Pacemaker Procedure Scheduled

Here is Grace pretending to be talking on the phone telling all of her friends about the upcoming procedure. Needless to say it is a cell phone. Such a 21st century girl!

On Tuesday morning we will be taking Grace in for the lab work, an X-ray, and some other tests as well as consult with the surgeon who will be performing the actual surgery. This begins at 11:00 AM and should take a few hours.

On Wednesday we will go to Children's Hospital in San Diego for the actual procedure. We will arrive at 7:30 AM for prep and the procedure will begin at 9:00 AM. From my experience with Jenn and the C-section last month they will start on time. The placement of the pacemaker should take about 2.5 hours which means Grace should be in recovery about 11:30 AM provided the surgery goes as anticipated.

Following the surgery Grace will stay in the hospital for a day or two before being released. The doctors are confident that the procedure should go fine. The larger concern is for bleeding and infection following the implanting of the pacemaker. There is almost no possibility for Grace needing blood but just to be on the safe side I am going to donate in order to have it on hand in the event it is necessary.

Below is a picture of our conversation with Grace concerning the procedure. As you can see she is taking the entire procedure very seriously and is thinking about the ramifications of having a pacemaker. She isn't too thrilled about having it done either but is glad that we'll be able to get this over with and move on with life.

She and we thank you for your prayers!

Pacemaker Needed

Yesterday Jenn and I took baby Grace to the cardiologist for her one month follow-up to our last appointment. It was unintentionally a long appointment due to the doctor's hectic schedule. We arrived at 12:30 PM and left around 5:15 PM. However, there was nothing eventful at the time.

This morning around 7:30 AM we received a call from the cardiologist himself. He was looking more closely at Grace's EKG and noticed an irregularity that he is concerned about. (Here's the technical information for those with a medical background. She has a long QT interval following her heart beat. This is also known as "repolarization" which is the recovery time after her heart beats. This is something that could cause serious problems down the line if it isn't addressed immediately.)

The doctor believes that because of this (not because of the arrhythmia) Grace needs a pacemaker now. They will probably schedule the procedure for next week (think procedure and not surgery).

Here's the scoop on the procedure: It will take about an hour and a half to two hours. They will make a 1.5 inch incision just below her sternum where they will go in and attach a lead to the lower part of her heart (they are still deciding if they will use the type that attaches to both upper and lower chambers or a simpler type that only attaches to the lower part). She will stay in the hospital for a day or two to recover they she will come home.

The risks for this procedure are minimal but obviously there are always some risks involved. Things then would be "back to normal." We will go back in a week for a wound check, then a month to check the pacemaker then in six months following that and every six months until they put in a different pacemaker several years from now.

How are we responding to all this? Initially well. Obviously it is a little bit disturbing knowing your baby is going to get cut into but we were prepared for this eventuality if the Lord didn't intervene and heal her directly. Obviously we covet you prayers and appreciate your words of encouragement.

I told grace what was going to be happening and this was her response:

She's a trooper!

With Love and appreciation,

Dave, Jenn and Grace

Random Lesson on Marriage

This is a random shot, so what gives? Why did this picture make it onto the blog page? Exactly! Why did this picture make it onto my camera and why did it make it onto my iPhoto on my mac at home? That's what I keep asking myself. But, after a year and a half of marriage Jenn has managed to take pictures of me standing next to bears, buffaloes, a sign that says, "taco farm," next to a giant bottle of milk and every other conceivable thing we happen to walk by when we have a camera.

Why do I do it? Why do I subject myself to the torture and humiliation? Because I am married. There is no more explanation than that. Why do I do a lot of the things that I do now that I wouldn't have done a few years ago? Because I am married.

Please don't misunderstand, I am not saying that in a pejorative sense whatsoever. In fact, what I am saying is quite the opposite. Jennifer gets a kick out of taking pictures with me standing next to random things. If it is odd or bizarre I can guarantee I'll be photographed with it. But in the grand scheme of things that's okay. There are a lot of more difficult things that I could be asked to do than stand by statues of British guards.

I am amazed sometimes at some of the things people tell me. A few months back I was talking to a guy who was considering getting a divorce. I asked him what his complaint was. Now there were several, but one of the issues we talked about for a half hour was the fact that his wife wants to hold his hand and he doesn't like holding hands. He was dead serious. This was a huge issue to him. Personally I couldn't believe it. He was ready to walk away and one of his major complaints is that his wife likes to hold his hand and he doesn't. Give me a break!

I am sure there was more going on than that but this is what he told me was one of the major conflicts. I finally told the guy that he needed to suck it up and be a man. Now that probably wasn't the most pastoral advice I could have given but it was what he needed to hear. Love means that sometimes you do what you might not prefer for the sake of others. Love moves outside of itself in order to show the other person that she is special and valuable to you. You don't like holding hands? Fine, do it anyway. I don't like standing in front of statues but there are worse things in life. And if it brings a smile to Jenn's face, it is worth it.

Husbands are to love their wives like Christ loved the Church (Ephesians 5:25). I think at the very least this means holding her hand if she likes it. Now go over there and stand in front of that stature and let me take a picture.

Yikes! I was just kidding.

Okay everyone who was quick to rebuke or correct me for my latest blog. I really do think Grace looks like both of us. It was more for Jenn's humor than anyone else's because people in the hospital kept giving her a hard time referring to Grace as Mini-Me or talking about the little Mexican baby. I was actually surprised by how many of you sent me personal emails to correct my distorted view of reality. Thank all of you for your firm but loving correction. You can stop now.

On another note, we finally heard from the doctor today about the heart monitor that Grace wore last week (see picture below). Everything came back great and we are fine until our next scheduled appointment on October 20th. We will again have the 24 hour monitor for the day.

For those of you who read this blog page in general I want you to know that I will be posting other things in addition to Grace Reports. Obviously Jenn and Grace are my priorities right now but I also have a lot of other random thoughts rolling around this cranium of mine that will eventually find themselves on this site.

One final thought, I have been overwhelmed by the response to my letter to Grace the night she was born. I actually wrote in on my computer to put in a file for her and only as an afterthought decided to post it on this website. I was very touched by how many people appreciated it. Thank you.

The Bionic Woman

Okay, don't freak out with all the wires. Grace was sent home just like every other newborn baby. After one week we had an appointment with the cardiologist and he wanted her to wear a monitor for 24 hours to see how her heart does over an extended period of time. We will be getting the result back in a day or two. This is part of the ongoing monitoring process. We will have another appointment on October 27th and then regularly from then on. After that we will have an appointment every month or two depending on the need. It could be months or years before she needs a pacemaker. One of our cardiologist's patients went 18 years before getting a pacemaker. She played varsity sports to boot! Keep on praying.


This is a photo of Grace's first trip away from San Diego. Jenn and I took a brief "vacation" to visit her parents in Glendora, CA outside of LA. I put "vacation" in quotes because it is impossible to take a break with a newborn. I am only asking for a full night's sleep. PLEASE! Seriously, hearing her cry is music to my ears (usually).


The final question is, who does she take after? I've heard feedback from both directions. Jenn's parents think she looks like her, everyone else in the world thinks she looks like me. I am not trying to be bias but hey, this is my weblog. Okay, seriously, I can see both of us in Grace but you have to admit there are some resemblances to me (poor girl, maybe she'll grow out of that).

Jenn and I have been doing well. She is almost healed from the C-section. I'd put up pictures to prove it but she would kill me.

I am learning how to take care of a newborn. The nurses were actually surprised that I knew how to change a diaper the first time out when we were at the hospital. I guess that babysitting as a kid paid off. I informed them that I come from a small Mexican family of 8 kids. I have lost track of all my nephews and nieces (but I think it is around 15 or so) not to mention grand-newphews and grand nieces (yeah, I'm that old!).

Things are falling back into a new routine. I think it is going to take weeks before we both get comfortable with our new roles. They keep telling me that eventually she will sleep through the night. In the mean time we wake up every three hours to feed her. Well, Jenn wakes up, I kind of grunt and roll over so the light doesn't get in my eyes. Hey, I'm just kidding. We both get up. Don't tell her parents.

Grace continues to grow at an amazing rate. Keep in mind she was less than five pounds at birth and 4lbs, 12oz when we left the hospital. A week after her birth she was at 5 pounds even and last week she was at 5lbs, 10oz. I'll throw out a guess that she'll be at around 6 1/2lbs at her official due date on October 16th which isn't too bad.

I joke about the bionic woman but she is doing things that she shouldn't be doing yet. I seriously think it was the steroids that Jenn was on for 16 weeks. She lifts her head and turns it to the other side, pushes off with her legs and tries to roll over. It's actually kind of freaky knowing how newborns are supposed to be. It is a little surprising when she lifts her head and tries looking around. She is so small I worry that she will hurt herself (no, I don't think her head is going to fall off). I think these unusual phenomenon will pass in time.

Well, I've gotten myself in enough trouble for now. Next time Jenn willl proof the blog before I post it.

Baby Grace is Home!!!

This is Doctor Catanzarite He is the brilliant doctor who saved baby Grace. He diagnosed Grace with her heart condition immediately and spared no effort to see her born healthy. He was a blessing from God. By the way, two of our doctors have both an M.D. and a Ph.D. They even impressed me! Truly in the presence of two brilliantly gifted men.

Fashion Shots


We are on our way!

Home Sweet Home - This beautiful crib is on loan from a good friend. His dad made it for him when he was an infant. It is a functional work of art.


Grace is home and Jenn is doing well. Her mom is here for the week helping out and trying to keep Jenn from doing too much (good luck!). We have our regular pediatric appointment on Wednesday and are planning on seeing the heart doctor next Monday. He will give us a monitor to put on Grace for 24 hours to see how her heart is doing. From there we will determine how often we need to see him. Right now it will probably be two weeks after that, then a month, then every few months unless any issues come up.

She is so beautiful and so tiny but perfect in every way. Here is one picture that may give you an idea of how tiny she really is.


Words cannot express enough how much we appreciate your love and interest in our lives. We know that we are here, and more importantly that Grace is here, because of your prayers to an Almighty Father. At the end of the day we named our daughter Grace because we knew that only the grace of God would allow us to see this day.

If I have a really good shot I will post a picture on this site. Also, I will give you updates if there are any changes in Grace's condition. I will also use this site from time to time to share any ramblings I have on life especially now that my life is irrevocably altered. Check back in a few days, now that the blogger bug has gotten me I don't think I'll stay away too long. Thanks and I love you.

Feel free to right click and save any pictures you want. I would be honored.

Sincerely,

Dave, Jenn and now, Baby Grace

Soli Deo Gloria (To God Alone by the Glory!)

Baby Grace Pictures

Mother and Child


Daddy and Daughter




Close-up


We have recieved news that Grace can go home tomorrow (Sunday)!!! However, since Jenn will not be released until Monday Grace will be brought up to her room for the night. What an amazing answer to prayer Grace continues to be! Thank you for all your love and prayer. God's Grace has sustained us throughout this time.

With Love and Prayers,

David and Jennifer

Soli Deo Gloria

Grace Report

Grace continues to do well in the NICU and she is off the heat lamp and they have taken her off of some of the more intensive monitoring that they often do with babies who are premature and have medical problems.

It is amazing that the body can adjust for a long time to a low heart rate and complete heart blockage. Her oxygen level continues to be at or close to 100%, she is eating well and has good color. She has a slight rash but it does not seem to be associated with the Sjogren's or the neonatal lupus (which is a skin rash we will be looking for because it is also associated with Sjogren's antibody.). It is just plain-old newborn baby rash.

We don't know for sure when Grace will be able to come home. It could be as early as this Sunday or it may be a week or two. What it is most dependent on right now is not the heart condition which is doing fine, but on how well she eats and her general overall health.

Dave

SDG

Good Night Grace Rose Monreal

Dear Grace Rose Monreal,

For the first time I set my eyes on you today. My heart flooded with emotions I didn’t even know I had. How could someone I have never met before fill my heart with so much love and joy? Only seconds after you were born I heard you cry for the first time. As I held your mother’s hand tears of joy began streaming down my face as well.

We were prepared for anything medically, and spiritually our hearts rested firmly upon our Sovereign God. The night before you were born, your mother and I prayed for you and committed you to the Lord. This morning as we prepared to go to the delivery room we listened to worship songs and again prayed to entrust you to the hand of our Loving Father.

After you were born, they quickly rushed you to another table to examine you. We barely had time to catch your birth on video (yeah, we took video). The doctors and nurses gathered around you anticipating that you might have some medical trauma but thankfully you disappointed them. I was anxiously holding my breath but you just kept squirming and crying like a newborn baby does. Your mom got to hold you for the first time before they whisked you away to NICU (Natal Intensive Care Unit).

The rest of the day has been like a dream, the best dream I have ever had. I couldn’t take my eyes off of you. It reminded me of when I met your mom. I just kept looking in awe at the beauty of God’s creation. They took you down to intensive care but you just breezed through it. They poked and prodded but you just rolled your eyes and went back to sleep. A stream of family and friends came by and you blessed them just by being you.

You truly are amazing Grace. You amazed the nurse by eating the first time your mom tried to feed you then you proved everything else was working fine too. Tonight when I held you in my arms I didn’t want to let you go, not now, not ever. I talked to you, introduced myself to you and told you about myself. I asked you not to watch too much television and please don't get annoyed when I try to tell you what I think.

Some day you are going to be a woman with a mind of your own. I will walk you down the aisle and place your hand into the hand of your husband to be. Someday I’ll be there when you are having your first child. But for now, tonight, you are daddy’s little girl. Goodnight Miss Grace Rose Monreal.

Love,

Daddy

Grace has arrived!

God is good all the time. This photo is a demonstration of God's grace and goodness in our lives. With literally thousands of people praying around the world for our baby Grace, she has lived up to her name. The heart doctor was just in and said that things could not be better and that Grace can go home as soon as the perinatal doctor gives her the okay. As far as her heart goes we will have regular check-ups and eventually will need a pacemaker but not today!

Jenn is resting and she is doing well. Grace ate for the first time like a champ then immediately demonstrated that the other end also was in working order. She had her first bath and mother and daughter are resting comfortably.

I will post more pictures soon.

It's a go for Thursday!!!

Dear Friends,

We have final confirmation that Grace will be born sometime shortly after 9:00 AM tomorrow morning. The next post I send will give you an update on how the C-Section has gone and if Grace needs a pacemaker immediately. The doctor is optimistic that she won't but we will wait to see at the time. Please keep us in your prayers. Thanks for your love and support.

Sincerely,

Dave

Soli Deo Gloria

Grace May be Delivered Tomorrow

The doctor was in this morning for an ultrasound and things are looking good. Grace is at 5 and a half pounds and her lung development seems good. Her movement is a little below normal but that is most likely a small side effect of the Lovanox that Jenn is on. After considering the entire situation the doctor decided to do an amnio (checking the amniotic fluid) and visually it looks like Grace's lungs are developed enough for her to be delivered.

We are waiting for the lab results to confirm what he has seen visually. If everything comes back fine (which he assumes it will) we will be delivering Grace tomorrow morning at 9:00 AM (Pacific Time which is noon on the East Coast and 11:00 AM in the Midwest). I will keep you informed as to what is happening moment by moment and I will have my digital camera and a video camera. I will post pictures once she is here. Sorry for being a slacker so far about that for those of you who have commented about that (you know who you are).

Look here for the latest information as it becomes available.

Jenn and Baby Grace - September 8

Dear Friends,

Our doctor has seen Jenn again and taken another ultrasound. The levels are up to an acceptable level being around 7.1cc which is the good news. However, the doctor thinks that they have increased due in large measure to the IV that Jenn is on in the hospital. That being the case it seems that he is prepared to keep her there until the baby is born next month. He has been vague as to the specific plan of action or if there is any possibility of her coming home anytime in the next month.

Jenn asked him why the fluid level has dropped like this and he seems to think that it is because of Jenn's other medical condition having Lupus anticoagulant which has the tendency to cause low fluid levels during pregnancy. Also, because the heart rate is slow Grace is not urinating as frequently as she would otherwise. Jenn is taking the situation well all things consider and we realize that this is a small sacrifice to pay when we consider the long-term health of our baby.

For my part I try to be with her in the hospital as much as possible realizing that my first responsibility and first ministry is to my family. Fortunately she is in such wonderful hands that when I cannot be there I know that she is being cared for by the best medical staff possible. She is doing great otherwise other than being bored and getting sick of lying down or sitting on a chair with an IV in her arm.

If you have any questions feel free to email me at GodFollower1983@cox.net and I will try to answer anything that you want to know.

Soli Deo Gloria

Back in the hospital for now - Continued

The doctor came back this afternoon to retest the fluid. Once again it was at 5.5cc which is what it was yesterday. A night of IV and fluids has not brought it up substantially. Jenn will be in the hospital tonight and will be evaluated again tomorrow. In addition to the fluid being low in the measurements it is visibly low when they are looking for pockets of fluid to measure.

Tomorrow we will have two significant tests. First, we will have the ultrasound to see if the regiment of fluids and IV are working. In addition to that we will have the echocardiogram if the doctors are able to come over from the other part of the hospital. We were told today that we would not be able to travel over there for the test. It will be disappointing not to be able to find out how her heart is doing since it has been a month since the last test. We have another one scheduled next week as a backup.

We appreciate your love and prayers very much. Please feel free to send words of encouragement as well. Jenn and I both appreciate them very much. Things are not always easy but God is always good. We know that His hand is in this situation and is on our lives as well as on Grace's life. We don't know why we are going through this or what He has in store but we know that ultimately it will redound to his glory.

Soli Deo Gloria

Back in the hospital for now

Yesterday when Jenn went in to the morning appointment the fluid level was again low. The reading was at a 5cc which is below what is acceptable. It would be great to have it around 9-11cc. They have her on an IV and are continuing to have her drink three liters of water and a liter of Gatorade. Our primary physician is on vacation but should return tomorrow. We also have a heart checkup tomorrow which will also give us further information on what is happening with Grace's heart.

I will write again this evening and let you know what the fluid level is today and if Jenn will be coming home.

Soli Deo Gloria

Baby Grace Update - A quiet week so far

Dear Friends,

So far it has been a quiet week which I have no complaints about. Jenn and I have been going to the doctor every day and the fluid level has been hovering around the 8 cc range which is permissible. Obviously we would like it to be around 11 cc but we will take what we can get. One good turn of events is that Jenn can go to the triage at Mary Birch Hospital at 9:00 AM on Saturday and Sunday rather than 10:00 AM which means she might be able to be back for church on Sundays.

Additionally I had my physical today and they confirmed that yes, I am still alive. Actually things went really well there. My cholesterol was under 175 with the good cholesterol at almost 50. My blood pressure was 110 over 70 and my BMI was at 23. His advice was too keep working out and don't get fat.

Next month is going to be busy for us. We are going to soon be closing on the property, resurfacing the parking lot, putting new shingles on the roof and having a baby. Since I don't have enough to do I am continuing to take Spanish classes at the community college. I'd hate to see what I would score on a stress test! Well, no use complaining.

Continue to pray for us in the weeks ahead. I will keep you posted as things progress. In the mean time we continue to rest in the goodness of the Lord.

Baby Grace Update - We're Home for Now!

Dear friends,

After an emotionally draining day and a half (it seems like a lot longer) the doctor released Jenn from the hospital shortly after 2:00 PM today. We had another ultrasound that was at 8cc's which agrees with the one that our doctor took yesterday afternoon. This confirms that Grace Rose is not in crisis at the present time.

One other instruction we have is that from now on for the duration of the pregnancy we are going to have an ultrasound every day. This is much better than in patient bed-rest so I am not going to complain. The one drawback is that the doctor wants Jenn to go to the Triage at Mary Birch Hospital at 10:00 AM on the weekends. Yes, Saturday and Sunday. I won't be able to always go with her but even the doctor commented that if you can't be with her what better place to be than at church praying for her. How true.

Thank you so much for your love, encouragements and comments. This has been an emotional time for us but we treasure the love the body of Christ has demonstrated both near and far on our behalf. We have literally had people praying for us around the world day and night.

God's grace is both amazing and sustaining. There have been times where it feels like the weight of the world is on our shoulders then we see a glimmer of God's grace and we are reminded that He is sovereign in His power and He is an All-Sufficient God who is able to meet our every need. Many times it has been through the words and expressions of His people, the church.

Soli Deo Gloria

The Roller Coaster Ride Continues - Baby Grace Update

The Roller Coaster Continues!

Jenn is staying in the hospital for the time being but there is good news! She was admitted to the hospital after our visit this morning to the doctor's office. About two hours after we got there our regular perinatal doctor, Dr. Catanzarite came in to see us. He was the doctor on call today which was a blessing and a comfort. He is also the resident expert on ultrasounds being both the head of the perinatal office but also teaching classes as well.

We were told we would not have an ultrasound again until tomorrow but he rolled in one of the state of the art machines immediately after he found out we had come in. He did this while being paged to do a C-section. From his measurements the fluid level was up to a safe level being at over 8 while only measuring three pockets of fluid. Had he done a fourth it would have been at least a nine or ten. Minimum acceptable level is 6-11 so we are safely in this zone.

So why are they keeping Jenn for a day or two or three? That's a good question for which I do not have a clear answer. I do know that our doctor wants to play it extremely safe and will take no chances whatsoever. I am sure he will want to make sure that the levels stay up overnight and decide what course of action to take tomorrow. When we went in he was preparing to do a C-section and had already called the cardiac specialists to be on hand if Grace immediately needed a pacemaker.

When we talked with him today it sounded like she would be in there for a couple more days and then we would decide from there. He even hinted that she could stay in there for the duration of the pregnancy if necessary! Yikes! That could be up to eight weeks but we will do whatever we have to in order for Grace to go to full term and be born in good health.

Thank you for your love, prayers and emails. I read each one and it means more than I can express in words to know how much love and support we have.

Baby Grace Update - August 24 (Hospital Visit)

Just when we thought things were getting back to "normal"... We went in this morning for our regular appointment. We were supposed to start going every day starting this Monday but things had been looking so good the doctor decided to stay on only three times a week for an ultrasound.

One of the critical areas they have been looking at has been the level of the amniotic fluid. It is supposed to be above 11cc in an ideal situation. They are cautious if it drops between 5 and 11. One of the reasons we have been going three times a week is that the fluid level was visibly low even though our readings have been in the 8-11 range. Anything below 5 is dangerous and requires constant observation.

Today our reading was below 5. As I write this Jenn is packing up some clothes for an unplanned hospital stay. They will put her on complete bed rest for the next three days or so in hopes of raising up the fluid level. If the level does not go up they will keep her in the hospital on bed rest for the duration of the pregnancy. Right now we are at 32+ weeks. A normal pregnancy is 40 weeks and the plan was to have a C-section at around 38 weeks. It is possible that they would do it earlier than that if the baby's life were in danger.

Feel free to drop me an email or leave a note in response to this posting. All the prayers and words of encouragement are greatly appreciated and taken to heart.

Baby Grace Update - August 19

Yeah, another update just two days later. If you didn't read that one go ahead and read it first.

For the last few days Jenn has been experiencing some cramping and other pains due to the pregnancy. She had been continuing to work full time throughout the pregnancy other than a few weeks off following the diagnosis of Grace's heart condition. We decided to go to the doctor again yesterday to check out the pains to make sure it isn't anything more serious. After three hours in the hospital they said things were fine and we could return home.

Today was our normal checkup. We are going every Monday-Wednesday-Friday. Starting next week we were supposed to start going every day. However, things are so stable he said to keep the three a week unless something changes. However, with the addition of the cramping he decided to play it safe and put Jenn on medical leave from her job beginning immediately.

The doctor says we will plan on a C-section at 38 weeks but then added that he will be surprised if we can hold out that long (a normal pregnancy is 40 weeks). In his eyes if we make it to 38 weeks he will be ecstatic. He is not convinced we will make it that long. In fact, he wouldn't be surprised if Grace came at any time from now until then. So far so good however. Keep on praying and trusting the Lord.