3 Weeks Old!!

Autumn is 3 weeks old. 

It's incredible to reflect on the past three weeks - Her birth... our 9 days in the NICU on PGE waiting for surgery and hoping Andre would still be here with us for surgery...the news on Wednesday night that surgery would be the next morning at 7:00 AM... praying with Pastor Karyn then walking Autumn up for her first big surgery... the long day waiting for updates for her 7 hour surgery... the recovery in CVICU with 10 different cords attached to our little baby girl... then the process of removing one cord by one... THEN IT WAS DOWN TO THE 15th FLOOR AND WE WERE IN CHARGE.

Day 1 After Surgery - It's still painful for me to see her with all these cords.

From the very beginning Andre dove in at the NICU... helping swaddle her, feed her, burp her, change her diaper, take her temperature and participate as much as we could in her care. The nurses in the NICU and CVICU were so helpful and willing to let us navigate the cords to hold her and take care of her. They gave us tips for how to best swaddle her - each nurse had a slightly different method and opinion about the best way to soothe her. Andre and I learned so much from them... we even discovered a potential culprit to Andre's sugar addiction... giving newborns sucrose water is a method NICU nurses use to calm down newborns. As Andre spent his first week in the NICU, we think he must have gotten more than his fair share of sugar water... I guess Autumn will share his love of chocolate.

Andre is an expert burper... 

And thanks to Occupational Therapy... Andre learned how to help her pace herself and finish her bottles

Last Monday they transferred us to the step down unit on the 15th floor. It was more or less a hotel room with nurses who came check on Miss Autumn every 3-4 hours. It felt so strange to be taking care of her almost full-time... for 15 days we had nurses staying with her all night. All of a sudden Andre and I were full time parents for a few days (with some great baby-sitters of course - Mom was always willing to give us some respite and do some Nana baby-sitting). Instead of sitting up and watching 'How I Met Your Mother' with Lisa to pump at 3:00 AM, I had to pump then feed Autumn. Andre and I spent the night with Autumn and instead of just waking up to her crying, we also woke up to the nurses checking her vitals during the night - not much sleep during those days...

Nana getting some good Autumn time.

To be released to the apartment, Autumn needed to eat well and gain weight. She relearned how to eat quickly and was soon eating 36 mL, then 50 mL then 55mL and even more because we began to request 70 mL as our baby girl was continuing to cue after she finished her bottle. She still wasn't gaining enough weight - about 90% of cardiac babies struggle to gain weight because of the energy needed to heal. We had to fortify my breast milk with formula (something I would rather not have done... but it's another detour moment...  best to help Autumn gain weight even though I am not a big fan of introducing synthetic formula into her diet). 

We said good-bye to Andre - he has a month long field exercise - and then hello to Christopher - first uncle to visit Autumn. Autumn has been listening to Andre's recorded voice since he's been gone. She loves hearing her dad sing Autumn Leaves, Summertime and Hum to her and looks around for him when she hears his voice. We can't wait to be together again in El Paso. It's definitely been the most difficult time to be apart since we've been married and we miss him every day.

First clothes!

Andre is a natural... he's so calm and gentle with her.

Chris came at a perfect time - his engineer brain was ready to help set up the stroller/car-seat (thank you Abuelo Clayburn) and drive Autumn back to the apartment. We were released on Friday as Autumn was gaining enough weight for the doctors to feel comfortable. It felt so strange pushing Autumn out of the hospital with no cords or monitors. Chris drove us safely to the apartment and we began our next journey with Autumn... about 3 weeks later than most infants... but home to the Houston apartment for the first time. Chris was wonderful - changing diapers, feeding Autumn in the middle of the night, and holding her to keep her warm. 

Getting ready to leave the hospital.

Chris meets Autumn...

And he's already making faces to make fun of her...

All in all - it feels like a rush... there are so many families who stay in the NICU for months and months but we transitioned out in 3 weeks. So many changes in less than 21 days and we are so thankful for the professionalism and compassion of the staff. Our baby girl has a chance that many children do not receive. This is just our first taste of surgery and recovery as Autumn will be needing 3-4 more updates in her life, but we could not feel more blessed and supported in this journey. 

Our tiny baby... only 5 lbs 4 oz... but she's growing!

No cords!!!

Tuesday, September 20, 2016

It so difficult to believe that is has been only 2 weeks since Autumn made her entrance into this world!  It has been a whirlwind of activities and at the same time, it is amazing  that four days after having open heart surgery, Autumn is doing REALLLY well and is on the way to the Highway to recovery!  Since Autumn was doing so well and was very stable, late Sunday night she was moved from the CICU to a step down unit.  This room is nice and big and has a pull out couch for Megan and Andre to sleep during the night.

I am so grateful that Andre was able to be her for the surgery.  Megan and Andre have a very strong faith and are such a support for each other.  Andre will be leaving early Wednesday morning to join the troops in AZ.  Even in two days, it seems as though Autumn is well on her way to becoming a daddy’s girl.  His gentle voice and soothing lullabies calm her quickly.  He is a pro at changing her diaper while she is testing all four heart valves, screaming at full volume.  

Megan is radiant as a new mother and has that ability to calm Autumn down quickly.  She is eating well from a bottle.  For the first day, the staff was supplementing her feeds by a feeding tube as weight gain for her is essential. She is doing really well and hopefully; the feeding tube will be removed very soon.  The PT visited to provide support with feeding and very soon will begin to assist Autumn to begin breast feeding.

Megan and Andre have been able to spend the past few days bonding with their beautiful baby girl without family and friends interrupting family time.  I had my first official Nana babysitting job last night so Andre and Megan could go out to dinner.  Autumn was really good.  We read stories, sang songs, and figured out how to solve the world’s problems.  She LOVES to be held and it is SO MUCH easier with less tubes and wires!!

We are awaiting details of her discharge from the hospital as well as our departure from Houston.  Words will never be able to express our gratitude for the many blessings we have received on this journey!  Thanks be to God!!

She finished her 36 mL bottle and is ready to start with the 50 mL tomorrow

We can hold her and walk around now!!! No cords connected to machines.

Story time with Nana while Mom and Dad went out for crepes.

Quick Post-Surgery Updates

Autumn is recovering well from surgery. Thursday was a long day - about 7 hours of surgery. Andre, mom and I were able to sit with Autumn and hold her in the NICO before the team came downstairs to pick her up. Pastor Karyn from St. Paul's Methodist in Houston came by around 6:30 AM to sit with us and pray for Autumn on her way up to surgery. 

We felt worried but also at peace. We were hoping to get to surgery before Andre has to return to El Paso for his field exercise in Yuma. Andre and I walked up with the anesthesiologist team (incredibly kind and warm team). The lead anesthesiologist told us "there's no crying in anesthesiology" and somehow our usually squeaky quick to let everyone know when she's not happy Autumn was calm on her whole way up to the eighteenth floor. Andre and I gave her a kiss and then went to wait on the floor below. 

It was a day of waiting... every few hours the nurse practitioner came to give us updates. When she was fully under... when she was on bipass... how the surgery went... even what type of music the surgeon listened to (Dixie Chicks)... and after 7 hours Autumn was taken to the CVICU for recovery. 

Dr. McKenzie fully closed her VSD with her own heart tissue - so that will most likely never need to be fixed again. He also replaced her pulmonary valve which means her heart will function like a normal heart and blood will pump like any other baby. This valve will not last for more than two or three years because it won't grow with her, but we will be able to return to get the valve replaced again... a process that Autumn will probably need to repeat at least 3 - 4 times during her life. 

It's Sunday now and she's doing really well. She's had 6 of her 9 lines removed... meaning she looks more like our baby instead of a robot baby hooked up to many tubes. She is off the ventilator and started to eat yesterday. She remembers how to suck and was able to finish all of her practice bottle and her 26 mL bottle but struggled a bit with her 35mL during the night. She's got a little tube down her nose to supply her with any food she is not able to finish through the bottle. 

We were able to start holding her yesterday and had about 4 hours of time when she was awake and looking at us. We got some good bonding time and she only had eyes for Andre for a good period of time. She liked touching his face and listening to him while he sang to her and told her stories. It was great to not have to worry every time she cried about her heart and lungs not being able to handle the strain. 

Today and tomorrow we will still be in the CVICU, but looking to step down to a lower level early next week and then maybe take her back to our apartment in Houston at the end of the week or the beginning of the following week depending on how well she is eating and gaining wait. 

We are feeling very thankful for the peace that God gave us during the surgery and the success of the procedure. Thank you for the love and prayers and we will continue to update as we go along. 

We had a rough day today.  There were several emergency surgeries last night so there are no beds available in the CICU so the Cardio Team said the surgery would be Monday or Tuesday.  Since Andre's battallian is leaving on Saturday for Arizona, he will not be able to be here next week. Needless to say, Megan was upset and Autumn felt her anxiety and screamed most of the morning causing her oxygen levels to go down. Therefore, oxygen is now required.   After both my girls settled down, our nurse, who usually works in the CICU took us on a tour of the CICU to show us all the wires and tubes and busyness  of the unit.  She really took us under her wing and helped us prepare for the next part of our journey.   A sense of calmness was beginning to return to us when Meg received a phone call from one of the pastors at the church we have been attending.  She was very supportive and had words of comfort for Megs. She will be stopping by tomorrow for prayer.  We finally persuaded Megan to take a nap and afterwards  a walk through the park with Andre.  Then the surgeon walked in and told Andre

Surgery will be TOMORROW @ 7am!! 

What a whirlwind day!  Yet through it all, we continue to feel God's arms around us! Brian is on his way back to Houston tomorrow as he is a calm, stabilizing force for all of us. We are grateful for all the loving and caring staff and the hospital and are ready to have little Autumn's surgery so she can start the healing process.  I will keep you updated!

Thanks for all the support and prayers!

The Story

It's been a week. Here it is. 

THE STORY

After a good night’s sleep in anticipation for a long, drawn out induction and labor process, we received a call from the hospital at around 0800 that it was time to come in and get things started.  Of course, Megan wanted to get in one last good walk in prior to her hospital confinement, (and this is even after getting in 17,000 steps the day prior) so we parked in a nearby neighborhood and enjoyed a pleasant walk to the hospital.

ONE WEEK OLD

Thanks for all the cards, prayers and support you are giving to our family! Autumn is doing great. She looks so perfect it is hard to believe she has a heart issue. She is eating really well and lets the world know when she is hungry! The genetic team has done all kinds of testing and ruled out any kind of chromosomal issues��. Since she is so stable on the medication, she is not an emergency case and other newborns with life threatening issues take precedent over her surgery. 
Her case was presented at grand rounds yesterday. We love the team approach at Texas Children's. They have decided it is best to do the full repair on Autumn's heart as a stint is a temporary solution and feel the repair will be much safer for them to return to El Paso. 
Megan and Andre explained to the surgeon that Andre will be leaving for the field to command his battalion on Friday and will be gone for at least 30 days. It would be a great support for Megan to have him here during the 8 hour surgery. The team is looking at the OR schedule to see if the procedure can be completed this week while Andre is here. 
While we wait, I am helping spoil her rotten by holding her whenever possible. She is growing and opening her eyes more and more every day. 
I am truly amazed at the strength of Megan. She is a strong, faithful woman and a great mommy! Andre is such a calm, strong force that he keeps everything balance. Autumn has wonderful parents!
Thanks for your continued prayers and we will update everyone when we find out the surgery date

Autumn is Here!!!

This is a quick update as we have been consumed with grandparents' visits and time in the NICU. We have been spending between 12 - 15 hours in the NICU with our beautiful baby girl. We have adjusted into a bit more of a balanced schedule... Autumn is a big fan of being held and cuddled so we try to have her day filled with people holding her and singing to her while she waits for her surgery. 

The birth was about 7 hours. I was able to have her naturally - even though the Cervidil intervention brought on some pretty intense contractions. Andre and our Doula - Robin - were absolutely wonderful supports and I could not have done it without them. She got an APGAR of 1 then 8 and pinked up really well after her first 5 minutes of life. The docs put her on me right when she was born - just for a few seconds then for about 30 seconds after all her checks. For all the interventions and hospital procedures, I am happy with the birth that I was able to give Autumn. I would not choose to be in the hospital again, but I am thankful that she came quickly and safely into the world. 

She traveled with mom down to the NICU for all her first echocardiograms and ultrasounds and implementation of her Pic Line to deliver the prostaglandins that keep her ductus open. 

Andre and I got to visit her about 5 hours after my labor. I walked to the other hospital pushing my wheelchair like a walker and feeling pretty good considering that I had just delivered a baby. We got to hold her and talk to her before we went back for our 2 hours of sleep.... sleep has definitely been a struggle as we've been spending all the time we can with Autumn and I've been pumping every three hours - including throughout the night. 

At the moment, Autumn is very stable. Her condition was confirmed and she has Tetrology of Fallot with the hole between her two ventricles and the pulmonary valve that is not working. All of the other potential complications seem to not be present and the cardiologist is looking to do the full repair within the next week. 

We love her so much and have been so thankful to have this time get to know her. Can't believe it's already been 6 days. 

Upcoming posts 

- Andre's perspective of the birth

- Mom will also be updating Autumn's treatment

Weekend update on Monday Night

Week 5 - Hospital/Birth Updates

Autumn is on her way!!!

We are at 39 weeks this week. Andre has arrived from El Paso and will be here for the next 14 days. Even though induction is not part of my preferences for natural/gentle/unmedicated birth, the hospital team is worried about letting Autumn go too far past her due date. I have appreciated their flexibility to let me go past 39 weeks - their usual preference to induce - but they are starting to put more pressure on us to have her induced.

Some reasons for induction:
- They have diagnosed Autumn with Intrauterine Growth Restriction (IUGR) because of her small size - less than 5% on the ultrasounds. She has consistently been small from about 20 weeks and symmetrically small so it most likely is not because of a deficiency of nutrients. More likely she is just small. 
- Risk of infant stress/risk to her life rises after 40 weeks.
- Andre will be guaranteed to be here if we induce... and also present for her surgery.

Reasons I hesitate:
- I want her to be able to grow as much as she can before she's born... the bigger she is, the bigger the valve can be in the surgery.
- She's moving well and passing all of her Biophysical tests.
- Most induction methods can snowball into more and more interventions and I really believe in the idea of doing this as naturally and gently as possible.

With all the reasons to induce and reasons I hesitate, we have decided to go forward with our induction appointment on Tuesday. Until then, I am doing everything I can to naturally induce - from walking briskly to eating spicy food to Acupuncture and Induction Massage. With Lisa's help and lots of reading, we've got a few things in place to help get ready for the induction or hopefully induce me into labor before the 6th. 

If I do need to go to the hospital for induction, the plan is to use the least invasive/medicated method possible. We are still looking into the cost/benefit of the preferred methods of our OB... Cervidil vs Foley Catheter. I'm practicing relaxing through this process and being open to the changes in what my picture for her birth would be. In the end, I want to make sure that I've done everything I can to make sure she comes into the world healthily so she can be strong and resilient for her first few weeks. 

At the moment we are enjoying our last few days before we meet Autumn. It's a little unreal to think that we will be meeting her within the next week. 

Week 4 - Hospital/Birth Updates

Cord Blood Banking
We received some excellent news last week. There's a new trend in baby "insurance" called cord blood banking. It was an option that Andre and I were not even considering originally because we wanted to delay the cord clamping and have skin to skin time with Autumn as she adjusted to transitioning out into the world. With the changes and need for immediate intervention, we have started to consider different options.

Cord blood banking is the extraction of stem cells and tissue from the umbilical cord when the baby is born. It is still relatively new science and shows potential for great medical advances in the future. At the moment it seems to have been successfully used for a stem-cell transplant with diseases like leukemia and lymphoma with lots of potential for other treatments. Like most technology for future medical treatments, there is no guarantee that the stem cells will be able to be used for treatment. 

After researching a bit, we found that the cord blood has been used in some trial studies with another congenital heart disease - hypoplastic left heart syndrome. There are a few articles for potential studies with valve replacement with cord blood stem cells. Click here if you're interested in reading about them. The summary of this article says 

"In the future, babies with heart defects may receive new heart valves created from cells in the blood from their umbilical cords, saved at birth. These valves could grow and change shape as a child develops, avoiding the need for repeat surgeries to replace outgrown valves from animal or human donor tissue or artificial valves."

This could be a game changer for Autumn's treatments in her lifetime. She could eventually have a valve made from her own stem cells that would grow with her and continue to live without degrading. Because it's all uncertain science, Andre and I were evaluating and researching to see if it made sense to invest in something so expensive especially if there's only a potential that it will be able to be used for her. 

Fortunately, we did not have to make the decision to invest or not because our OB referred us to a Newborn Possibilities Program through Cord Blood Registry. They have a program specifically for children with serious medical conditions. The hope is that research in the next few years will help these children to use the stem cells in new medical procedures. With Tetrology of Fallot and the potential for valve construction - Autumn qualified for the program which means they will store her blood and tissue for 5 years for free. Great news for us and for Autumn's future treatments.

Here's our pack ready to go for the big day.

Week 4 - Hospital/Birth Updates

Cardiology Updates
Mom and I met with the cardiologists last week. As of now, they are still seeing the same condition (Tetrology of Fallot with the VSD and pulmonary stenosis - a hole between the left and right ventricle and a small valve connecting the heart to the lungs). However, the lead cardiologist is recommending a different pathway to surgery. 

Most babies with this condition receive a plastic - very temporary - shunt to send blood to the lungs... this lasts for about 5 months until they are bigger for a valve replacement surgery. Because we live in El Paso, he was concerned about the safety of this shunt. It is much more likely to move or have problems than a valve replacement and we are 13 hours from the Houston hospitals where she could come to have it fixed. 

He is recommending that we fix the valve right away.

Benefits with an immediate fix:
- She is likely to have blood flow going to the correct places because her heart will be functioning like a normal baby heart - less need for corrective action during the 5 month surgery
- She is likely to eat and grow better because her blood will be moving normally

Downside with an immediate fix:
- At the moment, all valve replacements (biological or plastic) have a timeline... they do not grow... they start to leak and degrade... Autumn's valve will - by nature of her size right now - be smaller than the valve they would replace at 5 months. This means that she's looking at a second surgery to replace this baby valve around 2 - 5 years instead of 5-7. 

We feel good about the reasons the cardiologists are looking into this immediate fix and plan to be open to their suggestions once she is born.

For the visual people, we are skipping the first step (The temporary shunt operation) and going to the complete repair with the VSD patch and a valve replacement.

Middle Weeks of August

Visitors 

Mom and I were joined by quite a few visitors in the past few weeks. We've been doing really well with our routines - hospital visits, evening walks in the park, visits to the farmer's market - and we have tried to incorporate our visitors into our calm routines here in Houston. Other than the semi-stressful drives to the airport (Houston traffic is very congested and unpredictable), we have been able to keep ourselves relaxed and in the mindset to to welcome baby Autumn in the next few weeks.

Dad arrived on Thursday evening and we were able to show him some of our favorite walking spots. This is a picture outside of Rice University. The Rice community is pretty close to the hospital district and mom and I have spent a lot of time walking around during the afternoons. Dad finally got to experience the Houston heat and humidity - we've been carrying water everywhere to stay hydrated when we walk around. 

We were able to take advantage of a lot of the free events in the community while dad was here - a tribute to David Bowie and a bluegrass concert in the park. It was wonderful to have him here for the weekend while he's waiting for a place to stay back home :)

Andre arrived late Saturday to spend the weekend with us. We made sure to stop by his new favorite spot in Houston - the chocolate bar. They've got an excellent truffle cake and milkshake. We are making sure that Autumn has a taste for chocolate... something she and her dad and grandpa can share.

We had a few appointments on Monday that Andre was able to attend. Autumn is growing well - almost 5 lbs now!! At the moment, the doctors feel comfortable with her size, but it will be better if she continues to grow. If she's bigger when she's born, the surgeons can replace her valve with a bigger valve that will last longer for her - meaning she won't need a second surgery for longer. The cardiologists like to try and stretch the valve usage as long as possible.

Andre returned back to El Paso for the next 10 days and we are reminding Autumn to wait for her dad to get back to Houston before she decides to come. It was tough to say good-bye but the 10 days have been going by pretty quickly.

Diaper Project
Much of my time has been consumed with diaper-making. Thanks to my friend Judith, I have the pattern to make diapers for Autumn and it's been a little bit of a learning curve, but I'm making it through the diapers with less and less mistakes. The goal is to have about 10 baby diapers (0-4 mos) and 25 baby/toddler diapers (4 mos - 2 years). So far it's going well, but I'm starting to feel the pressure of the clock... I've only got a little more time to get them done!!

With our guests and diapers and routines, we've been busy but doing very well. Houston does not feel exactly like "home" but it's been treating us well during this period of waiting.

Week 2-3 - Hospital/Birth Updates

Appointments at the Hospital
For the past two weeks, we have had about 5-6 appointments at the hospital. We have appointments that check how I am doing, appointments to check how baby Autumn is doing, hospital tours of the delivery room and the NICU, and some studies that we've agreed to support. 


Monday appointments 
Autumn gets weekly checks for her biophysical profile - usually in the form of a Non-Stress Test (NST) and an ultrasound. She has been measuring very small (between 2.3 - 5%) from about 20 weeks. Although this can be a sign of problems with the placenta or nourishment she's receiving, the doctors have seemed to feel comfortable with her growth as she is continuing to grow equally at a steady rate - meaning she's small all over (her head, abdomen, legs, arms) and she's growing every time at the same pace. 

As of now all of her biophysical profiles have looked really good - passing 8 out of 8 of the signs to make sure she's safe and healthy. She sometimes needs a bit of cran-apple juice to make her move during the NST... she may be a bit of a sugar junkie because it only takes about 30 to 60 seconds for juice to wake her up and make her kick and wiggle. Other than her hesitancy to wiggle sometimes, her fluids, heart-beat, practice-breathing, nutrition, and overall development looks really good.

The nurses and technicians have been wonderful across the board... answering all of our questions and narrating the tests so we understand what we are seeing. The whole process here has felt more inclusive and I feel very informed about knowing how she is doing. 

After our last appointment Autumn was approximately 4 lbs and 13 oz. I am hoping that she gains at least a pound or more before she comes. The doctors/neonatalogists/cardiologists seem comfortable with her weight now if she comes early, but everything is a little easier for the cardiologists if she's bigger. I was having pretty consistent 'practice contractions' Braxton Hicks during the NST, but I still feel like she's got at least two more weeks of growing. I keep reminding Autumn that she needs to wait at least 10 more days for Andre to get back to Houston.

The nurse noted that she has pouty lips :)

She likes to lay against the placenta with her hand in front of her face, so it's been difficult to get a picture of her face - this is a pretty good view for what we've seen so far.

Baby feet! She likes to kick so maybe she'll be a soccer fan like her parents.

OB Appointments and Study
We've had pretty standard weekly OB appointments and are coming to really like our doctor. We've been on the same page for many birthing choices. Because I had switched to midwifery care, I've had a lot of tests to complete over the past few weeks - lots of blood draws... but all is looking good. 

We agreed to participate in a study that Baylor Medicine is conducting for children with congenital heart disease. The study is looking for affects on brain development for children with different heart conditions. The study included an ultrasound and my first MRI.

The ultrasound tech was really excited about the pictures they were able to get of the synapses in Autumn's brain... mentioning that they might even use her pictures in the journal when they complete the study. It was nice to get to see her again in the ultrasound... still kicking moving and most importantly GROWING. 

I was able to practice some of my hynobirthing strategies during the MRI. They seemed to work really well for helping me relax during the loud and slight uncomfortable MRI. Mom was able to sit in for the MRI and said I looked like I was sleeping. I will continue to practice in hopes that I can relax and have a gentle calm birth. 

Doula and Natural Health
We had our 3 hour prenatal doula appointment and learned a lot about exercises to practice in anticipation for the birth. We also learned about the process of birth - with detailed descriptions of what my body will be doing at each stage. Our doula is really wonderful and had many suggestions and answered all of our questions about what to expect with this hospital and the typical strategies she uses to help mothers with their birth. Mom and I had to go out and buy a different birthing ball because mine was way too small to practice the exercises. I am now sitting almost exclusively on the birthing ball and following pelvic floor exercises - squatting and stretching to help with birth and recovery. 

My sad birthing ball next to the recommended ball from the doula.

We are continuing to walk everyday - between 4 and 8 miles and trying to swim a few times during the week. Even though the transition was difficult, we have been able to start a lot of routines to help prepare for the big day :)

Coming up in the next week:
We have our first appointment with the cardiologist who will be performing the surgery. We will be able to ask about the projected treatment and his/her thoughts about cord blood/tissue banking - something that may be helpful for Autumn as they are researching the ability to create a value out of the baby's own stem cells. 

Love from Family and Friends - Week 1

People are amazing. 

This journey is not a journey that Andre and I are making alone. From the moment we knew we were expecting, we have felt love and support from our family and friends.  And now that we are facing this detour, we have never felt alone. From little messages to phone calls to card to gifts to prayers, we have felt surrounded by love (even though our family and friends are scattered throughout the country and world).

Some highlights and shout-outs:

- A heart-felt send-off from my co-workers at United Way. I will be missing my parent educators while I am here in Houston

- Lots of calls from friends and family - Mom and I have been pacing the halls of the apartment talking to our friends

- We were touched to receive an unprompted call from the cardiologist in El Paso - just checking in to see how "princess" is doing. He was incredibly compassionate and patient with us as the first person to explain her condition.

- A box of super cute gifts - books, nail polish, chocolate, journals... all detailed with messages from Mom's good friend Amy. Truly touched by all the detail and love :)


- A delicious edible arrangement from Mom's friend Martha... we've been picking at it all afternoon.

- A beautiful prayer blankey from Cindy with a prayer rock. (I don't know if Cindy knows but my childhood stuffed animal was a lamb... I had a super creative name... Lamby) . It'll be perfect for Autumn's bed at the NICU 


Thank you for all your support and love :)

Week 1 - Hospital/Birth Updates

A little bit of background...
One of the most difficult transitions for me has been the transition from the birth center in El Paso back to the traditional hospital setting. We began our prenatal care at the baby-friendly hospital in El Paso. Although I know the doctors and staff were kind and capable, I just did not feel comfortable with the philosophy and practices that have become standard in a traditional hospital birth. I am coming into my experience with doctors from my childhood with my dad - who has always been very didactic... taking the time to teach and explain what was happening. The environment in the hospital in El Paso did not support this climate... seeming to prefer patients as compliant recipients of care and expertise of the doctors. I have respect for the knowledge and experience of doctors, but I have always preferred feeling like my thoughts and preferences were valued and considered instead of being brushed aside. 

Around four months into the pregnancy, I began to seek other options and found a fantastic birthing center with a midwife I loved. Every appointment was life-giving and confidence-building. I felt like I was part of the team and my decisions were considered and valued. With my appointments at the birth center and our weekly Hypnobirthing Class, Andre and I were feeling really comfortable and excited about our calm birth and Autumn's gentle entry into the world. 

That, of course, all had to be altered after our last ultrasound in El Paso that altered us to the issues in her heart. (If you haven't read the Autumn's Heart page and are interested in understanding exactly what the cardiologists are seeing, please check out the page on the right of the blog or click here ... I did my best to explain what we understand as of now ). We are at the second best hospital in the country for pediatric cardiology and I know that Autumn's heart will be in some of the best hands in the world.

My initial fears about coming to Houston were mostly linked with the uncertainty of the birthing climate in the hospital. I knew that the Women's Pavilion had the label of being baby-friendly, but I know that a calm/gentle/unmedicated/natural birth is not always received well by doctors and nurses who are coming from a different philosophy of care. In some ways, I feel unsure about my goal to go through this birth using the hypnobirthing/gentle techniques because I know that she will need immediate medical interventions that will not be gentle and calm, but something continues to motivate me to give her this calm time as an entrance into a world that will be stressful and hectic for the first few weeks. I believe in the practices of natural birth and I think it most closely aligns with the type of entrance I want for Autumn in the world.


Our first interactions with the docs...
Andre and I were very impressed and thankful for the excellent care and compassion we felt at our initial appointments with the doctors. Our nurse case manager booked our Monday and Tuesday with appointments all day long - meeting the neonatalogists, obstetricians, cardiologists and counselors. We repeated all of the test from El Paso - a full anatomy screening, echocardiogram on Autumn's heart, and blood draws for gestational diabetes and test for 22q.112 (a genetic condition that can be associated with Tetrology of Fallot). 

Details make an impression on me... for example, all the ultrasound docs and techs made sure to make physical contact with me and speak with me before proceeding with a test. All docs always ask the sex of baby and refer to her as her during procedures - making the experience feel like an authentic human interaction instead of just a procedure. They have spent time to explain and let us ask as many questions as we need. I never feel like I am being rushed out of the room. And most importantly for me, these experts in their field seem to encourage patient investment and participation. They seem to prefer having the patients as part of the team - taking my thoughts and preferences as valid within the context of the team.

Some wins for our gentle/natural birth:
- Unless there is danger for me or baby...
- It looks like they will respect my wishes to not be induced (the docs in El Paso gave me the impression that I wouldn't have the choice).
- I will be able to drink and eat clear liquids during labor. 
- Varied positions and even hydrotherapy will be allowed.
- The doula (recommended by the midwives in El Paso) is excellent and will be an amazing support during the birth...she's participated in over 400 births and specializes in hospital births
- The neonatalogists seem to truly prefer breast milk - when possible for her digestive system and will exclusively feed her breast milk with supplements of IV fluid when needed 


Some compromises:
- Skin to skin contact will probably not be possible. The neonatalogists will need to check her for 30 minutes and start administering prostaglandins right away. I may get the chance to see her for a few minutes before they take her to the NICU (Mom will be following Autumn while Andre waits with me to be cleared to go see her)
- IV - I will definitely need the IV lock placed in my arm, even though I will not necessarily be receiving fluids unless they think it's necessary
- Limited flexibility for final pushing position - it looks like the standard is the back position and no flexibility for squatting or side.


Overall feelings..
I am thankful that we are here so early so I have had the opportunity to meet the docs and feel comfortable with the environment at the hospital. I feel so secure after meeting the doula and feeling her support already with more support to come during the birth. I am comforted to know that Women's Pavilion truly deserves its mother/baby-friendly distinction and that the doctors and staff are compassionate and willing to see me as a part of the team. I am thankful that our OB is flexible and kind - taking seriously my plans and hopes while also concerned about our experience in Houston (He recommended at least 20 restaurants and museum/events we should visit while we are here).

I am able to start picturing the experience and feeling at peace with some of the compromises to my plan of a birth center labor and delivery. One of my favorite affirmations from hypnobirthing is:

"I am prepared to calmly meet whatever turn my birthing journey takes." 

This affirmation has become more important in the light of this detour and any mini-detours that will come up as we continue along this journey.