Happy Birthday Ezra!

Around 1 am Saturday night there was some indication that Nicole was possibly going into pre-term labor.  Although we thought we might just be being overly cautious going in early Sunday morning we were met with the surprise that Nicole was already 5 cm dilated and therefore we had no choice but to deliver Sunday morning as soon as possible so the baby didn't start descending any more. Our beautiful baby boy, Ezra Keller Wilde, was delivered by c-section at 10:23am at 34 weeks, 6 days old.  He weighed 7lb 7.2 oz but a lot of that is because one kidney is 10cm in diameter and the other was around 8cm.  If he had a normal abdomen he would have weighed more like 4.5 lbs. Even with the abnormal abdomen he is still so perfect in our eyes.  Dr. Moore came in to supervise and called all the team members he wanted to come in as well.  We can't thank him enough for giving Nicole and baby Ezra the best care possible. We also can't thank Rachel and David enough for helping us out- from getting the call at 4:15am asking if Rachel would come over and watch the kids for the day to David going and getting Nicole's parents from the airport and waiting for them in the hospital.  Our amazing neighbor Abby also helped out with the kids yesterday and all of the texts and prayers we received were so encouraging in helping us get through the day.  It was also very nice and comforting to see Nicole's parents walk through the door early that evening (which is another story within itself regarding the plane tickets).

Ezra let out a squawk when he was born which was encouraging although we knew we had a long ways to go.  They immediately took him to another room where the resuscitation bay was and had his team lined up and ready to start working on him.  He tolerated CPAP for a small amount of time but because he also was struggling with pulmonary hypertension (high blood pressure in the lungs) they decided the oscillator (a ventilator that gently vibrates the lungs open and closed) was needed along with some nitric oxide which dilates the pulmonary arteries to decrease that resistance. They said it took them a few tries to get him intubated because he was crying...we hope he continues to keep his spunkiness to put up a good fight :). Although we thought we had a great plan of decreasing the abdomen fluid prior to delivery, when they did the u/s prior to delivery Ezra was turned in such a way in the womb that we couldn't get to his abdomen without going through one of Nicole's big uterine arteries and also to our surprise there was no ascites (fluid) there to drain anymore.  We don't know why this happened and we all looked at at each other in shock but we don't have any doubt in our mind that doing the procedure just  wasn't suppose to happen.  When they went to resuscitate him they also found that his belly was not taught like they thought it would be therefore they didn't drain any of the fluid.  From that point on his anatomy seemed to stump our nephrologist and urologist as far as where and what was bladder and what was kidney, cysts, etc. and what exactly we were dealing with so they went back and forth on many ideas of what was going on.  They tried to place a urinary catheter in but there is a clear blockage and they were not able to pass it into the bladder.  That blockage is what we believe has caused all of this to start with.  There is a valve there that didn't develop right when Ezra was 4-6 weeks old and therefore blocked the urine from going out appropiately which then backed pressure up into the kidneys.  Our urologist tried to place a suprapubic catheter in what they thought was the bladder but it may have been a different pocket of fluid and only put out 4 drops. It then became displaced today so they took it out all together today.  Today the picture was a little more clear on ultrasound and we have a tentative plan.  The left kidney looks to be multi cystic so we won't be doing anything with that one.  We are hoping and praying that the right kidney may possibly put out some urine if we get a drain in it.  However, we are unable to transfer right now to the children's hospital due to instability where they would need to do this and other procedures that are needed.  The bladder wall is pretty thickened and looks as it hasn't been used for awhile and we aren't sure where that will lead us yet.  The bigger issue is that Ezra's abdominal muscles don't appear real developed and may limit us to whether we will be able to do peritoneal dialysis which is troublesome and will put us in a big dilemma.

Ezra had a good night last night. They placed a chest tube to drain some air out around the lungs which so far has been working successfully. He is very sick but was stable throughout the night and able to be weaned some from the oscillator settings. They did an u/s of his bladder, his heart, and his head today and placed a PICC (Peripherally inserted center catheter).  Following all of these he started to require more oxygen and blood pressure medication.  We are praying that he can stabilize out now after the procedures because we don't have much room to give him any more fluids.  Since he is not draining any fluids out by pee we are limited on how much we can put in him. He is also requiring us to paralyze and sedate him.  They told us these hours would be crucial on how things go so we are just praying and celebrating every hour.

We know that God loves Ezra so much and has this in his hands. We thank him for each hour we still have him here with us.  We are amazed and humbled by all of the prayers and kindness that has been poured out to us during this time.  We have a lot to pray for yet a lot to be thankful for and for that we rejoice. Nicole was able to have a normal c-section for the most part and Ezra's feet were disformed initially due to being squished in the womb but have since straightened out and he doesn't have club feet. We have went from being told that Ezra would be a stillbirth at full term due to no lung function to not knowing if we would even make it to 30 weeks before delivering.  God has a plan and we are trying to hold on tight for the ride even though it's not always easy to do and we get bumped off track every once in awhile wanting to take the wheel.

With love,
Jeff & Nicole  

* A little bit of history behind Ezra's name...Mikayla's middle name is after Nicole and Malachi's middle name is after Jeff's middle name.  We wanted this baby's name to be after both sides of our family- the Kellers and Wildes.  We couldn't thank them enough for all the support they have given us, especially during difficult times like this, and this was a small tribute for that.

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