February 09, 2009

Recap and Update

Charles Robert Iker

Ambrose Augustine Iker

Ambrose receiving Baptism.

Wow...what a crazy two days! There are some who are not aware what happened over the last couple days. Let me recap.

Sunday afternoon Gina was having contractions and was given Terbutaline. The contractions stopped briefly, but started up again a couple hours later. She again was given Terbutaline. The contractions stopped, but soon started up again. Terbutaline can only be given twice in 12 hours. The plan that was agreed upon with the doctor was to give Terbutaline and if it did not stop the contractions completely, then to deliver the babies. Gina's contractions became more frequent to 2-3 minutes apart and the decision was then made to deliver the babies in an hour's time. I was about 30 miles away and really flew up the freeway.

Dr. Chavira came to Gina's room and we said a Hail Mary together. He took Gina to get her prepped and I put on my bunny suit (I think I pulled a muscle in my neck trying to get the shoe covers on!). There was quite a large team of nurses and doctors that arrived to take the babies once they were delivered. It was great to see how prepared they all were. During the cesarian, Gina was pretty medicated. I stroked her head and let her know everything was looking good and that I was able to see the babies. Once the babies came out, they were quickly whisked away to be with their teams. It was craziness after that. I ran around checking on the babies hoping to hear some sort of cry or any noise from them. I did hear a few grunts from Twin A, but could see Twin B was having difficulty taking a breath.

The babies were then taken to the NICU and Gina was sewn up. I went to see the babies after I knew Gina was ok. There was a lot going on in the NICU and a large team was assembled around Twin B, now known as Ambrose. They had him connected to O2, but he wasn't responding very well. Remember, his amniotic sac ruptured at 20 weeks, so he didn't have much fluid pass through him to develop his lungs. Next they connected him to a standard ventilator to expand his lungs and get a better flow of air into them. The decision was made that the ventilator was not helping him, so they brought in an oscillating ventilator, which "shakes" the oxygen into his lungs and "shakes" the carbon dioxide out. It's really amazing to watch the little boy's chest while the oscillator works. At some point an x-ray was done and they discovered he had a pneumothorax (air that is trapped inside the chest between the chest wall and the lung, causing the lung to collapse). The small hole was probably caused by the high pressure on his lungs by the oscillator. They placed a chest tube and were able to take out the trapped air. On the last x-ray I saw, the doctor said he did not see any other pneumo and part of Ambrose's right lung inflated.

If it wasn't one thing, it was another. If his O2 saturation levels were up, then his blood pressure was extremely low and vice versa. At one point, Gina and I went to check on him and his O2 sats were so low he was turning grey. Very sad sight to see. Eventually, the team was able to get his sats out of the low 40s to the high 80s and low 90s. He was given Dopamine and Debutamine for his blood pressure and then the doctor decided to give him a steroid, hydrocortisone, to improve his respiration. This was probably because he had Pulmonary hypoplasia, which is "a developmental abnormality of the lung characterized by a decrease in the number of alveoli, cells, and airways, eventually resulting in decreased size and weight of the lungs." The day was a roller coaster. So many ups and downs today made it really physically and emotionally draining. There are still more things that occurred to Ambrose today, but I'm not able to recall them all. He also received Lipids and TPN...and he was able to produce some urine.

Twin A (Charles) had a pretty good day overall. He was on a CPAP to give a little pressure to his breathing, but he was not intubated like Ambrose. They also had him on phototherapy to prevent jaundice. At one point, after he had his little protective mask taken off, he opened his eyes and looked around. He stretched and moved his limbs around quite a bit today. Ambrose made small movements, but he was also on morphine and sedated. Charles may be ready for food in a couple days. He received some lipids, fats, and a sweet glucose cocktail full of goodness. Meanwhile, Gina has been pumping and they're freezing the colostrum, until the babies are ready and able to eat.

I'm sure there's much more to say. When Ambrose took a downward turn this afternoon, we really thought we were going to lose him. He's a really sick little boy and it would take a miracle for him to survive. We know that these last eight weeks have been on borrowed time and we're grateful for the safe delivery of the babies and for Gina's health. God has a plan for each little boy and we respect His Will. We're also very grateful that both boys were baptized. Ambrose was given a more shortened form of the Baptismal Rite, due to his condition and the fact that he began to spiral downward at the time, while Charles was able to receive the longer, Extraordinary Form. Please continue to pray for our little boys. Wonderful things can still happen. We thank you for all the prayers you've said for our family over these last eight weeks. They're greatly appreciated! God bless you all. We'll continue to update this blog as events occur.


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