Sunday, June 9, 2013

MEET EZRA: THE BEGINNING



As many of you know, our sweet little boy, Ezra, has had a rough first few weeks in this world. As of now, the root of his troubles are a mystery. We are so looking forward to the day when we can get some answers and some treatment. To chronicle this journey, I thought I would start at the very beginning. I'm going to try to fast forward through most of the details of the birth story so we can get to the part where our beautiful little boy was born...and then when things started to get more complicated.

A little history. When I was pregnant with Judah, I tested positive for Group B Strep (GBS+). One in four to five healthy pregnant women carry the GBS bacteria. Mothers who test positive are treated with antibiotics via IV to reduce the risk of passing the GBS bacteria to the baby. Antibiotics need to be started as soon as the mother's water breaks, or, if the water hasn't broken, at least 4 hours prior to delivery. It's possible to test positive for GBS during one pregnancy and not during another, but as luck would have it, I tested positive again. With Judah, it was easy to know when I needed to go to the hospital to get started on antibiotics because my water broke. I didn't have a choice, I had to go right then. This time around my water didn't break. My contractions REALLY started around 1030PM on April 19th (just as Josh was getting home from a lacrosse game - I was already in bed and I was so exhausted, I didn't even have the energy to tell him I was having a contraction). I continued to have contractions every 15-30 minutes until about 1230AM on April 20th. At that point I woke up Josh to tell him what was going on. We finished packing our hospital bags and I told Josh to go back to sleep. I tried sleeping. No use. I went downstairs to have a snack, watched a little TV, and by 3AM I was timing my contractions about 8-10 minutes apart. I thought for sure it was time to go to the hospital (being GBS+), but after calling the midwife, she told me to wait until my contractions were 5 minutes apart (even though I stressed I was GBS+). By 4AM, my contractions were 5 minutes apart. We were to the hospital by 445AM. While we were parking I had a contraction and by the time we walked to the check-in desk I was having another. Things were really progressing. When I got up to the delivery room, the nurse checked my cervix, I was only at 3cm (but still having intense contractions every 4-5 minutes). They said they wanted to wait an hour to admit me to make sure I was really in labor...WHAT!!?? FINALLY after walking the halls for about an hour and dealing with seriously intense contractions that were getting closer and closer together they rechecked me. I was 5cm. They decided to admit me and got my IV in and ready for the antibiotics, it was about 6AM by this point. Finally at 7AM, they started the antibiotics (why were things moving so slowly!? Remember, I was supposed to be on antibiotics for being GBS+ for at least 4 hours before delivery). For the next hour my contractions were insanely intense and coming faster and faster together. It's hard to even put into words how much pain I was in from pretty much the time I got to the hospital to this time...don't get me wrong, I experienced an extreme amount of pain with Judah, but this was so much more intense, and so much faster. Finally by about 830, my pain was so intense I could hardly breathe and I could not keep myself from pushing. In the back of my mind, I knew I needed the green light from the midwife before I started pushing, but I couldn't not push. We had to run out of the room to get someone! About three big pushes later, Ezra Joseph Parker was born at 837AM!

Okay, this has already been too long, so let's switch to bullets to recap and tell the rest:
  • 3AM Saturday - called midwife, said I was GBS+, said my contractions were 8-10 minutes apart
  • Midwife said to wait until contractions were 5 minutes apart to come to hospital
  • 445AM - got to hospital, contractions were 4-5 minutes apart, was checked at 3cm, was told they were going to wait an hour before admitting me
  • 6AM - was 5cm, got admitted, got IV started
  • 7AM - finally got antibiotics started
  • Around 830AM we ran to get someone, I NEEDED to push
  • 837AM - Ezra was born
  • I had only received ONE dose of antibiotics (instead of the 4 hours of four doses I should have had before delivery)
  • 842AM - midwife decided to clamp umbilical cord FIVE minutes later (we were COMPLETELY unaware of the delay until after the fact. Ezra was PURPLE, I kept asking, "Is he okay!?" Midwife answered, "Oh yes, he's okay." I kept trying to pull him up closer to my face so I could see him, and the midwife said, "Be careful, he's still attached!" What?? It never even occurred to us that she had decided to delay cord-clamping and cutting. That was NOT apart of our birth plan! (This part is important later)
I'm not totally confident about the timeline for the rest of this, but it goes something like this:
  • A couple hours later we were moved to another room.
  • A doctor or nurse informs us that Ezra has low blood sugar, rapid breathing, and a high red blood cell count. They're going to have to give him some formula to try to bring his blood sugar up. I am distraught, Ezra has already been nursing, VERY well, I don't understand why they need to give him formula. I don't want to do anything to interfere with breastfeeding, but they tell me they have to give him formula, and I want to do what's best for Ezra. It's the tiniest amount of formula, but they say it will be enough to get his blood sugar up.
  • Ezra's blood sugar doesn't go up after the formula. Because of his symptoms, they must get him on an IV with glucose, and also want to start antibiotics since I had only gotten one dose of antibiotics for being GBS+ when I should have had four doses. Again, I am distraught. I'm unsure of the impact 48 hours of antibiotics at birth will have on Ezra's immune system for the long run. I'm SO upset that I was told not to come to the hospital when I called at 3AM. If I had come to the hospital at 3AM, I would at least have been able to get three doses of antibiotics, maybe even all four. Even if I had been admitted at 5AM when I got to the hospital (instead of them waiting until 6AM to admit me, and not starting my antibiotics until 7AM), I could have gotten 2-3 doses in!!
In the nursery
  • Ezra has to stay in the nursery overnight. Again, I am distraught. When we had Judah, he never left our sight.
  • Ezra is still being monitored by machine, but he gets to come back to our room late the next morning (Sunday)...hooray!
  • At some point, his IV starts bleeding (it is still in place for his antibiotics). After SIX attempts to get a new IV placed, they give up. That means he will have to get six ADDITIONAL pokes because now the remaining antibiotics will have to be administered by injection. At this point we have lost track of how many times Ezra has been poked or had his heels stuck.
Failed IV attempt in Ezra's head :(
  • By Monday we are totally stir-crazy, we just want to leave the hospital, bring our sweet boy home, and be back with Judah. But the doctors need to keep watching Ezra a while longer.
  • Early evening, the pediatrician on shift gives us an overview of what is going on with Ezra. He's never had a fever, there is really no evidence to support that he ever had any type of infection (so the 48 hours of antibiotics were probably totally unnecessary). We still don't know why he had low blood sugar, though, or why his red blood cell count was so high. The doctor says that sometimes the red blood cell count can go up when the baby receives too much blood from the placenta, it's essentially like a massive blood transfusion. LIGHT BULB! The midwife didn't clamp the cord for FIVE whole minutes, plus Ezra was PURPLE. Surely this is what happened, right? We look up "delayed cord clamping" and find that while this is widely popular these days, we read that complications can include polycythemia (high red blood cell count, just like the doctor said). We go on to read that polycythemia in newborns can cause the following: deep reddish-purple coloring, lethargy, rapid breathing or respiratory distress, jaundice, and low blood sugar. LIGHT BULB! Ezra had ALL of those things! Surely this is the explanation for everything going on with Ezra.
  • Then we get another curve ball. It has not been brought to our attention until this moment when the doctor tells us that Ezra also has a low platelet count. What!? Why are we just now hearing about this?? Anyway, we are still discharged late Monday night with instructions to see our pediatrician in a day or two. In the meantime, we need to watch Ezra for any abnormal bleeding. The platelet issue is now our main reason for concern.
Ezra's purple feet

It's hard to conclude all of this except to say, this story is just the beginning of an already long journey. In the next post I'll try to sum up Ezra's medical history over the course of his first seven weeks of life, that way from this point forward we can try to post what is currently going on with our sweet boy for all of you who are following along. Words cannot express how thankful we are for your continued love, support, and prayers...please keep it coming!

1 comment:

Jennifer House said...

Wow!! I am so angry reading this! I can't imagine how frustrating this was for both of you!
Thankfully, God is so much more powerful than any mistakes we silly humans can make. He has little Ezra in His hands, and somehow, someday, even these things will ALL WORK TOGETHER FOR GOOD because you and Josh love Him so much!