The Ballad of Ruby Mae

The Ballad of Ruby Mae

Well, we are pleased to announce the birth of our beautiful baby girl, Ruby Myfanway Kingscote. Her middle name is pronounced Ma-van-way, and we are calling her Ruby Mae. The vitals are that she was born at 11:03 pm on Friday, October 21st. She was 8 pounds, 12 ounces and 21-1/4 inches long.

As some of you have heard, Ruby’s introduction into the world has been considerably less than hospitable. It has been, though, downright convivial compared to the introduction Natasha and I have gotten to parenthood.

The facts go something like this: Natasha’s water broke at 4:30 am on Friday, and labored until Ruby finally made her appearance some nineteen hours later. We spent all of Saturday in our room, accepting visitors and generally just enjoying the glow of being with our newborn baby. Everything was going great, aside from the inevitable fatigue that follows such a birth. She was summoned for a routine test at about two in the morning, and never made it back to the room. A couple of hours later, we were told that she had had a couple of spells of apnea, or the cessation of breathing. They hooked her up to a monitor, which confirmed that the oxygen levels in her blood were, indeed, dropping well below the normal range. So, off to the Newborn ICU (NICU) she went. We were told that it wasn’t necessarily serious, but needed to be investigated, and that we could go down there at about seven.

By the time we got there, she was hooked up to a bunch of monitors, but sleeping peacefully in a special bed that has a heater and allows for easy examinations. Again, we were told that they weren’t sure what was going on, but that they were doing some tests to try to figure it out. They seemed to think that the most likely causes were either a ‘floppy’ airway in which the cartilage in her throat wasn’t fully solidified, a blocked airway due to spit-up (reflux), or that it would go away fairly shortly without us ever figuring it out. Because it was Sunday, they didn’t have the right people to test for the floppy airway or the reflux, so we basically waited while they did blood tests and the like. Nothing came back abnormal from those.

On Monday, it took quite a while to get the tests going. They decided that the most likely culprit was reflux, so we started that test first, which involved inserting a probe into her throat to see if the apnea spells correlated to times that she spit up into her throat. The test was to last 24 hours. In the meantime, we held her as much as possible (basically all of the time), and hoped for the best.

We finally broke down and went to sleep in our room late that night, but were woken up by the attending pediatrician at about 2:30, who told us that she had had a seizure. She was extremely informative, and encouraging. She said that this was fairly common, and that in the majority of cases, it simply goes away without them ever figuring out what it was. So, they would do the regular tests and go from there.

One of the regular tests was an MRI on her brain. This happened mid-morning on Tuesday, and the doctors acted as if they fully expected to find nothing. In fact, they did find something. At about one in the afternoon, we were told that there was bleeding in Ruby’s brain that was causing the seizures, which were in turn causing the apnea. We asked for a room to talk, where we freaked out a bit and realized that we had many, many questions. We went back to the doctor, who took us to another room to answer those questions. He said that the possibilities ranged from it being a one-time trauma which will most likely resolve itself when the blood gets reabsorbed into the system without any long term effects, to the possibility that it was a problem with the blood vessels leaking blood, in which case her chances of survival would be remote. He could not tell what Ruby’s situation was, and said that in order to know, we would need to consult a Neurosurgeon. One had been called, and was scheduled to arrive in the ‘late afternoon’. At around five a call came that he would be there in a while. We waited and waited, with our anxiety level rising. We finally found out at about eight that he had been pulled into an emergency operation at UCSF and that he would not make it until the next morning. Thus, we had what we now refer to as the Seventeen Hours of Hell.

When he did arrive in the morning, he said “you have a beautiful baby girl, and she will be just fine.” Needless to say, our hellish tears turned to tears of heavenly joy (I choked up mightily, and Natasha flat out bawled tears of relief). The doctors laid out a set of criteria that would need to be met in order for her to go home, which little Ruby Mae, ever her mother’s daughter, adhered to assiduously, even though because she was getting so much blood drawn and having so many tests done on her that they kept finding little abnormalities, such as an elevated ammonia level in her blood which in the end served only to make us incredibly anxious about both her health and prospects for going home.

They tested her brain again, and found ‘sub-seizure’ activity, which suggests the possibility of future seizures, so she is on anti-seizure medication, and is doing great. It made her really groggy at first, but she is acclimating to it, and so her little personality is starting to show through. Any long term affects won’t be known for quite some time, but the neurologist is quite optimistic that they will be none or very minimal. At the very least, the part of the brain that the blood was in is not involved directly in cognitive functioning, so we are very relieved about that. For now, she seems to be doing fine.

We are affectionately referring to her as our little chunky monkey because of both her copious rolls of fat and the fact that she was by far the largest baby in the NICU. They weigh every diaper to monitor output, and a nurse who has worked there for 30 years declared one of hers to be the heaviest ever in the history of the NICU. As you might imagine, we are very proud.

So, we were finally given the green light to go home on Monday, after six days of monitoring in order to confirm that the blood was not causing any further symptoms, and that the ones identified were under control, and although it was a somewhat arduous journey to wait that long, we are now grateful that they were so diligent, since we are much more confident that she is fine. No doubt, we would have been checking her breathing, and everything else, every five minutes had we come home earlier.

It’s been quite an experience, to say the least. Natasha said at one point Tuesday night that it was easily the worst day of her life. The first thing she said to Dr. Perry, the neurosurgeon, upon hearing his prognosis was “this is the best day of my life!” which should give you an idea of the emotional roller coaster we’ve been on. We are extremely grateful for all of the support, be it tangible or positive energy and good thoughts. Even though we had to go through this, necessarily, largely by ourselves, we have been comforted by knowing that your thoughts and prayers were coming our way. We knew the love was out there, and it helped.

Now that she’s home, we are easing into the normal routine of becoming new parents, enjoying and cherishing it all the more for the ordeal that we’ve been through. She is beautiful, and thriving, acting normal and healthy in every way, and we could not be more pleased.

Natasha & Antonio