SUPRISE! Ellie Jo Gramkow born at 27 weeks 6 days gestation

Day 2 of Ellie's life (Thursday September 4) her doctor was Dr. Navarro. They continued to wean her off the nasal cannula. The flow rate began at 3 liters (per hour?) and has been dropped down to 2. The doctors planned an ECG ("heart ultrasound") to check a valve near Ellie's heart. When open the valve allows blood flowing from the placenta to enter Ellie's heart. Once the baby is born the valve closes, but in premature babies it sometimes doesn't close or reopens after closing. With the ECG they will be able to check the valve. If it needs to be treated they'll administer neoprofen (Ibuprofen for babies). This medicine somehow helps the valve close while having the side effect of thinning the blood. Also in premature babies there is an increased risk of bleeding in the brain. The bleeding is rated on a four level scale. Bleeding of levels 1 and 2 will not cause permanent damage, but bleeding of levels 3 and 4 may. The thinning of the blood from the neoprofen would worsen the bleeding so if the ECG shows the valve open they will check the bleeding in the brain with a head ultrasound before treating the valve.

Thursday, September 4, 2008

Surprise!

On Wednesday, September 3, 2008 Ben took Mandy to her Dr's appointment at 11:00 AM. Dr. Roles examined Mandy and told us that she was dilated to 5 cm. That wasn't supposed to happen for another 2 1/2 months! So Ben drove Mandy to Mercy hospital in Manhattan. Dr. Roles had already called the LifeStar flight crew and Mandy was airlifted via helicopter to Stormont Vail Hospital in Topeka, a 30 minute flight. Alisha (Mandy's Jardine coworker and friend) drove Ben to Topeka with some clothes, etc. Soon Ben had found his true love in a small room in Triage. Doctors Bonebrake (no, really) and Cruze (that's with a long e) were briefing Mandy. They informed her that they wouldn't be able to wait for another 48 hours to have the baby like they had hoped. At Mercy regional they had given Mandy a steroid shot to help develop the Baby's lungs. Typically they give 3 such shots spaced out over a few days. Dr. Bonebrake had hoped to give Mandy a second shot before she delivered, but Ellie had other ideas. Mandy was 100% effaced and dialated to 5-6. The doctors wanted to make sure that everyone (especially the NIC team) was ready to greet our little bundle of premature joy. So they decided to induce with Pitosin and Dr. Cruze broke Mandy's water and they prepped Mandy to push and instructed her to just breath. Lamaze classes were scheduled for October. We didn't know how to breath. Soon they checked the baby and determined that she was breach. So they scrapped the natural birth and planned for an emergency C section. Things were moving so fast Ben barely had time to sign his wife's life away before they put her under the knife. Mandy had to brave the OR alone ... except for the 736.4 doctors ... while she was prepped and put to sleep. Soon after she went to sleep Ben was allowed in the OR and watched the delivery. Dr. Bonebrake pulled out Baby Gramkow at 2:29 PM and he sent her right over to the NIC team. After they had worked on her for a few minutes Ben found out that she was a girl and a little later he got to come stand beside her. After Mandy was stitched up they took Ellie down to the NIC Unit with the proud, excited, confused and nervous papa following close behind. They began to re-intubate her since the first tube they had used was too small. Dad was just happy to hear that something was too small for her. They had a little trouble getting the tube in so dad had to leave the room for awhile. Then they weighed her in at 2 lbs 7.5 oz. Soon after they began inserting a couple IVs into her umbilical cord. This was a sterile procedure so dad had to leave again and went to check on Mom. Mandy was recovering with faithful nurse Peggy who had been with Mandy since she got to Topeka. Ben and Mandy officially decided that our daughter's name was Ellie Jo Gramkow. Ben went back to the waiting room to deliver the news, had lunch, and returned to check on Mandy. Soon they were ready to move Mandy from the recovery room to a regular room on the labor and delivery floor. But first Mandy and Ben went to see Ellie in her room in the NIC unit.

Friday, September 5, 2008

Day 1 with Ellie Jo - The Breath of Life

The first day of Ellie's life was marked with lots of visits from family and close friends for both mother and daughter. Mandy and Ben got settled into a room in the birthplace at Stormont Vail. We met Ellie's first doctor and nurse. In the Stormont Vail NIC unit one doctor works a 24 hour shift at a time. Ellie's first doctor was Dr. Hall who explained quite a bit about Ellie's treatment to Ben. Dr. hall was the one who took care of Ellie in the OR immediately after her birth. In the NIC unit Ellie's first project was to start breathing on her own. She started on a ventilator giving her 40 breaths per minute. She could take more breaths than that if she wanted, but no fewer and she was taking over 70 breaths per minute. Good job Ellie. Over the next day and a half they weaned her off of the ventilator by taking the number of breaths they gave her down slowly. Then they removed the intubation tube and instead gave her a nasal cannula. (A tube with prongs for each nostril.) This delivered room air to help her breath through her nose. Meanwhile they watched all of her vital signs closely (which remained excellent). They also watched her nose carefully. While she was in the womb she had been pressed up against mom's pelvis and had some bruising and misshaping on her head. Her nose was also pressed to the side so they observed it to see if it would lead to a deviated septum.