Thursday, June 18, 2009

Autopsy Results and timeline with photos

I was slow getting this typed out. I was waiting for a time I was up to the task, it is an emotional thing. The results are comforting. They confirm she would not have survived no matter how hard we tried. She was much sicker than we knew. However comforting though, it was still difficult.

When she was born she weighed 3lb 1oz. The day she got sick she weighed Just under that, she was just reaching her birth weight again. When she passed away she was 5.2 lb mostly fluid from the swelling. They weighed her organs and gave what the normal weights should be. Most of them were much heavier than the norm, I assume from the extra fluid.

The clinical diagnoses precipitating death was NEC (Necrotozing Enterocolitis) and Respiratory failure. She had 34 centimeters of small intestine remaining, and 8.4 centimeters of colon. This remaining bowel showed necrosis and was also dying, so they did not remove it during her second surgery since it would not have saved her anyhow. She had some scarring and meconium in her abdominal cavity from where her bowel perforated, this caused severe neonatal septicemia (sepsis).

Blood taken from her heart tested positive for Klebsiella Oxytoca. This is the same thing Lillian had a week or so after genevive passed away, Lillian's was in the spinal fluid, not the heart, it was what caused her meningitis. This is significant, Genevive was fighting two things at once, NEC and Klebsiella.

Because she was so sick, she had serious blood pressure drops after her first surgery, it was fairly low most of the time really, largely due to the sepsis. This stress caused hemmoraghing in a lot of her major organs. And the lack of oxygen cause neurological damage, and necrosis in her liver. If she had survived she would have needed a bowel and a liver transplant. Plus she would have been a vegetable or have serious cerebral palsy from the brain damage.

Completely unrelated she had a congenital cystic adenomatoid malformation in her left lung. Her right lung had 3 lobes, her left lung had 2, where the third lower lobe should have been she had non working malformed lung tissue. Also in the left lung, not sure if the same lobe a Bronchial Atresia. Basically her left lung wasn't very useful. They said it would not have affected her life much.

TIMELINE (hope this doesn't bother anyone, I did it for me, but I think it really shows what NEC does.)

January 12, 2009
I left the hospital at about 5:30 pm she was perfect, we played, she smiled, and she went to sleep when I left. She first showed signs of having an issue (bloody stool) at 9pm, xray was clear. NEC showed up on the xray at 11pm.

January 13, 2009

She was very sick and xray showed bowel perforation at 1:15am and she was in the first surgery by 3am.

She came back looking much better. Red instead of green, and much less swelling in the belly area.

She continued to need a lot of intervention throughout the day. Her blood pressure was very low, and her respiratory performance wasn't great. At 10pm that night we had her baptized. She was switched to a jet ventilator shortly afterward. It shook her belly very hard. They said if that doesn't work there are no other ventilators to try.

January 14, 2009

By the morning of the 14th they decided she just wasn't doing well at all. She was much more swollen from all the fluids they kept having to give her to get her blood pressure up. They decided to do a second surgery to see what was going on in there that started at about 10:30am. It was very quick, afterward they told us that the rest of her bowel was dieing and she would not survive this. They gave us the option to wait and see how long she lasts, or to take her off the ventilator. We decided to spend some time with her and take her off the ventilator later on so she could die with us and not on a table. We called friends and family, and decorated the big family room. Around 2pm her blood pressure had a serious drop and we were told there was no more time, if we wanted to move her we would have to do it now. So I picked her up and we moved to the big family room. We removed everything except her pain medication. My mom wasn't able to get there in time, but Genevive was done fighting.

She passed away in my arms at 2:46pm. I think she was not in pain, she seemed peaceful.
Here is the photo taken the moment she had passed.

I miss her terribly.


Brittanie said...

This just breaks my heart. So very beautiful. Oh honey, that last picture...brings so much back. (hugs)

I'm so glad you got the time with her that you did.

Such a beautiful sweet girl.

Rachel said...

Crying with you...

Rebecca said...

She is so beautiful. I'm sorry she's gone.

Susan and Michael said...

Can't stop the tears right now. The last image is all too familiar and really hit home with me. We were both having to say goodbye to our angels on the same day. Oh how precious your little girl is, and I'm so sorry that you had to endure losing her. I am glad that you were able to feel some comfort from the results of the autopsy report. Thanks for sharing. Thinking of you.

Susan Brewer (Allie's mommy)

Lissa Lane said...

Sweet Sweet genevive. Poor Baby Girl. RIP

Nan and Mike said...

My prayers and tears are with you. Thank you for sharing her with the world. Lots of hugs, Nan

Anthony's Mommy said...

I'm so sorry that you lost your daughter! I am glad you got to be with her for her last moments and I know she felt your love. There is not better comfort then to be in the arms of ones mother.


Courtney said...

Bless your hearts .. What a beautiful baby girl.

Catherine W said...

I'm so sorry that you lost your sweet Genevive. What a beautiful little girl. I can't put it better than Anthony's mommy above, there can be no greater comfort than mother's arms. xx