Isaac Andrew is Born

Isaac Andrew is Born

I wanted to give everyone a not-so-brief update on Isaac, who was born six weeks early on May 5, 2010 at 1:12 pm. He weighed 5 lbs 2 oz and was 18.5 inches long. Initially, his breathing was very good, but he got tired. So, the doctors inserted a breathing tube and gave him a dose of surfactant. He was then transported via ambulance to Akron Children’s Hospital. He arrived at around 4 pm and was off the breathing tube by 11 pm, breathing on his own very well. I returned to Akron General to spend the night with Angie.

Around 9 o’clock this morning I participated in “rounds” as the doctor and three residents made their way around the NICU unit at Akron Children’s. Isaac’s report was very good, and the doctor and I began talking a bit about how long he might stay, and where Angie would stay once she was released (assuming Isaac had to stay longer). She called Akron General to see if there was room for Isaac to return. At this point, I was feeling very good, as I knew she wouldn’t be sending him back to the other hospital unless she felt like the lung problems (and associated heart and brain problems) had been avoided.

However, the doctor on the other end of the line asked her to show me Isaac’s x-rays.

The resident brought the image up, and the doctor proceeded to show me two areas of concern. Two of Isaac’s ribs come together, just before connecting to the spinal column. More importantly, the doctor believes that he has a hemivertebrae, essentially a vertebrae in which only half was formed, leaving a “wedge”. The residents (and doctor) informed me that we would have to have a conversation with an orthopedist in the next day or two. My take away from this conversation was that this could be a problem, but that it was something that would have to be monitored over time (through the teenage years).

After doing some research, I’ve found that hemivertebrae presents itself in a variety of ways. Isaac has one (from what I can tell from my view of the image and the way the doctors talked), which is good. One concern with multiple hemivertebrae is that they provide greater opportunity to lead to curvature of the spine (congenital scoliosis) and instability.

The prognosis for isolated anomalies is fairly good. (Casey says that he sees a fair amount of individuals who present with this condition, yet were never diagnosed until the visit him at some point adolescence.) 25% of patients show no progression, 50% progress slowly, and 25% progress rapidly. Part of what determines the effect of such a condition is the degree to which adjacent vertebrae “fill” the void left by the missing half of the hemivertebrae. I looked at Isaac’s scan for about three minutes, much of this time flustered hearing the news, but there was no apparent curvature. Only what looked like a misaligned vertebrae. This could mean that the half missing, assuming the neonatologists assessment is correct, runs parallel to the scan. Or, it could mean that additional (bone) tissue grew to fill the void.

A second concern is that hemivertebrae can be associated with both cardiac and genitourinary tract anomalies. Isaac’s urine output has been slightly low, but I did witness a bowel movement this morning. The doctor pointed to the fact that all of “his tubes” were inserted without complications as a good sign. Additionally, we are provided some comfort in knowing that a full range of tests and scans were done throughout the pregnancy, and no concerns were raised.

I’m not sure about the ribs, as the doctors suggested that this was not of great concern, but some of what I have read is a bit scary. My guess is that because they join so close to the vertebrae, they do not possess the potential to constrict lung development (the primary complication). This is a question that we will have to ask the orthopedist.

The neonatologist says that this was found “serendipitously”, meaning that the likelihood of severe associated conditions is unlikely. The most conservative course of action for hemivertebrae is surgery early, often times prior to 18 months of age. Often, the purpose of the surgery, for isolated hemivertebrae, is to remove it, resulting in near complete alignment of the spine.

They will run the full gamut of tests tomorrow morning, to check for any other areas of concern. We will talk to the orthopedist as well.

Angie and I have a choice in terms of how we view this. Nothing would have been found if Isaac was not in respiratory distress, which necessitated the taking of x-rays. This means that we have caught things early, and thus have the best opportunity to solve problems successfully and to minimize the extent (and number) of any surgery that has to occur. Isaac is in a great hospital, with competent, confident, and skilled doctors; individuals that will provide the greatest opportunity in terms of any course of action that must be taken.

Much of what I’ve written here is formed from extrapolation, synthesis, and deduction, and is based on what the doctors have said, how they’ve said it, and what I’ve read over the past twelve hours. Some, even a lot, of it may be wrong. I will let everyone know what we find out tomorrow.

Thank you to mom and dad who’ve done whatever we’ve asked, specifically helping watch the kids. Thank you to Dorothy and Joe, who certainly (and noticeably) put Angie’s mind at ease this evening. Thank you to Casey, who’s answered all of my questions honestly, precisely, and all the while never making me feel like I was “bugging him”. Thank you Laurie for watching Gracie today. Most of all, thank you all for your thoughts and prayers. Please continue to keep Isaac in mind. We are all connected and I firmly believe in the power of this sort of collective good will.

Images of the little guy can be found here. He’s beautiful.

2 Responses to “Isaac Andrew is Born”

  • Millsfamily5 Says:

    Andrew! What a beautiful post! I especially admire one of the final paragraphs that says you have a choice on how you look at all this, and I believe you have made the right choice. Everything happens for a reason, and what a blessing God has provided in giving you all a glimpse into this so very early!

    Psalm 139:13-14 “For you created (Isaac’s) inmost being, you knit (Isaac) toghether in (his) mother’s womb. I praise you because (Isaac is) fearfully and wonderfully made: Your works are wonderful, (we) know that full well!”

  • Ellen Crayton Says:

    Isaac is beautiful! Many good thoughts and prayers are sent to him and his family!

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