We had a doctor's appointment earlier today and found out some more things. After running a few preliminary blood tests, we've learned that the placental abruption took place as a result of a small placenta. There are several reasons for a small placenta, from a bad implantation to the uterus, to high blood pressure, and finally as a result of antibodies.
For Kari, the small placenta was a result of the antibodies. The immune system is comprised of white blood cells which make a variety of antibodies. Some antibodies protect us and others are harmful to our bodies. The antiphospholipid antibodies can damange the inside of the blood vessel wall, which allows blood cells to stick to the site of the injury and cause blood clots. In addition, the antibodies can cause blood vessels to constrict, causing decreased blood flow throughout the circulatory system. The combination of blood clots and constricted blood vessels may impair blood supply to the fetus and placenta. There is more to this that I won't go into, but suffice it to say that antibodies to phospholipid molecules can interfere with the development of the placenta.
These antibodies are not usually tested for during pregnancy, since it's rare. Our doctor mentioned that he only sees it once every 5-7 years. But up until the point of the abruption, everything was normal and healthy and it could not have been detected. All pregnancies have some sort of reaction against the fetus as it has a component of a "foreign object" (the paternal side of things) but it's just a matter of when the reaction occurs, as some may develop later, and some not at all. The trick is to understand how the mother's immune system is altered so that her body does not reject the fetus and allows the fetus to grow. There are many other antibodies that are important to the reproductive system, but the one that affected us was the antiphospholipid antibody.
Thursday, May 22, 2008
Tuesday, May 20, 2008
Ethan Blake Kanai
In order to avoid having to tell what happened over and over again (and having to re-live the painful moments every time) I'm documenting what happened. Be warned, however, as you read this at your own risk...
On Thursday, May 15th, I came home around 6pm or so and Kari mentioned she was having some lower abdominal pain. It didn't sound like it was too painful or anything, maybe it was just some cramping. Anyway, around 10pm, Kari went to the bathroom and noticed a lot of blood. While I was trying to research what to do on the Internet, Kari was yelling at me to get going and bring her some clothes and a bra (she was already in her pj's). I guess I'm not that good in emergency situations like this, since I was moving kinda slow. We went to the Overlake Urgent Care in Issaquah, and they told us to go straight to the emergency room at the main Bellevue Overlake hospital.
Once we got in, they took us to the childbirthing area, where they hooked Kari up to check her blood pressure and our baby's heart rate. We were thinking maybe the baby was already a goner by that time, but the heart rate was still going strong. However, Kari's blood pressure was really high, but we didn't feel too concerned, because she has "white-coat syndrome": her blood pressure is high at the beginning of a visit to the doctor's (probably due to anxiety on her part) but then it settles down when you check again 20 minutes later. Anyway, they were like, "no, this is really high." Kari was also contracting, with each contraction about a minute apart. How are we supposed to know what a contraction feels like? They had her on medications to reduce the blood pressure and get the contractions to slow down, but nothing seemed to work. Kari's doc showed up and mentioned how serious of a situation this was. After some time, her blood pressure may have gotten better, but nothing significant, and the next thing you know, the baby's heart rate just dropped, and the doc and nurse wheel Kari out of the room. It was such an emergency, that they didn't allow me to "gown up" and watch the birthing (via c-section) process. So here I am sitting all alone in the room, waiting to hear what happens. It goes from chaos, noise and craziness to silence.
Ethan Blake Kanai was born on May 16th, 2008 at 12:54AM after just 24 weeks of being in the womb. (I wasn't too hot on Blake, but the alternative was Henry...) They were able to successfully intubate him (put a tube down his throat to help him breathe since the lungs are still immature) and I was able to see him with all his tubes and wires (they had lines running through his umbilical cord to support him). While I was waiting for Kari, who they were sewing up after the emergency c-section and was still bleeding quite a bit, I was able to observe Ethan as they helped him along. He did have a pnemothorax (collapsed lung) in his right lung, so they had to put a chest tube in him. (Just like me, in high school, I had a spontaneous pneumothorax three times...) A doctor I talked to did say that Ethan did have a chance to live, even though he was born so early, but the survival rate was probably around 50-60%. He also had to be taken to the UW Neonatal Intensive Care Unit (NICU) since they are the only ones in the area able to handle a 24 week old.
In the meantime, I found out Kari was out of surgery and in the room recovering. The doctor said that it was essentially a life-threatening situation for both mom and baby as a placental abruption occurred - the placenta was separating from the uterus, and without that connection Ethan would not have been able to survive in the womb. The doctor did mention at that time that it's possible that Kari's body was rejecting the paternal blood (mine). In first time pregnancies this could occur, but then the second time around it's fine since Kari's body is now used to it. Later on, we discovered this may not be the case, but hopefully we will get more answers on why a placental abruption occurred so early. The pregnancy book we have discussed this at the 33 week stage and we were only at 24 weeks.
I was able to talk to Kari right after, but she doesn't remember too much of the conversation. After running around back and forth between Kari's room and Ethan's room, (Kari's parents were there, so they were able to watch over her and Ethan) it finally came time to transport Ethan to the UW NICU. So while Kari stayed at Overlake recovering, I rode in the specialized infant Ambulance to take Ethan to the UW.
After arriving at the UW, it sounded as if the transport couldn't go any better. Everything was ideal and I'm guessing that sometimes in transport things can go very bad when you're moving such a young premature baby. By this time it's around 5 AM. I go back and forth between the waiting room to get some rest and to the NICU watching the nurses and doctors do what they need to do and absorbing as much information as I can. They let you just watch while they work right up next to the isolette (or incubator).
I go home and get some rest and see how Kari is doing at Overlake. She is doing great. It seems ridiculous that the same day she had an emergency C-section, she is looking good and coherent, and fighting the pain like a champ. I guess she didn't press the morphine drip button very often at all and since it was an emergency C-section, she didn't get all the drugs she would have if it was a regular C-section. All I know is that when I had general anesthetics, I woke up from it, and threw up every time I moved my head an inch.
That night at the NICU I read a book to Ethan (Kari strongly suggested it...) I found it hard to talk to him, maybe I was self-conscious, so it was hard to read the book. Anyway, everything we've heard at the NICU was relatively positive. For someone born so early, things looked promising. All the nurses did say to take things one day at a time, and there was a "honeymoon" period of like a day or two where things were stable and then the real craziness starts. But they did say also to be prepared for the long haul, since Ethan would have to be in the NICU up until his expected date of early September.
The next day on Saturday, Kari was released from the hospital (she was supposed to stay until Monday, but she told them she was ready to go home and after doing some tests, they let her.) In some things such as this, Kari is really strong. It's ridiculous how good she looked and acted just two days after surgery. That night, Kari was able to truly see Ethan for the first time in the NICU. She read a lot of stories to him and talked to him as he couldn't see what was going on yet (his eyes weren't open yet). Unlike me, she was very comfortable talking to him and making him feel comfortable at the same time. She also was very good in asking the doctors and nurses a lot of questions, which helped us understand things better. It seemed like there were ups and downs in Ethan's condition, but overall, things seemed good.
The next day, Sunday, most of Kari's family was there earlier. Kari and I rested at home in the morning and then headed over to the NICU in the afternoon. We were at home as Kari was trying out the breast pump as the nurses all mentioned how every single drop of breast milk is important to save, as it is vital for the health of a preemie. So even though we felt ridiculous scooping up 4-5 drops of breast milk in a 3mL syringe, we did, to be frozen and stored until such time that Ethan could use it, even to wet his lips before he can truly have breast milk. There is something about the breast milk coming from the mom of a premature baby that is especially helpful for the preemie, so we were doing all that we could.
Anyway, once we got to the NICU, there were some good news and bad news we heard about him, but all in all, I thought pretty good. By 8pm or so, after Kari read Ethan's favorite story "Larry Gets Lost in Seattle," (which Ethan enjoyed as we could tell from his increased oxygenation rate) we left to go home, and right when we got on 520 to head home, we got a call from the NICU to head back as things turned for the worse. By the time we got there, Ethan had essentially passed away, there was nothing more they could do for him. Earlier in the day, it sounded like there was something going on with his left lung, but it didn't seem anything too pressing. It sounded like the ventilator had too much air going to the right lung, and not enough to the left lung, so they re-positioned it to help the left lung out. Anyway, later on something must have happened, and there was a lot of air outside of the left lung area. They put in a needle to get the air out, and some fatally large amount of air was trapped in there that wasn't supposed to be there that they took out. Combine that with the pneumothorax he already had in his right lung, and it was just too much for him. His heart rate dropped and he just couldn't make it.
Needless to say, this was the worst possible day in our lives. Ethan was in the isolette this whole time, and the only time we got to hold him was after he passed away. Kari was finally able to touch his small, cute feet and toes. Kari wanted him in a cute blanket, so we were able to get a snoopy blanket to wrap him up with. After reading all those baby books, I knew how to swaddle him properly, but unfortunately the first time I have ever swaddled a baby was after Ethan passed away. Kari didn't want Ethan to be lonely, so she left a picture of Henri with Ethan to keep him company. We didn't want to leave him there at the NICU, but we finally had to let him go.
Even though we knew Ethan out of the womb for less than 3 days, the sense of loss we feel is indescribeable. It's almost worse in knowing him for such a small amount of time because you think about all the possibilities that he didn't get to do, like his first birthday, or halloween, or going to Lake Chelan every year. Even having Stan teach him baseball, or me playing basketball with him. I stopped playing basketball a long time ago, after I blew my knee out, but I was going to start up again so that I could play ball with him. Ethan and I were also planning on going hiking and camping together, since Kari won't go with me. And Henri was finally going to get a playmate and we looked forward to our son growing up with him. It seems worse because so early on, you idealize what was going to happen. Maybe Ethan would have hated going camping like Kari, but you don't think that when he's just 2 days old. Anyway, this just sucks. It's been really hard and we wish Ethan was still here with us. It does makes Kari feel a little better knowing that Ethan is probably with her grandpa. Maybe her grandpa will be the one to teach Ethan baseball.
I'll stop for now and just say that I want to thank everyone for all of their thoughts, support, prayers, help and food we have received from everyone. We appreciate all of the offers of help and assistance as we could not get through this without all of you. Some people have asked about a funeral service, but I think we're just going to hold a very small, private, family only service, but I appreciate people inquiring.
I'll hold off for now, but once the memorial service is over, I'll update the blog with more info on Ethan and possibly some pictures if Kari lets me.
On Thursday, May 15th, I came home around 6pm or so and Kari mentioned she was having some lower abdominal pain. It didn't sound like it was too painful or anything, maybe it was just some cramping. Anyway, around 10pm, Kari went to the bathroom and noticed a lot of blood. While I was trying to research what to do on the Internet, Kari was yelling at me to get going and bring her some clothes and a bra (she was already in her pj's). I guess I'm not that good in emergency situations like this, since I was moving kinda slow. We went to the Overlake Urgent Care in Issaquah, and they told us to go straight to the emergency room at the main Bellevue Overlake hospital.
Once we got in, they took us to the childbirthing area, where they hooked Kari up to check her blood pressure and our baby's heart rate. We were thinking maybe the baby was already a goner by that time, but the heart rate was still going strong. However, Kari's blood pressure was really high, but we didn't feel too concerned, because she has "white-coat syndrome": her blood pressure is high at the beginning of a visit to the doctor's (probably due to anxiety on her part) but then it settles down when you check again 20 minutes later. Anyway, they were like, "no, this is really high." Kari was also contracting, with each contraction about a minute apart. How are we supposed to know what a contraction feels like? They had her on medications to reduce the blood pressure and get the contractions to slow down, but nothing seemed to work. Kari's doc showed up and mentioned how serious of a situation this was. After some time, her blood pressure may have gotten better, but nothing significant, and the next thing you know, the baby's heart rate just dropped, and the doc and nurse wheel Kari out of the room. It was such an emergency, that they didn't allow me to "gown up" and watch the birthing (via c-section) process. So here I am sitting all alone in the room, waiting to hear what happens. It goes from chaos, noise and craziness to silence.
Ethan Blake Kanai was born on May 16th, 2008 at 12:54AM after just 24 weeks of being in the womb. (I wasn't too hot on Blake, but the alternative was Henry...) They were able to successfully intubate him (put a tube down his throat to help him breathe since the lungs are still immature) and I was able to see him with all his tubes and wires (they had lines running through his umbilical cord to support him). While I was waiting for Kari, who they were sewing up after the emergency c-section and was still bleeding quite a bit, I was able to observe Ethan as they helped him along. He did have a pnemothorax (collapsed lung) in his right lung, so they had to put a chest tube in him. (Just like me, in high school, I had a spontaneous pneumothorax three times...) A doctor I talked to did say that Ethan did have a chance to live, even though he was born so early, but the survival rate was probably around 50-60%. He also had to be taken to the UW Neonatal Intensive Care Unit (NICU) since they are the only ones in the area able to handle a 24 week old.
In the meantime, I found out Kari was out of surgery and in the room recovering. The doctor said that it was essentially a life-threatening situation for both mom and baby as a placental abruption occurred - the placenta was separating from the uterus, and without that connection Ethan would not have been able to survive in the womb. The doctor did mention at that time that it's possible that Kari's body was rejecting the paternal blood (mine). In first time pregnancies this could occur, but then the second time around it's fine since Kari's body is now used to it. Later on, we discovered this may not be the case, but hopefully we will get more answers on why a placental abruption occurred so early. The pregnancy book we have discussed this at the 33 week stage and we were only at 24 weeks.
I was able to talk to Kari right after, but she doesn't remember too much of the conversation. After running around back and forth between Kari's room and Ethan's room, (Kari's parents were there, so they were able to watch over her and Ethan) it finally came time to transport Ethan to the UW NICU. So while Kari stayed at Overlake recovering, I rode in the specialized infant Ambulance to take Ethan to the UW.
After arriving at the UW, it sounded as if the transport couldn't go any better. Everything was ideal and I'm guessing that sometimes in transport things can go very bad when you're moving such a young premature baby. By this time it's around 5 AM. I go back and forth between the waiting room to get some rest and to the NICU watching the nurses and doctors do what they need to do and absorbing as much information as I can. They let you just watch while they work right up next to the isolette (or incubator).
I go home and get some rest and see how Kari is doing at Overlake. She is doing great. It seems ridiculous that the same day she had an emergency C-section, she is looking good and coherent, and fighting the pain like a champ. I guess she didn't press the morphine drip button very often at all and since it was an emergency C-section, she didn't get all the drugs she would have if it was a regular C-section. All I know is that when I had general anesthetics, I woke up from it, and threw up every time I moved my head an inch.
That night at the NICU I read a book to Ethan (Kari strongly suggested it...) I found it hard to talk to him, maybe I was self-conscious, so it was hard to read the book. Anyway, everything we've heard at the NICU was relatively positive. For someone born so early, things looked promising. All the nurses did say to take things one day at a time, and there was a "honeymoon" period of like a day or two where things were stable and then the real craziness starts. But they did say also to be prepared for the long haul, since Ethan would have to be in the NICU up until his expected date of early September.
The next day on Saturday, Kari was released from the hospital (she was supposed to stay until Monday, but she told them she was ready to go home and after doing some tests, they let her.) In some things such as this, Kari is really strong. It's ridiculous how good she looked and acted just two days after surgery. That night, Kari was able to truly see Ethan for the first time in the NICU. She read a lot of stories to him and talked to him as he couldn't see what was going on yet (his eyes weren't open yet). Unlike me, she was very comfortable talking to him and making him feel comfortable at the same time. She also was very good in asking the doctors and nurses a lot of questions, which helped us understand things better. It seemed like there were ups and downs in Ethan's condition, but overall, things seemed good.
The next day, Sunday, most of Kari's family was there earlier. Kari and I rested at home in the morning and then headed over to the NICU in the afternoon. We were at home as Kari was trying out the breast pump as the nurses all mentioned how every single drop of breast milk is important to save, as it is vital for the health of a preemie. So even though we felt ridiculous scooping up 4-5 drops of breast milk in a 3mL syringe, we did, to be frozen and stored until such time that Ethan could use it, even to wet his lips before he can truly have breast milk. There is something about the breast milk coming from the mom of a premature baby that is especially helpful for the preemie, so we were doing all that we could.
Anyway, once we got to the NICU, there were some good news and bad news we heard about him, but all in all, I thought pretty good. By 8pm or so, after Kari read Ethan's favorite story "Larry Gets Lost in Seattle," (which Ethan enjoyed as we could tell from his increased oxygenation rate) we left to go home, and right when we got on 520 to head home, we got a call from the NICU to head back as things turned for the worse. By the time we got there, Ethan had essentially passed away, there was nothing more they could do for him. Earlier in the day, it sounded like there was something going on with his left lung, but it didn't seem anything too pressing. It sounded like the ventilator had too much air going to the right lung, and not enough to the left lung, so they re-positioned it to help the left lung out. Anyway, later on something must have happened, and there was a lot of air outside of the left lung area. They put in a needle to get the air out, and some fatally large amount of air was trapped in there that wasn't supposed to be there that they took out. Combine that with the pneumothorax he already had in his right lung, and it was just too much for him. His heart rate dropped and he just couldn't make it.
Needless to say, this was the worst possible day in our lives. Ethan was in the isolette this whole time, and the only time we got to hold him was after he passed away. Kari was finally able to touch his small, cute feet and toes. Kari wanted him in a cute blanket, so we were able to get a snoopy blanket to wrap him up with. After reading all those baby books, I knew how to swaddle him properly, but unfortunately the first time I have ever swaddled a baby was after Ethan passed away. Kari didn't want Ethan to be lonely, so she left a picture of Henri with Ethan to keep him company. We didn't want to leave him there at the NICU, but we finally had to let him go.
Even though we knew Ethan out of the womb for less than 3 days, the sense of loss we feel is indescribeable. It's almost worse in knowing him for such a small amount of time because you think about all the possibilities that he didn't get to do, like his first birthday, or halloween, or going to Lake Chelan every year. Even having Stan teach him baseball, or me playing basketball with him. I stopped playing basketball a long time ago, after I blew my knee out, but I was going to start up again so that I could play ball with him. Ethan and I were also planning on going hiking and camping together, since Kari won't go with me. And Henri was finally going to get a playmate and we looked forward to our son growing up with him. It seems worse because so early on, you idealize what was going to happen. Maybe Ethan would have hated going camping like Kari, but you don't think that when he's just 2 days old. Anyway, this just sucks. It's been really hard and we wish Ethan was still here with us. It does makes Kari feel a little better knowing that Ethan is probably with her grandpa. Maybe her grandpa will be the one to teach Ethan baseball.
I'll stop for now and just say that I want to thank everyone for all of their thoughts, support, prayers, help and food we have received from everyone. We appreciate all of the offers of help and assistance as we could not get through this without all of you. Some people have asked about a funeral service, but I think we're just going to hold a very small, private, family only service, but I appreciate people inquiring.
I'll hold off for now, but once the memorial service is over, I'll update the blog with more info on Ethan and possibly some pictures if Kari lets me.
Wednesday, May 14, 2008
Week 24 - Update
Some out there feel as if there isn't enough info about Kari on this blog. Well, Kari won't exactly let me disclose certain info or post pictures of her, so there's not much I can update about her. I mean, what's wrong with disclosing how much weight she's gained or how big her belly is? Her belly is rock solid though. Since I've never touched a pregnant belly before, for some reason, I thought it would be softer (like if you actually had just a big gut) but it's actually pretty solid. Anyway, some things of note:
Kari felt the baby move for the first time on May 1, 2008, at 4:35AM (Week 22). I still haven't felt it, but Kari described it as someone knocking on her belly from the inside. Kinda like, "hey, let me outta here..."
Still finding it challenging to get enough protein for a non-meat eater. I mean, her doc says to get 100g of protein a day. That is ridiculous. Even back in the day when I tried to gain weight I couldn't average 100g of protein a day - and I wasn't about to chow down a steak every night. At least her doc says size-wise her belly is average although Kari probably feels like it's in the kujira range (that's whale...)
She's had some back and neck aches in the morning, and sleeping on the couch with her back against it helped for awhile, but now she uses the snoogle:
Also, it helped to do some neck stretching exercises before she went to bed (my idea) and it seemed to help.
No real food cravings to report, but she has wanted to eat a lot of fruit, which she never did before. She's had a lot of food aversions though, to pretty much anything. Especially since her sense of smell was strong from before being preggers, and now she's like a bloodhound. You should hear her try and take her pre-natal vitamins every night. She downs it and then makes this gagging noise like it's the worse thing that she's ever had. It's not like it's in her mouth very long and you just swallow it, but apparently it's that bad...or she's just dramatic about it.
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