Procedure tomorrow

"Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our affliction so that we will be able to comfort those who are in any affliction with the comfort with which we ourselves are comforted by God." - 2 Cor 1:3-4

Kara had a great day! The doctors turned her ventilator down even lower today and her blood gas was excellent. They are very confident that she is at the best place to handle a procedure. They have scheduled the surgery for 10/10:30am. The surgeons will be removing the mass. Again we appreciate your petition on our behalf before the Sovereign Lord.



- Pray for Kara's physical strength.
- Pray for the Surgeon's ability to properly identify the limits of the mass.
- Pray for the Surgeon's clarity of thought during the procedure.
- Pray for Kara's stability during her recovery, which will be several weeks.



Connor and Katie have really enjoyed the animals at Children's Hospital. Anytime Katie hears us speak of the hospital she says, with hands outstretched, "We are going to SEE THE ELEPHANTS!!" The trip is not complete until she pats, hugs, and kisses the elephants at the entrance.




We will have more time to update tomorrow during the surgery. We love you all. It is a joy to know we have so many praying for Kara, the doctors, and us.

Kickstarting Kara's Kurrent Kuality Kareplan

We arrived at the hospital this morning we were able to confirm what we heard on the phone earlier:

- Kara has been breathing well, so well they lowered the ventilator breathing rate and oxygen level.
- Kara has been able to be on her back for a couple hours at a time. (She's been on her left side mostly to allow her right lung to work better)
- Her blood gas levels (oxygen/CO2) have been very good.

We were able to speak with the surgeon when we came in. (Which is a blessing they are very busy and it is unknown when they will be able to stop by). He is very pleased with Kara's progress and current state. However, he and the care team think it is in Kara's best interest to do surgery now. The doctors think it is important for her to start developing her ability to feed and digest. They are confident in Kara's strength and ability to handle the procedure. One thing they are going to observe is Kara's ability to be on her right side over the next 24 hours. Which is the side she will be on during the procedure.

They have set Wednesday for the surgery to remove the CCAM. We will go over more of the particulars with them tomorrow.

We thank you very much for your prayers and would ask for more of your time before God's throne of grace.

- Praise Him for the progress Kara has made. (oxygen levels, resting in different positions.)
- Praise Him for the grace and strength He has supplied for Meg and I.
- Praise for Grandma and Grandpa Putman coming to help us
- For continued grace and contentment for Connor and Katie.
- For Kara's physical strength
- For the surgeons' wisdom, clarity, and steady hand

The Lord is a stronghold for the oppressed, and a stronghold in times of trouble. And those who know Your name put their trust in You, for You, O Lord, have not forsaken those who seek You. - Ps 9:9-10

Kara Update - Sunday

The Putmans, in general, had a full day today. We went to 2nd church service (enjoyed a more leisurely morning at home), then to Children's and then home again. Well, that doesn't sound like a lot when I type it out, but we're pretty tired. The stress of being split between our children is starting to wear on us a bit. Understandably, Children's is not a great place for Connor and Katie to be. They have quite a few things they REALLY like there (like the elephant statue and some toys) but there are plenty of screaming kids in the waiting room, and our kids don't like to be in Kara's room for very long. All that to say, we are working through whether or not to bring them back (and if so, when, how often, for how long, etc.) Thanks for prayers on that!

As far as Kara, she had a quiet day. Hooray! The first quiet day of her short little life. Yesterday she had been increased in her levels of: morphine, breaths per minute on ventilator, and %oxygen she was receiving in the ventilator. She was very touchy but did stabilize by the end of the day. Today they were able to bring the % of oxygen down from 60 to 45 and also were able to lower the pressure of the ventilator. The surgeon is extremely happy with her progress and his goal is to extubate (which means take out the ventilator or intubation tube in the next several days. To work toward that they will continue to lower the ventilator pressure and % oxygen levels.

On the ventilator monitor, we can tell which breaths are ventilator initiated vs. which ones are Kara initiated. Most of the breaths are Kara-initiated which is a good sign. Because of her pulmonary hypertension (too much pressure in her lungs) she gets quite worked up with any stimulation and really has labored breathing - which is why she is kept sedated.

Thank you for your continued prayers. We continue to trust that God has all these circumstances in His control, that He makes NO mistakes and formed our little girl EXACTLY how He wants her to be. We believe that as we look at her and weep and "cast all our cares on Him who cares for us." We are reminding ourselves that the surgeons know how well newborns do (and do NOT do) in surgery and that the path they are taking is for our good (Rom. 8:28).

Saturday Afternoon

Things we are thankful for:

- Prayers of our family and friends.
- Great care for our Children. Thank you Roger and Gail!
- That Kara has care close to home so we can have a good night sleep.
- The meals and snacks our friends have brought
- Burgermaster peanut butter shakes
- Knowing that God does not make mistakes

Things we are praying for:

- Patience and contentment as we wait and see whether she will improve or need surgery.
- Full rest when we are home to sleep.
- Clarity of thought and wisdom for the surgeons (they are the doctors attending Kara).
- Extra grace for Connor and Katie to be content as we are away more. Wisdom for us to balance our time.

Thank you for your continued prayers.

Kara's Birthday Party!

Yesterday afternoon Roger and Gail brought the children by for their first visit with Kara. We brought them in to the room to see Kara. They were both very sweet and wanted to hold her. When Connor saw Kara he pointed to Meg's belly and asked, "Do you have another baby?" We had a good laugh.

Because there is not much room with Kara we went out to the lobby and had a birthday party for Kara. The kids ate birthday cookies, that Meg and Connor made last week. Connor and Katie also opened birthday presents from Kara. Connor got a little John Deere dump truck and Katie received a puzzle. Meg is amazing for planning that! I have obtained great favor from the Lord (Pr 18:22).







Happy Birthday Kara! We are excited to get you home!

Kara Update Friday afternoon.

First, thank you everyone for your prayers and kind words! We are very blessed and encouraged to know so many are praying for Kara and us.

Second, I wanted to give an update on Kara's situation. (Picture from last night)



Kara is comfortable and stable. Her blood oxygen levels were low this morning and she needed intubation. The doctors installed a breathing tube with a respirator. The mass had inflated and was creating pressure on her right lung which reduced the amount of oxygen she was getting. She is breathing well and getting the oxygen she needs now. She does need some sedation. She is fighting the breathing tubes and heal pricks. Our little fighter!

Now we wait. The doctors are hoping the mass will stabilize and reduce in size. The main concern is the mass, if enlarged, will create too much pressure on the right lung (good lung) and the heart.

Please continue to pray for the doctor's wisdom and that we would be content with the circumstances God has brought us to. "Our hope is in the Lord, who gave Himself for Me, and paid the price for all my sins on Calvary"

Kara Elizabeth Putman is here!

Kara is here. We are thrilled - She is 7 lb, 20 inches long
We have been absolutely in awe of God's goodness and His choosing to give "good gifts" to us, His children, this last 24 hours.

I will upload photos when my Dad brings the camera cord (currently just have the SIM which doesn't work in the laptop, oops!), but for now here are some of the blessings we're thanking God for:

LABOR:
* Going into labor on my own. (2 a.m.)
* Already had a perinatologist appointment (next door to the hospital) to go to at 11 a.m. so we didn't have to worry about going to the hospital too early or too late.
* Jeremy was home for us to get the car packed and house ready, Mom was home to take Katie and Connor (ear infections) to the pediatritician's just before we headed into the hospital. Dad was still home to stay home from work with the kids.
* Our perinatologist let us admit from her office.
* The same nurse was with us the whole time. She was outstanding and stayed 4 hours past her shift to see us through delivery.
* Our perinatologist (O.B. also) switched "calls" to be here for us. She said her other alternative was to just be here and not get "credit". Wow!
* The perfect epidural (I had a not so perfect one last time and only now do I appreciate the difference!)

DELIVERY/RECOVERY:
* Great staff on hand - 3+ for baby, 4+ for me, Mom and Jeremy
* Delivered at 10:30 p.m. Close enough to midnight so I can stay an extra day if I want (Kara will be staying so this gives me an option of a more comfy bed).
* Awesome nurse just after delivery. Very kind and considerate, took me up to see Kara when I was ready to go (about 90 min after delivery, WOW. Talk about different from c-sec).
* Able to get some sleep afterward because of the time of the delivery - not so many nurse interruptions after 1 a.m., and also because I was not a c-section.
* I am recoverying VERY well. Was able to take care of what I needed to do, in the midde of the night, on my own. I have VERY little pain (and I'm a bit past due for my tylenol and ibuprofen).

KARA:
* Apgar of 8/9 (deductions for color only), cried at delivery, and was able to breath so we were allowed to hold her. This is all WAY above what we anticipated or could have expected.
* Extremely kind, caring, and skilled staff working with Kara.

Kara Update - Last night (and continuing to this morning) the neonatologist and staff continue to problem solve. She is (as we have known all along) quite unique in her circumstances. The shunt remained in place during delivery (it goes from the cyst in the mass in her lung to her back). So they had to clamp it to prevent airleakage. After a chest x-ray, they saw that Kara had oxygen inside the cysts in the mass as well as oxygen between the lungs and the chest wall. They closed up the skin outside the shunt with stitches and steri-strips to see if that would prevent the leakage outside the lungs. Kara is under an oxygen hood and her vitals are usually within normal, respiration rate is a bit high but not worrisome. She will continue to get x-rays every few hours.

Prayers/thoughts - My anticipation is that, with the shunt capped off, the cysts are going to reaccumulate fluid which will make the mass larger. They can open the shunt clamp to release this but don't know what the solution would be long-term (as long as Kara has the shunt in, we're staying in NICU). My prayer is that if Kara needs surgery now (in the next few weeks) that it would be evident sooner rather than later so we can move forward. Otherwise, healing and stability so we can hold off on surgery until 4 months would be amazing.

Please join us in thanking God for His provision. He truly has done above and beyond all that we could ask or imagine, and we are humbled by His grace. God has been so gracious to unfold His plan to us one step at a time. I'm thankful we had to (and still have to) walk through uncertainty and trust in Him, knowing He gives grace sufficient for our weakness and that His mercies are new (and enough) every morning.