Wednesday, July 31, 2013

Letter from Mommy

To my sweetest Karalyn:

How I miss you already. My heart is so heavy, and my arms are so very empty. I think of how just a week ago you were rolling around in my belly. You were so safe.

Even though your life was so short, you will be with me forever. My heart has been forever changed. I treasure the weeks I was able to carry you, advocate for you, prepare for you, dream for you. I treasure the hour we had with you and the nearly 24 hours we were able to have to cuddle you and stare at your sweet little face, which looks so much like your sisters. You have the same nose as Kenzie, and you look so much like your Daddy.

It’s amazing to me to think that your first breath was meeting Jesus face to face. I know he bent down and scooped you up in His arms. You are safe now little one, in the arms of Jesus. I know you are healthy now. You have a perfect heart and your lungs are breathing in the fresh air of heaven. Though I never heard you cry, I’m sure you are up there now, singing praises to our King. I can’t wait to see your beautiful eyes and find out what color they are. I can’t wait to hear your voice. I can’t wait to lock eyes with you and scoop you up in my arms. Heaven has never felt so real to me as it does now, knowing I have you there waiting for me.

You would love your sisters. They were so excited for you. Kenzie misses you already. She blows bubbles outside and tells me the bubbles are going up to you in Heaven. She even said she’s going to throw up some candy to heaven for you.

I was so ready to fight against your heart defects with you. To beat the odds, to cheer you on and watch you triumph over them. You have battled from the beginning of this pregnancy, and I am so proud of you. Your daddy and I did everything medically available to help you have the best chance at life. I am so sorry it was not enough.

Though this journey did not end how we had prayed, I would do it all over again because you were totally worth fighting for. You are our little girl, our third daughter. You are worth the heartache that we are feeling now. You are worth the tears. You are worth the blood test, the doctor visits, the echocardiograms, the ultrasounds, the worry, the poking and prodding, the amniocentesis, the research, the fetal intervention, the medications and the labor and delivery, even though we only had you for a short time. I know if you had made it, our journey was not going to be easy. It was going to be hard, really hard, and it was going to turn our world as we knew it upside down. I was so ready though. I was ready to have our world turned upside down for you, to take these heart defects by the horns and do everything I could for you. You are worth it.

I know God will bring good from your short life and this journey we’ve been traveling. It’s hard to see through the pain and tears right now, but I know He will redeem this heartache we are overwhelmed by. Your journey, though you are not here with us any longer, is far from over.  I can’t wait to see how God uses your journey to impact other people, to impact me.

It took us awhile to pick out your name. We wanted it to be beautiful and to have a great meaning. Karalyn means “strong; joy; song of happiness”. Elise means “pledged to God”.

This whole journey, we have prayed that God would prepare our hearts for whatever his will ended up being for your treasured little life. He has, in so many different ways. He never left our side, and He is carrying us now. We have the hope of eternal life through Jesus Christ-we will see you again sweet girl. I am forever grateful that we never traveled this road alone. Jesus was there with us the whole time, and He gave us the most amazing support group of friends, family and church family near and far who we are forever indebted to. We had an army of prayer warriors praying on your behalf, many who we have never even met. He blessed us with an amazingly supportive medical team at Children’s Mercy. I have made friends with other heart moms who have supported us through this journey as well. God is near.

Though you are no longer with us, your journey hasn’t ended because you are in our hearts. A piece of my heart will forever be missing. As I sit here I don’t know how the pain and heart ache will ever subside, but I know God will help us heal though there will always be a void in our hearts, there will always be a very real yearning that you were here with us. That we could be watching you grow up.

In the end, you changed my life more than I was ever able to change your life. I pray God would use this journey for His glory.

I will carry you in my heart forever. You will be forever treasured.

We will see you again sweet Karalyn.

Love,

Mommy

Letter from Daddy

Karalyn-

You are loved.  You were loved from the moment we found out your mommy was pregnant.  You were loved when the doctors told us that you wouldn’t make it to 18 weeks.  You were loved when we found out you only had half a heart.  You were loved when the doctors made it clear that we had the option to give up on you. That was never an option for us.  We wanted to fight for you.
Oh honey, we fought with you and we fought for you.  There was never a doubt that we were going to do everything we could to give you the best chance at life.  We held to hope when there wasn’t much to hold onto.  With the God we serve there is always hope.

We wanted to hold you in our arms, hear you laugh, see you smile, stare into your eyes and to see you play with your sisters. Your sisters love you so much.  They came to meet you when you were born.  They gave you hugs and sang to you.  Mackenzie said you were just perfect and Raegan tried to poke you in the eye.  Mackenzie wanted to know how you got up to Jesus.  Though I don’t know the exact answer to that question, I know you are with Him now.
It saddens me to think of all the dreams we had for you that will never come to pass.  To see you take your first steps or to hear your first words.  We didn’t ask for much because we knew the odds that were stacked against you.  We are so happy we got to hold you in our arms, play with your hands and feet and kiss your little forehead.

We had trouble finding a name for you because we wanted it to have meaning.  We wanted it to be sweet and beautiful.  We wanted it to be strong and resilient.  And, honestly I wanted a name I could easily make into a nickname.  We call your sisters Kenzie-bear and Raegie-bear.  You are my Kar-bear.  I even looked up the Carebears toys online and there is a Tenderheart Bear with a red heart on it’s belly.  It fits you just right.
Your mommy and I are reminded of you everywhere we go.  We’ll think of you every time we see a heart, a baby or a butterfly.  You are loved by so many and you touched the lives of so many.  You live in our hearts, our minds, our thoughts and our prayers.  I can’t wait until the day I can hold you in my arms again in heaven.  Until that day I’ll carry you in my heart wherever I go.

I love you my sweet little Karalyn…my little Kar-bear.  Daddy loves you…always has, always will.
Love,
Daddy

Grieving our sweet Karalyn

I have wanted to blog, but I have just not had the emotional strength to do so. The last ten days have been the hardest of our lives. But, our journey has been an open book from the start of this blog, and I wanted to share the rest of the story regardless of how hard it is to sit down and actually type it out.

We got back home from the fetal intervention on a Wednesday night. I stayed up pretty late that night and posted a blog entry. We came home with such renewed hope and excitement for our little Karalyn. We felt we had done everything we could on our end, and we were so ready to just relax and enjoy the next 7 or 8 weeks with our kiddos and each other until our precious little girl was scheduled to arrive. When I went to bed that night, my legs were quite swollen, and I could literally feel the swollenness up my legs. I have never felt that swollen before, but it was better in the morning.

I went ahead and called my nurse at my OB’s office at Children’s Mercy on Thursday just to check in and ask about the swollenness. We decided it was probably due to the traveling the day before, but I was told to watch it. My concerned and loving hubby banned me to the couch Thursday night and told me to relax, prop up my feet and stay put!

My nurse called me the next morning (Friday) to check in on me again and see how the swelling was doing. I had a little more swelling at one point in the day I told her. I also told her how my belly felt really hard the night before. There was no pain with it, and the hardness went away. She told me she could get me into the office that day if I wanted to have them take a look. I told her no, it had only happened once, and I wasn’t even sure if it was a contraction. She told me that if I felt any change in my belly or felt any pain whatsoever, that she wanted me to come in right away. With just having a fetal intervention and the severity of Karalyn’s heart defects, she didn’t want me to take any chances of going into pre-term labor. I don’t remember feeling anything on Friday. Then, Saturday came.

At about 3:00 p.m. Saturday, July 20, my hubby and I started noticing that my belly was feeling very hard, but then it would relax. I felt no pain with this whatsoever. I have never experienced contractions early in any of my other pregnancies-the only time I felt contractions is when I woke up in active labor with my other two daughters. We were a bit worried, so I was banned to the couch… again.

Mark’s brother and sister-in-law were coming for dinner and to hang out that night. When they came, we told them what was going on and how we were debating on whether or not to go into Children’s Mercy to be monitored. We figured maybe I was having some Braxton Hicks or something, and they’d probably just tell me to go home, drink water and relax.

We decided to go in. We didn’t want to take any chances. My hubby’s brother and sister-in-law stayed at our house with our two kiddos and their two kiddos. We drove the 30 minutes to Children’s Mercy. I continued feeling contractions this whole time, but they were never painful. We had called CMH in advance to let them know we were coming in, and we had our “patient passport” to get into the hospital since normally this is a hospital for only children, not pregnant mommas. We got to the hospital, showed our little “patient passport” card to security, received our security stickers to wear and headed up to Fetal Health on the third floor. It was about 6:45 p.m. Saturday, July 20.

I put on the hospital gown and got into the hospital bed. They hooked me up to monitor my contractions. I was definitely having contractions. They were about two minutes apart. They checked to see if I was dilated at all. I was a 1 and about 50-60% effaced. I felt hopeful since I was only at a 1 so far. Once I was in the hospital, I started to actually feel a bit of pain from the contractions. CMH is connected to an adult’s hospital called Truman Medical Center. They decided to transfer me there (they have a connecting hallway between the hospitals) to be monitored and start medications. There were several reasons for the transfer. 1. Children’s normally doesn’t deliver babies-only ones where they would need immediate intervention for their heart (we knew if I ended up delivering this day, then CMH would not be able to do any immediate intervention for her heart due to her being so early and too small). They have only delivered about 200 babies in the last two years. I would have had a scheduled c-section at CMH had we made it full term because Karalyn would have still most likely needed immediate intervention. 2. Children’s Mercy does not do VBAC’s (vaginal birth after cesarean). I had a c-section (not scheduled) with my first daughter and then a VBAC with my second daughter. We knew that if I actually ended up having to deliver her now, that I would go ahead and do a VBAC instead of a c-section. There was no benefit at this point to do a c-section delivery. And, unfortunately, we knew her odds of doing well if she were born this early were not good-we didn’t want me to go through a c-section if not beneficial to our baby. If we ended up delivering at Truman, they would stabilize the baby and then transfer her right back over to CMH. CMH explained everything that would probably happen once we got over to Truman. They were hoping to get my contractions stopped.

They wheeled me over to Truman. Once there, it took them awhile to get my saline IV going and get me hooked up to the contractions monitor. Then they also gave me a steroid shot for the baby’s lungs (thanks Katie for the advice of icing to numb my bum first-it really helped it not hurt nearly as much as it was supposed to!). Finally, we were settled in for the night. They said they would be keeping me until at least Monday afternoon. Mark’s parents headed to our house from Topeka to relieve my hubby’s brother and sister-in-law so they could get their kiddos home. A couple of my girlfriends came in and visited us that first night as well and brought me food since I had missed dinner. They kept us company, shared scripture with us and prayed with us.

That night was not very restful. My contractions became more painful, and they still seemed to be coming every 2-5 minutes. Finally at around 3 a.m., our nurse and my hubby decided that I should really probably be checked again to see if I had dilated more. We were trying not to check me too often because we didn’t want to encourage any more contractions. They could tell my demeanor had changed, and I was having to breathe through contractions and feeling much pain. I always hate having to rate my pain. One reason is because I have been told I have a high pain tolerance. The other reason is because I hate to over rate my pain incase it does get more painful, or I don’t want to under rate my pain and then have my nurse not think my contractions are serious.

When the OB came in to check me, I was at a 5 and 75% effaced. When we heard these numbers come out of the OB’s mouth, my hubby and I just started crying. We knew. We knew that at this rate (I usually go pretty quickly once in labor), we were going to have this baby. They were not going to be able to stop my contractions. I was too far gone at this point.

Once they saw how far along I had progressed, they started me on magnesium (this was to protect Karalyn’s brain, and it also has a side effect of relaxing your uterus). They pumped me with a ton of it when they first started the IV, and then it tapered off about 30 minutes later. Magnesium though makes you really hot. They brought a fan into my room to have blow directly on me. I was so hot! Then, the medication burns in your arm for that first 30 minutes. And, you just feel downright weird/disoriented. They had to put a catheter in because I wasn’t allowed out of bed once I had the magnesium because you are kind of loopy on it and your body is not super stable. I also had blurred/double vision while I was on it. My vision stayed messed up until they started weaning me off of it right before delivery.

Then they also gave me three shots in my hips of some type of medication that was supposed to help relax my uterus in hopes of slowing/stopping contractions. This did slow them down to about 7 minutes apart for the next few hours, and I was able to get a little bit of sleep on and off over the next few hours. But, it didn’t stop them by any means. I am not sure why they waited so long to give me this medication. I remember getting some other medications, too, but I can’t quite remember what they were or when I received them. It really is such a blur.

So, we waited. Once the morning came (Sunday, July 21), my contractions started picking back up. I didn’t really eat much that day because I didn’t want to be on a full stomach knowing I could be possibly delivering that day.

My mom and sister had already pre-planned a trip to fly out to our house this same weekend. They were to fly in on Sunday and fly home on Wednesday. So, when they landed in Kansas City Sunday morning, they just came straight to the hospital (after getting completely lost, of course). They stayed with us most of the day I believe and were there helping me through contractions. God’s timing is amazing, and I know He had His hand in the fact that this just so happened to be the weekend my mom and sis came to visit. He knew I needed them there during this time.

About 3 p.m. the OB checked me again. I was now at an 8 and 80-90% effaced. They told me I was definitely having this baby today. They brought the baby warmer in and some other things from the NICU. I think it was then that they started introducing different members of their medical team to me that would be in there during delivery.

I am not sure exactly when, but they eventually checked me again, and I was at a 9+ and basically 100% effaced. I was already feeling a small urge to push but was waiting to get completely dilated and for my water to break. I was in so much pain with my contractions and feeling the need to push (I did not have an epidural), that I just asked them if they could go ahead and break my water. I knew as soon as they did, I would probably need to push, and this baby was coming regardless. They agreed. I had my mom and sis leave the room, as Mark and I wanted to deliver her with just us two there and the doctors because we knew her future was so uncertain (my mom and sis were in the room during delivery of my first two daughters). So, they broke my water, and I of course had to push immediately. But, of course, it seemed like it took them a century to get ready for me to actually start pushing. They had to take the lower half of my bed off, get the stirrups in place, get my legs up in them, etc., all while I am in excruciating pain trying to hold little Karalyn in and not push.

Finally, I was able to start pushing. I assumed this would be a pretty easy job given she was going to be small due to only being 31 weeks and 2 days along. But, no, of course it wasn’t. I ended up having to have an episiotomy because her head would just not come out. Once I had the episiotomy, she literally shot across the delivery room. The OB literally caught her in mid-air. My uterus decided to not start contracting after delivery, so I ended up losing a lot of blood. It took over an hour for them to get me stable with stitching the episiotomy and stopping my body from losing blood and getting my uterus to start contracting. It was actually pretty traumatic for me and my worst delivery experience to date.

Our little Karalyn Elise was born Sunday, July 21, 2013, at 6:35 p.m. She weighed 4 lbs 6.6 oz. She was 16.5 inches long and had a head circumference of 12 inches. Her oxygen levels were only at 19%... not good at all. Karalyn means strong; joy; song of happiness. Elise means pledged to God. She was a good-sized baby for how early she was. She never cried. She never opened her eyes, she never really even moved except a few times where she gasped trying to get her lungs to open up. She never took a breath. They performed CPR on her, they tried to get her on the ventilator several times, and they sprayed surfactant into her lungs hoping that would get them to open up. Nothing worked. Her lungs would just not respond. Eventually, they told us we needed to just hold her. There was nothing more they could do for our sweet Karalyn. As I understand, there was too much fluid in her lungs, and they had just not developed well enough due to the heart defects. Mark held her most of the time because I was still being worked on (they were working on me the entire time she was alive). I held her briefly while she was still alive and while I was being worked on. I did get to feel her heart beat against my chest. I shared some skin-to-skin time with her. I saw her gasp for air once. I was in so much pain due to the OB trying to get my uterus to start contracting and then stitching me back together, that I did not get to hold Karalyn for very long. I remember hearing the doctor go over to Mark to check her heart beat again (they did this periodically). At 7:41 p.m., they no longer heard her heart beating. She passed away in her daddy’s arms while her momma was still being worked on in the delivery room. We were devastated and in complete and utter shock.

They eventually got me back together, and the room full of doctors cleared out. They did her footprints for us and gave us a keepsake box that had a shirt, hat and booties in it. They wrote her stats out on the little hospital card, and they put a special sticker on our door to let everyone know that we had just lost our child. We spent the rest of the night holding our sweet Karalyn, memorizing her little face, hands and feet. Crying together. In shock of what had just transpired. Was this a bad dream? Were we going to wake up from it soon? Oh how I wish I could just wake up from this.

Once we were ready, we had my mom, sis and my hubby’s parents and our two young daughters come in to see us and Karalyn. Mackenzie (nearly 4 years old) was so sweet. She said Karalyn was just perfect. We told her that Karalyn had to go to heaven with Jesus. We had talked about this a lot with her prior to going into labor because she understood and was so excited for her new baby sister, and we wanted to prepare her that Jesus may take her to heaven when she’s born if the doctors couldn’t fix her heart. Raegan (nearly 2 years old) cuddled her as well. Stroking her head and of course trying to poke her in the eye. We also had a photographer come in who I had been talking with prior to going into labor. She is a professional photographer and volunteers her services for an organization called Now I Lay Me Down To Sleep. She came in and took pictures of us with Karalyn. It was so special, and I am so thankful that we have beautiful pictures of our daughter to treasure forever.

We had several other visitors that night that came to show their love and support and also to pray over us. We were not alone. Finally the room cleared out for the night. We were staring at reality straight in the face, and it hurt so badly. The nurse said we could keep Karalyn as long as we wanted, so we did. She slept in our room, actually, she slept cuddled in her momma’s arms in the hospital bed all night long. I feel so blessed to have been able to sleep with her in my arms. I am so glad we kept her as long as we did. Mark and I shared many tears together that day. The next morning, we snuggled together in my hospital bed with baby Karalyn nestled between us and just wept.

We had several visitors the couple days we were in the hospital from friends and family to our whole fetal health team at Children’s Mercy, which meant so much. I shared sweet, tearful moments with some of my closest friends who have stuck by our side through this entire journey, and they were able to meet our sweet Karalyn who they had prayed so hard for over our entire pregnancy. At around 3:30 p.m. on Monday, the neonatal nurse came in and said we needed to start saying our goodbyes to Karalyn. They wanted to take her in the next 30-45 minutes. They had originally told me I could keep her as long as I wanted-I guess they didn’t realize this momma would literally keep her until forced to let her go. It was time though. I don’t want to be too graphic, but little Karalyn was continuing to worsen in color and other things, and we needed to let her go. To not engrave in our brains the way she looked when we gave her to the hospital, but to remember her when she was first born. The nurse gave us our privacy, and we just held our sweet daughter and bawled. My mom was there and thankfully captured some beautiful pictures of us with our baby as we said goodbye. They are heart-wrenching pictures, but they capture the emotions of the moment so beautifully.

I remember just holding her, trying to memorize how she felt in my arms. Trying to memorize every feature of her so I could engrave it in my memory forever. We didn’t get to build a huge memory bank with Karalyn, we had a short 24 hours. We tried to build our memories as much as we could. While we had her, we rocked her, slept with her, swaddled her in a blanket that Children’s Mercy had given us, took pictures, stroked her, kissed her, sang twinkle twinkle little star to her, read her a book and just stared at this beautiful little girl who was now in the arms of Jesus.

We buzzed the nurse to let her know we were ready (as if you could ever be ready for something like this). We put Karalyn in a hospital blanket so we could keep the baby blanket with us. They swaddled her, and then they took her away. That was it. I broke down of course. Here I was, stuck in this hospital where I had just delivered, but I had no baby to care for. I was released the next morning. They got us discharged first thing in the morning so we could get out asap. It was so hard walking out of that room, the room where all of our memories were made with our little Karalyn. Saying goodbye. Knowing she was still in the hospital somewhere. Knowing we were headed to the funeral home to pick out her urn (which is a beautiful pewter-colored heart that fits in the palm of your hand and engraved with her name, date of birth and Psalm 139:13-16). Not what you envision when you deliver your child. I still cannot believe this is how it all went. It’s heartbreaking. We are heartbroken.

But, we are not without hope. We know she is with Jesus. She has a perfect heart and lungs. We know we will see her again someday. Oh, how I can’t wait for that day! To scoop her up in my arms will be one of my greatest joys. I miss her every single moment of every single day. I know that Christ will bring healing. He is close to the brokenhearted. He will bring good out of this, and I believe He already has. I don’t think the pain will ever go away, and I don’t think God necessarily expects us to just toss the pain aside and be just as great as we were before our loss. A huge chunk of my heart is now in Heaven. We will be forever scarred. I will think about my sweet Karalyn every single day for the rest of my life. I know time will help heal our hearts, but our hearts will never be the same.

The following week was very hard. I had all the normal things that happen after you deliver-healing, bleeding, my milk came in, etc. My hubby and I celebrated our 9-year wedding anniversary three days after she passed away. We had to plan a celebration service for our daughter and get everything ready for that. The service was beautiful. The music we chose was beautiful, the sermon was beautiful, the letters people read along with the individual letters me and my hubby wrote for Karalyn were all beautiful. We spent time worshiping our Lord and Savior. We had a balloon release and blew bubbles for Karalyn. It was sweet and beautiful. I held it together during the service much better than I had thought I would. I had been begging God for strength to get through it, and He heard my cry.

My mom and sis basically took care of my kids for me that whole first week we were home. One of my best friends went grocery shopping for us and had our house stocked by the time we even got home from the hospital. Our church family started a meal train, and we had dinner delivered that Tuesday night, and they are continuing to deliver us meals Mon-Wed-Fri through the end of August! The generosity of our church family has blown us away. They have definitely helped share the weight of all of this. The flowers and cards started flooding in. Such comfort was found in the words and encouragement of so many people.

Now, Mark is back at work. The house is not filled full of family. We are back to “normal” or at least for me, trying to figure out what “normal” is when you have suffered such a tremendous loss. But, I wake up each day. Pray to God for strength, hope and just to survive another day at this point. I take a shower. I make our bed, and I go downstairs to start the day with the two beautiful daughters I do have with me on this earth. It’s so hard balancing grief yet trying to make the lives of your children still just as normal as before. I won’t lie, I am a little distracted by grieving the loss of Karalyn. I would love to just crawl in my bed and stay there all day long. But, I can’t. Life must go on, and my girls need me today and every day. I have let the girls watch more tv lately than I normally do. But, I think with each day I get up and do our “normal” things, life will get better. I will never be “over” my grief and sadness of the loss of Karalyn. But, I know God will bring me to a place of peace and rest. I pick up my Bible, I do my quiet time, I read the promises of God, and I know He will make those real in my life in time. It’s hard though because I feel like because we had such a short time with her, that my emotions are what keep me so closely connected to her now. If I give up allowing my emotions to overwhelm me, then I feel like I will lose some of the closeness I feel to Karalyn. Feeling so emotionally overwhelmed makes Karalyn feel so close and so real. Already the memories of delivering her and spending the 24 hours with her feel so far away. My emotions are the most real memories I have left I feel like. I was so ready to be a heart mama, and then all of a sudden that privilege was taken away. I had spent so much time preparing for it, learning, researching, asking questions-doing everything I could to become as knowledgeable as possible so I could be the best advocate for Karalyn. I compare it to basketball. I spent all this time perfecting skills, practicing, then I didn’t even get to play in the game. I am grieving in lots of different ways-mainly for Karalyn, but there are other things I am grieving in her loss like the fact that I do not even get the chance to be her heart mama; saying goodbye to our medical team at Children’s Mercy who have become like family to me; the fact that I still wish I could finish out the last 7 weeks or so of our pregnancy, to feel her roll around in my belly and to still have hope that this may all be OK in the end. I don’t know if that makes sense or not, but it’s my truth.

So, that basically brings me to today. Trying to find a new normal while having a completely broken heart. It will come. One day at a time. Whether I want it to or not, it will come. Normal with a shot of a forever broken heart. We love you sweet Karalyn.

Wednesday, July 24, 2013

Celebrating the life of our Karalyn Elise

We will be celebrating the life of our little Karalyn Elise this Saturday at 10 a.m. at Legacy Christian Church in Olathe, KS. The address is 13715 W. 151st Street, Olathe, KS 66062. All are welcome.

In lieu of flowers, please consider donating to one of the organizations below in memory of Karalyn. All three of the below organizations played a big role in our journey, and we are very grateful for each one of them.

http://www.sisters-by-heart.org/p/donate.html

http://www.chdfamilies.org/donate.html

https://secure2.convio.net/tcmh/site/Donation2?df_id=1382&1382.donation=form1

Wednesday, July 17, 2013

A Successful Fetal Intervention!

It’s hard to believe I am sitting here in the comfort of my own home writing this blog post and feeling my little one doing somersaults in my belly. Just yesterday morning, I was in the OR, and our little girl was having her first heart surgery… in the womb. How amazing. I figured some of you may be interested in how this all went down…

We arrived in Ann Arbor, Michigan, late last Thursday night. We started our appointments Friday morning at 9 a.m. and they took most of the day. Appointments included meeting with MFM, full ultrasound, echo, genetics counseling and meeting with two of the cardiologists to discuss the fetal intervention. It was a long day. We had the rest of the weekend to relax as much as we could as we waited for our Monday appointments. We were able to relax and enjoy ourselves for the most part, but the reason for being there was never far from our hearts and minds. There were lots of times we just looked at each other and took a deep breath. We definitely felt the weight of it all as the day of the procedure drew closer. We were begging God that He would sustain her life through this procedure and praying we were making the right decision for our little girl, and if we weren’t, that He would put a stop to the procedure somehow. We also worked on finalizing a name for our little girl. We are getting so close!!! Though, I hate to disappoint, but her name will remain a secret until she is born.

We were blessed to have two of our best friends come into town Saturday morning from Ohio and spend the day with us. We spent Saturday and part of Monday with them just hanging out and enjoying each other’s company. Sunday Mark and I “went to church” via the Web by watching our church’s online stream of the service. We had lunch, saw a movie, walked downtown Ann Arbor, ate dinner and had a nice time.

Monday we started appointments at 1:30 p.m. We met with anesthesiology, had more meetings with the fetal intervention team and then a blood draw for me. We were only there for a few hours.

Some of our other best friends drove in Monday night from Indianapolis to be with us on Tuesday. They got into town about midnight (of course we were still wide awake at that time), so they stopped by our room. We caught up with them until 2 a.m. then called it quits for the night. Our wake-up call was at 5 a.m. I didn’t mind staying up so late because (i) we hadn’t seen our friends in four months and enjoyed catching up, and (ii) hello, I was about to have a cardiac fetal intervention on my baby-who can sleep the night before something like this?! We “slept” from 2 a.m. to 5 a.m. (well, my hubby did, the baby and I just tossed and turned all night).

We got to the hospital a little before 6 a.m. Tuesday morning. I put on the stylish hospital gown, laid in the bed and was wheeled to what was technically a recovery room in the maternity ward. My nurse then put in an IV for a saline drip. She placed the first one in my hand, but then the IV wasn’t dripping, so she had to take the tape off, take the IV out and try it again. Sigh. Did I mention I hate needles? She finally got the IV placed correctly, and the saline started coming.

I was hooked up to monitor any contractions. I actually was contracting according to the monitor (I couldn’t feel anything). This may have been due to not having been able to drink or eat anything, according to the nurse. Then, I had to take a medicine that helped to relax my uterus. They did an ultrasound to see how the baby was positioned even though they knew the baby could be in a totally different spot by the time we got to the OR.

Then, off to the OR around 7:15 a.m.. This is when Mark had to go to the waiting room. In the OR, they placed my epidural. This is the first time I have had an epidural. I had a spinal block during my c-section with my first daughter, but they put it in very quickly during one of my contractions/pushing, and I didn’t feel a thing. I did a natural VBAC with my second daughter. Getting the epidural was awful! There was the main anesthesiologist in the OR with a resident and a fellow. I can’t remember which one did my epidural (it was the resident or fellow, I do remember that for sure), but it took nearly 20 minutes. They had to try at least two times. It was not fun. Finally they got it in though. Whew. This is why I opt for natural child birthing lol! I don’t know how long is normal to place an epidural (I thought they said it would only be a few minutes) or how many tries is normal, but that was not fun!

They laid me down, got me situated then started the epidural. During a fetal intervention, they give you more than a normal epidural during labor/delivery-they completely numbed me up to my chest. They kept testing the effectiveness and how high the epidural had climbed up my body by scratching me with a needle on the shoulder, then having me tell them when I felt the same amount of sensation on my belly. When they injected enough to make me numb through most of my body, they put oxygen in my nose, placed my catheter and started the procedure.

There was a blue sheet up in front of me so I couldn’t see the doctors, but I could watch the ultrasound monitor. I also brought in my iPod and had one ear piece in on a low volume so I could zone out if needed. I went back and forth between listening to the doctors and watching the screen to zoning out to my Jesus-loving music. I was shaking all over, and my body seemed to only calm down when I zoned out and got to a very relaxed state of mind. So, I zoned out, listened to my music and prayed during most of the procedure. When I would watch and listen, I would automatically kind of tense up and start shaking, teeth chattering, etc.

The Procedure
They stuck a needle through my belly and into our baby’s thigh to administer the drugs she would need (one to take care of her pain and another to basically paralyze her so she wouldn’t move during the surgery). Once she was not moving, they made about a one-inch incision just in my skin on my belly (they did not make any incision in my uterus-they only stuck the needle through my uterus). They put the needle (similar in size to a needle they use for an amniocentesis, pretty thin) through the incision and then went through my uterus. They went through her chest/ribs and into her heart. They poked a hole out with the needle, then pushed a balloon through the needle into the new hole and inflated it three times to stretch the new hole. Then they brought the needle out. This was all guided by watching the ultrasound monitor. My understanding is they weren’t sure if they really got a good hole or not that time, so since the baby and I were doing fantastic, they decided to do it again.

I believe at this point they had to give another dose of meds to the baby because her meds were wearing off. Of course, our baby girl was ready to roll around and play and didn’t want to succumb to the meds, so they ended up having to do it a couple times to get her to stop moving! Not surprising because she is very active in my belly. Once they accomplished that task, they went in again. This time they thought they made a better hole. They inflated the balloon another three times, then they removed the needle and stitched me up. They watched the baby for 15-20 minutes in the OR once they were done. Then, I went to recovery.

The baby and I did great. The baby had one time where her heart rate dropped, but it came right back up. They did mention there was some extra fluid around her lungs, but they didn’t seem too worried about it. I didn’t need any extra drugs to sedate me during the procedure-I was able to hold it together. It was amazing how quiet and calm it was in the OR, even with a medical team of 15-20 people in there. My hubby had a cell phone they gave him, and they updated him a couple times during the procedure. I think I was in the OR for about 2.5 hours total.

Once I was back in the recovery room, they hooked me up to monitor contractions (there were some), and I waited until the feeling in my body came back. I was able to order lunch (this pregnant momma was hungry!), and I finally made it over the last hurdle before being able to be discharged-going potty. They came up and did an echo to take a look at the hole and see how big they were able to get it and what the blood flow looked like. Before the procedure, they couldn’t see a hole or any blood flow through the atrial septum. During this echo, the cardiologist measured the new hole in her atrial septum to be 1.7mm, and she could see some blood flowing through. The procedure was a success, but they were disappointed to some extent. They were hoping to get the hole bigger than what they did. The balloon inflates to 3.0mm, so that was their hope. But, as our cardiologist at our home hospital said after she talked to the docs that day, going from no hole and no blood flow to a hole with blood flow is great!

After the procedure, I was a little sore. Mainly the area on my back where they poked and prodded to get the epidural in was the most painful part of my body. It hurt to sit against a chair, but it is better today. I have two stitches in my belly-not painful unless I accidentally bump them against something. I have probably about 7 other needle pricks from the IV and the needles used to administer the meds to our baby, but those do not bother me.

It’s funny because my head thinks I should be in more pain than I am, like I just had a c-section or something. Hello, they just performed a cardiac fetal intervention on my baby, I surely should be in excrutiating pain, right? You would think, but that’s not the case. I am sore, yes. The site where they did my epidural was a bit painful, yes. I have to be careful not to bump my stitches, yes. In my mind though, these are so minimal when you think that our baby just had her first heart surgery in the womb. Amazing. I am not on any pain meds. I had to take medicine for the first 24 hours to keep me from contracting but that was it.

I was dismissed in the afternoon. It was weird to leave so soon after the procedure knowing the magnitude of what just happened. But, we went back to our hotel and hung out with our friends. After some hang out time, they all headed back home. We went to dinner, rented a movie and went to sleep. We flew out late this afternoon and are now home sweet home with our other two babies.

We go back to our normal doctors here in Kansas City on Monday to take a look at how the new hole is doing.

We are so thankful. Thankful we didn’t give up on fetal intervention out of fear because that would have been easy to do and totally understandable. Thankful we had success and are celebrating this new hope for our baby. Thankful God chose to bless our decision to do everything medically available for our daughter to have the best chance at life. Thankful we are still pregnant with our little miracle. Thankful for our family who took care of our girls for nearly a week. Thankful for our friends who brought meals every night for our girls while we were gone and even brought freezer meals for us to eat now that we are home. Thankful for all you who are praying for us. Thankful for two great sets of friends who came up to be with us during this procedure. Thankful we are still on this journey. Thankful for Mott Children’s Hospital for giving our little girl a chance with fetal intervention when the other top two hospitals said no due to her Turner Syndrome. Thankful for a great team of doctors we were able to work with at Motts. There is so so much to be thankful for tonight. We have done all we can on our human end for our child. We are now going to try and slow down, relax and enjoy these last eight weeks with our two little girls before our world changes forever with the birth of our little one.

Our little girl still has a long road ahead of her. This procedure, though a success and something to be excited about, did not make her heart all better-it wasn’t a cure by any means. It doesn’t take away the fact that she is still going to be a sick baby when she is born, and she will probably be fighting for her life still. She may still need immediate intervention at birth. Her lungs have probably already been damaged in-utero. There are still so many unknowns. This hole they just made could close right back up, and we could be in the same spot that we were already in. We just have to wait and see. If this new hole stays open, her chances of surviving her first surgeries are sitting at a 50/50 chance. Those aren’t great odds, but we’ll take them! They are better than the 10-20% chance before the fetal intervention.

Some things we know for sure- (i) our God has a plan; (ii) God will prepare us for whatever lies ahead-whether it be what we’ve been praying for or our worst fear; (iii) God is with us through this journey; and (iv) our little girl is a fighter.

Ways to pray:
1. The hole in her atrial septum stays open and even gets bigger with the new blood flowing through it.
2. Her lungs to develop properly and that she will have minimal lung damage.
3. I do not go into preterm labor. I have to make it to 36 weeks for the doctors to be able to do anything for her heart. And, the bigger she is at birth, the better.

 

Saturday, July 13, 2013

Day 1 - Michigan Fetal Intervention

We had our first day of appointments at Mott Children’s Hospital (University of Michigan) in Ann Arbor, Michigan, yesterday. The great news is, they did not add to our list of complications for our baby girl. They confirmed everything we already knew-Hypoplastic Left Heart Syndrome (HLHS), Intact Atrial Septum (IAS), Cystic Hygroma, Multi-Systic Kidney, Turner Syndrome (TS) short femurs, short humorous (these are due to the TS). Her growth is around the 50th percentile, but her femurs/humorous are only in the 6th percentile. The cystic hygroma continues to look smaller, and there seems to be almost no fluid left inside of it-it’s now mostly just extra skin. She moves and kicks around all the time. She is just as active in the womb as her sisters were! And cute as can be of course J

Everything with me checked out just fine. I am healthy, and they feel comfortable with my medical history to put me through the procedure. They told us, which put my hubby at great ease, that I am their number one priority. They will not do anything or continue to do anything during the procedure if my safety is at a higher risk. Obviously, there are minimal risks to me with this procedure. I feel the main one is due to the fact they are putting a needle into my uterus. Anytime something like that is involved, there is risk of bleeding or infection. These are very rare, but if something did seem to not be going right on my end, they would abandon the procedure immediately for my safety. I think it calmed Mark’s nerves a lot to hear them say that their main concern is for my safety as he is obviously most concerned about me being OK through this procedure.

The doctors said that without a successful fetal intervention, they believe her chances of surviving through her first surgeries after birth are only about 10%. If this fetal intervention is successful, it could get her chances up to 50%. Our prayers in this procedure are (i) it would be successful; (ii) the hole they are able to make is nice and big and stays open (it’s always possible they could make a good hole but then it could close up again before birth); and (iii) it would make her much more stable at birth (though she will still be high-risk for sure and may still need immediate surgery).

Even during the procedure, if her heart rate is not doing well, they could abandon the procedure and not do it at all. Or, if they can’t get her in the right position, they will not do the procedure. Or, they could try and poke a new hole, and it just doesn’t work. There are still so many little things that have to line up exactly right during the procedure to even have a chance of success. Honestly, we will be grateful whether or not it is successful as long as our little girl makes it through this. Even if it’s not successful, we will have peace in knowing we tried everything. We just want her to be OK after the procedure. We, of course, are terrified of the worst-case scenario.

We will be the eighth fetal intervention they have done on the atrial septum. They actually just did a successful intervention two weeks ago, so we are glad they had a little practice round before our procedure to refresh their minds and hands J It’s also comforting knowing they have done this procedure successfully on a TS/HLHS/IAS baby before. She is 4.5 years old now, I believe. Hearing other heart warrior stories of beating the odds gives us hope and strength to keep doing everything we can.

We go back on Monday to meet with anesthesiology and then the team of doctors for the fetal intervention. They said it will be a full room of about 15-20 doctors. Mark will be in the waiting room (with several friends-he won’t be there alone). It may take 2-3 hours, which includes an ultrasound, getting the baby in position, my epidural, meds for the baby, the actual procedure, then watching the baby afterwards. They will keep me most of the day and plan on discharging me in the evening so I don’t have to stay overnight, given everything goes well and no complications. We will fly home Wednesday late afternoon.

If the worst-case scenario did occur, we would know very quickly the day of the procedure. Once we are home on Wednesday night, we can feel pretty confident that she made it through successfully.

We want to take a moment to thank our church family and friends. We have only been living in our new city for a month and a half, and our new church family has taken us in with open arms. My girlfriends and my hubby’s aunt watch our girls during all of our appointments, our life group is providing dinners every night while we are here in Michigan for our children and their caregivers, we have an army of prayer warriors, my church has arranged childcare for Raegan once the baby comes during the same time Kenzie is in preschool during the day so that I can be at the hospital those two days of the week. They have been such an unbelievably huge blessing. We have been overwhelmed (in a good way) and humbled by their selflessness and desire to help us through this without really even knowing us that well yet. I know so many heart parents who do not have a lot of support through their journey, or their situation scares people away. We are so thankful that we have been surrounded by people who are not afraid to step up and help us through this in a multitude of ways. So, THANK YOU – to our new church family, our friends and family near and far, to those praying for us that we have never met, to anyone who has read our blog. Thank you from the bottom of our hearts.

Specific ways to pray for us:
1. God to direct the hands and minds of the medical team during the procedure and to just be over everyone in the OR that day.
2. If this is not the path we should take, then God would close the door somehow.
3. Continued peace for Mark and I as we go forward with this procedure.
4. That God would bless our decision to do everything medically available for our little girl to give her the best chance at life.
5. Our little girl has already beat the odds in so many ways-from resolved hydrops to TS (only 1% of babies with TS make it to birth) to her CHD-she is a fighter for sure, and we pray that God would just continue to sustain her life in the womb and protect her through this.
6. Kenzie and Raegan as we are apart from them and for their caregivers while we are gone. That they would have an enjoyable time during our absence and be good little girls J