Another surgery done

It wasn’t long after we were informed about the possibility of surgery that it was actually scheduled (Friday).  Again, unfortunately the internet is very patchy so we’ve not been able to update.  Our neurosurgeon handed us off to a colleague of his who specializes in spina bifida.  Joshua’s new neurosurgeon has performed this type of re-closure many times and was happy to take Josh on his caseload.  Therefore on Friday Joshua went in for surgery for the second time on his back.  They had the plastic surgeon on standby but weren’t sure if they were going to need him.  The skin where the CSF was leaking is very thin.  The doctors compare it to tissue paper.  To help prevent the CSF from leaking they reopened the entire incision and pulled tissue and fascia from the sacrum and the lower back.  The new tissue covered the area where the CSF was leaking.  I asked the doctor if he thought that this “was it.”  He responded by telling me that this was going to get fixed before we leave here and that we didn’t need to worry about whether or not it was going to get taken care of.  It could take just this surgery or it could be multiple surgeries.  Regardless, it’s going to get taken care of.  I don’t think I ever questioned whether or not it would still be leaking when we left.  However it keeps as a reminder to me that as long as we leave here healthy and healed, that is what’s important. 

Today they pulled the dressing off of his incision.  The incision is much prettier than the one before, if that’s possible.  The other incision was raised and made him look like a football.  This incision is flat.  The neurosurgeon looks at it everyday to monitor progress and is extremely happy with how it looks. 

They are continually monitoring how much CSF is leaking from his head catheters.  On Thursday, the nurse flushed out his right catheter.  When she did that, the fluid that she flushed drained out the left catheter.  Now remember, originally they only put one catheter in because the left and right ventricles are connected and the fluid should freely move between both.  Therefore usually there is no need for two catheters.  It’s awesome that his brain is now communicating!  There was a little CSF leaking from one of the catheters this morning so the nurse paged neurosurgery to come and take a look at them.  The neurosurgeon didn’t get there until after we left (NICU closes between 2pm - 4pm).  When we returned, they had taken the right catheter out! Yay!  He still has one catheter, but the fact that he doesn’t need both anymore is a huge victory!  Next the neurosurgeon wants to begin challenging the left catheter by shutting off the valve to see if Joshua truly needs a shunt or not.  If his ventricles begin to swell or fluid shows up in other places, we will know that Josh needs the shunt.  We are still praying for a miracle!

We sit by his bedside almost all day.  Most of the time, we’re talking about what we’ll do as a family and what it will be like when we finally get to take him home.  We’re excited about normal.  Midnight feedings and dirty diapers used to feel scary.  I would trade this for that any day.  Despite the difficult circumstances and hardships, words can’t convey how grateful we are that he’s here with us. 

Leaking still? How?

We're still here.  I feel like we've been here for months and months.  So much has changed in our lives in such a short period of time.  It's a very weird feeling. 

Joshua is doing good.  As you can see from the picture above, he's been better...but he still looks cute!  :)  When his neurosuregeon checked him out this morning, he noticed that Josh is still leaking CSF.  Grrrr.  He shouldn't be leaking CSF still.  The one catheter should have been enough.  After they added the second, that definitely should've been enough.  Therefore, the doctor tilted him even more.  His bottom is at an incline which should move the fluid towards his head and allow it to drain.  The neurosurgeon wants to wait 3 more days to see if Joshua's back will heal and stop leaking CSF.  If it doesn't stop leaking by that point, the doctor wants to talk to the plastic surgeons about going back in the incision and pulling fat and tissue over the area that is leaking to help it stop.  We really don't want him to have to undergo yet another surgery, especially one that would put the healing for his incision back at square one.  We are praying that his incision would dry up independent of the plastic surgeons.

When the neurosurgeon came up, not only did he find more fluid on the gauze, but he ordered for Joshua to have a head ultrasound so that he could take a look at the ventricles again.  They needed to take the bandage off to do the ultrasound.  We were very interested to see what his catheters look like.  There are two one inch incisions on both the left and right side of his head.  The catheters are stitched in place.  It's hard to see but we know that they are helping him, which makes it a bit easier.  Good news is that there is a bit of peach fuzz growing back where they shaved my baby's head! 

I will say it again and again...we appreciate all of your mail, e-mails, phone calls, and texts.  It is all so encouraging and helps us get from one day to the next.  Most of all though, we are thankful for your prayers.  Our biggest prayer right now is that Joshua won't need additional surgery for his back. 

Two steps forward, one step back

Our morning began with a phone call from the anesthesiologist.  He wanted our consent for surgery.  That's how we found out that Joshua was going in for surgery today.  When the neurosurgery team did their rounds, they looked at Josh's dressing and found quite a bit of fluid.  When they weighed it, it weighed 4 mL.  They decided to proceed with surgery.  When we arrived, they paged neurosurgery so that they could come and  talk to us about what their plan was.  Since the CSF was still leaking, they needed to give it another outlet to leave his head.  They left the catheter in the right side of his head but put another one directly parallel to it on the left side of his head.  Ideally, Joshua's incision should dry up and heal.  There should be no leaking CSF from the incision from this point on.

So, I didn't get my wish which was to preserve the rest of his beautiful hair.  :(  Unfortunately it's not even the last of it either.  If they decide to do a shunt, they will be putting it towards the back of his head and will need to shave it YET AGAIN.  Thankfully, hair grows back!  For now, Joshua has a huge bandaid on his head.  He's extremely sleepy with all of the pain meds that they have given him.  We're looking forward to seeing a dry dressing soon!  We're on the road to healing yet again!

- Kim & Matt

Just wait 'til the end!

Our intent today was to stop by the hospital briefly this morning to see Joshua and then head to our house to exchange some things, get new clothes, and maybe even sleep in our own bed!  We didn't get very far.  We barely missed the neurosurgeon when he did his rounds this morning.  The nurse told us that he peeled back the dressing and checked Joshua's incision.  The dressing was wet and he saw more CSF leaking from the incision.  They were concerned that one of Joshua's ventricles may have collapsed or that the catheter wasn't draining from the optimal place and they would have to change the placement.  To check, the neurosurgeon ordered an ultrasound on Josh's head.  The ultrasound was inconclusive in finding the size of all the ventricles.  Therefore, the doctor ordered a CT scan of his head.  Once he read the CT scan, he told us that the catheter is in a prime location, which is good.  It was draining primarly from the third ventricle.  He wanted to pull it out 1 cm so that it would improve the drainage.  The nice thing is that he doesn't even need to go to the OR to do it.  He was able to give Joshua a little pain medicine and do the procedure right at the bedside.  It took the better part of an hour.  I'm so happy that they didn't need to go in and move the catheter to a different spot on his head, both for Joshua's healing and for us.  We feel like we're being stretched in every way, but if they shave off any more of our baby's adorable hair than they have to, I'm going to flip out! The neurosurgeon will continue to check Joshua's back throughout the weekend.  We pray that the CSF will stop leaking and his incision will dry out and heal up!  The doctor doesn't want us to hold him for a couple of days which is hard, but if it means that Joshua will heal faster, we're all for it.  So needless to say, we didn't go home.  Hopefully we'll get to at some point next week for a day or two.

Joshua continues to surprise us! As we had mentioned before, the physical therapist gave us some stretches to do with his legs and ankles and also encouraged us to massage them.  We have to be extremely careful now because they want him to lay flat so that the CSF can drain from his catheter but we can still do them.   Last night while Joshua was sleeping, Matt was massaging his feet and a smile kept sweeping across Joshua's face.  We were pretty sure that it tickled him.  Shortly after that, he kicked his right leg back!  Up to this point, any movement that we have seen in his legs is because he's been moving his hips.  We will really begin to see what his capabilities are when he gets a little older but we believe that this isn't where this ends!  Hold on little one...God's not done with you yet!    Not every tear has to be a tear of sadness! 

- Kim and Matt

Not the News We Were Hoping For

Yesterday Matt and I tried to get ready as quickly as possible so that we could see how our little guy was doing. It wasn’t long after we got to the hospital that the neurosurgeon came to do his rounds.  As soon as he took the gauze off of his back, we saw clear fluid leaking.  I could tell that the doctor didn't want to say it, but Joshua needed a shunt.  The doctor put another stitch in his back to tie up the area where the ceribral spinal fluid or CSF was leaking from and scheduled him for a shunt that day.  In preparation, they wanted a head CT scan to take a look at his ventricles.  The CT scan showed no obvious hydrocephalus had accumulated but it was obvious that he needed a shunt because the CSF was just finding another outlet.  Joshua went down to the operating room (OR) at 1pm.  The staff is great at making sure parents get consistent updates during the surgery.  They actually give you a buzzer like you get in a restaurant.  When it buzzes, you take it to the front desk and the OR calls you.  Not long after they took Joshua back, the neurosurgeon came out and told us that when he started taking out the stitches from Joshua's incision, there was CSF leaking in several places that weren't visible that morning.  If it was just leaking from the pinhole sized location that we initially found, they would have been able to do the shunt.  Since it was in several places, they wanted to put a catheter in his head ventricles (areas that store CSF in the brain) to allow the pressure that had been building to release and drain.  The doctor was concerned that Joshua could have an infection or meningitis from his insision.  The fluid that leaked out was pretty clear but he wasn't certain that there wasn't an infection.  Rather than simply closing the incision and putting in a shunt, they want the incision to completely heal on his back, give him antibiotics, and make sure that he doesn't have an infection.  The entire procedure took about 3 hours. Once the incision on his back is healed (about a week or two) they will take the catheter out and most likely put in a shunt.  After the surgery, waited for him outside the Neonatal Intensive Care Unit (NICU) to return from post-operation recovery.  When they brought him back, they wheeled him in on a adult sized bed.  His tiny body looked so sweet and fragile on that huge bed!  The catheter was sticking out of his head.  It is secured in place by a few small stiches that prevent the line from pulling out.  The neurosurgeon has still given me the thumbs up to breastfeed but I'm so scared to hold him.  He practically has something on every part of his body.  Plus, his head needs to be lower than his spine so that any pressure is reduced.

This morning when we got to the hospital to see Josh, I talked to the neurosurgeon briefly.  There was still CSF leaking from his incision.   The neurosurgeon wants his spine to be a little higher than it was yesterday to continue to reduce the pressure.  I fed him a bottle, but he continued to cry while I was feeding him.  He normally eats peacefully and maybe even falls asleep with the bottle.  Sometimes, he just looks at me in contentment.  I could tell that he was in pain.  As tears filled my eyes, I took a deep breath and told the nurse that I thought he might be in pain.  She checked his chart and it turns out that he needed a new dose of medicine.  He's such a brave little boy.  He's been through more in his 13 days of life than most go through in a lifetime.  We named him after Joshua 1:9, "Have I not commanded you? Be strong and courageous. Do not be terrified; do not be discouraged, for the Lord your God will be with you wherever you go."  He continues to show us his courage and strength through all of this. 

We certainly didn't want him to get a shunt, but Matt and I walked into this knowing that if he needs it, he needs it.  He needed this procedure.  The risk of meningitis or some other infection is too likely without it.  Again and again God is teaching us to trust Him.  We were hoping to bust out of this place a bit sooner than a month but it's looking like that may not be possible.  

On a positive note, the sleep study showed no significant problems.  His saturation level (amount of oxygen in his blood) dipped a little low at times but the pulmonologist wasn't concerned.  He wants to do a follow-up at some point but it's nothing to be worried about.

I forgot to mention before that when the neurologist saw Joshua's MRI she ruled out any problems with his brain.  Initially they thought he had something called migrational disorder.  However, she said that what she saw was typical of kids with mylomeningocele (the type of spina bifida Joshua has).  Her exact words were "This kid can do anything!"  We have high hopes of a bright future for our little guy!

-Kim and Matt

Still Healing

It wasn't a very exciting weekend.  We had some visitors which was fun!  Other than that, Joshua didn't really have any new updates.

Yesterday and today have been a little busier.  His saturation level of oxygen in his blood has dropped below "normal" several times.  This is the reason that he has been on oxygen in some of the pictures.  They don't feel comfortable with sending him home with his saturation level dropping this often.  They think that one of the reasons that they might be dropping is because he gets in a deep sleep and has brief pauses in his breathing.  Therefore they ordered a sleep study for him.  This will give them an idea if his saturation level is dropping because he gets into such a deep sleep.  It's ironic that he's here because of spina bifida and they are worried about his sats dropping.  It's almost scary having him hooked up to this many machines because when we go home, we won't have any machines.  We will have to rely on our parental instincts.

Last night Matt signed me up for a women's spa night.  There was a salon and church that donated their time and services.  We had a very nice dinner followed by our choice of 2 out of 6 services.  Each of the services were 30 minutes long.  They had pedicures, hair cuts, massages, manicures, facials, and make-up.  I chose to get a massage and my hair cut....wonderful!  It was such a blessing for all of us.  It was also comforting to talk to other women who are in the same position as you are, living at the Ronald McDonald House or having children who are hospitalized.  Having Joshua in the NICU and going to this event has opened my eyes even wider to other people's situations.  There are so many who have been here for months or even a year.  With some of them it's an issue of recovery or maturation, and others have issues that they will struggle with for the rest of their lives.  We are not in the worst position.
 
Today when the doctors were doing their rounds, we pointed out some fluid that we noticed leaking on Joshua's back.  They paged the neurosurgeon who came to take a look at it.  When he saw it, he decided to put an extra stitch in the place where the fluid was leaking.  We don't know if it's cerebral spinal fluid (CSF) or fluid that has built up underneath the skin.  It may not be CSF because it wasn't coming directly from the incision, which is where CSF typically leaks from.  It was about 1cm away from the incision.  Please pray with us that this isn't CSF.  If it is CSF, it may be an indication that Joshua would need a shunt.  We should know within 12 - 24 hours if it is.  After they did the stitch in his back, they did an ultrasound on his head to look at his ventricles again to see if any hydrocephalus has developed.  The CSF could be an indication of hydrocephalus.  It looks as if his ventricles are still the same size.  They have put gauze on his incision to see if it absorbs anymore fluid.  He will be monitored closely during the next 24 hours and his incision will be checked often.  He is laying on his tummy to avoid extra pressure on the incision.  There is still hope for him!

We still don't know when we will be going home.  I'm sure people are getting tired of seeing us in the same 6 outfits. We're tired of seeing ourselves in the same 6 outfits!  As much as we want him home though, we want him home and healthy!  All in good time....




This is Joshua after his hearing test... which he passed :)

Over a week old!

Lots has happened! Yesterday when we held Joshua, we were able to snuggle closer to him.  We spend a lot of time watching him, feeding him and changing his diaper.  Matt's becoming quite a pro at diaper changing.  I'll feed him and Matt can change diapers...I love that idea.

I'm looking forward to losing the baby weight. It will be nice when people stop thinking I'm having a baby.  About a half dozen times I've been in the elevator and some bold human being asks me when I'm due or wishes me a "Happy Mother's Day" to an expecting mom.  It usually gets very uncomfortable for everyone else in the elevator when I tell this person that I delivered not too long ago.  That elicits an akward pause in the conversation.  However, just yesterday someone told me that she didn't think I looked like someone who just had a baby...FINALLY!

Today has been crazy.  We got to the NICU at about 8:30am.  We hung out with Joshua for a bit and then the doctors started doing their rounds.  We met Joshua's neurologist, got an update from his neonatologist, and an update on his incision from the neurosurgeon. 

The neurologist is waiting on an MRI for Joshua.  He is actually in the middle of it right now.  This will hopefully give the doctors a good idea if he has any brain abnormalities.  We'll most likely hear back from them tomorrow.

The neurosurgeon said that his incision looks like it's healing great.  He can be laid on his back which is important for his MRI.  But the best news is that we can finally hold him!  I mean actually hold him!  It was such a great feeling to finally cradle him in my arms.  It sure makes feeding him a whole lot easier too!

We also met with the physical therapist who taught us some stretches to do with Joshua's legs at home.  This will help keep his legs loose and limber. 

The orthopedic doctor came by and looked at him. Unfortunately we weren't there because it was during the hours that the NICU is closed.  We should be able to meet with him on Monday. 

As you can see...a busy day!  We're still at the hospital and a little exhausted.  Looking forward to getting the MRI results tomorrow and hopefully breaking out of here before too long!

-Kim and Matt

PROGRESS!

Sorry it has been a few days since our last update, but it has been a little chaotic.  I was discharged Monday at 4:30 from the hospital (it was supposed to be noon). Literally, in the last hours of my stay at the hospital, there became availability at the Ronald McDonald House. Huge relief! Unfortunately, the Ronald McDonald House doesn't have internet access. In combination with a crazy schedule, it has been difficult to update. I apologize.

Joshua's last few days have been really productive. All the doctors do their rounds in the morning hours between 7-9, so Matt and I try to get to the hospital by 8am (when the NICU opens). His neurosurgeon has been monitoring Josh's head to see if hydrocephalus has developed. The day after his surgery, his head size increased slightly. We thought that would be the beginning of a steady climb. However, by the next day, it decereased back to the original size. Since then, it has not grown AT ALL! God continues to show how faithful He is!! So, if it continues to maintain no growth, we will be going home with no shunt, which is exciting... a little scary, but most of all exciting. Typically if hydrocephalus is going to happen, it forms within a week of when the surgery for the closure is performed. Then, after that week, the possibility of needing a shunt goes down. After the first year of life, if no need for a shunt has presented itself, the possibility decreases dramatically.

They took the bandaid off of Joshua's incision two days ago. The neurosurgeon warned us that it wouldn't look pretty, and he didn't lie. However, he was really happy with the closure. When they do the closure, they try to pucker the skin as much as possible to prevent cerebral spinal fluid from leaking. So, even though it looks scary, the doctor is really happy with it. Of course it is really emotional to see Joshua's back look like that, but since the doctor is happy, and we're happy. It's about 4 inches long and is risen off of the skin about 1/2 an inch.  As Joshua grows, it will flatten out more.  They are keeping the incision clean by routinely washing it.  They also have what are called "mud flaps," (yes...that's what they are called and that's what they look like!) to protect feces from entering the incision.  It basically looks like saran wrap that sticks to his skin right below the incision.  The plastic is then folded back and sticks out of his diaper to prevent a rash.  His diapers are worn backwards so that it is easier to clean him up.

They are also continuing to catheterize him to see how much urine he is not empyting from his bladder.  They will allow up to 20 ml to be left in before they feel the need to be on a catheterization plan.  They begin by catheterizing every 4 hours.  Then they move to 6, 8, 9, and 12 hours.  He is now being catheterized every 12 hours because the amount of urine hasn't been too significant. This is great news because it means that we will most likely not need to go home on a catheterization plan!  Only time will tell.

Orthopedics have completed x-rays and have discovered that he has dislocated hips.  We haven't met with the doctors yet but they will tell us what treatment will most likely look like when we see them.  At this time we also have not noticed any movement in Josh's legs and feet.  Please, please, please pray for healing.

Originally the doctors told us that I wouldn't be able to breastfeed for at least a week after surgery.  When we talked to the neurosurgeon yesterday and he gave me the thumbs-up to start trying.  Of course I am not able to hold Joshua like I typically would but it is exciting to be able to start feeling more like a mom and less like an observer.  The only way we've been able to hold him is by laying him tummy down on a pillow up to this point because we can't put pressure on his back.  Today I got to have him nuzzled up close to me while he layed on his side.  These small victories mean the world to us. 

The nurses have been doing a great job of preparing us to take care of him.  We are starting to feed him more, change his diaper, and tomorrow we will learn how to clean his incision.  He's finally starting to feel like ours!

So as you can see, God has been doing some great things.  He has also continued to stretch our faith.  Thank-you everyone for your e-mails, calls and text messages.  We haven't been great at returning all of them because of time constraints but they have encouraged us in ways that words can't express.  It doesn't feel like we're alone here...we have all of you with us. 

Kim and Matt

Happy Mother's Day!

Happy Mother's Day to all the moms!  It was a beautiful Mother's Day for me. We headed over to the NICU this morning at about 8:30am.  Joshua had a really great night.  They had him on oxygen all of yesterday just to be safe.  He was teetering on needing it and not needing it.  It kept falling out of his nose anyway because he only lays on his stomach. Since he did so well without it they decided to remove it. 

When I came in, the nurse told me "Joshua and Brandi (his nurse) made something for you last night."  They had put Joshua's handprint on a little paper doylie for Mother's Day.  It made my heart melt!  I held him on his little pillow for about an hour.  I had to leave for a bit and when I came back they told me that I could feed him his first bottle!  Originally the nurses said that they were going to attempt to give him a bottle after he was finished with his morphine.  Since he was so alert though, they felt that it would be a good time to be able to try.  Plus they knew it would be special for Matt and I to be there.  He didn't take the bottle as well as we would have liked but he drank about half an ounce and the nurses said that it was successful being as how this is the first time he's drank from a bottle.  They were going to try 2 more times tonight.

I love the nurses here!  Both at UAB and at Children's Hospital.  We couldn't have asked for better people to be working with our little man and myself.  The nurses here at UAB have sympathized with my situation and been completely understanding about me coming and going.  Joshua's nurses have been extremely caring and have made some of the milestones like holding him and feeding him possible for us.

Please continue to pray for joy and peace for us. We pray Romans 15:13, "May the God of hope fill you will all joy and peace as you trust in Him, so that you may overflow with hope by the power of the Holy Spirit."  We are literally only held together by the Lord and one another these days.

Our first family photo! It's Matt and I and in that little tiny box in the corner is Joshua. :)

The first time I was able to touch Joshua Eli.

2 Days Old!

I can't even begin to explain to you how cute this little boy is!  Of course I'm partial but believe me when I say HE IS PERFECT!

Today started with us rushing around this morning so that we could quickly get to Children's Hospital to see Joshua.  We were told that today we would probably get to hold him so we didn't want to delay.  It was so wonderful....needless to say, an emotional moment.  Since his back is in the process of healing, he had to lay on his tummy.  They put a pillow underneath him and a little "donut" for his head and he was able to lay on our laps for about an hour each.  Lucky for Matt, I needed to pump otherwise I'm not sure I would have let go of him.  This gives us so much excitement for when we get to pick him up with no restrictions and cradle him in our arms.  We probably won't put him down for a year! :)

They still haven't fed him yet. He's getting lipids and vitamins intravenously for nutrition.  They didn't want to feed him before his surgery and now he is on morphine for pain so they don't think he would be very receptive to a bottle.  They don't foresee me being able to nurse him for at least another week unfortunately.  Something else to look forward to!

We went back to UAB so that I could rest for a few hours while the NICU is closed for shift change between 2pm and 4pm.  We visited him again tonight for a few short hours.  I had to take it easier today because I pushed my body too far yesterday.  My nurses weren't very happy with me but I don't regret a second of it. :) 

We look forward to seeing him again tomorrow. It will be my first Mother's Day and a wonderful one at that! 

It's a Boy!!

Yesterday Joshua Eli was born at 10:15am at 7 lbs 11 oz and 19 inches long. He surprised us in a few ways...he was much bigger than we thought he would be, he has a head full of beautiful brown hair, and he was a boy:) It has been so exciting to meet the baby that we've been imagining for so long.

As planned, we had an amnio scheduled for May 4th to check to make sure that the lungs were mature.  The doctor went ahead and schedule me for my delivery on May 5th being 95% sure that everything would be in order for a May 5th delivery.  I began prep for my c-section at 8:00 and was finally wheeled into the OR at 9:45. They got him out at 10:15. Because the sac that covers the exposed area on his back was ruptured, they took him into a separate room within the OR immediately to cover his back with a sterile plastic covering and placed him in an enclosed isolet. It was then that we first saw our beautiful baby boy. Man is he chubby, especially considering that during the amnio the day before they measured him at 6 lbs 10 oz. My OB shared after Joshua's delivery that the only fluid she could find to take during that amnio was right next to his penis...we were none the wiser:)

Rather than the original timeline of 4 hours with us at UAB hospital, the doctors and nurses felt that it was in Joshua's best interest to transport him over to Children's Hospital 2 short hours after his birth due to the risk of infection to his back since it was ruptured. Matt was able to be with him while he was transported and my sister was able to come and be with me in the OR recovery. The nurses told me that with permission or not, they were going to find a way for me to see him even if it meant wheeling him in with a blanket over his cart:) Allison and I were in conversation when we suddenly heard the tiniest muffled cry because he was in his isolet. When they brought him in, they opened his 5 inch round window and we had our first physical contact by holding hands. Though this seems small, it was the highlight of my day.

Once over at Children's Hospital, the NICU did their own assessment and got him settled in while Matt handled his paperwork. We're very pleased with the quiet, peaceful environment that Joshua is in and how loving the staff is. It helps us sleep at night knowing that he's receiving such good care.

By the end of the day, Matt was able to meet with Joshua's neurosurgeon, neonatologist, and anethesiologist. They put Joshua on the schedule for early the next morning to do the closure on his back. Needless to say, I was exhausted from delivering and Matt was exhausted from running back and forth.

Today we arrived at Children's Hospital at 6:30am to meet with the neurosurgeon before Joshua's scheduled 7:30am surgery. It was a very emotional moment when I was able to be reunited with Joshua since I was only able to spend about 2 minutes with him the day before. He had received a sponge bath that morning and the nurse gave him "church hair"....it was parted and combed down on each side of his head.

The OR staff brought Matt and I back with Joshua to where his surgery would take place. We got to say good-bye and they gave us a pager for the OR staff to contact us every hour to give us updates. Surgery lasted a little over 3 hours and we got 4 updates. Each update was very positive about his progress. Since Joshua's repair was quite large and a little tricky, the neurosurgeon called in his colleague to work on one side while he worked on the other. After the surgery was finished the neurosurgeon spoke to us about the healing process which will likely take 4-6 weeks (not the original 2 weeks that we were told). He will lay on his stomach for the first week to allow his back to heal. If by next week he needs a shunt, they will do the procedure at that time. The doctors still do believe that it's a 90% chance that Joshua will need a shunt. We're really hoping to get the opportunity tomorrow!  Joshua is on a morphine right now.

The nursery closed from 2:00pm until 10:00pm today because there was an emergency so I took the opportunity to head back to UAB to get some rest and continue to recover from the c-section. Even though I need the rest, we were excited to possibly have the opportunity to hold Joshua for the first time tonight. Unfortunately it just didn't work out.  So we're hoping for tomorrow!

Thank you all very much for your love, support, encouraging messages, and most of all, prayers. Please pray for peace, upcoming tests that Joshua will have, as well as shunting and God's healing for him. We will put up another update tomorrow!