Thursday, July 9, 2009

Five Weeks Old

I can't believe our little Olivia Ann is already five weeks old! (This is Jessica, by the way.) I just read our last blog entry, which Chad wrote the day Olivia was born, and mentioned that I would probably blog "tomorrow". Oops...

Well, life has been a whirlwind since our precious girl was born, and I didn't get that blog written. Life with two kiddos is a little a very good way, but crazy none the less. =) Olivia seems very healthy at this point, and we feel blessed to be able to say that. Time will tell, as we watch her develop, if the TTTS had any permanent negative effects. Right now, though, we are just overjoyed that she is here, and we love her no matter what.

She really is a pretty easy baby. She cries when she is hungry or occasionally when she wants to be swaddled tighter, but for the most part is very happy. She brings me so much joy. I love to watch her little expressions, watch her little body wiggle, feel her hand grasp my finger, play with her crazy head of hair, snuggle her close to me, laugh as she sticks her little tongue out when she is hungry...I could go on and on.

It is amazing to watch Emily with Olivia...she is totally in love with her little sister. When Olivia cries, Em comes running, volunteering to hug her, kiss her, give her a pacifier, or "hold" her. We laugh at how Emily uses this cute, high-pitch voice when talking to Olivia. She repeats little phrases we use to soothe Livie, and it's so much fun hearing these things come from this little two year old acting like another little mommy. =) We are practicing being gentle: not to squeeze Olivia too tight or force her pacifier into her mouth. Em is trying, but it is hard when you are at the age where the more you love something, the more aggressively you show that love!

We continue to be so blessed by so many. Thank you for the many gifts, cards, emails, meals, etc. that have been sent our way. Most of all, thank you for the prayers that have been said on our behalf. Knowing people have been praying for Olivia's safe arrival has encouraged and sustained us.

We also appreciate your prayers for our hearts and healing process over losing Allie. I'll admit, it was really difficult right after Olivia was born. There were many moments of joy, finally having our beautiful Olivia here, but moments of grief as we dealt with another phase of losing Allie. We did have a small service at her grave site with our pastor, Steve, and his wife Terry. It was the hardest thing we've done, but at the same time, it was what our hearts needed. Like I've said before, I will never be "over" losing Allie, but the having the service brought a lot of peace and the start of some healing I felt couldn't happen until after delivery.

So God has brought me to a good place. Allie is living a life of complete joy with Him, which is what I want for all of my girls. And right now, I have two amazing, beautiful, precious little girls with me, and an incredible husband, for whom my love has deepened even more through all of this. I am extremely blessed.

I just want to say that as we have journeyed through this difficult time in our lives, we have watched family and friends go through their own difficult struggles. We want you to know that we have appreciated your love and support in spite of your own trials, and we are lifting you up in our prayers too. We so desperately want to be a support to each of you, as there are so many kinds of hurts and troubles out there, and we don't want you to face them alone.

May God richly bless each and every one of you!

Love, Jessica

Monday, June 8, 2009

Olivia Ann Reade

Born June 8, 2009 at 9:53 a.m. after Jessica pushed once. (Of course, we had been at the hospital for 6.5 hours before that waiting for her to dilate.) 7 lbs, 13.6 oz; 18.5 inches; and had dark hair like her mommy (probably already has more hair than Emily). Her APGARs were 9 and 10, and she latched on very well with feeding.

Emily met her baby sister this afternoon (she let Olivia know, "You can have pacifiers"). Emily also gave her a number of kisses.

Things for which we are thankful:
1. Healthy mommy-Jessica felt better immediately postpartum than after Emily (may have something to do with the fact that Emily was a feather under 10 lbs)
2. Healthy baby
3. Great support of family and friends, physical and moral.
4. Wonderful staff here that have been exceptionally sensitive to what we are going through. Carol, an OB nurse of 18 years, candidly told us this morning, "We don't deal with your situation often. We are used to rejoicing with families whose childbirth experience is very smooth, and we grieve with families who lose babies. But we don't often have both happening at once."

Jessica and I are grateful that we were spared the tragedy of having one baby die on the day her twin was born. The grieving process is not over, but we feel a sense of relief that we can now begin to take a step toward some closure. The hospital chaplain was helpful in putting us in touch with a local mortuary. Tomorrow, I will begin ironing out some of the details. Throughout the day, the people here at Bergan validated the dignity and importance of Allie's life...which greatly comforted us.

Jessica is doing well this evening according to her OB and the nurses' reports, and "Dr. Mike" (our pediatrician) came to the hospital after he finished clinic today to let us know that Olivia looks good. If all goes well, we will have an uneventful day tomorrow and will head home in the MINIVAN Wednesday. (Note: We drove the Camry to the hospital. I was supportive of buying the minivan, but I am not embracing driving it...yet.)

I suspect Jessica will blog (6 months ago, I didn't know the word could be either a noun or a verb) tomorrow. Until then, thank you for your prayers--and thank God for answers.

Saturday, June 6, 2009

Still waiting...

Well, we are 38 weeks and 3 days, and no baby yet. =) I joked that this would happen! I think I got myself so geared up to go into labor soon after the cerclage was removed that I am having difficulty with impatience. I need to remember that I am still 11 days away from my actual due date, and that every day she is with me she gets a little bit bigger and a little bit stronger. However, I am also getting a little big bigger (my shirts barely cover my tummy), and a lot more tired! More than anything, though, I am just anxious to finally hold our little girl. It has felt like a long road to get her here, and I can't wait to meet her.

Just wanted to let you all know that we are still waiting, and will happily post when baby girl arrives! Thank you for your continued prayers!

Much love, Jessica

Friday, May 22, 2009

36 Weeks!!!

Yesterday I officially reached 36 weeks! Today the cerclage came out (glad to have that over with), so now it is just a waiting game until baby arrives. Thankfully, the cerclage removal didn't send me into labor, so hopefully I will be hanging out for another week or two to give baby a little more time to pack on some weight. But finally the end is in sight!!! Yay!!!

Friday, May 15, 2009

Getting Closer

Thirteen weeks ago, we were working to get our baby to 24 weeks before I went into labor. It's such a blessing that we are now at 35 weeks and 2 days, and baby girl seems to be doing well! Thank you so much for your prayers...I truly feel they have gotten us to this point.

Last Thursday (May 7), I had my final appointment and ultrasound with my MFM doctors at Bergan. They did a full scan of baby, and Dr. Fleming was very happy with her development. Her structure looks good, her amniotic fluid looks good, her activity is good, and they estimated her weight at the time to be approximately 4 lbs. 10 oz. She is just under the 50th percentile still for growth, but not too far off. She won't be 9 lbs. 14.5 oz. like Emily, but with each day that passes we are hoping she packs on a little more weight. And who knows? Emily was supposed to be "average size," and she certainly surprised us all...maybe this little one will too. =)

Of course we still have some fears. We won't know until she gets here, and maybe not even for a while after, if this little one suffered any lasting effects of TTTS. Our concern is mainly any neurological issue. We are hoping and praying that she is a happy, healthy little girl.

I saw my primary OB yesterday, and he is planning on removing my cerclage next Thursday. It is my hope that I can carry baby for a week or two past then just to give her a little more time to grow, and some might ask why not just wait to remove the cerclage. The cerclage is meant to prevent pre-term labor, but once your body reaches the natural point of going into labor, you don't want the cerclage in or it could cause some potential problems. (I won't go into those, but trust me, I don't want to experience them.)

So, it looks like the time is drawing near. We have mixed emotions...we are so ready to have this little girl here, to hold her and know that she is okay. But it will be hard, knowing for a time that we thought we would be bringing two precious ones home from the hospital. I praise God everyday, knowing that Allie is safe and loved with him, but I still miss her.

So I guess our prayers are for this little one to be healthy and arrive without complication, and for us to be able to rejoice in her birth even though we know there will be some feelings of sadness in the process.

Thank you so much for your continued prayers and support. You continue to bless us in so many ways along this journey.

Much love, Jessica

Thursday, April 16, 2009

Checking In

Today was another appointment with Dr. Ryder, and at this point he said we are "cruising along" like we should be. It has been nice to feel like things are going a little more normally these days. Baby girl is so active, and I love every second of it. She has lately taken to doing somersaults frequently, and I praise God every time, as an active baby is a good sign of a healthy baby. I was 31 weeks as of yesterday, so we are praying to get at least 5 more weeks along. At that point they will remove my cerclage and baby can come whenever she wants to! =) (Watch...after going to great lengths to keep me from going into labor, I will get to 40 weeks and nothing will have happened!)

In the meantime, we finally felt like we could start preparing our home for her arrival. Mom, Dad, and my grandpa painted the baby room last week, and this weekend we are moving the crib into her room. It is exciting, yet a little sad to see Emily switch from the crib (which has been set up as a toddler bed for a couple of months) to a big girl bed.

Finally, it was time to say goodbye to my little red Accent and get...a minivan. It was sad to get rid of my little car that I had driven since college, but (and I NEVER thought I would say this) the minivan is SO handy, and immensely easier to get Em in and out. She loves riding in "Emily's new car." It also accommodates my growing belly better, too!

Thank you so much for your continued thoughts, prayers, and encouragement. If you think about it, would you please send up some prayers for "Chad and Jessica's friends"? Both of us have a few of friends who are dealing with some difficult health issues either personally or within their families and could definitely use the prayers. We have felt so blessed and loved by the prayer support we have received, and our hope is that our friends would experience that same kind of love and support as they face their own difficult challenges. Thank you so much!

Much love, Jessica

Monday, April 6, 2009

Grandma Esther

Thank you for all of your thoughts and prayers for Chad's Grandma Esther. Grandma went to be with the Lord in the early hours on Friday. While we are sad for our own loss, we are thankful that Grandma lived a long and full life, and that she didn't suffer in the end. They released her from the hospital on Thursday, so she was able to pass away peacefully in her own home on Friday. We will miss her wonderful heart and her great sense of humor. She was a true blessing to all of our lives.

Tuesday, March 24, 2009


Today we had a full ultrasound of the baby at Bergan. We were so excited to find out that she is now near the 50th percentile for growth, which means she is of average size!!! She continues to be very active, and all of her functions look great. We feel so blessed! I was also informed that I have "graduated" from weekly cervical ultrasounds. My cervix seems to be holding up and I am 28 weeks tomorrow, so I can just proceed with my every-other week check with Dr. Ryder and don't have to go back to Bergan until 34 weeks. =) I walked out of the hospital with a genuine sense of excitement. Chad and I both feel like we can now proceed with some of the planning we have been wanting to do, but were holding off for fear of getting our hopes too high. I cannot express how thankful I am that things went well today!

Immediately after my appointment, Chad, Emily, and I headed to Shenandoah, Iowa to see Chad's Grandma Esther. She was admitted to the hospital yesterday with some heart and lung issues, and the doctors are in the process of evaluating the best treatment for her. Grandma is 98 years old, and is such a classy, loving, and funny lady. We would be so grateful if you could add Grandma Esther to your prayers tonight. We are praying that the doctors would make the best decisions for a woman of her age, and that she would be experiencing God's peace. Thank you!

Thanks for reading, and God Bless!!!

Wednesday, March 18, 2009

Still hangin' in there...

Hello, dear friends. We've received a few emails and calls regarding our blog, asking, "Is no news good news?" Sorry we haven't posted in a while, and yes, so far things continue to go okay. I continue to see the MFM doctors at Bergan every week, but I wonder if people get tired of updates on my cervix. It's funny how things that would once make my face turn red to mention are now an everyday topic of conversation. =)

Tomorrow I have my appointment with my primary OB, and then this next Tuesday's appointment at Bergan will include a full scan of baby. I am very excited to see if she's catching up growth-wise...she's getting stronger it seems. She is a busy little girl and likes to move a lot! When I lay down at night or for a nap, she really starts going. It feels like she's doing somersaults in there...what a blessing! Also, next Wednesday I will hit 28 weeks, which is our next milestone. Many of the problems babies suffer from premature birth are reduced at that point. Of course, I would love to get all the way to 36 weeks if possible. We're praying that happens!

Many of you have asked how we are continuing to do emotionally. We continue to do okay. We both still definitely have our difficult moments/days. I miss Allie everyday...sometimes I wonder if people think I am crazy with the way I have handled losing her, the way I talk about her. As we are thinking about names for this other precious girl, I am always thinking, "What name goes well with Emily and Allie?" I know that it may seem weird to people for me to be this way when I will never get to actively be her mom, never hold her or care for her here on Earth. But I can't help how my heart feels, that she will always be my little girl as much as Emily and this other baby are. I hope this doesn't offend anyone, for I'm not saying that my response is the right one...I know others might handle this situation differently. I guess this is just the way God designed me, and the only way I know how to handle it.

In spite of this still being a challenging time in our lives, good things continue to happen around us. One of the most exciting things recently is that my best friend Gina and her husband Casey just welcomed a new baby boy on March 6th! Baby Leo is just as precious as can be! Gina lives in San Diego now, and before we had complications with this pregnancy, I fully planned on going to visit soon after baby arrived. But my doctors have said travel is a big no-no, so it pains me to have to wait to meet him in person. Gina was thinking ahead, though, and sent me a web-cam for Christmas so we can see him that way. Now if I could just get it set up...=) Congrats, Casey and Gina!!! We love all THREE of you!

Also, we have been able to get out of the house a little more, which has been great. This last weekend we had a date night event with my MOPS group, a brunch with our dinner club, and then a get together with our worship team. Tonight we went to see "Taken" with our friends Kyle and Melissa, and I must say it was a good, albeit intense, flick. My parents watched Emily and Baby Cole, Kyle and Melissa's 6 month old. I don't know who had the better evening, the four of us or Emily. Baby Cole is the apple of Emily's eye, so getting to spend the evening with Nana, Papa, AND Baby Cole...well, let's just say she was more wired than we have ever seen her by the time we came to pick her up.

I am also looking forward to this weekend with my friends Erin and Stacy. We originally wanted to take a girls' trip before both Stacy and I have babies, but again, no travel for me. So we are planning on having a great little getaway right here in the Big O. Who needs a crazy destination if the company is good? =) (And a big Thank You to the husbands for taking care of the kids!)

Thank you again for your continued prayers, support, and generous acts of kindness. It always seems like when I am having a hard day or struggling with questions over this situation, God provides comfort and answers through just the right phone call, text, card, email, etc., from one of you. We continue to be amazed and humbled by all of the love shown to us. God bless you all!

We will let you know how the ultrasound goes on Tuesday!!! =)

Love, Jessica

Tuesday, February 24, 2009

Re-entering the world...

Since our first procedure, I had been delegated to "couch potato" status. While it sounds good on those days when life is busy, it can be maddening when forced to do it day after day. I wanted to be up playing with Emily, cleaning my house, doing laundry...something. However, it kept me home-bound for a couple of weeks, and for that I was secretly thankful.

I talked to a wonderful mom at church on Sunday who lost her first baby very late in her pregnancy, and she said exactly what I was feeling: Losing a baby changes you forever. She shared with me her hurt over losing their first baby girl, but also shared the blessings they received from their painful experience.

She couldn't have put it more perfectly. I am different now than I was a mere three weeks ago, and I admit the thought of facing the world after this was frightening. I was so thankful to have my friends come over to the house and visit, to laugh and cry with me. But I was terrified of being around large groups of people and knowing how to handle myself.

When I received the news last Wednesday that I didn't have to be sedentary all of the time, I was excited, but also a little scared. Chad, of course, had been working and had plenty of time out of the house...he thought it would be good for me to get out now too.

I had an appointment with my primary OB last Thursday. I had an ultrasound at his office since he had not seen one since the ultrasound showing the girls had TTTS. He was so excited to see the amount of fluid that our little girl had accumulated, that her blood flow was great, and that she was very active. Her growth even went from being 10 days behind to 7 days behind. I was even more encouraged than before, even excited. How I desperately want this little one to be okay.

After my appointment, I drove down to the Med Center to drop something off for Chad. I decided to go inside and wait for him in the lobby rather than my car. He was glad to see me, and asked if I could stick around for a little while and visit some of his fellow residents and staff. We talked to several of the wonderful people with whom he works, and they were so encouraging, letting us know they had been thinking and praying for us. Chad showed the new ultrasound pictures to everyone we saw...he's such a proud daddy. God showed me that it was going to be okay, that I could go out in public and not fall apart, and that people were wanting to show their support.

That night I went to help prepare for our MOPS meeting at church the next morning, and it felt good to get back into something I really enjoy. The ladies at MOPS continue to show me so much love and support, and it was great to be with them and laugh and have a good time. Sunday came and I went to church for the first time since we lost Allie. We are so thankful for our church community...we were so touched by the many people who came up to us and shared that they had been praying for us.

I also want to thank the many wonderful people who have shared their own experiences of losing a baby with us. It breaks our hearts to know that so many of you have had this heartache in your lives, but you are such an example to us as you persevere through life with faith and joy.

I guess that is where I am now...contemplating the road ahead with this other precious baby girl. Every time she kicks I am elated, feeling reassured. But I think about the day she arrives. I want more than anything to be joyful, but will I feel sorrow having planned on having Allie with me too? Will I always look at this little one and think of her missing half? This little one will always be a twin...I will always be the mother of twins. Will I be able to rejoice in who she is and all of her milestones without feeling loss? I hope so. I will always hurt over losing Allie, but my prayer is that God will give me the ability to rejoice over this other precious girl for who she is as an individual too. She already brings me so much joy, and I pray each day that God would keep her safe and healthy...I desperately want to meet her.

Tomorrow is another trip to the hospital to check the condition of my cervix. We are praying it continues to hold its length so our baby has plenty of time to grow and get stronger.

Thank you for your continued prayers and acts of love.

Love, Jessica

Tuesday, February 17, 2009

Feeling Encouraged

We had a follow-up appointment today with Dr. Barsoom to see if my cervix is still behaving after the circlage last week. We were thankful to find out that it is still at least 3 1/2 cm, which is a normal cervix length. I will go back again next week to have it checked again, and I expect I will have weekly appointments at Bergan for quite a while. While I don't have to be as inactive as I have been since last week (Yay!), I do have to "take it easy" for the next five weeks. By then I will be 28 weeks, and the problems a premature baby would encounter are greatly reduced at that point. Of course our hope is that I would be able to carry this little girl until at least 36 weeks. The longer I carry her, the better.

I have an appointment with my primary OB, Dr. Ryder, this Thursday. I'm accepting the fact that I will be seeing my doctors constantly for the duration of this pregnancy, and I am appreciative that they want to keep a close eye on me. I feel confident in their care.

While we are excited about this news, we are still working through the loss of our Allie. A great encouragement to me was a book we received from our friends Mary and Steve, who are on our worship team at church. It is called, "I'll Hold You in Heaven." It's written by a pastor for parents who have suffered a loss of a baby during pregnancy or soon after delivery, and answers some questions about Allie's little life.

The main points are that God has designed every child to have a purpose, whether their little life goes beyond the womb or not. Allie's little life accomplished something in her brief 21 weeks...we trust that is true, as we have already felt her impact on our lives. And even though relationships don't exist the same way in heaven as they do here, heaven is a place where we are known. Allie will know us, and we will know her. I wish more than anything that we could have known her in this lifetime, but I am thankful that there is hope, and I will hold her someday.

In the meantime, we await the much hoped-for arrival of her sister. We continue to be so thankful for your prayers and acts of kindness. God continues to overwhelm us with His goodness through all of you.

With much love, Jessica

Friday, February 13, 2009

Since Tuesday...

When we left the doctor's office on Tuesday, Dr. Fleming said, "If you feel your ears burning tomorrow, it's me talking to Dr. Ryder and Dr. Barsoom about you." Sure enough, Dr. Ryder (my primary OB) called at 10:30 AM and told me to get my things together and head back to the hospital. Apparently they were all concerned about the shortening of my cervix and decided we shouldn't wait to have something done to repair it. Fortunately, my mom happened to be at my house doing laundry and helping with Emily, so I got a bag together and she drove me to the hospital.

It was decided that Dr. Barsoom would do a circlage, and I am 99% sure I just spelled that incorrectly. It is a procedure where they stitch the cervix closed, hoping to prevent preterm labor. I was admitted to the hospital, and began my wait to have the procedure. I have to admit it was a difficult afternoon. When they put the monitor on me to track baby's heartbeat, she was moving around so much they couldn't hold the beat very long. I was so thankful that she seemed to be doing well, but was scared about the potential of going into labor long before she was ready.

Chad was supposed to be on call overnight at the hospital, but thankfully his co-worker, Eric, was kind enough to switch call nights with him so that Chad could be with me at the hospital. A little after 4 PM, they did the procedure. The procedure itself only took about a half an hour, and then I spent about an hour in recovery. I was awake during the procedure, but had a spinal block to keep me from feeling anything. Dr. Barsoom said he was glad we didn't wait until next week to re-evaluate, as I was starting to dilate by the time of the procedure.

Because the procedure can cause the uterus to start reacting, they kept me in the hospital overnight to monitor any contractions. I had several contractions at first, so I received two injections of some kind of medicine to calm my uterus. I also took some other kind of oral meds to help with contractions too. Thankfully, the contractions subsided and I didn't have any more contractions after midnight.

After I returned to my room, the fear kind of set it for both Chad and me. The fact that I was starting to dilate was scary, and we were dealing with the fear of losing this baby too.

Fortunately, Chad's parents and then our friends Erin, Stacy, and Maggie came up to the hospital to visit, so we were distracted from our fears for a while. The girls also brought me Runza french fries, which tasted even better than usual since I hadn't been allowed to eat since Dr. Ryder called that morning. It was a blessing to talk and laugh with each other. I was so glad to have them there.

I had an ultrasound the next morning to see how my cervix was doing, but Dr. Fleming didn't come in to the hospital until the afternoon to evaluate the results. I sat around all morning waiting and praying that the procedure worked. Chad got off work around 2 and was to the hospital by the time Dr. Fleming came in. When he finally entered the room, Dr. Fleming's first words were, "Well, do you want to go home?" Of course I said yes...I was missing Emily like crazy, and I thought I might go nuts sitting in a hospital bed anymore. Then he delivered the great news that the circlage had worked well, and the pressure of the stitches actually helped lengthen my cervix back to 4 cm! We were so excited to hear the news, and so thankful that there wasn't a "but..." following it. I still have to be a "couch potato" until my follow-up appointment next week, but my hope is that next Tuesday will show that I can maybe be a little more active.

Thank you so much for your continuing prayers for our baby girl. You continue to be such an encouragement to us. While I was in the hospital, a nursing student asked if she could do a patient survey with me. One of her questions was, "Who is your support system during this time?" I was able to name my wonderful husband who has run back and forth from a busy work schedule to be with me, and who has been so strong, making all of the hard phone calls and doing all of the communicating with my doctors. I was also able to name our wonderful parents and families, our incredible friends and church community, and so many other people, some I have not had the opportunity to even meet but who have offered their prayers and encouragement. My heart breaks for those who go through a difficult time without the kind of support we have received, because you have really been God's greatest way of sustaining us during this time.

We love you all so much, and we are praying for each of you as well. We know that many of you are going through your own difficult times right now too, and we count it a privilege to be praying for you.

Thanks again for reading.

Love, Jessica

Tuesday, February 10, 2009

Some good news

We are so blessed to tell you that our little girl was looking good today at the ultrasound! Thank you so much for all of your prayers...God answered the cry of our hearts!

I will tell you that today started as a tough day. I was very anxious about the appointment and what we might find. I prayed all throughout the day, pleading with God to please protect this baby girl. I was so blessed when I was sitting at the table reading this afternoon and I felt her kick me. She did it several times, and I was so excited and happy to know she was okay. I haven't felt any movement since the one time before we went up to Mayo, so I was so blessed to feel those little kicks. Then while we were in the waiting area at the hospital before the appointment, she started kicking again and Chad was able to feel. It was the best feeling he'd had in a while too.

We have two prayers now: baby girl is looking good structurally...Dr. Fleming said all of her parts are looking great, and he was very excited to see she was very active and had more fluid in which to move around. She is measuring about 10 days behind my actual gestational age, so the longer I can carry her and give her time to "catch up," the better.

Which leads to our second prayer: the ultrasound at Mayo revealed that my cervix had shortened considerably, and it appears to have shortened a little more. The hope was (and still is) that with the removal of the extra fluid after the ablation that my cervix would recover on its own. Dr. Fleming wants to see me next Tuesday to check it again. If it worsens, we will have to discuss possibly doing something to try and repair it. While I have not been put on official bed rest status, Dr. Fleming did tell me that I need to be a "couch potato." We are so excited that our little girl seems to be doing well, so the last thing we want now would be to go into preterm labor.

So the best thing would be to go back next week, see our baby girl still growing, and see that my cervix had recovered.

Again, thank you so much for your thoughts and prayers for our little girl. While we are still grieving the loss of Allie, today brought us much joy. We are so hopeful that I will be able to carry this little girl for many more weeks, and she would be a healthy little girl.

Thank you again! Love, Jessica

Monday, February 9, 2009

The army


I want to echo what Jessica said yesterday. We don't pretend to think that we are the only people in the world with worries or problems, so the fact that all of you have invested yourselves in our world has made an incredible difference. There have been great gestures of kindness that have met anticipated and unanticipated needs. When returning to work wasn't easy, the countless kind words, understanding smiles, and pats on the back made me feel understood and supported without having to explain myself to anyone. I still cannot believe that so many people would take the time to read what has become our family journal.

Speaking to my brother yesterday, he shared how saddened they were to read of Allie's death. When he said he felt they were there with us in Minnesota, he said it perfectly. That is exactly what we felt: we were part of an army of friends and family who journeyed to Minnesota. I heard a song once written by someone grieving a loss who said, "Words aren't remembered, but presence is." Never has that been more true for us than this last week. As you have shared our grief and reminded us of your steady presence, you have validated to us the importance of Allie's life.

A friend told me today that these events have caused her and her husband to think about their faith in a new way. As we grapple with all the "Why?" questions, hearing statements like these brings us a greater sense of peace. It reminds us that this is about much more than us. To think it is possible that the death of our unborn child could bless the lives of two people she never met gives us comfort beyond measure.

Tomorrow is the next ultrasound, and up until now I have not allowed myself to think about it. I don't want to see Allie again, to be reminded of the life that could have been. When I see her in my dreams, she is either 6 months old and is lying on her back, staring into her twin sister's eyes, grinning just like her mother does; or she is a grown woman, smiling at me before I walk her down the aisle. I don't want to be reminded that these will never be more than dreams. More than all this, we don't have it in us to lose another child.

Sunday, February 8, 2009

No words to describe...

It has been three days since we posted our last blog and left the Mayo Clinic for home. So many thoughts and emotions have been running through me (Jessica) since then, and I feel compelled to share some of them with you.

When we left for Mayo, we had such great hope for the many doors had been opened for us to get there and have the procedure done that I knew this was in God's hands, that he had gone before us and prepared the way. While there were definitely moments of fear and anxiety before the procedure, I had this peace that everything was going to be "alright." The doctors and nurses were fantastic, and I knew we were in good hands. After the procedure, I came out of my sedation well and immediately noticed that I felt physically better. As they were still taking care of me in the operating room, they did an ultrasound and saw that both babies had made it through the procedure. I felt such relief, and for the first time in over two weeks, my worries seemed to be disappearing. I felt so happy that night, seeing Chad and feeling like my little girls were finally going to be okay.

As they wheeled me from my hospital room to the ultrasound the next morning, I felt a little nervous, but mostly confident that everything would be fine. But when the ultrasound revealed that Allie's little heart wasn't beating, I was shocked...and heartbroken. Everything seemed to be going according to plan, and she should be fine now. How could this be happening?

Every thought imaginable ran through my head, questioning what went wrong. I knew the "reason" things happened: Allie's cord blood flow was not normal the day before and she was most likely already struggling from the TTTS. The change in flow after the procedure was probably just too much for her already fragile little body to take. But I believe in God and his sovereignty...why didn't he miraculously fix this? Why did he allow this to happen to her?

I confess that I have asked God these questions multiple times over the last three days. I don't have an answer, and I don't know if I ever will. I don't understand, but I don't think God expects me to understand. The only thing I can do is trust.

There is a song our worship team sings, and the words say:

"Your ways are higher than our ways,
and the plans that You have made are good and true.
If you call us to the fire, You will not withdraw Your hand,
we'll gaze into the flames and look for You."

Ever since we found out about the girls having TTTS, I have been reading the Psalms. David and the other psalmists offer praise and thanksgiving to God, but there are many psalms where they are crying out to God, questioning Him, displaying anger, confusion, and sadness. And still, after their ranting and raving, they offer praise to God.

I've done a lot of ranting and raving in my own way these last couple of days, and by no means am I "over" what has happened. But I am still offering my praises to God, trusting that His ways are better than mine, that there is a reason He took Allie home, and while He has called us to this fire in life, He has not left us alone. He has shown himself in mighty and powerful ways.

Which is where each and every one of you comes in. I know I wrote a blog a few days ago expressing my thankfulness, but I can't seem to fully convey how floored we are by the goodness of all of you. Right now, you are God's physical arms for us, loving and comforting us in ways that we could never have imagined.

From those of you who have known us forever to those of you who we have never met, thank you for encouraging us through this journey. Every prayer, thought, blog message, email, card, phone call, text message, and facebook note has touched us in a way we cannot express. We cannot believe the acts of kindness that have been shown to us. My fear is we will never be able to fully express and repay what each and every one of you has done for us. I am trying to write thank yous, return texts and emails, etc., and I can't seem to do it fast enough. I'm sorry, and I hope until you receive your personal "thank you" that you know we are so extremely grateful.

I also know that many of you following our journey have experienced the hurt of losing a baby. And I want to say a special thank you to you, knowing that you feel just like we do, and that the hurt doesn't probably ever go away completely. It is probably hard to read our entries without feeling that hurt again, so we are especially touched that you are willing to walk this road with us.

Allie was a name that Chad chose and we both loved, and it means "of noble birth." I find this fitting, because she was never born here on earth, but was born into Heaven. Hope of course means "trust and faith." While we don't understand why we lost her, we trust and have faith that there is a reason.

Our prayer now is that our other baby girl is doing okay since the procedure. We go to the doctor again on Tuesday afternoon, and I admit we have fears about what will happen. We love this little girl with all our hearts too, and we desperately want to meet her. We will probably update the blog Tuesday night since our appointment isn't until 4:15.

Again, thank you to each and every one of you.

With much love, Jessica

Thursday, February 5, 2009

Allie Hope Reade

Deceased February 5, 2009.

Her twin sister is alive but the situation remains perilous for her life and health. There will be more to say on another day, but this is all we have energy to say for now.

Please no phone calls today. Text messages are welcome.

Wednesday, February 4, 2009

The Waiting Game...over...for now

I have spoken to Dr. Watson on the phone and have seen him in person, but I have yet to see Jessica. She remains in the recovery area at this point. What I have been told...

The procedure was technically difficult because of the course of the amniotic membrane dividing the babies. For this reason, it took a little longer than expected. She had accumulated a notable amount of fluid, even just since yesterday. (I infer that it was a good thing we did not wait any longer.) Dr. Watson indentified 8 abnormal vascular connections and ablated them all. Afterwards, they removed 2.5 liters of fluid.


Now that I started typing this, Jessica finally just arrived to the room! WHAT A SIGHT! She looks great. She said she was scared when she was going to the OR; when she arrived, there was a cast of thousands. Everyone was very professional and kind. She remembers little; the most painful part was getting the IV (which they trouble placing) and removing the drape. Immediately, she felt (and I see that she in fact is) significantly less swollen.

With her back in the room, we now await Dr. Watson. I spoke to my dad earlier, and Jessica's parents are on the phone now. It was great for us to hear Emmy's voice. In the last few days, she has gotten wise to the multiple ways adults say goodbye. She has also realized that she cannot get off the phone until she says them all. As a consequence, she now (abruptly) ends conversations with, "I miss you, bye-bye. Talk to you soon, bye-bye. I love you, bye-bye!", dropping the phone and running away before you have a chance to get a word in edge-wise. It reminds me a bit of my niece Sarah, who learned at a young age that the easiest way to get out of a conversation with me would be to take the phone to her father and say, "Daddy, your brother wants to talk to you."
Dr. Watson just popped in. He said that they will plan to recheck the ultrasound tomorrow morning (as well as checking her cervix at that time). He believes that her going as far as she went with 9lb, 14.5 oz Emily bodes well.
Questions with some answers, which raise more questions:
I read a recently published study entitled "ELA (Endoscopic Laser Ablation): When are We Out of the Woods?" It looked retrospectively at stillborns following ELA to find out when they were lost. 10% were lost within 48 hours of the procedure, and by four weeks, 90% of the babies that were going to die had died. (Obviously, the latter group likely represents babies that were going to be lost regardless of what happened.) Practically speaking, I think this means that we do not know when to stop being concerned. The best we can hope and pray for is for the babies to keep growing and for the fluid issue to resolve on its own (ie, not requiring repeat ELA or amnioreduction). We will just have to take it one day at a time, not knowing what the next ultrasound may show. If both babies are born alive, even then we may not know whether or not they sustained any neurologic damage or will have developmental problems.

For two people who wanted to plan ahead for the big change of having twins, our hands are tied. But, we embrace this with long as we don't know, it means we haven't lost our two youngest daughters.

The Big Day

Dr. Watson called this morning: Jessica will go back to the clinic at 11:00 a.m., where Dr. Davies (Dr. Watson's partner) will look at her ultrasound to be sure that he is confident about her anatomy too. Then, she will be admitted to Methodist Hospital (in the attached Eisenberg building) and will go to the OR at 1:00p.m. She will likely be discharged tomorrow after a repeat ultrasound. We are not committing yet whether we will come home tomorrow evening or Friday morning--we will just wait and see how Jessica feels.

One thing for which we have been very grateful: good sleep. I cannot attribute this to anything but prayer, because we were both sleeping very poorly at home before we left.

I am also grateful that amidst difficult circumstances, I have come to see what a courageous person Jessica is. I have always loved her joie de vivre, her infectious laugh, and her capacity for love and joy. In my younger and less mature days though, I was poorly equipped to understand or deal with the way she expressed sadness or grief. It scared me a bit; truthfully I felt out of control with it. One of the fears that came to my mind after we learned of this diagnosis two weeks ago was that the grief of losing a child might be too much for Jessica.

But this experience has taught me a great deal about her. She has fear, but she has faith. She grieves, but she continues to be grateful. The thought of losing a baby has made us both cry more days than not in the last two weeks, but she has not lost her capacity for joy. Yesterday, I watched her take a stand and tell Dr. Watson that we would rather lose these babies fighting for them than watch them die before our eyes. And last night, after we had both shed some tears, I shared how daunting it is to think about riding this emotional rollercoaster for another 2-3 months...and that is if things go well. She calmly but firmly said, "It is worth it."

It gives me great confidence that God is protecting our marriage through this.

Tuesday, February 3, 2009

Moving forward

Well, the appointment took 3.5 hours, but things are moving forward. The ultrasound showed that things have gotten worse for the babies. 10 days ago, the fluid pocket for the baby with too much fluid was 11cm--now it is 18cm. The doppler flow is now abnormal--which means that the staging of severity has progressed from stage I to stage III. This places Jessica in a risk category where laser ablation gives the babies a better chance of surviving than amnioreduction. He said, with what he sees now, the mortality for the babies would be ~100% without any intervention. We discussed at length his experience with the procedure, where he trained, etc. He has a partner in practice who will be there for the procedure as well.

Of concern, Jessica's cervical length has decreased to a worrisome degree. The risk of this is basically premature delivery and represents a separate but related issue. There are interventions that can be done to treat it, but Dr. Watson suggested we just watch it for now. There is some hope (how much I am not sure) that it may reverse once the pressure of too much amniotic fluid is removed.

Specifics about the procedure:
He will call us tomorrow morning to tell us a time, but it will be sometime tomorrow afternoon. Jessica will not be able to eat anything after 6:00 a.m. He said the procedure takes about 40 minutes or so once the scope is in. After giving Jessica some local anesthetic and IV pain medicine/sedation, they will make a small incision in the left lower quadrant of her abdominal wall. The scope will be passed through the abdominal wall and uterus and angled to get a very close look at the vessels. They will "map" the connections between the two babies, then use the laser to ablate the vessels in a specific sequence. When they are done, the scope is removed and the wound closed with a steri strip or a stitch.

When the procedure is done, Jessica will be transferred to the antepartum unit (ie, high-risk OB unit) for an overnight stay. Thursday morning/afternoon, they will recheck the ultrasound. Depending on how things go, we will head home Thursday or Friday.

He reemphasized that in the immediate period following the procedure, there is a higher risk with laser ablation than with amniocentesis. Specifically, there is a higher risk of Jessica's water breaking. If that happens at this point, it is likely we would lose both babies. However, taking this risk is better than doing nothing or only the amnioreduction.

While we are nervous going into this, we feel that this is the right thing to do to give both babies a good chance of not only survival, but also lowering their risk of problems once they are born. Our prayer is that no matter the outcome, we still made the best decision for our babies.

Thank you for continuing to keep us in your prayers. We are so comforted knowing so many people are praying for our little girls.

In Rochester safely

Yesterday we departed by 1:00pm and had a good trip up here. We made frequent stops and Jessica worked her legs out as we were driving to minimize the chance of getting a blood clot. On one such stop, I was washing my hands in the restroom when a gentleman (who appeared to be a trucker) suddenly entered. It surprised me, since it seemed that we were the only people at this particular gas station. In fact, I had been feeling comfortable enough about our privacy that I was singing at the moment the gentleman opened the door. Earlier yesterday morning, I ran with my iPod listening to "Chicago's Greatest Hits: 1982-1989"; you can therefore imagine how I might have the song "Hard to Say I'm Sorry" in my head. It so happened that as the door swung open, I was singing the lyrics, "Hold me now...". The trucker and I made eye contact just as I sang the word "now." His look of surprise and confusion quickly turned to a look of disdain. My eyes fell to the floor and I promptly exited.

As some of you may know, the clinic complex in the downtown area amounts to several high-rise buildings, all adjoined by underground walkways (the "subway"). We had no idea when our church family got us a room at the Residence Inn that the hotel would be an easy two-block walk to the clinic where Jessica has her appointment today. There is a subway connecting the hotel to the clinic in fact. The hotel is absolutely the closest place we could have stayed to go to this particular clinic. A special thanks to Adrienne for setting this up.

After getting a good night's sleep, we enjoyed a complimentary warm breakfast with the thriving tourist crowd here in Rochester. It felt a bit like being at work to me: we were the youngest people there, and throughout the room you could hear people sharing stories about their medical problems. Jokes aside, there was an air of community, the spoken and unspoken sense of shared experience of coming to this place and putting your health and life in the hands of the Mayo healthcare team.

Today's schedule:
12:30-Jessica will go for her third ultrasound in three weeks. Please pray for healthy babies!
1:30ish-we will have the appointment with Dr. Watson

I wish I had more details. The biggest subjects for prayer are for the babies' health and for Jessica to be a candidate for the procedue. I will write more later today.

This evening, we hope to go see a movie--something we have not done in a long time.

A couple additions to the list of people for whom we are thankful:
1. Jessica's parents for watching Emily (and Baxter) this week
2. People at work:
-My program directors and chief residents for not only letting me go but ensuring that I did not worry about how things would be covered.
-Jay Hawkins, Abby Cheloha and Kara Meinke-Baehr for directly shouldering more burden in my absence. (To those of you who are doing so without my knowledge, thank you.)
-Dr. Ganti, who is doing more work towards a research paper than he would otherwise be doing.
-Drs. Cannella and Young for allowing me to forward my pager for a few hours Sunday night so Jessica and I could go have an anniversary dinner
-All the friends at work who took the time to ask, listen, and give me a pat on the back with what we are going through.

Saturday, January 31, 2009

Blessings and Thank You

It's the first time I (Jessica) am trying my hand at this blog, but the events of this last week have been so astonishing to me that I need to let you all know how blessed and thankful I feel.

Of course the news that the babies have TTTS is devastating, and it is scary to know that there are no guarantees. But it is amazing to me how God has provided so much hope and encouragement this last week, and you have all been a part of that, so I want to thank you.

We have been blessed. Since we first found out about the babies condition, we have been flooded with phone calls, text messages, and emails from so many of you saying you are praying for us, offering help, and sending encouraging thoughts. You have no idea how much these things have given us strength and made us feel so loved. I hope one of these days to respond to each of these emails and return calls to those of you who I haven't talked to yet. And I plan on saving each email and printing them, so one day I can show these little girls all of the people who loved them and prayed for them long before they were born.

We have been blessed by so many at UNMC...from Dr. Tomich who so wonderfully worked us into his schedule and coordinated our trip to Mayo, to Chad's bosses, who have told him not to worry at all about being gone from work because they've got it covered, to his fellow residents who have asked how we are doing and offered their encouragement. Thank you!

We have been blessed by my parents' employers. Mom and Dad will have Emily next week while we are at Mayo, and both Hallmark and KAT 103 have demonstrated so much flexibility with their schedules. Mom's boss Amy has even helped us with a connection to another family who just had two baby boys with TTTS, and we are anxious to talk with them. Thank you!

We have been blessed by my dear friends at Black Elk, where I used to teach and still sub. Thank you for your emails, prayers, and for the wonderful gift you gave brought me to tears.

We have been blessed by our Worship Team at church, who were there the night we realized what we were facing and immediately prayed with us. Thanks for your incredible help while we are at Mayo...we are speechless.

We have been blessed to spend some time with friends over the last week, sharing our fears about what is going on, but also being able to talk about other things in life and laugh. It is great to have joy in the midst of a hard time. Thank you!

A couple of other blessings I want to share:

Emily-What a blessing she has been in our lives since the day we knew she existed. However, I think the events of the past week and a half have amplified just how much she amazes us. She has kept us laughing during this time. Wednesday we went to her 2 year check up, and she was the picture of health. I am always thankful that she is a healthy little girl, but I think I was more thankful this time due to circumstances. And Thursday night blessed me most of all. We were getting ready for bed when she said "Wanna read a book?" She handed me one she had already picked out and attempted to sit in my lap. My tummy is rather tight, so it is uncomfortable to have her sit in my lap right now. I asked her if she could sit next to me because of my tummy, and she responded, "Mommy's tummy full?"

"No," I said. "What is in mommy's tummy right now?" She smiled and lifted my shirt, said "Hi, baby twinkles!" and gave my tummy a kiss. I have no idea how much she truly understands, but she knows that whatever is in mom's tummy is precious and loved by us.

Finally, last night Chad and I had just finished watching a movie and he was on the phone. I was still reclined on the couch when a giant bump appeared on my stomach. I felt it, and it was baby B, the one who is crowded in her little sac, moving. I grabbed Chad's hand, and he was able to feel her pushing and moving around. I haven't really been able to feel the babies move yet, so I was amazed that it was so obvious! There she was, pushing some little body part with such strength. "Hang on, little girl," Chad said. "In a couple of days, you'll have more room in there."

I know there are not guarantees, but I have a lot of hope for these babies. You have all been a part of that...I know your prayers are helping these little girls. Thank you so much, and we love you all.

Thursday, January 29, 2009

Borrowed Time

In the last few days, as Jessica and I have been discussing these little girls, and as I have spoken to them myself, I have been struck by how it feels like we are working on borrowed time with them. I feel a sense of anguish and get jittery if I think about it too much, but the last few days it has been good perspective. The truth is, we are on borrowed time with Emily too. And each other.

I know it is nowhere near an original thought, but the realization that we have no guarantees about the time we will have together is helping us to enjoy each day--even as we face our greatest challenge to date as a married couple. We attribute the peace we are experiencing to the prayers of so many loved ones. So, to all of you, we give innumerable thanks.

Romans 8 says:
"And we know that in all things God works for the good of those who love him, who have been called according to his purpose...What, then, shall we say in response to this? If God is for us, who can be against us? He who did not spare his own Son, but gave him up for us all—how will he not also, along with him, graciously give us all things?...For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord."

As I have read this again and again, I keep wanting to read where it says, "I promise your children will live and be healthy." It doesn't say that, but is does remind me of his love, from which no one can separate Jessica and me. AND it says that we if lose a child, we are in good company. We are confident that God loves these children even more than we do, and we believe that whatever the outcome, it will be for their good. I will readily admit that I don't know what it would mean for him to "graciously give us all things" in the event we lose one or both babies. We are not going to let it bog us down though...we have better ways to use this borrowed time.

Monday, January 26, 2009


Dr. Tomich confirmed that he thought we should go to Rochester and be seen by Dr. Bill Watson for laser ablation. Unfortunately, Dr. Watson is out of town this week. Our appointment is set for next Tuesday (February 3) at 12:30. I suspect we will drive up Monday. If Dr. Watson decides Jessica is a candidate for the procedure, it would probably be done Wednesday.


In the wave of pregnancy challenges we have encountered recently, so many friends and family have been contacting us with concerns, wellwishing, and assurances that we are being prayed for. It is wonderful and uplifting to hear from people, but we feel bad when we cannot find the time to call everyone back in a timely fashion. Last night, I spoke to Jessica about starting a blog so people could feel "in the loop."

If you do not know what I am talking about, let me fill you in:

One week ago today, Jessica and I went to her OB appointment for the 18-20 week ultrasound (she was 19 weeks as of last Wednesday). We were excited to find out the gender of the children, but more importantly to make sure they were structurally intact and growing. I noticed during the ultrasound that one baby was moving much more and seemed to have more room than the other. We were very pleased to find out both babies are girls (did not know at the time whether or not they were identical); yet, I felt an uneasiness that I hoped would subside when we spoke to Dr. Ryder.

Unfortunately, he gave us good reason to feel uneasy when he said that one baby had too much amniotic fluid, the other had too little (technical terms=polyhdramnios/oligohydramnios). He said not only that he wanted Jessica to see a high-risk pregnancy specialist (aka Maternal-Fetal Medicine doctor or perinatologist) but also that we should try to get it done ASAP. Before Jessica arrived home from the appointment with Dr. Ryder, the MFM doctor's office had already called to schedule the appointment. Monday and Tuesday night were nights of poor sleep. Part of this was anxiety, much of it was Jessica's ongoing feeling of heartburn at night. Wednesday, Emily turned two and we had a nice evening with family celebrating her. She continued to use her favorite phrase from Christmas: "Wanna see what's inside?" Still, sleep was hard to come by Wednesday night.

Thursday at 12:30 we went in for the ultrasound first, then met with the doctor at~1:15. He told us that there was oligo/polyhydramnios, and that it was due to a connection between an artery and a vein that results in one baby stealing blood flow from the other. Later, I would learn the name of this syndrome: Twin-Twin Transfusion Syndrome. Most people could guess that it is not good for the baby who is being denied blood flow (called the "donor" twin), but not everyone would guess that it is also bad for the baby who receives the extra blood (the "recipient"). The recipient gets fluid overloaded and develops heart failure. Dr. Fleming, the MFM doctor at Bergan, told us our options: 1) a large volume amniocentesis (poking a needle through the uterine wall and removing a large amount of amniotic fluid to even things out) with septostomy (poking a hole in the membrane dividing the two babies, hopefully maintaining equal pressures), or 2) going to Cincinatti for a laser ablation of the abnormal blood vessels. Jessica and I both had the impression that that the laser procedure was new and experimental, and when we asked Dr. Fleming point blank what he would do, he said without hesitation, "I would have the amnioreduction with septostomy." So, we scheduled the procedure for Tuesday at 3:30.

As I read more about TTTS later on Thursday, I was devastated. It turns out this is a very bad thing, especially if it occurs early in the pregnancy. (You can google it to find out more info). We have an evidence-based service that we use in researching the most current data available on a number of medical topics at work, so I used this to research the topic. The facts about amnioreduction are:
1. In patients with moderate to severe TTTS, it produces better survival than just watching and seeing what happens.
2. In many cases, the procedure has to be repeated multiple times because the fluid reaccumulates.
3. Everytime the procedure is done, there is a 10-15% chance of a complication that will result in the loss of one or both babies.

The largest pooled study looked at 223 women with moderate-severe TTTS. Collectively, they underwent 760 amnioreductions (ie, an average of 3-4 per woman). In 55% of cases, both twins were born alive, in 30% of cases one baby was born alive; in the remaining 15%, both were stillborn. In the first month, an additional 30% of babies die. Of the ones who survive, approximately 25% have neurologic dysfunction of some kind (ranging from mild developmental delay, to mental retardation and cerebral palsy). Keep in mind, these numbers are better than women with severe disease who undergo no treatment.

Up-To-Date, the resource I mentioned above, states that laser ablation is the definitive therapy for severe TTTS in women who are between 16 and 26 weeks. The procedure is only done at 15 places in the United States. A trial directly designed to compare amnioreduction to laser ablation therapy looked at 142 women with severe TTTS and showed better survival of at least one twin to 28 days (76% vs 56%) and to six months (76% vs. 51%). Neurologic outcomes at six months were also better (though admittedly poor): 48% of babies whose mommies underwent ablation had some kind of neurologic problem, versus 69% of babies whose mommies underwent amnioreduction. The link to the article PDF is located in the column to the right ("NEJM PDF").

Other studies that indirectly compared them also suggested better outcomes with laser ablation (I will spare you the details...I think you get the point).

So the bottom line is...I was crushed by the statistics and confused about Dr. Fleming's recommendation. Immediately after reading this, I went to church to practice singing for the Sunday service. I shared some of the above with Jessica, and it wasn't long before we were on our way home; there was no way we could sing that night. I talked to several friends and family and asked for prayer: health for Jessica and the "twinkles" (as Emily calls them); clarity about our next step; and peace through the process. Without seeing it coming, January 22, 2009 had quickly become one of the worst days of our lives.

Friday morning, I woke up early and got my work done quickly so I could attend to making phone calls. After asking for some advice from my boss, I made my way down to the OB/GYN department. I found an administrative assistant, who kindly took me to Dr. Tomich, who was in clinic. I asked if he would have five minutes some time during the day that I could speak with him about a personal matter. (Keep in mind that I had never met him before. He knew only that I was a resident in Internal Medicine and that my wife must be pregnant.)

With a gentle smile, he escorted me to a private office and asked what was going on. As I told him about the above details, he patiently listened and asked a few questions. When I finished, he said "You are right, this does not bode well. I cannot say how severe it is until I see the ultrasound, but there is no reason to settle for a less than optimal procedure just because the best one cannot be done in your hometown." He went on to tell me that the procedure is also done at Mayo, where he trained. He assured me that if needed, he could facilitate the referral quickly. I was thinking, "This is is helpful, I will give Jessica a call." But he wasn't done.

He asked me to follow him, and before I knew it, he was talking to his assistant about getting Jessica an appointment. She was very kind but said, "Your schedule is totally full Monday." he leaned over the counter to verify it. His assistant explained that he had an appointment available Wednesday morning (he is not in clinic on Tuesdays). He responded, "Not good enough." She explained that literally the only time he had available Monday was his lunch time. Without flinching, he said "Book it." As if this wasn't enough, he then handed me a card with both his pager and his cell phone number. "Call me if you need anything this weekend. I will be out of town. But please, call me if there are any problems."

I cannot imagine a more clear answer to your prayers. Which brings us to this morning. Jessica's repeat ultrasound will be at 11:30, then the appointment is at 12:30.