One week of labor and one week of life...

Shannon and I wanted to start a blog to keep everyone updated on Charlie's health and progress in the NICU. We also wanted to create a permanent record for Charlie to read in the future. So, this post is going to contain all the information up to this point and the hopefully we'll be updating daily as we have time.

This whole adventure started last Monday, March 10th. Shannon and I had just returned home from a trip to Disneyland. Shannon woke me up at around 1am and told me that we needed to go to the emergency room because she was having painful contractions. We drove to Mercy Gilbert, because we had previously had a good experience there.

They immediately sent us up to their maternity ward where they checked Shannon and found out that she had already begun to dilate slightly (1cm). The nurses quickly put Shannon on an iv of Magnesium Sulfate and gave her a shot of Terbutaline. Both these drugs are used to help slow down or stop pre-term labor. They also gave her a steroid shot to help Charlie's lungs develop in case he did end up being born early. Since Shannon was not even 25 weeks pregnant at that point, the doctor at Mercy Gilbert said she needed to be transferred to Banner Desert Hospital because they have a Level 3 NICU capable of handling such a premature birth.

At first, they wanted to transfer Shannon via helicopter, but decided she had enough time to go via ambulance. So, I followed the ambulance at 5am in the morning to Banner Desert Hospital where we were given a room in labor and delivery. For the next 6 days we had 3 different rooms at Banner Desert as they transferred Shannon back and forth between the Labor and Delivery and Antepartum areas as they tried to keep Shannon pregnant as long as possible.

Four different drugs that are routinely given as Tocalytics (used to slow or stop labor) were given to Shannon in different doses and combinations throughout the 6 days. She was also given a second steroid shot for Charlie 24 hours after the first. The most effective of all the medications was Magnesium Sulfate which made Shannon one step away from completely comatose. The second most effective, but shorter lasting was Terbutaline which made Shannon feel speedy and shaky. The back and forth of these two medications was not pleasant for obvious reasons. Some degree of abbreviation is necessary here, but the short version is that the although the drugs did help slow Shannon's labor, by Monday March 17th, she was fully dilated and it was time for Charlie to be born.

At this point, Shannon was 25 weeks and 5 days along in her pregnancy. I was actually at home taking a much-needed nap when my Mom called and told me that Charlie was on his way out. I arrived at the hospital about 12:30 and it was then when they finally took Shannon off of the Magnesium Sulfate iv. So, Shannon had to push through the maximum dose of the medication. Even so, the delivery went quickly and Charlie was born at 1pm weighing only 1lb 14oz and measuring 14 inches long. The doctors spent about 10 minutes or so checking him out and getting him stable before rushing him up to the NICU. I was able to head up to the NICU with Charlie right away while Shannon stayed in the delivery room and got finished up. After getting briefed on Charlie's current status and the rules and regulations of the NICU, I met back up with Shannon downstairs as she was being moved to her 4th and final hospital room of the week.

Despite the fact that Charlie had been born almost a full 3 months early and was going to be in critical condition for the next few months, Shannon and I were filled with a sense of relief that one phase of the ordeal was over. Shannon was feeling well enough to be able to be discharged from the hospital the following day and we were able to go home together for the first time in a week.

Charlie's first 36 hours went really well. He looked good and healthy (despite being hooked up to a handful of different machines) and the doctors said he was even breathing on his own a little over the respirator. All his numbers looked good and we were able to touch him briefly and Shannon even helped change a few diapers. Regardless, the doctors and the nurses seemed to go out of their way to make the point to us that usually the first 1-3 days were pretty easy (the "honeymoon period"), but things usually got worse before they got better.

Wednesday morning we were awakened at 6am by a call from one of the NICU doctors (Dr. Patel). He explained to Shannon that Charlie's lungs had started bleeding that night and that they had taken steps to stop the bleeding and had put him on a different type of respirator (called an oscillator) that could work even if the lungs were not completely clear. We rushed to the hospital and the doctors and nurses further filled us in on his condition.

The lung bleeding is not abnormal for a preemie, but the issue of importance is where the bleeding is coming from. The ideal situation (as odd as that sounds) would be for the blood to be coming from a PDA which is a valve in the heart that commonly does not close in premature babies. The valve can close up on its own, but usually medication or surgery is needed. The worst-case scenario would be that the blood is coming from a bleed in the brain. The problem with that, besides the obvious, is that there is nothing that they can do to stop the bleeding in the brain. The scariest side-effect of the brain bleeding is brain damage.

So, we find ourselves in the odd position of wanting there to be a problem with Charlie's heart. Further complicating matters, it is possible that Charlie may not be well enough to take the medications that might be able to close up the PDA. The medicines that are used effect the entire cardiovascular system, whereas if he had the surgery, the surgeons would be able to just go in and directly pinpoint and fix the PDA. The doctors ordered an echo-cardiogram to confirm that there in fact is a PDA and see how severe it is. They also ordered a head ultrasound to check for brain bleeding. The tests confirmed a moderate to sever PDA, but the head ultrasound results were less definitive. Dr. Wang checked the ultrasound and said she thought it looked clear. However, the radiologist report indicated possible level 2 bleeding. Since then, Dr. Patel has also disagreed with the radiologist and stated that he did not think there was any significant brain bleeding.

So, tomorrow is Monday and they will be repeating both the echocardiogram and the head ultrasound. Our hope is that the PDA will present somewhat less severe and the head ultrasound will show no evidence of bleeding. If all is well and the head ultrasound is clear, the doctors may try one small dose of the PDA medicine and see how Charlie responds. However, Dr. Wang has made it pretty clear that she thinks the heart surgery will be necessary. If so, we are hoping that the surgeons will agree to do the surgery in the NICU, so that Charlie will not have to be transported to the OR. There is some debate as to whether it is better for the surgery to be done in the sterile OR where the surgeons are comfortable or whether it should be done right in the NICU where all the NICU doctors and nurses are comfortable. Beyond that, the doctors in the NICU seem very nervous about having to transport him, so, again, that is what we are hoping to avoid.

There are, of course, many other possible and probable complications with such a premature birth, but for now we've outlined the most pressing issues and will continue to try to provide more information in subsequent posts.