Introducing Joshua Gus Bales!

-Introducing JOSHUA GUS BALES!

-Born on March 1st, 2012 at 7:59 PM.
-Weight: 2 lbs, 5 oz, 1050 grams (yes, he made it out of the "extremely low birth weight category" and into the "very low birth weight category), bigger than the ultrasound estimate of 2.0 lbs. :)  That's in the 7th percentile for age.
-Length: 14.6 inches (37 cm) 17th percentile for age.
-Head Circumference: 25th perecentile for age.
-Gestational age: 30 weeks and 3 days (nearly 10 weeks premature).

What happens when you have the best technology (31 ultrasounds) and the best doctors scratching their heads, deliberating over when will be the best time to deliver a baby via c-section? 
"A CHILD SHALL LEAD THEM!"  (Isaiah 11:6, ok, taken out of context a little)  Joshua had a mind of his own.  He knew when he wanted to come out and see the world, and he wasn't going to let anyone make that decision for him. 

Skipping to the end result, he looks great.  He is healthy, fully formed with all his parts (even a normal nose), and he is able to breathe on his own.  Labor and delivery went so smoothly, and I am so amazed that I did not need a c-section!  Of course we'd prefer a full term, full size baby, but given the whole scenario, and the fact that we were able to hold on for more than six weeks longer than expected, we are ecstatic. Praise the Lord! Thank you all sooooo much for your continued prayers. We couldn't have done this without you! Even people we don't know have been praying for us, and you all mean so much to us!

In case you are wondering where the name came from...we decided on it months ago, not realizing the meaning of the word Joshua: GOD RESCUES. I can't think of a more perfect name for this little fighter. Just think how many times, and how many ways, God has rescued him over the past months. We have always liked the Biblical story of Joshua, a man of faith and a strong leader, and I love this verse.  I even hinted at it the other night in my blog, not sure if anyone caught that.

Joshua 1:9 "Be strong and courageous. Do not be afraid; do not be discouraged, for the LORD your God will be with you wherever you go."


My maiden name is Gustafson, and when I was in sports growing up, some people called me Gus and cheered, "Go Gus!" But the real reason for Gus is my dad, which is the name he usually goes by. We have always been so close, and he is such a huge inspiration to us. This little guy is already Grandpa's Boy!

They wrapped him up in saran wrap under his blankets to transfer him from L&D to the NICU

(to preserve body heat).  Check out those feet!

Not too sure if he's enjoying life in the outside world yet...

This is my first up close view of Joshua, before they took him to the NICU.

This is how he looked when I got a chance to see him in the NICU.

 

Ok, here's the long version for anyone who wants the details of the labor and delivery.
The night prior to delivery, I was having contractions about 3-5 minutes apart.  Nothing painful, but I could feel them.  No big deal since they were so small, but they gave me terbutaline to stop them, and it worked.  The next morning, we had our dopplers which showed normal blood flow, and we thought we can make it to 32 weeks.  I was feeling contractions, more than usual, but they weren't painful.  When I was on the monitor, we saw they were about every 3-5 minutes.  Dr. Middle decided to check me just to make sure I wasn't dilating (I hadn't been checked since I was 1.5 cm early on in the action three nights before).  Surprise, I was dilated to 5 cm!  Basic review: when the cervix dilates to 4 cm, you're officially "in labor," on the way to 10 cm, or complete, when it's time to push the baby out. 

Once again, I was transferred to L&D and started on Magnesium to protect the baby's brain just in case he was going to be born sometime in the next 12 hours.  We arrived around 11:30 AM.  I got a medication called Procardia to help stop the contractions.  The mag wasn't as bad this time around, except for the headache.  Everything seemed to slow down as the contractions spaced out to greater than 10 minutes apart, and I was comfortable.  After several hours of just hanging out, Dr. Middle said, "well, looks like we've stopped things.  We'll plan on discontinuing the mag at 11:30 tonight and monitoring you continuously, and we'll see what happens overnight and tomorrow."  The baby was happy and not having any decels (drops in heart rate) with contractions, so we just waited.

At about 6:45, the contractions were still spaced out, about every 8 minutes, but they were a little stronger than before (about 3-4 out of 10 on the pain scale), so Dr. Middle wanted to check me.  I was dilated to 7 cm with a bulging bag!  This baby was definitely on his way.  Since I was so far along, we'd continue watching and see how the baby was doing.  The doctor warned me that I still may very likely need a c-section.  Ideally I'd have a spinal for anesthesia, but it would have to be given lying down because sitting up would cause the baby to go off the monitor, and she wasn't willing to risk not seeing exactly how he was doing.  If his heartbeat would drop and stay down, a very likely possibility given the state of my placenta and the unlikelihood of it handling strong contractions very well, there would be a "crash" c-section, and I'd get general anesthesia (put to sleep and intubated). 

By a little after 7:00, the contractions were much stronger with each one increasing in intensity.  Over the next 45 minutes or so, there were about six contractions that were nearly unbearable, and by the last one I wondered how it could possibly get any worse.  {Aside: I know women have been having babies for thousands of years, so this is no big deal, but I had an epidural with my first one.  With Jeremiah, I didn't fully appreciate the pain until the end of 2 hours of pushing after the epidural wore off}.  Feeling lots of pressure, I had James get the doctor to check me.  Dr. Middle walked in during a contraction and said, "NOW you're finally acting like a woman in labor!"  I'll take that as a compliment.  I think.  Sure enough, I was completely dilated.  The baby was right there just waiting to come out.  It was about 7:55, and the NICU team rushed in; the doctor gowned up; the tech got the delivery table all ready; everyone was all set.  I got the go ahead, and one little push later (barely even a push), we got to meet our tiny, crying baby.  Let me tell you, it's A LOT easier pushing out a 2 pounder than it is an 8 pounder!  Several hours later, I can also say the recovery is much nicer, too.

He was very "vigorous" with Apgar scores of 8 and 9.  Apgar measures the baby's activity, pulse, appearance, grimace and respirations at one minute and five minutes after birth to assess his overall well being.  8 and 9 is awesome!  He didn't even need to be intubated.  Once he got to the NICU, he ended up needing CPAP, a mask on his face that forces air into his lungs, not a big deal.  It's set at room air, so he hasn't required any extra oxygen. 


If you are at all interested in the deal with my placenta, keep reading.  Otherwise, stop here; we're done. 

It turns out, during early development, a fluke thing happened and the umbilical cord attached into the edge of the placenta, right where all the hemorrhaging later occurred, instead of in the middle of the placenta, where it is usually found.  That means the blood flow to the baby had to go through a lot of membranes to reach him rather than getting a straight shot from me to him.  His umbilical cord was a super tiny string of a thing, so (as James says) it was almost like he was trying to suck air through a tiny little straw this whole time.  The placenta was huge, and about 1/3 of it was a discolored, useless solid rock, where the hemorrhage was located.  Poor little Joshua wasn't exactly living it up at the comfy Hilton as Jeremiah was when labor had to be induced at 41 weeks just to entice him to come out of his cush pad.

The first picture is our placenta.  The second picture is a picture of a typical healthy placenta that I just pulled off the internet for comparison.