Thank You Kings!!

While today was medically boring we had friends come down and make the past two days go by much more quickly.  (In fact, they snuck Michelle in a donut...don't tell the nurses).  We enjoyed their company greatly as they sat with us and helped us pass the time.  

Thank you!

Boring Day!!

It has been a while since we have had a medically boring day, but alas, today was one.  Thankfully there is no news to report.  We are looking for many more medically boring days during the next 6 weeks (hopefully).  If all goes well and we have more boring days ahead, it looks like Karsie will be delivered somewhere between August 10-14.  Dr. Cousins has said that the 38th week will be the delivery goal so those are most of the days in that 38th week.  We're getting close! 

Michelle's Outing with Kevin and the Kings

This is Michelle's big 1 hour trip for the day

We apparently love taking reflection pictures in elevators.  We have one on a cruise ship looking up at the ceiling reflection.  
Parked by the coffee cart so Michelle can at least enjoy the aroma.  This is right outside the front entrance of the hospital.
Michelle and Allison and Matt in the rehab garden that we discovered next to the hospital.

Parking by the bench next to a grassy area to enjoy the warm weather.  
Today her snack coincided with the trip, so we had a little picnic...sugar free pudding with almonds and strawberries.
It got a little cold (sorry Bakersfield) so Michelle had to put on her maternity sweatshirt...also known as Kevin's clothes.  

:(

We have a new address until delivery.  Here.  For good.  Very sad for Michelle.

Dr. Cousins came in today and talked to us about our situation.  The weight loss that occurred was not quite concerning to him as it was to us.  But we'll be keeping an eye on it to make sure it doesn't continue to drop.

He said that everything is status quo thus far, which is good, and we will be continuing to monitor the progress of Karsie.  At this point it looks like he was saying that around 38 weeks is our cutoff.  We are going to try to keep her in until then, but if we get there we will do an amniocentesis.  The amnio will measure how Karsie's lung development is.  If she looks good, then she comes out.  Until then the reasons for taking her out early are as follows:

-water breaks followed by labor (and lungs look good)

-labor starts and cannot be stopped

-fluid starting to move into the heart

Other than that, we keep her in until 38 weeks.

Morning Update (6-29)

Well....it has been a week, and we're still here.  Our doctor, Dr. Cousins, is here today and we are very excited about when he comes in to do his rounds today.  Whenever that is.  

We are slightly concerned with Michelle's diet.  The nurse came in early this morning and had Michelle weigh herself.  According to the numbers Michelle has lost 7 lbs. in a week.  This might have to do with the scale itself, the fact that she weighed in the morning (which if you've ever dieted you know that the morning is the most friendly), or it could be accurate.  Given the diabetes diet they have her on, gaining weight will be hard other than the natural weigh gain, so we're going to ask about that and see what's going on.  

Michelle has been assigned a "movement therapist" for help with bed rest (which is not a good sign that we will be able to go home).  She is currently teaching Michelle some exercises to do so she can keep aches and pains away that are associated with bed rest. 

We did get some good news that there is a message therapist that comes in every so often to do prenatal messages.  Michelle's eyes got huge when she learned that.  Here we come week 2!

Mad at the Monitor

Around 34 seconds look at the bottom left of Michelle's stomach.  Before 34 seconds Karsie periodically kicks right on the monitor.

Afternoon Update (6-28)

We're here and all moved in.  So far, Michelle has been testing right in the desired area for her blood sugar.  She is only having to take insulin two times a day just to keep her down.  

We have to only test Michelle's contractions two times a day.  Last night Michelle did fine with only a few contractions in the hour.  This afternoon Michelle felt four during her test and for the first time the machine read the same number she felt.  Hopefully this will keep Michelle from stressing since they were usually telling her she had 6 contractions when she felt 1 or 2.  

Getting ready for our daily sonogram......

Moving Day!

We are moving....to the other side of the floor.  The floor is divided into two sides, women's surgery and long-term pregnancy bed rest.  Since bed rest was so full they started to file us into the surgery unit (that's where we were).  They have since had some vacancies and have moved us to the correct side.  As far as our room is concerned it's exactly the same with a worse view.  But our window opens.  

Contractions

Michelle's contractions picked up again this afternoon.  She has been being monitored every 12 hours for one hour each.  If she has more than 8 contractions in that time frame, they measure another hour.  If it continues their instructions are to up the dose of anti-contraction medicine (I'm not about to try to spell that out).

She had to have the shot of the anti-contraction medicine in conjunction with the oral medication she is taking regularly.  We are currently on the tail end of the third hour to make sure the shot is working. 

However, the doctor came in and said everything looked normal.  We asked him to check Michelle's cervix and it was still long and thick, so the contractions, although a little concerning, are not changing that.

Hidden Mickey

These darn sonogram pictures always come out blurry, but trust us there is a definite hidden Mickey in this picture.  This is the top view of Karsie's face with the umbilical cord loosely around her neck.  Her eyes are closed.  Can you spot the hidden Mickey?  If any of you find this fantastic and want a clearer look, ask us if you come down.  It is a definite sign that Karsie is of her mother.  

Late Update (6-26-09)

Everything is still looking good.  The on-call doctor had three vaginal births, 6 Cesarian births, and a heavy duty surgery all in one shift, so he didn't get to do the sonogram until way late (11:00) or so.  He comes in each time and asks "How are you my darling?"  "How is cutie pie doing in there?"  He is very warm and was very reassuring.  Karsie did have the cord around her neck, but since she's in fluid, she'll probably wiggle out of that by tomorrow.  

Good news:  Michelle gets an hour a day now to get out and tour the area....by wheelchair of course.  But we are all very excited about that because she is getting pretty antsy.  

Thank You Friends

We are approaching a week in the hospital and we wanted to give a real quick thanks to all of our friends and family who have supported us in ways they can:

We especially want to thank Carlos and Reva who have been here by Michelle's side for hours and hours.  It really helps to have Nana here with a medical background and the ability to help calm Michelle.

Kelli and Dave have been here often getting food for Kevin, visiting, and offering help.  We have been visited by friends like Megan, Amber, the Tiners, and are very excited to see our friends the Kings this coming week.  We have missed them very much since coming here a few weeks ago.

We also appreciate greatly our friends back home that have offered to look over our house and our friends in San Diego that have offered to play with our puppies.  

If you've ever needed to depend on friends and family during difficult times you know how appreciative and important you all have been to us.  Especially when stress exacerbates the problem, having friends and family supporting in all these ways has played a part in keeping Karsie healthy and inside.  You all are working to keep our baby safe.  Thank you!!! 

Karsie is 32!

Well, it's not ideal, but 32 weeks is better than 31.  There seems to be an unspoken goal (by the doctors) to get to week 34, but every doc has said that Karsie will probably do okay if worse comes to worse...however, throw in the omphalocele and then risks go up.

This week Karsie works on her lungs and practicing breathing.  The good news is that she has already shown us signs of this practice in last week's sonogram (the one that put us here).  She will be working on sucking and may be using her thumb.  Yesterday's sonogram showed her trying to suck her thumb, and if you look closely at her upper lip from yesterday's pictures you might see what might be a sucking blister that many babies have there.  (it also might be distortion from the camera or a little triceratops precipice).  

We are praying she stays in this week as this week is vital to her breathing practice and thickening.  She is supposed to be around 4 pounds by the end of the week, so she will probably gain 1/2 pound in just a week's time.  This is very important because the bigger she is the better she will cope with major abdominal surgery that she will have to go through.

Keep growing Karsie!!!

Evening Update (6-25)

Michelle has had the frequency of her contraction checks reduced.  Since she has slowed down significantly the doctors feel there's not a necessity to check her every six hours, but now every 12.  This might be a sign that Michelle might get to go home.

Michelle has also been diagnosed with a strand of strep.  This is a common bacteria that is present in about 50% of pregnancies and she is now taking antibiotics to fix that.  

Our anesthesiologists are okay to have two people present with Michelle in the operating room, but we still have a few people to convince.  Hopefully when all is said and done, this can happen for us.  

Visual Visit

Morning Update (6-25)

No big news is good news.  We did have a sonogram today with a new doctor and got some great pictures!  We should have those up by the end of the day or early tomorrow.  

The doctor did find a new thing which is a blocked tear duct.  He reassured us immediately that it was a non-issue.  They would just unclog it when she is born.  The fluid has not moved at all still and she is still kicking like crazy and moving around, which every doctor is thrilled when they find that out.  

The rest of the day should be pretty slow...finally...but if something comes up we will let you know.  We have our favorite nurses with us today and maybe tomorrow.  Their names are Kristina and Elaine.    

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!