Holy Smokes, a lot has happend!

Alexander arrived 8 days ago!! I can't believe that he is already 8 days old and how much occurred last week! Alexander Baxter Alleman arrived unexpectedly Monday night, February 11th at 10:52 pm. He weighed 5 lbs. 6 oz and was 16 inches long (so much for the doctor being correct about his weight).

As you know, he was expected to arrive on Tuesday, February 12th at 7:30 am, apparently he had his own agenda! I think back now and realize that my labor started on Sunday morning, when my contractions were 7 minutes apart first thing in the morning, however, they quickly became sporadic after the first hour, so I wasn't concerned. Then later on that day, the contractions started to become regular again, accompanied with back pain and pressure. Again, as soon as I became a little concerned, they became sporadic. Monday morning arrived, with my mom coming down to help me with some stuff around the house, did lab work at the Hollywood Presbyterian, and finished up all of my assignments for school. My contractions continued to occur but sporadic and no more back pain or pressure.

Wes and I went to Larsen's Steakhouse for dinner (decided to have one last dinner as a couple), had a fabulous dinner, and as we got the bill I heard a pop! and thought "oh crap, what was that!" I then asked the waiter where the restroom was, who proceeded to to show me where it was, and as I stood up I felt the gush of water and thought "oh crap!!!" As  I went to the restroom, freaking out and confirmed my water had just broke. I quickly and carefully walked out of the restaurant, saw Wes signing the bill, and stated "Wes we gotta go, my water just broke!" He quickly jumped up and we carefully and quickly ran out of the restaurant. We safely and quickly raced home so that I could change my pants, called my doula, my mom, and headed to Hollywood. On the way, we had to get gas of course (I planned on getting gas the following morning).

When we arrived at the hospital, I was quickly checked in and given the fetal heart rate monitor. When my OB arrived, I told her I was having contractions and my back hurt. She then informed me that I was 2 cm dilated and 35% effaced. My OB then told me that they were going ahead with an emergency c-section, instead of waiting 6-8 hours because I had just eaten, because his heart rate was dropping. He was delivered relatively healthy, needing to have some of the meconium pumped from his lungs. Thus far, it appears that they got it all and there were no issues. I was able to have face to face for a few seconds with Alexander.

Happy Birthday Alexander!

Before I knew it I was in recovery. Once I was able to feel my legs again, the doctors wheeled me into the NICU to see Alexander for several minutes before taking me to my postpardum room. After being in the room for an hour, I was informed that he would be transported to CHLA. The transport team brought him to my room for a few minutes prior to taking him to CHLA. I didn't get to see him for another 3 days.  However, my loving husband sent me pictures and daily updates of Alexander. He was making so much progress prior to surgery (grasping daddy's finger, not needing a ventilator, and using his pacifier). He did require a blood transfusion to infuse his system with oxygen carrying red blood cells. Since that time, he has gotten good color, good oxygen saturation of the blood and maintained a relatively good heart rate.

Snuggle Time with Daddy

A day or two prior to his scheduled surgery, he had an echocardiogram performed to see the details of his heart, as well as some chest x-rays, ultrasounds of his brain and kidneys, and an MRI of his brain. The heart echo confirmed an earlier diagnosis, that he has both major arteries (aorta and pulmonary) were formed on the right chamber, and were both well formed, meaning that reconstructive surgery would not be required on the aortic arch – which would be typical for a baby with HLHS.

February 14th soon arrived - my day to be discharged and Alexander's big day for surgery. I tried my hardest to get over to see him before he was taken in, but that didn't happen. Prior to be taken into surgery the surgeons decided that Alexander needed a compressive band attached to the pulmonary artery. Because both major arteries are attached to the same heart chamber, that single chamber must pump both arteries. The pulmonary artery pumps blood to the lungs to collect oxygen, and because it is a low pressure flow region, as opposed to the aorta which distributes oxygenated blood throughout the body, more blood would pump through the lungs than through the body (path of least resistance). This results in an oversaturation of blood in the lungs, while depriving the body of oxygenated blood. The compressive band reduced the flow capacity of the pulmonary artery and forces the blood to travel throughout the body.

Baby Alexander also has an Atrial Septal Defect and a Ventricle Septal Defect. The septal is the wall in the heart separating the left and right sides. In baby Alexander, these walls never formed correctly. Since he is operating as a single chamber heart, the decision was made to remove the remnant of the unformed atrial septal wall. This is because the blood circulation returns to Alexander’s heart on the respective left and right sides as normal, but the left hand flow travels through the hole in the atrial septum and down into the right chamber. To ensure that the blood can mix coming into the heart, and to ensure that as the muscle grows internal flow restrictions do not form, the surgeons decided to remove the remnant of the atrial septal wall.

Thursday was an exhausting and overly emotional day for Wes and I! I was in pain physically and emotionally because I couldn't be with my boy! To top it off, all of the information we were receiving from his doctors that his surgery didn't go as easy as they thought, which was even more upsetting.  Upon administration of anesthesia, Alexander’s heart rate and blood pressure fell. It did not get to a critical level, however restoration compressions were administered and supplementary medication was required. Additionally, he went into what is known as Heart Block. 

Heart Block is a condition that occurs in the electrical signaling of the heart. Normally, the upper and lower chambers work in a sequence to optimize the blood flow. First the upper chambers pump, then after a slight hesitation the lower chambers pump. An electrical signal is transmitted to the upper chamber, then down to the lower chamber to accomplish this. In Alexander, the signal somehow got lost between the upper and lower chambers, meaning that his atriums are pumping, but not his ventricles. Because of this, he is currently hooked into a pacemaker. It measures the signal at the atrium, and then transmits a signal to the ventricle when it needs to pump. He will have to remain on this pacemaker until his body recovers, or the cause of the problem is resolved. If it remains unresolved, he will have to have a permanent pacemaker installed. While he was recovering he was on substantial pain medication and blood clotting medicine to help him heal from the surgery. He is also on a pacemaker and breathing machine to help his systems function. 

Since yesterday, Alexander has been showing some improvements! Something his mommy and daddy very much needed, with tears of joy from mommy!  Yesterday, he kept his oxygen level and blood pressure in the positive, was taken off Nitrate, had his catheter and his drainage tube removed. Today, he has kept his levels in the positive area and is being weaned off some of his medication! One step closer to being able to hold him and eventually go home! :) 

However, he is still in heart block and the possibility of having to put in a pace maker permanently is being discussed and could happen as early as Thursday. We are hoping that the lower portion of his heart will start improving so that he won't need the pacemaker.

As of today, he is still doing very well! Some of his lines have been removed and he continues to be weaned off more of his medication. His oxygen and blood pressure levels are staying positive too! We got to change a few dirty diapers-something I didn't think I would be happy to do! But right now I'll take what I can get to be hands on with him! We hope tonight and tomorrow will be just as positive, if not better! I am finally feeling better and will be back to updating daily with pictures of our Superman and his progress!