Big Progress!

So sorry for the lack of updates lately!  After a couple scary weeks, this week has been much more enjoyable and we have even been able to catch up on a little much needed sleep here and there.  It's kind of funny...you'd assume since we don't actually have Makenna at home with us during the night that we'd be sleeping pretty well, but that is just not the case.  I still have to pump in the middle of the night whether she is here or not, so in that regard it is essentially like having her home...only way worse because I am awaked by an obnoxious alarm (rather than crying) and the unfortunate reality that instead of seeing her beautiful face for 20 minutes, I get to look at a pump!  It's okay though because I know that my milk is the absolute best thing for her---it is totally worth the aggravation of pumping every 2 to 3 hours!

During the day we spend our time going to and from the hospital.  When we aren't there...our every thought is inevitably consumed by her....and that stress can become so draining.  We realized last night that we have been here for 23 days, although other than Rex seeing a movie with my dad and us both taking Sadie to the dog park, the only other thing we have done besides the hospital is eat---and honestly I wouldn't have it any other way.  I love every second I get to spend with my sweet girl, even if all I am doing is staring at her while she sleeps. 

That being said, we definitely spent the first two weeks of her life running on pure adrenaline, faith, and love.  We worried every step of the way...during her birth, ECMO, surgery, and during all the other scary things that have popped up---it was so mentally and physically exhausting to worry all the time (while recovering from child birth), pumping constantly, and having to go to and from the hospital every day.  Leaving her there every night will never feel normal and never be easy.  But we have finally reached the point where the "scariest" times are behind us and now she just needs to be weaned from the medicines and machines that kept her alive for the first two weeks and recover from her major surgery.  Until then, we can finally relax a little bit and begin experiencing fun milestones!

MILESTONES!
This week came with several fun and exciting milestones!

As of 10/27 our baby girl weighed 7.19lbs (she was 6.67lbs at birth).  Any weight gain is great, especially since all babies tend to loose a little weight after birth.

On this day she was also moved to her own private room.  Her previous space was out in the open and is considered a surgical space.  Since she already had her surgery and another baby was born that needed surgery, she was moved to the only other space that could meet her needs---an isolation room. Now she has 3 solid walls and a glass door entrance.  There is also a curtain that can be closed for privacy, which allows me to pump in her room. 

On 10/28 she was able to wear a real bow for the first time!  This means we are one step closer to actual clothes!!

On 10/29 --- her original due date --- I got to "lift" her for the first time!  They needed to change her sheets, so I was able to hold her in my hands for the minute or two it took for them to do that.  We also were able to give her kisses for the first time.  What a special day!

 

She also got to experience laying on her belly for the first time.  It was so cute to see her little bottom in the air and she looked so comfortable!  The doctors say it is always a good sign when babies are finally well enough to tolerate this position!

On 10/30, when she was 20 days old they were finally able to wash her hair for the first time!  Her hair is so dark, shiny, long and beautiful!  

She also was able to have her first feed!  Up until now she was only getting fats and lipids through IV's for nutrition, so giving her actual breast milk for the first time was particularly exciting!  It is great to know that her body will be getting great nutrition and that I am the only one who is able to provide this for her because I am her mom. Up until now her "medical mommies (and medical daddy)" provide the majority of care for her, but this is one thing that only I can give her!  She is going to start by getting 4cc (about a medicine syringe worth) of milk every 3 hours through a tube that goes to her stomach.  Eventually the quantity will be increased and then they will begin attempting bottles.  Kids with CDH have a lot of trouble with feedings because of increased acid reflux, trouble digesting food due to organs being "rearranged," lack of exposure of eating early in life, and because they do not have any positive experiences involving their mouths.  Right now her mouth has been continuously used for tubes and ventilators...they also stick a "spit sucker" in her mouth every 4 hours to get rid of the saliva and mucus that builds up.  It takes time for them to learn that not everything that goes in their mouth is bad!

WHAT'S NEXT!?
This week has been all about weaning!  They weaned her off of the nitric oxide on Friday and she handled it like a pro.  Her stats didn't drop at all.  The doctors said they had never seen a DH baby that was able to oxygenate their blood but not get rid of CO2.  They weren't really even sure what to do.  So they used their amazing medical minds to quickly come up with a plan of action...they tried nitric oxide, Viagra, and changing her vent settings.  Thankfully one of those things or a combination of two or more things worked like a charm!  This allowed her to come off the nitric pretty quickly.

Once they got her CO2 figured out they were able to begin weaning the flow of her ventilator.  As of Friday the vent was doing 100% of the breathing for her.  It was taking 70 breaths for her per minute and providing 46% oxygen.  Her body could take breaths on it's own if it wanted to, but it didn't need to in order to get what it needed.  In order to come off of the ventilator and show she is ready for nasal cannula oxygen, the machine has to be down to 8 breaths a minute and 30ish% oxygen.  This process could be pretty fast or it could be slow, it all depends on Makenna and how quickly her lungs are able to begin taking over the workload. 

Thankfully Makenna seems determined to get off the ventilator and has been doing pretty well.  Dr. Kays and his fellows started by lowering the breaths/oxygen as they saw fit, but then on 10/29 they developed a plan.  Every 8 hours (at 6am, 2pm, and 10pm) they draw blood and check her blood gasses.  This tells them how well she is oxygenating her blood and whether or not she is getting rid of the CO2.  The plan is that if her blood gas numbers look good they will lower her breaths per minute by 4 and her O2 by 2.  As of now her breaths per minute is set to 34 and she is on 36% oxygen.  We are hoping that at 10pm it is lowered to 30, but we will see---they weren't able to lower her at 2pm due to her numbers being slightly elevated.  Either way, our baby girl is doing great and they may begin talking about extubation during the weekend or on Monday if she keeps up this pace!!  It will be so nice to finally say "bye-bye" to the vent, but we are on Makenna time and only time will tell when she will be ready to make this big step! 

They have also started lowering the dosage of several medicines she's been getting since birth, including her pain, sedation, and blood pressure medicine.  This allows her to be less medicated and act more like a real baby.  She is definitely a little bit more fussy during hands-on time and moves more too, simply because she is in less of a fog.  I don't like when she cries, especially since you can't hear it and the monitors start beeping because her heart-rate is going up so high, but I have to keep reminding myself that healthy babies cry!  Every day she is one step closer to being a healthy baby!

CO2 Scare!

Having a child with a diaphragmatic hernia is definitely a roller coaster.  She is only 12 days old, but we've already experienced our share of exciting ups (her birth, seeing her eyes, getting off ECMO, changing her diaper...) and scary downs (going on ECMO, clots in the line, the repair surgery...).  So realistically we knew getting surgery behind us wouldn't be the end of the wild ride, but we were hoping and praying that the downs would start being few and far between.  

That being said, Dr. Kays warned us that the first 48 hours after surgery would be rocky and we quickly discovered that he wasn't kidding.  Makenna's stats were pretty good on Monday; however, by Tuesday her body started having trouble getting rid of carbon dioxide.  She was able to breathe in oxygen with the help of the ventilator, but she wasn't expelling the CO2 appropriately.  A healthy baby should have CO2 levels between 30 and 40 while a baby on a vent usually has levels between 50 and 60.   Makenna's blood gas measured her level to be 78.  They decided to remove her ossilator and put her back on the regular ventilator.  After this change we waited an hour for another blood gas to be taken.  This time it was 76---better but not great.  They made more changes, we waited two more hours, and discovered it was 74--they were happy the numbers were creeping down, but it just wasn't low enough.  The process of attempting to find the right vent setting continued throughout the day and into the night (so stressful)! Although, suddenly at about 8pm the numbers started creeping in the wrong direction.  They went from 74 to 84 and then by 3am they were up to 95---triple the "normal level" for a baby off a vent and double for a baby on a vent.  What worried us more than anything was the fact that they were supposed to do surgery to take the ECMO cannulas out of her neck, but because of these numbers they decided to postpone the procedure.  They wanted to leave the cannulas there incase they couldn't get the levels under control and she needed to go back on ECMO.  Not good, although the Dr. assured us that while her CO2 levels were undesirable, this is something they do see often with DH babies.  They also said that they didn't foresee a need to go back on ECMO, it is just a precaution, so that helped---a little. 

On Thursday it was crucial that they get the levels down to avoid ECMO, so they decided to put her on nitric oxide.  From my very basic understanding the nitric oxide helps dilate the vessels in the lungs and allows them to do their job more effectively.  They attempted nitric oxide with her when she was 1 day old to avoid going on ECMO, but it didn't work and she ended up on ECMO the next day.  I worried that we would have repeat results.  Thankfully this time we started seeing an improvement immediately and her levels started creeping back down.  They then did the surgery to remove her ECMO cannulas (YAY!).  I can't believe my 14 day old baby has already had *5* surgeries.  She is definitely an amazing and strong little girl. 

By Friday her blood gas was down to 65 and they began slowly weaning her off the nitric oxide.  It started out at 20 parts per million then went to 1 part per million.  Even with this drastic reduction her blood gas came down to 41!   We hope she can maintain these levels once the nitric oxide is removed, but for now I am proud of my baby.  She had a good day today.  Her stats were all good and she spent several chunks of the day with her eyes open and very alert.  This whole CDH process is so slow and tedious.  Lots of ups and downs.  It is hard to see the progress she is making, but I have to just keep reminding myself that even on days she has "downs," she is still making huge strides towards getting better and coming home. 

Wide awake after her ECMO cannulas were removed!



Words can't describe how much I love this little miracle! 

Surgery Day? Maybe?

Monday morning we woke up still not sure if today would be the day for Makenna's surgery.  We called the NICU and they said that her surgery was schedule to begin in 30 minutes.  We raced to the NICU hoping we would at least get to see her for a minute or two before it was time to begin.  When we got there they told us that another baby was just brought in and needed Dr. Kays for emergency surgery, which meant Makenna's surgery was pushed back.  Part of me was disappointed because I just wanted the repair surgery to finally be over, but part of me was very thankful to have a little more time with my baby before her big day.  They allowed us to stay with her until 11:30 when it was time to began prepping her for surgery.  Thankfully they are able to preform the surgery inside the NICU so she didn't have to be moved, but unfortunately that meant anyone in her side of the NICU must leave.  So while we were sitting in the waiting room waiting for her surgery to be over, a few other families were also waiting for her surgery to be over as well. We began talking to the other families in the waiting room and doing anything we could to keep our nerves at bay the best we could as we started our long 4 hour wait.  But I must admit we were both very worried about our sick little 11 day old baby, even though we knew she was truly in the hands of the best pediatric CDH surgeon in the country and his team, all of whom are also very experienced in the repair of CDH.  While we waited they were very good about coming out and giving us updates along the way, this also helped keep the "what ifs" out of our minds.  

The surgery is actually pretty straight forward, but that doesn't mean it is easy or without risks!  What they essentially do is make an incision (about 2.5 inches) along we rib cage, take the organs out of her chest and return them to her belly where they belong, close the hole in her diaphragm using a gortex patch, and then close the incision. 

During the surgery they discovered that Makenna was in fact much more sick than they had originally thought, hence the need for ECMO.  If you remember they had estimated the likelihood that she would need ECMO to be about 10%, but she ended up needing it to save her life after just 24 hours.  This was our first clue that her CDH was more severe; however, before the surgery they didn't know why or to what extent.  Once they opened her up they discovered that in actuality she only had about half of her diaphragm, so all of her intestines and half of her liver were able to travel up through her hole into her chest.  Also, since she had so much in her chest, her right lung growth was restricted and it is only about 1/3 of normal size.  All of this means that on the CDH spectrum, what they thought was a mild/moderate CDH (right-side, liver down), is actually one of the more severe types (right-side, liver up).  The liver is very dense so it restricts lung growth more than soft organs (like the intestines) and it doesn't like being moved, where as other organs don't mind being relocated. 

Thankfully we knew about Makenna's CDH ahead of time and were able to get to Shands before she was born.  This allowed her to be under the care of Dr. Kays from the beginning.  He is a miracle worker and he put everything back where it belonged.  I seriously can't explain how thankful we are for Dr. Kays, his wonderful fellows/partners, nurses, and the rest of his team.  Their devotion to CDH literally saved our babies life.  We are also equally as thankful to everyone who has been thinking about and praying for our little miracle this whole time.  You also had a hand in saving her life!

After surgery they removed a sensor from her hand--so we could hold her hand for the first time!  :)

Holding her daddies hand after surgery!

Holding my hand!

48 Hours

After her 9 day run on ECMO we were told that we would wait 48 hours to see if her body could handle the lack of support and breathe with only the ventilator before they would consider doing her repair surgery. 

During the first few hours they weren't 100% thrilled with her stats, so they decided to switch her ventilator to a different kind of ventilator called an oscillator.  The traditional ventilator inflates and deflates the lungs in a way that mimics the human body, while the oscillator vibrates the lungs really quickly without allowing them to ever deflate.  It wasn't a major change and they were very casual about it, but we were still worried that this might be a sign that she may need to go back on ECMO.  ECMO is wonderful and it saved her life...but we still didn't want her to ever need it again!

Once the ventilator was switched out we spent the next two days just waiting to see what would happen.  Every time her blood pressure would drop near 40 or her CO2 would drop/rise, we worried; however, the nurses and the doctors just adjusted her medicine as needed and continued to monitor her business as usual. 

During her first 48 hours off ECMO Makenna also seemed more responsive.  I don't know if she was feeling better or if she was beginning to build a slight resistance to the sedation medicine she'd been getting since birth, but she was moving more and opening her eyes for longer stretches of time (10-15 mins at a time).  She started becoming a little bit more bothered by the tube down her throat and began sucking and gaging on it a lot.  She also seemed a little bit more aware of her surroundings, she would cry (without sound because the ventilator interferes with her vocal cords) and become visibly upset during hands-on time or when the environment got too noisy.  It broke my heart to see her so uncomfortable and not be able to hold or soothe her.  As much as parents hate hearing the baby cry and probably wish their baby came with a mute button, it is much worse when your baby physically can't cry but you can see the crying look on their face.  As much as I loved seeing her beautiful eyes open, I almost wished she would go back to peaceful sleep so she wouldn't have to feel any pain, fear, or discomfort.  Thankfully her nurses are all fabulous and do a really good job of keeping her as comfortable as possible. 

When we left the hospital on Sunday night we still weren't sure if she would have surgery the next morning.  That was especially hard.  Naturally you want to mentally prepare yourself for "the big day" and we couldn't really do that because we didn't really know when the big day would be.  We were hopeful that it would be Monday though!

Bye-Bye ECMO

Day 7 (10/17/13):
On day 7 of ECMO (8 days old), they decided to begin the process of getting Makenna off of ECMO.  They turned the flow of the machine down to 150 and because they had been administering her medicine through the ECMO machine, they needed to do a procedure to install a PICC line in her leg.  Now once the machine is gone they can still give her medicine through these lines.  By this evening they had lowered her flow to 100.  If she handled this setting all night, she would come off ECMO the next day!

Day 8 (10/18/13):
Makenna handled the flow of 100 well, so on day 8 of ECMO they decided she was ready to come off!  However, one caveat that scared us all is that if they couldn't get her stable off of ECMO they would have to change out her whole ECMO circuit, which would mean going back to a flow of 300 and starting the whole process over again (aka going back several days in her recovery process).  Up until this point the ECMO was not only doing 100% of the breathing for her, it was also adding oxygen to her blood and removing the carbon dioxide.  She was getting daily blood transfusions, blood platelets, and plasma.  The ECMO was also helping to regulating her temperature by warming the blood.  We were hopeful that her body could handle doing these things on its own, but we knew it was asking a lot of her little body, especially since it wasn't able to do these things just 7 days earlier! 

At about 12pm the whole crew arrived to take her off.  They began by clamping the line so that the flow would stop and then they watched her stats to see if she could handle it.  The whole process only took about half an hour, but when you are sitting in the waiting room that feels like forever!  After Makenna's line had been clamped for a few minutes her stats dropped and they determined that her lungs weren't able to handle being off the machine just yet.  They decided to give her Viagra for a few hours and see if that would be enough to improve her lung function.  We were definitely disappointed that she couldn't come off, ECMO is a scary machine that can cause scary complications, every day she is on it there is a chance something could go terribly wrong.  We knew that there is a full-time ECMO tech sitting there watching the machine 24 hours a day to make sure nothing happens, but unfortunately even with the tech, some things are just out of there control.  Also, we were worried that she may not be able to come off the machine at all and would need to have surgery while on ECMO.  This would be extra risky since the machine uses heprin to thin her blood, surgery while on blood thinners brings extra risks!

At 5:30pm after a few hours of rest and Viagra they tried again.  This involved another long stressful wait, but unfortunately in the end she just wasn't ready.  Her body wasn't getting rid of enough carbon dioxide, so they had to put her back on the machine.  They upped the flow back to 200 and decided to try one more time in the morning.  In the meantime they gave her cortisone steroid shots to help give her lungs a little added support.  If these things didn't work, they would have to change the circuit and up the flow to 300. 

Day 9 (10/19/13):
At 10:00am they began their third attempt to get her off of ECMO.  Rex and I sat nervously in the waiting room hoping and praying that the third time would be the charm.  Rex (a computer programmer) even wore what we hoped would be a lucky shirt.   It said "If at first you don't succeed, try and try again!" in programmer speak.  :)

 

After a long 1 hour wait, they finally said we could go back.  Thankfully when we got back there our beautiful baby girl was finally off of ECMO.  Dr. Kays was still in there and we were able to talk to him about her progress.  He seemed pleased with how she was doing, but he was still slightly concerned about he carbon dioxide levels and blood pressure.  He said they would watch her for 48 hours to give her body a chance to adjust to its new workload and for the heprin to work its way out of her blood. If she is still stable on Monday he will do the repair surgery; however, there is a chance that the next 48 hours will prove too much for her and she could go back on ECMO.  They left the cannulas in her neck just incase, but we are hoping and praying that they don't have to use them again!

 

Either way, for today we were very happy to see them pack the ECMO into a biohazard box so that we could officially say BYE-BYE ECMO!

 

 

 

 

   

 

Oh ECMO

Day 1 (10/11/13)
Makenna responded really well to ECMO right from the beginning.  Her color looks so much better and her blood pressure and blood gases improved dramatically as well.  The machine is allowing her body to rest and get stronger, which is a good thing, but it also indicates just how sick our sweet baby really is.

Day 2: (10/12/13)
On day two of ECMO I was able to touch her for the first time.  Babies are stimulated by touch and while most babies can handle this stimulation, Makenna's body needs to use it's energy to get better.  As a result we can only touch her in certain ways, for example we are allowed to rest our hand against her leg.  We can't stroke or "pet" her and definitely can't hold her.  Her nurse are also only allowed to touch her as little as possible.  Every 4 hours they have a "hands-on time" where they will suction her nose, change her diaper, check her temperature, switch her position, etc..  This is like her workout and then she spends the next 4 hours sleeping, they won't touch her again until the next hands-on time unless it is necessary.     

Day 3: (10/13/13)
On day 3 of ECMO the ECMO techs noticed that Makenna had several large clots in her tube.  The clots looked like stringy octopi and were collecting blood platelets quickly.  The doctors had never seen clots develop like this before and sent them to pathology to be checked.  They also needed to remove the clots from the lines.  To do this they needed to remove her from ECMO completely for 5 minutes, clean out the lines, and then put her back on ECMO.  While she was off ECMO she used the ventilator to breathe.  This was scary because for the last 3 days the ECMO was doing 100% of the breathing for her and we weren't sure if the ventilator would provide enough support (wasn't enough 3 days ago).  Thankfully she handled being on the ventilator like a pro for the whole 5 minutes!

 

 

Day 4:  (10/14/13)
On day 4 you could really see edema start to form.  She is sedated and needs rest so she spends a lot of time laying on her back, which causes fluid to collect.  They have been giving her medicine to help eliminate the excess fluids and have been turning her on her side to help move the fluid around.  Also because she handled being off ECMO for 5 minutes the day before they decided to lower her ECMO flow from 300 to 275.  It is a small change, but a change in the right direction!

Day 5: (10/15/13)
Makenna handled lowering the ECMO setting well yesterday, so today they lowered it again to 250---again she handled it well again!  Also on this day we had another special milestone!  I was able to change her diaper for the first time!  Other than pumping milk (that she can't drink yet), this was the first real "mommy" thing I got to do---so it was extra special. 

While I was changing her diaper she opened her eyes and looked at me for the first time.  Until this point I have never seen her eyes open in person (only in a picture taken by Rex the day she was born) and she had never seen me before either.  It was definitely an extra special day I will remember forever!!  :-)

 
Day 6 (10/16/13):
Today they turned her ECMO setting down again from 250 to 200!  To come off ECMO she needs to be around 150, so she is very close!  Tomorrow Dr. Kays will be getting back in town and he will decide if she is ready to come off ECMO completely.  If she is, he will also decide when she will be ready for surgery.

ECMO

At 4:35am we were awakened to a call we definitely didn't see coming.  Makenna's stats had been dropping all night and no matter what intervention they tried, her poor little lungs just weren't big enough or strong enough to sustain her any longer.  After many efforts, Dr. Kays made the decision to place Makenna on ECMO.

What is ECMO?
ECMO is a lung and heart by-pass machine that can be used for a long period of time.  There are two cannulas that are surgically connected to blood vessels in Makenna's neck (the blood vessels connect to her heart/bloodstream).  The cannulas have tubes, one tube takes the blood from Makenna's body and enters a machine that adds oxygen to the blood and removes carbon dioxide, then the blood travels back to her body through another tube.  This lets her lungs and her heart both rest.  There are a lot of risks involved in this process including blood clots (that can lead to strokes/embolisms) and internal bleeding (they give her blood thinners to reduce the risk of clots).

Because ECMO is so risky they have an ECMO tech assigned to the machine at all times (day and night).  Their job is to watch the numbers, check for clots every hour, and remove clots when they form (along with lots of other "medical things" I don't understand!). 

The ECMO tech can also control how fast/slow the blood flows through the tubes.  They started Makenna at a flow of 300 (I believe it goes as fast as 400).  The machine was doing 100% of the "breathing" for her so her lungs could rest; however, she is still hooked up to the ventilator so that her lungs will continue to inflate/deflate.  This helps them practice breathing and keeps her lungs from collapsing.  To be ready to come off ECMO she will need her flow to be around 150.  They will slowly lower her setting as her stats indicate she can handle it.

Surgery: 
Once we received the call that she needed to go on ECMO we immediately went to the NICU to see her.  We were still sleeping in the hospital, so it didn't take long.  When we got there we talked to one of the doctors and she said that Makenna was doing so poorly they need to get her on ECMO immediately or she wouldn't make it. They said hooking up to ECMO would take about an hour and since she was being prepped for surgery we weren't able to see her.  We went back to my hospital room and began what felt like the longest wait of our lives.  4 hours later we finally received the news that Makenna's surgery went well and to quote Dr. Kays "This kid likes ECMO."  He also said that only time will tell how long she will need to be on ECMO.  It could be a little as a week or as much as 3 weeks and that her surgery most likely wouldn't happen until she was off ECMO because the blood thinners make surgery even more risky. 

The ECMO machine (the tubes are red because of blood)

Makenna after surgery

 

   

Meeting Makenna

Makenna was born at 12:01am on Thursday morning and  I was able to meet her for the first time 12 hours later.  Even though I knew she was a very sick little girl, she looked so adorable and perfect.  She had a ton of tubes and wires connected to her body and was still messy from birth (cleaning her would be too much for her body to handle), but I didn't notice any of that.  All I saw was my sweet baby and A LOT of hair!  I knew from the ultrasound pictures that she was probably going to look a lot like I did as a baby, but now that she is here, the similarities are seriously uncanny!  It is so amazing seeing this tiny little version of myself and knowing she's mine!

Me                                        Makenna's Ultrasound

 

 

 

Our Birth Story!

Disclaimer:  Details the details of our delivery! 

We arrived in Gainesville at 5:30pm on 10/7 thinking we would have two weeks to get settled into the apartment.  However, Makenna had her own plans and at 9:00pm on 10/8 my water broke.  We weren’t sure if my water had really broken or not and I didn’t have any other signs of labor, but we headed to the hospital anyway.  When we got there they confirmed my water did brake and admitted me.  By this time it was 11:30 and we were both terrified that Dr. Kays (the pediatric surgeon) wouldn’t be able to make it if I delivered during the night or that he would have prior commitments that would keep him from being there.  Thankfully they were able to reach him and come up with a plan of action.  Since I wasn't showing signs of labor, they decided to hold off the induction until the next day. 

14 hours later I still didn’t have contractions and was dilated to barely a 1.  They gave me a pill to begin the induction and that kicked started the contractions.  The contractions came quickly and were quite strong.  After 5 hours of serious pain, I was still only “almost” 2cm and it was nearing 5pm.  My doctors talked with Dr. Kays team and they created yet another plan of action.  They decided to give me a mild epidural to eliminate some pain, stop the induction, and have me wait until morning to deliver.  

But again Makenna had her own ideas and when they checked me at again at 9:30pm, I was at 10cm and it was time to have our baby!  Rex and I began worrying again---this wasn’t “the plan,” what if Dr. Kays couldn’t get to the hospital in time!?  Also the pain was rapidly intensifying because my epidural had been wearing off for a few hours and there wasn’t time to have the anesthesiologist stop by.  On the bright side, the hospital has a strict 1 person in the operating room policy, but I asked if my mom could go as well and I guess due to the unique situation, they said yes!

They called Dr. Kays and he headed to the hospital, in the meantime the nurse wanted to take me to the operating room to begin pushing.  Of course there was no way I was going to begin pushing until he was in the hospital!  So we waited in the L&D room until he arrived.

At 10:20 Dr. Kays was spotted and we headed to the operating room.  They needed me to deliver in the operating room because of the large number of people that needed to be in the room (14 doctors, nurses, surgeons, etc.) and if Makenna began to show distress this would allow us to be in the room already set up for a c-section.

As time went on we began to wonder, would she be born on 10/9 or 10/10?  I personally thought 10/10 was a better birthday, but given the pain of childbirth with an epidural that had pretty much worn off completely, I wanted her out --- fast!  Either way, I knew it was Makenna who would make the ultimate decision, not me. 

At 12:01am on 10/10 our little miracle came out sideways and made her way into the world.  She was immediately snatched up, Rex cut the cord, and she was taken to the back corner to the NICU team.  We heard a very faint and forced little cry, I tried to watch the NICU team work, but there were so many people I couldn't see Makenna.

Right about this time they realized I was also at risk.  I was bleeding heavily and they couldn’t get it to stop.  I could literally hear my blood hitting the floor as if someone was pouring out a bottle of water.  Everyone kept telling me everything was okay and not to worry, but I knew it wasn’t good.  A few minutes later they called for a surgeon and a blood transfusion.  Although before the surgeon arrived the doctor was able to finally get my uterus to clamp down and it stopped.  Thankfully I didn't need the transfusion and they were able to begin stitching me up right about the time Makenna was stable enough to bring to the NICU III.  As they wheeled her out, they held her up briefly and I got my first real glance of her.  It only lasted a second---but she was beautiful!  Then they were gone.   

 

At 1:30am I was taken back to recovery.  Eventually Dr. Kays came in with an update,  but unfortunately he said she was much more sick than they initially thought.  I spent the rest of the night in the recovery room.  They said my blood count went from 11 to 8 so they needed to monitor me closely.  I don't remember being faint or feeling any physical pain, I just remember being worried about my baby girl and sad that I couldn't see her.

Finally at 4:30am, Rex was able to go visit Makenna for the first time.  Despite the fact she looked like a very fragile baby and was covered in plastic, he came back beaming.  He was such a proud daddy and I could see the deep love he already had for her!

Makenna's Room

The last two weeks have been spent getting ready to head out of town.  The three main things on my to-do list were

1.  Pack  
2.  Finish Makenna's room
3.  Cook freezer meals

(Rex took control of the logistical aspects of leaving town for so long -- i.e. making sure the alarm system was working correctly, disconnecting cable/internet, paying bills in advance, etc.)

It took a lot of work getting everything ready, especially since my energy level was 0 and my massive belly seemed to make even the simplest tasks seem huge.

In the end everything came together:
I made 12 different freezer meals, which ended up creating enough food for Rex and I to both have 50 meals!  We are bringing half of it with us to Gainesville and leaving half at home for when we get back.   It will be nice to have "homecooked" food while we are away!

 
The meals I made were:  Lasagna, baked ziti, beef stew, enchiladas, taco soup, chili,
chicken cacciatore, fajitas, spare ribs, honey garlic chicken, black bean jerk chicken, and breaded chicken.

 

Her nursery is also pretty much finished.  I just love how it all came together!

 

We painted the knobs for the changing table pink, but still have to attach them.  We also need to finish making the cushion for the bench under the window.   Also, my dad made the mirror for her!!

This is what you see when you first walk in the room.

 

We also spent time cleaning out the guestroom (which had become a huge catch-all).  I decided to turn it into a fun little reading/playroom for her. 

 

Makenna’s delivery was scheduled for the 21^st, so on the 7^th we packed up the car and said good-bye to our house.  It was so bizarre pulling out of the driveway knowing that when we returned our lives would be forever changed.