Oct 13, 2018 Latest post:
20 hours ago
Welcome to Gabriel's Caring Bridge Website. Kevin and I decided to make this site as an easy way to update close family and friends each day on Gabriel's progress. We appreciate your support and words of hope and encouragement. We appreciate you keeping Gabriel in your prayers. Thank you for visiting.
Gabriel's journey actually started last year when I underwent in vitro fertilization. After several months of fertility treatments, I was told that IVF was the only way I could get pregnant. Gabriel was actually "conceived" on August 21st, 2017, the date of the total eclipse. However, it took several more months of failed treatments before my doctor thought I was ready to try embryo transfer. She did not think my chances of conception were good but we decided to give it one attempt. In April, I was finally ready for the procedure, and just 5 days later, we found out I was pregnant. We were thrilled!
At 10 weeks, we found out that I was having a boy and decided to start thinking of names. Kevin and I each made a list of our top five boy names to show to each other and we were surprised to find that we had both listed Gabriel as one of our top five. So the choice was easy and the name stuck. We kept the pregnancy a secret for several months because I was worried that my fertility issues may cause a miscarriage. It took nearly four months before I was ready to share the news.
However, our joy quickly turned to fear when my 16 week blood work showed an abnormally high alpha fetoprotein level. This level can go up for many reasons but one of the most common is a blood flow issue with the placenta. We were told that we would just have to wait to see what the implications of the high level were. We continued to get bad news with each doctor's visit. At my 18 week ultrasound, the baby was only measuring in the 5th percentile for weight, which is quite abnormal since neither Kevin nor I are small. My doctor recommended transfer of my care to the high risk maternal-fetal medicine center at Mercy Hospital. My next ultrasound, done at 20 weeks, showed that Gabriel had completely dropped off the growth chart. The doctor prepared us for the possibility that I would have a late term miscarriage. We were devastated. We decided to discontinue my blood pressure meds to encourage blood flow to the baby. I began monitoring my blood pressure at home. At 22 weeks I had a third ultrasound back at my ob/gyn and the news continued to worsen. Doppler blood flow studies showed stagnant flow through the umbilical arteries and vein, a condition called "absent end-diastolic flow." My doctor feared that I would soon miscarry and had me admitted to Mercy Hospital for overnight monitoring and another appointment with the high risk doctor in the morning. He told me that unfortunately, there was not much that could be done as the poor blood flow through the placenta was just not supporting the baby. He told me to cut back on my work hours and stay horizontal for most of the day. I returned a week later for a 4th scan which showed neither improvement nor regression, so I continued my activity restriction and waited.
One week later, at just 24 weeks gestation, things really took a turn for the worse. Another Doppler study showed that the absent end-diastolic blood flow had progressed to reverse diastolic blood flow, meaning that the blood was actually flowing the wrong way through Gabriel's umbilicus. The doctor warned us that I was on the verge of miscarriage and told us that we had some big decisions to make. She could admit me and start me on steroids as a last minute attempt to encourage Gabriel's lung development. They would place a fetal heart rate monitor on me and watch carefully for the heart beat to drop and perform an emergency c-section when it did. But she warned me that due to his size, he would almost certainly die without the full benefit of the steroids on board. The alternative was for me to go home and take the steroid injections at home and return in two days for another scan and get admitted at that time. I decided to go home and wait it out. The doctor prepared us for the likelihood that there would not be a fetal heart beat in two days and that they would induce me to give birth to a stillborn baby. Once again, Kevin and I were heartbroken.
The next day, things went from bad to worse. I awoke feeling like my legs were swollen with fluid. I asked Kevin where the blood pressure cuff was since we were in the midst of packing for a move. I took a blood pressure reading and it was way too high. I notified my doctor and took a dose of my blood pressure meds and then rechecked an hour later. It had continued to climb. Kevin met me at the hospital early in the afternoon and I was diagnosed with severe preeclampsia and admitted to the hospital. Suddenly, the doctors' focus shifted from keeping Gabriel alive to keeping me alive. For the next three days, the doctors checked my liver and kidney values and platelet levels twice a day and kept track of my blood pressure and the fetal heart beat. On the evening of 9/29, the doctors could not get my blood pressure down and decided that I had to have a c-section immediately.
Gabriel Evan Doss was born at 9:57 pm on 9/29. He was 25 weeks gestation and weighed 410 grams (14.4 oz), making him the smallest baby in the NICU. Kevin and I heard him cry right before he was intubated and placed on a ventilator. A team of NICU doctors and nurses worked quickly to get him stabilized and placed catheters in his umbilical artery and vein. After a few minutes, he was whisked away to the NICU.
Gabriel is now two weeks old as a write this. The last two weeks have been an absolute roller coaster ride for me and Kevin. One of his doctors told us today that when it comes to infants as small as Gabriel, good things happen very slowly, and bad things happen very quickly. Positive progression is going to happen over weeks to months, but a serious setback can happen in hours. This is what we've experienced. Gabriel's lungs are severely underdeveloped and congested. After several "good days," Gabriel decompensated last week and was not ventilating well. His oxygen level was increased to 100% and his pressure on his ventilator was raised. They added medications to increase his blood pressure and discontinued his feedings to prioritize blood flow to his brain and away from his GI tract. It was devastating to see his regression. The doctors took blood and sputum samples for cultures, however, they could not wait for the final results to come back and started him on steroids to improve his lung function and blood pressure. Thank God, it was the right choice and he began to improve. The last 48 hours have showed improvement again.
Unfortunately, the doctors have warned us that this is what we can expect for the next several months. Gabriel will likely be in the NICU for 3-6 months and will likely leave the hospital still needing oxygen support. Kevin and I will continue to visit him daily and are grateful for each day that he gets a "good report." We appreciate all of your prayers and will continue to keep you updated through this blog.