Tuesday, August 9, 2011

The Beginning...

Several folks are following the blog, but were inadvertently excluded from the original Facebook or text updates. I thought I would take a few minutes to rehash how this all started.

Sunday, 7/31/2011 518AM

Court was in a lot of physical pain, so we arrived at the St. Joe East Women's Center. Court was hooked up to the NTS monitors while the nurses reviewed her issues and spoke to her. The NTS monitor is to watch vital statistics of the baby and the mother. Initially, all vitals were good, and they started the process of getting an IV drip in her because she was severely dehydrated.

Sunday, 7/31/2011 705AM

After a 7AM shift change, the new nurse came by to introduce herself and to glance at the NTS results. She said, "It looks like we are going to be delivering a baby today". Court and I just looked at each other, because it was the first time it had been mentioned.

Sunday, 7/31/2011 713AM

The nurse left to go check on a few other things, and returned to view the NTS monitors again. She looked at us, and said we are going to be delivering your baby by C-section in about two minutes. It didn't happen that fast, but the speed and pace of the rest of the morning is seered into my mind forever.

Sunday, 7/31/2011 731AM

Within just a few minutes, resident doctors and nurses arrived to prep her for immediate surgery. It was obvious at this point that something was wrong, but no one was really talking. At 731AM Courtney was rolled into an operating room. I was left in a room next door. I didn't know at this time if I was just waiting or if they would be back or what - so I prayed. I prayed for the safety of my wife and then unborn child, and for the knowledge and wisdom of the doctors to do the right thing.

Sunday, 7/31/2011 734AM

At 734AM, a nurse came to get me and help me get a gown on. I remember her telling me that if our baby had shoulders as broad as mine, Court would appreciate a C-section at the end of the day. In hindsight, that was my last laugh for a several days. I entered the operating room approximately three minutes after she was taken in, and they had already completed the epidural and had her on her back, and the incision complete. Dr. Butler, our backup OB (Dr. Campbell was on vacation) arrived right around this time also.

Sunday, 7/31/2011 737AM

Jackson Roger Scott was brought into the world. Initially he had no heart beat and wasn't breathing on his own. With just a couple of thumps to his chest, his heart beat was restored and he began his fight. He was intubated pretty much right away, and for approximately thirty minutes, the nurses had to breath for him before he started on his own.

Sunday, 7/31/2011 815AM

I was originally taken with the nurses to the NICU while they worked on Jax, but when they learned the severity of it, they escorted me to a room where I was asked to sit and wait for Courtney - it was her recovery room. Around 815AM Courtney arrived. She was a little out of it, but other than that all seemed well. We still didn't really know why what had just occured had occurred - we just knew that it did.

After this, the times get a bit more loose, so I will just use approximates.


The doctor comes and gets me, and takes me to Jax bedside. He tells me that Jackson is very critical and his survival depends on the next few hours. He immediately starts talking about the cold blanket therapy, but tells me if he is a candidate that it has to be done at UK Children's Hospital. He is communicating with Dr. Grainger at UKCH already. Ultimately, they didn't know why, but Jackson's vitals had started dropping very rapidly around 7AM. After they had stabilized him at birth, they found his blood gases, lactic acids and liver enzymes and extremely high levels. In short, his body was producing massive amounts of chemical waste, but not processing it correctly. The cold blanket therapy was meant to slow his respiratory, blood flow and metabolism to help avoid any additional organ damage - especially to the brain.


The decision was made to transport Jackson to UKCH. Dr. Mundy, the Neonatal doctor at St Joe said Jackson was really lucky and would have survived a maximum of twelve more hours in the womb.


Jackson was prepared for transport, and finally got to meet his mother for about two minutes. During this whole time, Courtney was doing well, and seemed to be fine in general. The focus of everyone was on Jackson. Honestly, seeing my son laying in an incubator packed in with ice, I didn't know if I would ever get to see him alive again. Letting them take him was one of the hardest things I have ever had to do.


Dr. Grainger at UKCH found me and let me know Jax was ready to be seen. We stopped in a consult room for a brief conversation. I can't say that he painted the best picture in the world, but he sure made me feel a whole lot better about things. He told me that Jax' levels were already coming down quickly, and that he had barely met the criteria for the cold blanket. They decided to do it as an added precaution more than anything. When he escorted me to Jax' side, I honestly thought he had taken me to the wrong child. A world of difference! He still had tubes and wires everywhere, but the only explanation I can give his presentation. He just looked better.

UKCH ran lab tests hourly throughout the rest of the day, and with each test he improved remarkably. By Tuesday, Jax was off the ventilator. By Thursday he was off all external oxygen. By Friday, he was off all IVs. He has been doing all the work himself since. He is my little Superman!

Monday, 8/1/2011 Afternoon

Court had started to show signs of worsening by now. The staff at St Joe didn't know what was wrong, and Dr Butler knew enough that he had to get her to UK as well. She was transferred around 4PM approximately.

I hadn't been able to see her very much since this whole event started, as I was staying with Jackson as much as possible. Thankfully, Court's mom had been by her side taking care of her little baby girl for me!

I was able to get to her around 6PM. When I had stopped to visit her that morning on my way to Jackson, she looked well and was just starting to have some pain from the epidural wearing off. about twelve hours later, I was smart enough to know something wasn't right. However, I knew that she was in the right hands at UK. I had seen the miracle help they had given Jackson.

The doctors had a few diagnosis in mind, but still were not totally sure. One of their thoughts was Acute Fatty Liver Pregnancy (AFLP). This turned out to be accurate.

Tuesday, 8/2/2011 Morning

When I got to the hospital, Court was in pretty high spirits considering they had ran tests on her all night long - literally. Court's mom was heading to Aunt Judy's to try and get some sleep, and she would relieve me later in the day. Court's dad and Andrea were on their way from Nashville to visit for the day. Court was excited to know they were coming to see her. At this time, they were just watching her lab results and doing what they could to make her comfortable.

They were pretty sure it was AFLP at this point. The problem with AFLP was there isn't a true cure. Delivery is supposed to put you on the path to healing. Jackson had been around for two days at this point, but her body hadn't recognized that she had given birth.

One of Courtney's nurses, Allyson, was measuring the girth of her stomach hourly. Later we found out it wasn't protocol. It was just something she had picked up about ten years prior and had always done. I believe it may be one of two things that saved her life. Around 12PM, Allyson realized that she had distended 2 inches in one hour. She called in the OB doctor, Dr. Duang - the best doctor I have ever met in my life. Dr. Duang had Courtney on an ultrasound of her stomach in literally seconds. What she found was pools of blood in her stomach.

Court's vitals were dropping fast at this point, and to me it was like Sunday morning all over again. I didn't know what was going on. Things were moving very fast. The one difference is I could see Court. It was obvious that she was in bad shape.

Dr. Duang had ICU called. Within minutes (the rapid response times are amazing at UK) the Director of ICU, his entire personal staff, and the several of the resident doctors were in her room to evaluate what was going on. They listened for about two minutes, and took charge. Within about ten minutes of them being contacted, Courtney was on her way to the Critical Decision Unit (CDU) to be stabilized, and then taken to trauma surgery to open her back up and see why she was bleeding internally. I was able to follow part of the way, but then I was escorted to a waiting room.

One thing I have learned in all of this is if the doctors are concerned then something is really, really wrong. I knew something serious was going on, and I had a horrible feeling about surgery. She just wasn't strong enough. I knew it with all my heart. I think the doctors did too though.

After a few minutes, a doctor came out to see me with a packet of papers. He said he had a list of things they may need to do for Courtney, but I needed to sign for them. He said he didn't really have much time to explain. He grabbed a nurse for witness, and I signed. The situation was grim, and I felt it was right to call in the family. Steve and Andrea were very close, and they stopped to get Elaine. She couldn't have barely been to Judy's when all this started. Kara also started the process of coming in from Georgia, and Tracy from Clarksville, TN. I also called for a priest at Christ the King, the cathedral in Lexington.

Within about twenty minutes the family arrived, and shortly after Fr. Richard arrived. Bless him, he had come the day prior for Jax! He is a true Godsend! This is where my confusion started. Fr. Richard and I went back to her first, and I was so befuddled. Courtney looked fine - she was obviously sick, but she was awake and lucid and her vitals were back to normal.

I just can't explain the feeling of relief I felt. It was all surreal to be honest. it just didn't make sense to me. This is around the time they started to identify the problems related to the AFLP. Ultimately, Court's blood was so thin it was seeping straight through all of her organs and pooling inside. They gave her five units of blood within an hour. We had survived a near tragedy!

Shortly, Court was transferred to the Medicine ICU and started on dialysis. By the time they got her settled in, she was quite drugged up, and extremely tired. We let her sleep for the night.

Wednesday, 8/3/2011 Morning

When I arrived at the hospital, Court had just taken a turn for the worse again. At this point, Court had received 13 units of blood since the prior morning. Her symptoms were very similar to Tuesday. The main difference was they knew what to do now to get her back faster. At the same time though, the second thing I credit for saving my wife's life occurred. Dr. Russell decided to give her Factor 7 - a blood coagulator. It was later described to us as "the bazooka of blood treatments". Of note, Courtney needed two doses of it - but it stopped the internal bleeding.

Since that second dosage, the internal bleeding has stopped. Her swelling has started to reduce. Her kidneys have started functioning on their own again. Her liver is starting to normalize. She is on the road to recovery.

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