Merry Christmas

Merry Christmas everyone.  We've had a great week.  Grandma and Grampa are here from Ohio and I (Emily) have spent a great week at home cleaning out the office, sleeping in our bed and getting Luke's bedroom ready.  We've had lots of well wishes and spent last evening delighting in the children at the Chrismas program at church.  We've been keeping track of Luke by phone and visiting.  He's been doing really well.  He's finally off IV and on full feed and growing.  Go Luke Go!  Now we just wait and see how he grows. 

The week we had (thank God for antibiotics)

What started off as a relatively uneventful week ended up to be quite the adventure.  On Thursday last, Bryce left early from the Ronald McDonald house and made it to work about the time that I was rolling into the parking lot at RUH.  Just as I was coming into the hospital, the nurse to parent liason called to tell me that Luke had had a tough night, he had several bradys (bradycardia episodes) and was exhibiting periodic breathing...not quite apnea.  They had drawn blood and immediately put him on a general antibiotic, took him off food and back onto cpap.  When I got there he was so sick looking.  I called Bryce to come back.

Ok, I had no idea what the love of a parent was until I considered a life without Luke.  I don't want to dwell too much on it, except to say that I have a new understanding that we are now no longer ours alone but we now also belong to Luke.  Does this make sense to you?  Its a strange feeling.

The staff was extra vigilant against me that day.  They made me go for coffee (how can I go for coffee when my heart is struggling to breathe?) And to have lunch (how can I ever eat again?) When I came back from lunch, Bryce was with me and together we sat and watched.  And by 2 in the afternoon the cpap was doing its magic, the antibiotics had kicked in and our little  wiggler was making signs of coming back.  Oy.  What an adventure.

Since then he has only improved.  On Saturday they took another blood culture that turned out negative  (go antibiotics). Bryce and I went on a date to the sing along Handel's Messiah, and I slept in my own bed.  Luke is in good hands.

I returned today after 2 nights at home and found Luke sleeping in a rather odd position.  I havent laughed so hard in weeks.  I took a picture and included it here.  Note what isn't quite right...1 lead pulled off body, eyes blindfolded by headgear, cpap nasal prongs in mouth, splayed out body.  Our wiggler is back.  Thanks be to God.

"This is my very favourite thing EVER"

“This is my favourite thing.”  I can't believe how often I've said that lately.  I believe I said it first when noticing my (Emily) blood pressure at 116/73.  What a glorious thing!  And then I said it when eating crackers and cheese for a snack in the maternity ward.  And then there was that time when I felt numb from the waist down in preparation for birth (ya, it actually felt pretty good) and then there was that time when I heard Luke cry for the first time right before they wheeled him away to NICU.

But I have to say that every day now is my favourite time.  When Luke looks crossly at the sound of a wailing baby...when the doctor laughs at Luke and says, “He's trying to crawl out of his isolette”...when he poops (horray for any size of poop!)... when he can keep his food in and doesn't spit up. ..when he nestles into my chest and makes squeeky noises...when he cuddles into Bryce and gazes up at him...ok.  enough schmaltz.

We're actually doing ok.  Luke has some digestive issues, it seems as though we both have some milk issues and I've got some wound issues.  None of these are overly serious, but each demand the attention of doctors.  That is good, because we are surrounded by competent doctors here.

Today I ran into the resident who informed us of our impending birth - and then proceeded to bring Luke into the world.  I told her how happy we all are, how grateful that we're all relatively healthy.  I thanked her for her part. 

Ya.  Feeling all blessed tonight.

The mundane begins

After being freed from the confines of the hospital bed on Sunday afternoon, I, Emily,   have taken up the most ancient of occupations known to humanity...that of the ferocious she-bear.  I delight in that image. 

Yesterday was our first "normal" day.  I spent much of the time in NICU gazing adoringly and with delight in our kicking- and-pulling-out-all-his-wires-and-cpap -prongs son.  He is such a wiggling nut. 

So far we've just had one kangaroo care time (where he is held next to our skin) because Luke has some digestive issues.  To put it lightly, he's all bunged up.  Thankfully the nurses and drs know what to do about that and if thats the least of our worries then we are golden.

I've found secret safe spots in the hospital where privacy for pumping and napping can be found.  I will not tell you where these places are.  Keep it secret; keep it safe.

Bryce is back to work.  Its another busy week at Drake Meats with a consultant coming on Thursday from the UK, and a giant pole being raised for network acutriments going up today.  Bryce came in last night and had a chance to take many photos of our new beloved one.  It had been a while since we slept in the same room, let alone bed, and this too has been a healing balm.

I'm staying at Ronald McDonald House and finding that it exceeds my expectations.  The staff and volunteers are friendly, the space is restful.  I love observing the families that are there interacting with their children.  And I love that there seems to be a general state of good will and restful peace about the place.  Could even Ronald Macdonald be a   conveyour of the holy?  I'm trying hard to keep an open mind...actually I'm not really trying too hard.

So, today is more of the same.  I'll try to make it to rounds, I'll pump and nap hopefully hold Luke and maybe even find some time to buy some groceries.  

This will be the last blog we post on Facebook.  If you want to follow our blog, we will keep it updated probibly once a week.

Thanks for your love, all.

Luke: I am your father and other things my son is about to become tired of

We went to visit our beautiful son cocooned in his NICU bed.  He was sleepily moving around and exploring his world, all be it confined to a plastic bubble.  He has a full head of black hair and much reddish skin is about the best thing I have seen, well, ever.

We waited on Emily's chance to meet him until settling on our short list of names, though his actual name sounds like a short list of names:

Luke Malachi Toews Miller

To be clear, we did not select this name just for Bryce to make a repeated Star Wars reference.  It was just gravy.  Delicious, Delicious, gravy, like the Poutine of his home and native land (one of them at any rate).

So that is enough surrealism for one day.  We will share more in time.

So here's how this happened

It was supposed to be another boring day at the hospital.  It was supposed to be the same routine-- monitor, measure, medicate, repeat.  It has been the routine for quite some time, and we were expecting it to continue for quite some time to come.  Like days or weeks.

Instead we had a baby.

I am glad that after 2 days of necessary work at Drake demanding driving back and forth, the day ended up being today.  Last night was not a great deal of fun for Emily with a goodly amount of discomfort in and around the torso.  With this in mind, I was going to stay here in the city working on my system via a remote connection.  When I arrived in the morning, our now routine was well underway.  Blood draw. Doctor's rounds. Pills. Non-descript breakfast. We were just settling into our respective quiet activities when our OB resident walked in and said:

"So, the plan has been to keep you pregnant.  I am here to change that."

Right.  This was 9:10 or so this morning.  We were getting on the slide and going down from there.

The numbers, while improved had been moving and in a downward trajectory which, left to their own devices, did not represent a good trend.  This was not unexpected.  The initial steroid treatment can produce a response that can mask the underlying syndrome.  As that treatment wore down, the numbers began their backward slide.  The morning blood draw confirmed the diagnosis to a certainty, as well as the general direction of the blood cultures and numbers.

So there we are.  An initial physical exam was made and they were not able to establish with certainty which end was up (or more to the point, down) on then Blasto.  An ultrasound showed him rather contentedly lounging across the womb lengthwise, there by making conventional childbirth ill advised.  C section was the order of the day.  Consultation with the Anesthesiologist recommended a spinal block as the best way to have the delivery, thereby allowing Bryce into the operating room. Immediately changing into scrubs and gear, we were off to the races.  Pack up, down a few more meds, move to the pre-op area and by 11:50 or so we were in the room and getting started.

The baby was born at 12;14, 2 pounds 10 ounces and 10 weeks premature.  The C section went well and Bryce was able to watch while the baby pop out and was handed to the waiting NICU group who took care of Blasto, got him set and on his way to the NICU (only after a number of photos from Pops).  We had another 45 minutes or so of sewing up to do, and then another hour in post op, and we were ensconced in our room in the post-partum ward by 3:30.

So the snails pace of our last several days turned into a sprint at the end.

Bryce was able to visit him in the NICU by 5 and we were both down there this evening.

Blasto-come-baby is a healthy, robust, hairy individual already poking his away around the great big world.  We are thrilled beyond words.

The story is far from over yet.  There will be days and perhaps weeks of recovery for Emily, and further complications, while not likely, are possible.  We are looking for a stabilization in blood pressure and the all important lab tests from Emily, and we trust that will come in time.

For baby, it is now the work of doing the development he was supposed to do in the next 9 weeks.  There are challenges and potential pitfalls, but those seem broadly unlikely (but I guess that would be why they are called pitfalls, aren't they).

We hope to continue to update you here, though likely not with as great of frequency.  Thank you each for your love, care and support here and throughout life.  We feel it and appreciate it deeply.

With Love,
Bryce

Unto us ....

And unto us a child is borne. 2 pounds 10 ounces baby boy borne at 12:14 pm via c section.  Baby is good, all things being equal and mama is doing well.  We are thrilled.  Now begins act II: waiting to be able to know how he develops on our way home a likely 6 week process, even with all going well.

And he shall be called....  tune in after Emily has met him in the flesh on the outside, probably later today.

And off we go

We are one our way to a c section now.  More explanation soon.  Today is a birth day.  Cake to follow.

First long day

Greetings friends.  After last night's fun move back to labour and delivery observation due to my not decreasing blood pressure, we are all happy to say that bp is normal again.  The ob put me on Magnesium Sulfate again to prevent seizures (due to the high pressure) and that and multiple introvenus meds made for a dopey night and much of the day.

This morning and afternoon I was delighted by visitors!  Too bad I was strapped to the bed with electrodes picking up Blasto's every heartbeat and movement.  Unfortunately because of the magnesium sulfate even Blasto was dopey.  By 6 pm I had been strapped for 6 hours ( 3 in am and 3 in pm) and Blasto was still sleeping so they set us free.   Bryce came, I had a shower and everyone felt human again.

Thanks to all of you for your prayers.  We're just waiting now to figure things out.  Hopefully once again out of the woods.

Emily

Baby by numbers; the origins of "Blasto"

9:45 PM November 22, 2015

It seems like we are having a baby by the numbers. Our lives (all three of them) are sort of being steered by them now.

Like the quarter hourly blood pressures.

The thrice daily blood tests.

And the all important hours, days and minutes of time that Blasto remains right where the kid needs to be.  The more the better.

We find ourselves in the power of the numbers at the moment.  Blood pressure has climbed above the thresholds that we are wanting to see, and they are not coming down, despite the best efforts of everyone here.  And if that remains true the 1 shall become 2 all too soon.  Like as soon as over night.  Which is OK, just not what we would choose.  Having 3 days to wrap our heads around the possibilities of how things might end up working here helps a great deal.

The blood pressure calls the game, but the blood analysis tells the score.  Liver enzymes (which tell the liver function) want to be low.  Platelets (which help with clotting) want to be high as possible.  These numbers are moving, but only slowly which makes the difference between concern and crisis.  This is what will, ultimately, tell when the time has come for Blasto to come into the world.

Then is the trivia numbers.  Like the more than a liter of pee put out in the last 2.5 hours by the lady of the hour (we measure everything around here).  And the 140-150 beats per minute ticking on the monitor behind us with Blasto's pulse, assuming the kid isn't actively kicking, punching, or generally hiding from the all hearing ear.  Blasto is a squirmer, which delights us (for now).  We even overheard hiccups the other day-- pretty cool.

We have heard that some explanation of the nick name Blasto is in order.  You will no doubt be relieved that this is not the child's name, though we are still considering "Helium Unicorn" as nominated by cousin Nora.  Blasto is what we arrived at when finding out that the pregnancy was a practicality.  When the egg and sperm first implant into the uterus, it is called a "Blastocyst", a generic term for lump of cells (we offer apologies to those for whom this congers images of cancers; not our intent).  We decided that we, not wanting to anticipate anything gender wise, would decide to call the one growing in our midst "Blasto".  Besides, its a great playground nick name.

More soon

With much love,
Bryce, Emily, & Blasto

Sleepy time update

Well.  We made it through another day all where we ought to be.  We heard this morning that my platelets had increased to normal, liver enzymes good and kidney function is ok.  That is pleasing and good news.  Now comes observation and observation and observation.  Will it all stay steady? The Dr's remind us that steroids, while helping the baby's lungs also temporarily can boost my blood platelets.  Thus observation.

Baby and mama are sleepy today.  I did manage about 6 hours intereupted last night, but 6 hours is better than 45 minutes the night before.  Baby isnt punching and kicking today, but the heart is steady and strong and baby is moving and hiding from the machines.   We laughed and sang silly songs to baby today while on the machine...baby just slept on. 

So, tonight a baby friendly sleeping draft for me and there will be dancing and running and singjng in my dreams. 

Bryce is taking the service tomorrow. I'm slightly jealous.  It's my favourite Sunday of the year - Memorial/Toten Sontag/Eternity Sunday and this year they'll light a candle for Dad.  Always so meaningful. 

Anyway, thanks for all your prayers this week.  We are resting in your and God's hands.

New LEG of the journey

What pretty ankles I have! And look! Tops of feet!  It feels so good to have my legs back to their typical grisly-Toews shape.  And, aside from lack of sleep on my part, things are looking good.

We had an ultrasound this evening and baby looks and acts healthy and strong.  No sense of any damage to baby or placenta yet (fingers crossed) with my preeclampsia.  The obgyn estimated the baby to weigh about 2.6 pounds.  That is good.  I want baby to be at least 3 pounds before I see baby's face.  We didn't actually see the baby's face because it was tucked in snuggling my back.  Sweetie.

So, I kicked Bryce out of the hospital...to Alexander's for good food - and took a shower.  We're back in Antinatal in a private room where, hopefully, I can finally sleep. Now I'm just waiting for my evening bloodwork and hoping all goes well tonight.  We'll keep you posted.

Heading to a new normal

From the monitoring equipment:  do not shower pregnant with electrodes on.  Pro tip.

2:45 PM November 20, 2015

The latest lab results have come back and they show that while the organ involvement has yet to stop, it is not worsening.  In sort this is where we want to be.  Blood pressure being controlled, by in large. Body systems healing themselves.  And a healthy mama and healthy kiddo.

Moments of surrealism abound.  Like the medical assessment "it is just that your baby is trying to kill you."    

The upshot here is we are now in the sense of days rather than hours, as was said before, with the word weeks being thrown around on occasion, allbeit with a high degree of caution.  The baby will quite possibly need to be early, but perhaps not as early as, you know, today.  Emily will need to be curtailed for the remainder of the pregnancy, and perhaps hospitalized, however that ends up being.  

All of which makes a guy kind of glad to find himself in Canada, but that is a different conversation all together. Though I still snicker as I pass the plaque unveiled by Her Majesty the Queen on the opening of a wing of the hospital, I am glad to be at home in a different place with one year behind me. I am just not sure how long it takes for monarchy to start sounding normal to American ears. Takes some getting used to.  

So the order of the day is now to rest.  Bryce has confiscated Emily's cell phone and turned it off for at least several hours in the hopes sleep might, just might be possible.  We will see if she gets it back.

Thank you each for your concern and your prayers and much much love.  We only hope to be given opportunity in time to fully demonstrate our gratitude.

PS:  the cell phone restriction fails miserably.

The numbers keep getting better

9 AM November 20, 2015

Another 6 hours, another blood draw and more news.   And it is good.

The meds are having the desired effect.  Liver function is improving. Ankles are emerging (much to Emily's delight). The baby is bouncing around happy as a clam.  It sounds now that we now from "the next time you see us we will likely be delivering you" to "yeah we're just going to hang out today."

Good news today is more boredom.

More soon

It 3 am. Do you know what YOUR liver function is?

3 AM November 20, 2015

The blood work came back and the numbers have stabilized, and somewhat improved.  This buys us another 6 hours until the next round.  and now we try to sleep.  or Emily tries to sleep while Bryce snores in the corner.

11:30PM Thursday, November 19

Pre-eclampsia or preeclampsia (PE) is a disorder of pregnancy characterized by high blood pressure and a large amount of protein in the urine.^[1] The disorder usually occurs in the third trimester of pregnancy and gets worse over time.^[2][3] In severe disease there may be red blood cell breakdown, a low blood platelet count, impaired liver function, kidney dysfunction, swelling, shortness of breath due to fluid in the lungs, or visual disturbances.^[2][3] Preeclampsia increases the risk of poor outcomes for both the mother and the baby.^[3] If left untreated, it may result in seizures at which point it is known as eclampsia.^{[2]   -- wikipedia  The only cure for preeclampsia is birth}

So that is what it is.  And we have it.  Emily has struggled for some time with high blood pressure for some years, and we knew this was a risk.  We have been working together on blood pressure and working with medications, with little effect.  This week our family doctor referred us to a Obstetrician to get it checked out, especially as Emily has had a number of highly resetless days and nights with extra ordinary high blood pressure and a general discomfort.  

We were left contemplating delaying today's appointment after receiving the first winter storm of the season and have 120 km of ice covered roads to deal with.  We decided to risk it and we are glad that we did.  Our OB took a look and sent us off to the Royal University Hospital.  We got settled in and I (Bryce) headed home as the plan was control the blood pressure and get things stable-- not much to worry about and now medical drama in the near offing.

But that changed. I got home and had supper just in time to get a call from Emily saying that I needed to come back, that Pre-eclampsia had indeed set in and we may well be seeing our 29 week old child sooner than we either expected.  With that, I packed a bag, and headed back to the city.

 We are now in waiting to see how the blood tests look.  The problem, it seems with Pre-eclampsia deprives the organs of the mother with adequate blood supply.  Emily's body is starting to show signs of this deprivation, and we need to address this.  The question, it seems now is not whether our child will appear well ahead of schedule (a true first for the Miller-Toews household), but when the kid will make an appearance.  Ideally mother and child and continue sharing space for a while longer yet, but it seems like the arrangement is coming to and end sooner rather than later.

The 2 AM blood test will tell the tale.  Stay tuned.