Baby Abe In Utero

Week 20

Sent May 17, 2011

Joel and I got some unexpected news at our ultrasound yesterday. Our baby has a diaphragmatic hernia, so the stomach and part of the intestines have moved up into the chest cavity, pushing the heart over to the right side, which will hinder lung development. We’ll likely have more frequent appointments in Sioux Falls to monitor things, and if this is occurring in isolation (not part of a syndrome or chromosomal disorder), the baby will have surgery right after birth to correct this and spend time in the NICU to develop healthy lungs. Right now there are no other indicators of a syndrome (baby is 86th percentile for size, has 5 digits on each limb), but the perinatologist was going to keep an eye on the ventricles because they were on the “generous” side. There are lots of unknowns and really nothing that can be done until the baby is born, as far as we know. We covet your prayers for the LORD to work a miracle in our baby’s life and for us as we make decisions and trust in the LORD. We’re only 20 weeks, so this baby has a long way to go, but that’s more time for things to change, too. It’s not expected that they will, but we know our God can do anything. We just have to trust Him no matter what He does. Thank you for your love and your prayers.

In Christ,
Joel & Holly

Week 25

Sent June 22, 2011

Dear friends and family,

We had another check-up at the hospital in Sioux Falls yesterday, and overall got good reports! Here’s a run-down of what we learned:

Dr. Sami (pediatric cardiologist) – fetal echocardiogram to check the heart – everything looked normal (structure and function). We’ll see him again in 2 months to check again.

Dr. Wahl (perinatologist) – another ultrasound – nothing changed (this is good because that means the liver didn’t move up which would crowd the heart and lungs even more). They do a ratio of lung area to head circumference, and greater than 1.4 is a good thing. Our baby was 1.9. Yay! Our baby is growing....he/she is now 93rd percentile for size (weighing in at 2 lb, 1 oz). Another ultrasound in a month.

Dr. Bufo (pediatric surgeon) – We didn’t have an appointment with him, but he took the time to meet with us anyway. We got a lot of information from him. He explained that he won’t do surgery until the baby is stabilized, which could be 2–8 days. He said that survival for babies with diaphragmatic hernias is 50%. We didn’t ask specifically, but we’re assuming that since our baby doesn’t seem to have any other issues going on that our chances of bringing him/her home will be greater than that. He told us about a treatment option called ECMO (the blood is artificially oxygenated and put back into the baby’s body) which can increase survival to 60% but also has a 10% risk of stroke/neurological problems. If we would choose that option, we’d have to go to Minneapolis or Omaha. Anticipated time in the NICU would be at least 1 month. He also told us that he’d prefer a natural delivery because that would naturally squeeze the amniotic fluid out of the lungs. That was a surprise for us! There’s a potential for pre-term delivery since I’ll likely have extra fluid because the baby won’t be swallowing as much because of his/her small lungs.

Lisa (midwife) – The normal part of our day at the hospital.

Tour of the NICU – A reality check. So many little tiny babies hooked up to big machines! The nurse who gave us the tour showed us the ventilator and oscillator that our baby will most likely be on, and explained that he/she will get nutrition thru an IV (via the belly button) until he/she’s ready to start learning how to suck and swallow. The nurse has worked with 10–12 babies with diaphragmatic hernias, and she said 8–10 went home. I liked her stats better than Dr. Bufo’s. Joel and I would have a room in the NICU where we can stay, and we can go in and out as we please except for the 2x/day they change shifts and give reports. There are 5 neonatologists on staff plus several neonatal nurse practioners who would all be involved in our baby’s care (we’ll probably meet with one at our next appointment). Initially our baby would have his/her own nurse.

An overall theme that we heard from everyone we met with was that so much depends on how the baby does after he/she is born. They really can’t predict how each individual baby will handle all the stresses. Our next big appointment is July 18th.

So with all our new information, we are praying for specific things:

• For God to work a miracle in our baby’s body and heal the hernia completely.
• Strong and healthy lungs for our baby. Even if they’re smaller than they should be, they can still do their job well.
• Full-term delivery
• Wisdom for Joel and me as we make decisions (treatments, insurance, etc.)
• That the liver would stay put and not move up
• That the heart would continue to grow and function as it should
• No other complications
• That our baby would learn how to suck and swallow quickly
• Continued trust and faith in our LORD

I went to my ladies’ prayer group tonight to pray for people we’d made quilts for as we tied the quilts. The 3rd quilt we prayed over tonight was for Joel and me! What a tremendous blessing to know that we have so many faithful prayer warriors. The quilt is beautiful (and gender-neutral!) We are so thankful for God’s faithfulness and blessings. And we are thankful to all of you for your prayers.

In Christ,
Joel & Holly

Week 29

Sent July 18, 2011

Hi again, everyone,

We had another ultrasound today and nothing’s really changed except that the baby’s gotten bigger (3#, 6 oz, 80th percentile for size). The lung area to head circumference ratio was 1.7 this time (>1.4 is good). The amount of my amniotic fluid also looked good (it’s possible that I’ll have more fluid than normal which could lead to pre-term delivery).

We were also able to meet with a neonatologist (another impromptu appointment) this afternoon. The neonatologists and nurse practitioners will be the ones taking care of our baby in the NICU. Dr. Soares reiterated that it’s impossible to predict how our baby will do, and that we just have to wait to see how our baby’s lungs are able to function. He said the quality of the lungs (how well they do their job) is more important than even their size. He’s worked with about 12 other babies who have had diaphragmatic hernias and he said all but 1 went home. Our baby will have a central line of some sort for medicines and nutrition. Infection will be a risk. He also talked a little bit more about the feeding and gastrointestinal issues that we’ll likely encounter. Sucking will be a challenge and the stomach may have to “learn” how to move food through so our baby may experience quite a bit of reflux and throwing up. There will be lots of medical people in the room when our baby is born (midwife, OB, OB nurse, neonatologist, neonatal nurse practitioner, neonatal nurse, respiratory therapist, etc.) Dr. Soares indicated that he felt prognosis for babies with diaphragmatic hernias is probably better than 50% but was quick to say you never know what can happen. His best-case-scenario was a 3-week NICU stay, but said 3–4 months is a possibility, too.

We’ll have another ultrasound and fetal echocardiogram on August 10. I’ve been feeling great throughout the pregnancy which is a huge blessing. Today we got to see our baby playing with his/her toes. We’re praising the LORD for another good report!

Here are a few specific things we’re praying for:

• complete healing of the diaphragmatic hernia
• that our baby’s lungs function well on their own so minimal support is needed from ventilators
• full-term delivery
• that our baby’s heart will continue to develop and function normally
• labor and delivery without complications so our baby has the best start to life
• our baby to learn feeding and digestion quickly
• wisdom as we continue to make decisions
• that God would be glorified through us and through our baby

Thank you for your continued prayers and words of encouragement. We’re so grateful for the wonderful support we have from all of you. We’re cautiously optimistic, and we know it’ll be a roller coaster ride, but ultimately we trust that our baby is in God’s hands, which is the best place for him/her to be.

In Christ,
Joel & Holly

Week 32

Sent August 11, 2011

Hello again,

We had another full day at the hospital. The ultrasound showed that nothing’s changed as far as they can tell. I still have a normal amount of fluid, which is good. Baby Molascon is measuring 5#, 4oz, putting him/her at the 95th percentile for size. Dr. Wahl says our baby has long limbs, and we’re trying to figure out where they’re coming from! Since Baby is so big, I did another glucose screen to check for gestational diabetes, and I was borderline this time. So to be on the safe side, I’m going to be watching (and documenting, at least for a while) what I eat and checking my blood sugar 4x/day. Good thing there are only 8 weeks left! We also had another fetal echocardiogram done, and the heart still looks good! Praise the Lord! For some reason I was more apprehensive about that test than the ultrasounds. Dr. Sami said that he doesn’t see anything wrong, but ultrasounds can’t catch everything. He said if there is a problem, it would be minor, and we’ll deal with it after the baby’s born. We also met with our midwife (and the midwife who will be covering her maternity leave). Our next appointment is August 26th where we’ll do a BPP test (I think it stands for bio-physical performance – an ultrasound to check fluid, tone, movement, etc.). Then it sounds like we’ll have the BPP done weekly.

Things to pray for:

• Complete healing of the hernia
• Praise that our baby’s heart looks good!
• Good, strong lung function so that our baby won’t need much (or any!) support from ventilators
• Labor and delivery without complications
• Feeding and digestion to be learned quickly and without complications
• My attitude about the gestational diabetes component....I’m not excited about all the documenting and precise timing of everything (or limiting my juice intake)
• Continued wisdom for Joel and me as we make decisions and prepare for the unexpected
• God to be glorified through our baby and through us

Thank you for journeying with us through this situation. We appreciate your prayers and support more than you know. Even though there are times we wish we were the ones in control, we trust that our great God has a purpose for all this.

In Christ,
Joel & Holly

Week 34

Sent August 28, 2011

Good morning!

We spent another full day at Avera in Sioux Falls on Friday, and got more good reports! Baby passed the BPP (Biophysical Profile) ultrasound. They check for fluid, movement, tone, and breathing via ultrasound, and if any of those are abnormal they do a non-stress test. Baby scored 8/8 on the first 4 areas, so we didn’t have to do the non-stress test. When Dr. Wahl came into the room, she said “Oh, we have a happy baby!” and gave an “excellent” report. She seems pretty optimistic. We met with our midwife again and then with the diabetes team. Mostly they were looking at my food records and how they affected my blood sugars, and it was hard for them to find a pattern, too. One bedtime snack that’s worked well for me is ice cream w/ melted peanut butter....she told me to have more of that, so I’ll have to follow that rule carefully. We’ll have the BPP done weekly now.

We also had some fun celebrating our 2nd anniversary (a few weeks late). We went to a drive-in movie then stayed in Sioux Falls and ran some more errands on Saturday, getting a few more things for Baby. We’re getting close....only about 5 weeks left!

Please continue praying for all of us:

• Praise God for more good reports!
• Complete healing of the hernia
• Labor and delivery without complications
• Healthy lungs and heart for our baby, and that no ventilator support (or very little) will be needed
• Baby Molascon to stabilize quickly and for a successful surgery
• Quick recovery after surgery
• Feeding and swallowing to be learned quickly and for no reflux
• A short NICU stay (I’d love to have our whole family at home by my birthday on Nov. 3)
• Final preparations at home
• Wisdom for decisions that will need to be made
• Peace that passes understanding
• Glory to be given to God through our family

Once again, we thank you so much for your prayers and encouragement. We don’t know what God has in store for us, but we trust Him and praise Him for the ways He’s already shown His faithfulness. Have a great week!

In Christ,
Joel & Holly

Week 35

Sent September 4, 2011

Hello again!

We had another check-up on Friday in Sioux Falls, and everything continues to look good! Baby measured 6#, 4 oz, putting him/her at the 68th percentile (Ultimately, we want Baby to be >10th and <90th percentile). Dr. Wahl mentioned that there can be a 20% variance w/ ultrasound measurements, so they give us an idea but aren’t 100% accurate. Baby passed the BPP again without needing the non-stress test. My fluid levels are still normal, which is great! Both Dr. Wahl and our midwife said that if the baby came early, they wouldn’t try to stop labor. We’re still praying for full-term, but we’re past the critical stage at least. Praise the Lord! The dietician at the diabetes center is in awe that ice cream w/ peanut butter is still working for me, and she said that I’m not like a typical gestational diabetic....I took that as a compliment. The carb-counting is wearing on me though...I had a dream (nightmare?) a couple nights ago that I was at a church social event with all sorts of desserts available, and I could only have half a piece of one of them. It was torture! Just a little over 4 weeks left...

We’re enjoying LifeLight this weekend w/ my mom and Hunter here. Hunter even swept and washed the kitchen & dining room floors for me! We’re hoping to utilize his brawn before they leave to help move some of the furniture as we re-arrange to accommodate for baby things.

Our prayer list hasn’t changed much, but we appreciate your faithfulness in continuing to pray for all 3 of us.

• Praise God for continued good reports, a slowed growth rate, and my better attitude about the gestational diabetes regimen
• Complete healing of the hernia before birth
• Labor and delivery without complications or setbacks (and minimal pain :)
• Healthy lungs and heart for our baby, and that little to no ventilator support will be needed
• Baby Molascon to stabilize quickly after birth and for a successful surgery to repair the hernia
• Quick recovery after surgery – no infections, no hypertension or swelling (especially in the lungs)
• Feeding and swallowing to be learned quickly and for no reflux
• A short NICU stay (I’d love to have our whole family at home by my birthday on Nov. 3) and that a room would be available for us to stay at the hospital
• Preparedness for us to be parents
• Wisdom for decisions that will need to be made
• Peace that passes understanding
• Glory to be given to God through our family

We’re so thankful for your friendship and prayers. We are blessed to have such an incredible support system of family and friends!

In Christ,
Joel & Holly

Week 36

Sent September 10, 2011

Good evening!

All our appointments yesterday in Sioux Falls went well. Baby passed the BPP again (8/8). I asked Dr. Wahl if there’s anything that could be better, and she said there really isn’t....everything looks good. I don’t have extra fluid, Baby’s moving and growing, and my blood sugars have been where they’re supposed to. With our midwife, my measurements are on track and baby’s heart rate is normal. The dietician continues to be impressed that I’m managing my blood sugars w/ diet. All in all, it was a good day with more good reports! Praise the Lord!

Please continue praying with us:

• Praise for more good reports!
• Complete healing of the hernia (In faith, I have newborn outfits packed in our hospital bag, just in case)
• Labor and delivery without complications (and high pain tolerance for me, or just minimal pain)
• Wisdom for the doctors and nurses who will be working with our baby, and for us as we make decisions
• A room to be available at the hospital for Joel and me to stay, and for a short NICU stay for Baby
• Baby will stabilize quickly (with minimal support from ventilators) to be able to have the surgery as soon as possible
• Successful surgery without complications or infection and a quick, complete recovery (and for Dr. Bufo, the surgeon)
• Baby to come in God’s perfect timing (I’ll be 37 weeks on Monday)
• Breastfeeding, swallowing, and digestion to be learned quickly
• That we’d be witnesses of God’s love and faithfulness, and that we continue to feel His peace
• Choosing names....it’s getting to be crunch time!

Once again, we thank each of you for your prayers, love, and support. It really makes a big difference knowing there are so many who are with us on this journey, every step of the way. We are so blessed.

In Christ,
Joel & Holly

Week 37

Sent September 15, 2011

Good evening!

We had another check-up today, and Baby continues to look good! Baby passed the BPP w/ a score of 8/8 again. My fluid was a little more than last time, but nothing that Dr. Wahl is concerned about. She mentioned the possibility of induction between 38–39 weeks, but she said we’d talk more about it next week at our appointment. She’s hoping that my labor will be natural and we won’t have to induce. I asked her what the biggest concern will be for Baby after he/she is born, and she said lung function – if there will be enough lungs to sustain the baby. My blood sugars continue to be in range. I tested positive for the Group B Strep culture (it’s not an active infection), which means I’ll be given antibiotic during labor so it’s not passed on to Baby. It’s uncommon that it is, but it’s standard procedure for women who test positive during pregnancy. It was frustrating for me to find out I was positive because only about 20% of pregnant women are positive and it’s just 1 more thing to worry pray about. We were able to tour the Labor & Delivery part of the hospital and the postpartum area. It worked out well because during the tour we ran into some NICU nurses and the lactation consultant who answered some questions we had.

We covet your prayers for Baby Molascon and for us:

• Praise for another round of good reports!
• Complete healing of the hernia before birth
• Supernatural amount of lung tissue and ability of Baby’s lungs to function well without ventilators or with the minimum level
• Perfect timing of Baby’s arrival, and that he/she would come naturally and not have to be induced
• Labor and delivery without complications and that’s short with minimal pain (It can’t hurt to ask, right? ;))
• That the Group B Strep infection wouldn’t be passed on to Baby (I think it can cause respiratory problems, which we really don’t want)
• Successful surgery and a quick, complete recovery
• A short NICU stay – no complications/infections, learning to breastfeed/swallow/digest quickly
• All the doctors, nurses, midwives, and specialists working with us
• For God to be glorified through us and through our baby’s life

Thank you for supporting us and especially for praying for us on this unexpected road. We’re so grateful for each of you. We continue to trust the LORD and rely on His strength.

In Christ,
Joel & Holly

Contractions

Recorded September 23, 2011

These are the times recorded for contractions before we arrived at Avera McKennan hospital in Sioux Falls, SD.

1. 2:01 AM
2. 2:07 AM, 2:08 AM
3. 2:12 AM, 2:13 AM
4. 2:16 AM, 2:18 AM
5. 2:20 AM, 2:21 AM
6. 2:23 AM, 2:24 AM
7. 2:26 AM, 2:27 AM
8. 2:31 AM
9. 2:35 AM, 2:36 AM
10. 2:39 AM
11. 2:45 AM
12. 2:50 AM, 2:51 AM
13. 2:55 AM, 2:56 AM
14. 3:00 AM, 3:01 AM
15. 3:04 AM, 3:05 AM
16. 3:09 AM, 3:10 AM
17. 3:14 AM, 3:14 AM
18. 3:18 AM, 3:19 AM
19. 3:23 AM, 3:24 AM
20. 3:28 AM, 3:29 AM
21. 3:32 AM, 3:33 AM