Afternoon Update (6-24)

NICU - We took about an hour to tour the NICU at both Mary Birch (where Karsie will go immediately after delivery and where she will go after she is stable) and at Children's Hospital (where she will go directly after surgery and stay until she is stable).  We had two tour guides:one from Children's and one from Mary Birch and both were social workers that knew a lot about the NICU.  Children's was very busy.  There were lots of machines and lots of activity.  The babies are very well cared for.  Mary Birch's NICU was a tad slower (mostly because the babies are more stable than at Children's) but still very nice.  We were given a ton of information about how visiting will go after delivery.  Here is what we can remember:

Karsie will be delivered at Mary Birch hospital by C-Section.  (after talking with the surgeon) We most likely will have a bit of time between delivery and surgery as an omphalocele is not life threatening on its own (assuming Bob is the only thing wrong with her).  She will be transported to the Mary Birch NICU and prepared for surgery.  We may get to have a few visitors here before she is shipped off to surgery.  When she is ready and our surgeon is ready, she will be delivered to Children's via cool corridors and halls that connect the two, and will have surgery there.  Michelle will still have to stay at Mary Birch and get fixed up (and greatly comforted by Reva) while Kevin travels with Karsie to Children's.  Karsie will have surgery and then begin recovery in the Children's Hospital NICU.  When she is stable and ready to not have to be monitored so frequently, she will be transported back to Mary Birch's NICU until she can be taken home.  From what we can tell this whole process can take anywhere from 3 weeks to two or three months from delivery.  A later birth means a faster recovery.  

This brings up an incredibly stressful and difficult decision for us to make regarding visitors. While the Mary Birch NICU has an open door policy (anyone with the parents can visit), Children's NICU has a maximum of 6 that can visit...total...for the whole time she is there.  We will give them 6 names and, to prevent the amount of foreign germs to the babies, only they will be able to accompany Michelle or Kevin for the entire time Karsie is there.  Automatically, the grandparents are included, which takes up 3 spots.  Therefore, we have to choose 3 people to take the final spots to see Karsie while she is in recovery.  

The maybe good news about this is that Mary Birch is open door, and she will most likely go there immediately after delivery.  So, people here at birth MAY get to visit her before she goes to surgery.  And pretty much anyone can take a little visit after she is stable.  We are so, so sorry.  They are making us make too difficult decisions during this part of pregnancy.  

We did meet our surgeon today.  We really like him and he seems really confident in his ability to fix the problem.  He pretty much went over the basics of omphaloceles, which we mostly knew, and then answered our questions.  The only real news is that he will try to get it all in in one shot and if he can't their team does siloh, which is the protective casing over the organs.  He said that he puts in a little at a time after that as her abdomen accepts the new tenants.  He just came by to introduce himself, but he is coming back early next week, bringing a sample silo and answering more questions.  At this point it looks like everything is a guess until she comes out. However we really like Dr. Saenz and feel very confident in his abilities.  

P.S. - we saw a little premie that was about 3 pounds, which is about the size of Karsie, and she looked much bigger than we expected, so that helped us psychologically.  

From now on we're not sure what plan of attack is other than monitoring her.  We have no immediate tests and meetings (as we have met everyone at this point) that are pending, so we will be having ultrasounds and checkups daily until either we are discharged or delivery.  Pray for nothing else to come up. 

Heart News!

A-Ok.  The heart is not causing the fluid in the abdomen and it looks great!  So far, the heart has been solid as a rock when we go in for appointments.  We will be continuing to see what is causing the fluid.

We are about to step out to tour the Children's Hospital NICU, which we will maybe see some premies.  Karsie will spend a good chunk of time there after she is born, so we were given special permission to tour it.  It's lucky to have a mom working in the field.

We are also waiting on our surgeon that will hopefully come after we come back from the NICU.  

Help from our Friends in Bakersfield and San Diego

Many of you have been asking what can you do for us.  While prayer is still our biggest and most important request, we do have something you can do if you can.

Bakersfield - Kevin had been planning on going home after a few weeks to check on the house. Since Michelle has been admitted to the hospital and we're not sure when we might have to take Karsie out, Kevin will not get to make it back home to check on the house.  If some of you would like to help out (seriously, no obligations) other than prayer, we can send down a few keys for you to check on the house periodically if you happen to be in the area.

San Diego - Our poor puppies are getting the shaft with us not being able to play with them or walk them.  Again, no obligations, but if you would like to do something besides pray we're sure our dogs would like to have some attention.  

Thank you guys so much!

Morning Update (6-24)

We were able to get good sleep last night.  This may have to do with the fact that we both got no sleep the night before and are making up for it, but we both feel much more rested today.  

Today's schedule is not quite as hectic, but still is full.  We will be visited by Dr. Saenz, our pediatric surgeon, to talk about what we can expect.  We will be taking a tour of the Children's Hospital NICU (Neonatal Intensive Care Unit).  As we are visiting, we will visit Dr. Fripp, our cardiologist to look at Karsie's heart, which will be nerve racking for us.  He will be looking at the fluid in the abdomen as a sign of heart failure, therefore looking very closely at the heart.  He looked at it a month ago and it looked good, so hopefully nothing has changed, but the fluid is concerning for the heart.  Finally, we have our daily sonogram to check the fluid in the abdomen to make sure it is staying put.  They will also be measuring growth.  

As we are typing this we are realizing that today's schedule is actually just as busy if not more busy than yesterday.  Oh well, it will be good if we can get good marks on all of our visits and tests today.  

So far, Karsie is looking great!  Michelle had a few contractions last night, but only when she was being measured and on her left side, which is more uncomfortable for her.  She had 5 when she was being measured, which is just under the level where they would do something about it. So we guess that's good.  

Michelle's blood sugar was again high first thing in the morning, which if it follows the same pattern as yesterday she will be high again after breakfast and really high after lunch.  But then it went way down to normal after dinner.  We'll see if it stays the same.  Michelle chickened out again on the shot which makes her 0 for 3, but she's getting closer each time and the nurses are very supportive.  She also has a practice syringe and a lemon that she has been working on. Good luck Michelle!  

New - We just got a call from our cardiologist and we will be having our fetal echo at 11:00.  If you think about it then, pray for good results.

Michelle did it!!!!  She stuck herself on the 4th try!  Awesome job!

Ultrasound

It has been a while since we have had the ultrasound, but it has also been a while since we have had the time to update.  

The good news is that the fluid has not moved.  This will be monitored everyday until the end of the pregnancy (or that is what was communicated to us).  Since it seems that the contractions are able to be controlled the fluid is our main concern now that we are actually at the hospital.  

The not so good news is that we will probably be here for the rest of the pregnancy.  It's probably not so much bad news is that it is a bummer that Michelle can't enjoy some days in San Diego before delivery.  However, if this is safer, it's better.  

We will be visited tomorrow by our surgeon.  We were able to get Dr. Saenz as our surgeon and he will be here tomorrow to give us a consult.  Being a Harvard grad we at least feel like we're in good hands.  At least the pieces of the information puzzle seem to be coming together.  There seems to be a plan and a team ready to tackle Karsie's birth.    

Neonatologist Talk

One doc down...two or three to go.  The neonatologist (doctor responsible for the well-being of Karsie) just came in and sat down patiently with us to answer a ton of questions regarding the delivery and afterwards.  We will list a bunch of things we can remember, but we were able to get a few more questions answered:

-Obviously the longer we go in the pregnancy the better.  He did say that 31 weeks is definitely doable, but he did give us a realistic approach to that scenario.  Basically the longer that we go now the shorter time she will be in ICU.  If we delivered now she could be in past the end of September because she would need to be on a breathing tube, feeding tube, etc. waiting for everything to work.  

-Getting Bob back into Karsie's stomach can be a balancing act.  The biggest concern in breathing.  If they just crammed everything back in, her lungs might not be able to hold all of that pressure since her stomach has not been growing with the organs (giving there less space inside for her soon-to-be organs.  Therefore, when they put the organs in it pushes up the diaphragm and creates stress on the lungs.  They will need to decide whether she can handle all of it going in at once or doing stages where they put some of Bob back in her abdomen and then wait a while for her to adjust.

-The other part of that balancing act is trying to time the surgery.  While they will probably keep some of Bob outside after putting some in, they do not want to keep all of Bob out for a long time as there is an increased risk of infection.  Unfortunately that's just a worry that will not be resolved until it's resolved.

-The most heartbreaking news we received was that it is very unlikely that Michelle will get to hold Karsie before she goes into surgery.  Kevin will be following her to surgery while Reva (hopefully the doctors let us have more than one guest in the room) stays with Michelle.  We wanted Michelle to be able to have skin on skin contact, but it looks like a picture might be all we get.

We are just about to go in to get an ultrasound to talk with our doctor so we should have news later, but the basic understanding here is that this is all adding up to be a complicated matter when we need to bring her into this world.  This is not just an omphalocele to fix, it's not just prematurity to fix, it's not just fluid in the abdomen to fix, it's all of the above.  An omphalocele is one thing when born on time because they can do things to help the breathing, but add on a premature birth with premature lungs and it creates more of a problem....and this is made an issue with the possibility that the fluid in her abdomen moves up close to her heart to create something called hydrops which is when the body is basically breaking down.  If signs of that start to happen then we will have an emergency C-section.  

Pray lots.  Thank you for the ones we have had already!  We love you all.

Afternoon Update (6-23)

We are just doing quick monitors of Karsie and testing Michelle's blood sugar.  So far Karsie has been fine.  We are just about to do a contractions test, so fingers crossed.  

Michelle's blood sugar has been quite high lately - every test today has been over the recommended range including one over 200.  That is all the medicine and steroids pumped into her.  It stinks that it is so high, but she's being monitored and balanced with insulin.  

Time to see if she chickens out on sticking herself with a needle....

We have had a bit of a frustrating morning.  We need to see our surgeon, but when we called their office (as they were supposed to call us) they told us they had not received the fax from our perinatologist's office giving them our charts and they were supposed to fax it over 2 weeks ago!!  This means the earliest appointment we were able to get was July 28th.  Hopefully we make it until then.  We have some calls that are supposed to be returned today to see if we can speed this process up, but needless to say we are a bit frustrated as we don't want just some on-call surgeon fixing Karsie.  We moved down for the best ones.  So far we have seen no doctors today, but most of them make their rounds in the afternoon.  Let's hope that we see some soon as we are a bit antsy.  

FYI - she chickened out on the shot...maybe next time...

 

Mid Morning Update (6-23)

We just got finished talking with the nurses about our plan for the day.  At this point we will be giving Karsie more monitoring to see how her stress level is.  So far, she's a trooper.  Very relaxed and happy.  That's a good sign.  

We will also be monitoring Michelle again for any signs of contractions.  The nurses told us that even though Michelle has had some contractions they are not real worried because her cervix is still very long and thick (for those of you like Kevin that don't know what that means, for lack of better words it means Karsie is being blocked still by a strong barrier).  We may get to be discharged if they die down or are able to stabilize the contractions with medication.  Even if we are discharged we will have to make frequent visits to be monitored for the rest of the pregnancy.

Finally, we are waiting for doctors and surgeons to come talk to us about the fluid in the abdomen.  Hopefully we will have them talk to us about that and do some more testing, but the nurses do not know their schedule, so it may just be a surprise drop in at some point during the day.  

Michelle was a little high again on her blood sugar, which again is normal with the medication, so she had another shot :(.  Everything else is status quo at this point.  More to come when we hear.

Insulin

Michelle's blood sugar was a little high for the first of the morning (due to the medicine to keep Karsie in) so she was given a shot of insulin.  This was Michelle's first.  She totally wimped out though on doing it herself the first time.  (although Kevin could barely do the finger prick).  At first the nurse said it wasn't high enough to call any doctor, but then the on call doctor here recommended the insulin to play it safe.  

Talk about good karma after this!

6-23 Morning Update

Not much sleep last night.  We were calm enough, but our neighbor seemed to have every machine go off multiple times during the night with frequent nurse visits that woke us up just enough to make it a little harder to go back to sleep.  However, we both got a couple of hours in.

The nurse just came in and after an hour of monitoring Karsie and contractions everything looks good for now.  Karsie has looked strong all night.  We are not sure what is next, but we will get an update we're sure when the nurse shift changes.    

Status Update (11:00)

All systems check.  Michelle's contractions went away for an hour which means the medicine kicked in.  She will have to take the medicine every four hours (1:00 - pill, 4:00 - monitor) to make sure everything stays good, but for now, we get a few hours to sleep.  Thank you all for all of the encouraging words.  Good night!

Steroid Shot

Michelle was given a shot of steroids a little after 9.  She will have another shot tomorrow at about the same time.  We will be here to monitor Michelle's blood sugar because steroids will boost blood sugar.  It will help Karsie's lungs grow and mature a little faster in case she comes premature.  

Michelle's contractions picked up a little again lately and so we're monitoring them closely to see if it was just a fluke after getting stuck with a needle and steroids.

Contractions

Michelle was still having contractions for a few hours so she was just given medicine to stop them. It seems that her uterus likes the medicine.

Update

We are at the hospital indefinitely. They are monitoring Karsie. Michelle is having frequent contractions which is hopefully just stress, but if Karsie starts to have a hard time with them we will be moved to labor and delivery. We will keep you posted as news becomes available.

Prayer Needed...Again

This just seems to be the way things go for us and Karsie. If we went in and they told us everything looks normal it would be wierd.

When we went in today for our ultrasound the tech said that she saw some fluid in Karsie's abdomen. She called it Acites (I can't spell check this as I am on the phone). When we saw the doctor he confirmed the diagnosis and explained it to us.

Basically fluid in the abdomen is a bad thing because there is an abnormality that is causing it and not flushing it out. If it stays in the intestines that is the best case scenerio. They will drain it at birth and fix the problem. The more serious issue can have to do with the heart. It can be a sign of deterioration of her heart if it starts to move up. The fluid does not cause the failure but is a sign of it.

We are being monitored daily to see if the fluid is stationary or moves. We want it either to be stationary or just go away completely. Because it looks like we will be giving birth prematurely Michelle is getting rounds of steroids to help Karsie's lungs develop faster, so she is admitted for a few days to the hospital.

We just need lots of prayer support. We are now in the middle of a rock and a hard place. On the one hand we want to have Karsie in as long as possible, but we don't want to keep her in too long that the surgeons cannot repair the problem. Thank you guys!

Two Months to Go!

It's hard to believe we're almost done, but here we are. Two months from today will be our original due date. If we deliver that late we will be extatic!! So really we're looking at 7 weeks or so.

We are currently waiting for an ultrasound followed by a doctor checkup. We're praying for boring, mundane news. We are also going to ask about our surgeon contact. We have kind of selected our surgeon but have not gotten a call yet, so that is on the appointment agenda.

We were able to see where Karsie will be delivered and kept after surgery this past weekend. So far everything looks very nice. if we have news, we will update soon....

Happy Father's Day!!

We just spent Kevin's first Father's Day in childbirth class.  It did have some helpful information for us, but it's hard to be excited about it on Father's Day.  Congrats to all dads.  

We have a checkup tomorrow that begins our weekly checkups until it turns into biweekly.  We are praying there is no "news."  We're sick of "news."  From here on out boring is best.  

We're still waiting to hear from our surgeons.  Hopefully tomorrow we get some information about when we are going to meet with them.  Stay tuned....

31 Weeks!

We're counting down.  Karsie has been kicking and moving like crazy lately.  We will be attending a birthing class all day tomorrow and all day Sunday.  We're still curious to see how they are going to approach the C-Section in a birthing class.  She is probably somewhere around 3 pounds at this point and she feels every bit of that.  

We have an appointment on Monday for a sonogram and a check-up.  Keep posted.

Nesting via Skype

This week was the first of a few times this summer that Kevin made the trip to Bakersfield to check on the house and tend to some necessities. He left San Diego on Monday and will be returning to San Diego Thursday at some point.
During this trip, he took all Karsie's newly acquired belongings back to Bakersfield with the assignment of putting them away! Michelle laid out specific instructions on where each item was to be put and sent those along with Kevin as well. Like a wonderful and very supportive husband, Kevin obliged. He took all the loot into her room, opened up the computer and gave Michelle a call via Skype so she could be a part of the nesting! He did a fantastic job putting everything away and he really even seemed to understand what was what and the purpose of all the items. There were a couple little set-backs, like figuring out what the spit-rags were and understanding how to hang a dress with coordinating panties. He was a trooper and did a really great job. He even hung a branch with little birdies (a decoration from the shower) from the celing for Karsie!
He really helped Michelle nest and get the room ready, even if she was sitting in San Diego watching through a computer screen!

San Diego Shower

Satuday was Karsie's second shower. Some friends in San Diego threw an amazing shower for Michelle and Karsie and the turnout was great! Thanks to Lisa, Kelli and Megan (and Lindsay, who couldn't be there)! They did such a lovely job!

Karsie was given some really special gifts... like this journal from Aunt Chrissy and Uncle Todd. Kevin was especially fond of this gift! He was ready to start filling it out right away!

This is a prayer quilt from the nurses at Michelle's mom's hospital. Each knot tied on the quilt represents a prayer said for Karsie Gene. What a blessing!

One of the flower arrangements with little birdies (made by Kelli and Lindsay). There were little birdies and beautiful flowers everywhere! The little birdies are flying to Bakersfield to make their nest in Karsie's room!

A special "thank you" to everyone who helped with the shower and to all who came. It was a perfect shower and we are so thankful for our friends and family in San Diego!

Our Daughter Turns 30 Today!!

30 weeks that is.  It's hard to believe we have passed 75% of the pregnancy already.  

Our goal is to keep Karsie in until around 39 weeks, which is about August 15 or so.  Any way you look at it, we're coming down the home stretch! (horse racing analogy for Kevin).  A while ago, we mentioned that our safety zone was about 34 weeks, so we're getting close.  However, if you have been participating in praying for Karsie, that is just the first benchmark.  We are hoping for 5 weeks later than that.  

Lots of Love.

Diabetes Appointment

Bad news: Michelle is technically diagnosed with gestational diabetes.

Good news: She tested so marginally that it is managable with diet and exercise. We sat down with the counselor and she gave us the lowdown with diet, but we also got a little finger pricking kit. Lucky Michelle! No real news other than that on the diabetes side.

We were able to snag our doctor and ask him about the negative test results from yesterday. Basically, we will be closely monitoring Karsie to make sure she is staying put but other than that everything looks okay. What the test says is tha Karsie won't be coming this week, but other than that we don't know.

Check back for updates.

Negative!

It's a good thing that our doctors know that news like this consumes their patients because they decided to call us before we came in for our appointment.  Long story short...actually, it's not a long story at all...the results are negative.  This means that Karsie is almost definitely NOT coming in the next 7 days, which is good news obviously.  

We are also happy for the good news early because we think Michelle has been having sympathy contractions lately.  We think she had two last night (1:11 am, 2:42 am) but Karsie could have just been pulling.  

Thank you all so much for the prayer blitz!  You have no idea how comforted that made us to know that we have such great support.  We still need prayer as the news is good for 7 days, but we are still cautious of the contractions.  We will keep you posted...more to come around noon or so today.

Prayer Request

If you think of us around 11:00 tomorrow keep Karsie in your prayers.  We went to the doctor today and came out feeling sorry for ourselves and slightly concerned.  It might be nothing, but given everything we seem to be going through all at once, we can't help but feel that life sometimes isn't fair.  We've accepted the fact that our baby will have special conditions that we will need to deal with when she is born, but we're never prepared for news that comes unexpectedly.

We went into the appointment knowing that Michelle quite possibly has gestational diabetes. The reason that this is possible is of the many tests that Michelle took, only one came back positive. However, one positive is still positive.  Therefore, there will need to be some fixing of  her blood sugar.  This could be as simple as changing her diet (which is not really simple for a pregnant woman) or it could be something that causes her to have to give herself insulin shots regularly.  In any case, she will need to be monitoring her blood sugar.  While this is a pain for a few months, the real concern is that this can cause premature labor, which for our case is the last thing we want to be a side effect.  We are meeting a diabetes counselor tomorrow at 11:00 to go over the specifics and we will update you as soon as we can.

Even more concerning is the news that we learned next.  Michelle has been having what we thought was round ligament pain for a long time.  It still may be just normal aches and pains every woman goes through, but when we described them to Dr. Cousins he seemed to be a bit more concerned than we thought he would be.  He said that it could just be the ligament pain, but it could also be contractions.  While Braxton Hicks contractions are normal, any contractions for us are something to be concerned about.  Cousins did a test that will also be ready tomorrow that tests the possibility of giving birth within the next week.  If it comes out negative we are safe.  If it comes out positive, it doesn't mean a definite labor sentence, but there is a chance Michelle will go into labor within 7 days.  To make matters worse, Michelle felt a very tight stomach this evening and that has her very paranoid.  We are about to week 30 and given our situation, Karsie coming now would be a very bad thing.  So, please pray for us tomorrow if you think about it.  

We will be sure to update here as soon as we can tomorrow...   

Settling in San Diego

We made it!  We're here for the final weeks of our pregnancy.  We just wanted to give you all a brief update of our schedule and things happening soon.  

We have a doctor's appointment tomorrow in the morning that will probably come with a bit of news.  We will try and update as soon as possible.  Our appointments will be every other week for a couple of weeks and then it will be gradually upgraded to living at the hospital.

We have some pregnancy classes to go to very soon.  That will be loads of fun especially for Kevin. We're not quite sure how that is going to work out given we are not having a natural birth.

Last night was amazing.  Karsie was dragging her foot or hand or something across Michelle's belly and it looked like a fish swimming around.  She kicked Kevin in the face!

Michelle is experiencing some pretty annoying pain that we will ask about tomorrow, but it seems to be what every mother goes through during this point in the pregnancy.  Any testimonies?