Day 203 - Care Conference & Digging into IVF (ICSI)

Wednesday, July 21st, 2021

This day last year James as a Blastocyst (180 cells) was transferred into Mom's uterus! There was a 49% chance that he would implant. He has defied all odds since the beginning and every step of the way! 💪

This is a picture of James as a Blastocyst. Not everyone has a baby picture this early!

What's really crazy is that James was first created back in March 2019 when Mom had her aspiration surgery. That's when they retrieve the eggs to undergo Intracytoplasmic Sperm Injection (ICSI). In the ICSI process, a tiny needle, called a micropipette, is used to inject a single sperm into the center of the egg. After James grew for 5 days into a Blastocyst, he was then frozen for a whole year just waiting for the day he was chosen by the embryologist for implantation!

Below is an example of the IVF process and how it's normal to lose anywhere between 35-60% at each stage in the process. 

Mom & Dad's IVF Journey in 2019

• 19 eggs retrieved
• 12 mature
• 11 fertilized
• 8 grew to Grade A & B Blastocysts 
• 3 embryos were chromosomally normal after PGS testing

Mom was told getting 3 embryos out of 19 eggs is very good. But when you go into it not knowing what to expect that number is hard to hear. We had Baby A in October 2019, a girl we named Hannah Lynn who was born sleeping at 20 weeks. Sweet Baby James Weston is our Baby B. And Baby C is cryopreserved or frozen at the Fertility Clinic. 

If anyone starting out on their IVF Journey has questions feel free to reach out to Mom on Facebook or leave a comment below.

Update on today:

• Increased prune juice to 30ml (10ml 3x/day). James did not have a bowel movement so we ended up giving him a glycerin suppository at 6pm. Mom asked the RN to only give him a portion since that is what we did in the NICU. Unfortunately he still did not have a bowel movement throughout the night.
• James did a 3 hour LTV Trial during day but for the night trial there was a lot going on and unfortunately we ended it early. More on that below...
• Care Conference - Every time we have a meeting with the doctors we have to reset our expectations. We discussed the fact that even though he may transition to the LTV quickly, James needs to come down on the settings. They are still pushing for diuretics, even though we have stressed our concerns for his ricketts.
• Physical therapy stopped by and actually worked with James while he was on his LTV trial.
• Discharge coordinator stopped by and we discussed a few things like lack of staffing and possibly getting a medical crib through insurance.
• Mom called a Medicaid Humana Rep recommended to her, someone who is actually a case manager for one of her local Trach Mom friends. She provided a lot of conflicting information then what we are hearing from our discharge coordinator and social worker. But it was hopeful!
• James started his 3-hour night shift LTV trial at 11pm. Unfortunately the ventilator sounded off a very loud alarm right away saying "HIGH f" (which means that his rate is too high). Well that wasn't the case at all. James was breathing in normal range. The RT had no idea how to change the threshold settings to the alarm. Mom actually started googling for her. This alarm is piercing. She said that she would probably need to end the trial due to the fact she couldn't figure out how to fix it. Then...
• At 11:30pm, we were asked to move rooms in the middle of the night one being that there was a patient who needed a negative air pressure room (that means the patient has some type of infection). Second being that we requested a larger room if one opened and there just happened to be a larger room open. So it was going to be a win-win for everyone. Mom packed up the room and made multiple trips back and forth with several RNs and Charge Nurses. Literally only a couple doors down. We moved from 233 to 236. As Mom was organizing the new room Baby James was getting his bed rolled into the room and was getting bagged. The bagging was happening extreme slow and he was turning blue. He ended up having a full BPD episode which he hasn't had in a month since his hernia surgery. There is no reason why he should have been bagged when they could have connected him back to the Servo and roll the ventilator into the room. This would have avoided all human error. His PEEP was already being disconnected to bag so connecting to the Servo would have been a much safer option. For the PICU it seemed very unsafe, the bagger could barely reach James at one point and almost let go to walk around the crib. 😱 Needless to say Mom didn't get any sleep after that.

P.S. You can email James your love and support as often as you’d like. Mom and Dad read these emails to James as they come in. We all love them! JamesWestonAbramowitz@gmail.com