Saturday, July 18, 2009
Delivery: As far as we can tell the problems happened here. We have not had this explained to us in great detail and officially, but this is how we understand it. Michelle did amazing through the surgery, but there were some abnormalities/complications with the delivery of Karsie. When they were pulling Karsie out her omphalocele sac was stuck to the placenta, so it tore quite a lot and it ruptured the sac which was protecting Karsie's organs. In doing this all of the organs became exposed and suffered severe trauma both on the way out and as they were trying to stabilize her. The liver appears to be the biggest hit organ, which is the most sensitive organ. (A quick word to our friends with omphalocele babies that read this blog, all of the doctors said that this condition is very rare. The placenta, during birth, naturally lets go of everything and if the sac ruptures it almost always happens in utero. Our doctor immediately let us know that it happened and that he had never seen that before. This is not something to be concerned about for your baby. But if you could pray for ours since it did happen to us, we would be forever grateful).
Thank goodness both Reva and I were able to be with Michelle during this process. As soon as Michelle's c-section was complete they moved her into a temporary recovery "room" (with vomiting patients in the "room" next to her). I was told from our perinatologist (the doctor in charge of Michelle and the baby in utero) that things weren't looking good and there were some major complications, but that our neonatologist (the doctor in charge of stabilizing Karsie) would come and talk with us as soon as he could. Reva and I went into the room and tried to gently tell that to Michelle and a short time afterward our neonatologist came in and explained the situation.
He said that there was so much trauma to Karsie that he was doubtful she was going to make it. He explained some of the things I have said already, but told us that she was bleeding so much that they could not stop it. Not only could they not stop it they didn't even know where it was coming from. He said that there was probably no way she would make it. (Obviously we remember things a certain way under a lot of stress, so that might not be exactly as he said it but that's how I remember it. However, it was not looking good).
Michelle, Reva, and I tried to mentally prepare for the bad news we were sure was going to come at any moment. This is probably the worst time to have to explain this to a new mom as all of the hormones are working overtime, but Michelle did okay. We were shortly visited by another neonatologist that said that thankfully they were able to stop the bleeding at this point and barely stabilized her, but she had significant blood loss and her blood pressure was so low she spent an extensive amount of time without sufficient oxygen to the brain. So, as good as things may look soon, we will always be looking for signs of damage. The hopeful news about that is that baby's brains (as explained to me by her current nurse) have incredible stamina and are quite a bit different than adult brains as they arrive ready to encounter trauma. The hope is that the trauma encountered is not significant. They said they rushed her to Children's Hospital and they were able to get a transfusion done, so she was, for the moment stable.
We separated at that moment and Reva went with Michelle to move to a private room, and I went with Kelli and Carlos to Children's hospital accompanied by a nurse. I was put into a consult room and had to sign a bunch of papers giving them permission to basically do what they already did, but permission to continue to do some things and then permission to have the surgery. Both the anesthesiologist and the surgeon came and talked to me and explained her condition was extremely delicate and she is very, very sick. He took her into surgery and about 3-4 hours later we were given the word that she was going to be brought back to the NICU, which was uplifting news to us. At this point I had Kelli, Dave, and Carlos with me, which without them I'm not sure how I would have made it waiting that long. We saw her wheeled back into the NICU, which we have video of, and we had a small conversation with the surgeon that went like this:
Carlos: It's just encouraging to us seeing her move from surgery to here.
Surgeon: I would say it's a miracle.
He told us later everything that happened in the surgery. Basically, the liver was still bleeding. The trauma had hurt a lot of the blood vessels that travel from the liver to the heart and many of them were stuck. He was able to fix that (amazing!) and stop the bleeding. He said that pretty much every organ was outside the body, heart and lungs being the exception, and so he couldn't put anything back in because she is so small. We think he was able to get the stomach and bladder (if it was out) back in. We know this because she peed last night, which is a great sign. We are still waiting for more pee as she hasn't done it in a while, but we know that those organs are working for the time being. Currently, her organs are hanging from a sac over her and sitting on her abdomen, which gravity is pushing them in so very slowly. When we post pictures, if you can handle it, you will be able to see this sac.
We have been prepared, by the doctors, that this process could take a very long time. We're looking at another pretty major surgery in a couple of days to put the liver back in the body because that is the most crucial organ outside. If they can't get everything sewed up in a couple of weeks, we will probably be looking at a multiple month, even year process to get things back in.
I'm about to go back in to see her as the shift change has happened and I can go in (they only kick out parents from 6:30-8:00 when the shift change happens). If I didn't cover a question that you have feel free to ask. If we don't feel like it, we won't answer it (hope you understand) but for now it keeps our mind doing something other than worry. Thank you for the continued prayer while being in the dark for so long. We'll update as soon as we can.