Wednesday, September 18, 2013

Kanaan's Kidneys

On September 5th Kanaan had an ultrasound on his kidneys to determine what exactly was going on. It turned out that he did not have the horseshoe kidney, instead he has 2 kidneys, but they are about 50% smaller than they should be and the adrenal glands are larger, making it appear to be a horseshoe kidney. Also he has bright spots on his kidneys that aren't where they should be. His actual diagnosis is Kidney Displasia, but that is kind of broad general term. His blood work showed that his creatinine level was elevated, but since his electrolyte levels were normal, it isn't a concern. The creatinine isn't a toxin, it won't hurt him being high, it just tells the kidney function level. If it stays high and other levels start getting out of whack then we will start to be more concerned. At some point Kanaan may need dialysis and a kidney transplant, but right now we are trying to keep his kidneys working as well as possible for as long as possible. The doctor said that some babies with kidneys like his need dialysis immediately, Kanaan's are functioning the way they need to be for now, we just don't know for how long. Eventually we may need to add certain medications to his milk that condition the milk to make it the easiest for his kidneys to process. That process would be adding the meds to the milk, letting it sit for a certain period of time. The "bad" things would fall to the bottem and then we'd scoop off conditioned milk from the top to give to him. At this point though we don't need to do that. Once he starts eating baby food, we'll meet with a dietician to discuss what he can and can't eat to keep everything in balance. To help keep his electrolytes in balance he is on a sodium supplement, and a medicine to control the acid in his blood. We also add a special high calorie formula powder to his breast milk to help him gain weight. In the hospital he had a little trouble gaining weight, which is common for his condition. Since we have to fortify his milk and also mix his meds in it, I am pumping exclusively and we give him the milk in a bottle. We have to keep track of how much he is eating verses peeing out and it is impossible to know how much he gets by nursing. The important thing is that he gets the breast milk, if it's better for him to get it in a bottle than that's what we're going to do. It actually makes it a little less stressful, just because we know he's getting what he needs. He is gaining weight well, on the fortifier. The doctors said he looks and acts just like any other normal baby, he's just a regular baby with a kidney condition. We just have to keep a close eye on any changes in his eating habits, or if he starts to swell. Also if he gets sick we have to take him to the pediatrician immediately to have his blood levels checked to make sure his kidneys are doing ok. We really like the nephrologist, Dr. Seifert and his pediatrician Dr. Raad. They both are very knowledgeable and very easy to talk to. We feel that we can ask them any question without feeling like it's a dumb question and they are very reassuring, yet truthful with their answers. At this point we really are not sure what the future holds, but we are just taking it one day at a time. We meet with Dr. Seifert on Wednesday for lab work and a follow up. His creatinine level was starting to drop a bit as we were leaving, and I'm curious to see if it continues in that direction. The normal creatinine level in a newborn is 0.3-0.6 and Kanaan's was 3.1 and then dropped to 2.5 before we left. It's good that it's going in that direction, but a change from 0.3 to 0.6 is more drastic than a change from 3.1 to 2.5. The higher the level, the more change is necessary to make much difference. We're praying that his levels remain stable or improve, that his kidneys will continue functioning as well, if not better than they currently are, and that he continues to gain weight and thrive.

Thursday, September 12, 2013

Kanaan is Here!!!

We arrived at the hospital around 3:30pm on 9/3/13. They did another size check and measured Kanaan to be about 7lbs 5oz and they started the cervadil around 5 I wasn't allowed to eat or drink, only ice chips and popsicles. I was 1cm dilated and 50% thinned out.  Cervadil is a medication to soften the cervix to help it open in labor. It can sometimes start contractions and in about 10% of women will put them into labor, but it is mainly to get the body ready for the pitocin later on in labor. Pitocin is the medication that starts/strengthens the contractions. The goal was to put the cervadil in, let it sit for 12 hours and then take it out and start the pitocin.

 I started having mild cramps/contractions right away when they put the cervadil in. They gradually got a little stronger throughout the evening and by 3:30a.m. they were so strong I had to breath through them. They were also back to back the whole time. Three minutes apart was the most spaced out ones, they usually came in threes. I'd have 3 30 seconds to 1 minute apart and then a 3 minute stretch. They went ahead and took the cervadil out at 4am instead of 5 because my contractions were so close together. They were hoping that they would settle down a bit once the cervadil was out. The contractions didn't lighten up at all once the cervadil was out and I had dilated to 3cm and 70% thinned out. Since the cervadil had put me into labor they did not start the pitocin. Earlier they had said that once the cervadil was out that I would be able to eat some breakfast and drink something, also that I'd be able to walk around. However, since the contractions were right on top of each other they wanted me to stay hooked to the monitor in the bed and I couldn't eat or drink.

At 9am they came in and broke my water to try to make the contractions stronger and more effective. It did make them stronger, but they stayed at about the same pattern.

At about 11am I got an epidural and was almost 4 cm dilated. I really wanted to go without the epidural, but the contractions were so back to back there was no break in between and Kanaan was positioned so that I was having a lot of back labor as well. The doctor wanted to give me pitocin, because even though my contractions were strong they wanted them to be more evenly spaced and into a better pattern. They started the pitocin after the epidural was placed. Since I had only gotten about 2 hours of sleep, Andy, Kayla and I all napped after the epidural for a bit.

They checked me again at about 4:30pm and I was still basically 4cm but they could stretch me to a 5. At this point it had been 24 hours since the contractions started and I had only changed 4 centimeters, the doctor thought maybe Kanaan was turned wrong or he was too big to fit in my pelvis because I was still not progressing. Dr A said that we could try a few more hours if I wanted or we could go ahead and do a c section. I decided just to do a c-section while Kanaan was still tolerating things well instead of waiting until he was in distress. I was ready for it to be over at this point. Since I already had the epidural they were able to start fairly quickly.

Kanaan Lee King was born at 5:14pm on 9/4/13 and weighed 7lbs 12oz 20in. He took just a few seconds that seemed like hours then we heard his squeally high pitched cry. He was put on 50% oxygen but was breathing on his own. They took him off to the NICU and Andy went to tell Kayla, Mary and Alan he was here.

An hour and a half or so after he was born the Neonatologist came in and told me that Kanaan was doing well and that he was now on 30% oxygen and otherwise doing well. Andy was able to take Mary and Alan up to the NICU around 8ish and at around 9:30pm Kayla and I went to see him for the first time. By that time he was off all oxygen and they let me hold him. It was so nice to be able to hold and see him.

Monday, September 2, 2013

Kanaan Week 35 and 36 Update and Induction Date Is Set!

Week 35 Updates:

On 8/19/13 Kanaan got a 10/10 on the BPP/NST. The fluid level was 7cm and he was still head down.

On 8/22/13 Kanaan got a 10/10 on the BPP/NST. The fluid level was 9.2cm and he was still head down.

Week 36 Updates:

On 8/26/13 Kanaan got a 10/10 on the BPP/NST. The fluid level was at 12cm and he was still head down. This was my last visit with the regular OB.

On 8/29/13 I had my appointment with Dr. A the specialist. Kanaan's fluid was at 15.6cm! Dr. A said "You have a miracle baby!". They measured Kanaan and he weighs approximately 6lbs 13oz. He checked to see if I was starting to dilate at all, he said I was less than 1cm dilated but more than a 0. Since I wasn't really dilated much, we will go in to the hospital on Tuesday 9/3/13 in the afternoon. They will start the cervadil, a medicine to help the cervix soften and dilate that night and then the next morning they will start the pitocin to get contractions and labor going. He said Kanaan should be here by Wednesday night!  About 10% of women will go into labor with just the cervadil and not need the pitocin, I hope that happens with me. I'd really like everything to go as naturally as possible. He said that as long as Kanaan is crying and breathing and looks good I will be able to hold him right away and nurse him as soon as possible. The NICU doctors will be in the room when he's born as well so that if he does need any help they are right there.

Even though the fluid has gone up and he's done fantastically, he was still without fluid during the crucial time when his lungs were developing. This means we won't know if he will have enough lung tissue to support him once he's born. If this is the case there is nothing they can do to help him breath and he won't make it.  Please pray that Kanaan is able to pass over this last hurdle and amaze the doctors once again with how well he's doing. I believe God is using Kanaan's story as a testimony to what He can do!!