Okay, here are a few pictures of the Subaru Crash

This is a picture of where I slid off the road.  As you can tell by the tire tracks I was spinning out of control at the time that I launched the Subaru.

These two pictures is where I launched the car into the culvert.  The best I can gauge it was about 10 or 12 feet in the air while still spinning and landing about 6-8 feet down.

The last two are top views from the road level which shows how far down the car flew and where it landed.

I thought for sure the car was totaled.  It took two and a half hours and two four-wheel drive tow trucks to get the car out.  But after cleaning it off it was only the front left tire and suspension that were broken and some of the trimming in the front and side.  Honestly this car is built to last!

As I reviewed the accident I realize how much worse it could have been.  If I had lost control a few seconds earlier I would have hit the cement beams holding up the overpass I had just crossed under.  If I had been just a foot or two over my underside of the car would have caught on the cement lip on the culvert and it would have been a much different type of accident.  God's hand of protection was clearly on me while I was spinning out of control.

Sophia is home and we are one happy family!

Thanks you for all of your prayers.  More pictures will be posted soon.

Love,

Daddy

Sophia Elisabeth Monreal Pictures

Here's the official birth information:

Sophia Elisabeth Monreal
Born at 7:44 AM on November 2, 2009 at MeritCare Hospital in Fargo, ND
Birth Weight: 5 lbs. 9 ozs.
Length: 16 3/4 inches

Mom and baby are doing great!  She is out of the incubator and into a crib for the evening.

If thing continue to go well she be brought into the room with Jennifer tonight for the night!

It is possible that she can go home at 35 weeks which will be on Thursday!

Please continue to pray for health for both mother and child.

Sincerely,

David and Jennifer Monreal

Good Night Sophia Elisabeth Monreal

Dear Sophia Elisabeth Monreal,

What a day it has been.  We have been excited and nervous for your arrival for months.  Last night as your mom and I prayed we knew that a journey was ending and a new adventure beginning.  Your name means wisdom and we have asked for God’s wisdom every step of the way.  At so many points along this journey we didn’t know which way to go and the Lord provided the way and made our path straight.

Having you has been quite a journey, and I mean that literally.  We drove thousands of miles over the months for doctor’s appointments and your mom was willing to go through a lot to see you born healthy.  It was also a spiritual journey of trusting our Savior and trusting that He gives wisdom to those who ask in faith.  Watching you be born and hearing the sound of your voice made it all worth it.

We have longed for another child and we have loved you from the moment we knew you were coming.  The moment I saw you for the first time a place in my heart opened up for you and I sensed a new pool of love for you without loosing a drop of love for your brother and sister.

Another little girl in the house! This morning as I held you in my arms I thought of all the joy we will share in life: dances with daddy and walks in the park, going out for ice cream and swinging in my arms, these are the things I look forward to.  I told you all about your big brother and big sister, how much they love you and how happy they are that you’re here.  You’re big brother is all boy so you better watch out!  But big sis will take you under her wing and teach you everything she knows.

We talked all afternoon and I never wanted to put you down.  I kissed your forehead and I kissed your cheek.  I laid you on my chest and watched you fall asleep (I started to fall asleep too!).  These days are so short and one has already passed.  Days will turn into weeks and months and years.  In all those future days, here are two things I always want you to know.  First, I will always love you and nothing will every change that.  Second, it is my greatest desire to see you come to know Jesus as your Savior and walk with Him each day.

I have never missed a day of telling your brother and sister I love them and on this, your birth day, I want you to know how much I love you too.  I will always remember our first, best day we spent together.  You are daddy’s little girl and you will always be my little sweetheart.

Good night Miss Sophia Elisabeth Monreal!

Love,

Daddy

A moment to say thank you.

Dear Friends,

As we continue to be in the midst of a whirlwind of crises and challenges I think it is only right and fitting to express my thanksgiving to our Lord and Savior for His sustaining grace and the depth of love He has shown through so many. As we have gone through these last several months (and honestly continue to go through them), the Lord has provided many people who have loved us, cared for us and met practical needs. Beyond that, we have known that a great many people have prayed for us fervently and faithfully and we know that we have been sustained by God's grace in answer to many prayers. So I want to thank the Lord and also thank each of you who have read these blogs and specifically prayed for me and my dear family.

Although this in no way diminishes anyone's acts of service, I would like to take a moment to specifically thank one person whom God used to minister to me personally. He is a personal friend who also served as one of our summer interns at the church. His name is Cody Wilde. Cody is finished up his undergraduate degrees in Minneapolis and said he would stop by while I was in town for Grace's pacemaker surgery.

With Jennifer in the hospital in Fargo on bed rest with our third pregnancy and no one able to travel with me I knew that there would be a deep sense of "aloneness" while anticipating the surgery and waiting for it to be completed at Children's Hospital. On one level I knew it wasn't a major surgery but emotionally it was difficult having had so many things go wrong the last time and a two day stay at Children's Hospital in San Diego turned into almost two weeks in the neonatal intensive care.

Cody stopped over the evening before the surgery and hung out in the hotel with me keeping me company as Grace was going to bed. He offered to stop by the following morning after Grace was taken back into surgery. After walking with Grace into the surgical room and watching my little girl be put under, Cody was there in the waiting room to hang out with me.

We talked a little bit about the surgery and a host of other topics. When Grace came out of recovery and we were able to go up to the room Cody graciously went with us. He spent the day there just hanging out, talking, and helping like there wasn't anything else in the world that he needed to do. He stayed there until it was time for us to go to bed. In a sense it was nothing but to me his being there was everything. Not through anything he said or did, but just his being there with me was a reminder of God's grace and goodness and in a very real sense God's answer to many prayers for us by you.

The surgery went great and we found out the day before that one of the delicate aspects was not needed after all. But the emotional drain of anticipation and the stark reality of driving your child across the state alone to have surgery was difficult. I was reminded once again of the mystery of ministry to others. Most often it isn't what we say or do that has the most lasting impact, but our willingness to be there, to really be there for another person that makes the difference.

I have many people to thank and I hope to be able to effectively do that over the coming weeks but I didn't want to miss this opportunity to thank one person specifically for making a difference in my life at a very straining time.

Thank you Cody for being there for me.

Your friend,

Dave

Things aren't slowing down yet...baby coming soon!

Dear Friends,

I just pulled in the driveway from Minneapolis after a very successful pacemaker surgery. Miraculously, she did not need the lower lead (wire) changed. For four years technicians complained but it tested perfect in the office on Wednesday and directly on Thursday during the surgery so the procedure itself was very minor. There is a bit of pain and always the possibility of infection but it was a very simple procedure compared to a bit more delicate if they had needed the change.

Okay, baby stuff. Things still look good with Jennifer and Sophia, however, the doctor still wants to deliver early by C-section THIS MONDAY MORNING AT 7:15 AM. Low fluid is the main concern again with the AFI's coming in around 3 or 4 but the biophysical profile and the doppler cord have all been excellent. I don't know exactly what to say about this whole thing but will reserve my judgment until after speaking with the doctor. But, unless things change it looks like Monday morning it is.

Keep this in prayer that the baby is strong, healthy with good lung development.

Sincerely,

Dave

As the world turns...

12 hours later and a totally different situation. They took the biophysical profile again this morning and what was bad yesterday (2 out of 8) was perfect today (8 out of 8). The doctor said that there is no likelihood that we will be having the baby this week.

Of course this means that we will be going ahead with Grace's surgery (or at least that is the plan as of this moment). We want to avoid having her surgery the same week as the c-section which is why we scheduled it for this week rather than waiting a few weeks longer. We never anticipated Jennifer would have to go into the hospital early.

I'll keep you posted if (or when) things change.

Thanks,

Dave

The Very Latest on Jennifer and Baby Sophia

Here’s the latest.

Jennifer is in the hospital with a heart monitor to track the baby’s heartbeat. With low amniotic fluid they want to make sure the baby isn’t in any duress. So far so good with that. The biophysical profile (measurement of the amniotic fluid, small movements and large movements) was not good today. They checked the blood flow in the umbilical cord, which was good so no immediate urgency. However, if things don’t improve most likely they will decide to take the baby early. They will do another biophysical profile in the morning, which will determine the course of action.

This would put Grace’s surgery on hold for a few weeks. Honestly, unless things turned out perfect tomorrow we would put it on hold. It was our hope to have this surgery before the baby arrived but even if things are tentative with Jennifer and the baby I couldn’t risk being away with Grace in Minneapolis having the pacemaker replaced. We have a few months window to work with so we would reschedule sometime in November or early December and just run a test sometime in November to check battery life and function of the pacemaker.

Also, Jennifer’s grandmother is not doing well and doctors indicate that she does not have long to live. She had a stroke a month back and has not shown any signs of recovery or responsiveness. More recently she has had congestion and pneumonia and her heart is failing. She is a believe which brings comfort in the midst of hurting.

Honestly this seems like a lot and it really is. But the one thing that I keep in mind is that problems are moment by moment and we don’t face the full weight of it all at once. We are weak and powerless and I don’t realize that any more than at the moments when there is absolutely nothing that I can do. But God’s grace is sufficient and His power is perfected in our weakness. We are not handling this well, God’s grace is enabling us to handle things well. We are not sufficient in ourselves but we are trusting God and hanging on to Him knowing that He is holding us securely in His strong and gentle hands.

Sincerely,

Dave

Never a dull moment!!!

Dear Friends,

Brief update. Jenn went in to the doctor today for her twice weekly test and things were not as good as they have been. The fluid is again low and there isn't a lot of movement but otherwise the baby looks healthy and there is good blood flow through the umbilical cord. The short of it is monitoring tonight and see how things go. If they don't look good for the baby then they'll decide to deliver. If they stabilize then she'll be in the hospital for a while with bed rest.

Of course this put's Grace's surgery up in the air. We'll see how things go tonight before making a call on going to Minneapolis. If Jennifer is only being monitored then we'll get the surgery done but if there is a chance of delivery this week then the surgery will be put on hold.

More info coming as I find out more!

Sincerely,

Dave

Time for Grace's pacemaker to be replaced

Dear praying friends,

We went to the cardiologist for our semi-annual visit at the beginning of October and already knew that we were in the last 3-6 months before Grace's pacemaker would need to be replaced. The battery life is almost gone so it is time.

We could wait a month or two to get this procedure done but with Jennifer scheduled to have a c-section on November 19th we decided that it would be better to take care of this now before the cold, snowy weather is upon us.

Grace and I will be driving to Minneapolis on October 28th for the pre-op and the surgery will be done the following morning at 8:00 AM. This should be a relatively routine procedure with the one caveat that they will have to replace the lower (ventricular) lead (a "wire" sewn onto the exterior of her heart). Grace's pacemaker is located under her sternum and other than the scar is it not noticeable. This is still the best location to give her complete freedom and mobility without worry.

Later in life they may decide to place it under her pectoral muscle but that would limit repetitive motion with her arm that might cause issues with the wire wearing over time. We want to give her maximum options for her interests and activities. With this location her only concern would be full-contact sports which she would need to avoid. We're not too worried about that anyway.

Please remember us in prayer as we travel and as she undergoes this procedure. She should only be in the hospital for 24 hours if all goes as planned. You can look at the blogs for November 2005 to read about the first time this was done and all the problems we had. Things definitely didn't go well that time but we trust for better situations now.

We should be back in town late on Friday, October 30th.

Continue to pray for Jennifer the baby and our son Alexander as they will not be traveling with Grace and me.

Sincerely,

David Monreal

weekly Update-October 13, 2009

Dear Friends,

No news is great news as far as this blog is concerned. I do want to keep you updated on how things are going but be assured that they are going great at the moment and we continue to pray that they stay the same way.

All of the tests are coming out absolutely ideal at this point in the pregnancy and we have every confidence that if we stay on the present strategy we won't have more issues before delivery. Things are going so well we have scaled back from three visits to the doctor down to two visits per week. For most pregnancies that would be excessive but for us it is a relief and a huge improvement.

We've gone from inpatient hospital bed rest with tests run daily down to home bed rest (which does include sitting on a reclining chair in the living room) with an IV and twice weekly visits to the doctor. At this point the doctor doesn't want to change anything which might risk a relapse with low amniotic fluid or increased risk for heart block. At present both those risks are very low and we want to do everything we can to keep it that way.

We have confidence in God's guiding hand of the doctors and us to find solutions to our issues that have protected our baby and lowered the risk of lifelong issues. We thank you for continuing to pray and to keep up with this blog post. Sorry for not posting last week but like I said, no news is good news.

With Love and gratitude,

David Monreal

Weekly Update-October 2, 2009

Dear Friends,

I want to continue to share the good news regarding our pregnancy and the health of Jennifer and our baby. Jennifer continues to be at home on an IV and complete bed rest. We have gone in twice this week for testing and both times all the indicators are that things are fantastic and progressing well. Jennifer will go again this afternoon for testing and I will post an update if anything changes.

I continue to thank you for your prayers. I know that it is God's grace and strength that have sustained us during this harrowing and trying time. For a time there it looked like we would have a severely premature baby with not the best chances of surviving and thriving. Every week the baby remains inside Jenn's womb is one week closer to a healthy baby and a full-term delivery. The doctors are very pleased with the turn-around and in spite of the unusual positive response of Jennifer to IV fluids they are content to keep doing a strategy that works.

If you have any questions or there is some aspect of the pregnancy, Jenn's health or the baby's health please feel free to drop me a line and I'll answer your question. Just to let you know, any posts on this site will go directly to my email address so I can be contacted through the blog page as well as directly.

With love and thanksgiving,

Dave

Jennifer is coming home!

Dear Friends,

Things continue to go well and we had our appointment with the doctor today. Things looked so good we all agreed it was time for Jennifer to go home and continue the pregnancy at home under home bed rest. The AFI was over 12 today and everything looked absolutely great. How much things have changed over the last few weeks when we thought we might be delivering at 26 weeks!

The insurance company approved a home IV for Jennifer (always subject to review after the fact!). We will still be coming down to Fargo three times a week for the PR interval test for the heart and the Doppler Cord study like we have been doing for several months now.

Please continue to be in prayer that the AFI (Amniotic Fluid Index) stays up. We have about 8 more weeks until the baby is here!

Sincerely,

Dave

Consistent Stability

Dear Friends,

There isn't really too much to report since last time regarding updates to Jennifer and the baby. The AFI has generally been between 8 and 10 cm which is a good number and the PR interval is steady around 117. There doesn't seem to be any major concerns at the moment which is great. They did a growth study and our little girl was tracking at 29 weeks and 2 days weighing in at around 3lb and 7oz! Our intention is to have a c-section around 37 weeks which would put a tentative delivery date of November 19th, a week before Thanksgiving.

Jennifer remains down in Fargo, 70 miles away from our town of Grand Forks. For those of you who haven't read the previous posts, this is because there are two tests that need to be run that cannot be done at the local hospital, the PR interval checking the speed of communication between the upper and lower chambers of the heart and the AFI which is an Amniotic Fluid Index that they want to be above 8cm ideally at this point in the pregnancy. They do a doppler study on the flow of blood in the cord which is something they are not yet trained to do here in Grand Forks also. One other concern, when this all started they feared a very early delivery for which Fargo had the neonatal intensive care facilities that can handle severely premature babies.

At the rate that Sophia is growing we might not need to pull out the premie clothes if we come close to that 37 week goal. We'll keep you posted. We are meeting with the specialist tomorrow to find out if he wants us to keep this strategy up or try something else. We'd love nothing more than for Jennifer to come home but we don't want to risk it if the stakes are too high. We need reasonable assurances that things will continue to remain stable.

Sincerely,

David Monreal

Things Keep Looking Good

I just got today's results from our Amniotic Fluid Index (AFI) and the p-r interval. Both look absolutely great! The AFI was at 10.18 cm and the p-r was steady at 117 on all three tests. This is incredibly good news and gives us a lot of hope and confidence that we will carry the baby to term which is better than it was just a few weeks ago when it looked like we might have to deliver incredibly early.

On a discouraging note, Jennifer's grandmother on her mom's side had a stroke yesterday. She is in the hospital and there is a bit of swelling on the brain, she took a hard fall and broke her nose and as of last night weren't able to fully assess the damage. She is 85 years old and in moderately good health otherwise. Please continue to pray.

I was also saddened to hear yesterday that the younger brother of one of my best friends from high school passed away early this week from an undiagnosed heart condition at age 37. My prayers go out to the family at this time as they grieve and if things were different with our situation I would be out there to share this time with them. Life truly is brief.

Sincerely,

Dave

No news is good news

Dear Friends,

It has been a few days since my last post. First of all, let me say that things are very stable at the moment even though Jennifer is in the hospital and will remain there for the foreseeable future. We might try to get her back home sometime soon but the unborn baby's safety is our first concern. I'll let you know how that progresses as we continue.

We have gone back to three full tests a week, Monday, Wednesday and Friday unless there are problems that develop during one of the tests. Due to the holiday we are doing tests on Tuesday and Friday.

Yesterday's tests results were all great! The p-r interval was between 113-125 (110-140 is normal range), and the Amniotic Fluid Index (AFI) was at 8.14-10cm which is also great. 10 is ideal so we are doing fine.

By the way, I am a teacher at heart so I try to make these blogs both informative and educational (gee, I sound like PBS). So if you want to learn more about what is going on or why they are doing what they are doing please read the earlier posts. Also, to find out all the details about the situation we are facing with Jennifer and baby Sophia or to find out how things worked when this happened with Grace you can click on the 2005 May-November posts.

All the other stuff is just my ramblings about life but it might we worth a read if you're bored. Thanks for thinking about us, checking up and most of all for praying. Without the grace and strength of our Lord Jesus Christ we are week, frail and fearful people.

Sincerely,

Dave

The Latest on Jennifer and Baby Sophia

Dear Friends,

Here’s the latest information about Jennifer and Sophia. We met on Wednesday with the specialist and he understands that our desire is to do whatever works and will be helpful to see the baby come to full term. It was very different from the situation on Monday for which we are both very grateful.

It does not follow the normal pattern that being on an IV should have as dramatic of an impact as it is having. However, there is a possibility that the dexamethasone that Jennifer is taking somehow makes it less effective for her to hydrate orally and it have a direct impact on the amniotic fluid index (AFI). But there is a lot we don’t know about this particular dosing which is higher than for other types of difficulties in pregnancy so perhaps this higher dose has different characteristics than at lower doses.

Her AFI was at 8.7 on Tuesday and 8.5 on Wednesday. Today her AFI was at 8.2 which is still an acceptable reading. Since it seems to have stabilized with the IV we have scaled back taking the AFI every day and will only do it on Mondays, Wednesdays and Fridays along with the p-r interval. That was great on Wednesday and today it was between 113-119, which is perfect.

Another amazing answer to prayer a friend from San Diego is going to fly out here and help us with the kids until Jennifer is released from the hospital or the baby is born. She has cared for her children and grandchildren and is wonderfully qualified to help us. She and Jenn are wonderful friends and our children know her from her time in the church nursery with her. She will be here in just over a week. I cannot even begin to express how blessed we are that she would be willing to minister to our family in this way. (We have warned her the winter is a little more brisk than San Diego.)

What are the possibilities that Jennifer might be able to come home under home bed rest? That is a good question and one that we will be exploring in the next couple weeks. We are hesitant to suggest another strategy which might put the baby at more of a risk especially when we have found a strategy that is working and would allow us to continue to full term (or a few weeks early with a c-section which is most likely).

If things continue to go well we might explore seeing if perhaps Jennifer could hold a good AFI without an IV or we might see if it is possible to have home nursing with an IV. Again, the concern is that we wouldn’t have the same level of care and it is much harder to have true “bed rest” when you are at home which we found out with our first child. Our first priority is doing everything we can to have a healthy full-term baby. It isn’t ultimately about our comfort or convenience if it means sacrificing our baby’s wellbeing.

We appreciate so much your love, prayers and practical support. For those of you from around the country and overseas reading this blog let me brag on the church family here for a few moments. They have organized daily meals for us since Jennifer went into the hospital, a few ladies have come over to clear, others have volunteered to help clean and another gave us gift certificates for several hours of cleaning. Also, they have lined up childcare every day so that I can be free to visit with Jennifer since taking the kids every time is difficult for the kids. I could go on and on sharing how our church family has rallied to our side during this trying time and you can imagine how much this has encouraged and helped us.

I’ll share more in a few days. We won’t be doing more tests until Tuesday so it is unlikely that things will change much between now and then but if they do I will let you know. Otherwise, look for a blog post sometime on Tuesday or Wednesday of next week.

Thank you for your love and prayers,

David Monreal

Good News, More Good News and Hmm?

Good News

First the good news. Everything looks great with the baby. Jennifer went back on an IV on Monday afternoon and the Amniotic Fluid Index (AFI) was 8.7 yesterday and 8.5 today and it also visually looked good as well. It seems that the IV has helped bring the fluid level up and stabilize it like it did with our first pregnancy. In some ways this defies expectation because good hydration only accounts for 10% of the amniotic fluid. However, it seems to have an almost immediate and dramatic effect in bringing the level up.

It looks like we have found a strategy that both helps the baby’s heart develop without heart block as well as deal with the issue of low amniotic fluid.

More Good News

Without much discussion whatsoever the doctor agreed with this strategy and is pleased with the results of what is happening. We had hoped to be transferred to Grand Forks where we live but they are unable to do two of the tests (The Doppler color blood flow study of the umbilical cord and the p-r interval reading). There was also talk of Jenn going down to Sioux Falls, SD to be under the daily care of the perinatologist but we determined that this wasn’t necessary.

Hmm?

It looks like Jennifer is going to stay under hospital bed rest with an IV for the foreseeable future. Our due date is December 10th and it seems like a very real probability that Jennifer will be in there until the baby is born. Most likely we will deliver by C-section around weeks 36-38 which would put us around November 12-26 depending on the size and lung development of the baby. Wait a minute! It is only September 2nd. Exactly! Hmm.

What does that mean for the kids and me? Honestly I haven’t quite figured that out yet. But what is most important is that Jennifer is healthy and the baby is doing well. Everything else is but a momentary hassle. Please keep us in your prayers, especially for the kids who have to deal with the absence of Jennifer here to love and nurture them. Also, pray for me that I can stand in the gap and be extra sensitive to their needs during this short period of time.

Sincerely,

Dave

Medical Update #6 on Jennifer and baby Sophia

Dear Friends,

A bit of good news amidst the confusion. The Amniotic Fluid Index (AFI) was back up today to 8.7 but the doctor is concerned that it is only "artificially inflated." We are still confused as to why having the fluid up through hydration and an IV is worse than doing nothing and having the baby in duress and possible being delivered dangerously early.

What really bothers us is that when we had this situation with our daughter our doctor in San Diego was glad that he could find a strategy that worked and kept the fluid level up even if we weren't able to keep it up without an IV. It seems to me that it is better to have it up even if it is through an IV than having one more negative factor that might adversely affect the baby.

We are meeting the doctor tomorrow and I am hopeful he can explain his rationale and strategy in this pregnancy. Over and over again I have reiterated that we want to take the safest and wisest course of action to ensure the best possible outcome. I am coming to wonder if there are not other factor or considerations that are affecting the recommendations of the doctor other than the well being of Jennifer and the baby.

At present we are happy with the results of taking a cautious approach to the situation but frustrated and confused why the doctors are not excited that the very outcome we'd hoped for is actually happening. I suspect it is going to be an interesting conversation we have with the perinatologist tomorrow. I will keep you posted on how that goes.

Dave

Quick Update on Previous Blog

Dear Friends,

I asserted a little influence and was able to get them to start the IV again. Apparently the perinatologist doesn't want to "artificially" inflate the Amniotic Fluid Index (AFI). On the face of it that is transparently foolish and dangerous. After our insistence the on call doctor agreed to order the IV even though the specialist decided against it.

They will keep the IV going at least until Wednesday when we meet with the perinatologist and come up with a plan of action from there. I'll keep you posted on the AFI's and the situation with the doctors.

Dave