June 15, 2007 - Day 1

The day of Andrew's birth was one of great anticipation for us. He was due on the 9th, and we had decided to induce labor one day short of 41 weeks, six days late. We were both excited and nervous as we drove to the hospital. We checked in at 7am, were admitted to an LDR room (Labor, Delivery, and Recovery), and D was prepped and on an inducement IV by around 8am.

I won't bore you with the details of the day, but labor progressed as expected. D got an epidural a bit later than expected, so she got to feel some good, solid contractions....a real taste of natural labor. We spent a lot of time staring at the fetal heart rate and contraction monitors, making sure the epidural was working and seeing how the labor moved forward. For a while we were a bit concerned that the fetal heart rate would drop when a contraction came on, but rolling over and changing positions seemed to provide a temporary solution until the problem later disappeared on its own. The doctor kept checking in on us and our nurse was fantastic.....we were very well taken care of.

We'd always been worried about the need for a possible cesarean, due to my large birth weight, pre-labor ultrasounds that showed a big baby with a bigger head, and the fact that both D and I required C-sections. This was a very real possibility, especially when the nurse determined that the baby was coming down face-up, which makes for a more difficult natural delivery. Fortunately, the nurse has been doing this a long time and managed to get him turned around during the "pushing" phase. D started pushing at 3pm, and delivered at 4:58, only ten hours after arriving. Andrew was delivered, suctioned, snipped (umbilical), and handed over to the nurse.

The first indication we had that anything was wrong was when we didn't hear a cry. The "delivering a baby" scene in TV and movies only has a few main requirements...a "mother pushing" scene, an "I see the head" moment, and a "baby screaming" view. Believe me, D did her share of pushing, and I got a good look at his head on the way out.....but we didn't hear him crying. That was scary enough, but the flood of doctors and nurses that followed was even worse. They performed CPR on him to ensure that his heart was still beating, they tried to "bag" him to give him some air, and eventually they had to intubate in order to get some oxygen in. Everyone seemed a bit stymied initially, but the first possible diagnosis we heard was a pneumothorax, as they weren't hearing any breath sounds from his left side. They wheeled him out of the room and down to the nursery, where they did a chest X-ray and determined the actual problem....the diaphragmatic hernia. The reason they hadn't heard any breath sounds from the left side is because his digestive tract was taking up that space, rather than his lung.

Though the doctors and nurses were surprised by this issue, they were very professional and dealt with it as quickly and efficiently as can be expected. They were giving him as much oxygen as they could, but his underdeveloped lungs couldn't process it very well. He improved from dark purple to a light blue, but was still in critical condition and obviously needed some additional help to breathe. They decided to transfer him to Children's Hospital, which is only a short drive away and one of the primary care centers for this sort of neonatal disease (and many others). The three-person transport team arrived, moved him to a mobile cart, and took him to the ambulance for transfer. We got to see him again before he left, and though he was better than at the delivery, it was probably the most scared we've ever been....he looked very sick, very blue, and very fragile.

D obviously had to stay in recovery, so I drove over to Children's to see how he did after the transfer. I was there for a few hours and spoke both to the transfer team and to the neonatologist that worked on him after he arrived. There was both good news and bad news. The bad news was that a pneumothorax had developed sometime between his first chest X-ray and arriving at Children's for his next X-ray. This meant that his "good" right lung had a hole in it, collapsing his lung and filling his chest cavity with air. They had to put in a chest tube to drain the released oxygen, which was successful, but the collapse didn't bode well for his lungs being able to take over. The good news was that he had actually gotten a little better in the ambulance on the way over, and that he didn't (yet) have to be put on the most advanced life support machines. Even on a normal respirator, he was looking MUCH better than he had been when he left.

The Neonatal ICU at Children's is only for the most critical kids, and Andrew definitely applies. In order to have the best access to give him medicine, draw blood, and provide other care, they inserted multiple IV lines (in his arm, foot, and umbilical cord), a ventilator, a stomach tube, and the aforementioned chest tube. His arms and legs were splayed out to the sides, he was sedated so that he wouldn't feel any pain, and he looked a little doll-like....however, he still looked 100x better than earlier, and I was just happy to see him pink. In the wee hours of the morning, I went back to the hospital and spent the night with D, who was recovering nicely but understandably emotionally distraught.

[I'll introduce pictures as I took them, starting with pictures from that first night. These pics will look better and worse as I write about later days....but I want the opportunity to explain what's in them instead of throwing a ton of pictures up all at once.]