February 4, 2008 – Katelynn’s surgery

I am very relieved to report that Katelynn’s surgical ligation surgery to correct the large PDA hole went perfectly.  It is an ongoing challenge to keep our emotions intact, but each victory does make us feel a little stronger.  Katelynn is now resting comfortably under sedation.  Her nurse walked me through all of her vital signs and all seems well.  There is an inch-long incision site on the right side of her back, which would lead you to think that this is a fairly small cut.  When I saw her after the surgery, I was reminded that she’s only about 13.5 inches long, and that inch sure seems a lot longer than it really is.  If I try to think about how long of an incision that might be for me, proportionally, it would be equivalent to a 5.3 inches. 

My Katelynn has always been a fighter.  Just ask Jenn-Jen and she’ll tell you that she lost count of all the kicks to the bladder she’s felt from our fiesty daughter.  Even after she was born, she made full use of her limbs whenever the nurses needed to work with her.  One nurse actually said that “she’s a wild one alright!”  Katelynn’s a tough girl and I’m so proud of her.

Thanks for keeping up with what seems like a daily drama with the Owyang family.  I’m on my way back up to the NICU to check on both of the girls and will have some news on Daria in the evening.  Jenn-Jen is resting in the car, as hospital waiting areas really don’t mix well with fatigued parents.

February 4, 2008 – The unexpected call in the morning

Normally, I try to write a post in the evening when I can gather and summarize the day’s events, but circumstances have changed quickly this morning.  Jenn-Jen, Adam and I were at home in the morning when a phone call from Katelynn’s doctor came at 9:45 AM.  My wife took the call,  suddenly looked pale and her voice began to quiver.  She gave me the phone and the physician informed me that Katelynn’s heart echo results came back with an indication that the PDA hole was quite large.  He asked if we could come ot the hospital immediately, as they believed that Katelynn should go into surgery as soon as possible.  As we were already in the process of readying Adam to spend part of the day at a friend’s house, we moved quickly to leave home. 

When we arrived at the NICU, we met up with Katelynn’s neonatologist and the pediatric surgeon that would be performing the ligation procedure.  Essentially, the blood vessel with the large PDA will be tied off to correct Katelynn’s blood flow.  We were informed that the whole operation, including transport will take about an hour.  Jenn-Jen and I watched as Katelynn’s nurse and another medical staff member moved my tiny daughter, along with all of her vital sign leads and ventilator attachments, into a transport incubator.  I don’t think I blinked once as her breathing tubes were being switched.

Although surgical ligation is very common in premature babies, the challenges Katelynn has been through this week makes us very nervous about the thought of her going through surgery.  The operation itself is not as invasive as you expect, but the surgeon did explain that they would need to physically move one of Katelynn’s lungs aside to access the PDA site.  I asked the doctor how many of these procedures he’s performed during his career and breathed a sigh of relief when he responded, “oh, probably two or three hundred.”  Nonetheless, there’s about a one percent chance that life-threatening complications, such a major hemorrhage may occur.

When we arrived downstairs in Surgery, the anesthesiologist met with us and reassured us that they have performed many of these procedures.  She also said that Katelynn’s vital signs were looking really good, so we should not worry.  A nurse brought us over to the Surgery Waiting Room and told us that the surgeon will come see us in about an hour.  Jenn-Jen and I touched Katelynn, told her to be strong, and are now waiting.  I said a quick prayer for our daughter and will keep you updated.

February 3, 2008 – God is answering our prayers

It’s 10:58 PM here at the Sutter Memorial Hospital.  I’m sitting outside the NICU in the waiting area, and I think I’m going to call this my evening base of operations for some time to come.  I actually enjoy the peace at this time of night, as most of the parents and visitors are probably home resting to prepare for their long journey ahead.  As I mentioned in my previous post, I was very spent emotionally and physically last night.  The better part of discretion won over my determination to spend as much time as possible at the hospital cheering on my girls to fight the good fight for life.  Believe me, it was painful not to be here, but I’m glad that I was able to get a decent night’s rest. 

Today was the first Sunday since Katelynn and Daria were born, and I took Adam to church (www.theriverchurch.net) to allow Jenn-Jen get some much needed rest at home.  My heart was heavy as I knew that there would be dear friends that would offer open arms with hugs and touching words of encouragement.  It was a very emotional time for me as I was singing worship songs as a cry out to God to move mountains as only He can do, but what came next opened a floodgate of tears.  My senior pastor took a moment to share the crisis my family was going through and asked the congregation to join him in prayer for us.  I know so many have been keeping us in your prayers, but it really touched my heart to be reminded that “no one paddles alone.”  Before the premature arrival of Katelynn and Daria, a good number of you were complete strangers or, at best,  somewhat familiar faces we said hello to on Sundays.  Now, I am honored not only to call you my dear friends, but my family in the deepest sense.  On behalf of the Owyang family, no words can truly express the love and  gratitude we have for you.  Your support through this difficult time will never be forgotten.

Adam and I departed from church and headed home to pack a lunch and pick up Jenn-Jen.  While my son was very excited to go see his sisters, he may have been more so to know that he would be spending the afternoon with his best friend.  We arrived at the hospital, ate our sandwiches and headed upstairs to the NICU.  Katelynn and Daria’s neonatal physician wanted to give us an update, so I was very anxious and nervous at the same time.  I didn’t anticipate that it would be a touching moment as I introduced Adam to the doctor, but almost five years and a month ago, we were in this same NICU with the same doctor, scared to death that our precious son was born eight weeks too early.  I would have never thought that each of my children would experience Sutter Memorial Hospital under such similar circumstances.  Adam has been such a success story, and someday I hope to bring Katelynn and Daria back and share their stories with all the dedicated NICU medical staff.

The update I received on Katelynn was promising.  The two antibiotics are working, as she’s winning her battle with her infection, which has been confirmed to be the nasty E. coli (http://en.wikipedia.org/wiki/E._coli) bacteria.  Her complete blood blood count, or CBC, is showing continued improvement, so that is wonderful news we have been hoping to hear.  Additionally, Katelynn will be undergoing another head ultrasound tomrrow to check on the status her brain hemorrhage, or IVH.  Her doctor and nurse said that his external assessment of her head looks very promising, and we pray that Katelynn will not need the ventricular shunt I described yesterday. 

As you may recall, I have been tormented the past few days as the doctor mentioned that we would need to make a decision to continue or withdraw life support for Katelynn.  I shared the story of Dick and Rick Hoyt with the physician in an attempt to get clearer expectations for Katelynn’s longer-term prognosis, and was encouraged to hear that the doctor remains confident that there is an very low probability that my daughter would be in a persistent vegetative condition.  I was even more hopeful after learning that the severity of Rick Hoyt’s cerebral palsy may not be something I should necessarily expect for Katelynn.  Rick’s condition resulted from a traumatic episode of asphyxia, or lack of oxygen, when his umbilical cord was suffocating him in his mother’s womb.  As the doctor explained, a grade 4 IVH is actually less damaging than the loss of oxygen to the brain.  This is mainly due to the systemic or general trauma to the brain overall in cases of asphyxia, as compared to the more localized damage created by an IVH. 

If you haven’t seen the story of the Hoyts, I strongly encourage you to read my post on February 1st.  I also urge you to watch this additional video clip of Team Hoyt(http://www.youtube.com/watch?v=dDnrLv6z-mM) to understand why I am completely convinced that there would be no reason why Jenn-Jen and I would even consider removing life support for Katelynn.  It is absolutely unconscionable that we would not allow our Katelynn to not live her life to its highest potential.  This has lifted the heaviest burden Jenn-Jen and I have faced this week, and I feel renewed, hopeful, and more inspired than ever before.

As for Daria, it is actually comforting to tell you that I do not have much news to share.  It may seem that I have spent a disproportionate amount of time laying out the battlefront for Katelynn, but in many ways, no news for either of my daughters is good news.  Daria’s vital signs are continuing to improve and we are seeing fewer oxygen desaturation episodes.  The heart murmur or patent ductus arteriosus (PDA) condition continues to remain stable, and we are awaiting the results of her heart ultrasound taken today.  I found a couple of decent  illustrations of a normal heart versus a one with a PDA here (http://www.nhlbi.nih.gov/health/dci/images/patent_ductus.jpg) and here (http://learn.sdstate.edu/craigg/pdadiagram.gif).  Daria’s neonatal physician informed me that the heart echo scan will determine the size of the PDA, and that will help guide him toward the next course of action.  If treatment is needed, he plans to try to remedy the defect medically by using Ibuprofen.  This sometimes helps seal the hole, but if it doesn’t, surgical repair is still on the table. 

Unfortunately, we did find out that Katelynn has a heart murmur as well.  Due to her brain hemorrhage, treatment with Ibuprofen is out of the question, as it thins the blood and can be threatening to Katelynn’s health.  We will need to wait for the results of her next heart ultrasound to see if treatment is needed at this time.

All in all, today has been a very positive day, but Jenn-Jen is feeling the effects of exhaustion set in.  We left the NICU during the 2:45 PM shift change and Jenn-Jen ended up vomiting.  I took her out of the hospital by wheelchair, brought her home and was pleased that she took a nice, long nap.  She is feeling much better, but understands that we are in a marathon and must do our best to adjust to our new lifestyle.  I am encouraged to share with you that Jenn-Jen is recovering from her surgery pain well, and is working on weaning herself off Norco.  Please keep my wife in your prayers for her continued recovery.

One of our dear friends asked me if the twins will be able to share an incubator, as she heard that it often helps in the healing process.  The nurses in the NICU tell me that they are very much looking forward to the first opportunity to put Katelynn and Daria together, but unfortunately, both girls will need to be completely off their ventilators before they attempt this.  Right now, the two of them aren’t even in the same room, so my goal will be to ask each day to get them closer together.  The girls have spent twenty five weeks pressed up snugly against each other in Jenn-Jen’s womb, and everyone understands how harsh and cruel it is that they are apart.  Hopefully this will be a very temporary situation, so I urge you to pray that the ventilators come off soon.

My dearest friends and family, I thank you again for all of your prayers, support and encouragement throughout these challenging weeks.  I consider myself blessed beyond measure and honored that you have decided to make our lives part of yours.  In closing out tonight’s post, I would like to listen to a song titled Your Love Oh Lord (Psalm 36) by one of my favorite bands, Third Day.  While I don’t think I can upload the MP3 for copyright reasons, I found this link (http://www.youtube.com/watch?v=7mP4LhdE4vc) so you may meditate upon the words and share in my worship of our Lord.  God bless you all and goodnight from the fourth chair in the waiting area outside the NICU.

Your love, O Lord, reaches to the heavens, your faithfulness to the skies.  Your righteousness is like the mighty mountains, your justice flows like the great deep.

Psalm 36:5-6 New International Version