Successful Delivery!

Hello, everyone. This is David writing, so things will not be as eloquent as usual. Here is the quick version, since we are still tired and short on time.

Hope is alive and doing very, very well! She was born on Thursday, April 14 at 11:25 AM. She weighed 6 lbs. 12 oz. and was 17 3/4 inch long. She had an APGAR score of 9 -- she came out of the womb screaming with her lungs open wide.

Hope has continued to do well since then. She has breathed on her own from the beginning. She has not needed any life support of any kind. Other than her encephalocele she is completely healthy. We give God glory for His kindness to us in this. As far as Hope's health goes, this is just about the best outcome that was possible. She is alive and strong.

Hope is still in the NICU, but only because her blood sugar level has been borderline from the beginning. The NICU here at St. Vincent in Indianapolis is "aggressive," in their own words, on the blood sugar level because of the way it helps babies to remain stable and grow. So, they want to see her able to keep a consistently strong blood sugar level before they are going to release her (either to Anna's room or from the hospital). In order to keep her blood sugar level up Hope is getting supplemental nutrition from donated breast milk (check it out if you are able to donate. If you are having a baby soon and he needs extra nutrition, ask if donated milk is available instead of formula.) Because Hope is not very interested in eating -- like all our other kids at this point she falls asleep after a few sucks -- she has a tube inserted in through her nose in order for the additional milk to be given to her. This is apparently pretty common in NICUs and they do it because it is less invasive than giving nutrition through an IV.

Anna was very tired yesterday and in a lot of pain. She was grateful for a few women who stopped by to visit, and especially for her Doula, Barbara Lehr, who was faithfully by her side throughout the day. I was often with Hope, making sure she was getting the kind of care we wanted. Barbara was able to stay with Anna for the many times that I was not able to be with her. Barbara's wisdom, experience, and godliness was of great help throughout the day -- thank you!

Anna slept well last night: "Well" relative to sleeping in hospital rooms! She is feeling much better today. She is still tired and in some pain, but nothing compared to yesterday. She has been in to see Hope twice today and both times Hope was able to latch on.

About two hours after she was born Hope had an MRI done so that neurology could get a clearer look at what is going on her brain. We have met with our pediatric neurologist and our pediatric neurosurgeon to discuss the results and what their recommendation is going forward. Neither of them thought that there was any substantial change in the condition of her brain from what it was when she had a fetal MRI done. The sac is about 1/4 the size of her head and is filled almost entirely with fluid. There is a small amount of brain matter in the sac that should have been part of the cerebellum. As a result, the cerebellum is slightly undersized. This is exactly how things stood 6 weeks ago.

The neurosurgeon would like to wait about two months before performing surgery to remove the encephalocele. This is shorter than the 3 month period that he had discussed with us after the fetal MRI. He would like to see her in 1 month to check how she is doing and then hopefully do surgery a month after that. From his perspective, there is no reason at all that she cannot go home as soon as the neonatologists (the pediatricians who run the NICU) say she is ready.

We also met with our neurologist, who is different than the neurosurgeon. Surgeons cut stuff, other doctors don't. So, the neurosurgeon will be doing the surgery (literally brain surgery) to remove the encephalocele and then the neurologist would be doing all of the followup and any future non-surgical treatment. The neurologist basically confirmed all of the things that the neurosurgeon said about how Hope's brain looked. He talked with us a bit about what to expect about after the surgery.

The short version is this: the brain is really, really complicated. We know very little about it. Even with an MRI, that is still just a big-picture fly-over of how the brain looks. There could be little details wrong that we can't see (and even if we could see them all we wouldn't know what they all mean). So, with this kind of surgery and with a brain scan like the one he saw for Hope, there are a lot of possible outcomes. She could have everything from severe mental and physical handicaps to absolutely no ill effects. If the neurologist had to guess, he expects that Hope would have mild to moderate handicaps of some kind. Given the complexity of the human brain, that is the most that the specialists of the specialists can tell us right now.

In other words, as she has been from the beginning, Hope remains in God's hands. He knew her before she was born, and He made her precisely the way He intended to. The neurologist says that these defects in her brain were present well before the first trimester was over. From that point on, all that human hands could do is shear away the excess (the encephalocele) and do our best to nurture her as she is. That is what we hope and plan to do -- to bring Hope home to live as a part of our family, in whatever capacity she is able to. What a joy!

At this point, it looks very likely that we will be able to bring Hope home with us soon. Once she is able to get full nutrition from mom and keep her blood sugar level up that way then we will be able to bring her home. We are hoping that this happens by Monday or Tuesday, which is as long as Anna is able to stay at the hospital. So, if everything goes well, we will all be home together by the beginning of next week.

I also want to thank my mom who has been watching our kids for the past two days. The kids have been good for her, but we know it has been hard (even including taking Laura to the doctor for an ear infection and having two [2!!!!] house showings). We are very thankful that she has come out and is taking care of our children. It is a great burden lifted off me to know that the children are safe and happy. She is truly a "worker at home" who has "washed the saints feet." We honor her and ask you to do the same.

We thank you all very much for your prayers. Please continue to pray:

-- that Anna gains strength and that the pain remains under control.
-- that Anna's nursing progresses well and that Hope is able to get full nutrition from her within a few days.
-- that Hope remains strong.

Most of all, give thanks with us, rejoicing in God's goodness.

Pictures and video will be coming up soon in future posts.