His Timing, His Plan

We got to meet our sweet twin boys today! Caleb was born at 8:19 am and Gabriel was born at 8:20 am. Both around 4-4.5 lbs.

Well, not a couple of hours after I posted the last blog post yesterday, my water broke at home around 7pm. In a race to pack, we threw things in a bag, Anne picked up Aaron, and we took off down the road to Levine Children’s Hospital in Charlotte, where we had just been to meet all of the teams that would be involved in our care just the day before.

After getting up to the OB triage room, I was examined (maaaaybe 1 cm dilated and very mild contractions.) The goal was to get an IV going for antibiotics, steroid shots for the boy’s lung maturity, and medication to help with slowing down the contractions to allow for me to stay pregnant for another week to 3 or so weeks. Caleb’s heart rate dropped dramatically and all of the sudden we were surrounded by 6+ nurses and doctors. It went back up once on my side but of course the theme of the night was hunting for the babies so they could both stay on monitors. I was then transferred to a room for observation and given the meds to slow and stop contractions. This was not working and my body was determined to dilate from 1 cm to 5 cm by this morning (Thursday January 28th).

Throughout the night, nurses worked tirelessly to readjust monitors, use ultrasound to locate sneaky heartbeats, and give me some relief from the intensity of the pain. By morning, the doctor said we have done what we can, it’s time to deliver and prepare for c-section. The tears started flowing, and reality was setting in that I would not be able to keep these babies in for the goal of 35+ weeks. In that moment, I just said, “You are in control, God”.

When we got to the very large room for the c-section, it was unbelievable how many people were in the room with us. There were 20+ people and multiple teams, from the two teams from the Nicu, the Cardiac team, the anesthesiology team, the nurses and doctors orchestrating the actual c-section, and many more we don’t even know. Hormone changes and sheer adrenaline made my body shake uncontrollably. The nurses helping guide me through this were the sweetest, most tender coaches I’ve ever met. The spinal was not bad at all, I was told everything every step of the way, and felt no pain or nausea. When Adam was brought in to sit next to me, my heart melted to see his tears flowing. I turned my head to look at him and say, “Adam, look at all of these amazing angels God sent to be with us in this moment. To take care of us and our babies. To use their God-given talent to help us”. This was one of the most overwhelming yet humbling feelings I have ever felt.

First came Caleb at 8:19 am and then Gabriel at 8:20 am. I could only see them from a distance and rely on Adam’s view to get a closer description. After placing breathing tubes in both boys, Caleb was quickly taken with his team to the cath lab to receive the catheter to open up his restrictive atrial septum. Because of Gabriel’s more stable state, Adam was able to cut his umbilical cord and take more pictures of him.

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After being transferred to my room for recovery, getting lunch, and Adam visiting Gabriel, we were receiving updates every hour from one of the nurses about the surgery with Caleb. Unfortunately, we would only get to hear, “He is stable, they are still working on him”. This was the update for pretty much every single call for what was supposed to be a 2 hour procedure. It was now nearing 6 hours and we were feeling desperate to know more. We then received a call that Caleb was stable, and the doctor would be coming to talk to us. Immediate worry filled our hearts.

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What we didn’t know was happening during this time, was that this doctor, Dr. Paolillo, and the packed room of other medical professionals were saving Caleb’s life. He told us outright, this was the most difficult surgery he has ever performed in the 20 years he has been practicing. Our hearts dropped. He went on to say that because of the smaller size due to him being premature at 33 weeks, it was very difficult on his body to go through this trama. However, he said had we not delivered now and waited weeks, it would have likely had very damaging and devastating effects for Caleb. He then explained what happened in the Cardiac OR. When they went in through the thigh to insert the catheter and go up to the heart, the goal was to place this balloon into the atrial septum and widen it. They didn’t know it would have more a tube shape. It was squirting high-pressure blood into the right atrium, making it impossible to get through after attempting to for 4 hours. He finally decided to burn a new hole near the atrial septum in order to place the stent, relieving the pressure of this blood flow. These materials needed to be fabricated or repurposed since they don’t use these things on babies this small. While doing this though, somehow the lining heart wall was punctured by one of the anchoring wires, however, this was undetectable are using contrast, etc. to find it. Blood collected around the heart. They went through the chest to collect this blood and but it back into the body. It didn’t take long for this blood to stop collecting though which was good. Blood was also filling in the lungs. Lungs are like sponges and absorb this blood, causing them to not work well and not release oxygen into major parts of the body. Caleb’s oxygen levels were in the 30’s and 40’s for a long while and this can be damaging to the heart, lungs, liver, kidneys and brain. We were so scared to heat this. We’ve since heard that other children go much longer with those levels and have been ok. We are hoping that he is able to rebound well after this time of low oxygen levels. Once the stent was placed however, oxygen levels went from the 30’s to the 80’s almost immediately. An updated xray around 3pm showed, largely to their surprise, that the lungs have improved a lot! His blood pressure is looking good, and even though he is on a ventilator, he doesn’t need a ton of extra oxygen. They also said he isn’t having to be on a ton of heart meds either. These updates were from Dr. Matthew C. Schwartz, a partner with Mr. Paolillo. When we went to visit Caleb, Dr. Schwartz was hold compression on the spot on Caleb’s leg that was used to insert the catheter. Because his blood is pretty thin right now, he doesn’t clot well and they don’t do stitches on a tiny baby. This man stood for 6 hours helping to work on Caleb, and hours later, was still holding the gauze on and staying right there in the ICU room. I am so so touched.

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Dr. Paolillo candidly shared that first, it was so lucky that we delivered now, even though the prematurity adds difficulties. He shared though that this was it for Caleb, he had no choice but for this to work or he wouldn’t have survived. He said that “I’m a stubborn Italian and was determined to give your son a chance.” He said that it was so fortunate that we were able to get here and do this surgery here, since a good portion of surrounding facilities would likely not have taken this on. He, along with his colleagues, wanted to do this and were determined to see it through. He mentioned that the fact that we delivered this morning was especially crucial. Had we delivered in the middle of the night last night, all of the coordination and collaboration of the teams would not have worked out like it did today. See, he and his partner as well as many of the other medical professionals in the room canceled procedures and their schedules to make this happen. They conferenced with each other last night to be prepared for today. He said, we are so lucky that we went to those appointments on Tuesday. We were able to find the restrictive atrial septum and teams were able to discuss this and discuss a plan to intervene immediately after birth.

Today, Adam and I got to bear witness to some of the highest of highs and lowest of lows. We finally got to meet our twin sons and look at their little bodies, standing in awe of God’s goodness. We were in the middle of a tornado and survived today. We almost lost Caleb today. BUT GOD! God had a plan and His timing is exactly what this baby needed, though we couldn’t see it. The amount of things that needed to fall into place in order to save Caleb’s life were exactly what we needed to acknowledge and have acknowledged for us to get through this. What an INCREDIBLE God we serve!!!

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We are asking for very specific prayers right now. Please pray for amazing growth and development for our boys in the weeks and months to come. Pray that Caleb is able to rebound quickly after this unexpected bump in the road. Pray that the low oxygen doesn’t have long lasting effects. Pray for Adam and I to have strength and peace beyond all understanding. Pray that Gabriel continues to do well in the NICU and doesn’t have any complications. We need our village more than ever right now.