Thursday, May 31, 2012

Remember When...

Remember when Caleb was 11 days old and he was less than an hour away from getting heart surgery?

When he was one day old he was doing so well breathing and keeping up his oxygen that they took him off of the ventilator.  After almost 24 hours he had to go back on, because it was too much work for him to keep breathing on his own.  About a day later, he was doing so well that they extubated him again.  That time he could only breathe on his own for a few hours before needing to be intubated again.  I remember seeing him struggling to breathe on his own, and wishing they would just put the ventilator back in.  It was painful to watch him like that.  He had quite the nap after being intubated again!  He was so peaceful.

They did multiple chest x-rays a day, and his lungs kept looking fuzzier and fuzzier until one lobe of one of his lungs was almost completely collapsed.

At six days old they did a routine (for early preemies) heart ultrasound that diagnosed him with PDA (Patent Ductus Arteriosis).  The Ductus Arteriosis is a duct in the heart that is open during pregnancy to allow the blood to bipass the lungs, because an unborn baby doesn't get oxygen from their own lungs, they get it from their mother.  The duct is supposed to close when a baby takes their first breath, but since Caleb didn't take a breath on his own until he was a whole day old, his duct didn't close.  When the duct is open, it can allow fluid to enter a baby's lungs.  Usually, even when the duct is open, it is closed just enough that a nurse can hear a slight murmur when listening to the heartbeat.  But Caleb's duct was so wide open that there wasn't any friction from the blood passing through to cause a murmur at all.

When the nurse practitioner called me to tell me the news, she said not to worry, it was very common in preemies, and the duct commonly closes with a three-day course of a special type of ibuprofen.  I really wasn't worried at all.

So after the three day treatment was over, they did another heart ultrasound.  It was still wide, wide open (they still couldn't hear a murmur), so they decided that they needed to do surgery.  I was scared, of course.  My little baby was still well under three pounds.  (He didn't hit three pounds until his three-week birthday.)  But I was more excited than anything--I couldn't hold him until he was off of the ventilator, and he couldn't be off of the ventilator until he could breathe on his own, and he couldn't breathe on his own until his lungs were clear and functioning, and his lungs wouldn't be clear and functioning until his PDA was closed.

That day was a Friday.  They couldn't schedule the surgery until Monday morning, so they decided to give him two more days of the medication, because, well, why not?  They were not hopeful at all that the medication would work, because three doses didn't even close it a tiny bit.  But there was no harm in trying.

Sunday night I couldn't stop thinking about how I, myself, had never had surgery, but how my tiny, tiny baby would be getting surgery at just 11 days old.  It seemed so unfair.  I had a hard time watching him go through something that I knew nothing about.  I wanted to feel empathy, but I didn't know how.  So I just felt fear and sadness.

Monday morning rolled around, and we were told to be at the hospital by 7AM to talk to the surgeon before the surgery.  It was a simple surgery, performed right there in the NICU.  Caleb would stay in his isolette the whole time.  For that reason, they had to call every parent in the NICU to tell them that they wouldn't be allowed in the nursery from 7-8AM.

So we stood by Caleb's bed as the surgeon talked to us about the risks.  Infection, which is the number one killer of babies in the NICU.  A cut or strained vocal nerve that helps the vocal cords function and could lead to a very soft, raspy voice and may cause him to need speech therapy.  The scary side effects of anesthesia and having a hard time waking up (and possibly not waking up).  The possible need for a blood transfusion.  For some reason the surgeon felt the need to tell us the exact chances of Caleb contracting HIV from a blood transfusion.  Too bad he had already had two by then (and had a third later that week).

Although the surgery would only need a tiny incision under his left arm that would be so small that they would put a steri-strip over it when it was all said and done, Nate and I were still scared.

So after talking to us about exactly what would happen and exactly what risks were involved, just before ushering us out of the nursery to wait in the Parents' Lounge while they cut open my baby and reached inside of him to place a clamp on a duct in his heart, they did one last heart ultrasound.

And do you know what they saw?


His duct had closed on its own.

And that's when I knew that God loves us enough to provide miracle after miracle after miracle.

By that evening, Caleb's lungs were so clear that they took him off of life support for the last time.  The next day, at 12 days old, I got to hold him for the first time.

It was the happiest moment of my life.


*Alice Anne* said...

I'm so glad you're documenting all this! I'm reading it and I'm all anxious about what's gonna happen, even though I already know the ending! Caleb's story is awesome. :)

Katie Bradley said...

That must have been one of the biggest reliefs of your life. And then to hold him! Precious memories

Manda said...

Anna this is incredible to read!

Katrina said...

I'm so glad you wrote this down and shared. I had NO idea! What a wonderful blessing and miracle. I have tears in my eyes. you say...all bad things must end. The Lord is watching over you still, just like then, because you are such a good and dedicated mother. :) Keep it up.

Thanks again for sharing this story. So sweet and such a tender mercy. :)