Progress

Abby has officially conquered the infection, although I'm not sure we'll ever know exactly what it was or what caused it.

What we do know is Abigail is back to being healthy and happy, and making progress. The doctors took her back off the ventilator and onto CPAP yesterday for the third time in her short life. Feedings likely will resume soon, and we're probably going to get to hold her again at some point soon.

Still fighting

It's another busy, long week of work, thus explaining my lack of updates. Also, there really hasn't been much to report. Abby continues to fight the infection, and there are some encouraging signs that she is succeeding. For a more detailed update, visit Katrina's LiveJournal.

A step back

I'm sorry to say that Abigail's streak of great days has ended.

We received a call around 5 a.m. Sunday letting us know that she had been put back on her ventilator because she had been having some episodes (brief drops in heart rate or breathing that are quite common in the NICU).

As Sunday progressed, it became clear that something was wrong. Now they're fairly certain she has some kind of infection. This is quite common in premature babies; in fact, it's amazing that she's gone this long without one. It will take a day or two to figure out specifics. For now, they've put her back on the ventilator, stopped giving her milk and started giving her a general antibiotic. She's also back on her blood pressure medication for the time being.

This is not a surprising development, but it is a tough one to deal with because we've been so used to the great progress she had been making. She should be able to get through this, but it might be a tough few days ahead. As always, we request your prayers on Abigail's behalf.

Happier news from Saturday
In happier news, we did get to hold her for about 20 minutes each on Saturday morning before I went to work. She was essentially asleep at the time, but it was still exciting. We had to put her back a little earlier than hoped because we weren't able to keep her temperature as high as the nurses wanted.

The best way to hold an infant at this age is called "kangaroo care," where you essentially tuck your baby inside your shirt on your chest. This helps retain warmth with skin-to-skin contact. So you'll probably see us wearing a lot of button-down shirts once we are able to starting holding her again.

An interesting bill
I know all children are exceedingly valuable to their parents, but this is insane. On Saturday, we got the bill for Abby's four days at Ohio State University Medical Center (June 6-June 9) before she was taken to Children's Hospital. Before I share the total, make sure you're sitting down:

$50,074.00.

No, that's not a typo. And that's just for Abby. We already received a much smaller bill for Katrina's care, including labor and delivery.

Thankfully, that is the total amount that is being submitted to our insurance. We're confident that insurance will cover most of that, and there is other financial help available for babies who are born so early and so small.

Just imagine what the Children's Hospital bills will look like when they start coming in. Katrina and I have been joking that we'll have to frame some of these things!

More good news!

The good news just keeps coming. In the last several days, Abigail has:

-Been taken off the ventilator. She is now breathing with the help of what's called a bubble CPAP (as Katrina put it, "the next step up on breathing. It means she's breathing completely on her own but has Continuous Positive Airway Pressure to give her lungs support.")

-Started taking real feedings of milk. Not from a bottle yet, but via a tube down her throat to her stomach. We were there Friday for her first "feeding" of 1 mL. We've been told they're moving her up to 2 mL every three hours today.

-Been able to have her arterial line removed. This connection, which was taken out at 5 a.m. today, was the last obstacle stopping Katrina and I from holding Abby. We're leaving for the hospital soon, and, we've been told, we should be able to hold her today.

So, as you can see, it's been an exciting and blessed few days. Everyone seems so pleased with the progress Abigail is making! Thank you all for the role you have played in her life thus far by bringing her before the Father in prayer and supporting us.

2 weeks and counting

Abby reached the 2-week mark yesterday morning, and things are moving along nicely.

-The brain scan earlier this week remained normal.
-Abby is recovering extremely well after her valve surgery on Monday. Apparently, she didn't read the part of the book that says she's supposed to be sick for several days after that surgery.
-She is breathing well enough to come off the ventilator, but they're waiting to make sure a minor problem with her ostomy is resolved before doing so.
-She is up to 1 pound, 14 ounces and is growing every day.
-They're working towards removing her stomach tube. Once they do, they will start feeding her.

Katrina had a chance to hold Abigail on Tuesday when she was helping with her care. Katrina held Abby up inside her incubator so the nurse could do a few things. For pictures of this and pictures of Abby's incubator and area of the NICU, click on the Facebook photos link in the previous post.

Progress

I don't have time for a full update, but you can go to Katrina's LiveJournal for more on the great progress Abigail has made in the last few days.

Also, more photos are posted here: http://www.facebook.com/album.php?aid=29819&l=b2484&id=502335575 .

Success!

Good news: The surgery went well. Abby is resting comfortably tonight; she is obviously quite out of it, at least for the rest of today.

To our knowledge, this should be the last of the big issues that needed addressed. No doubt more difficulties will come, but things are looking up for the moment.

I just returned from taking care of the formalities involved in having someone give you a car. We now have the use of a teal 1992 Plymouth Acclaim with 185,000 miles. It's just what we needed to allow Katrina to get to and from the hospital when I am at work.

My mom is hopping on the bus back to Iowa tonight after two weeks supporting us and Abby in Columbus. She's already anxious to come back, of course, as are the other family members who have already visited and fallen in love with Abigail.

I might not update daily now that things are a little less critical. Please safely assume that no news is good news. We will keep you all informed, however, and we continue to request your prayers for Abby; she still has a long battle ahead.

Surgery delayed

Obviously, in the previous post, I meant valve surgery -- not value surgery. (I always say it's hard to edit your own stuff!)

Anyway, Abby still is scheduled for surgery sometime today. As of 11:45 a.m., it has not begun yet. It seems when they said 8 a.m., they meant "8 a.m. or anytime later in the day that we feel like it is convenient for us." We've been told early afternoon is likely, but there's no guarantee.

We'll keep you posted.

Sunday update

For those of you who haven't heard, Abby is having the value surgery Monday morning around 8 a.m. Eastern. It's a fairly routine procedure for premature babies, but, as with any surgery, there is risk.

Everything else is looking good. Her vital signs are stable and encouraging, and she seemed more content today than she had before. It's likely the surgery will set her back for a few days, but, after that, things should be looking up.

It was great to worship with our brothers and sisters in Christ again today. The F&K family has been taking care of us lately, with a lot of emotional and other support. One of the brothers is giving us an oldish car for Katrina to be able to go visit Abby when I'm at work, and people are taking turns preparing meals for us for a few weeks.

In short, we've been quite blessed all around in the last few weeks. Abby still has a long road ahead, but things are looking good.

Thank you to everyone who has been supporting us in any way, from prayers and cards to meals and cars.

I will post updates after the surgery as soon as I can, but it might be later in the day or evening before I can do so.

More photos added

Friday was another good day for Abby; you can visit Katrina's LiveJournal for a more detailed update.

We've added some more pictures of Abby. You can view them here, even if you're not a Facebook member: http://www.facebook.com/album.php?aid=5650&l=d1e0c&id=502335575.

Have a good day!

Friday update

Yesterday was another good day.

Abby did have to have another minor surgical procedure to insert a line that will allow them to stop giving her so many shots and IVs. That went well and should be very helpful in the long run.

During my time at the hospital yesterday, I had my best moment with Abby thus far. When I first arrived, she was alert. I was standing by her bed and talking to her. She was clearly looking directly at me, even following me with her eyes when my face moved. Then, at one point, she reached out to me with her right hand. I, of course, let her hold one of my fingers for a while. It's just great having her be able to see us now.

In other good news: Her heart valve problem might be fixing itself. In yesterday's heart scan, it was classified as a small opening rather than a moderate one. If they can keep her on low levels of supplemental oxygen, there is a chance the problem will be fixed without surgery.

Katrina's mom just left to go home; my mom will leave sometime this weekend. That means this is the time that people in Columbus can call and arrange if they want to visit. Just give us a call!

Katrina also posted about yesterday at her LiveJournal: katrinafcook.livejournal.com.

Thursday Update

Sorry for the long delay between updates; going back to work and going to see Abby take up most of my time now.

Katrina has posted her first update on her LiveJournal: katrinafcook.livejournal.com. You can also check in there to keep updated when I don't get a chance to post here.

Abby had another good night overnight. Her blood pressure situation has improved, and her vital signs are still encouraging. She's also started gaining weight, which is very exciting.

So far, there are no signs of infection resulting from the intestinal problems earlier this week. The big issue today is getting a PICC line in. (A PICC line allows them to stop putting so many IVs in her.) They're having trouble getting one in, though; it might require a surgical procedure.

After that, we'll probably start looking at the heart valve problem. That likely is another surgery on the horizon.

In happy news, however, Abby's brain scan earlier this week was normal. Considering the situation, she's doing great. She opened her eyes for the first time on Tuesday, and it's been a lot of fun actually being able to have her look at us. (Sorry; no pictures of that yet!)

Thank you all for your continued support!

Monday Update

Today was another rough day, but Abby still is hanging in there.

We found out late this morning that the minor surgery to insert a drain didn't solve the problem; the hole in her intestine had not healed. Thus, we spent most of the afternoon waiting for the surgery to begin and waiting for word of the results afterward.

The surgery was a success. She was given an ostomy -- in other words, her bowel currently is emptying in to a bag. This allowed the surgeons to cut out the small area with the hole. The ostomy shouldn't be permanent; they plan to revert the area to normal in several months, after she is more stable and her numerous other issues are dealt with.

The next few days will be spent fighting the serious infection that has been created by the bowel problem. After that, doctors will attempt to starting dealing with other issues.

Abby actually came through the surgery quite well; considering her condition, her vital signs are looking great, but the infection is a serious problem.

This was a hard day, as any surgery is a risk, especially for a tiny preemie. My mom decided to stay, and Katrina's mom already planned to stay through later in the week. If things continue to be stable, I'm planning to return to work on Tuesday to save my paid days off for later.

So many people have continued to offer us support in various forms. We appreciate your love and concern!

Pictures of Abby

To see the pictures we've taken of Abby, follow this link:
http://www.facebook.com/album.php?aid=5650&l=d1e0c&id=502335575

Please feel free to pass this link on to others who aren't on Facebook who would like to see pictures of Abby. Facebook members can access the photos via my profile.

Nothing new to report this evening. Things are still looking good overall. We've survived our first hard day, as has Abby.

Thanks again for your support.

5:30 p.m. Saturday update

Abby remains stable at Columbus Children's Hospital, where she will remain for at least the next few weeks.

Around 2 p.m. today, she underwent a minor surgical procedure in which a drain was inserted into her abdomen to allow gas and fluids out of areas where they should not be. By all accounts, she responded quite well to the procedure.

We were able to go see her before and after. She was heavily sedated most of the time, but otherwise seemed in relatively good shape. The doctors are "cautiously optimistic," as she seems to be doing quite well considering the situation.

We were told that after this procedure, there was about a 1/3 chance that the problem would be solved, about a 1/3 chance that more extensive surgery would be required, and about a 1/3 chance that she wouldn't make it. So far, things are looking good.

We will know more after some tests that will be administered around 6 p.m. and 8 p.m., but it might be a few days before we totally know if that problem has been solved or not. All other problems are on the back burner until this one is resolved.

We're heading to dinner and then going back to visit her again. I'll probably update again late this evening.

Urgent update

At this hour (late Saturday AM), Abby is being transferred to Columbus Children's Hospital. X-rays have revealed some stray air in her abdomen, which likely is caused by a hole somewhere in her intestinal tract.

When she arrives, she will be evaluated and possibly be facing surgery later in the day or soon.

We will update you all as soon as we know more and can get back online. Obviously, your continued prayers would be appreciated.

Saturday update

Abigail is still doing exceptionally well, all things considered. We just received a phone call informing us that she has been put back on a ventilator for now. We had been warned this was a likely occurrence at some point, so it's not too worrisome. Some of her other signs are looking up, so that's good.

Abby spent Friday looking like she couldn't decide if she wanted to go to the beach or go skiing. To help prevent jaundice, she had a large overhead light on her and an odd-looking neon light underneath. Because she's still so sensitive to light, this meant she spent the day with most of her face covered -- kind of like a ski mask.

She also got a heart ultrasound on Friday. There were two problems discovered, but neither one is critical in the next few days:

1. There apparently is a valve that is supposed to close between the artery that takes blood to your lungs and the artery that takes blood to the rest of your body. In premature babies, it often doesn't close on its own. They are giving Abby a drug that often corrects this problem. If the drug is not successful, though, doctors will have to go in and fix the problem.

2. This one sounds bad, but it's actually much less serious. Abby has a very small hole in between two of the chambers in her heart. Again, this is common in premature babies. This often fixes itself, and often doesn't cause any problems in any case. One of the nurses said there are probably many people walking around with this problem who don't even know it.

Katrina was discharged from the hospital late Friday morning. She's still doing well and feeling good overall. She hasn't had a chance yet, but she'll likely start updating her LiveJournal later today. (The link is on the right side of this page.) That's about the most strenuous thing she's allowed to do for several weeks.

Three more family members (my dad, sister and grandma) arrived in Columbus last night and had their first chance to meet Abigail late in the evening. Now we just have to juggle visitation arrangements and figure out what to do with everyone when we're not visiting Abby. (By the way, it's no fun only being able to "visit" your child.)

Again, thank you all for your love and support.

Abby Update

Abigail is now more than 40 hours old. There's not a whole lot new to report. She's still doing as well as can be expected at this point. She's lost a little weight, but that is very common in the first few days after birth. She was taken off her ventilator today, which is a huge good sign this early. She still has a ton of tubes and wires attached, and there's still a long way to go.

We've been told the first 48-72 hours are critical, as is the first week. By this time next week, we should have better insight into the situation. She's set for a heart ultrasound in the morning, and a brain ultrasound next Thursday. (These are both normal in this situation.)

We got to go and see Abby a lot today. There are about 16 hours a day that the NICU is open. We're allowed two visitors at any time, and we can rotate in and out whoever we want. Abby was moved to a special eight-bed area, which is, as Katrina called it "the ICU of the ICU." It's where the eight babies most in need of care stay.

Abby certainly recognizes her mom's voice and is calmed by it. By this evening, she was having a similar reaction to me. We love spending time with her and learning things from the staff, which, by the way, has been outstanding. Now we just need to learn everyone's name ...

She's spending most of her time under a bright light to help prevent jaundice, which is quite common in premies. When we come to visit, we can touch her and talk to her. Maybe we'll work our way up to singing, but I'm just now becoming good at talking to her without breaking down a bit.

Katrina is set to be released from the hospital Friday morning. She's doing wonderfully and enjoying the taste of Diet Pepsi again.

We had a lot of visitors and phone calls again today. After Katrina's released in the morning, you'll need to call our home or cell numbers to arrange if you want to visit Abby, as you can only do so when we're there too. (Obviously, we'll be there a lot; just call and we'll arrange a time for you to meet us there.)

Family members continue to arrive as they can. Katrina's grandma arrived this evening, and another handful of Iowans should arrive Friday evening.

We are continually hearing about groups, individuals and congregations who are lifting Abby and the rest of us up in prayer. We truly appreciate your support in this and every other way.

Making An Entrance

Abigail Grace Cook was born at 8:30 a.m. Eastern on Wednesday, June 6.

Katrina is doing wonderfully; she'll likely get to come home Friday. Abby, on the other hand, faces a long road. She would have hit the 24-week mark on Thursday, so she is just on the line where a baby has a reasonable chance of survival with intensive care.

Given that fact, Abby's doing quite well. She weighed in at 1 pound, 8.5 ounces, which is actually quite large for her age. She is 12.5 inches long. She will be at the neonatal intensive care unit for the foreseeable future, likely several months at minimum.

Katrina and I got to go see her and touch her in the NICU several times today. We also were able to let several visitors take a turn seeing her up close, but only the parents are allowed to touch her at this point.

Speaking of visitors, we really appreciated all the support we received from so many people today. We had a steady stream of friends and family visiting throughout the day and an even more steady stream of phone calls of support from all over the country. We received word that Abby had been lifted up in prayer by at least a half-dozen congregations and many more individuals from New Hampshire to China. God is good!

For those of you in the neighborhood, calls and visits are welcome. If you're wanting to visit, you probably should call ahead (614-293-1131 is Katrina's direct line) to make sure our little room doesn't run out of room. Also, the NICU is closed for several stretches throughout the day, so you'll probably want to make sure you're coming at a time you can go see Abby. (By the way, Abigail and Abby are both fine. Your choice.)

Here's a Cliff's Notes version of the last 27 hours, for those of you who'd like to know what in the world happened:

Tuesday
9:45 p.m.: Katrina calls me at work to report a worrisome symptom. I convince her to call 911 and start getting ready to leave work early.
10 p.m.: As I prepare to leave the office (~1 hour away from home), Katrina says the medics are on the way.
10:30 p.m.: Katrina says the medics have examined her and determined the situation isn't urgent. They say they can take her to the hospital, or she can wait for my arrival. She decides to wait.
11 p.m.: I arrive home, grab a few things, and take Katrina to the hospital.
11:15 p.m.: We arrive at the emergency room and are immediately transferred to the labor and delivery wing, which handles all pregnant women who come to the emergency room in this kind of situation.

Wednesday:
Midnightish: By this point, we have talked with several medical students, residents, nurses and doctors. They are asking us about the situation and running some tests in an intake room.
12:45 a.m.: We get the news: The cervix is essentially gone, and there is some serious dilatation. In other words, the chances were very slim they were going to be able to stop Abigail from being delivered in the near future.
1 a.m.: Katrina is moved down to a labor and delivery room. We're told that they're going to give steroids to try to develop Abby's lungs and some other chemical to try to calm the contractions. Their hope was to delay delivery for at least 48 hours to allow time for a full series of steroids to help her lungs.
1:30 a.m.: We try to call our parents with the news so they can make plans to move towards Columbus ASAP.
3 a.m.: Things seem to be stable, with contractions every eight minutes and holding. They even got weaker for a while.
4 a.m.: With things still stable, I run home to pack a suitcase and do a few other things while Katrina gets some sleep.
5:30 a.m.: I arrive back at the hospital and get a total of about an hour of sleep before phone calls and hospital activity start a new day.
8 a.m.: All of a sudden, Katrina vomits. In the ensuing examination, it is discovered that delivery is imminent. The delivery room fills with about a dozen people. Because we hadn't had a chance to take childbirth education classes, I was fairly useless. The staff really stepped up and took care of things, though.
8:30 a.m.: After a short active labor, Abigail is born. She is immediately placed in a special bed in the room to be cared for by a group of specialists. I get to see her some, Katrina barely gets to see her at all.
8:45 a.m.: I follow the staff as they wheel Abby to the NICU. They say it will take several hours to stabilize her.
9 a.m.: I make an urgent round of phone calls to spread the good news.
10 a.m.: We get our first visitor, Jeff Darby, the college minister at our congregation. He comforts us and keeps us company as we wait for news and as Katrina drifts in and out of the conversation because of fatigue.
Noonish: We finally get word that Abby is stable and we can go see her in the NICU. She's so small! We stay about 20 minutes, but Katrina needs to go back to bed. It was so hard to not be able to hold her!
Rest of the day: A whirlwind of visitors, phone calls and hospital stuff. By the end of the day, we had gone to see Abby several times, and she seemed to be a little more comfortable each time. She grasped her little hands around a finger several times, especially when Katrina touched her hand.

I will post updates as warranted and as I have an opportunity. Thank you all so much for your prayers and support. They truly carried us through an extremely difficult 24 hours.

Urgent Pregnancy Update

Your prayers are urgently requested.

As you can see by the tag, I'm typing this at 4:35 a.m. Wednesday. Katrina has been admitted to Ohio State University hospital with serious complications. She and the baby are doing fine for the time being, but there is an extremely good chance that Abigail will be born sometime this week.

As we're at 23.5 weeks, that's obviously a problem. There's hope, but even the best scenario is dicey to say the least.

I'll update as I have the opportunity. Thank you in advance for your prayers and concern.

"Headlines"

3. (an ad) "Come to work for Subway and have your dreams crushed like the rest of us."
2. (a classified ad) "Sausage stuffer $5, meat grinder $5, animal carrier $5"
1. (a cheerleader's biography) "When she isn't cheering, she likes to spend time with your boyfriend."