this morning, 4/16/10. Weight at birth: 440 grams--15.5 ozs. Can she survive?

The nurse with whom we spoke in the NICU (neonatal intensive care unit) said she has cared for two babies who were smaller than Gracie . . . who survived.

The attending doctor said the real crucial period for babies like Gracie is the first 72 to 96 hours (through next Monday or Tuesday). "If she makes it past that--if she makes it," said the doctor, "then we can begin to talk about what next. Right now, we just want to do what we can to keep her alive." He said one major threat is bleeding in the brain which could lead to long-term issues like cerebral palsy or other problems.

The doctor said Gracie is in the "honeymoon period" right now. Usually, the second day things start going really poorly.... At the moment, however, she has good oxygen.

Her white blood cell and red blood cell counts, however, were both low, so the doctor intended to give her a transfusion. ("Babies like this will often have up to eight transfusions," he said.)

Gracie also had low blood sugar. "We'll be trying to bring that up. Of course, then we will overshoot, and we'll have to bring it back down. . . . It usually takes a few days before we get it just right," he said.

The doctor and several other staff members commented: "She's a real fighter." Yeah. "Feisty" is a word we heard a few times.

As I've said elsewhere: We appreciate your prayers.

A few photos:

Dave and his mom next to Gracie's high-tech incubator.

Tiny Gracie under the blankets.

You'll see a little reflection over her chest. That's some kind of cellophane in which they wrapped her to hold her tight and limit her movements.

Now you see the cellophane more clearly. Look at that little left hand working its way out, though!

She has almost broken free . . . and she is stretching toward those IV tubes into her umbilicus. --We wondered whether she was going to pull them out. --As I said, she is one feisty kid! :-)
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