Day 2

Man, this kid is going to run me ragged. This has been quite honestly the toughest, hardest day of my entire life and I've only been a dad for 48 hours. At this rate I'll be bald by one week! Here's the low down....

So this morning at about 7 am, after getting my first real sleep in 2 days, I woke up and went in to check on my little warrior. They said that during the night he took some steps back, suffering some cardiac problems and congestion. They changed his medication and put him on a stronger antibiotic to combat the infection. They said that he hemorrhaging had completely stopped and he was doing better, but that he wasn't progressing. His oxygen saturation was at 80-86%, when it should be up to 90-95%. His blood pressure was faltering some and so they put him on dopamine to help his heart. They said that his heart was fatigued due to the load it was bearing and that it needed to have some help. Apparently during infections like this, the heart overcompensates to help out, and his got tired and wasn't providing good oxygen.

Later in the morning Lisa and I both went and Kai didn't look so hot. His color had deteriorated because of the lowered oxygen levels and they mentioned the need to put him on a high frequency ventilator. They were trying to get one relocated to the hospital to help him out, just in case it was needed. We left the NICU a little broken seeing Kai struggling and praying for improvement.

At this point in the day, I needed a break. There is only so much stress and complication that one brain can handle, and mine had reached it's saturation point. At the urging approval of my wife, I escaped for some much needed "me" time (which sounds incredibly selfish considering the situation). I went and changed clothes, got some food, and went to run an errand at the Post Office before heading back. In the process of licking stamps for some envelopes I get a frantic call from my wife telling me to rush back because they needed to transfer Kai.

I flew from the Post Office lickity split (no pun intended) and made it to the hospital in no time. I rushed to the Nursery to speak with the pediatrician. The situation was that Kai was not improving and they were at their limit with the equipment available in this hospital. He needed the high frequency machine and needed it now. Cultural Clarification Moment: our hospital is a private hospital and one of the nicest facilities in El Salvador, however it is not government run. Government funds go to State hospitals and therefore they have the best equipment.

Back to the story now. His oxygen levels weren't great, his blood pressure was ok, but his chances were not good on a regular machine alone. Plus, since the ventilator was running at high capacity it was putting a lot of pressure on his lungs, which could cause a rupture in his lungs. He needed the high frequency machine, which keep all his passageways and air sac completely open, providing maximum oxygen flow without all the pressure on his little lungs. If he stayed in our hospital, his chances of survival were very low. He would deteriorate and possibly die. The option was to transport him across town to a children's hospital (government run) where they had this machine waiting. As it is, there was only 1 machine of this caliber in the country for rent and it was being used elsewhere. So, the only option was to go to the state hospital and use theirs. The risk was this: to move him they had to remove him from the ventilator and run a hand pump until we arrived. He could deteriorate and possibly die in transit because he was very delicate and critical. Cultural Clarification Moment: El Salvador is not known for giving right of way to emergency vehicles and it was rush hour.

I broke down. No ifs, ands, or buts about it, I simply lost control. What parent of less than 48 hours should ever have to make such a difficult decision? Life and death literally in the balance, teetering on my decision. After composing myself, I went back to Lisa to explain and she lost it. Was this some sort of bad joke? As if Day 1 wasn't hard enough, now our very decision could cost the life of our child!

There really was no choice in the matter. Stay here and die. Move him and live, with the great risk of death in transit. With the scales of life teetering precariously, Kai was prepped, the ambulance readied, phone calls made, and poor mama left with friends to console her. I jumped into the back of the ambulance with the pediatrician, neonatologist, 2 nurses, the ambulance staff, and the all the equipment, and headed out on our adventure across town through the worst possibly traffic (Friday night mind you!). Just as we leave the hospital, we come to a halt in the middle of the road and just sit there. We asked the driver the situation and he said we had broken down. They had to call another ambulance to come and take us. WHAT!!! Are you kidding me? What kind of Archie Bunker operation are we running?

A few minutes later, as I sit there on the verge of cussing (I'm a Christian and missionary, but at this moment I almost lost it all!), I hear the wail of sirens as our new chariot approached. We quickly unload and reload Kai, neonatologist pumping his little lungs without fail. Off we go, in our brand new, dented up little ambulance, weaving in and out of traffic, lights flashing, sirens and horn blaring. In what should have taken over an hour to accomplish due to conditions, we miraculously arrived at the children's hospital in about 20 minutes. Kai stayed completely stable the entire ride and his oxygen levels actually increased in transit. I think possibly he just got cabin fever and wanted some fresh air!

We rush him inside the hospital, me holding the heart rate monitor on top of the incubator as we all maneuver through the corridors. Upon arrival in the NICU ward, Kai is rushed to the Promised Land where our wonderful machine awaited him. As I took care of the admission papers, the medical staff worked to remove him from his current incubator and transport him to the new one, attaching all the appropriate hoses and such to the new machine.

Literally within minutes of arriving, Kai was hooked up, the machine firing on all cylinders, and already improving. The neonatologist came out and was more optimistic than she has been in the the last 48 hours. She would have done cartwheels if we weren't in an emergency ward. He was stable and doing much better on the new machine.

I was allowed to see him after washing what seemed like every square inch of exposed flesh and putting on a "long sleeve" smock, which for me was more like a three quarter sleeve baseball shirt. Cautiously and anxiously I moved into his room. Kai looked a hundred times better. It was a completely different kid from just minute earlier. His color was restored, his oxygen levels were 92-95%, blood pressure stable, heart rate perfect, and daddy sighed the greatest sigh of relief ever since the creation of the world. I sheepishly asked the doctor, "This may sound stupid, but can I kiss him?" "You can kiss him all you want," was his confident reply. And kiss I did!

I returned home after our little adventure to be with Lisa. Kai is doing much better and happier on his new machine. Lisa is jealous, but she will get her chance soon. He is my little warrior and is fighting like crazy. We love him so much and would do anything for him. But I'm praying this is the last of our adventures with him until later. I'm ready for some boring, nothing exciting happens but us holding him, kissing him, and changing diapers. Looking forward to good things tomorrow morning!

Day 1 - continued

Time for another lengthy report of what is going on in the world of the Sears'. Here goes....

Not too long ago the OBGYN, Pediatrician and Neonatologist came in to talk to us about Lisa and Kai. First, Lisa is doing good. They changed her bandage and cleaned her up and it all looks good. No major bleeding such and they are going to get her up tonight and give the opportunity to go see Kai for the first time.

With regards to Kai there is quite a bit to say. First, they got back another x-ray and the lungs look even better. They said that he has progressed better than they expected and looks good, although there is still a ways to go. Second, he urinated a good amount, an adequate amount according to his age, so his kidneys are working great. Third, a cardiologist came in and checked out his heart to make sure there was nothing wrong. The heart checked out perfect and so they are one by one checking off the various symptoms. They put a catheter in so as to more easily take blood samples and administer medication. Fourth, they did a transfusion of plasma and platelets and both went well. They are going to check later to see if they need to transfer red cells as well. They hadn't stopped the hemorrhaging in the lungs, but after administering the platelets they have controlled it. The amount of blood that was coming back through the respiratory tube has diminished by 60% and so they have the hemorrhage controlled and that means the platelets are doing their job perfectly. Tomorrow morning they will check his levels to make sure he is reproducing his own and the levels are good. Fifth, they are doing an ultrasound of the brain to make sure that the cerebral function is good and there aren't any lesions or hemorrhaging in the brain. They said that clinically speaking he looks great and doesn't show any signs of brain damage or bleeding, but they want to be 100% certain. He is active and fidgety, they called him a fighter. They said he is fighting and working at recovery, so much so that they had to give him a mild sedative to settle him down so he doesn't mess the tubes up. That's my boy, a little wiggle wart! 

All said and done they told us he is completely stable, although still in the critical stage. He looks good, moves good, responds good, and is starting to get better with the lungs. Tomorrow they are going to take blood to test the levels and we are expecting the blood to have stopped completely. Once that happens the ventilator will help him remove or absorb the blood that is currently in his lungs. 

That's where we stand right now. God is so amazingly faithful and we are excited to see what tomorrow brings. This has been one roller coaster 24 hour period and we are hopefully expectant for the coming hours and days. Thank you for your continued prayers, I'll be in touch later. 

The toughest 24 hours....Jack Bauer has nothing on me!

Day 1 - The countdown suddenly turns the page and becomes real time. I guess it never really goes as you think it will, no matter how much you dream, plan, and think about it, you honestly have no idea what life will throw your way. Somehow I imagined that since this child was an absolute miracle, when it came time for his birth, no matter the circumstance, it would be a piece of cake and without any complications. But here I sit, in bewilderment, clinging to faith and a promise, kinda like Abraham and Sarah when Isaac was to be sacrificed, knowing that my God is faithful to complete His promises. Let me back up...

So, we came into the OB yesterday morning (yesterday being 9/28) for our appointment and Lisa hadn't been feeling super good. In fact, she lost 4 pounds since the last exam (not a good sign). The doc was worried for that and because the baby was out of room, but everything appeared fine. She said if he didn't come naturally by Friday that she would induce and get the process started. I think Kai heard our conversation and decided to show us all what for.

Lisa and I went to lunch and after lunch she started having really frequent Braxton-Hicks, strong and tight, but no pain. We saw a movie and afterwards they got more frequent and pain started to appear. Unsure if this was real or false labor, we loaded up the car at home and headed to the hospital to see what awaited us. They admitted her and put her on a fetal monitor to check the baby and the contractions. The baby's heart rate faltered during/after contractions, dropping to 90 or so bpm, when it should be 130-160. They said that they needed to do an emergency C-section to get him out and that we could wait, but the result would be the same since she was only 1 cm dilated. So, off they took Lisa into the OR to prep her and I got ready.

C-section, contrary to vaginal birth, is really a quick, fascinating process. It didn't gross me out and made life really easier on my end (no hours of standing, holding a hand like a vice grip saying, "Breath, Breath, BRea....DON'T BREAK ME!). I know that Lisa didn't want a C-section and I didn't want one either, but nature does what nature does and Kai needed out NOW!

So, out he comes in a gush of fluid and blood, crying for all the world to hear. Healthy and long, 6 lbs 3 oz, 19 inches. Well, we thought he was healthy. The pediatrician and I flew to the nursery to begin doing tests and checking the baby, all the normal newborn stuff. Kai seemed ok, but started having some respiration problems, which the doc attributed most likely to immature lungs (common for early children).

He put him in an incubator with oxygen to get him warmed up and going. The oxygen didn't do the job, so they added it in a hood (see above picture), and then decided to put the little nose thingy on him to get positive pressure in his lungs to keep them expanded, basically a baby CPAP.

After some time they noticed he was still struggling and getting tired when he breathed, so they did an x-ray and saw fluid in his lungs, common symptom of immature lung tissue. They said that the next step was to put a tracheal tube into his lungs to apply steroids of sorts to his lungs to enhance the growth and help him mature some. Here's where it got interesting. Upon getting the tubes ready to insert, they discovered hemorrhaging in his lungs (thus the fluid) and were able to get the tracheal tube in to provide airflow via respirator. In hindsight, they said that it is impossible to distinguish immature tissue and infection in the lungs like this, even to the most trained professional eye. Nurse friends of our confirmed this with us, so it wasn't smoke being blown you know where.

All of this happened in about 4-5 hours after being born, which put us in a state of shocked panic (at least for me). Note: if you haven't experienced something like this, seeing your little baby hooked up to tubes, monitors, machines, etc. is the most terrifying and humbling experience ever. Talk about helpless!

At 3 am they brought a respiratory therapist or specialist in to help with treatment. They told us that he essentially had 50% chance of living, that he had lost blood due to hemorrhaging, the the blood test showed extremely low levels of plasma, platelets, and white cells, and he was 100% dependent on the ventilator for breathing. ::::Sound of wind leaving out sails:::::

What do you do at that point? How do you respond in a situation like that? The only way we know how as Christians, we started bombarding Heaven with prayer. Within minutes, literally, prayer chains started around the world, through friends, family, contacts, missionaries, pastors, etc. This kid had thousands of people lifting him up to God for another miracle. Another side note: in my professional opinion, this is a direct spiritual attack. I don't see demons around every corner, but I recognize the work of that toothless lion when I see it. If he so desired to attack this baby, sending an aggressive infection to attack him, time to call out the big guns. I serve an Aggressive Healer who crushed that serpents head!

With prayers flying regularly toward Heaven, we waited. The x-rays at 3 am showed lungs covered in white, when they should show black on an x-ray. So we tried to rest and see what happened. NO news came for 4 hours. No news is good news, right? I'm never quite sure if it is No news? That's good news or Absolute no news is good news. Either way, the docs were silent.

At 7 am, with only about an hour or so of sleep in me, I rose to go to the nursery and check on my little angel. Lisa had not (and still hasn't) seen him because she is bed-ridden in recovery. Upon arrival in that room of perpetual infancy, the pediatrician greeted me with a better prognosis: Kai was stable, although critical, and the transfusion of platelets and plasma was on the way. He had more x-rays to show me, showing improvement, which he called "discreet improvement" so as not to sound too optimistic (I'm not sure why they do that). But even with my untrained, tear blurred, blood-shot eyes I could see that his lungs were starting to turn black on the edges and the white was disappearing.

With this positive news, I returned more hopeful to my wife and waited my next visit. At 10 am they started the transfusion and it was finished. At noon I stopped by and check on him again before running some errands. They said that he was starting to show signs of hypertension and had called a cardiologist to check his cardiac function and make sure it was all ok. They mentioned the possibility of putting in a catheter through a bigger artery to administer some medication more directly to the heart and lungs to help them get stronger, so that they could possibly start weaning him from the ventilator sooner.

And that brings me to right now, 3:00 pm on 9/29. We're lacking 4 hours and 44 minutes to the end of this first day, which if you watched any episode of 24 you know the most exciting part doesn't come until the second to last hour and there's still time to save the world 3 times over. So, mama sleeps while daddy keeps watch, waiting for more news on our little Kai.

I'm beginning to catch a glimpse of God's heart in this. In the last 20 hours of life, I have fallen more in love with the kid than I thought possible and I would do anything, ANYTHING to protect him. I see my child, ravaged by some infection threatening his existence, and I would give every drop of my blood to cleanse his system, gladly taking his disease into my own body and even dying if it meant he would live. I don't say that flippantly, but in all seriousness. I would give everything to see him healthy, whole, and living. How does that match God's love? The One who, seeing sin's deadly infection, eroding the heart and life of man, gave up His Son, His life, pouring out His blood, to cleanse our infected body. He took our sickness so that we could be healthy, whole, and living. Now I understand in a whole new way what it means to experience the love of a father, unconditional, willing to sacrifice everything for my cherished creation. Thank you Father for allowing me a glimpse into your heart!

36 weeks - the countdown begins!

 Final month and the fun really begins. I've decided that waiting for a baby is just as bad, if not worse, than waiting for Christmas, your birthday, or any vacation for that matter. The closer it gets, the slower that time seems to go. Right now I think time has converted into an 80 year old man with rheumatoid arthritis, a double hip replacement, and about 30 pounds of lead in his shorts. Each second seems like an eternity.

A week ago we finished the nursery, as Lisa is posing in front of the crib. You can see the pictures on Facebook. Everything is ready for him to come, the only thing missing is him! The crib is built, nursery painted, clothes put away, decorations up, closet organized, hospital bag packed, car seat installed, diapers ready, and just time to wait for Kai to make his grand appearance.

At 36 weeks now, Kai is gaining weight at about an ounce each day, but I personally think he is gaining more. According to our most recent ultrasound, Kai weighs 6 pounds 6 ounces and all his measurements he is about a week ahead of development still. Lisa has been having more frequent Braxton Hicks contractions and even had one in the OB visit. The doc saw it and she basically told us that he can come at any time. She was 40% effaced and about 1 cm dilated, with the baby in the perfect position and engaged, at least from what I understood. Essentially, the baby is ready and we're just waiting on him. The doc and most others think that he will come early and Lisa is praying that way.

Kai should be starting to shed that fine coating of hair (lanugo) that he's been sporting, as well as the vernix caseosa, a waxy substance that has protected his skin during this little trip in the fish bowl. He is swallowing both of these in the amniotic fluid, along with the other secretions, and these all mix together to become that wonderful substance I mentioned in the last post: meconium.

At 37 weeks Kai will be considered full term. Last night Lisa didn't sleep at all because she was having BH contractions (Braxton Hicks) all night at intervals of 5-20 minutes apart. This could either be early labor or false labor. We are hoping for the former and not the latter. After last night, Lisa I think officially issued the eviction notice to her little tenant and is ready for him to move to a bigger location, namely the nursery. It's all over now, except the waiting. Jesus, please have mercy on my wife and give her relief from this 9-months of torturous blessing! Thank you for the miracle, but please make him come soon!

Week 35 - So close and yet so far!

Kai is now officially too big for the uterus. Lisa feels like she is about to explode any minute now and all day long is just uncomfortable. Kai is out of room in the womb and it's obvious he agrees. He thrashes and moves all the time, like someone who just can't get in a good position.

According to Baby Center, he is just over 18 inches long and weighs around 5.5 pounds or so, about the size of a honeydew melon. His physical development is basically complete, aside from the remaining development of his lungs, and all he does now is take up room and put on weight. His kidneys are fully developed and functional and his liver can now process some waste products, which will turn into a wonderful tar-like substance called meconium, something I'll have to deal with according to Lisa...her first present to me as a daddy. YAH!!

It's rather obvious now where Kai is at all times, as he has no room for hiding because he doesn't fit anywhere anymore. It's really funny when he gets the hiccups (a bout that usually lasts for 20 minutes or so) because Lisa's whole belly will just bounce rhythmically as he hiccups. So cute! There are no more somersaults or spins, just stretching and kicking as he attempts to make more room in his one room little apartment. Lisa started threatening him with an eviction recently. I think she is about done with pregnancy! Only 5 weeks to go now!

Week 34 - Our little Cantaloupe!

Ok, according to Baby Center, Kai should now be about 4 3/4 pounds, the size of a cantaloupe, and roughly 18 inches long; however, Kai isn't following the "standard." We did another 4D ultrasound and the doc says that Kai weighs about 5 pounds 9 ounces, so he is running ahead of schedule. Actually, according to all his measurements, he is about 5-7 days ahead of development and the estimated delivery date by his size is October 14th. We are actually hoping for a little sooner than that, but we'll see. His fat layers are rounding out, which will help control his body temperature after birth. He is definitely getting little chubbier. On the ultrasound you could barely see much because he is so cramped, but we got a good look at his chubby cheeks and he has definitely put on weight.

Kai also dropped in the past week or so and is sitting very low. We have another appointment in 2 weeks and from there it is every single week. The doc says that he is in position early, head down, face to the back, and ready to go. Lisa hasn't started dilating yet, but apparently as soon as the baby drops dilation is soon to follow, so we'll see what happens in the next few weeks. Lisa officially started writing an eviction notice for Kai and is ready to kick this tenant out of her womb. She is generally uncomfortable all day long, can't sit, lay, lean, or sleep for any period of time. I've never seen my wife so fidgety! Well, only 5 1/2 more weeks to go, babe. Time is flying and the clock is ticking. CAN'T WAIT!!!

Week 33 - getting closer and daddy is getting nervous!

A change of backgrounds. We are currently in the process of moving houses and living in a temporary apartment at the lake camp while the house we will be living in is vacated. We will be moving into a fellow missionaries house while they are on itineration but they don't leave for another 2 weeks and we had to leave our apartment because the contract was up. That's why I haven't been Johnny on the spot with the posts. We don't have internet currently so I can't really upload pictures and such if I don't have internet.

Anyway, enough excuses. Kai is now 33 weeks old and getting bigger by the day. I'm now at the point of pulling my hair out and stressing occasionally. Every time I leave the house without Lisa, I always make sure that my phone is on me and that I know the quickest route back home and to the hospital. This whole waiting and not knowing the day or the hour thing drives me crazy. Maybe pregnancy is a good illustration for the Rapture...no man knows the day or the hour, but the Father knows. Cheesy pastor-type comment number 1.

The baby now weighs 4 pounds, about the weight of a pineapple, and he is over 17 inches long. These are all the estimates given by baby center, not the exact ones for Kai. His skeleton is starting to harden more and more, although I'm convinced that all children are made of rubber until they are 2 years old. His skin is also smoothing out as he gains weight and fattens up for life on the outside of the fishbowl. His bones won't fuse together until much later. He needs this rubbery quality to exit the birth canal. I actually think that the real "miracle" of birth is the actual exodus from the womb. How does a baby that big fit through an opening that small? Wow!

Anyway, all our preparations for the baby are on hold as we wait to be able to move into our house. All our stuff is crammed into one room at their house until we move in. We are just praying that he doesn't come right now, at least until we can get in, unpack, build the crib, and paint the nursery. Then he is welcome to come!

Week 32

So, for week 32, Kai weighs 3.75 pounds (about the size of a large jicama). Not exactly sure what a jicama is, so check at your local grocer's produce section for a comparison. =) He also is roughly 16.7 inches long and continuing to grow. He is quickly running out of room in the womb, which we notice by the fact that now his little feet extend all the way up into Lisa's rib cage. He regularly plays xylophone on her ribs and punches on her hips bones. I can only imagine what that must feel like, but from the reactions I get from Lisa, I don't think I want to know.

He now has toenails, fingernails, and real hair (something that daddy is quickly loosing). Lisa is about done with this pregnancy at this point and ready to have this child out of her. It's kinda funny, I must admit. She enjoyed the second trimester, for the most part, but now is at the point of really wanting this baby gone. He has overstayed his welcome and mama's ready to kick the bird from the nest. Should be interesting to see how this develops in the next few weeks.