Thursday, July 2, 2009

Family Reunion

Day Four: Tuesday, June 30
This was a big day for all of us. Will had his first reduction of the gastroschisis, I came home from the hospital, and Blaise and I got to go up to Salt Lake together for the first time to see our baby boy.

Up to this point Will had only needed minimal oxygen from the ventilator. With the reduction scheduled for Tuesday they increased his oxygen levels to compensate for the extra pressure that the bowel would put on his lungs. It surprised all of us when after the reduction they found that he still didn't need the extra help from the ventilator. He's been such a little fighter so far!

I was pretty excited to get out of the hospital that day. We didn't get out until about 4pm. I must admit I was a little nervous about how things would go without having an adjustable bed and nurses at my beck and call. The transition of getting home was pretty stressful too because I was starting to come off of my pain medication and Blaise had to run to the pharmacy and wait quite a while to get those filled. The ride home was pretty miserable because of the pain and every little bump in the road made it worse. When we finally got there and up the stairs to the apartment I was exhausted. My mom and Blaise had some balloons, a candy bar, and some flowers for me. They had also spent the morning cleaning up the house. It was all so nice, but I couldn't help but get emotional about not having my baby with me coming home from the hospital. Up to this point I still didn't feel much like a mom, just an invalid. I needed to see my baby.

Blaise and I made the drive up to Primary Children's later that evening. It was quite the endeavor for me in my physical condition. Lucky for us, we were able to have free valet parking and a wheelchair available to us for the visit. When we got up to the fourth floor and over to Will's bed I couldn't help but cry. He was so tiny and precious; smaller than the pictures made him look. It was so good to see him and touch his little feet and his face. We can't wait to be able to hold him.




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1 comment:

  1. The Rasmussen Family July 4, 2009 at 12:49 PM

    Well now I'm cryin too! Just know that the baby blues are totally normal and you have extra reason to be emotional...don't ever try to hold the tears back, I think it just makes it worse! We are still praying for little Will, what a sweet and wonderful spirit you have been entrusted with. That speaks very highly of you two, knowing that our heavenly father knew he could depend on you to be so strong for him. I am so happy to hear he is still doing great! Love you guys!

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About Gastroschisis

I have posted some links for your information and research, but here's the run down on gastroschisis.

What is it?
Gastroschisis is a birth anomaly in which the baby's abdominal wall does not close all the way during early development. These abdominal defects can result in several problems, the least of which is gastroschisis. This is when some of the intestines escape through the small opening in the abdomen and are now outside the baby's body. During pregnancy these organs are exposed to the amniotic fluid for some time which makes the once maliable and functional bowel stiff and swolen.

How is it treated?
Since gastroschisis is not as serious as other similar defects, it is not dangerous to still deliver the baby vaginally. Upon delivery the baby will go to the NICU and be examined by the pediatric surgeons. At this point of evaluation, there are several courses of action. What needs to happen eventually is that the bowel needs to be surgically put back into the abdomen of the baby.

Option 1: If the bowel has little damage, is quite maliable and healthy, and the baby's belly seems to have the room to accept all of the intestine at once, the surgeons will perform a "primary closure". The surgery is fairly simple. They will make an incision to enlarge the opening enough to push the bowel back inside and sew it up once it is finished.

Option 2: If the bowel is stiff and swolen and or the baby's belly does not have the room to accept it all at once, they will perform a "staged closure". This is more complicated and takes some time. This invloves placing a "silo" over the bowel (this is basically a bag that holds the bowel suspended above the opening). This silo will be somewhat inserted into the baby's belly so as to allow the abdominal fluids to enter and thus healing the bowel by bringing the swelling down and making it malleable again. As the bowel heals and with a little assistance from the doctors the bowel will slowly but surely re-enter the baby's abdomen.

Recovery
A staged closure can take up to a week or two. So you may ask why does he have to be in the hospital for 5 to 6 weeks. Since the baby's system is not used to the pressure introduced by this bowel that is now inside the abdomen, and the bowel has been exposed to the amniotic fluid for so long, it simply takes time for the baby's digestive system to normalize. Aside from the digestive system, other things may be affected such as breathing due to the increased pressure inside the body. The baby's recovery can be broken down into three distinct stages. Pre-Surgery, Post-Surgery/Pre-Feedings, and Post-Feedings.

The first is simply the waiting period before the baby's bowel can be put back inside.

The next period is after surgery, the baby's system is still very fragile and can only be fed interveinously. During this time the amount of nutrients is slowly increased until the baby is ready for the final stage, when his body can accept real food.

Once on breast milk feedings from a bottle, the baby is closely monitored. The process is slow as the baby must phase into these feedings from the IV. Once the baby is up to full feedings and is gaining weight, we can all go home!

Long term effects
Once the baby has fully recovered and is ready to go home, he should be fit as a fiddle and have little or no related complications thereafter. The main thing that he may experience is a case of acid reflux, but this can be treated with medication and it usually will go away as he grows and gets older.