Archive for the 'PIH/Preeclampsia' Category

Old wounds

Published on December 12, 2008 in PIH/Preeclampsia, Parenting, Prematurity and Rants. 10 Comments

I almost hesitate to write this post.  Why?  Because I am mostly over this stuff.  Aidan is a thriving, active, intelligent, curious, healthy 3 year old boy.  Yet it is still possible to be brought back to the difficult feelings of the NICU and his first year or so in a heartbeat.

It happened while on the phone with a friend yesterday.  Her daughter is almost 6 months old now.  I was commenting about how much I am loving age 3 and how much more freedom I finally have.  I said, “Yeah, the baby stage was just not my favorite.”

She replied with an almost tangible indignance in her voice.  She told me that she LOVES her daughter’s infancy and she has PLENTY of freedom.  I swallowed hard and tried just to move along.  But I couldn’t.  I had this idea in my head that I was being judged for what I just said.  Judged for saying I didn’t love the baby stage.  I started my reply.  Lots was going through my head and only some of it came out of my mouth (at least I have learned something!).

I told her that I might not have felt that way if we had had ANY help during Aidan’s infancy.  We have NO family here and our friends didn’t/couldn’t do much to help us.  So for Aidan’s first year we had very, very few breaks.  I reminded my friend that her parents live a few miles from her and will take her daughter absolutely whenever she asks.  I continued by saying that she also has a full term healthy daughter, while we had just taken home a perilously premature baby on home oxygen and with a saturation and apnea monitor.  I reminded her of my “Summer of Puke” and how hard it is to enjoy a 6 month old who is battling such food aversions that he vomits on you 4-6 times a day. 

I didn’t even get into all we battled the first couple of years, but when I look back on it, sometimes I am surprised we made it.  That our sanity held.  That we managed to remain married while things were so hard.  So just for a moment I am going to allow myself to remember all we managed to make it through.  Bear with me.

Early subchorionic hemorrhage during week 7.  Bad quad screen during week 16 of pregnancy.  21 week ultrasound reveals severe IUGR.  Amniocentesis comes back with 46XY baby.  Preeclampsia hits at the beginning of week 24.  Baby doesn’t even weigh a pound yet.  Prognosis is grim.  Strict bedrest at home.  Week 26 sees blood pressures no longer controlled at home and I am admitted to the antepartum ward for worsening preeclampsia.  Each day we are subjected to ultrasounds that decide the fate of whether or not I am allowed to carry the baby for another day.  27w 6d.  Severe Class I HELLP syndrome.  Liver threatening rupture.  Platelets nearly nonexistent.  Aidan is starting to show some signs of distress.  Emergency cesarean.  Aidan weighs 1lb 8oz and is 12 inches long.

7 weeks on a ventilator.  Bronchopulmonary dysplasia develops sentencing Aidan to scarred lungs.  We are fortunate and do not experience brain bleeds or sepsis while in the NICU.  We spend 105 days going to and from the hospital until we can finally take him home. 

Aidan comes home on December 12, 2005.  We are happy but scared shitless.  He has home oxygen (not that big a deal once you know what you are doing).  But the saturation monitor is another thing entirely.  He needs to have it on, especially while sleeping to let us know if he needs his oxygen turned up.  Lots of false alarms and almost no sleep for Brandon or me.  December 25 sees us back in the ER and Aidan has viral pneumonia.  We didn’t even make it 2 weeks at home before something happened.

January 2, 2006 is a night that neither Brandon nor I ever want to relive.  Aidan was happily eating a bottle and for whatever reason, he aspirated.  He choked a little and vomited.  Brandon laid him on his stomach while he grabbed for a spit rag.  I looked over and noticed Aidan seemed a little blue.  I said, “Brandon, is he breathing?” 

Brandon looked and never even replied.  He grabbed Aidan, did back thrusts and then turned him over and gave him breaths.  I am not sure I have ever been more scared in my life.  I called 911 and I kept saying out loud, to myself, “NO! NO!  Not now!  Not after we went through all this!  If you were going to take him, you should have taken him while he was in the NICU.”

Brandon flipped him over one more time to do the back thrusts and I was on the phone with 911.  Aidan started crying.  Brandon had him breathing in well less than a minute.  The 911 operator sent the paramedics to check him out.  The paramedics looked him over thoroughly, felt reassured that we had a monitor, and told my husband, “Good job Dad.”

The winter and spring were lonely.  The RSV risk was so high we didn’t dare expose Aidan to germs with his fragile lungs.  We spent those times in relative isolation.  In the spring, Aidan came off his oxygen and we started solid foods.  He must have had body memory of that ventilator tube, because he developed a HUGE oral aversion at that time.  I spent most of the summer learning what I could/could not do when it came to food with Aidan.  And I spent most of the summer cleaning up vomit.  Finally around his first birthday, I talked to his pediatrician and said I thought he needed feeding therapy.  He agreed and we started.  Gratefully, it did wonders and we have not had behavioral or sensory vomiting in a very long time.  Probably almost a year and a half. 

That January, Aidan had to have a minor urological surgery.  We had no idea what was about to happen.  About a month later, Aidan got VERY sick.  Fevers of 105+ for a few days at a time.  The night I knew something was really wrong, we were in bed with him and he woke up suddenly and vomited bile.  He was lethargic and we both knew a trip to the ER was our next step.  The ER doc ran all the expected tests.  He did a chest xray, urine sample, and drew blood (just in case, he said).  Well, somehow the lab lost the urine sample, but the chest xray was clean and we needed to wait on the results of the blood culture just in case.  I think we went home with antibiotics and he had been rehydrated while in the ER.  He was tired and listless the next day, but did better.  The following morning, my pediatrician called me and asked me where I was.  I told him I was at home.  He informed me that Aidan’s blood culture showed Enterococcus growing in his blood.  Aidan had sepsis.  This was deadly serious.  I needed to get to the hospital right away.  The doctor had already called and done the preadmission over the phone.

Aidan  spent the next two weeks in the hospital on IV gentamicin and ampicillin.  I had a nagging feeling that this somehow had something to do with the surgery the prior month, so I called the doctor who had done the surgery and explained my theory.  He told me that we could set Aidan up for a VCUG.  This test shows the dynamics of the kidneys, ureters, and bladder and would show if a bladder/kidney infection had been the source of the sepsis.

The test was conclusive.  Aidan’s left ureter had mild reflux allowing urine from the bladder to travel back up mildly into the kidney.  Not normally a problem when the urine is sterile, as it normally is, but a huge problem when you have a urinary tract infection.  Aidan likely got the UTI after surgery and it travelled to his kidney where it went into the blood and he became septic.

The condition was called VUR and occurs in about 5% of kids.  The angle of insertion of one or both of the ureters into the kidney allows for the flap to allow backflow into the ureter and up to the kidney.  We could wait for Aidan to outgrow this (at about age 5or 6) or do a minimally invasive procedure where a bulking agent called Deflux is injected into the bladder wall to bulk up the area near the valve and prevent it from backflowing.  We chose this.  As a result of the kidney infection that moved to sepsis, Aidan’s left kidney was scarred minimally.  Gratefully his right kidney is measuring a bit larger than average so it seems as if his body is compensating.  His left kidney is still slightly smaller than his right, but it is growing on the same trajectory as the right one, so the doctors believe he will be just fine.  Even still, we need to have kidney ultrasounds every couple of years to be sure.

Meanwhile, Aidan was sleeping poorly.  When in our bed with us, I noticed he seemed to sometimes pause for several seconds, and then almost gasp a bit when he took his next breath.  It sounded a bit like sleep apnea to me and I asked his pediatrician about it.  He referred me to an ENT who told me his tonsils and adenoids were big but not huge and she would want a sleep study to confirm apnea prior to feeling ok about surgically removing tonsils and adenoids from a 1 1/2 year old.  We went for the sleep study.  The results were horrendous.  Aidan had 54 obstructive apneas in 7 hours of sleep.  During REM sleep, he had an arousal almost every other minute.  The theory was that many former preemies have some transient low tone in their trunk.  When we sleep, all our muscles relax, including the ones that hold our airway open.  So in a sleeping, former preemie with borderline tonsils/adenoids, there was a “perfect storm” being created for obstructive apneas.  His tonsils and adenoids came out the following month.  He slept like a different kid.

At this point, Aidan had gotten pretty healthy.  He was about 1 1/2 years old adjusted age. 

Even reading through this sounds overwhelming now.  I can’t quite believe we went through all that in such a short period of time.  We also spent the first couple of years worried about his developmental milestones.  He managed to reach them all on time, but it doesn’t stop a preemie parent from wondering if it will happen.  Instead of joyfully watching your child sit for the first time, or roll for the first time, a preemie parent wipes their brow and thinks “Phew!  He managed to do that one on time.  What’s next?” 

So to bring you full circle, perhaps you might understand why the comments of my friend hit a nerve.  It isn’t as though I didn’t love Aidan and didn’t WANT to enjoy his infancy.  I just couldn’t.  It is hard to enjoy anything when you are living through that much fear. 

As we celebrate bringing him home to us 3 years ago today, I mostly don’t think about that stuff.  I mostly live in the here and now.  The now of  a precocious 3 year old boy who is giving us a run for our money.  He is bright.  He is funny.  He is joyful.  He is loving.  But it took a lot to get us here.  And while I don’t think of the hard times very often anymore, they will always be there with us.  They are part of our experience as parents.  They played a part in shaping who we are today.  The way we navigated them (I believe) speaks highly of us as a family. 

The sting of prematurity never fully goes away.  But gratefully I can say that it does fade into the distance a bit.

Blame the mom

Published on February 26, 2008 in HELLP, PIH/Preeclampsia, Prematurity and Rants. 14 Comments

I stumbled across a claim on another blog recently that got my blood boiling.  Not much sends me into hyperactive research mode now that I am a stay at home mom.  But I haven’t forgotten how to do it. 

There is a diet that claims to prevent 100% of preeclampsia and HELLP.  My sniffer went into overdrive.  100%?  There is almost nothing in medicine that can accurately have the word 100% attached to it.  I did some reading about this diet and started becoming enraged.  I found many sites that spout the claim found on the diet’s website.  Their claim follows in blue…word for word from the homepage of the site.

“Toxemia. Pre-Eclampsia. HELLP Syndrome. Premature birth.
Low birth weight. Intrauterine growth retardation.

It’s not genetics. It’s not random. The cause is NOT unknown. Toxemia CAN be stopped. PreeclampsiaA-toxic-condition-developing-in-late-pre... CAN be stopped. Best of all, YOU can stop it!

HOW? All the scientific research being done on toxemia and preeclampsia these days is focusing on treatment, and none of it is promising. But the research has already been done, many times and many ways in the past 50+ years, and we know that you can PREVENT this from happening to you in the first place, no matter what your personal history may be. The simple answer? GOOD NUTRITION.”

 

Oh, gosh!  Why the hell didn’t I think of that?  Good nutrition?  Guess it is my fault my son was a preemie! 

Except….except that it’s not my fault.  You see I followed this diet.  I clicked on their sample diet and I can tell you….that is what I was eating.  Yet, I still developed Class I HELLP. 

Now, don’t get me wrong.  I believe nutrition and protein intake play a huge role in pregnancy.  It is this idea that pre-e and HELLP would go away if we all followed the diet.  But it won’t.  You see, preeclampsia is a syndrome.  (ie. a disease that may be triggered by several independent factors that leads to a common situation (compromised placenta)   In my particular case, I was in ridiculously good shape going into pregnancy.  My resting heart rate was in the low 60’s, my baseline BP was 105/60, I worked out and taught classes at the gym 6 days a week, and (as I recently discovered) I ate this site’s recommended diet. 

When the underlying reason for your pre-e and HELLP syndrome IS actually genetic, diet manipulation can only go so far.  In my case my homozygous MTHFR c677 was my problem.  Following the diet to the letter would not have saved me from pre-e or HELLP.  Knowing prior to conception that I had this thrombophilia might have….heparin could have been given from early on.

I think there is even a bigger picture here.  It is the “Pregnancy is not a disease” movement.  For most women….it isn’t a disease.  It is a natural part of life.  But there are those of us that fly in the face of that fanciful notion.  Those of us (and our babies) who need medical intervention, sometimes drugs, and science to intervene throw a huge monkey wrench into that movement.  So what is the solution to explain us outlyers?  That the bad things that happen to us ~5% of pregnant women must be OUR fault.  That is essentially what this diet is purporting. 

This is not only grossly inaccurate but emotionally damaging to women who have done everything right and still ended up with pre-e, HELLP, and/or a premature baby.

I love it when I see that new research is uncovering more of the mystery behind pre-e and/or HELLP.  All that I ask is that before some well-meaning soul tells me about it, writes about it, etc, that you actually check to see what kind of research is being touted.   Is it peer-reviewed? Randomized?  Double blind?  Placebo controlled?  Prospective or retrospective?  The answers to these questions matter.  You see this is the benchmark to which I was held every day of my professional life.  I worked for a pharmaceutical company and whenever I presented a study to a physician these were the criteria they asked about.  When a “study” didn’t meet all of these criteria, it was treated with great skepticism.  I have searched extensively for studies done on this “diet” that meet the above criteria.  Surprise!  ;-)   There are none.

This theory makes me angry.  It makes me sad.  I wonder how many former pre-e or HELLP sufferers have read information about this “miracle diet” and felt their heart sink and then blamed themselves.  It is this kind of misinformation that further damages already traumatized women.

There is a wonderful thread I found on the Preeclampia Forum website that has numerous links to peer-reviewed studies that will dispel the notion that “Mommy could have prevented it.”

http://www.preeclampsia.org/forum/topic.asp?TOPIC_ID=9742&whichpage=1&SearchTerms=%2Cbrewer%27s%2Cdiet

 I also wanted to send a shout-out to my MTHFR/HELLP/preemie mom pal Kathy, who I just discovered as I was editing this post, wrote about this very issue.  She makes some excellent points as well.

I think moms spend enough time playing the guilt game in their own heads without adding unsubstantiated fuel to the fire. 

Only You

Published on February 11, 2008 in Aidan, Family, HELLP, Marriage, PIH/Preeclampsia, Parenting and Prematurity. 4 Comments

Recently I participated in an online discussion on a preemie group I belong to regarding having a clotting disorder during pregnancy.  The discussion began with a woman asking a question about a subchorionic hemorrhage she had in early pregnancy.  A couple of us advised her to ask her perinatologist about having a thrombophilia panel done since she had had a preemie just a couple of years ago and now this early bleed in her second pregnancy. 

I, too, had a subchorionic hemorrhage in very early pregnancy with Aidan.  About the 6th week along.  It was absorbed by the next ultrasound and was not thought of again until that day in the hospital when I was diagnosed with homozygous Methylenetetrahydrofolate reductase gene mutations, better known as MTHFR.  (For those of you wondering at home, high risk OBs, perinatologists, and antepartum nurses do use *that* word it looks like to describe it.  Sorry have to keep this G-rated.  :-)   Hmmm…I wonder if that early bleed was a sign? 

Anyway…the discussion led to me pointing out that any future pregnancies for me would include daily shots of heparin or lovenox in my stomach.  Ugh.  I know…it isn’t great, folks.  It friggin hurts.  I literally still had bruises on my abdomen 3 months later from those shots.  And I only endured it for the last 2 weeks of my pregnancy once we knew about my disorder.  But I would gladly do it again for another baby…the whole nine months.

Except….that Aidan is our one and only.  How did we come to this decision?  Not lightly.  Not without a lot of soul searching, a lot of tears, and finally a lot of gratitude.

When Brandon and I were starting to talk about children seriously, we discussed how many, spacing, etc and we both stated that we may indeed decide we are happy with only one. 

This disorder makes the decision for us…or rather, the HELLP syndrome that resulted probably was more of a deciding factor.  There is too much that happened that is so scary and so painful, that the idea of repeating it is torturous even to consider.  The first time we found out at 21 weeks that his growth was not on track anymore, but lagging significantly.  The PIH at 24 weeks.  Then the hospitalization at 26 weeks.  The MTHFR diagnosis.  The physically grueling hospital bedrest accompanied by twice daily heparin injections, high flow oxygen, blood pressure meds, so much protein that when I saw my meal tray I thought I would vomit to have to take in so much food, and the 1.5 gallons of water I had to ingest each day.  The daily biophysical profile.  Holding our breath and hoping the umbilical cord flow had not reached reverse diastolic flow.  The 4 c-section scares before it actually happened.  Listening to the fetal monitor and hearing occasional decels.  The night of delivery.  Knowing my liver was about to rupture and wondering if I would ever see Aidan alive since I was going under general anesthesia.  Having to say goodbye to my husband as they wheeled me down the hall to the OR, frightened beyond measure.  Learning later that I bled out—a lot.  That I very nearly died.  And that my husband waited for 40 minutes alone in the hallway not knowing the fate of his family. 

The wondering of the next couple of years was just as difficult.  Will Aidan meet his milestones?  Will he have disabilities and what will they be? 

This kind of thing is also hard on a marriage.  Most people don’t talk about this.  And honestly, I think a lot of people who know us would be surprised to learn that all of this stress strained our marriage immensely.  But it did.  We each had our own personal brand of grief and PTSD we dealt with and we lived a lot of the first 2 years of Aidan’s life in a kind of survivor mode.  Don’t get me wrong, we have had wonderful times as a family.  But it is just recently that we have both started to let our guard down and take inventory of what an experience as scary as this was does to you.  Brandon and I are in a wonderful place again in our relationship and the idea of putting our relationship through that again makes me shiver.

Do we ever want another child?  Sometimes.  We love being parents.  Aidan is amazing.  So far, he has no significant problems lingering today from his premature beginning.  That doesn’t mean we couldn’t see some issues like ADHD surface later as it is about twice as common in preemies. 

Sometimes when we watch Aidan play alone, we feel the urge.  We think it would be nice for him to have a playmate.  But I don’t think it is essential.  Often times when he plays alone it is because he wants some space.  Brandon and I play with him a lot.  He goes to playgroups.  Sometimes Aidan will leave what he and I are playing with and just go grab a book and ”read” to himself.  I think even toddlers sometimes want their space.

Sometimes I want vindication.  I want to carry a baby to term.  I want to get big and pregnant.  I want a baby shower.  I want my husband and I to be present during our child’s delivery.  I want to breastfeed successfully.  I will admit there are times that I want a do-over.  But there are no do-overs in this realm of parenting.  We can’t change what has been by having another.  Wanting those experiences is not the right reason to have another child.  

The idea of this possibly happening again terrifies me.  It terrifies Brandon.  There are no guarantees.  Aidan and I almost died.  Period.  The idea of having another very early preemie terrifies me.  The idea of having a baby with an outcome vastly worse than Aidan’s terrifies me.  The idea of leaving Brandon to raise Aidan alone is just too much for me to bear.  Don’t get me wrong.  He could handle it.  He would do a wonderful job.  But Aidan deserves to have us both.  And more importantly, he deserves to have us as we currently are.  Happily married.  There is no guarantee that would remain the same if we had to endure something this stressful again. 

So what am I left with?  I have been thinking about this a lot.  I am left with *gratitude*. 

  • I am grateful I didn’t die in that OR. 
  • I am grateful my son is alive. 
  • I am grateful my son is a vibrant, loving, rambunctious 2 year old boy.
  • I am grateful my marriage survived something that ends many.
  • I am grateful for my 2 “boys”.  I have more love than any woman has a right to have. 

I was thinking of an old Elvis Presley song I love and it captures how much I love both my only son and my only love.  So to both of my “boys” (Brandon and Aidan):

“For it’s true
You are my destiny.
When you hold my hand, I understand
The magic that you do,
You’re my dream come true,
My one and only you.”

My two boys...aren't they the cutestHi Mom...we've been playing with the hoseKiss for DaddyWe have lots of these days in our future son

My pregnancy with Aidan (long)

Published on December 11, 2007 in Aidan, Bedrest, HELLP, PIH/Preeclampsia and Prematurity. 3 Comments

Warning!!!  This is going to be a LONG story.  But it deserves to be told before I forget any details.  At some point soon I will write a summary of Aidan’s NICU stay and summarize how he has done in his first 2 years.  If you have questions, please feel free to drop me an email.

October 1999:  Brandon and I met at the gym.  We were introduced by a mutual friend, and it was all over.  We knew early that the other was “the one” and we were quickly talking about marriage.  We had similar backgrounds and interests, and we loved every moment we spent together. 

 

July 14, 2001:  We were married in July 2001 in the Portland Rose Garden.  We got married on Brandon’s 30th birthday.  (I turned 30 6 days later on our honeymoon in Jamaica)

March 2002:  Soon thereafter we bought our first home and settled into marriage.  We took great pride in the ownership of our first house and spent a couple of great years there.

Summer 2004:  A couple of years passed and we went on an amazing trip to Italy. 

 

When we came back, we built our second home.  This was definitely our dream home.  We watched excitedly as all of the customizations we selected went in and the home was completed.

 

Fall/Winter 2004:  We decided we were ready and excited to be parents so we decided we were going to start trying to get pregnant.  I went to the OB I chose and had my preconception check-up, cut out caffeine, started eating even better, and got ready to get pregnant. 

March 17, 2005:  I had missed my period, and took a pregnancy test a few days before this that came out negative.  I took one again first thing in the morning on 3/17/05.  Three minutes later, I came out of the bathroom with the pregnancy test quivering in my shaking hand.  We were pregnant!

We were both elated!  We found out the baby was due around Thanksgiving of that year, November 23, 2005 to be exact. 

Week 6:  Pregnancy seemed to be going easily for me.  I felt good, albeit tired, during the first few weeks.  I took a nap pretty much everyday and relished in the thought of becoming parents.  My skin was glowing and I felt wonderful.  We started shopping for maternity clothes and planning the baby’s nursery.

Week 7:   I woke up to minor bleeding and to be frank, I freaked out.  I am so glad Brandon was home to calm me, sit me down, and call the doctor’s office for me.  They had me come right in for an ultrasound and found everything to be mostly OK.  By mostly I mean that they could see a subchorionic hemorrhage but it was something that happens relatively frequently as the placenta grows and attaches.  What did worry them was the baby’s heartbeat.  Only 90 beats per minute.  An unfeeling nurse made an unfortunate comment at that time that we would schedule another ultrasound in a week to see if the heart-rate picked up but that I “shouldn’t count on this pregnancy.” 

Ugh.  Punch to the gut.  I spent the next 9 days scouring for information on subchorionic hemorrhage and low fetal heart rate.  It wasn’t all that encouraging. 

Week 9:  About 9 days later I returned for an ultrasound that I feared would confirm that this pregnancy would not continue.  To the technician’s surprise, our little peanut was growing well and his heartbeat had picked up to almost 140 beats per minute.  Further, it looked as if the hemorrhage had been reabsorbed.  What amazing news!  We were on top of the world!

Week 12:  At 12 weeks we finally heard his heartbeat on the doppler and the doctor said I was measuring perfectly, gaining weight perfectly, and was having a “textbook” pregnancy.  We started to scour baby name books and narrow the choices.  We decided to adopt a couple of more kittens before the baby came to make our older kitty adapt and to have more pets for our baby to come.  Here I am looking a little tired with the two new additions. 

Week 16:   I had a routine exam and the doctor did the blood draw for the  quad screen.  This measures 4 parameters which can be indicative of the need for further testing for some birth defects such as spina bifida and down’s syndrome.  Honestly, I didn’t give this test much thought.  Until a few days later when my doctor’s office called with the crushing results.  The values of this test were coming back with a 1 in 40 chance the baby had spina bifida.  The normal result is about 1 in 1000.  They were going to refer me to a perinatologist the following week for a level 2 ultrasound to look for anomalies.  I was panicked to say the least. 

Week 17:  At 17 weeks we went to the appointment.  We met with the genetic counselor at the peri’s office before the ultrasound and felt well informed on what the test results mean and what answers we would and wouldn’t get in the ultrasound.

The tech began the ultrasound and Brandon and I were nervous as hell.  I remember that I was crying because I was scared of what I was going to see/hear.  The tech began to smile and I just knew that everything was OK.  I asked him what he could tell me.  I know that normally techs are not supposed to reveal what they are seeing and leave that to the doctor to discuss.  But I think he saw how much agony we were in and said, “Your baby is doing great.  Do you want to know the sex?”  One of the biggest rollercoaster dips I have ever felt in my life.  One moment worrying about the health/viability of our baby to hearing everything is normal and we could know the sex.

Of course we wanted to know!  He pointed to the area with an arrow on the screen and said, “You are having a baby boy.”  I looked at Brandon and we were both crying.  We were looking at our son. 

The doctor came in and talked to us about what the ultrasound was revealing.  She told me he looked “beautiful” and that given what she was seeing she would estimate our risk of spina bifida at the normal rate of 1 in 2000.  She didn’t feel we needed to get an amniocentesis and she would just have me back for another ultrasound in four weeks to make sure the baby was still growing well.

On the way home we decided on his name…Aidan Christopher.  We were having a son.  The relief and elation was amazing. 

Week 18:  We began to decorate Aidan’s room in the Finding Nemo Theme.  It was the beginning of a wonderful few weeks for us.  I started to feel Aidan move and Brandon felt him a couple of times.  I was starting to wear maternity clothes and was loving being pregnant. 

 

Week 19:  We went to Florida to visit a dear friend and on that visit I felt my heart racing.  My friend worked at Shriner’s Hospital so she suggested that we have a nurse take my blood pressure just to be sure.  135/80.  On the high side.  My blood pressure is usually 110/60.  We called my doctor who told me to take it easy and that the heat and my increase in blood volume was probably doing it to me.  Despite minor worries about this, we had a wonderful last childless vacation.

Week 21:  We returned to the peri’s office for our repeat ultrasound to check Aidan’s size on our 4th anniversary.  (stupid idea to choose that day, looking back on it)  What began for us as just another chance to see the baby turned into a nightmare.  The tech began measuring head circumference and then onto femur and humerus.  He measured and remeasured these.  My heart sank.  There is no reason to remeasure the length of a bone so many times unless the finding is not good.  He pulled the doctor into the room.

She measured and remeasured.  Aidan’s head size was on track for his gestational age, but his femur and humerus length weren’t.  He was measuring almost 3 weeks small.  What did this mean we asked her.  Maybe Down’s Syndrome was her answer but she couldn’t be sure.  She suggested an amniocentesis to be sure.  We had the rapid FISH test done so that we could have an answer on major anomalies in 24 hours.  Another crushing blow.  I went home and just lay in the fetal position on our bed.  I was devastated.  The next day we got the news…the amnio was 46XY.   We were having a chromosomally normal boy!

So why the short limbs we wondered.  The doctor said the placenta may be having issues or he could be getting ready to go into a growth spurt.  We would keep our eye on it but she wasn’t overly concerned at this point.

Week 22:  I relaxed a bit.  I was still uneasy about the small measurements, but more relaxed given the amnio findings.  We tried our best not to worry and I just tried to do my best to rest and grow the baby.  We had our niece Morgan and nephew Gavin up to see us for the weekend to give my brother and his wife a break.  I enjoyed myself so much with the kids, but didn’t feel great that weekend.  I was very tired and had more heart-racing symptoms.

Week 23:   On July 29 we went to our friends’ Clay and Linda’s wedding.  I was starting to feel really good again.  Brandon was a groomsman in the wedding and we had a wonderful time.  The following pictures are the last I had taken of me before Aidan’s delivery on August 30.

The next day I went out on a long walk with my neighbor and when we were having breakfast, I noticed swelling in my hands.  It got bad.  I couldn’t remove my wedding ring or even my shoes.  I had a horrible headache.  I worried a bit and almost called the doctor, but the swelling went away after an hour or so and I decided just to mention it at my appointment the next day with my regular OB. 

Week 24(August 1, 2005):   At the appointment, the nurse asked me how I was doing.  I relayed the swelling story.  As she took my blood pressure, she got a worried look.  She exited the room and returned in less than a minute with the OB.  Not good, I thought.  The OB asked me what I would do if she put me on bedrest today.  Sucker-punch.  Ouch.  I told her I would do whatever she said.  She relayed that my BP was 140/90…I was developing pregnancy induced hypertension or PIH.  The good news was that there was no protein in my urine so I wasn’t preeclamptic.  But she did tell me that at only 24 weeks gestation, seeing signs of PIH already was ominous.  I was to go home, lay down except for going to the bathroom, and see the perinatologist the next morning.

The peri visit was not good news.  Aidan definitely had IUGR or intrauterine growth restriction.  Aidan’s growth was behind but holding its own—not falling further behind the pace we had seen 3 weeks prior.  Most concerning outside of my blood pressure was somehow called diastolic flow in the umbilical cord.  I was experiencing periodic episodes of absent diastolic flow in one of the umbilical arteries.  If this became continuous or was present in both umbilical arteries, they would worry that Aidan needed to be delivered.  Here are three pictures of this.  The first is normal flow, the second absent diastolic flow, and the third reverse diastolic flow.  Seeing the third is usually cause to consider fairly immediate delivery.

The good news was that home bedrest was working to bring my blood pressure down and that Aidan’s IUGR (intrauterine growth restriction) was asymmetric.  His body was funneling most of the precious nutrients to his brain and letting his limbs fall behind in growth.  This kind of IUGR is generally more promising for the baby’s overall outcome than symmetric IUGR. 

I was to be at home, laying down unless I was taking a bath or going to the bathroom.  I was to check my blood pressure at least 3 times a day and chart the results.  Anything over 130/80 was a reason to call the doctor.  This time was acutely painful for my husband.  He felt helpless.  He was relegated to watching his formerly active, unstoppable wife laying down trying desperately to grow his baby. 

Week 26 (August 19, 2005):  I made it 19 days on home bedrest before I got a high reading on an early evening blood pressure check.  150/96!  How could this be?  I had been fine a few hours ago.  UGH.  I called to Brandon in the other room and told him we needed to call the doctor.  The peri on call (Dr. G—who would largely take over my case from this point on) told me to go straight to Labor and Delivery at the hospital.  That he would call ahead and I needed fetal monitoring and tests.  Maybe an overnight stay.  Somewhere in my heart I knew I wouldn’t be coming back home until Aidan was born.  I gave hugs to my cats and looked at my house…imprinting it in my mind.

We arrived at L & D and they strapped a fetal monitor on me.  They drew bloodwork and monitored my blood pressure.  Everything seemed to have settled down.  But Dr. G was cautious.  He wanted me kept at least overnight and he would be in to see me the next day.  He entered the room the next day and had a very long conversation with me.  We talked about all of the things he thought *might* be causing this and wrote up a lab slip with many different blood panels on it.  He started me on a blood pressure med and ordered 24/7 fetal monitoring.  I was not going to get to go home until the results were back.

August 20, 2005:  The next day Dr. G entered the room with an almost dumbfounded look on his face.  He asked me, “Is your chart right?  You’ve never miscarried?”  I told him yes, it was right, this was my first pregnancy.  He handed me a sheet of paper and explained that I had tested positive for homozygous (2 copies) of the clotting gene MTHFR c677.  Basically this was likely causing a clot in Aidan’s placenta and most women have a few miscarriages before this is discovered and treated in order to have a viable pregnancy.  He could not believe I had made it to 26 weeks untreated.

He started me on heparin shots twice daily in the stomach to thin my blood.  He also added a ton of protein and calories to my diet, 1.5 gallons of water per day, an IV, and oxygen via nasal canula.  All of this to try to push as many nutrients as possible into Aidan and his damaged placenta.  Our aim was to grow Aidan as much as possible, try to combat reverse diastolic flow, and make sure I didn’t get so sick that I might die. 

Week 27:  The hospitalization was difficult both physically and mentally.  Having to lay down (mostly on my left side) was actually painful at times.  It was hard to keep my mind from not focusing solely on the imminent danger of Aidan having a bad deceleration and needing to be delivered.  Meanwhile, Brandon tried to continue working despite having to keep up the house and come be with me as much as possible.  There were ultrasounds and biophysical profiles nearly every day to assess Aidan’s condition.  Dr. G explained that we were playing a balancing act between getting Aidan more “womb time” and him becoming too distressed in there.  He explained that at this gestation every day in the womb meant almost 2% additional survival.  We kept a close eye on his cord diastolic flows, my amniotic fluid, my lab values (PIH labs), growth, etc.  I was still strapped 24/7 to a fetal monitor.  When Aidan would have a deceleration, a nurse would rush in, look at the strip and give me a bolus of IV fluid.  He always recovered from these, but sometimes he seemed in a bit more distress.

We had no less than 4 instances where we almost went to c-section during my 11 days in the hospital.  Each time, the doctor would come in, look at the strip, do an ultrasound and see that Aidan was doing well.  We were going to let him cook some more. 

During this time, it was hard for me to feel so vulnerable and like such a failure.  I absolutely forbid pictures of me.  Now, I wish I had.  But that was my emotional state at the time…so be it.  We met with a neonatologist who gave us encouraging, yet sobering statistics of preemie born around this gestational age.  It was staggering to process what we might face.  I became so good at pacing the sound of the fetal monitor in these days that I could hear a deceleration coming, and turn around to see it happening on the monitor.  The continuous oxygen was making my nasal passages so dry that I had lots of bloody noses and nostrils full of sensitive scabs.  Every muscle ached from weeks of bedrest.  I felt like a stuffed pig because I was being so flooded with fluids, food, and protein that I had gained almost 20 pounds in those ten days.  The good news was that Aidan’s ultrasounds were showing weight gain.  Whatever we were doing was working.  But how long was I going to be able to keep him in?  Nobody had the answer to that question.  Sleep didn’t come easily during those hospital days.

August 29, 2005:  This was actually a good day.  Aidan’s biophysical profile was great.  He was practice breathing and my amniotic fluid level had come up a bit.  Further, the dopplers on the cord blood flow showed a mildly positive diastolic flow.  Dr. G (who had come in even on days off to see me for 10 days straight) said he was going to run my PIH labs (liver enzymes, etc) and if they looked good they we may even get to skip tomorrow’s ultrasound and give me a mental day off.  He stopped back in at the end of the day and told me that my PIH labs looked a bit high, but about where they had been during the whole hospitalization.  He told me that he was going to let another colleague in the Maternal Fetal Medicine practice take his calls that night, but that if something went wrong and I felt uneasy, I was to have the nurse call him. 

Even though the day was relatively good, I was feeling uneasy.  My stomach felt queasy and I asked Brandon to stay the night on the daybed in the room.  Most nights I was having him go home so he could at least get some sleep. 

Around 8pm I started feeling pain in my upper stomach.  It felt a little like gas.  I asked the nurse for some antacids.  When the pain didn’t go away in a couple of hours, I asked for another dose.  Still no relief.  I called the nurse and asked her to call the doctor on call.  At around 11:30 she called him and he had her re-run PIH labs.  They were run stat, and came back higher than 6 hours earlier, but nothing outrageous according to on-call doc.  Still I didn’t feel right.  I had her call him again asking him if this could be my PIH progressing.  He told her that the labs didn’t look like it and she should offer me an ambien so I could calm down and sleep.

I flatly refused the sleeping pill because I didn’t want to be out of it if something wrong was happening inside me.  The pain got worse and worse. 

August 30, 2005:  It was a little after 2:00 a.m. and the pain was only increasing.  I was getting a headache and feeling more nauseous.  I called the nurse and basically demanded she call Dr. G.  She reminded me he was not on call.  I told her I knew that but that he had left a note in my chart that it was OK to call him if I felt he needed to be called.  She went and verified this and called him.  She came back into the room with the phone and told me the doctor wanted to talk to me.  I apologized profusely for waking him and he told me it was no problem.  He asked me to rate the pain in my upper stomach.  I told him it was on the right and it was a 9 out of 10.  He simply said, “I’m on my way” and hung up.

10 minutes later, the scent of Dr. G’s cologne filled the room and he was dressed in scrubs.  Brandon had been sleeping off and on, but he awoke to the scent and sound of the doctor entering the room.  Both our hearts fell.  We knew that scrubs was a bad sign.  The doctor came over to me, lifted my shirt and saw my distended liver.  I had had no idea how big it had gotten or that the outline of it could be seen through my skin.  I looked at the doctor and asked, “HELLP syndrome?”  I had read about HELLP syndrome while on bedrest in the hospital as a potential complication of PIH, but I never really figured I might get it.  He nodded and said, “Most likely with your liver being this enlarged, but we really don’t have time to wait for the labs to get back.”  (The next day the labs would reveal that I was rapidly developing Class 1 HELLP syndrome and that early detection probably saved my life)

In moments, an anesthesiologist came into the room and discussed the cesarean section with me and had the consent paperwork with him.  He explained the a c-section with epidural anesthesia was too risky because I had had a dose of heparin just hours before.  I would need to be under general anesthesia for the birth.  This meant Brandon could not be in the delivery room.  I felt panicked but knew that it had to be done.  Before I knew it I was saying a tearful goodbye to Brandon and giving him one last apology for not being able to keep our son in longer.

As I was wheeled into the operating room, I couldn’t believe how many people were waiting there.  Were all of these people really for just my delivery? 

As the anesthesiologist was preparing to put me under, it must have become evident to Dr. G how scared I was.  He asked if I would like him to hold my hand while I went under.  I nodded yes.  He came around, held my hand, and told me “Don’t be scared.  It’s time to meet your son.”

That is the last thing I remember until the recovery room nurse was waking me.  “How is he?”  I blurted.  She told me he was small, 1 pound 8 ounces, but feisty.  She told me he came out pink and thrashing and my husband was with him.

I often think of what the 40 minutes in the hallway outside the operating room must have been like for my husband.  He stood out there waiting to hear what his future held, feeling powerless.  Was he taking a baby home, or even his wife?  At 3:24 a.m. Aidan was born.  At 3:40 a.m. the door to the O.R. opened and a doctor and two nurses pushing an incubator emerged.  The neonatologist told my husband to follow him up to the NICU.  Brandon nervously asked about me and the neonatologist was shocked that nobody had been out to talk to him. 

They told Brandon I had had considerable trouble clotting and that removal of the placenta was difficult and that it came out in many pieces.  They had given me a lot of blood (about 5 units), but I seemed to be clotting now and that I was going to be OK.

Brandon watched his son in the dim light of Aidan’s NICU room being wired up.  Sensors for everything imaginable.  But this little 1.5 pound, 12 inch baby was doing seemingly well.  An active little guy for his size according to the staff.  Apgars of 7 then 8. 

Our son was here.  And the rollercoaster ride was just beginning.

Mom catches everybody up

Published on November 28, 2007 in Aidan, HELLP, PIH/Preeclampsia and Prematurity. 0 Comments

I sent this email on 9/4/05.  Our beautiful baby boy had dropped to his lowest weight of 1lb 3 oz.  But he was “acting” more like a 28 weeker and was dodging most of the major bullets.  I think I was still in shock to a certain degree, but was feeling good about Aidan’s prospects and keeping my chin up.

Hi all!

Brandon has done a wonderful job of keeping you all up to date on the health of Aidan and I over the last few weeks.

It seems I will most likely be released from the hospital tomorrow, but of course little Aidan has some growing to do in here before we can take him to his home.  The last weeks and especially recent days have been extremely taxing on all of us in the  family.  There are things that were very scary but also many joys and reason for hope.  Here are just a few:

1.  Through self-awareness and the doctor’s help I was able to somehow know that the night we delivered Aidan, I was progressing in to a very dangerous condition called HELLP.  This can be fatal to pregnant women if not halted early enough and the only “cure” is delivery of the baby.  My labs on my platelets and liver the next morning told the story.  We had delivered him at exactly the right time to maximize his growth and stop any permanent damage to either Aidan or myself.  My platelets were slipping low and my liver values had multiplied by over 5 times and if the baby was left in, it could have meant terrible things for the two of us.  The doctor was impressed at my body awareness and said it had made a huge difference in the outcome.

2.  The doctor, Dr. Gavrila, came in to deliver Aidan.  He was the one managing my condition literally by day.  Even when he was off and not even on call, he would show up and be the one to do the doppler studies on Aidan, go over the changing course of the treatment plan , etc.  I have never known a doctor to give so much of his personal time to a family when he could have let one of his colleagues who was actually on call on his off days handle us. 

3.  It will take time, but I am already on my way back to health as my bad lab values are self correcting and my  blood pressure is already dropped back to almost normal.

4.  I have a supportive, unwavering husband who was there for me and our son every step of the way through this and it has only confirmed for me what a wonderful decision I made in a husband and fatherl

5.  We have amazing friends and family who are/were willing to do whatever they could for us and it was/is such a huge help and source of support for us.

6.  MOST OF ALL……Aidan is doing extremely well.  Many things that the nurses do not expect a baby his age and weight to have are present.  Such as the determined way in which he moves his limbs.  He moves them with a purpose and not a flailing as most kids born at his gestational age.  He is strong.  His grip is very strong.  When laid on his stomach for a bit today, the nurse tried to pry one of his arms out from underneath him because it looked “uncomfortable”.  Well, he let her have it!  He grimaced and pushed himself up off his tummy with a combo of knees and arms for a few seconds. 

He has had several tests know for things often present in a baby born when he was.  There is a valve called a PDA which normally closes upon birth in full term babies and almost never does in preemies.  His is open and he is being given a med to close it.  His blood sugar is stable.  Another big hurdle is finding out if he had an IVH which is a bleed in the brain.  There are 4 different severities of this condition.  He will be screened again in a few weeks to be sure he doesn’t develop one, but surprisingly he has NO bleeding there.  Also unusual for his gestational age.

7.  Last but not least, I had my first moment of bonding on Thursday.  A nurse offered to let me help wash his scalp/hair.  She removed his little hat and glasses (he has been under lights for jaundice).  I blanketed him across his arms and chest with my left hand.  Babies like this feeling as it reminds them of being in the womb.  The nurse rinsed his head with warm water and gave me a bit of baby shampoo.  I began massaging his scalp and cleaning it, when Aidan curled his hand around part of mine and grasped me.  Then he opened his beautiful  little eyes and stared right at me.  He sighed  and I got to finish washing his hair.  I did this through tears of course, as the nurse told me that Aidan most likely knows I am his mommy just through touch, voice, and smell. 

As I go home tomorrow (without him…for now) it will be hard.  But I know he has amazing care here and he is SUCH a fighter with a strong spirit.  I am so proud.

Keep in touch!

Welcome to the first tee Aidan

Published on November 28, 2007 in Aidan, HELLP, PIH/Preeclampsia and Prematurity. 0 Comments

This was written by Brandon just a few short hours after Aidan was born on 8/30/05.

Well… a mere 5 minutes after I click send on the mail indicating everything was hunky dori, things took a turn.  Lori started experiencing a lot of pain in her tummy.  It turns out the liver was starting to distend, causing some serious discomfort.  The baby’s heart rate started to fall off its normal baseline.

The doctor (Daniel Gavrila…a classic Italian accented soap opera doctor) decided it would no longer benefit the mom or the baby by continuing the pregnancy.  SSOOOOOOO….

At 3:24 a.m. Aidan was born.  12″, 1 lb 8 oz of pure pink joy.  He wasted no time in filling a diaper from both ends and doing his best to flail around so the nurses couldn’t get him wired up (IVs, temp probes, O2 sensors, feeding tubes, breathing tubes, ventilators etc….).  The doctor indicated he was really strong for his gestational age, and had a lot of fight in him.  We aren’t out of the woods yet, but he seems to have the courage to keep fighting.

He is too young to really determine who’s features he has with one exception…  the kid has some HUGE hands for his size.  Comes from his poppa. I have taken the liberty of attaching the first pics taken of the little man. 

Lori is doing fine after the C-section.  Drugged out and tired, but feeling much better in general.  I will know more after she wakes up.  Me?  Dunno… too tired and drained from one hell of a roller coaster ride.  What I can say, is that we are truly blessed to be parents.  I love this little tadpole/alien-looking thing and can’t wait to see him start to survive on his own.

Wow…

What a ride.

The scary thing is that it is just starting.

Love to all

Brandon, Lori and Aidan (Biscuit)

Treading water

Published on November 28, 2007 in Aidan, Bedrest, PIH/Preeclampsia and Prematurity. 0 Comments

Captain’s Log, Stardate 8.25.05.

Evergreen Hospital:

Day 6 finds the family still in the hospital with Lori hooked up to continuous IV, Oxygen and a baby monitor.  She is getting daily shots in the tummy to help thin the blood so it flows easier to Aidan.  Lori gets to take a 45 minute warm bath every day to help open her blood vessels.  Lots of drugs, lots of protein in the diet, lots of ups and downs.  Overall, Lori is doing very well considering. 

The baby is doing well.  Still small but has gained 2 oz in the last 9 days, pushing him to a whopping 1 lb-6oz.  His little humerous is 4.4cm (just under two inches), to give you some perspective on size.  Brain, bladder and kidneys seem to be forming as expected.  He is a little fighter.  It is weird to feel like the birth is either imminent, or within the next two/three weeks.  A little nerve-racking whenever a nurse comes in the room.

The last three days have seen 2 room changes to various floors in the hospital, 2 emergency C-Section false alarms, one pretty pissed doctor for the false alarms, 3 ultrasounds, flowers, cards and more love and support from our friends than we ever anticipated. 

I am trying to balance a bit of work, a bit of time for myself, and a lot of worry…. doing well at one of them. 

More updates to come

Thank you all for the kind words/thoughts/prayers/cards/flowers/support/love.  It helps makes things a lot easier to handle.

Brandon, Lori and Aidan (aka Biscuit)

P.S.

We are about to be moved to the 4th floor (again).  Good sign since this is a longer-term room, away from the surgical area on 2nd floor.

In the klink

Published on November 28, 2007 in Aidan, Bedrest, PIH/Preeclampsia and Prematurity. 0 Comments

This was written by Brandon shortly after admission to the hospital for hospital bedrest on 8/19/05.

Just a quick note to let everyone know the status of Project Aidan:

Friday night started out like any other night.  Lori was camped out on the couch and I returned home from work. Lori was experiencing shortness of breath, heartburn, high bp and slow pulse (45 bpm).   This means only one thing, and it ain’t Brandon playing golf on Saturday ;-)  

So off to Evergreen Hospital we go to get everything cheked out.

They decide to admit Lori to the maternity care facility and administer some drugs to help thin the blood.  This helps lower bp, increase heart rate and give Aidan more nutrients through the placenta.  They are keeping Lori there at least until Sunday to monitor mom and kids’ heart activity.  Incidentally, the nurses have a hard time tracking down the boy inside the tummy because he keeps swimming around and won’t sit still (remind you of anyone?)

Both mom and baby are doing well.  Lori continues to amaze me with her strength and perserverance through all of this.  We both know in our hearts Aidan will be fine.  He is going to start out small, but will catch up in short order and be just fine.  A good friend of ours mentioned the similarities between Aidan and Seabiscuit… kinda fits.  Hence a possible nickname has been born. Since ‘the little pain in the caboose that drove mom and dad nuts for months even before he was born’ doesn’t exactly roll off the tongue, we will shorten his nickname to ‘biscuit’.  I’m sensing a possible snack at a baby shower snack at some point…

Thank you all for your kind thougths and prayers.  The support we have received from friends and neighbors has been astounding.  We are truly blessed.  We will send out another update when things change.

Bless you all,

Brandon, Lori and Aidan

Trying to hold back the tide (an email dated 8/17/05)

Published on November 28, 2007 in Aidan, PIH/Preeclampsia and Prematurity. 0 Comments

The following is the email I sent to all of our family and friends on 8/17/05, just 13 days before Aidan’s arrival.

Hello to all our family and friends:

First, of all, let us apologize for the length of this email, and I am sorry if some if this will be redundant to many of you, but it will get everybody caught up.

Some of you are more up to date than others, so in the interest of not updating everybody by phone individually, it is easier to send out an email to you all and keep you up to date on what is going on with us.

As of Wednesday, August 17:

A couple of weeks ago Lori had slightly elevated blood pressure at a routine doctor’s appointment.  Her urine is showing no protein and she has no prolonged swelling so she has not progressed into preeclampsia, though there is a possibility of that happening.  She has what is considered PIH (pregnancy induced hypertension).  This can strike any pregnant woman and research has still not been able to discover exactly why and who this will strike.  For those of you who are curious, here is a link explaining the conditions.

http://www.preeclampsia.org/FAQ.asp

Lori was put on bedrest and has been doing that for a little over 2 weeks.  It has brought her blood pressure down pretty successfully while she is lying down.  Yesterday, we had another ultrasound at the perinatologist following us to check Aidan’s growth.  We had seen the perinatologist for some other  possible concerns that proved to be a non-issue after we were given an amniocentesis.  Aidan has lagged a bit behind in his growth for the last 6 weeks.  He is measuring about 2 weeks behind predicted in a few measurements.  But he is holding his own.  At each ultrasound he is not losing ground but rather maintaining.  The concern yesterday is that while the blood flow in his brain, heart and vital organs is good, the blood flow in the umbilical cord is not optimal.  The doctor said the doppler readings on these can look different day to day, so we are returning Thursday to have another look and also complete what is called a Non-stress test on Aidan to see how his heart rate responds when he moves.

We will continue to do this 2-3 times per week to keep a close eye on how he is doing.  If there is a point where he can be supported better in the NICU that in the womb, they will make a decision to deliver him.  The good news is that the hospital where we are patients is Evergreen Hospital and is well known for their excellent Level 3 NICU and outcomes if this is necessary. 

He is at the age and weight where his prognosis is very good for a positive outcome.  Our perinatologist is hopeful that we can make is another few weeks because she is not seeing any signs of contractions in Lori and his doppler flows in the umbilical cord are not yet absent or reverse flow which are indications of impending need to deliver.

We have had so much support from virtually everybody we know.  We appreciate your thoughts, prayers, and deeds more than we can say.

That being said, the question arises from most everybody we know, “What can we do?”

While we understand the desire to call and speak to us, the best thing for Lori right now is lots of rest and as much peace of mind as she can get.  That being said, if we do not answer your call for some reason, please do not feel slighted and take this personally.  It is simply taxing to tell the same story 25 times in a day.  This does not mean that we will not want to talk, just that we may not always want to and really appreciate your understanding when that is the case. 

As much as possible, we will communicate status changes via email.  (They will be shorter than this initial email.  ) 

That being said, your offers of help are all SOOOO appreciated and we are so touched to receive them.  And we know we will need much of this support at some point (i.e. meals, etc.)  But we have no idea of exactly what we will need and when it will be needed until this situation makes itself more clear to us, so we will let you know as we have a better idea. 

Meanwhile, we are so grateful for all of you and we will keep you updated.

Love,

Brandon, Lori, and Aidan (26+ weeks and still cooking!)