Thursday Oct 17-
Carissa was on a high dose of Fentanol, and was barely moving. She was intubated and not taking any breaths on her own because the meds that numbed her pain and relazed her muscles also suppressed her breathing. We had to be carefull with touching her, a rub would make her arch her back in pain, she could only tolerate the ocassional firm still touch.
Friday Oct 18.
The Drs started decreasing her Fentanol, and Carissa started trying to breath over her tube ocassionaly, but it did most of her breathing for her. She was more awake, but also more agitated. I was able to help with her care, doing a diaper change, mouth care and taking her temperature. We were able to give her her first kiss that evening.
Tuesday, 22 October 2013
Monday, 21 October 2013
Oct 16- Carissa is born!
They started induction at 8 am, but progress was slow because we were still early. By around 6:30pm they decided to break my water. Carissa had been head down at every ultrasound since 20 weeks, but as soon as they broke my water she decided to flip to breach. They tried manually flipping her, then brought us to the OR for a C-section. Carissa Danielle Holwerda was born at 6:56 pm, weighing 4 lbs 12.5 oz. (she was 5th percentile for weight) I was so happy to hear her cry as she was born, and until she left the room. I did not get to hold her, and only saw her across the room, but Dennis was able to cut her cord. Thankfully she inherited Dennis's long back, and had less intestine out then the Drs had expected. She went immedatly for surgery and had primary closure within an hour of birth. after a few hours I was able to see her in the NICU, but could only stay a few minutes, with no touching. We are so thankful to our heavenly Father for how well everything went, He held Carissa in his loving hands and protected her. Primary closure is possible in less then 10% of gastro babies, and we were told at 22 weeks already that it looked like too much intestine was out for it to be an option. Prayers are powerfull!
35 weeks- Oct 8, 36 weeks- Oct 15
Had another ultrasound Oct 8. The amniotic fluid levals were good, she scored perfect on her movement/breathing tests. They estimated her weight to be 5lbs 4 oz (this measurement was way off)
Oct 15 was my next ultrasound, this time they noticed a large unexplained drop in the amniotic fluid levals. they did not dare wait long before delivery because Gastro babies have a higher risk of stillbirth. They did a non-stress test, and decided it would be safe to wait till the next day for delivery, but no longer. I was booked in for 8 am Oct 16
Oct 15 was my next ultrasound, this time they noticed a large unexplained drop in the amniotic fluid levals. they did not dare wait long before delivery because Gastro babies have a higher risk of stillbirth. They did a non-stress test, and decided it would be safe to wait till the next day for delivery, but no longer. I was booked in for 8 am Oct 16
Wednesday, 25 September 2013
Sept 24- 33 weeks
I had another ultrasound/Mac visit and things are looking good! There is not much to report since there are few changes. They estimate Baby's weight to be 4lbs 2 oz now. Baby also scored perfect on all the tests.
Saturday, 14 September 2013
Sept 10, 31 weeks
Our prayers are being answered! I had my Mac visit yesterday and things are looking great. Baby jumped from the 30th to the 50th percentile, they estimate weight to be 3lbs 10.5oz. There are also no signs of swelling or intestinal damage yet. Amniotic fluid levels, blood flow and Baby's movements were also great. We are so thankful for the care our Heavenly Father has shown to protect our precious child so far, and praying for continued good news.
Tuesday, 27 August 2013
Aug 27 ultrasound and Mac Visit
August 27- 29 weeks
I had another Ultrasound and OB clinic visit today, and then met one of the Neonatologists. At the Clinic they said things are still looking great. Thankfully there is no sign of damage or swelling in the intestines. The Baby's growth is following its percentile curve and looks good. (about 30th percentile meaning Baby is bigger then 30% of babies for gestational age) They estimate Baby's weight to be 2 lbs 4oz. today. These are all blessings, things could be looking much worse at this stage. They also told me they see about 10-14 cases of gastroschisis at McMaster each year.
The Neonatologist is the Dr who will provide day-to-day care in the NICU. They work as a team, so we will see one for two weeks, then a new one for two weeks ect. (Next week I will meet with a pediatric surgeon; Baby will have one primary surgeon from birth through the entire hospital stay, and for follow up care after we go home.)
The Neonatologist explained the normal care for Gastro babies at Mac. He said when Baby is born he will wrap the intestines in gauze or plastic and insert a small sugar-water IV. After this I will be able to hold Baby for a few min before they go to the NICU unless there are urgent concerns. In the NICU the surgeon will examine the bowel and if it looks to be in good condition put it into a silo. (usually it is in the silo within 4 hours of birth) They will put in an IV line that leads to a major vein and start TPN within 24-48 hours, baby will also be on antibiotics until closure surgery at least. He said the bowels will slowly be pushed inside the abdomen from the silo over approximately 2-7 days (usually). Over the next 1-2 weeks they watch to see if the bowels are working. They are looking for no more bile coming out of the mouth/tube, listening for bowel sounds, and waiting for baby to poop. When they are sure the bowels are working and there are no blockages they can start tube feeding. they give 1-2 ml at a time to start, and if baby tolerates well they will slowly increase feeds and decrease TPN (usually this happens during weeks 4-6) When Baby is nearing full feeds they will allow nursing. After Baby is able to nurse or drink from a bottle and is growing We will be ready to go home. (Usually around 6-8 weeks)
He has seen this process go very quickly before, and sent babies home after 3 weeks, but says that is rare. If there are complications at any stage things will take longer. Some of the complications he mentioned include infections, a bowel obstruction or kink, or "Short Gut" These issues happen in about 10% of Gastro cases, and can be very serious. Short Gut comes in two varieties; functional short gut and physical short gut. In the case of functional short gut the entire intestine is there, but it is not absorbing nutrients well. this is from damage in the amniotic fluid and can often be predicted by ultrasound. In physical short gut the bowel is actually short because pieces of it died or were so badly damaged they had to be removed surgically at some point. Both Short Gut syndromes act the same way, leading to malabsorption, poor growth, special medications, longer hospital stays, and long-term TPN use leading to liver dsyfunction/failure.
Please pray that things continue to go well.
We are thankful to have made it to 29 weeks with no sign of labor, please pray that continues- It would be Ideal for Baby to be born at 37 weeks.
We are also thankful for good growth with no signs of damage, please pray this also continues.
Please also pray that everything goes well after Baby's birth, that we do not experience infection, bowel obstructions or either form of Short Gut. Please pray for strength for the rest of our family; it will be a stressful and very busy time for us.
Psalm 33: 20-22
We wait in hope for the Lord;
he is our help and our shield.
21 In him our hearts rejoice,
for we trust in his holy name.
22 May your unfailing love be with us, Lord,
even as we put our hope in you.
I had another Ultrasound and OB clinic visit today, and then met one of the Neonatologists. At the Clinic they said things are still looking great. Thankfully there is no sign of damage or swelling in the intestines. The Baby's growth is following its percentile curve and looks good. (about 30th percentile meaning Baby is bigger then 30% of babies for gestational age) They estimate Baby's weight to be 2 lbs 4oz. today. These are all blessings, things could be looking much worse at this stage. They also told me they see about 10-14 cases of gastroschisis at McMaster each year.
The Neonatologist is the Dr who will provide day-to-day care in the NICU. They work as a team, so we will see one for two weeks, then a new one for two weeks ect. (Next week I will meet with a pediatric surgeon; Baby will have one primary surgeon from birth through the entire hospital stay, and for follow up care after we go home.)
The Neonatologist explained the normal care for Gastro babies at Mac. He said when Baby is born he will wrap the intestines in gauze or plastic and insert a small sugar-water IV. After this I will be able to hold Baby for a few min before they go to the NICU unless there are urgent concerns. In the NICU the surgeon will examine the bowel and if it looks to be in good condition put it into a silo. (usually it is in the silo within 4 hours of birth) They will put in an IV line that leads to a major vein and start TPN within 24-48 hours, baby will also be on antibiotics until closure surgery at least. He said the bowels will slowly be pushed inside the abdomen from the silo over approximately 2-7 days (usually). Over the next 1-2 weeks they watch to see if the bowels are working. They are looking for no more bile coming out of the mouth/tube, listening for bowel sounds, and waiting for baby to poop. When they are sure the bowels are working and there are no blockages they can start tube feeding. they give 1-2 ml at a time to start, and if baby tolerates well they will slowly increase feeds and decrease TPN (usually this happens during weeks 4-6) When Baby is nearing full feeds they will allow nursing. After Baby is able to nurse or drink from a bottle and is growing We will be ready to go home. (Usually around 6-8 weeks)
He has seen this process go very quickly before, and sent babies home after 3 weeks, but says that is rare. If there are complications at any stage things will take longer. Some of the complications he mentioned include infections, a bowel obstruction or kink, or "Short Gut" These issues happen in about 10% of Gastro cases, and can be very serious. Short Gut comes in two varieties; functional short gut and physical short gut. In the case of functional short gut the entire intestine is there, but it is not absorbing nutrients well. this is from damage in the amniotic fluid and can often be predicted by ultrasound. In physical short gut the bowel is actually short because pieces of it died or were so badly damaged they had to be removed surgically at some point. Both Short Gut syndromes act the same way, leading to malabsorption, poor growth, special medications, longer hospital stays, and long-term TPN use leading to liver dsyfunction/failure.
Please pray that things continue to go well.
We are thankful to have made it to 29 weeks with no sign of labor, please pray that continues- It would be Ideal for Baby to be born at 37 weeks.
We are also thankful for good growth with no signs of damage, please pray this also continues.
Please also pray that everything goes well after Baby's birth, that we do not experience infection, bowel obstructions or either form of Short Gut. Please pray for strength for the rest of our family; it will be a stressful and very busy time for us.
Psalm 33: 20-22
We wait in hope for the Lord;
he is our help and our shield.
21 In him our hearts rejoice,
for we trust in his holy name.
22 May your unfailing love be with us, Lord,
even as we put our hope in you.
Sunday, 11 August 2013
Aug 6- Ultrasound and Mac Visit
I had an Ultrasound Aug 6 and everything looks good. So far there is no damage to the intestines showing, although it sounds like they don't expect damage yet. Baby is growing well and measuring where he/she should be for dates (I was 26 weeks) They estimate weight to be around 1 lb, 9 oz right now. According to the ultrasound there is no signs of labor yet.
We met the Dr who will be following the pregnancy. She says they will probably induce between 36-37 weeks because the lungs are developed by then, but they want to prevent as much of the late pregnancy damage as possible. This means our baby will be born mid to late October, if Baby doesn't decide to come sooner on its own.
Many of you have asked how I'm doing, and really for now I'm OK. I had a hard time when we first got the diagnosis, but we have come to accept it (Dennis much quicker then I did). I know that this is the Lords will, and He has a plan for good in this as well. This child is His first, and He loves Baby even more then I do. Everything is in his Fatherly hand, He Cares, for this baby, and for our family. There is nothing I can do for Baby right now, so I am enjoying the summer with my family. Our wedding text has been bringing comfort these last few weeks, It was Psalm 121, with the focus then on the last verse, which the minister (uncle Matt) described as a summery of the entire psalm:
We met the Dr who will be following the pregnancy. She says they will probably induce between 36-37 weeks because the lungs are developed by then, but they want to prevent as much of the late pregnancy damage as possible. This means our baby will be born mid to late October, if Baby doesn't decide to come sooner on its own.
Many of you have asked how I'm doing, and really for now I'm OK. I had a hard time when we first got the diagnosis, but we have come to accept it (Dennis much quicker then I did). I know that this is the Lords will, and He has a plan for good in this as well. This child is His first, and He loves Baby even more then I do. Everything is in his Fatherly hand, He Cares, for this baby, and for our family. There is nothing I can do for Baby right now, so I am enjoying the summer with my family. Our wedding text has been bringing comfort these last few weeks, It was Psalm 121, with the focus then on the last verse, which the minister (uncle Matt) described as a summery of the entire psalm:
Psalm 121
A song of ascents.
1 I lift up my eyes to the mountains –
where does my help come from?
2 My help comes from the Lord,
the Maker of heaven and earth.
where does my help come from?
2 My help comes from the Lord,
the Maker of heaven and earth.
3 He will not let your foot slip –
he who watches over you will not slumber;
4 indeed, he who watches over Israel
will neither slumber nor sleep.
he who watches over you will not slumber;
4 indeed, he who watches over Israel
will neither slumber nor sleep.
5 The Lord watches over you –
the Lord is your shade at your right hand;
6 the sun will not harm you by day,
nor the moon by night.
the Lord is your shade at your right hand;
6 the sun will not harm you by day,
nor the moon by night.
7 The Lord will keep you from all harm –
he will watch over your life;
8 the Lord will watch over your coming and going
both now and for evermore.
he will watch over your life;
8 the Lord will watch over your coming and going
both now and for evermore.
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