@ Almost 6 Weeks

Tate will be six weeks old on Saturday. This will put him at the same age as I was when my parents moved to Spain in 1977 for my dad's Fulbright Fellowship that year. We've had some different circumstances than my parents had, but I remain amazed that they pulled off such a feat so soon after my birth. From my vantage point, such a move seems at this point all but impossible, and makes me proud of them for their go-for-it attitude.
Speaking of my parents, they came to visit for Tate's fifth week in the world, and had a lovely time. As you might imagine, they were quite taken with Tate. While they were here, we got word that Tate's liver enzymes had dropped to levels at or very near normal, which produced an overwhelming relief. I had no idea how much concern I still had pent up inside of me until I heard from the nurse Thursday night that his bloodwork indicated the levels of his liver enzymes had dropped 200-300%, and a more than 50% drop in his bilirubin level. The news was celebrated with a cork popping out of a nice bottle of Santa Rosa Pinot.
So now, for the first time, we've been enjoying medically unnecessary activities: walking by the river, checking out bunch grasses and salvias at the Dry Creek Garden nursery, speaking with friends and family, and offering prayers of thanksgiving for good news regarding Tate's health...

Through the Wringer and Back

Wow. Have you ever seen one of those old-fashioned washing machines with parallel rollers for wringing water out of freshly washed clothing? They look kind of like a printing press with a wash basin attached. It feels like we've been put through one of them in the last five days. Tate has had elevated levels of bilirubin for three weeks, but a week ago we also learned that he had elevated levels of two important liver enzymes. A week ago yesterday, we had been told that Tate's bilirubin level had dropped from 17 mg/dl to 0.1 mg/dl (yes, one tenth of one deciliter) in three days, and that as a result we could take him off the biliblanket. As it turns out, that test was wrong, but that's a longer story. To make the long story short, last Tuesday, May 8, our pediatrician saw in this test that Tate's bilirubin had dropped precipitously. The doctor was amazed (we now understand his skepticism was justified). At the time, Tate already had elevated levels of these two liver enzymes, called AST and ALT, but the pediatrician's sense was that they were elevated largely because his liver had finally kicked in to get rid of the bilirubin. So we began celebrating a bit, believing that Tate, in effect, had a clean bill of health. The doctor wanted us to have Tate's blood checked for the presence of the enzymes one more time later that week to see that the levels had dropped, which would indicate that his liver was returning to normal after working very hard to purge all of his bilirubin. So on Thursday last week, May 10, I took Tate to the lab, and had his blood tested. We had relished for those two days the freedom from the biliblanket, and enjoyed doing some slightly more normal, medically unnecessary things with our boy, but on Thursday night, the pediatrician called, and told us the levels had not only not gone down, but in fact had risen alarmingly, to the point that the doctor wanted us to get Tate to the hospital right away for observation and tests to figure out what the deal was. You can imagine our initial panic and fall from the happiness of the two days of relative freedom from medical procedures.
For the next four days nothing much happened, really, aside from regular daily blood tests, discussions with the pediatric unit staff and a pediatric gastroenterologist, and an ultrasound of Tate's liver. This was at times emotionally exhausting, frustrating, frightening, and overwhelming, as you can imagine. As each day passed, however, the likelihood of something extraordinary and seriously wrong with Tate's liver diminished because the enzymes were trending downward (thankfully), but their cause remained (and as of today, remains) a mystery. The best news came with the ultrasound, which indicated that Tate's liver structure was normal and healthy, and showed no signs of a missing or malformed gall bladder, spleen, or bile ducts, any one of which would have certainly required immediate surgery. Because the liver's structure appeared healthy, the next most likely scenario was that Tate had somehow contracted a liver infection (literally a hepatitis) of some sort, which was causing the elevated enzymes. This remains the notion under which we are currently operating. I'll find out Thursday morning if Tate's enzyme levels have dropped on their own, which will essentially confirm the diagnosis of an infective, and that Tate's body is taking care of it for him. As with any virus, there's little to be done, really--it just has to run its course. So the likelihood that we'll ever know what Tate has had is increasingly remote. This is just fine with me.
A week or more ago I was talking with my dad about how Tate's bilirubin levels were still elevated, and how we were feeling grateful but frustrated by the constant necessity of the biliblanket that we had been using to reduce his bilirubin levels. We were talking about how people frequently gripe and complain about "how stressed out they are" with everyday circumstances--I certainly have been one of these people on more than one occasion--when real stress in fact lies in the concerns regarding the health of a new baby. It's certainly given me a few grey hairs recently.
Tate is 25 days old today, which hardly seems possible. 7.5 of those 25 days have been spent in the hospital--at his birth and for his most recent liver concern. Half of these days he's been connected to the biliblanket, which effectively kept us tied to the house. On 20 or so of his 25 days, he's had blood drawn from his feet, his arm, or his groin. We are extraordinarily grateful that Tate's liver ultrasound indicated it was healthy; it means that the scariest of the possible diagnoses is increasingly remote. We're also really grateful for all of the good thoughts and prayers of friends and family as these days have transpired. They have helped buoy our spirits and make us feel encouraged during it all. Thank you.
Here's a recent picture of the boy, tough guy that he is.

Sweetly Sleeping Under the Waning Moon

Little Tate's bilirubin levels are falling. Although they are dropping only incrementally at this point, the important thing is that they're going down. The measurement for bilirubin is taken in milligrams per deciliter of blood, or mg/dl. Safe levels of bilirubin are about 10 mg/dl and below. Last week, Tate's levels fluctuated between 17.3 and 20.9 mg/dl until Friday, when they went down to 16.7. We still have a ways to go, but there are encouraging signs: the whites of his eyes are beginning to turn white again near the iris, he's noticeably less jaundiced (though not entirely cleared up), and his poop has a lot of yellow in it--a good sign, indicating that his liver is now working to rid his body of the bilirubin as a waste product on its own . We're awaiting today's test results yet, and have another visit with the doctor tomorrow, at which we hope to hear that he's gained weight since Friday and that his bili levels are continuing to drop. Gotta run to the lab once more for another blood test...but isn't this kid adorable?

The Happy New Mommy & A Milk Coma

Who knew that one could be so tired, and yet so happy? I guess anyone who's had a child [duh!], but it's not the kind of thing you realize until it's you--no matter how empathetic you might be. So far my main point of reference has been the exhaustion I felt during the first year of graduate school, which is actually not all that different from this exhaustion, except that this one comes with some significantly more joyful elements, and while books are often beautiful things, they don't breathe and move on their own.
Tate's bilirubin count continues to drop slowly, but it is going in the right direction, so that's the only thing that matters at this point, really. We continue to be astounded by the realities of our new little man, even in his hourly wakings in the last few nights that are accompanied by 100-decibel cries. I never guessed something so loud could come from something so small. It's really quite amazing. And what a remarkable survival strategy! Cry so loud that you could break windows, and virtually no one can ignore your needs...
I need also to say just how wonderful my wife is. The first few days home with Tate we both looked a little bit shell-shocked, I think, confounded by the utter reality of our new responsibilities, but I've watched Monica over the last 12 days, learning how to care for Tate, observing his behaviors, examining all his little parts, washing his soft brown hair, learning to be his mommy. What a joy that is.

April Flowers Celebrating Monica

For Monica's birthday this week, you would correctly imagine that we had a lovely little celebration at home without too much fanfare, save the joyfulness of celebrating with little Tate in the house. Mom sent the lovely tulips in the photo, which have looked beautiful for several days. It's a bit of a blur, really, but I think Monica enjoyed celebrating her birthday with our son in the room. If that doesn't sound out of this world--"our son"--I don't know what does.