Tuesday, July 29, 2008

God's plan

The priest came in and consoled me. “Be strong. God may have other plans for your baby and for your family.”

I politely told him that he may have mistaken me for someone else. Heaven Czar, our son, is doing just fine.

At the Neonatal Intensive Care Unite, next to Heaven was another pre-term baby inside an incubator. The baby’s young mother, barely 20 years old, sat still, silently crying. Her newborn was dying, primarily due to complications with the baby’s heart. The baby’s sex, I heard, was also unsure. The baby was born without an identifiable genitalia.

The priest was there to baptize the baby. The parents decided to have the baby discharged from the hospital and await the baby’s last moments in the company of loved-ones.

A nurse aide was helping Aires express breast milk for Heaven. Yesterday, Aires expressed about 0.8 cc of colostrum. Heaven was given 0.1 cc every hour since last night. We experienced firsthand what breastfeeding experts and advocates have said all along: Just a few drops in the first few days is enough for your baby’s tiny tummy.

All night long, however, Aires became feverish. It was another sleepless night because the fever reached 40 degrees. Everybody believes it is because of the un-expressed milk in Aires.

So while the young mother next to us was coming to terms with her child’s farewell, Aires sat there, silently enduring the pain of expressing her life-giving gift.

The priest started the rites. The nurses and doctors stood as witnesses. We all joined in the prayer. Aires was expressing milk. I stood praying, beside Heaven, stroking his tiny fingers, telling him that indeed God has big plans for him. Saying farewell this early, I firmly believe, is not one of them

Monday, July 28, 2008

From rupture to rapture: Our Heaven on earth

“I think my water bag just broke.”

My wife, Aires, mumbled, shortly after midnight of 26 July, Saturday.

Clear fluid gushed out from Aires, trickling down her legs. Clinically, this is called a rupture. To us, it was simply unexpected. We just came from the hospital a day earlier following a treatment and consultation with our reproductive immunologist, Dr. Ed Lim, and were told to get ready for our baby’s arrival in the first week of August. Our Heaven Czar was only 31 weeks and 6 days old. We were hoping to welcome him on his 33rd week.

In 2006, Aires was diagnosed with exhibiting an anti-phospolipid antibody syndrome (APAS), a condition common to women who often miscarry or have difficulty getting pregnant. This condition is characterized by the hyperactivity of anti-bodies that make the placenta, the baby’s life support system, incapable of sustaining a full-term pregnancy.

Since January --- when Aires and I first learnt that she was finally pregnant (after six long years), we have been on a rollercoaster ride --- replete with syringes and needles, tons of tablets, and bucketful of blood, sweat, and tears.

We were plotting out our next steps when the rupture came. We tried valiantly to stay calm as we scrambled for our stuff and hit the road en route to the Manila Doctors’ Hospital. We live in the outskirts of Metro Manila and the drive to the hospital seemed long and endless. At 1 am, Aires was wheeled into the delivery room. An early rupture of the amniotic fluid bag would mean possible infection for Aires and the baby. Hence, pregnancy books recommend delivery of the baby within at least eight hours after the rupture. Aires was given antibiotics to prevent any infection.

But Aires could not deliver just yet. She needed transfusion of “freshly squeezed” human plasma, platelets, and red blood cells to counter the anti-coagulant medicine, Heparin, which was in her system for the last eight months. This drug helped prevent blood clotting to ensure that Heaven would get a steady supply of nutrients through Aires’ cardiovascular system.

We had been planning our strategy for selecting ten Type O blood donors all week long and requesting them to donate a few bags of their blood, maybe on August 2. Our doctors preferred fresh human blood over frozen stock.

But at 1 am, our plan went down the drain. Where on earth could we get at least eight donors in the next eight hours?

The next eight hours became a tactical drill. At 5 am, I started calling up friends and loved ones, waking them up from their fitful slumber. “Hi. Sorry to call this early but Aires and I need your blood. Please go to the National Blood Center at 8 am for the blood screening. Blood letting will be done at around 1 pm.” The blood center of the Philippine National Red Cross, about 10 minutes away from the Manila Doctors’ Hospital, performs a more efficient blood letting system called Apheresis, which leads to higher yield from fewer donors.

My brother, Jay, a topnotch UP professor, was at a party with former students that Friday night. He came to the center with four potential donors at tow. My cousin, Ramir who was already on our list, rushed all the way from Cainta to Manila with two other potential donors. My brother-in-law, Kuya Archie, requested his wife’s uncle, Tito Roland, to give his fair share. My high school bud, Adam, made several calls and asked an office colleague, Richard, to proceed to the center. Melissa, another high school friend, promised to drop by before going to her 10 am presentation. My parents came with two potential donors, Greg and Wendell.

My other brother-in-law, Kuya Lon, called up two friends. Another cousin-in-law, Minmin, was on her way. My friend, Osmond, asked his brother to rush to the center. But these four potential donors could not make it in time for the 10 am cut off.

So, before the screening cut-off time of 10 am, we had 12 potential blood donors, good enough considering the frantic turn of events. We needed six donors who should pass the rigorous blood screening test. But the pre-screening test of donor viability whittled down the list from 12 to six. We had to cross our fingers that all these six viable donors would eventually pass the test.

Waiting for the results of the test was a test of patience. Every hour, I would call the delivery room to check on Aires and the baby. How uncomfortable it must have been for Aires to be lying down there at the pre-labor room for such a long time, not knowing what was happening with the blood letting ordeal.

At 2 pm, I was asked to go back to the hospital and stay outside the delivery room. Our ob gyn, Dr. Gigi Martinez, informed me that she would open up Aires at around 6 pm. The next few hours were all about “Where is the blood?”

I waited outside the delivery room for any word about Aires’ condition and any update from the blood center. Keeping me company were Osmond, his wife, Bing, and their daughter and my godchild, Nina.

Aires’ mom and brother were saying the rosary at the private room we reserved for our stay in the hospital.

At 4:20 pm, Kuya Archie delivered the “freshly squeezed human plasma, platelets, and red blood cells” to the hospital. I waited outside the delivery room, with my digital camera. We expected a nurse or an orderly to summon for us to give the camera so that the most awaited moment would be captured on digital memory --- our Canon moment!

True enough, at 4:50, a nurse called out for me. My heart leapt. This is it! Our Canon moment is finally here. The nurse ushered me in to the delivery room’s reception area only to be told to rush to the newborn viewing area across the hall because our Heaven Czar was already born and was being attended to by our neonatologist, UNICEF breastfeeding advocacy partner, Dr. Meann Silvestre.

He’s here? I was stunned in disbelief. He’s really here. There went our most awaited Canon moment. But who was I to complain. All that we could say was “Thank you, God!” We finally made it --- Aires, Heaven Czar, and me --- with the help and prayers of all our loved-ones, friends, and newfound friends who willingly shared with us their gift of life.

Our ob gyn said that Heaven was a tiny big boy. For a pre-term baby, he looked big, with an Apgar score of 9.9. She said that Aires is okay and needed to stay at the recovery room for four more hours.

At the neonatal intensive care unit (NICU), we saw Dr. Silvestre prepping up Heaven. An hour later, Heaven was placed inside an incubator, his “space pod”, where he would stay at least for one week until he is ready to breathe on his own. Dr. Silvestre informed me that Heaven’s lungs have liquid that needed to be suctioned out in the next few days. Other than this, Heaven is well on his way to becoming a healthier baby, especially with Aires’ breast milk.

Aires and I visited Heaven at the NICU on his “day-sary” to celebrate his first 24 hours. He was asleep, and would occasionally let out a grunt. We talked to him and waited till he opened his eyes. He did after several cooing. We finally got our Canon moment!

Wednesday, July 9, 2008

Dear God

Dear God,

Heaven Czar is now almost 30-weeks old. In five weeks, he will be in our arms finally. But Aires’ strong immune system is again going overdrive. She is producing antibodies which make her placenta go old so fast that it is no longer safe for Heaven to stay in his mom’s womb.

We are now at the hospital again. Aires has to undergo another round of the intravenous immunoglobulin treatment. For almost 10 hours, Aires is hooked to a machine that controls the flow of the drug. 25 grams of this drug is needed to temper the immune system of Aires.

Next week, Aires will also need to undergo another round of lymphocyte immune therapy. We asked our Ateneo friends to donate their white blood cells for this treatment. This therapy will also help temper her immune system.

Please give us the strength to go through all these again. Please give Heaven a fighting chance. Please make him ready for the world outside the womb. Please help Aires become a rightful vessel for Your miracle.

Your will be done. Amen.

Saturday, July 5, 2008

The good parents

Aires’ friends from the Ateneo recently threw her a baby shower get-together.

It was a night for the couples. Ruby and Mannix Evangelista came. Elsa and Vince Magtibay came. Vhangie and Alf Quemada came. Jacque Aguinaldo and Wilmer Sabaria came. (Well, everybody wished Jacque and Wilmer came as a couple.)

Ruby was games mistress and ruled with an iron fist. She came prepared with props and prizes and rules she created along the way.

They gave us gifts for Heaven Czar. But the most valuable ones were the lessons they shared about marriage, parenting, and children. Here are the best tips we have ever heard from friends whom we have known from our teener’s years at the Ateneo.

Vince: Your faith will see you through.
Elsa: Give what is the best for your child.
Ruby: Say what you feel.
Mannix: Know your priorities.
Vhangie: You feel what your child feels.
Alf: Each child is unique.
Jacque: God knows what is best for you.
Wilmer: There is always time for change.

Indeed, God knows what is best for us. He made us wait this long and let our friends get a head start. Aires and I listened to their stories and wondered what stories and lessons would we share next time. In the meantime, their stories give us a living narrative of how to become good parents.

Lost and found

I am good with directions. I can easily find my way to an unfamiliar destination. I can also find my out. I make a good cab driver, my wife Aires once quipped. I am not afraid to test unknown streets and curves. If I get lost, I just roll my window down and ask politely for directions.

I also follow directions really well. I can be left alone to decipher how to set up a new software or how to build a book shelf.

But recently I made a big boo-boo with directions. Of all things, it had to be with a new prescription for Aires. Our gynecologist asked us to buy a skin patch. The patch has nitroglycerin which dilates blood vessels allowing better blood flow. It is usually for patients with heart problems but, for Aires, it is meant to regulate the blood flow from her cardiovascular system into the baby’s own system.

One late night, Aires asked me to read the directions. I got one patch and took off the protective covering and attached the patch on Aires’ tummy. For three nights, I did the same routine. The patch wouldn’t hold for a long period of time. Aires soon found out that I did something wrong. I was attaching the protective covering and not the adhesive patch that contained the medicine.

My only excuse? I was so sleepy that night when I read the directions that I got it all mixed up. My other excuse? Sorry, I am just human, still prone to make mistakes, no matter how great I claim to be with directions.

But Aires lost a little faith in me. She now double-checks everything I do when it comes to her prescription drugs. It may take some time again to get her confidence. But I believe she will believe in me in due time.

I got lost. I would find my way back home.