Thank you so much!

[Written last night, in anticipation of our leaving this morning.]

Words cannot describe how significant the support of all my/our friends has been over the last two weeks.

Sarita and I are headed out of town this morning for almost two weeks. We're traveling down the Yangtze River, looking forward to visiting the Three Gorges Dam and "simply" enjoying whatever we can learn of central Chinese culture.

I am expecting it will be a good "time away" and "time off."

Monday night, Dave and Jonelle called: "Will you come and pray with us? We just don't think we can go to sleep."

And so we had a time of prayer . . . after a bit of pointed, heart-to-heart sharing of feelings and thoughts one doesn't normally say out loud.

As we prayed, it struck me: We are all wounded.

Jonelle is still recovering from the wounds of her C-section--a major pair of wounds . . . one on the outside--a major horizontal cut--and one on the inside, a giant vertical cut into her womb . . . far bigger than "normal" because the doctors wanted to be able to take Gracie out with as little trauma to her as possible.

But Jonelle is still left with that wound and still needing to heal.

But Jonelle is not just left with that wound.

Her heart is wounded, too. And, as she has said a few times, she is also reminded regularly about that wound by the fullness of her breasts as they produce milk for a baby who won't be needing it.

Pain upon pain.

But with all of Jonelle's pain and all of her wounds, sadly, she is not the only one who has been wounded. Dave's heart, too, has received an ugly blow.

And so has Sarita's. And so has mine.

I do not want to equate any of our wounds. They are not equal. They are not the same. But they all need to heal.

Wounds take time to heal.

And so we have agreed together that we will give each other the time we need.

Sarita and I are so grateful that Jonelle's older sister, Amy, will be coming to town while we are away, so the two sisters--and their two children (only two weeks apart in age)--can enjoy each other's company.

A tribute to hospital staff who astonished us . . .

[Finished just before I received the emergency call about which I just posted.]

Dave, Jonelle, Sarita and I talked about this several times over the last week and a half/two weeks: The staff in the Labor & Delivery and Neonatal Intensive Care Units at St. Joseph Hospital/Denver absolutely stunned us. At one point, Dave and Jonelle said, "They have reestablished our faith in the medical profession."

I said, "What? . . . Why?" --And part of my question arose from knowing (or sensing I knew) how well Jonelle had been cared for during her last delivery in which she had had to undergo an emergency C-section to save her life.

What we discovered, partially by pure observation, partially by conversation, were--among many other points, I'm sure--these things. And I want to list them by way of tribute.

Overall: the staff of St. Joseph's Labor & Delivery and Neonatal Intensive Care Units communicate effectively. But this is how that looked to this observer:

• To quote the doctor who pulled us aside on Saturday evening and sat and talked with us for half an hour (or, at least, to convey the gist of what he said): "We have a saying here: 'We are here to treat the entire family' . . . because the whole family is involved in what is going on." Therefore, our questions and concerns were important to him . . . and to the other staff members. --He . . . and they, all . . . communicated that message through their actions. Consistently.
  
  We, all of us, were important to them. And they proved that.
  
  How?
   
• As they walked into the room (while Jonelle was in the hospital), and when we walked into the NICU (when we would visit there), they made sure to greet us, to identify who they were, why they were there, and what their roles were . . . and, though it was not so noticeable to us, they made sure to identify each one of us and to acknowledge who we were and why we were present. --This was something we noticed immediately, within minutes of first entering the recovery room following Jonelle's surgery. Just the act of identifying themselves by name . . . and honoring us--and themselves--by making sure we all understood each other's roles.
   
• They listened intently to whatever we had to say, whatever questions we had.
   
• They looked us in the eye--each one who asked a question--as they answered our questions. There was no looking around, no "being distracted" with "other duties" that might call.
   
• They communicated thoroughly.
   
• They communicated knowledgeably.
   
• They communicated as much as we wanted to know and in a patient and astonishingly unhurried manner.
  
  --It was clear: Our questions mattered.
   
• They communicated in a manner that honored the hearer--whether it was any one of us who was a member of the family, or it was another member of the staff. --I never saw anyone "talk down" to someone else.
  
  All of the above meant,
   
• There was amazing unity among the staff. We saw no dissension or distance between doctors and nursing staff. They fully honored one another as fellow professionals and human beings.
  
  Continuing with the theme of excellent communication:
   
• They told us [and now I am speaking primarily in behalf of Jonelle and Dave] . . . --They told us what they intended to do and why they intended to do it . . . before they did it. Always. Consistently.
   
• They fully explained what they were going to do if we ever had any questions.
   
• There was no sense on our part that we needed to "shut up" and simply acquiesce to their treatments.
   
• We, all of us, were an integral part of the treatment process.
   
• They were all well-informed of what was happening. (Noticeable: Every shift, the staff who were coming on made sure to engage in a thorough debriefing from and by the staff who were departing.
   
• They were well-educated about the issues they were dealing with. They could speak knowledgeably with us on whatever topic was of concern. And yet even as (for example) one of the nurses fully explained a matter, she would offer--indeed, make the effort--to pull in a doctor: "_______ asked ________. Would you mind explaining it to him [or her]?" --What an amazing experience to hear virtually the same explanation, in slightly different words, from two different sources! What wonderful confirmation of competency!

Much of what I have said here, at this point, seems so reasonable.

But, as Jonelle and Dave noted, these are not typical of what they experienced 20 months ago at another local hospital.

*******
One more observation.

I believe it was Saturday night, as four of us were gathered around Gracie Lou, as tears were flowing, as prayers were being said . . . it struck me what a difficult job these staff members--especially the NICU nurses--have during times of deep distress and stress on the parts of the families.

How do you know when to speak up? How do you know when to be silent? How do you know when to maintain a distance when the family needs to be left alone and, yet, to "be there" for them when they need someone to buoy them up?

How do you know when to speak words of encouragement and hope (when, otherwise, the family would be given to potentially needless despair) . . . and when to speak words that communicate about the potential gravity of a situation (lest family members hold out wildly inordinate optimism)?

I am astonished at how the staff of St. Joseph Hospital did all of these things . . . and did them well.

Thank you to all the staff at St. Joseph who touched our family. You have blessed us deeply!

Jonelle on the way to the emergency room . . .

Dave just called: "Jonelle is bleeding out of the vagina."

They dropped Natalia off and then raced to the closest hospital. "She is almost fainting!" Dave called as he ran to the car.

. . . Meanwhile, Sarita and I are supposed to leave for the airport in an hour.

We are supposed to be going to China for two weeks.

"I want you to go," Jonelle said. . . . She just called from the car as they were still on the way to the emergency room.

Luke is picking up Natalia.

Gracie Lou finished her earthly battle . . .

Mommy and Daddy spoke gentle words of blessing to her as her time came closer and closer.

The LORD bless you and keep you.
The LORD make His face to shine upon you and be gracious to you.
The LORD lift up His countenance upon you and give you His peace. ["Peace," echoes Gracie's older sister, Natalia, whenever this prayer is said.]

--Numbers 6:24-26 (a special prayer in our family)

Shortly before 11, Mommy and Daddy decided it was time for her to make that final journey.

"Can we just keep her comfortable?"

"She is comfortable," the nurse assured us. "But we will keep watch, just in case."

She was taken off the oxygen oscillator at 10:58. Her oxygen levels actually went up for 10 or 15 minutes afterwards. But then they began to subside, as did her heart rate. She had been fighting so hard. Heart rate right around 180. . . . But then it slowly came down. . . . 133. . . . 121. . . . Oxygen bouncing from 18 up to 65 then down again. . . . Heart rate 99. . . . 93. . . . Sometime when it was down in the 60s, the nurse asked if we would want to remove the monitor so we wouldn't be distracted by watching the numbers.

"Yes, thank you."

Gracie Lou  rested comfortably against her Mommy's chest throughout--except for a few minutes while Daddy held her against his. Then back to Mommy for the end.

Sometime between 11:30 and 11:45, she left us. Jonelle, Dave and I prayed together during that time. Many tears. But joy, too, that her struggles are over.

Two exhausted, bereft parents are heading home to be with their older daughter right now. I do not know of plans for memorializing Gracie Lou nor for disposing of her body.

Thank you, all, for "being there" with us through this difficult time.

Gracie Lou: They are going to put her on Jonelle's chest . . .

I am not trying to be euphemistic. We have been told of at least one "miracle" when a baby boy, just a few years ago, in a very similar circumstance, was put on his Momma's chest to die . . . and that was when he revived.

I am going up to take a few last pictures, God willing.

Gracie Lou: Just got off the phone with Jonelle . . .

"She's stable, but her oxygen is in the 60s, which is not a sustainable situation. They have her on everything they can possibly give her. 100% oxygen. At the highest pressure. They stopped giving her the [bicarb] at 5:15. They said it would take another hour or two for that to wear off. But she is still hanging in there.

"We have said, 'Lord, what You will do, do quickly. Either heal her or let her go. Peacefully. Quickly. Let it not be in the midst of some kind of crisis. If we are to rejoice, then let us rejoice. If we are to grieve, then let us grieve. But don't prolong this!"

The NICU lifted its ban on siblings coming to visit as of 15 minutes ago--8 o'clock this morning.

If Gracie Lou is still hanging in there in another hour or two, Jonelle said, and as long as they haven't simply put Gracie Lou on Jonelle's chest to die--"Why don't you bring Natalia up so she can meet her sister?"

. . . So that's the latest.

Gracie Lou: One more round?

I just called the NICU to see what might be happening. "Could I speak with Dave or Jonelle?"

"I think they might be asleep. . . ."

"Well, please don't wake them. . . ."

A few moments later: "Yes. they are both asleep. The baby is stable at the moment, but they will have to do her care, here, pretty shortly. . . ."

Yeah.

Natalia and Grandma and Aunt Becky seem to be doing fine.

Gracie Lou: It's almost two hours since Dave called with "the latest" . . .

At the time--about 4:25 this morning--they had stabilized Gracie Lou, but her blood oxygen percentages, Dave said, were in the 70s (that's low), and she was on some kind of bicarb, to reduce the acid in her blood from too much CO₂.

"They say that, in another hour or so, the bicarb should start wearing off, and then they figure it will be another 20 or 30 minutes," he said.

His voice was flat. So was mine.

Actually, when he called, it was not to give us an update on Gracie Lou, but to ask that one of us get over to their house when we awakened, so we could be there for Natalia . . . who is being accompanied, at this time, by her Aunt Becky, Dave's sister, who flew in, rather unexpectedly,  late last night. "Natalia hardly knows Becky," Dave said. "It would be nice for her to have someone familiar present when she wakes up."

Sarita is about to leave for their house (just a couple of blocks away) in a few minutes.

There's exhaustion all around.

Gracie Lou: Dave & Jonelle are on the way to the hospital for the second time . . .

"Gracie Lou is sinking fast. We cannot get her vital signs to stabilize."

They received a call like that at 6:30 last evening, in the middle of dinner and raced to the hospital. But a shot of epinephrine helped bring her around.

They received another call like that at around 1:00 this morning (I'm guessing).

Sarita and I received a call from Jonelle just 10 minutes ago or so: "Dave and I are on the way to the hospital."

I don't know how much more of this kind of craziness we all can take. At this point, Gracie Lou suffers an "event" every time her diaper is changed.The hospital has deliberately chosen to extend the time between her "care" so as to reduce the frequency of these events. But as they seem to be becoming successively more and more destructive . . .

"Lord, what You will do, do quickly!" I prayed with Jonelle just now.

Good night.

iPad as the Kindle (and print books)-killer

Sarita, the reader par excellence, was introduced, firsthand, to the iPad two weeks ago today. Two weeks ago tomorrow, she asked me to get her an iPad from the local Apple store. "I need to keep up with where the market is going," she said. "Robert [a Sonlight curriculum developer] told us about a book he owned in print . . . and that is available also as an app on the iPad. No contest, the iPad version wins over the print version. Robert said the print version might have held his son's attention for 10 minutes, tops. But as an app, he was mesmerized for hours."

Well, when I went to the Apple store, they were all out of iPads. Completely. Not a single one available at any price in any configuration. So I ordered one (a basic model; $499). On Saturday, the 17th, I picked it up.

Sarita had fallen in love with it by Sunday. And I will confess, I, too, have a certain interest, though I have told Sarita I want to wait for the HP Slate. (See also this for more on the Slate.)

One of the things Sarita is concerned about--and I am, too--is how a company like Sonlight is to keep up with what we perceive as a societal move toward electronic books. How should Sonlight Curriculum be reconfigured to meet the needs of the coming technological shift?

Well, last week, just before Gracie Lou took the turn for the worse, I was doing some reading online and was struck by a few sobering articles.

This one, in particular, grabbed my attention: "The fanboys were right. The iPad is a Kindle killer, but for all the wrong reasons."

Why?

The author says it is not because of the iPad screen. As far as that's concerned, the iPad is lousy; "your eyes get tired after a few pages. You find yourself wishing you could print out the rest of the book and read it properly, away from the screen."

The problem with the iPad as a Kindle-killer, and, indeed, as a print book killer, has to do with the fact that

the way that Apple displays books . . . suggests that they consider books to be just another kind of app. Something to fire up, play with for a couple of minutes and then swap out for the next five minutes of Flight Control. . . .
Even for those who love books enough to persevere with reading without e-ink will soon face another problem with the awesomeness of the iPad. The device does so many different things so well that there’s a constant urge when you’re using one to do something else. Two or three pages into a book, you’re already wondering whether you’ve got new mail, or whether anyone has atted you on Twitter.

One of the joys of reading is to be able to shut yourself away from distractions and lose yourself in a book. When the book itself is packed with distractions, the whole experience is compromised.

That explains why it will kill book reading. But/and why will it kill the Kindle? Because,

If you have to carry around one device – for your commute to work, for an hour in a coffee shop, or on a long-haul flight – then the iPad is the one to carry. . . .

For a few months, the Kindle – or the Sony Reader, or whatever e-reader floated your (Three Men In A) boat – was the perfect take-anywhere device. Sales of ebooks soared as first early adopters, then everyone else, left their paper books at home and started carrying around something smaller and lighter that still gave them access to their reading material.

Those same people are now the ones who will buy iPads, or presumably any one of the myriad alternatives that will soon be flooding the market. But those people don’t want to carry around two tablet-shaped devices to help pass their commute, so they’ll make the sensible choice and leave their Kindles at home. Sure, the Kindle is unarguably the better reader device, but what many booklovers (myself included) have arrogantly overlooked is that it’s not competing on a level playing field with other e-readers. It’s competing against the whole universe of portable entertainment. “This ebook hurts my eyes – I’ll just surf the web instead.”

Y'know what scares me? I think he is correct!

While you're mulling this issue, consider Cody Brown's response. He says, Dear Authors, Your Next Book Should be an App, Not an iBook.

And for books like Gray's Elements, I think he is correct. What a brilliant idea. But for other works where the thought. the ideas, the concepts are essential, and physical realities are less so? I agree with Ned Resnikoff: Dear Authors, Your Next Book Should Be a Book:

Imagine if someone wrote, “Dear Filmmakers, Your Next Movie Should be a Video Game.” Or, “Dear Playwrights, Your Next Play Should Be a Movie.” Cody’s right to point out that we’re going to see some really interesting innovations in how to read from the iPad and similar devices, but I don’t see how those innovations can displace books entirely. What about the tactile sensation of reading? The physical artifact of a book? The way you can chart your progress through it by the movement of the bookmark?

But there is something more fundamental at work, here, I am afraid. It has to do with the potential difficulty of getting published. As Tariq Kamal comments on Cody Brown's post:

Here’s the thing, though: books — media in the written word, really — are really easy to make. What you’re asking for is a multimedia production, and you know what? Those are hard to make by single authors.

Not impossible, true! But harder to make. And that barrier to entry might mean the difference between millions of diverse, raw voices or merely dozens of slick, pre-productioned and marketed consumerist pap for the proles.

And yes, you’re right! That’s exactly what’s happening right now with publishing! And you know what? That’s the exact same future the iPad is selling to me, right now. No change to the status quo, except making it harder for individual voices to get their stories heard.

And that brings us back, potentially, to a glimmer of hope, according to EvilDave:

The truth is . . . while all of these “books as apps” things sound great, most of them will be poorly done and a hindrance to finding information.

Writing a decent book is hard. Writing a decent book while writing a software app to put that book in is triply hard. . . .

[Therefore, n]ormal text-based books aren’t dead and probably won’t be in our lifetimes.

To be honest, I'm not sure where this discussion leaves us as we contemplate what ought to be done for curriculum. As many people have observed, the advent of new technologies like these rarely destroys the old.

Certainly, the printing press put scriptoriums out of business. But radio didn't replace newspapers or books. And TV didn't replace books, newspapers or radio.

The internet, however, is gravely endangering the newspaper industry. . . .
*******
Well. One last comment. While we're on the subject of print v. electronic media, I thought this article (from September 2009), too, had a lot of good to say. I especially appreciated the author's conclusion:

True, a long-overdue culling process is certainly taking place in publishing. But critics should be careful about using too broad of a brush when painting a grave for print. Last Wednesday, TNS Media Intelligence released its U.S. Advertising and Expenditures Report. Granted, some of the numbers were bleak. Yet several of this country’s largest advertisers, including Wal-Mart, Campbell Soup, Time Warner, and Clorox, all increased their print advertising dollars from 2008 to 2009. And these are certainly companies with the resources to do their homework on ROI.

In the winter issue of Angling Trade magazine, Kirk Deeter ran a letter from Joe Healy, of Fly Rod and Reel, that was a response to an article that I had written in the previous issue, on why I think companies in the flyfishing industry should support independent filmmakers. Joe’s letter was basically telling advertisers that I was pretty off base, and that they should stick to putting their money in print (which I thought was pretty funny, since I publish a magazine for a living. But whatever.) At any rate, Joe made some good points, and ended his letter with this sentence: “When flyfishing industry folks want to target truly large numbers of new fly fishers and impassioned long-time anglers with their marketing messages, magazines remain the top choice.”

I would agree wholeheartedly with Joe, except that he forgot one word: good. As in, good magazines remain the top choice. What makes a good magazine? Who knows? Ultimately, the market will determine that. But I can give one surprising example that flies in the face of almost everything the print critics are saying: The Economist.

This is the news magazine category we’re talking about. Time and Newsweek these days look like leaflets that should be dropped from airplanes. But earlier this month, when the Audit Bureau of Circulation released its first half report, The Economist announced that its North American circulation had grown 8.5 percent from a year earlier, and that its global circ was now 1,418,013—more than twice what it was ten years ago. Even more impressive, the Economist Group reported that its profits, in large part due to an increase in advertising, grew 26 percent year-over-year, to nearly $100 million.

Gracie Lou: Rough night

Sarita and I attended a most wonderful wedding and dinner reception for one of our employees, then took off to visit Gracie Lou.

We arrived on the NICU to find five or six or seven medical staff huddled around her bed, Dave and his mom standing outside looking in, tears on their cheeks, praying.

"What's happening?"

"They were doing her regular care [change diaper, change bedding, etc.] and then they switched her around, and they can't get her oxygen levels to normalize." --Dave was obviously in deep distress. "This is the second time today! They should have Dr. _________ here whenever they are going to do that. They know it's going to happen! They should just have her regular nurses and Dr. _______, and then this stuff wouldn't happen! I'd like to punch somebody out!"

"Whoa! Whoa! Whoa! Dave! . . . Maybe you shouldn't be here!" I responded. And then immediately repented that I had said anything.

High emotions. Not good.

The struggle went on and on . . .

Dave said they had been at it for five or ten minutes before we got there. And now it was 10 minutes into our presence. And still they struggled.

"Where's the line?" asked the lead doctor. "What's the number? What's the number? Where are we?"

"Five."

"Try five and a half. . . " [Based on previous experience, they are talking about markings on the breathing tube indicating exactly how deep the tube is being inserted into Gracie Lou's mouth. I believe the numbers may refer to millimeters. They are certainly only tiny fractions of an inch.]

"Give me 12 liters of oxygen."

"You've got it."

"No. I'm not getting 12. I'm getting too much! Please! Twelve!"

Tension.

"We're at 12."

"It's not right!"

And so they struggled. . . .

"Come on, baby! Come on, baby!" Two grandmas are praying in the hallway. Daddy is in tears. And grandpa is taking photographs. . . .

"Okay! Okay!" says the lead doctor. "You've got the tube just right! Let's tape it. Right there."

It's been 15 minutes since Sarita and I arrived.

The doctor continues to pump air into Gracie Lou's lungs. . . . Eventually her numbers begin to rise . . . and the staff begins to back away from the bed.

It's been twenty-two minutes since Sarita and I arrived. And, according to Dave, another five or ten minutes more since the episode began.

Eventually, as the doctor begins to walk out of the room, Dave pulls him aside. His voice is strained.
"Can we please stick with staff who know her? . . . And can they wait until you are here before they do this kind of stuff?!? . . . This happens every time!"

Graciously, patiently, humbly, the doctor seeks to console . . . and comfort . . . and explain.
"I would trust every one of these staff members with my life," he says.

"Shall we go someplace and sit down?" invites the doctor. "Let's go sit down and talk."

Soon the five of us--Dave, his mom, Sarita and I, together with the doctor--find ourselves sitting in the "family" room off to the side of the NICU. And undefensively, gently, with utmost consideration, he answers every one of our questions and explains the real gravity of the situation.

I will confess: Tonight things sounded very grim. For the first time I got the sense that the doctor is not too hopeful. "She is as sick as they come." "Normally, preemies' lungs don't look as bad as hers do until a month or so after they have been born." "Her lungs have become far more damaged far more quickly than normal." "One of these times, she is going to have one of these episodes, and we won't be able to pull her through." "There were a couple of times today when I honestly thought we had lost her. . . ."

******

Eventually,  with our questions answered, we returned to Gracie Lou's cubicle where we were able to enjoy a few last moments with her. . . .

"Goodnight, Gracie!"

******

Prayer needs: 

• Besides the obvious miracles to see Gracie's lungs healed . . .
  
  
  
• I think the adult members of the family could use prayer that we don't blow our own relationships apart in the midst of the stresses and strains of the situation as it is and as a result of the fact that we differ in the way we handle grief and fear and frustration.
  
  
  I have heard stories of husbands and wives whose relationships were unable to withstand the strain of this kind of experience. I pray our extended family will withstand and, in fact, grow, through this trying time.

Thank you.

Gracie Lou: Amazed . . .

Following the Thursday scare, we really are amazed at how well Gracie Lou is doing.

Sarita, Jonelle and I went to the hospital last night and spent a couple of hours with Gracie Lou and her nurses. Diane, her day nurse--normally on-duty from 7 am to 7 pm--was still there at quarter to 8. She gave us a picture she had taken earlier in the day of Dave and little Gracie Lou.

None of us had ever seen her outside of her incubator. But Dave was there, apparently, when they were doing some major reorganization. . . .

"How's she doing with her weight?" asked Sarita.

"She is 570 grams!"

I think that is pretty amazing. She was born last Friday at 440 grams. On Saturday, she went up to 470. Sunday, she was back down to 410. Since then, she has been on a steady rise. 570 grams marks a 30% increase in body weight in the course of a week.

Of course, she started out at half the weight she should have been for her age. So she still has a lot of catching up to do. But it's nice to know that she's gaining weight.

Here day nurse Diane is showing her photos to Sarita and Jonelle:

Meanwhile, just around the corner, the respiratory therapist and night nurse, Maegan, were turning Gracie Lou around.

Lying on her side as she had been, GL's lungs were developing at different rates. They wanted to give the other lung a better chance to catch up:

Poor kid! Being jostled and [wo]man-handled at every turn: poke, prod, yank, nudge, pull this cord, shift that tube . . .

The rearrangement went on for, I would guess, five minutes. . . .

. . . And I winced all the way through. Gracie Lou, however, seemed to take it all in stride . . .

Of course, her blood oxygen plummeted briefly. I didn't see it, but Jonelle said she saw it fall to 40 before bouncing back.

Gracie Lou has been doing amazingly well. Thursday, they had her on 100% oxygen and, as I reported, the doctors seriously questioned whether she would make it.

By mid-morning on Friday, she had been quite stable all night and they were able to wean her back to only 40% oxygen and her numbers continued to look good. But by the time we got in last night--what with all the moving and jostling, her number weren't looking so good, and she was up to 92% oxygen feed. . . .

"What's going on with her oxygen levels?" we asked.

The staff explained: Every time something upsets Gracie Lou, her body demands more oxygen. The fact that she is trying to grow so fast: that requires more oxygen. Every time they adjust the oxygen input, her body has to acclimatize to the change. And while it is acclimatizing, the percentages of oxygen in the blood can fall. --Kind of like what happens to people who normally live at sea level and then come to visit Denver (at 5,300 ft above sea level). The air is relatively thin(ner) here, and their bodies need time to adjust. They find they are winded easily. They may suffer headaches. They need extra fluids.

So it is for micro-preemies like Gracie Lou. Their bodies need time to adjust.

And so it was with Gracie Lou. After a few minutes, her blood oxygen levels slowly rose to normal (or near-normal, anyway!).

At some point, after the rearranging had been going on for some time, I noticed Gracie Lou's left ear seemed rather deformed:

"What's going on with her ear?" I asked.

"Oh, at this stage, babies' ears lack the cartilage to hold their structure," said Maegan. And she gently flapped the ear back in place:

Ahh! Much better!

Then it was time to put in some Momma scent cloths--cloths that Momma has kept close to her body "simply" to absorb her scent so Baby Gracie Lou can enjoy the fragrance. . . .

"Oh! Look at that! She has opened her eyes!"

One of my readers encouraged us to check out Kangaroo Mother Care--a "method" by which newborns are given maximal skin-to-skin contact with their mothers (and fathers!) pretty much from the moment of birth. Mentioning this kind of information and opportunity (much less pushing for it) can become highly emotional and controversial in the midst of ongoing medical care.

Despite the risks, I thought I would broach the topic gently with Jonelle: "Have you heard of Kangaroo . . . ?"

I didn't even get the question out, and Jonelle said, "'Kangaroo Care'? Yes! We are planning to do that the moment they take the second line out of her belly."

"You mean the hospital is aware of Kangaroo Care?"

"Yes! . . ."

We asked the staff when Gracie Lou would get the line out of her belly.

"Probably next week," said our contact. "Y'know, we have it in her primarily so she doesn't have to be poked so much to get blood samples. . . . She probably had five or six samples drawn today. And that's a lot of poking!"

Without the benefit of full body-to-body skin contact, we have been left with the next best option: as much gentle holding as possible. And so it was time for Jonelle to get her hands on the little one:

Items for prayer:

• That Gracie Lou's lungs will continue to strengthen.
   
• That the nursing staff will be able to continue to wean her off of the oxygen and the nitric oxide (used for vasodilation) that they have been feeding her in order to keep her blood gases properly balanced.

At this time, we were told, these really are the two key points for prayer.

Thank you!

Gracie Lou: Stable . . .

"No news is good news."

Sarita and I finally couldn't stand it anymore: "What's going on with Gracie Lou?"

"Oh!" said Jonelle. "She's quite stable. Mom Lilly stayed at the hospital till 11:30 last night, and her numbers were really stable in the mid-80s [for oxygen]. And they were able to reduce the oxygen in the respirator to 75%." [They had been giving her 100% oxygen earlier in the day.]

Jonelle also said the patent ductus arteriosus is closing off. "It's now 'small' instead of 'large,'" she said. So that's a good sign.

This morning, however, despite the general stability, Gracie Lou's oxygen numbers did fall into the teens to low 40's before being restabilized more where they should be.

I'm not sure why the doctor would have commented on the fact that they have discovered that when GL's carbon dioxide gets too high, then she doesn't absorb the oxygen as well. --It seems to me, that would be self-evident. But either that is an insight that they can work with (do they have some means of relieving the CO₂ overload and thus improving oxygen uptake?), or else, considering that I am at least the fourth link in the communication chain, maybe something got garbled.

Whatever. Much more hopeful and positive outlook today.

Thank you.

For the technically inclined . . .

My sister in Hamburg, Germany, who is a nurse, sent me a link to a Wikipedia article that seems to describe the technical details of Gracie Lou's condition to a "T." It's called infant respiratory distress syndrome or IRDS. As a result of reading that article, I got the idea of looking for something about "infant emphysema" to see if I could find the official name that the nurse used yesterday. I believe I found it here. It's called pulmonary interstitial emphysema, or PIE.

Not sure it helps me a whole lot . . . other than to confirm that the hospital staff has communicated to us very well and they are and have been doing everything possible to give Gracie Lou every opportunity to live.

We are so grateful to them for their amazing service.

Gracie Lou: Still hanging in there . . .

It's been about three hours since we left the hospital. I can't believe how emotionally--and physically--draining this can be! And I'm not even the mom or dad. Just . . . wrung . . . out. Dry.

Sarita, Jonelle and I arrived at the hospital with Natalia in tow, just as our pastor also arrived.

When we got to the room, Gracie Lou was laying dead still. Not a twitch. Not a flutter. No motion of breathing. Nothing. But the monitor showed her heartbeat was steady in the 150s. Her blood oxygen percentage, however, was in the mid-50s. Really low. And, we were told, it had gotten down as low as 8% at some point in the morning, "briefly." 16% at some other time. And they were pumping her with 100% pure oxygen.

Major problem: The alveoli--the air sacs--in Gracie Lou's lungs had all more or less "exploded," so that her lungs had become very dysfunctional.

I said, "It's like emphysema."

"Well, that's actually what it's called," said the nurse. (She gave the full name; I don't remember.) "It's a little different from adult emphysema, but functionally, that's the way it is."

"Is there any hope? Can someone come out of this condition?" Jonelle asked.

The nurse said, "There is a 15-year-old boy--he is now my 'friend' on Facebook. He was in exactly the position that Gracie Lou is in right now. Actually, he was worse. Every sign showed he was going to die. So we actually took him off of the respirator, took him out of the incubator, and handed him to his mother to hold him while he died. . . . But as she held him, all his vital signs picked up. And, as I said, he is now my friend on Facebook.

"So, yes. They can be healed."


With this encouragement, we gathered around, Dave and Jonelle placed their hands on Gracie Lou through the side holes of the incubator, and we started praying. It wasn't immediately, but I can say that within two or three minutes, her oxygen number suddenly started climbing . . . 60, 61, back down to 57, 58, 62, 63 . . . back down again, then into the mid-60s . . . back down, but not below 60 . . . --Hope!

Jonelle prayed that they would go to 94. ("Whoa!" I thought. "No higher! That's on the extreme high end of what we would want!")

Gracie Lou's blood pressure, meanwhile, spiked. Her heartbeat was normal/steady. Her oxygen levels were fine. But blood pressure was up in the mid-90s systolic/mid- to upper-40s diastolic. (The nurse said they look only at a third number [an average?] that was in the mid- to upper-60s.) "Where is that one number supposed to be?" I asked.

"We like to see it about equal to the baby's gestational age. So, at 27 weeks, it should be about 27.

So 68 or 65 was really high.

The staff were concerned about the high blood pressure possibly blowing a blood vessel in Gracie Lou's brain. They wanted to do an ultrasound to check on her brain.

It was about then, with the tiny room way overcrowded, and it getting past 1 o'clock, and nobody having eaten, I suggested maybe I would get some lunch.

I never got back. But as Sarita and I ate out in a park nearby with Natalia, Jonelle came down to give us a good report.

"It's unofficial. The tech, of course, isn't allowed to give a final word on anything, but he said the brain scan looked normal to him; he didn't see any blood."

Beyond that, Gracie Lou's blood oxygen levels had actually climbed through the 70s . . . into the 80s . . . and even hit 93!


*******
Latest news, just a few minutes ago: Her blood pressure has come down. It was 37. (That's where it has been and no one is particularly concerned. --65: That's a concern. 37: We're okay.)

Okay. That's the latest.

Again, thank you for tracking with us and praying.

Truly. Thanks.

Gracie Lou: "Sinking fast; she may not last 10 minutes . . . "

Just got a phone call. "She may last 10 minutes; she may last 10 hours; maybe a few days. Bring Jonelle to the hospital."

Thanks.

We're on the way. 'Bye.

Gracie Lou: "Honeymoon" ended tonight; reality begins to strike . . .

Jonelle and I went to the hospital tonight. Others had spent many hours earlier in the day.

We got there just as the respiratory therapist was completing a transition to a new ventilator for Gracie Lou. She hadn't been doing well enough on the "regular" ventilator they had had her on. So they put her on what they call an "oscillator" that kind of vibrates air into her lungs (I am over-simplifying and not accurately stating exactly how it works, but . . . it's kind of like that) rather than "simply" providing an extra push when she might need it.

The night nurse was also helping to rearrange her bedding and get her resettled.

Here, the respiratory therapist is holding her up while the nurse rearranges the bedding.

I was astonished at how calm she was through all the jostling. Her numbers on the screen continued in a normal range:

Here, from the other side:

Finally, Momma Jonelle got to touch Gracie Lou:

The whole event felt almost holy: a "laying on of hands." . . .

But then things started to go haywire, it seemed. An alarm sounded. A red light flashed. Gracie Lou's heartbeat went up (in the photo below it is at 181), and her oxygen levels began to fall (77). . . .

After another 15 minutes, we had seen her heartbeat rise into the upper 190s . . . and, at least for a few moments, her oxygen fell as low as 60.

Not good.

We spoke with the doctor.

"I don't want to be discouraging, but this is really very common. She is really very sick. . . ." And so we got the details.

The ADP vessel has not closed. She may need surgery tomorrow if it doesn't close. That may be part of what is causing the oxygen problems.

On the other hand, she has been through a very stressful day, what with the one tube (of two) being removed from her umbilicus and being replaced with an IV in her left arm. And the new ventilator. And it appears that the upper portion of her right lung has collapsed a bit. . . .

Yeah.

The reality is beginning to settle in.

Jonelle asked me to post so you could pray: "God doesn't have to let her go through all this!" said Jonelle. "He can close up that vein so she doesn't have to go through surgery. . . ."

Thank you for being there.

Gracie Lou: feeder tubes out of belly . . .

We are stunned. Jonelle received a phone call this morning from the doctor: "Nothing is wrong! . . . We are planning to remove the feeding tubes from Gracie Lou's belly and insert a regular intravenous line into her arm."

This is amazing to us. We did not expect such a thing for many days, yet. But, if what Jonelle tells me is correct, it means that when she goes to visit Gracie Lou this evening, she should be able to pick her up and hold Gracie Lou against her chest.

I hope to go with Jonelle to take some photos. . . .

Again, thank you for all your prayers.

God has been very gracious.

Sociology 101: counting and calculating

I've talked before about my penchant for sociology or cultural anthropology.

As I've been reading through 1 and 2 Kings, I was struck by another cultural difference: How the ancient Hebrews counted--or expressed numbers--compared to how we would express them in our culture today.

See if this strikes you.

Let's start with the observation that Jeroboam and Rehoboam began to reign in their respective kingdoms at the same time: Jeroboam over the Kingdom of Israel; Rehoboam over the Kingdom of Judah.

1 Kings 14:21 and 31: "Rehoboam . . . reigned for seventeen years. . . . And Rehoboam slept with his fathers. . . ."

1 Kings 15:1 and 2: "Now in the eighteenth year of King Jeroboam, . . . Abijam began to reign over Judah. He reigned for three years. . . ."

1 Kings 15:9 and 10: "In the twentieth year of Jeroboam king of Israel, Asa began to reign over Judah, and he reigned forty-one years. . . ."

1 Kings 15:25: "Nadab the son of Jeroboam began to reign over Israel in the second year of Asa king of Judah, and he reigned over Israel two years."

1 Kings 15:27 and 28: "Baasha the son of Ahijah . . . conspired against [Nadab]. And Baasha struck him down. . . . So Baasha killed him in the third year of Asa king of Judah. . . ."

--I could continue the series. (I have done so in my own reading.) The pattern remains consistent. Have you caught what is going on?

• Abijam comes to power in the 18th year of Jeroboam.
   
• Abijam reigns for 3 years and Asa, his successor, comes to power in the 20th year of Jeroboam and will reign for 41 years.
   
• Nadab comes to power in the 2nd year of Asa's reign.
   
• Nadab reigns for 2 years before he is killed in the 3rd year of Asa's reign. . . .

Catch that?

• A three-year reign takes place when a king comes to power in the 18th year of another king's reign and dies in the 20th year of that other king's reign.
   
• And a two-year reign occurs when a king comes to power in the 2nd year of another king's reign and dies in the 3rd year of that other king's reign.

Normally, the way I look at things, if someone reigns from the middle of the eighteenth to the middle of the twentieth year, I would say he reigned for two years. Similarly, if someone reigns from the middle of the second year to the middle of the third year, I would say he reigned for one year.

But, according to how the writer of 1 Kings records it, I would be wrong. The correct answers are three years and two years, respectively.

Best I can make out: If you reign in the 18th year, then you have reigned for one year. If you reign in the 19th year, then you have reigned for a second year. And if you reign in the 20th year, then you have reigned for a third year: three years, total.

Similarly, if you reign in the 2nd year, then you have reigned for one year. And if you reign in the 3rd year, then you have reigned for a second year: two years, total.

And so forth.

Check it out!

The pattern continues at 1 Kings 15:33; 16:8, 10, 15, 23, 29; 22:41-42, 51; 2 Kings 3:1; 8:16-17 . . . --And that's as far as I've gotten.

Gracie Lou: bili lights off; heart valve needs to close

This little miracle child is doing extremely well.

Sarita and Jonelle went in this morning to visit her. She is looking good. They have turned off all (formerly three!) bili lights. Her liver seems to be functioning at a level where they are no longer concerned.

I forgot to mention on Sunday: she had received two blood transfusions to get her red and white blood cell counts into a good, stable, normal range. She has been good since then.

The one primary matter of concern raised by the medical staff: one of her heart valves hasn't matured enough to close properly. The tech who did the sonogram, however, remarked, "It's [the hole or gap] is looking smaller! . . . But you didn't hear it from me."

May his report prove accurate.

The long-term socioeconomic impact of the Eyjafjallajoekull (actually, Eyjafyoll) eruptions

First, let's deal with the name. According to the London Telegraph, the long name commonly used to refer to the Icelandic volcano that is causing so many travel problems in Europe is really the name for the glacier that covers the crater. The volcano itself is called Eyjafyoll (Ay-uh-fyotl).

As for the long name: "Eyja means island, fyalla or fyjoll means mountain, and jökull means glacier, so the name actually means the island mountain glacier," said Urdur Gunnarsdottir, of the Icelandic Foreign Office.

But now to the potential socioeconomic implications of the eruption.

An article I read this morning from Markman Capital Insight encouraged me to look at historical results of volcanic eruptions--not only of Eyjafyoll but of others.

1. Notice that eruptions of Eyjafyoll have been associated (somewhat weakly, it seems) with eruptions of Katla, a much larger volcano about 25km east northeast of Eyjafyoll. According to The Economist, "two or three (depending on who’s counting) of the 23 eruptions of Katla over historical times (which in Iceland means the past 1,200 years or so) have been preceded by eruptions of Eyjafjallajokull."
   

   There is no geophysical evidence for a causal relationship between such eruptions — no indication that the two volcanoes share the same plumbing — and since Katla erupts more often than Eyjafjallajokull the effect could just be coincidence. . . . That said, Katla does seem to erupt on a semi-regular basis, with typical periods between eruptions of between 30 and 80 years. The last eruption was in 1918, which makes the next overdue.

   And if Katla blows, it could be big, indeed.
   

   When it comes to lava output, its eruptions can be 100 times larger than what is going on at Eyjafjallajokull. This would be far more disruptive for the people living in southern Iceland and could also do harm much further afield. A very large eruption, thought to be one of Katla’s, left ash all across northern Europe about 10,300 years ago. When explosive volcanic eruptions in Iceland and elsewhere in the Arctic are large enough to insert significant long-lasting hazes into the upper atmosphere they can change weather patterns around the world.

   . . . And that's the first major, long-lasting socioeconomic outcome we might want to consider.
    
2. According to Dr. Andrew Hooper, an Assistant Professor of Geology at Delft University of Technology and an expert on monitoring deformation of Icelandic volcanoes,
   

   At the end of the last ice age, the rate of eruption in Iceland was some 30 times higher than historic rates. This is because the reduction in the ice load reduced the pressure in the mantle, leading to decompression melting there.
   
   Since the late 19th century the ice caps in Iceland have been shrinking yet further, due to changing climate. This will lead to additional magma generation, so we should expect more frequent and/or more voluminous eruptions in the future.

   And if that's the case, as The Economist article concludes,
   

   Iceland has other [volcanoe]s capable of even greater nastiness [than Eyjafjoll and Katla]. The eruption of Oraefajokull in 1362 may have been almost as large as that of the Philippines’ Mount Pinatubo in 1991, which was the largest eruption of the 20th century. The Laki eruption of 1783 sent poisonous gases far and wide across Europe. And there is evidence that some of the island’s volcanoes, especially those under the central ice cap, (which, other things being equal, will produce more dusty and explosive plumes if they break through) may be in cahoots, their average activity rising and falling in a cycle of about 130 years. On this analysis, the past few decades have been one of the quiet patches. It seems likely that the first 50 years of jet travel across the North Atlantic enjoyed, in historical terms, particularly clear skies.

   --Which, if we turn the logic around, means future international travel could be extremely difficult for quite some time.
   
   (By the way, apparently, volcanic ash has been of such a concern that there have been at least two international conferences on "Volcanic Ash and Aviation Safety." The second such conference was held back in June of 2004. "What's at risk from the 550 historically active volcanoes worldwide?" asks the cover page of the conference agenda.
   

   • Thousands of airline flights--more than 80 commercial aircraft unexpectedly encountered volcanic ash in flight and at airports.
   • Safety--hundreds of thousands of passengers
   • Billions in airline resources annually--costs of up to $80 million in repairs to a single aircraft

    
3. I just quoted The Economist's minor reference to Laki. Let's take a closer look at what someone else has said about that particular eruption.
   
   This is from How an Icelandic volcano helped spark the French Revolution by Greg Neale, founding editor of BBC History Magazine, in The Guardian.
   

   The Laki volcanic fissure in southern Iceland erupted over an eight-month period from 8 June 1783 to February 1784, spewing lava and poisonous gases that devastated the island's agriculture, killing much of the livestock. It is estimated that perhapsa quarter of Iceland's population died through the ensuing famine. . . .
   
   Crops were affected as the fall-out from the continuing eruption coincided with an abnormally hot summer. A clergyman, the Rev Sir John Cullum, wrote to the Royal Society that barley crops "became brown and withered … as did the leaves of the oats; the rye had the appearance of being mildewed".
   
   The British naturalist Gilbert White described that summer in his classic Natural History of Selborne as "an amazing and portentous one … the peculiar haze, or smokey fog, that prevailed for many weeks in this island, and in every part of Europe, and even beyond its limits, was a most extraordinary appearance, unlike anything known within the memory of man.
   
   "The sun, at noon, looked as blank as a clouded moon, and shed a rust-coloured ferruginous light on the ground, and floors of rooms; but was particularly lurid and blood-coloured at rising and setting. At the same time the heat was so intense that butchers' meat could hardly be eaten on the day after it was killed; and the flies swarmed so in the lanes and hedges that they rendered the horses half frantic … the country people began to look with a superstitious awe, at the red, louring aspect of the sun." . . .

   And having survived an unusually hot summer, the following winter was exceptionally cold. The Mississippi River is reported to have frozen at New Orleans!
   
   Keep moving and you've got Asian monsoons no longer operating as they do normally, a major famine in Egypt, economic upheaval across northern Europe. . . . Indeed, "food poverty was a major factor in the build-up to the French revolution of 1789."
    
4. For just one more example of volcanic impact, consider the eruption of Krakatoa in the Sunda Strait back in 1883. I encourage you to read the entire article in Wikipedia. It gives you a good idea of the potential effects of a large volcanic eruption. (From an immediate, physiological perspective only, "The pressure wave generated by the colossal final explosion radiated from Krakatoa . . . was so powerful that it shattered the eardrums of sailors on ships in the Sunda Strait and caused a spike of more than two and half inches of mercury in pressure gauges attached to gasometers in the Jakarta gasworks, sending them off the scale. The pressure wave radiated across the globe and was recorded on barographs all over the world, which continued to register it up to 5 days after the explosion. Barograph recordings show that the shockwave from the final explosion reverberated around the globe 7 times in total.")
   
   But from a climatic perspective, "In the year following the eruption, average global temperatures fell by as much as 1.2 °C (2.2 °F). Weather patterns continued to be chaotic for years, and temperatures did not return to normal until 1888."
   
   Or, as Jon Markman commented in the article that originally inspired this one, Krakatoa "threw up so much ash that crops were devastated as far away as the United States. Appearing at a time when the U.S. economy was fragile anyway, it kicked off a financial panic and turned a recession into a brief depression."

Yes, indeed. Quoting historian John Murray: "Volcanic eruptions can have significant effects on weather patterns for from two to four years, which in turn have social and economic consequences. [And, as a result, w]e shouldn't discount their possible political impacts."

*******
One final note. About the ash that is coming from Eyjafoll.

According to The Economist article:

Eyjafjallajokull is not a very big [volcano]. It is, however, particularly good at producing fine-grained ash — the sort of stuff that can hang in the air for days. . . .

The fineness of the ash is, says Thorvaldur Thordarson, an Icelandic volcanologist, unusual. Ash particles are normally in the 50-100 micron (0.05 to 0.1 millimetre) range. But at a site 50km east of the eruption, 24% of the ash falling to the ground was in the form of particles 10 microns or less in size. Studies of ash captured from the air show that for every one of the largest particles (about 300 microns) there are a million or more in the 2 micron range. So though the total volume of the eruption, put at about 0.14 cubic kilometres, is low, the amount of ash capable of travelling long distances is high.

Causes for this unbelievably fine grain:

1. The viscosity of the lava from which the ash is made. (Higher viscosity means gases are trapped more completely within the lava. When they are finally released, they go with a bang - producing a finer grain.)
   
   And,
    
2. The fact that the eruption is occurring under water/under ice means the steam generated by the eruption itself also contributes to forceful explosive forces further pulverizing the ash and yielding finer dust.

Momma is home . . .

Sorry. I keep falling behind in my reporting.

Jonelle and Dave came home from the hospital yesterday afternoon to a very happy daughter Natalia.

Jonelle is doing wonderfully. She and Dave are now making arrangements to go up and visit Gracie Lou every day--separately--so they can continue with all their other responsibilities in life as well as stay in touch with Gracie Lou.

Jonelle said she was able to rest her hand on Gracie Lou . . . indeed, she was encouraged to touch her . . . Sunday night/Monday morning.

"I was up at about 2 o'clock [Monday morning] and I went in to the NICU and her nurse told me it is a good thing for me to touch her. So I just laid my hand on her head and across her legs. . . .

"The nurse said that when parents do that, all the baby's vital signs immediately settle down."

And, apparently, according to the nurse, it is not just being touched and held by anyone, period, that makes the difference. Babies, apparently, can discern the difference between their parents' hands and other people's hands.

"The nurse said that, in about a week, when they remove the lines from Gracie Lou's belly and insert them into her arm, I will be able--in fact, they will want me--to pick Gracie Lou up and hold her against my chest," said Jonelle.

We look forward to that day!

I know I am writing to far more people than I can write to individually, so I hope you will receive my thanks personally and individually: If and as you have been praying for Gracie Lou and her parents--and even Sarita and me and her other grandparents: thank you. And thank you for your well wishes.

Federal judge: National Day of Prayer is unconstitutional

US District Judge Barbara Crabb of Wisconsin ruled in favor of the Freedom From Religion Foundation last Thursday in the Foundation's suit seeking to force the federal government to stop declaring national days of prayer.

Reason: Such declarations go "beyond mere acknowledgment of religion" because their "sole purpose is to encourage all citizens to engage in prayer, an inherently religious exercise that serves no secular function in this context."

"Recognizing the importance of prayer to many people does not mean the government may enact a statute in support of it," she concluded, "any more than the government may encourage citizens to fast during the month of Ramadan, attend a synagogue, purify themselves in a sweat lodge, or practice rune magic."

"This decision is a tremendous victory for religious liberty," said the Rev. Barry Lynn, executive director of Americans United for Separation of Church and State. "The Constitution forbids the government to meddle in religious matters. Decisions about worship should be made by individuals without direction from elected officials. That’s what freedom is all about."

More on Yahoo! News.

Update: Gracie Lou, Natalia and Jonelle . . .

From the moment we were in the hallway at the hospital, we knew her name was Grace--"Gracie."

"But what about a middle name?"

"We're not sure yet," both Dave and Joneelle agreed.

"We're thinking we want to call her, informally, Gracie [loo]--short for Gracie [loo-ellen]. But we're not sure." [I spelled the middle name in the manner I have, here, because we only discussed sounds, not spellings. And I realize there are all kinds of ways to spell a name that sounds that particular way. The loo portion could be spelled Lew, Lou or Lu; the ellen portion could be ellen or ellyn, at least. . . .]

Anyway. This morning I received a phone call from Daddy Dave: "How do you spell [loo-eez]?"

"Well, normally, that would be L-o-u-i-s-e. . . . Why? Is that what you're thinking for her middle name?"

He handed the phone to Jonelle.

Story from Jonelle:

This morning, while I was in that halfway state between wakefulness and sleep, I got thinking: What about Louise for her middle name? . . . Dave hadn't been too excited about [loo-ellen]. But we both liked Gracie [loo]. So I asked him what he thought. He wasn't all that excited.

Then Dr. Anderson [the ob/gyn who delivered Gracie] stopped by and asked what we were thinking for her full name. And we told her how we have been thinking along the lines of Gracie [loo], and she said, "That's the name of my oldest daughter!"

"What's your daughter's real name?"

"'Grace Louise.'"

Well, that settled it! In honor of Dr. Anderson, Grace's middle name is Louise.

I asked Jonelle what spelling she wanted for [loo].

No hesitation: Lou.

So Gracie Lou it is.

--Pretty cool.

I looked up Louise in a name list. It's of Teutonic extraction and is the name of a famous warrior maiden. Kind of fits with a feisty fighter! :-)

*****

Some people have asked about older sister Natalia. With all the talk about Gracie Lou, it could seem as if she has been neglected.

She has not.

With two grandmas and, actually, since Saturday afternoon, two grandpas, too, to take care of her when we're not at the hospital, she is doing very well.

She has also had the privilege of visiting Mommy and Daddy a couple of times--once on Saturday morning and once yesterday morning. 

We stayed till 1 or 2 o'clock in the afternoon--three-hour visits--and then left.

Just a week or two ago, Jonelle had been telling us how poorly Natalia was sleeping at night.

Due to recognized wheat sensitivities in our family, we questioned whether perhaps Natalia's sleep problems may have been related. So Jonelle took her off of all wheat . . . and Natalia seemed to settle down.

Grandma Lilly, who has been staying with her at night, said she has been sleeping just fine.

And yesterday, as we sat in the yard (beautiful weather here in Colorado!), it struck me how affectionate Natalia was to her Grandma Lilly, with whom she has spent only relatively few days and hours during her 20 months. . . .

So Natalia is doing wonderfully.

*****

Finally, Jonelle. She is scheduled to be released this afternoon.

Her blood pressure yesterday was high (again). It had gone down dramatically, as soon as Gracie Lou was born, but then, yesterday it was something like 128/92. "And I haven't been on any blood pressure medicine," said Jonelle.

"When Natalia was born, I had high blood pressure for something like six weeks. And I was on medication that whole time. So I'm not too concerned," she said.

*****

Okay. That's the latest.

The latest on Gracie . . . with a bunch of photos!

Really good news!

They did an ultrasound scan of Gracie's brain and saw no blood . . . which is a very good sign, indeed!

"Her" nurse (at the moment--and maybe for another day or two--she has one particular nurse assigned specifically to her care) . . . "Her" nurse said all her vital signs have stabilized really well.

Again, we're not "out of the woods," but the signs are very hopeful. . . .

Once more, "her" nurse said she thinks Gracie will soon be assigned to share a nurse with another premie . . . because she is doing so well.

I thought I'd share a few photos with minor commentary.

Enjoy!

*******

It's so hard to give an idea of how big (or, rather, small!) Gracie is. . . . So we thought maybe a pencil would provide a clue. --Here she is laid next to a 7" pencil.

Well. . . . I don't think that quite does it.

"How about using a wedding ring?" asked Gracie's nurse, Diane.

So I handed mine over. . . . And, after sterilizing it, Diane proceeded to put it on Gracie's arm!

Gracie seemed to wear it as a badge of pride: "Doesn't it look great on me?!"

That still didn't do it for us.

"How about a measuring tape?"

"Actually . . . How big was she when she was born? I mean, how long was she?"

Perspective gives you a skewed view. She was 27.5cm long at birth . . . and here. --Just shy of 11 inches.

Well . . . It was time to feed her some more of Momma's milk. The staff had changed her breathing tube--replaced the original (tiny) one with one that is slightly bigger.

"It has made a world of difference," said Diane. "As soon as we got it in, all of her vital signs just seemed to settle down. She seems to really like it."

But in changing the breathing tube, they had to remove her feeding tube. --It was time to insert a new one. . . .

Diane just slid it in her mouth and down her throat! . . .

"Hey, hey! That's a lot of food!"

--I didn't notice how Gracie had thrown her arms up high over her head until after I looked at the photos. . . .

All the delicate ministrations of loving adults to this tiny little baby . . .

*******

Here's a picture of the apparatus that measures all her blood gas levels . . .

Amazing!

Well . . . A few last parting shots.

"'Bye-bye, precious baby! Keep up the good fight, little girl. Grandma and grandpa love you!"