Friday, January 29, 2010

Happy New Year 2010!

Crazy December!


Hello, Many of you are wondering if I had a baby:) Yes I did! This was the hardest pregnancy and recovery I ever had... Here is what happened (a copy of an email that Micah wrote to family).

Hello everyone (FYI: if you don't want to read a lot, skip to the summary paragraph),

'just sending out an update on Tina and the baby. If you didn't hear, Tina has had a few unexpected problems in the hospital. The delivery was without complications. She was kept in intensive care for 24 hrs afterwards and put on magnesium for her preeclampsia as a precaution in case she developed seizures (eclampsia). Two days after the delivery we noticed that the right half of Tina's face wasn't working properly. When she'd smile or laugh, only the left side worked. She also felt some swelling near her cheek and jawbone. The OB doctor had two specialists come and see her: a neurologist and an otolaryngologist (Ear Nose Throat). The apparent diagnosis was Bell's palsy (or facial nerve paralysis) of the right. She then had a CT scan of her sinuses, which showed sinusitis (for which she was started on iv antibiotics), and an MRI of the head, which did not show anything serious, just a tiny lipoma. It's unclear what caused the palsy, however two recent events may explain it. She, somehow, caught the mumps several weeks ago. This is known to cause Bell's palsy, in addition to several other viruses. She also had dental work done on a right upper molar the day before delivery. Whatever caused the palsy, she has it. She was started on a short course of prednisone to help reduce the swelling that is likely compressing her facial nerve. This is standard of care and has evidence of multiple trials to document its effectiveness in improving recovery (with minimal side effects and benefits greatly outweighing risks). Data shows that 80-90% of people with Bell's palsy recover without any lasting effects. However, that means 10-20% will have mild to severe lasting effects on the face and its ability to appear normal. Lets hope and pray she's in the 80-90%.

The other problem, which is the main reason she is still hospitalized, is that three days after delivery she started having very high blood pressures. Unbeknownst to me at the time is that preeclampsia (which is what she had and prompted the early delivery) can linger for days to weeks after delivery. It is uncommon, but does happen. And while delivery is the 'cure' for preeclampsia, its effects, including high blood pressure, can persist. So, she was started on two oral medications to lower her blood pressure (labetalol and procardia), in addition to an iv push medication (hydralazine) as needed to keep the pressures low. She did require the hydralazine a few times. From day 2 to day 4 she felt absolutely miserable, physically and emotionally. She broke down crying a few times. On day 5 she felt a little better, but her pressures were back and forth from slightly high to very high. Now, today her blood pressure was still elevated. Her labetalol was raised to a more effective level. We shall see how it turns out.

Oh, and one other little thing, she did have her abdomen and uterus cut open for delivery and is still sore and recovering from that.

The neurologist saw her again today and was surprised the prednisone did not improve her face at all. He has decided to add an anti-viral medication, which has shown benefit in some trials. We will follow up with the ENT specialist after we leave the hospital. We also called the endodontist to let him know and see if his work could be related. A speech pathologist also came in today to assess Tina and inform her in general of Bell's palsy. The OB doctor said that she will probably not go home today, and again that is because of her high blood pressure, but hopefully go home tomorrow. That will depend on how Tina's condition and blood pressure do.

As for the baby, she is doing just fine. In fact she was discharged from the hospital last night, even though Tina remains. This is an insurance issue. However, even though she was discharged, she stays in the hospital with Tina, under my care. She is really a good baby - calm and only cries at feeding times. That's a change from our other kids, a very welcomed change. Lets hope it stays that way.

At first I had confidence that Tina would pull through just fine, but she has been in the hospital much longer than I thought and there have more set backs than I expected. It has also been much much more difficult for Tina than I ever anticipated. Please keep Tina in your prayers and that her body recovers its former function.

SUMMARY PARAGRAPH: Tina, still in hospital, lots of problems (high blood pressure/body swellings, c-section, sinusitis, right facial muscle paralysis, very high blood pressure), lots of work-up/treatment (multiples iv's, magnesium, antibiotics, steroids, blood pressure medications, CT scans, MRIs), feeling miserable, husband worried, baby ok, needs everybody's prayers.

Take care. I will let you know when she gets out and also send more baby pics.

Micah


I am doing much better now still have high blood pressure which is controlled by medications... but so far I feel OK.