Saturday, July 18, 2009

Update

Karsie is still stable. They are currently putting in a central line to get medicine and nourishment much more quickly. I should be getting word about that soon.

Earlier today they did a sonogram on the brain to see if there was any bleeding. Often with premature babies there is a high risk of that, but there was none. Her brain looks normal for now. We will still need to test for other problems, but we're ruling out a lot right away.


video

Michelle's First Time Seeing Karsie (Graphic Pics)




Pictures (WARNING...graphic pictures after the warning signs)

I was lucky to see her eyes open because she was just coming out of the medicine that they want her on so she doesn't move too much, but they said I should take a quick picture w/ her eyes open.
The liquid around her eyes is medicine they put there to help them with the low activity they are getting in the NICU.


The siloh is under the towels. This is the first picture I got. They later removed it when I told them I could handle the blood.
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What Happened

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.

-Kevin

Morning Update

No news is now wonderful news. Karsie stayed stable throughout the night. Kevin walked in about an hour ago to see her and she had her eyes open. They are trying to keep her as still as possible so she doesn't damage her incision, but it was cute to see if only for a minute. The nurses are so wonderful here and understand that we have no idea what's going on with her.

Our nurse last night, and until about an hour ago, was named Ruth. She was so amazing at updating Kevin on every detail of Karsie's stabilizing process from what looks good to what they are concerned with. So far it looks like everything that is cautious for now is something they can fix. There are always about 4 nurses around her 24 hours a day. Kevin loves the times when he sees only one or two as it doesn't accelerate his anxiety.

Pictures will be posted as soon as Michelle has had a chance to see them first. We're having to do a lot of transferring being in two different hospitals and her still not getting to see her baby. We just got word that she may get to see her this morning if she checks out as being okay. We definitely don't want her injuring herself trying to get down here. Thank you so much for all of the prayers last night and continuous. It has been both comforting and helpful. We are still aggressively praying for a miracle.