Sunday, July 24, 2011

Happy as a Lark

We have one group of very happy siblings about now - they have finally gotten to hold their new sister!  Caleb, especially, is happy as he has been asking practically daily, "Am I going to get to hold Leah yet?".  Mommy was discharged from the hospital for the second time on Friday and we all went to get her and it was also a chance for the kids to see Leah.  Since she has been put back on the oxygen she is doing great and since she is otherwise very stable, we could let the kids hold her for a brief time.  As you can see below, by the beaming smiles they all were "happy as a lark".  Mommy is happy too to be out of the hospital and hopes to stay out for good this time.  She has been changed over to oral antibiotics and will be rechecked in 2 weeks.  Thankfully her fever has not come back and she is feeling much less fatigued.

Biggest sister holding littlest sister
Biggest brother holding littlest sister

Noah holding Leah

Joshua holding Leah

Very Proud Caleb holding Leah

Happy as a lark Uriah holding Leah

Big little sister holding littlest sister

Thursday, July 21, 2011

Update on Ralanda and Leah - part 2

In the last post, I mostly updated about Leah and it got late so I didn't get to what has happened with Ralanda.  Everything that happened with delivery of the baby and the second surgery afterwards was discussed in the very first blog post.  After receiving many blood transfusions Ralanda slowly began her recovery and was discharged from the hosptal on July 7th.  For the next 10 days we all tried our best to keep Mommy from doing too much and get her to rest and recover.  Daddy and Mommy continued making daily trips to Albany (1 hour each way) to visit Leah in the NICU.  Ralanda's mom and dad had come up the day Leah was born (July 3rd) and Ralanda's mom had stayed and helped us so greatly and was due to go back home tomorrow.  That was all the plan until this past Sunday.  Ralanda became very tired and sleepy and did nothing but sleep all day Sunday.  Scott was concerned as she was very weak and pale and would complain from time to time of having the chills.  Finally, with no change by Monday, Ralanda finally consented to going back to the hospital and getting checked out.  We returned to Albany Medical Center and Ralanda wound up being readmitted due to lethargy, chills and fever.  The doctors suspected a hematoma (collection of blood) had been infected, or an abscess had developed.   A CT scan was performed Monday evening and confirmed that a collection of fluid was present (hematoma or abscess).  She was started on IV fluids and 2 different IV antibiotics.  There was talk of needing to perform surgical drainage of the fluid if the fever did not respond.  So far the fever has responded to the antibiotics and for now the doctors are talking of avoiding surgical drainage.  They are hopeful that if the antibiotics continue to work that the fluid will be resorbed, thus avoiding another surgical procedure.  Today the last of the IV antibiotics were given and Ralanda has been switched to oral antibiotics.  We are praying that this infection will resolve and not recur.  At this point, Ralanda has gotten a good amount of her energy back and is feeling much better.  The current plans are for her to be discharged from the hospital (again) tomorrow.  Because of all of this, Ralanda's mom is staying another week, and we are so thankful.

Leah was taken off of supplemental oxygen 2 days ago and today started to develop quite rapid breathing.  We asked to be notified when the doctors would be rounding today so we could hear their assessment and plan for Leah.  The doctor said that "sometimes we push these little ones a little to quickly as we are excited that they are doing so well".  She said that sometimes it will take a day or two before they tell us "whoa, not so fast".  Well, it appears that Leah was not quite ready to give up her oxygen supplementation yet.  They put her back on the oxygen this afternoon and she is breathing much better again.  There's not really much concern over this - it just means she needs weaned off of the oxygen a little slower.

Overdue Update on Ralanda and Leah

Unfortunately things have been very crazy for the last 2 1/2 weeks and although I intended on recording updates, it just has not happened.  My goal will be to update more frequently if this format of a blog works out well.  Going back to the end of the previous/initial post:  Baby Leah now has a middle name and it is Ralanda, after her mother.  Mommy was considering several names, but Leah Ralanda won the final vote.  Leah is still in the NICU at Albany Medical Center where she is receiving excellent care.  It was very rough the first week as she had an endotracheal tube (breathing tube) down her trachea (windpipe) and was hooked up to several IV lines, monitors, etc. 

Leah with the endotracheal tube
Being attached to all of these things and being so fragile, we were not able to hold her, but simply touch her while in her special bed.  Her brothers and sisters were so glad to get to see their new sister, even though all they could do at this point is to look at her.  Because NICU rules only allow 2 people by the bedside at at time, we had to get several pictures as we traded off visitors.

Leah with Gi-Gi and Naomi

Leah with Scottie and Uriah

Leah with Joshua and Caleb

Leah with Noah

  To improve her breathing, she was given surfactant, a substance that prevents the lungs from collapse, and that babies make on their own later in pregnancy when they are near term.  Premature babies often do not have surfactant, or do not have enough, and need it given to them as was done for Leah, a couple times over her first several days.  After a couple days, her breathing improved enough that the breathing tube was able to be removed and she was put on a CPAP mask similar to the ones that people with sleep apnea wear.

Leah with CPAP mask

 Finally, after 6 days we were able to hold our baby!  At this point she had lost weight (as all babies do at first) and got down to 3 lbs 7 ozs and it felt like we were hardly holding anything.  It was so good to finally hold our baby, but it was difficult to watch her work so much to breathe.
Tears of joy as Mommy holds her baby for the first time.

Daddy holding baby for the first time.

After a couple days the CPAP was able to come off and she was put on a nasal cannula (the tubing that you sometimes see that goes over the ears and has prongs in the nose).  She was originally fed TPN and lipids through a central IV line and then was gradually started on formula through a tube inserted through her mouth.  Once she started keeping the formula down the tube was then changed to a nasogastric tube (the tube enters through the nose) which is still in at this time.  She is being fed mostly through the tube but is slowly starting to drink small amounts through a bottle, once or twice a day.  She needs to be able to take all of her feedings through a bottle before she can go home.  I'll try to add what has been happening with Mommy tomorrow.

Saturday, July 16, 2011

New Beginnings

Well, here's to new beginnings.  A new baby.  A new blog.  I'll start off with the original post that was posted on facebook and some received by e-mail.  As soon as time allows, there is a lot to update and we will do it here.  Thanks to those of you who have taken the time to contact us and who have offered your prayers.

Baby Leah Stipe, 4lb 4oz, 18 in long was born on July 3, 2011 at 2:05pm at Albany Medical Center in Albany, NY.  Needless to say, Daddy is hoping that this does not become a regular tradition of spending holiday weekends on a roll out chair at Albany med (Noah had his bleeding and surgery over Memorial day weekend, last year)!

We have purposely kept silent (to all but a few very close friends and family) about Ralanda's pregnancy with Leah to avoid some of the negativity from some family and friends who have at times asked, "aren't you done yet?" or other more colorful questions and comments.  We understand that some of these comments were out of concern for Ralanda's wellbeing and safety.  We tried to explain that we do not take her safety lightly and some were understanding, some were not so.

We completely understand that many do not hold or understand our view regarding family size, however we respect those who do not share our view, and have simply asked that we receive the same respect in return.  Psalms 127:3-5 says, "Lo, children are an heritage of the LORD: and the fruit of the womb is his reward.  As arrows are in the hand of a mighty man: so are children of the youth.  Happy is the man that hath his quiver full of them: they shall not be ashamed, but they shall speak with the enemies in the gate."  For us personally, this means that conception and childbearing are a blessing from God and we have always desired God's blessing in all areas of our life.  God choses to bless some with no children, others with one child, to others many children, all according to His will.  We simply have desired that His will be done in this area, for in scripture it is God to opens and closes the womb.  Again, we do not pass judgement on anyone who feels differently, this is simply what is right for us.  The belief that God is in control, in every area of our life, is the foundation from which we try to operate.  It is because of this firmly held belief that we cannot let adverse circumstances cause us to trust God less, but rather to trust Him even more.  Because of  Ralanda's previous diffuculties in child birth, our faith has been put to the test, repeatedly.  It has not been easy. Many have suggested that we should have relied on medical technology and avoid any further difficulty and risk.  For us personally, we felt that in light of scripture we would be leaning on our own understanding and not putting total faith in God, as we say we believe we should do.  We are human, and despite our faith, have been fearful at times, but have relied on God to see us through.   We, personally, simply believe that God wants us as to rely on Him, especially when it is not so easy to do so.  Proverbs 3:5-6 says "Trust in the Lord with all thine heart and lean not unto thine own understanding..."  Our faith was again put to the test this weekend...

With our last pregnancy Ralanda had a condition known as placenta previa that carried a risk to mother of massive hemorrhage, and even death in childbirth.  Thankfully, God saw us safely through, and as hard as it is to imagine, Naomi Ruth will be 4 years old in October!  The concern then became that the chances of placenta previa on any future pregnancies would be even greater.  There also was a concern of placenta accreta, a condition in which the uterus and the placenta essentially grow and "weld" together.  The problem is that, at the time of delivery, separating the placenta from the uterus can result in massive hemorrhage.  When this happened with Naomi, the bleeding was, thankfully, able to be controlled.  When we found out that we were expecting again, the immediate concern was if we would have to deal with placenta previa and placenta accreta again.

Jumping ahead to this weekend, Ralanda had preterm bleeding that started without warning on Friday.  This is an event that occured two times during the pregnancy with Naomi, and was able to be controlled so that we could postpone her delivery until 37 weeks gestation (full term is 40 weeks).  This bleeding was a disappointment, but not totally unexpected, as we had been through this before.  After consulting with the doctors, Ralanda was advised to strict bed rest this weekend, which she began on Friday.  The bleeding seemed to stop on Saturday, but she was awakened with  bleeding around 2am Sunday morning.  We pondered if going to the hospital was necessary or not, but after another amount of bleeding around 4am, we called a close friend to sit with the kids and headed to Albany Medical Center.

Having been in this situation before, we really thought that we would be spending 48 hours in the hospital, that the bleeding would stop, and that we would be headed back home by about now.  This, however, was not in God's plan.  The doctor initially gave very good news.  After ultrasounding, he determined that the placenta previa was no longer present (as it can sometimes resolve as the pregnancy progresses).  This was a direct answer to prayer and we were rejoicing!  There was still concern of the placenta accreta, however, the doctors were leaning towards the fact that this was not present either!  The plan was to monitor the bleeding throughout the morning and it was likely that Ralanda would be sent home on bed rest for the remaining 6 weeks that it would take to get us to 37 weeks gestation (we were currently at one day short of 31 weeks).

  Unfortunately, although not severe, the bleeding did not stop.  Additionally, we later in the morning we were told that they were suspecting that there was amniotic fluid in the blood and that meant that the membranes had ruptured (aka the water broke).  The concern was that once this happened, it creates a negative pressure that can tug on the placenta and cause it to separate from the uterus prematurely.  After another ultrasound it was determined that this is exactly what happened.  Although through prayers the placenta previa was no longer present, and the placenta accreta looked possibly unlikely, we would be tested with a totally different and (according to the doctor) unrelated condition - placental abruption.  It was explained that although the baby was quite premature, that the risk of total placental separation and death of baby, and possibly mother, was high if we did not act quickly.  The decision was made to deliver immediately and at 2:05pm, baby Leah was delivered via cesearean section.  Because she is 9 weeks early, she is only 4 lbs 4oz in body weight.  Although we were concerned about Leah's prematurity, God gave us a major encouragement when the doctor told us that there was no placenta accreta, and that the placenta separated normally!  The doctors finished the surgery and Ralanda returned to her room to recover.  It was at this point that things changed even more.  About 45 minutes after returning to the room, the doctor was checking Ralanda and determined that her uterus was not contracting sufficiently and as a result there was ongoing bleeding.  In a matter of minutes there was a swarm of activity and they whisked Ralanda out of the room telling me that they needed to go back to surgery.  The difference this time is I was not allowed to accompany her and she would not be "awake" this time, but rather under general anesthesia.  Concern was expressed about possible early D.I.C., a very serious blood clotting condition that causes fatality in up to 50% of patients who develop it.  This was one time that my veterinary knowledge was a curse rather than a blessing.  All I could think about was how in school we were taught that the initials for disseminated intravascular coagulation (or DIC), often should be interpreted as "Death Is Coming".  Ralanda has received several blood transfusions and blood products, but so far, by God's miraculous grace, does not appear to be experiencing DIC.  Although, in very rare instances, it can develop in the first couple days after surgery, the highest risk period is now over.  God took me though the darkest hour of my life last evening and it appears that we may be spared by God's overwhelming grace.  I would be lying if I claimed that in the thick of the moment that doubt and fear did not take hold, but I did truly meditate over and over on Psalm 56:3  - "What time I am afraid, I will trust in Thee."  God is so good and so gracious.  Although God has now closed our womb and decided that our quiver is full, we rejoice in his blessings and faithfulness to us.

After a stay in surgical ICU last evening, Ralanda was moved to the regular ward at lunch time on Monday.  She is in alot of pain and is experiencing a lot of swelling from the massive amount of fluids and blood products that were given to her.  We were told ahead of time to expect this and that likely after 2-3 days the swelling will subside and all will be well.  Please pray that the recovery continues in this positive direction.  Considering everything, she is very positive, and we are both at peace with God's will in this matter.

Leah is in the NICU (Neonatal Intensive Care Unit), on a ventilator, but is thankfully stable.  They are hoping that they may be able to wean her off the ventilator over the next day or so.  We have been told that the full expection is that Leah's long term prognosis is very good, but that we should expect a rocky road along the way.  The biggest challenge is that she will likely remain in the NICU for 8-10 weeks, and we live an hour away.  Obviously this will be a minor issue, if she ultimately can come home healthy.  God's grace has been abundant to this point, and we will continue to lean on him as we go forward.  Please pray for Leah as life threatening compications can arise at any time, although the doctors says her long term outlook is very positive.

For those of you who have been supportive and loving to us, we cannot fully express our gratitude.  We love you and covet your continued prayer and support.