Medical bills and therapy

Our world completely changed early in the morning on October 1st. I'll do my best to explain everything that happened that morning, but first I want to apologize if this is the first time you are hearing our story, and you know our family on a personal level. Our two older children just got to meet their brother for the very first time yesterday, and it didn't feel right to tell the story until that happened.

Let's start from the beginning, a very good place to start. At 01:05 on Saturday morning, I got a text from Nikki that she was having contractions. I had just gotten off work(half shift), and we talked the entire way home. Her contractions were light, but steady every 5-6 minutes. I called my mom to come stay with our kids. From 2am to 3am her contractions lessened in intensity, and then completely stopped. We found out later that this saved Nikki's life. We did all the normal things a family would do on that Saturday. Graeme had a soccer game, we went to a fall festival at our church,

watched some college football, and went to a friend's house for dinner. Thankfully, Graeme spent the night at that friend's house, so it was just Nikki, our daughter, Kyle, and me, at our house that night. We were now approaching 20 hours without any contractions. I fell asleep about 23:30, and woke up less than an hour later to Nikki screaming in pain. I had no idea what was going on. Nikki is so tough, I knew something was wrong, though. As she cried out from the pain, I knew something wasnt right, but I had no idea just how serious it was. I called our good friends to see if we could drop off Kyle on our way to the hospital. Luckily, they didn't answer, and I told Kyle that she was going to come with us to the hospital. I told her Nana would pick her up from the hospital, and that things were going to be scary, and that there would be a lot of people trying to help mommy, and that I needed her to be brave. "OK, daddy", she said.

Nikki was somehow able to get to the car in between intense contractions, that she described as stabbing pain, different from regular squeezing contractions. I drove as fast I could, running red lights after seeing no one else was at the intersection, all the while thinking that I might have to deliver this baby on the side of the road. I had no idea that my wife and baby were currently fighting for their lives. When we got to the hospital, she was in the middle of a contraction. She said she couldn't move. I waited the agonizing ten more seconds for it to pass, and then got her out of the car, and into a wheelchair. The nurse in triage shouted "close your legs and dont push!" As they started to take her back Nikki yelled out "Mark, don't leave me!" I had to let her go, though. I reassured KyKy that they were going to help mommy, but I didn't how serious it really was. Next, began the worst night of my life, as I waited for updates from strangers about the person I love more than anyone else in this world.

My mom arrived at the hospital shortly after they took Nikki back in order to take Kyle home. I sat in the waiting room, unable to go back, and unable to be with Nikki. The nurse walked out a little later with a solemn look on her face. "Your wife is stable, but her uterus ruptured, and things don't look good for the baby. When he was delivered he wasn't breathing on his own, so we intubated him, and are going to start a cooling therapy that can slow or reverse some of the brain damage that occurred from the lack of oxygen."

I started crying as soon as I heard "uterus ruptured", and that pain only increased as she told me about my son. They took me back to the room Nikki would eventually be in, room 7, God's number, and so began the long wait to see my wife and son.

My Dad arrived shortly after. He held me while I sobbed in his arms. We sat down and prayed for Nikki and Brooks. We sat in silence. I called Nikki's parents. I anxiously paced the room. I've never been so scared as I was that night.

The OB doctor that was working that night came in a little later. She told me that "Nikki was stable, but that the rupture was so intense it ripped the placenta away from the lining of the uterus, and caused the bladder and uterus to completely separate." She then proceeded to tell me a little more about the time frame, and how quickly they worked to save Nikki and Brooks. She said upon exam, that Brooks's heart rate was in the 60s(dangerously low for a baby) and that upon palpation, her uterus felt extremely rigid. According to the OB, Nikki let out a horrific scream when they got her on the exam table. Nikki would later tell me that everyone was yelling at her to get up on the table, but that she was frozen in pain. We believe that when she forced herself to get up is the time when full rupture occurred. I'm so glad I didn't drag her out of the car as soon as we got to the ED. If full rupture had happened at that point, Nikki might be here, but our baby would not. Here is the unbelievable timeline of events.

When the OB opened up Nikki, she said it "looked like a bomb went off inside her abdomen, and that as soon as she made the first cut, the baby was there, outside of the uterus, inside the abdominal wall! During initial exam, what she thought was the uterus, was actually Brooks's head!"

The OB told me that they were working feverishly on Brooks, but that he was blue and lifeless when she pulled him out. I distinctly remember crying out and repeatedly smacking the faux leather fabric of the hospital chair as my Dad squeezed me tight. This was the second confirmation that things did not bode well for my boy. The OB told me that he had a heart rate upon delivery, and that they started cold therapy, but that he wasn't moving, and had sustained serious brain damage. In essence, he was alive, but he was brain dead. I told the OB that I was a nurse, and knew that even a few minutes without oxygen could be devastating. As fast as they worked, if full rupture happened at 00:47, 13 minutes without oxygen would certainly be catastrophic. "It's not going to be a good outcome for him, is it?", I asked. "No, I'm afraid it's not. We don't know how long he was without oxygen, but it was significant", she replied. She told me that they never had to do compressions, a tiny blip of good news amongst tragedy. His heart rate was in the 30s when they delivered him, but quickly jumped to the 70s. Their threshold for chest compressions is under 70 bpm.

Before she left, I said "Can I ask you a question? I don't understand how he had a heart rate if the placenta was completely detached." She replied, "I don't know....God....a miracle....I'm really not sure." We will never know exactly how long he was without oxygen. My best guess is 3-5 minutes, but I fully believe God kept that little heart beating, circulating that blood, even if it wasn't fully oxygenated.

For the next hour and a half, I paced and prayed, trying to figure out how I was going to find the words to tell Nikki that her baby was brain dead. I could get about five to ten words formulated, and then I'd start over. It just never felt right. How do you have that conversation?

Because Nikki's bladder separated from her uterus we had to wait for a urologist to come in and evaluate her. So, as my wife laid on the table, unable to be stitched up until urology arrived, I tried to figure out how I was going to tell her the worst news of our lives.

Nikki's primary OB arrived during this time. Her and the OB on call agreed that Nikki's uterus was in good enough shape to be repaired, instead of removed. Her OB told me she's seen five uterine ruptures in the 17 years she's been in practice. In other words, every 3.5 years, she sees one. She told me that there's a chance for survival when they happen in the hospital, but that even those aren't usually as violent as Nikki's was. "The fact that this rupture started at home, and didn't end catastrophically is a miracle", she said. To further explain just how serious this was, her OB has personally called her just to check on her, days and now weeks after the fact.

Praise be to God for the miracles that saved Nikki's life:

Still searching for the words to tell my wife the worst news ever when she woke up, I pondered aloud why we were doing so much for a baby that was brain dead. "At what point do we stop doing all of these things, and let Nikki hold her baby while she says goodbye?" "That might be a conversation that needs to happen" my Dad said, "but we aren't there yet."

The NICU doctor eventually came in, and told me that Brooks was moving!

"What?!?!", I exclaimed. "How is that possible?"

She told me that the cold therapy was working, and that he was starting to move around and make regular baby movements. The cold therapy gives the brain time to rest from the trauma it just endured, and is effective if started within 6 hours of HIE (hypoxic ischemic encephalopathy.)

They started therapy on Brooks within 30 minutes.

Needing a higher level of care, they reached out to WakeMed Raleigh-no NICU beds, then Duke-no NICU beds, then UNC-one NICU bed. As many of you know, UNC is where I work, and we were more than happy to be headed there. I can't say enough about the care we all received while there. To be able to decompress with my work family, be with my wife, and be with my son all in the same place was such a blessing.

Brooks had a fighting chance, but a long road ahead for sure. There was a chance for full recovery, a chance for mild to severe developmental delays, and a chance for severe handicaps for the rest of his life. All three scenarios seemed just as likely according to his doctors and nurses. They hooked him up to continual EEG monitoring, and told us he would be cold for 72 hours. As the brain begins to wake up and synapses fire, seizures are very common.

On Monday afternoon, I drove up to the hospital with my father-in-law, and my older kids Graeme, and Kyle. We were planning on surprising Nikki with a visit from G and K. As I got out of the car, my father-in-law got a call from my mother-in-law, "Mark, you have to go to Brooks now!", he shouted. I took off running towards my son, numb from all the heartache and hope of the last 36 hours.

My mother-in-law, who had spent the night with Nikki, was visiting Brooks when he had a massive seizure(uncomformed officially, but neurologists described it as "rhythmic brain wave activity".) His heart rate dropped to the 30s, his O2 saturation dropped to 19%, but they never had to do chest compressions. When I arrived they were bagging him(giving him full mechanical oxygen support.) Brooks's medical team was actually giving Nikki bedside report and great news about him when the seizure happened. Their first notice that something had happened to Brooks was Nikki's mom calling repeatedly until Nikki picked up.

They started him on seizure medication. During the 72 hours of cold, Brooks would vary between his oxygen support needs. After being extubated, he never had to be reintubated(even after the seizure), but he did toggle back and forth between CPAP and hi-flow nasal cannula. All of this took a tremendous toll emotionally on Nikki and me.

After the 72 hours of cooling, they began the warming process. It's common to have more seizure-like activity as the body warms up, and the brain synapses begin to fire more frequently.

This wasn't the case for Brooks. So far, he hasn't had any additional seizure activity that we know of. He had an MRI early Sunday morning that came back "unremarkable". We've never been so happy to hear those words. Every one that has cared for Brooks has talked about how quickly he has recovered from such a traumatic event. He smashed every goal that they set for him in order to be discharged. Speaking of discharge, Nikki left the hospital after spending just three nights, a typical stay after a normal c-section. The doctors called her an inspiration, and lauded her resolve to heal and go home.

As of now, it appears that Brooks will make a full recovery. Some developmental delays, if any, might not show themselves for years to come, but the doctors expect him to lead a normal, healthy life.

Nikki and I praised God at 04:00 in the morning on Wednesday. 72 hours from the onset of cold therapy, and 2.5 hours into warming, where seizures are most common. We cried and prayed, begging God that he would not have any more setbacks. We asked that he continue to heal "as long, and as slow as it might take, just please let him keep improving. We can't handle the two steps forward, one step back anymore", I prayed.

Ever since that prayer, he has continually improved, slowly weaning off of his oxygen demands. He hasnt needed any O2 support for over 2 days now. Brooks is such a fighter, just like his mom. They will forever be my heroes.

Lamentations 3: 22-24: The steadfast love of the Lord never ceases. His mercies never come to an end. They are new every morning. Great is thy faithfulness. The Lord is my portion says me soul. Therefore I will hope in him.

We still have a long road ahead. So many of you have asked how you can help. Even with good insurance, we will reach our out-of-pocket maxes for Nikki and Brooks. The entire family will be pursuing therapy, both together and individually to process everything. Both Graeme, 7 and Kyle, almost 5, know that Brooks almost died. It's amazing how perceptive and in tune they both are, even at their young ages. Kyle had to see her mom scream out in pain while we rushed her to the hospital. Just the other night, as we she was getting ready for bed, she asked Nikki about that night. They don't know that Nikki almost died too, and we would like to keep it that way for awhile.

Understandably, she lost it when she got in the car with Nana, and again when they got home. The financial strain on us, even with good insurance, will easily be in excess of $10,000. If you can help us, we would appreciate it. It isn't lost on us, however, that we are beyond fortunate to have good jobs, and a cornucopia of friends and family that support us in so many ways. If you are able to donate, thank you. If you can't donate, please share our story. At the very least, please pray for our family and our ongoing healing.

We know that we have had a miraculous outcome that some people don't get to experience. Our hearts go out to those that have lost loved ones, especially children. We don't know what God's plan is for Brooks, but we will tell his story, and praise our God for the rest of our lives.

We are so thankful for modern medicine and the expertise of the doctors, nurses, respiratory therapists, and ICU transport teams that saved his life.

Amongst all of that, I believe that it is impossible to read our story, and not see the powerful hand of God at work in our lives. I hope our story inspires you to reconnect with God. We will praise Him forever.

Zephaniah 3: 17: The Lord your God is with you, the mighty warrior who saves.