One Week has passed.

This morning about 1:15 am I passed the one week mark. Everyone here is very happy that I've made it this far. As we have said, over 80% of women who's water breaks, will deliver within a week. From here the Dr's can not even guess how long I will hold onto this baby. They are encouraged that I've stop leaking fluid and haven't had a single contraction during this whole process.

We still have a long way to go, but right now things are on a positive note. We will keep you posted on events or interesting tidbits.

Let's try this again.

First Sharron and baby (aka Fish Face) are doing great! I was up to see her today and it was happily uneventful.

I caught some flack about my stats in my last post. They were missing margin of error etc. The numbers I posted are based on very rough guidelines. None of these numbers are intended to predict an individual outcome, only a likelihood of falling into a given category. My last post was based entirely on something called the "Threshold of viability". The threshold of viability is defined as the gestational age at birth where a given NICU can successfully discharge approximately %50 of their patients.

The biggest draw-back of using the threshold of viability stat is the fact that it ignores quality of life. As long as the child is able to be discharged it is considered a success. There is a significant risks of other complications the earlier the birth. The harder medical science pushes the lower this number gets, at the same time more infants are able to survive with increasingly profound disabilities. The threshold of viability at DHMC in Lebanon is 24 weeks. The NICU in Nashua told us theirs is 28 weeks.

There is another set of numbers based on 1998-2003 data that the NIH collected.
They have a calculator here. Plugging in our current data gives these results.

Based on the following characteristics:
Gestational Age (Best Obstetric Estimate in Completed Weeks): 24 weeks
Birth Weight: 822 grams
Sex: Male
Singleton Birth: Yes
Antenatal Corticosteroids: Yes

Estimated outcomes* for infants in the NRN sample are as follows:

Outcomes	Outcomes for All Infants	Outcomes for Mechanically Ventilated Infants
Survival	77%	77%
Survival Without Profound Neurodevelopmental Impairment	60%	61%
Survival Without Moderate to Severe Neurodevelopmental Impairment	42%	43%
Death	23%	23%
Death or Profound Neurodevelopmental Impairment	40%	39%
Death or Moderate to Severe Neurodevelopmental Impairment	58%	57%

Please note that these data provide only possible outcomes, and that the estimates apply only at birth. It is important to keep in mind that every infant is different, and that factors beyond these standardized assessments may influence infant outcomes.

A Quiet Day

The more boring the posts the better things are. Really there has been no change in mine or the baby's condition. The doctors feel confident enough to only monitor the heart rate once a day now. So now it's a waiting game against time, infection, or other complications.

This mornings rounds of monitoring our little April/Davis personality boy decided he had enough of being poke and monitored. After 45 minutes on the monitor and less than 5 minutes of continuous readings the doctors decided he was just fine with the amount of movement and the strength of his kicking. Unfortunately, it left me with quite a tight back. Hopefully I'll see the physical therapist soon.

Another day another 3%

I spent the night in the hospital with Sharron last night. The "dad" beds are still right out of Guantanamo Bay, but it was worth it to spend some time with Sharron. Morning rounds and monitoring are done and all systems are still go. No contractions, no signs of infection, vitals for both mother and child are right where they are supposed to be. Sharron's belly is feeling firm again. That could indicate that the position of the baby is closing plugging the leak allowing fluid to accumulate.

NIH (National Institute of Health) says that the baby's chances get about %3 better every day. If my math is right that puts us in the low 60s. We're in this for the long haul. Our short-term goal is 26 weeks, that's when the ICN (Intensive Care Nursery) folks start to feel like survival is not just a miracle that is out of their control. Beyond that we're aimed at 34 weeks where we loose the moderately premature label. If all is well till 34 weeks where the risk of infection crosses the risk of being premature.

I don't intend to scare anyone, but on the same token I don't want anyone thinking we are close to being out of the woods yet.

So far all is quiet. (That's a good thing.)

A blissfully boring Day

There still aren't any changes with baby's or my vital signs. We are both strong and stable and I still have no contractions. The baby is still very active and gives the nurses a run for their money when they want to put him on the fetal monitor. Typically the nurse or I have to hold the sensor down hard and pin him to keep his heart rate on the monitor for 10 to 20 minutes. He will have his parent's and sister's stubborn and willful attitude.
I'm now off the IV antibiotics and fluids. They took the IV out this morning. I finally can move my wrist around without jabbing myself. I have 5 days of oral antibiotics to go through now. After that, I should be medication free unless complications develop. I'm finding it amazing how much better I physically feel now that I've stabilized here. I didn't realize how horrible I have felt during this whole pregnancy. Again I am reminded how everything happens for a reason. I guess I needed that vacations more than I thought I did.
Thanks to Maine for the use of the magic sweater. I can feel the comforting vibes already.

past the 48 hour mark!

At 2:15 am this morning I passed the 48 hour hurdle with no contractions or signs on impending delivery. If the baby stays in for 5 more days, my chances to carry until 34 weeks increases dramatically. The longer I can carry the better the outcome is for the baby.

On a happy note, with all the training I've gotten on reading ultrasounds, we now know we are having a little boy. He shows off his movement everytime we have an ultrasound and makes it hard for the tech to get all the measurements they need. He loves to hold his hands covering his eyes while making a face similar to what Lys has dubbed "fish face" on Rachel. His heart rate and activity is very strong and steady. Everyone is happy with both of our vitals. He is strong enough to kick very hard at the sensors that measures his heart rate. The nurses have to physically hold the sensor for the 10 minutes they need to ensure he stays on the monitor.

Today I also had a very nice visit from Rachel. She was upset at being at the hospital at first. They allowed me to take a wheelchair walk around the campus which put her much at ease. After we got back she was comfortable enough to eat a whole pear by herself and color 2 pictures for me. She accepted that I couldn't go home with her only with the promise of seeing me on the web cam tonight. Poor thing doesn't understand anything that is going on.

Why do these things always start at 1am?

Being awoken at 1am is rarely a good thing. Wednesday morning was no exception. When Sharron announced that we're on our way to the hospital the bottom fell out of my stomach. After one very long day, 3 ultrasounds, a few rounds of blood tests, and a 80-mile ambulance ride we now have an idea what we're facing. To make a long story short Sharron's water broke at 24 weeks (13 weeks early). The name of the game at this point is to hold off delivery as long as possible. It is possible (~50%) for babies to survive at 24 weeks, though at high risk of profound disability.

• 80%[citation needed] of cases go into labor within 48 hours of a rupture.
• After one week chances of prolonging the pregnancy get much better.
• The NICU folks tell us that the possibility of profound disability is greatly reduced at 26 weeks.
• At 28 weeks there is a possibility of transferring back to Nashua (the NICU in Nashua starts taking cases at 28 weeks).
• At 34 weeks the risk of infection extends beyond the risk of premature birth. The goal is to get to this point so that we can induce labor.

Lots of things can go awry here. We have no idea what the outcome will be. Feel free to follow along with us. Be warned that there will be ups and downs. More to come soon.

--Ben