[this text was originally posted on carepages.com; it is being put here so it will exist somewhere besides my laptop, and Juliet can read it when she gets older]

I'm putting the name as "Juliet Sascha Hartshorn", although Cassandra and I hadn't even finalized which other middle name(s) she would have if any. Thought we had plenty of time left!

very tiny

[this text was originally posted on carepages.com; it is being put here so it will exist somewhere besides my laptop, and Juliet can read it when she gets older]

To begin at the "beginning": Cassandra and I were expecting Juliet to be born on or about October 20th. Since July 4th seemed to be about the latest we'd want to travel before then, we took to the road to visit friends and family in Southern Illinois. On the 4th and 5th we saw my brother Wally, my sister-in-law Dawn, and my ~7 month old nephew Orlando. At the time, he seemed really small.

Cassandra started to feel some pain, and Wally asked her to rate it on a scale of 1 to 10. She said "7". Wally and Dawn exchanged coded glances, then suggested (gently but persistently) that she call her clinic back in Austin. She did, and they suggested she might be dehydrated, and asked her to drink a lot of water and call back in an hour to say how she felt.

Sure enough, she began to feel better, so when she called back they said just to make sure she kept drinking enough water. The next morning, she felt pains again, but it got better again and we went with "Mexican Wrestler Flower Girl" Rob and "Orange-Purple" Jennifer to St. Louis. We hit a record store, a clothing store, a cool diner, and so on. Then, we went to the pub "Fox and Hounds" in the Cheshire Hotel, and I had we all had a drink while Cassandra had more water. She began to feel pains again, though, and we pondered whether this might be more than dehydration. Rob and Jennifer and I convinced Cassandra it was time to hit an emergency room, just in case.

We asked the waitress her opinion of the local hospitals. It turned out she had worked as a volunteer in more than one of them, and recommended that we go to St. Mary's, which was about two blocks away. Afterwards, we imagined how this scenario might have played out differently if we had been in the middle of rural Illinois or on the road, rather than in the nearest city right next to the hospital.

We went to the emergency room, checked in, and waited. Jennifer made a sketch of the three of us reading, at my request, which I'll see if I can scan and attach here. Then we were taken to another waiting room to wait in. Then Cassandra was taken to a third place to wait. Then, the doctor was able to get to her.

At almost that exact time, the bleeding started. The baby's heartbeat went from very low to very high and back again, and they had to hurriedly decide that a C-section was required. A nurse went to fetch me, and I got smocked up and ready to go see her beforehand. But again, things went faster than expected, and they had to begin before I could go in.

Of course, I knew very little of this, because they were more occupied with taking care of mom and daughter than talking to dad, which is of course the right priority. But I went through all kinds of awful scenarios in my head. Rob and Jennifer in the second waiting room knew even less than I did.

Juliet was born a little after midnight, weighing 1 pound 11 ounces. The statistics are that babies born this early, around 25 weeks or so, have between a 62%-80% chance of surviving, and about a 50% chance of surviving without blindness, mental retardation, or other serious lasting effects. So, I am happy to be a Dad, but not so happy that it happened so early.

Cassandra and I were told not to let her become pregnant without this, that, and the other being checked out beforehand. Given that she had just been through a very hurried and more-than-usually complicated C-section, she did not have to be told twice.

Juliet was stabilized and taken to Cardinal Glennon Children's Hospital, a sister-institution a few exits down the road. It has more pediatric surgeons on staff in case one of many potential surgeries has to be done later on. Cassandra is staying at St. Mary's until she is ready to leave.

[this text was originally posted on carepages.com; it is being put here so it will exist somewhere besides my laptop, and Juliet can read it when she gets older]

Apparently I went over the 4000 word limit on my last post.

I visited Juliet yesterday at 5 pm, and they said she was breathing with help from a ventilator, and heartbeat was normal, and otherwise everything looked good. However, they also warned that with very premature babies there is often a "honeymoon period", and that it is normal for things to take a turn for the worse after a day or two.

This is because of the number of things that have to happen, months ahead of schedule:

  1. the blood, which was primarily routed through the place where the umbilical cord connects to her, now has to be routed primarily to the lungs for oxygenation
  2. the liver, which was not having to purify the blood before now because Mom was doing it for her, has to "turn on" and start doing the work
  3. the immune system, which didn't have to do anything before now because Mom took care of that and anyway it was in a fully enclosed environment, now has to get started. The environment is sterile and we have to scrub up with iodine, then soap before we come in, but it is still not as protected an environment as the womb.
  4. many more things which I don't know about
  5. I just saw Juliet again today at about 2 pm, and she had sure enough taken a turn for the worse during the night. She is jaundiced, which is not uncommon for normal babies and normal for premature ones, and so they have her under a blue light which is supposed to help the liver break down the I-forget-what which the new liver hasn't quite gotten ready to filter out.

    She also has been switched from the normal ventilator to one which gives her 600 tiny puffs of air a minute, which translates to 10 a second. It makes her look like she is shivering, although her skin temperature is monitored and there's a film that look like saran wrap over her bed to keep heat in.

    By the way, yesterday they coated her in what looks like Vaseline (it isn't, but it's somewhat similar), to help keep in moisture and heat because her skin isn't thick enough to do that yet. Her eyelids are also too thin to keep out light, so her eyes are more exposed than they should be. The latest evidence says that she doesn't need to be in complete darkness, but she does have to be kept from daylight, camera flashes, and that sort of bright light.

    On another front, Cassandra is now off the morphine, though still requiring painkillers. They had to give her a more invasive cut than the typical modern C-section; it's actually more like what a C-section would be a few decades ago. This is because of several factors, including the fact that she had a fibroid which we have called "Jasper" because it was sitting in there with Juliet.

    Fibroid seems to be a medical term meaning, roughly, "thingy", or more specifically a fibrous non-cancerous lump of flesh which shouldn't be there but occasionally is anyway. It is possible that it was the fibroid which caused the premature placental rupture that forced them to do a C-section this early. It is also possible that it was unrelated. The doctors warned us against trying to figure out "why did this happen", because unless Cassandra had been using drugs or smoking (no on both counts), there's no known factors which cause it. Sometimes it just happens.

    Cassandra is eating solid food and walking (very slowly) around today. She gets tired, but not as tired as yesterday, and she is in pain, but not as much as yesterday. So she seems to be improving.

    I hope Juliet does. The doctors at St. Mary's said her odds were better because she was a girl; for unknown reasons, girls survive very premature births better than boys.

    Well, I'd better go check on Cassandra again. Now I have to figure out how to tell everyone this page is here!