
So I've felt like I should share some information that we got and just fully understood on Wednesday about how all this happened and what our baby boy's real risks were and still are to some degree. A lot of it was/is a little scary, which is why I hesitated, but since all of you are so concerned and following his progress so closely, and because much of the really scary stuff has passed with the "first 72 hours" and this evening marking his 1 week birthday, (another major milestone) I figured I may as well clue you in as best I can.
First off, I want to thank our friends Andrea Schneider and
Laine Rosenberg from NYC for sending us a great new doctor in Eric
Su. Eric is
Laine's brother in law, who just happens to work at St. David's
NICU along with Doug's other two doctors, Dr. Rivera (that's him above, who was on call and arrived in minutes at South Austin hospital last F
riday night), and Dr.
Dekowski, who is his primary doctor since he was the one working at St. David's the night Doug was transported there, 1 hour after he was born. All three of them are great, but Eric was maybe just a little more forthcoming and easy to talk to about some of the harsher realities and the how's and
why's of this whole nightmarish/miraculous episode, probably due to the fact that the scariest times had passed.
So... it all started because Melissa was a carrier (like 15-60% of all adult women, depending on who you ask) of Group B Strep (Group A is the one that causes strep throat.) This is a bacteria very commonly carried in a woman's vagina, bowels, or other areas, and rarely causes a problem. Pregnant women are screened for this at 35-37 weeks, which of course Melissa never got to. Well, it turns out the bacteria had made its way into the uterus and the placenta was acutely infected (the pathology on this just came back a couple of days ago.). Apparently little Douglas knew he didn't have the time to wait for 35 weeks, and made his mommy aware of this just in the nick of time. Because it was just such a sudden thing, Doug didn't have the benefit of steroids or antibiotics that would have been administered to Melissa had they been aware of the infection. So his little body had to do all the work of adjusting to the outside world once he was already on the outside, rather than the rapid evolution a baby can undergo to get ready if it's apparent he's coming early for a few days.
Now, I insisted from the beginning of this that Melissa not start doing searches on the Internet about preemies at 27 weeks, all that can happen, statistics, etc. Mostly because I don't care to know the odds in such situations, as I believe in things not covered in numbers, like the human spirit and family and little Doug's namesake looking after him from wherever he is. Of course, from the second I found out this is what caused all this, I did all those searches myself, as I'm sure many of you will. It's a lot of pretty scary stuff, and I found out today just how afraid Dr. Rivera was for little Doug when he first met him about 20 seconds after delivery at South Austin. Fearing this infection, Dr. Rivera immediately put Doug on just the right antibiotics, even before the pathology was sent off, much less having the results back.
The first night's head ultrasound revealed that Doug had a little bleeding in his brain cavity (ventricles, the empty spaces are called) which while common in babies delivered at this age, also terrified Dr. Rivera initially, reaffirming his fears that the infection had likely gotten into Doug's bloodstream, which we found out the next day was true. This is why the doctors didn't tell us too much in the beginning, other than "the first 72 hours will be very critical." Other than us being in shock and in no way ready to deal with it, I believe now that they feared the worst... that the antibiotics wouldn't work in time (he already had infected lungs) or that they might not be the right ones or that the bleeding would increase or spread and that the little guy just might not make it.
They, of course, did not yet have the benefit of knowing our son.
Within another day, he had beaten the infection with the help of the antibiotics (we probably all owe his life to Dr. Rivera's initial judgment and haste) and was ready to start really showing his stuff. His head ultrasound revealed no further bleeding, as has every one since (they were daily for 3 days and then they skipped a few days and now they will be weekly), and of course you know that those lungs of steel just started working once the infection cleared and haven't stopped since. He was able to get off the big (and dangerous if used too long) ventilator very quickly, and just as importantly was able to get down to room oxygen levels and stay there. All of this was astounding to the doctors given Douglas's age and infection and sudden arrival with no preparation. His lungs now look "unbelievably good" (per Dr. Rivera today) and he breathed fine with no support at all for several minutes today while they made some adjustments to his gear. He is now only on the smaller ventilator as a preventative measure.
I also caught Dr.
Su yesterday morning, just as he was leaving his all-
nighter shift. At midnight Wed night they performed the spinal tap on Doug (a tiny, tiny version, which went flawlessly) and while the pathology won't be back for 48 hours, the initial look at the fluids they got was very reassuring that the infection hadn't turned into meningitis, another of the big scary risks that I knew about but dare not utter the words. Dr.
Su's last words to me before he left this morning were that after the first 72 hours Doug's chances of further bleeding around his brain were much lower and that after 1 week (tonight), the chances are down to like 5 percent. So I feel OK talking about this now, and I hope you all are OK reading about it.
NOW... every Dr. and every parent we've spoken to at that amazing
NICU unit has advised us that this is a marathon, not a sprint, and that there WILL be setbacks. Count on them coming, and we'll all be able to deal with them better. Dr. Rivera said today that there is a very good chance that Strep B infection will come back. But they will be monitoring it very closely, and will treat it as necessary. Eventually (around 5-6 weeks), Doug's own immune system will adjust to be able to deal with the bacteria just like all of us do every day. There may also be another spinal tap later (Doug barely feels this, they promise) to check the fluid in there again, just to make sure as the tiny bit of blood in Doug's brain drains down into the spine, that it is still not infected. There are probably a million other things that could happen, and some of them will, in all likelihood. BUT... I want everyone reading this blog to know, as I know in my heart now, that Doug is going to be just fine in the near and long term and that the chances of all of this affecting him long term are getting to be quite small... he's in a world class facility and everyone working in it is fascinated by his strength and story.
As the saying goes, what doesn't kill us makes us stronger, and Doug will have strengthened our family and the entire community of people who love him by the time its done, just like our friend Doug did on a daily basis while he was with us, and even since he passed.
All my love,
Mike
BIG PS... I got word from my mother Tuesday night that my oldest brother Clint, who has had asthma all his life and has had some near-death experiences with it in the past few years, has had another massive attack on top of the nastiest strain of flu and is once again on life support himself at Willis Knighton South Hospital in Shreveport (where Melissa and I grew up, and where my mom and brothers and grandmother still live). He's a tough, stubborn, guy with a great sense of humor and will likely be regaling us with stories of seeing the light at the end of the tunnel once again very soon, but if you could add him to all those prayers and energy chains and everything else circling the planet for our Douglas, my family would be forever (even more) grateful. Royce Clinton Wilson is his full name... he's 53 and the Royce part is after my dad.