Too Soon for 'Hellos' and 'Goodbyes'
Our Adventures
On June 17th, 2019, Caitlin surprised me with a positive Clearblue pregnancy test hidden in her purse. Having a son or daughter has always been something I've looked forward to in life, but always worried me. Unfortunately, when I was six years old, my sister Alexis MacKenzie Louden was stillborn at full-term. As days passed by, I asked Caitlin to take pregnancy test after pregnancy test. By the first ultrasound, Caitlin had taken at least twenty pregnancy tests. To say that I was relieved to hear baby's 171 bpm heartbeat in that first ultrasound was an understatement.
Caitlin had a very hard first trimester, she threw up daily, crippling body aches, and a challenging mental state. You would think that those three things alone would make anyone beg for the pregnancy to be sped up, but not Caitlin. Caitlin was so happy and proud to be carrying this wonderful baby, that nothing would stand in her way of enjoying these next months holding her in. On October 15th, Caitlin and I excitedly awaited the gender reveal ultrasound. After that ultrasound, we were made aware that baby was a couple weeks behind in growth and that we would be referred to the Maternal Fetal Medical specialists. On October 17th, Dr. Brady would tell us that the MFM specialists will see us again in two weeks to determine future ultrasounds.
On October 19th, Caitlin and I had a wonderful party to announce the long-awaited reveal of baby's gender. Around 1800 hours, baby was revealed, it was the girl I had secretly hoped for; and her name, MacKenzie Grace Louden. The sky that night resembled a purple/pink Jackson Pollock painting. All seemed well and joyful until our next ultrasound. On October 29th, we received unsettling news, MacKenzie did not continue the trend in her growth and had fallen 22 days behind. Caitlin had an abnormal ultrasonic finding, showing MacKenzie was small for her gestational age and an exogenic bowel. Dr. Hoffman was tasked for giving us the news that no parents should ever have to hear, "MacKenzie has an improved percentage of not surviving these next two weeks." Caitlin sobbed as I held her in my arms, telling her everything would be okay. It's hard to convince your love that everything would be okay, even though I wasn't even sure that she would make it. My worst fears were coming to fruition; Caitlin is going to have to go through what I went through fifteen years ago. Caitlin and I were referred for genetic testing to determine if Trisomy 13, 18, or 21, cerebral palsy, cystic fibrosis, or any infection could be playing a factor in this growth restriction. On November 6th, all genetic testing came back normal and showed no signs of chromosomal interference or viral/bacterial infection. On November 8th, Caitlin was diagnosed with Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP). PUPPP is a very itchy rash normally developed in the third trimester of pregnancy.
On November 20th, Caitlin and I nervously awaited the ultrasound that could make or break her pregnancy. We walked into the MFM specialist office expecting to hear the worst, "Your daughter has no heartbeat". To our hopeful ears, the heartbeat was loud and proud. Our daughter was without a question very much alive. To even more of a surprise, MacKenzie had cut down her growth restriction down by one day. she was now only 21 days behind. In MacKenzie's case, small wins were very significant. Everything was looking good, the ultrasound tech was going to talk with Dr. Thomas, the MFM specialist watching and reading our ultrasound. Little did we know, Dr. Thomas knew something wasn't right. MacKenzie's dopplers were lacking. Blood-flow to MacKenzie's brain and her 3-vessel cord were restricted. Dr. Thomas informed us that MacKenzie would be arriving in a matter of days and that Caitlin needed to be admitted to Good Samaritan Hospital immediately so that their level IV neonatal intensive care unit (NICU) would be readily available.
Upon admittance into Good Sam, Caitlin's blood pressure steadily rose. This rise in blood pressure caused concern for Pre-eclampsia. The next step was a urine test to get an accurate look at the kidney and liver (the two most important organs when diagnosing Pre-eclampsia). In a sense of strange relief, we finally had an answer of why MacKenzie was so behind. It was an answer we waited for the whole pregnancy. Caitlin was diagnosed with Inner Uterine Growth Restriction (IUGR) and Pre-eclampsia. The next steps were to just wait and see how long MacKenzie could continue growing in that hostile environment. Caitlin was injected with a steroid shot to help mature MacKenzie's lungs and other organs, so that she would have a better chance to survive outside the womb. It was evident that MacKenzie was expected soon, very soon.
Caitlin had daily ultrasounds and dopplers to monitor MacKenzie and to determine when it was no longer beneficial to be kept in utero. Days passed by as we anxiously anticipated the arrival of our first baby girl. Days filled with Monopoly, sleeping, and interrupted nights. Finally the night came, on November 25th at 2127 hours, MacKenzie Grace Louden was delivered via c-section at 26 weeks and 5 days, weighing 1 lb 2.3 oz, due to Pre-eclampsia. MacKenzie came out crying, a very reassuring sound of a child at her gestational age.
MacKenzie was immediately admitted into the NICU for further care and monitoring. I will never forget being introduced in the operating room to our primary night nurse, Crystal. Crystal took care of MacKenzie during her stay almost every night. Crystal and Katie (MacKenzie's other primary night nurse) were such a blessing to MacKenzie and us during these next twenty nights. They dealt with our constant late night first time parents anxiety, and our continuous interrogation. During MacKenzie's time in the NICU, she had two bad days. Thanksgiving and day 20.
We were informed the day before Thanksgiving, that construction work would be continuing to improve NICU B. Unfortunately, construction was taking place where MacKenzie was. Caitlin, myself, and all her NICU nurses/doctors joked that MacKenzie hated being touched. Anytime MacKenzie had her vitals taken, she dropped in heart rate, respiration rate, and oxygen saturation, but she made sure that it was only during this time. With that in mind however, MacKenzie faced a big task of being transferred from NICU B to NICU A. Before transition, X-rays concluded that the conventional ventilator had dropped farther into one lung and was causing the opposite lung to collapse. NICU respiratory therapists placed the oscillator in her new pod to be put on after the move. Once she was hooked up to the oscillator, the respiratory therapists turned her up to 100% oxygen. As things looked grim, MacKenzie did as she knows how, improved her condition by being left alone. By the end of the night on Thanksgiving, MacKenzie had reduced the oxygen she needed to 35% and was slowly improving herself.
As days passed, the NICU nurses slowly became family. Christy was our wonderful nurse on Thanksgiving who stood by our side as we wept for fear that our daughter would not make it. Jesse was our other primary day nurse that allowed us to begin our physical bond with MacKenzie through kangaroo care. Lastly, never could we forget Jill, who got to be with MacKenzie no more than a couple days, but still showed such an amazing kindness to Caitlin, myself, and our families during our stay. Each day was an adventure with MacKenzie and each day was a day I will be forever thankful that I had with her.
On day 19, MacKenzie was on the CPAP and at 21% oxygen (the lowest percentage possible). On fateful day 20, things took a very serious and quick turn. Doctors had reintubated MacKenzie after discovering that her stomach had hardened. MacKenzie had been diagnosed with Necrotizing Enterocolitis; a devastating disease that affects mostly the intestine of premature infants. The wall of the intestine is invaded by bacteria, which cause local infection and inflammation that can ultimately destroy the wall of the bowel. Unfortunately, MacKenzie's bout would turn out to be very severe and ultimately fatal. MacKenzie passed away at 0502 hours on December 15th.
Caitlin and myself cannot thank the NICU nurses and doctors on that final morning for allowing us to hold our beautiful baby girl exactly how she entered this world, peaceful. I wish I could thank each individual that played a part in this marvelous adventure, but there were so many sonogram techs, doctors, nurses, phlebotomists, genetic counselors, etc., there were so many who touched our lives. So if you happen to stumble upon this, allow us to personally thank you for your part in this marvelous adventure. Mommy and Daddy love you MacKenzie.