Lourdes' head ultrasound "inconclusive"

Today I'm thankful for...
Cute and fun loving boys
Getting to go on a walk
Very caring and helpful friends
Going on a date with my wife
Lourdes doing better each day

Today Baby Lourdes surprised everyone with reducing her oxygen needs. Last night we were told that she keep having air accumulate in her chest wall and the chest tube was repositioned to try to relieve the pressure. This repositioning of the chest tube most likely is helping her to need less oxygen. Wow, some good news. To be followed by some less than good news.

Lourdes had a ultrasound done on her head to do a routine check for bleeding in the brain (not a good thing, but common in such premature infants). This ultrasound was inconclusive (which I now knows that nobody knows for sure but there's a possiblity that there could be a problem). They would re-test her brain in two more days. Let me tell you those were some very long two days.

Also, they doctors were concerned about Baby Lourdes' heart, and getting the hole between the two chambers to close properly. They began her on medications they will hopefully cause a closure of the ductus, but this is a strong medication and the dosage confused Lourdes' other body parts. We were told that it may take multiple dosages of the medication over the next 3 or 4 days to cause the closure. We had more praying to do.

Quite a big day in the NICU unit for our little strong girl, and the whole gravity of the situation wore on us emotionally. You learn quickly how much you rely on your loved ones for support in those times when you think you are emotionally spent.

In a funny way daily, if not hourly, I could feel my wife and I grow closer together propping eachother up when one of us was down. That can only be from a higher source?

Tough for us to vacate the NICU that night, but we keep reminding ourselves that Lourdes was just one day closer to being home!

Leaving St. Mary's hospital

Today I'm thankful for...
Grandma's help with the boys
Lourdes care team at St. Mary's
Mom coming home
Mom feeling better
Support of our friends and family

Today is a difficult day for Lulu. She is excited that she gets to leave the hospital after more than 2 weeks, but she doesn't want to be away from Baby Lourdes. This is the first time I have seen Lulu emotionally frail. As I helped her gather her belongings (as you can imagine there were a number of things after 2 weeks) I saw the sadness in her, and I knew that she was torn between being home for the older boys and being close to Baby Lourdes.

To make the day even more emotional for her, Lulu had been seen by the OB today to check on the healing of the C-section incision. It hasn't been healing as expected, and she had extra fluid under the tissues in the area. The OB open the stapled area and recommended that she keeps it open for 3-4 days until all the infected material has resolved. To her credit, Lulu had to repack the open drainage area daily, so the wound would heal completely. She was to have a follow up appointment the next Monday in the OB doctor's office.

We said our heartfelt goodbyes at 7:30 PM to all the post partum staff nurses, loaded up the van with all the items that Lulu had accumulated during her stay, and make the somber drive home. At was a time of reflexion, where we started two weeks ago, where we were now, and what's going to happen in the future. I could feel her pain, but I also knew that we were strong together and everything would turn out alright in the end.

We again prayed for Lourdes strength, and for us to stay strong as well. Little did we know how much more lay in wait for us?

Rough road ahead for Baby Lourdes

Today I'm grateful for...
Being surrounded by good friends and being able to discuss the future with them
Watching Baby Lourdes and seeing her grow
Taking a moment for myself and mow and trim the lawn
The warm, sunny weather
Feeling good

The Honeymoon is over! As I came to the NICU this morning I saw the concern on my wife's face. Baby Lourdes is now on a special ventilator that she can tolerate better. The chest x-rays (taken every 4 hours) had revealed she had developed a Pheumothorax in her left lower lung, and was having great difficulty with getting enough oxygen. After some tests and discussion amongst the doctors, it was decided that Baby Lourdes would need to have a chest tube placed to releave the pressure she had in her chest. Lulu and I consented to the procedure, and we thought it best to leave as they placed the chest tube into her little body.

We spent the next hour talking as we as a couple with three (now four) kids rarely get to do. Of course the most dominent subject was how we could be with Lourdes as much possible. We also talked about when Lulu might return to the office and what her schedule might look like? In 24 hours she would be discharged from the hospital, and though she never said it, I could tell that she wanted to stay and be as close to Lourdes. Another important subject was how we needed to be there for the older boys. In a time of crisis you have a tendency to forget that we have three wonderful boys at home that can easily get neglected. Even with family and friends to help us during this stressful time, the boys need their Mom and Dad, so we scheduled our lives to include them as much as possible.

Lulu had been having some issues with her incision from the C-section. It had been healing properly, and to close her incision they had used staples. The area looked as if it was getting infected and very red and irritated looking. We surmised that because Lulu had a allergy to Nickel that possible once the staples were removed the area would improve? Yeah, this afternoon the nurse removed the staples form the incision site. We just know that the healing would improve by tomorrow!

We returned in the evening to Baby Lourdes side. She had been sedated and looked quite comforable even with the myrid of wires, tubes, and such dangeling from her. Not much changed with her prognosis at this time, wait and see if the chest tube relieves the chest pressure, and hope that your lungs mature sufficiently so she can one day breat on her own?

Again we said our prayers, and begrudgently left her to the care of the hospital team.

Sleepless nights watching over Lourdes

Today I'm grateful for...

Daughter Lourdes gettig stronger today, and I thank God for blessing us with her

Seeing 6 year old Thomas graduate from Kindergarden

Lots of loving, supportive family to share difficult times with

Feeling good enough to stand, sit, and walk

Living in Reno

Today we celebrated Baby Lourdes' 2.5 day birthday. I spent a mostly sleepless night, waiting for the phone call from the NICU unit (or Lulu still in the postpartem department at Saint Marys) telling us Lourdes was not doing well or worse. I remember thinking how being only a 20 minute car ride to see her, but feeling continents away from her. The anticipation as I drove into the hospital that morning was palpable, and as I saw Lulu's face my concerns quickly faded away. Lulu said that Lourdes had a good night, and that she had the chance to see her a couple of times during the night. We mostly took turns watching over the angelic girl today. But this morning was my turn to be alone with Lourdes, while Lulu completed her breast pumping routine. I cherished the moments that I was to get alone with my first little girl. Just I had the opportunity with my three older boys, I had many chances to bond, grow, and learn solo with my kids. I didn't know it at the time, but these moments between Lourdes and I would be therapeutic in dealing with the future diagnosis coming our families' way.

As I sat vigilantly observing every diminutive detail of Baby Lourdes, I barely noticed the whizing, bleeping, buzzing of all the machines that had been attached, sometime during the last night, to her small frame Her future flashed before me and the struggle was only beginning for her. I felt this incredible sense of helplessness. Not being able to understand whether or not she's feeling the difficulty of breathing or the discomfort of the needles protuding form it seemed about every appendage? We know that she was a fighter (of course she would be having that Pueto Rican blood in her), but could the crisis' she's facing be too much? It's amazing to see the Neonatal nurses stay so positive, and we greatly appreciate the support that they have been giving us. We know that it's there job to take care of the babies, but do do it with a smile and the compassion we've experienced is just short of a miracle! As day turned into night, lulu and I sat with Lourdes, not wanting to leave her even for a moment. We ended the day with "The Lord's Prayer", and prayed God to help Baby Lourdes be stronger tomorrow.

We were afraid that she wouldn't live through the night?

I'm grateful for...

A new baby girl, Lourdes
My wife is healthy and is recovering well from the surgery
The incredible care that we are all receiving
Getting a good nights sleep

I arrived to the NICU (Neonatal Intensive Care Unit) at 9 AM, and Lulu was getting the information from the team of nurses, respiratory therapists, and specialty doctors on Lourdes' condition. This NICU experience wasn't totally unfamiliar to us, as our oldest boy Carter had been treated there for a Pneumothorax condition soon after he was born in 2000. Carter's condition required him to stay in the NICU for 4 days for oxygen treatments and monitoring. We were quite pleasantly surprised to see that many of the same nurses were still part of the NICU team that treated our son some 8 years prior. All I have to stay, "Way to go Saint Mary's because you have one heck of a team assembled and obvious are doing something right if most of them are there 8 years later?"

The Neonatal physician (her son just happens to be a patient of Dentistry for Kids) gave us the "What we can expect" talk about Lourdes condition. Just as all the care givers that we have met in the NICU, this doctor has that love for her profession that translates into compassionate, through, competent, and informative care. I learned more from her in that first 24 hours then I probably had a right to know? But i absorbed everything. Lourdes couldn't have been in better hands, unless you consider the hands of God.

We learned that 26 week old babies have a number of health concerns and development issues:
1. Their lungs haven't fully developed, so they need to have assistance breathing.
2. Their circulatory systems can be compromised, and that they have a hole between chambers of their hearts that need to close in the first few days.
3. They can have incomplete digestive systems, or blockages in the digestive systems that can prevent them from feeding properly.
4. Their eyes haven't fully developed, so you need to protect their eyes from the lights wile being careful that you don't increase the air pressures that can effect the development of the eyes.
5. And in Lourdes case that she doesn't have or get an infection in this first days of life.

The above were all the challenges that Lourdes was to battle at one time or another, and many times she was dealing with multiple issues at the same time.

We also learned that the little girls born premature seem to thrive and grow better then the boys (I guess that we had one thing going for us)? Premature babies many times have a honeymoon period, where they tolerate their environment fairly well, and then later they start to show signs of distress. We learned this honeymoon period is for the first 24-48 hours. We prayed over her everyday.

Boy did this ring true for Lourdes!

Lulu's recovery from C-section

This evening I'm thankful for...
A wonderful team of doctors and nurses caring for Lulu and Baby Lourdes
Saint Mary's Hospital
All the money and research on Neonatal care of premature babies
God watching over our family

I stayed only for 5 to 10 minutes with Lourdes, I wanted to be with Lulu for the recovery from the general anesthesia (I was hoping that she might indulge privy information that consciously she would never tell me)? Lulu was now in the Labor and delivery recovery room, and lucky for us they don't have a room #7 there too! I held on to her hand as she was coming out of the anesthesia the whole time telling her how much Baby Lourdes looked like her; dark long black hair, long fingers, and distinctive Molina facial features. How great that she looked and what wonderful the care she was receiving.

Lulu's recovery was uneventful, but in a very personal way extremely gratifying. Not in the way that you would want to see your lovely wife go through the process of having our baby by C-section, but gratifying in the since that for once I could be there when my she needed me, not the other way around! After two back surgeries in the last 48 months, Lulu was always emotionally there for me and she to supported me through some difficult times. I relished at the opportunity to be there for her as she had been for me. I could feel our mutual love for each other leap to a level never before experienced in our 12 years of marriage, and as she gave me the thumbs up coming out of the anesthesia; I heard that higher calling whispering into my ear, "This is what love is all about, love is not what you receive, but what you give."

How could my life be more perfect and how could a person feel more purpose in their life then I did at that moment?

Lourdes Elizabeth arrives

Today I'm thankful for...
A healthcare system that is compassionate, advanced, andthe best in the world.
Having good health insurance
Being alive
Beautiful sunny weather
Being with my wife

The night ended up being uneventful for Lulu and the Baby Lourdes. The contractions stopped, and the tests show that all was well. I rescheduled my patients to be with Lulu on this Monday, and good thing that I did, because the day started just as the last 10 days in room #7, but ended with us having a baby that would end up being born three months prematurely.

I got a phone call from Lulu letting me know that she was having the contractions again, after her night was mostly quiet. I arrived at the hospital at around 9 AM, and at that time Lulu was having contractions about every five minutes and the staff and doctors were giving her medications to hopefully stop the contractions? More tests and another round of labor stopping medications (the first dosages weren't effective in stopping the contractions). This was the day's event Lulu having contractions, the baby wanting to be born, but everyone working hard to just get another hour, if not day, before Baby Lourdes was to arrive. We were told by the nurses that for every day that we could prolong the birth of Lourdes, she would save her three days in the Neonatal intensive care unit. Knowing that she was only 26 weeks old, we were all for keeping Lulu pregnant for as long as possible.

Unfortunately, Lourdes wasn't cooperating and she was determined to have June 1 be her birthday. After the third course of medications to try and stop the premature labor, the doctors were looking at the possibility of having to deliver the baby soon? The final decision was made after the blood test returned for the lab with a very high white blood cell count (twice as high as normal).

Lulu requested to use the anesthesiologist that she has built a professional and personal relationship with. After years of working with someone Lulu knew that she wanted him for her anesthesia. Luck would have it that he was available to do her anesthesia for her C-Section now scheduled for around 5 PM.

Lulu and I prayed that this was the right choice to have Baby Lourdes so early and we knew that she was to have a large fight ahead of her just for survival at only 26 weeks gestation. In this situation you have to have faith that the doctors are making the best choice for both mother and the baby, and we prepared ourselves for the birth of our first little girl.

After multiple physician consultations (the doctors have to decide on whether or not the baby was at risk for infection), a course of antibiotics, and nurses prepping Lulu's lower abdomen for the surgery, leaving room #7 after 10 days was bittersweet (would would have liked to stayed there until Lulu's due date, but we also wanted to see the little bundle of joy), Lulu was taken to the labor and delivery operating room for birthing Lourdes.

Lulu had General Anesthesia instead of a epidural C-section due the risk of introducing bacteria in the Meningeal spaces (especially concerning due to the high white blood cell count from early in the day). From the time they induce her to the birth of Baby Lulu the procedure took approximately 10 minutes, and we had a wonderfully beautiful baby girl weighting 2 lbs, and being about 14" in length.

Baby Lourdes was immediately placed into a incubator and whisked away to the Neonatal Intensive Care unit conveniently only 20 feet or so away.

I had never in my life seen something as beautiful as Baby Lourdes, but I was terrified that I might not be able to care for her a lifetime?She was so small and fragile looking there in the incubator almost as if it was made for a baby two or three times her size? As the care team scrambled around caring for her immediate needs, I just stood frozen in time. It happen all so sudden, what now? Here's was that baby that we had been waiting to see for the 6 months for, and now she was on the table just a arm length away. My heart ached to hold her, to maybe just reach out to help her in this most critical moment? I can't express the emotions of wanting to care for this incredible treasure, but only being a spectator in what seems like a dream.

I managed this picture before they attached the myrad of tubes, IVs, and monitors to the newly delivered girl we now could call Lourdes Elizabeth Wilkerson