Thirty two weeks and 5 days at 10:09 on 05-16-2004 my wife gave birth to Graham Bennett via cesarean. He was 3 pounds 7.5 ounces and 15 1/2 inches long. Up until 32 weeks and 2 days we were convinced this would be our first pregnancy that would go full term. The first 31 weeks things were going extremely well, and there were no problems or issues to be concerned about. But then Tonia started to have severe itching, the type that no matter how hard you scratched it made no difference. She was having trouble even sleeping at night because of the constant need to itch. It was around this time that her blood pressure started going up. On Thursday May 13th we found out the reason why Tonia had been itching so bad over the past week; the results of her recent blood test showed that she had Intrahepatic cholestasis (ICP) which means her liver was storing bile and not sending it properly into the intestine. Bile is dangerous for the baby and there is nothing they can do to help the body remove it. The level of bile does not matter, it is either there or not type of thing. It does not cause birth defects but there is a 10 in 1000 chance we could lose the baby IF we do nothing. However, in the 1000 cases studied stillbirth occurred late in the pregnancy usually after 36 weeks. So the current recommendation is to have the baby delivered as soon as the lungs are mature enough. Of the cases that delivered before 36 weeks the rate of stillbirth was more like 2%. Thursday night was a tough night for us, because we were so convinced that this baby would be our first to make it to 40 weeks. At this point the plan was to schedule a cesarean or maybe even try natural birth at 35 weeks giving our son the best chance of avoiding stillbirth and far enough along to avoid most of the struggles of prematurity. On Friday May 14th Tonia was asked to come back for another evaluation at which time our Perinatoligist became more concerned about Tonia's toxemia (pre-eclampsia or high blood pressure). Tonia was hovering between 158-165 over 98-110. And for the first time they noticed that Graham was no longer gaining weight. His abdomen was starting to decrease in size which is an indication that he was not getting the nutrients he needed to sustain growth. The body will begin to redistribute nutrients to the brain when there is a deficiency and one of the first signs of this is when the abdomen beings to decrease in size. If Tonia's blood pressure stayed above 160 systolic or 110 diastolic then the risks of delivering the baby early are outweighed by the dangers of abruption (tearing of the placenta away from the uterous). As a result of these new findings Tonia was checked into the hospital that morning. We went from thinking we were going to make it to 40 weeks to coming to grips with 35 weeks to having to hope 32 weeks will be long enough. We were both heart broken and a little scared but we knew we were in good hands, and we had the comfort of knowing how Lane turned out and the fact that Graham made it almost a full month longer than Lane. We also had 48 hours to allow the steroid shots to take hold and help Graham's lungs develop. The cesarean went smoothly and since I was little more collected this time compared to Lane's birth, I remembered to bring my camera and was able to take some pictures and video of Graham's birth. Graham came out crying and looked just like Lane. It felt like a dream because I was standing in the same spot, and in the same emergency room that I was in just 18 months earlier with Lane coming into the world in this exact same fashion. It was almost unbelievable at times that this was happening all over again. All 3 of our children were born prematurely for completely different reasons. Ellie was sort of an unknown, but the doctors had guessed that she was a possible abruption, or just one of the many unknown reasons of preterm labor. Lane came early because of placenta previa and bleeding, and Graham was due to pre-eclampsia and cholestasis of pregnancy. Graham struggled a little bit his first week and had to be put on a ventilator, but he quickly turned around after the first week and progressed very rapidly. He went through many of the same hurdles as Lane did, and similar to Lane he continued to jump them faster than predicted. Similar to Lane, Graham had no bleeding on the brain, and had his PDA close without the need for surgery. Learning from experience we signed to have a PIC line put in on the first night to avoid having new IV lines put in every few days or in some cases more than once a day. A PIC line is a special IV that goes in the vein similar to a normal IV but instead of just an inch or two it travels all the way up the arm, up and around the shoulder and down into the heart. With Lane we waited a week or two before signing the release for the PIC line because we knew it was a dangerous procedure. But after seeing how often they had to replace the standard IV lines and how painful it was for Lane to be stuck with the large needle and how painful it was for mom and dad to watch this happen we decided it was necessary.  Like most preemies Graham had a mild amount of jaundice and required some lights for a few days to help him recover. But fortunately unlike Lane, Graham has not had a problem with apnea. As I write this letter Graham is still in the NICU (3 weeks today) and doing extremely well. He is now 4 pounds 4 ounces, in an open air crib (more like a small plastic tub), and no longer being fed with a gavage tube. He is breast feeding for 10 minutes twice a day and bottle feeding the rest of the time. There is a very good chance he will be coming home in the next week. Both Tonia and I are going to the hospital as often as we can, and fortunately my current job is just a few blocks away from the hospital so I get to see Graham on my lunch breaks and on my way home from work. Tonia tries to get over to the hospital at least twice a day, but unlike when we had Lane, we now have an 18 month at home, so we do not get to be with Graham as often as we would like. Again we owe a great debt of thanks to Pomona Valley Neonatal Intensive Care Unit and the incredible nurses and doctors that took care of Graham. We are so fortunate to be living in time where technology and medicine is capable of saving babies like ours. It is hard to imagine a better hospital staffed with better nurses than PVHMC. In my mind they are among the best in the world. Many of the nurses and doctors remembered us from when we had Lane and we were excited to have all of our favorites that took care of Lane also take care of Graham. In fact our primary nurse for Lane is also our primary nurse for Graham.  We are so fortunate to have so many family and friends praying specifically for Graham and the nurses and doctors that are watching over him. We have been blessed again to have this precious gift of life and we give thanks to God for Graham and his continued progress.  

Dennis & Tonia Levens