Sunday, January 10, 2010

Liza finally has her Crew!

Hello all, this is Matt and I have been granted the special honor of being this week's "guest writer" to Liza's blog. I told her that I would be sure to include a number of typos and other errors so that I don't actually compete with her writing abilities. So if you find any, just know that it was just one more way I am trying to be a good husband. Before I get started, I want to thank everyone who has been there to help us get to this point. We have had help from anyone and everyone and it has made all the difference.

So, onto the reason why I am writing this blog post . . . Liza doesn't remember a thing. You will have to excuse the length and detail of this post. Liza not only wants me to tell what happened, but she also wants me to include such detail that it will serve as a record and reminder for the next time she says she wants to try for a little girl.

On Wednesday night I was working late trying to finalize a big presentation for Thursday. Liza and her mom were at home with the boys and just as BYU was about to come up with a huge win against UNLV (I was listening on the radio), I got a call from Liza telling me her water broke. Her mom rushed Liza to the hospital where I was then waiting and we headed up to the labor and delivery. We were all pretty calm at that point knowing that it was time, but feeling pretty dang good that we made it to 35 weeks and 5 days and we thought we were home free. When they took us to triage the nurse hooked up the baby heart monitor, only she couldn't find a heart beat. She changed the position on the monitor about 4 times trying to find something. Liza, Leslie (Liza's mom) and I all looked on knowing exactly what was happening since we had been in the hospital for two weeks and she never had a problem finding the heart beat. The nurse finally found a faint heartbeat of about 70 beats per minute (it is supposed to be between 120-160).

She left the room to alert everyone of what was going on and told them to prep for immediate surgery. The next thing we know about 4 other people invaded the room, including the on call doctor, two nurses, and the anesthesiologist, who happened to be Ryan Huffman from our ward. As an aside, Liza had previously secretly expressed her hope that no one from our ward be in the OR (we have lots of doctors in our ward), especially after the verbal abuse she dished out to the last anesthesiologist who took just a minute too long to get her that spinal. It ended up being a great blessing to have Ryan in the room, as he was a familiar face that helped keep Liza calm when everything was chaotic and I wasn't able to be there with her.

Anyway, back to the triage room. They brought in a mobile ultrasound machine to check her, but they couldn't see what was causing the problem, so they took her immediately to the OR for what her doctor has dubbed a "splash and dash" C-section, referring to the hurried manner of applying the iodine for surgery prep. As we headed to the OR, they handed me all the scrubs, facemasks, etc. but told me I had to wait outside the room on a chair until they were ready to get me. The chair was a little down the hallway where I couldn't see what was happening. I felt like a little boy that had to go to timeout or something. I never went to the chair, instead I stood at the door of the OR looking on through the window and that is as close as they let me throughout the surgery. I could only hear what they were saying as someone would run in or out of the room opening the door for just a second or two. So here is what I saw and heard from the window:

As they wheeled her in to the OR, it was pretty chaotic. They took the mobile ultrasound unit with them and tried to keep tabs on the heartbeat. The last thing Liza remembers is that they explained that they were going to try to get the baby's heart rate up to buy enough time to get a spinal started. About two seconds later the on call doctor told Dr. Huffman, "we are out of time, put her under now." Apparently the heart rate got down to about 40 and the doctor decided they couldn't wait, so Liza just got general anesthesia.

Just as they were about to start the surgery, Liza's doctor (Dr. Harris) rushed through the door from the prep area to where I was and the on-call doctor came out to meet her and made it clear to Dr. Harris that there was no time to waste. They rushed back in together and started the surgery. It was all a blur. I have been able to sit next to Liza and hold her hand the last two times we did this, but they never let me in for this one. I could see a little through the window every time a doctor would move out of the way. In the rush of it all, the baby got a little scrape from the scalpel as they sliced Liza open (nothing a little bandage can't take care of).

They opened her up, grabbed the baby out and plopped him on her lap trying to clear his airway. After a couple of attempts she gave up and handed him to the NICU team that was there waiting to receive him. At this point, my attention shifted to the baby, as I knew Liza was in good hands and was off in "la la land" dreaming of all the fun things she was going to do finally off of bedrest.

The baby, Crew, didn't look good. He was blue and lifeless. Sometime between the last ultrasound and his delivery, his heart had stopped beating and he wasn't breathing. They bagged him immediately as they tried to get the oxygen in flowing. They continued to work on him, but all I could see was one of his feet and a little of his leg, which continued to be blue and lifeless. I finally stopped looking. Because I wasn't in the room when they were doing the final ultrasounds, etc. I didn't know if the heart had stopped 5 minutes ago, or one minute ago.

I didn't know how resilient these babies can be, so after a minute or two out of the womb and still no signs of life, I thought it was over and I just paced back and forth in that hallway in shock. I would peer in every once in a while but I couldn't see what was going on. They kept working on him, and kept bagging him, and after a few minutes they got him stabilized. They opened the door and told me to look in at my new baby, who was now breathing and he was nice and red. They told me that they were able to get his heart started after only a minute and he started breathing on his own after two minutes. That still seemed scary to me, but he looked a lot better than he did just a few minutes earlier. They told me they were going to take him to the NICU and continue doing some tests.

They did a series of tests. The most important test was the blood gas test, which they did three times (once from the cord blood, once right when he got to the NICU and once a few hours later). Apparently the cord blood test was really low and really bad, his next test was still too low, but it showed that his body was working to stabilize things, and the third one showed that his body was progressing and his numbers were no longer low. Apparently the blood gas test can help the doctors understand or at least guess how long the baby had been in distress and how long he had been oxygen deprived. Based on the tests, they estimate that he had been oxygen deprived for at least 10 minutes.

In the NICU things were calmer. They put him on a c-pap to help him breath, but he started looking better and better. The on-call doctor who helped with the deliver came in and wanted them to put a "Cool Cap" on him, which is a device that cool the brain and helps reduce the chances of brain damage. They consulted the charts and the neo-natologist and determined that Crew didn't meet all the requirements to get a Cool Cap, which I guess is a good thing. I stayed by his side for a while until they told me he was completely stable and I could go check on Liza. As I left, the nurse mentioned that because of the way Crew was breathing and reacting to their treatments he was considering Crew a low risk for long term effects.
After what seemed like forever, they finally let Liza come out of the OR where her mom and I were waiting in the recovery room. She was out of it and couldn't speak very well since she had been intubated when she was put under. I spared her the details, and just told her that the baby was fine and stable. Little did she know all the drama that had taken place. It wasn't until the middle of the night that she woke up enough for me to tell her what had happened, but by that time Crew had really progressed and everyone was VERY optimistic about his future.

By the next morning they had completely taken him off of any oxygen and he was getting ready to start trying to eat. They talked about doing a brain ultrasound and MRI to try to determine what kind of damage may have occurred, but because he was progressing so well, the neo-natologist decided it wasn't necessary because they would have had to put Crew under and he had already responded so well. The only complications that we know of right now is that he has a slight heart murmur, which they are going to continue to monitor and they will have us work with a developmental pediatrician over the next few years to track his development. As I mentioned, they consider him very low risk at this point, but they will still want to monitor his progress. For Liza and myself, whether there are some developmental challenges that lay in store or not, we are just happy to have another boy to add to the our family.

Amazingly, Crew has continued to progress and it is now Sunday morning, just 3.5 days after he was born and he is out of the NICU and we are getting ready to go home. For the first time, Liza and I get to bring a baby home with us. I think in the end, Crew just didn't want to feel left out. He knew that Carter and Mac came into this world with a little drama, so he wanted to upstage them all, which he definitely did, but then he decided to act like a true 36 weeker, and we are all headed home.

So, that is our story. Since Liza has used this blog to talk about everyone else, I have a thing or two to say about her. She has been through a lot over the last year or so. When we miscarried a little over a year ago it was pretty hard for her and it was a trying time. Then in July we thought for sure that she had miscarried again, but this Crew is a fighter and wasn't going to give up that easily. The last 7 weeks of bed rest have been a challenge, especially for someone like Liza who always has to be doing something and can't ever rest. She has been a good sport and has let everyone else take care of her, which is hard for her to do, but it has all paid off in the end. She is an amazing mom and an amazing person and I am lucky she hasn't replaced me yet.

So from all of us in room 3427 (Liza, Matt and Crew) we are checking out and off to the next phase . . . life at home with Carter and Mac. Wish us all luck, keeping Carter and Mac from smothering the baby may be the biggest challenge of all. They are pretty excited to finally have him home and have all sorts of Star Wars knowledge to begin to teach this young "Baby Yoda" as they have decided to call him. For the rest of us, we will stick with the name Dylan Crew Richards (born 1/6/10, 6lbs 3 ounces).