She's off to surgery

So far the culture has not grown, so the chances of infection are slim.  The plan right now is to go in and try to clear this shunt.  They are not sure where it is clogged or malfunctioning so they will go back in and take each part apart to diagnose and correct the problem.  The entire procedure takes about 1-2 hours.  She has been NPO (nothing by mouth) since 4 am, so my poor baby is starving!  The fluid in her brain is also quite built up, so I'm sure she has a headache.  They will let her eat again after the procedure and the fluid will be able to drain correctly, so I am sure she will be a much happier little gal!  If the cultures continue to stay negative and the shunt clears correctly, we will be able to go home tomorrow, which would be awesome!  We are praying that the procedure goes smoothly and she comes through it ok, that no new infection is introduced during the procedure, and that the new parts function correctly so that we do not need any more shunt revisions for a very, very long time, if at all.  Dr. Moss, Madi's neurosurgeon, is on vacation, so Dr. Shaffron, his associate, will be doing the surgery.  He is also very well known so I know she is in good hands.  This will be her 5th brain surgery in her 7 weeks of life.  She had the initial shunt placement, two external shunts, her new internal shunt, and then this revision.  I'd say she deserves a break from all these surgeries.  She is one tough little girl!

(This is a picture of Madi sleeping on a pillow in my lap while she waits for surgery) 

Well, here we are again

Just as I feared, we are back in the hospital. At some point, Madi's shunt had stopped functioning correctly.  It started about 4 or 5 days ago.  Madi wanted to eat constantly and would only take a small 45 minute nap before wanting to eat again.  Considering that she is exclusively breastfed, let's just say I was hurting a bit!  I took her in to the pediatrician who said it was most likely a growth spurt and not to worry.  I also called the neurosurgeon who said it was normal for babies to act like that after surgery because they are trying to heal, which takes a lot of calories.  She continued to want to eat constantly, but her fontinel (soft spot) felt great, she had no fever, and she was reletively happy so I continued to monitor her but thought everything was ok.  Last night I started noticing her fontinel felt firmer.  She slept well and still had a great appetite but throughout the course of the night it started feeling more and more full.  This morning I knew that something was off.  I tried to call her neurosurgeon but the office was closed for the holiday.  After that I called her pediatrician and left a message for the nurse on call.  The nurse talked to me, the doctor on call, and then instructed me to take Madi in to the Children's Hospital.  As soon as we got here we were brought back to a room in the ER.  They ordered a cat-scan and some x-rays but couldn't find anything wrong.  Next they decided to tap her shunt to see if she has an infection.  The initial gram stain came back negative but we have to wait 24 hours to make sure that nothing grows in the culture.  If it comes back that she has an infection they will take out her internal shunt, put in an external shunt, start antibiotics, and we will be here for another 2- 2 1/2 weeks.  If there is no infection then they will go in and see what is clogging up the shunt.  That would mean we are here for about two or three days.  Either way, Madi will need yet another surgery and goes NPO (nothing by mouth) at 4 am.  I am praying that her shunt is not infected again.  As of right now, Madi and I have spent 50% of her life in the hospital and it's just not much fun.  I know that God has a plan and there is a reason why we are here, but today is just a depressing day.  We should know more tomorrow and I will keep everyone updated.  We would greatly appreciate your prayers!

And here she is!

At 36 weeks, the day had finally come.  Dr. Moss felt it was best to induce and have Madi early because her hydrocephalus levels were getting high and he didn't want to risk long-term brain damage. 

David and I got to the hospital on Sunday night at 9:00 for our induction.  We got checked in and settled and they started cervidil to thin my cervix.  After 12 hours of nothing, they decided to try a folly ball (pardon my spelling on that) to speed along my dilation.  After 3 very painful attempts and a few tears, they abandoned that idea.  They tried a few more things but fast forward many more hours, and still, nothing.  I was given the option of  starting pitocin, though it most likely wouldn't do anything to change where I was at since everything else had failed, I could have a C-section right then, or they could give me one more week and allow me to (hopefully) progress on my own.  If I did progress, we would try again to induce.  If not, I would get a c-section when I came back.  I am guessing you already know what I chose.  Since I am not a fan of contractions that aren't effective, nor am I too keen on the idea of a c-section, I opted for another week.  Surprisingly, Madi's neurosurgeon, Dr. Moss, agreed to the idea, so I was discharged after 36 hours (which equated to 2 nights in the hospital).  I was a bit surprised to be going home empty handed, as I really thought that something would work, but Conner was glad to have his mom and dad home and I welcomed an extra week in my own bed.

On November 11th, at 37 weeks, the day had finally come (again).  On Tuesday morning at 4:30, David and I checked in to the hospital.  Today was the day we would finally meet our little angel!  Upon checking in, we were told that there were many emergencies the night before and our room would not be ready until 6:30.  They did decide to check me, though, so we knew if we were proceeding with a c-section or an induction.  Over the course of the week I had dilated another centimeter to 3 centimeters and had continued effacing to 60%.  My doctor, Dr. Elliot, (can you believe out of 17 doctors, my doctor was actually on call that night?!?!), was hopeful that pitocin would be effective in starting my labor.  At 8:30 we were finally brought back to our room.  They started pitocin at about 11:30 that morning.  I would have appreciated the extra 7 hours in my own bed, but none of that mattered now.  I was just happy to get things started!  They started the drip and slowly upped the level every 40 minutes or so to try and mimic natural labor.  They new my goal was to have a natural birth, free from pain medications or interventions, and they wanted to help me along that path.  They checked me around 2:30 and I was at 4 centimeters and 70% effaced.  I had made it up to a level 6 with the pitocin (out of 30) and was having regular contractions, though they were still not very intense.  They decided to speed things up by breaking my water and it worked.  My contractions slowly started to intensify and grow closer together.  I sat on the birthing ball for a while, sat in the rocking chair, and then started to get to the point where I didn't want to be talked to or asked questions during my contractions.  All I wanted to do at that point was concentrate.  I called David, who had gone home with Conner to nap, and told him he might want to start heading my way, just in case.  My mom was there with me, but I, obviously, didn't want him to miss the birth.  At 5:00, David hadn't quite arrived, but was just around the corner.  They checked me again and I was at 6 centimeters and was almost fully effaced.  They told me I was close and it would just be a few more hours-- I couldn't wait!  Madi's heart started blipping, though, so they were keeping a very close eye on me.  They had my lay on my left hand side and had me breathe oxygen through an oxygen mask.  David arrived safely in the room, offering his encouragement and support.  Moments later I started getting very fast and very strong contractions.  I didn't have any break in between them and my body was starting to tell me to push.  They had me roll over to check my progression, as they were worried I was only 7 or 8 centimeters and pushing would cause me to tear.  To their surprise, I was fully dilated, fully effaced, her head was engaged, and she was coming fast!  I was told not to push or do anything until the doctor could get there.  I tried to stay calm and relaxed, but my body was telling me it was time.  A few minutes later the doctor, a resident, a few nurses, and the NICU team arrived and it was time to push (let me tell you.. giving birth in front of about 9 strangers is just fabulous!).  I pushed for about 15 minutes and there she was!

Madilynn Joy Veprek was born November 11, 2008 at 5:40 pm.  Our birth was wonderful and  just as I had hoped for.  Madi did fantastic and even scored 9's on her apgars!  People would say to me that they were praying she would be born perfect, to which I replied, "she already will be, because she's exactly how God intended her to be".   She was even more beautiful than we had imagined.  She had a full head of dark hair, dark blue-ish grey eyes, 10 little finger and 10 little toes, and was absolutely perfect!  The covering on her back had remained in tact, her lungs were working well, and she was perfectly healthy.  After putting her on my chest for a few minutes they covered her back, cleaned her off, and took her to the NICU.  Conner got to meet his sister for the first time and I think he was very proud.  They let me spend that night with her in the NICU before taking her to Phoenix Children's Hospital.  At 7:30 the next morning they took her in an ambulance to the hospital.  David got to ride with her but was a bit disappointed that they drove below the speed limit.  I was released the next morning at 11:00 so that I could be there for her surgery and stay with her in the hospital.  Things couldn't have gone more perfect and we were so thankful!

Update- Wow, I just realized I left out a lot of our story!!  After Madi was transferred to Phoenix Children's Hospital, she had a surgery to insert a shunt and close her back.  The nurses and neurosurgeons knew that nursing her was important to me, so they let me hold her and breastfeed her just a few hours after her surgery.  She latched right on and did great!!  They didn't have a private room for us the first night, but I told them I wasn't leaving, period.  They had me sleep in a room they have for babies and moms who are waiting to get discharged, but are deemed "healthy", and came and got me whenever Madi was awake and hungry.  In hindsight, I should not have left her bed.  A nurse decided to give her morphine, but gave it to her too fast, and she stopped breathing.  They had to give her something to counter-act it, and I missed it all.  I will never leave her side again (unless I have a very good replacement). 

The next day we were transferred in to a private room.  It was on the corner and was really nice and quiet.  There was no restroom in the NICU and no food was allowed, so I had to leave every time I needed to eat or pee or change a postpartum pad, but mostly I stayed right by Madi's side.  The nurses were great with helping me nurse her and hold her.  My milk hadn't come in yet, so I was using a Medella supplemental nurser system with donor breastmilk to help supplement so that Madi could get the nutrients she needed to recover from surgery.  We had lots of visitors, but I really missed Conner!!  They had said we would probably be there 2 weeks, but we were actually only there 5 days.  They waited until Madi regained her full birth weight, then let us go.  No one could believe that we were leaving so quickly.  They had never seen another child with spina bifida leave as quickly as us.  All the doctors and nurses kept coming by to stare at us and tell us how shocked they were.  I wasn't shocked at all, though.  Madi had her momma there with her, good milk in her tummy, and many people praying for her. 

We were home two weeks when Madi started acting funny.  It turns out her shunt was infected.  They had to externalize her shunt and put her on antibioitcs.  After it had cleared for a bit, it came back, so they gave her a new external shunt.  After we got 10 days of no infection, they re-internalized her VP shunt and we got to go home.  The whole process took just under 3 weeks.  It was a rough time, but we made it through, and that is what is important!!