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“Waiting for Dekar to be born, in the O.R., Dr. Mann, Sue, and I were aware that he had Trisomy 18 and a hypoplastic left heart ventricle. We knew this meant that he would probably not survive for very long, or possibly not even be born alive. His parents, Marge and Cortney, had known for some time about Dekar’s condition, and had come up with a very carefully thought-out birth plan. Our priority as the health care team was, upon delivery, to take care of Dekar’s immediate needs as quickly as possible so that Cortney and Marge could hold him and spend as much time with him as possible.. We all watched as Dr. Jeakle lifted Dekar out of Marge’s womb and cut the cord. We listened for that first cry, which didn’t come. Dr. Jeakle brought him to the warming island–he was so blue and barely breathing. But I remember noticing how sweet he looked–tiny, with lots of dark hair.
Many thoughts raced through my mind as I dried him off—He’s so tiny–He looks so perfect–PLEASE BREATHE. Dr. Mann listened to his heart beat. He tapped the heart rate out–at first around 100, but very quickly dropping to 70’s, then 60’s. Dr Mann asked me to give him some positive pressure ventilation. I gave him several breaths, while Dr. Mann continued to listen to his heart and tap out the rate, which continued to drop into the 50’s.
At this point, Sue, Dr. Mann, and I all thought that Dekar was not going to make it. So we quickly wrapped him up and took him over to meet his parents. When Cortney held him and Marge started talking to him, is my first recollection of hearing him cry. This is when it seemed to us that he started trying–fighting–once he was near Marge and Cortney. We could see him become more vigorous with his parents.
At this point, Sue, Dr. Mann, and I felt conflicted. Dekar probably could have stood to be suctioned, but his heart rate was still very low, and we were reluctant to take him away from his parents. We were still thinking that it didn’t look like he would survive. At that time, though, Marge thankfully asked if we thought he should be suctioned. We quickly took him to the island, suctioned him, and listened to his heart rate, which was actually starting to rise. He returned to his parents, where he continued to have more effective breathing efforts, and a little stronger cry. By this time Dr. Mann got a heart rate between 130’s and 150’s, but Dekar’s color was still pretty blue. We were able to give Dekar some supplemental oxygen by mask while he remained snuggled with Marge and Cortney during the completion of the surgery. His color did improve, and his heart rate stayed in the 130’s to 140’s. Dr. Mann, Sue, and I were becoming cautiously optimistic that this little guy would get to meet his siblings.
Once Marge’s surgery was completed, every one returned to her room. Dekar was carried by Cortney. He appeared at that point to be holding his own, without the supplemental oxygen.
It was a real privilege and honor to be present while Dekar got to meet all his siblings. He truly seemed to respond and be aware–there was so much love in the room for that little baby! After a couple of hours, with Dekar continuing to hold his own, I was given the opportunity to weigh, measure, and bathe him. His sister, Rachel was right by my side, watching everything I did..
I will always be grateful for the chance to meet Dekar and your whole family–and to be able to share in this special, yet difficult time in your lives.
May God bless you all.
Kathy D. RN”
After the diagnosis of Trisomy 18 and hypoplastic left heart, my head swirled. I kept praying that God would heal Dekar. But having experienced a child that went through cancer**, I knew full well that God sometimes has other plans and allows us to go through very difficult situations. So, as I prayed for Dekar’s complete healing, I also prayed for guidance and direction to plan for the worst case scenario. I started scribbling notes on what I should look into. Below are items I researched and discussed, along with things I wish I had done or questions I wish I had asked. I am also linking to the Now I Lay Me Down To Sleep forum where parents weigh in on this matter in more depth.
These are items that were on my mind at the time (or things I wished I would have done.) The Birth Plan is the outcome of researching most of the items below. (This page will be updated as time goes on and my memory is refreshed.) Last updated June 18, 2009.
MY CARE:
- What would be best for me? Natural delivery or c-section?
- If I chose c-section, what pain medication would allow me to be as alert as possible after Dekar’s arrival? (Discuss with ob nurse and doctor.) What pain medication will allow me to be the most mobile?
- If I go into labor naturally, do I want pain medication?
DEKAR’S CARE:
- What will give me the best chance of seeing Dekar alive–natural delivery or c-section?
- If Dekar is able to eat, will he be able to breastfeed? If not, what other options are available? Will a nurse be able to teach me to tube feed him? What is the hospital equipped for?
- Can he have surgery to fix his heart? What outcome could I expect?
IF HE IS ABLE TO COME HOME:
- Contact local hospice and talk to them. What do I need to know?
IF DEKAR DIES:
- How long can I hold him after his death? Does the hospital have a policy for deciding this time frame?
- Does the funeral home have a time frame for picking him up?
- When do I get his clothes returned from funeral home? Will they be washed when they are returned? (We chose cremation, so his clothes were returned to us. I suggest removing the clothes and reclothing at the hospital directly before sending the baby to funeral home. Dekar’s clothes were returned smelling of the funeral home, and that made me sad.)
- Cremation or burial?
- What funeral home? (Don’t assume the local one in town will be the best to serve your needs. Meet with the funeral director personally. Choose your funeral home as carefully as you would pick your doctor.)
- Will you be able to view your child again if you choose cremation? In other words, once the funeral home has him, is that the last time you be able to hold his earthly body? Some funeral homes allow another viewing before the child is taken for the cremation, some don’t.
- If I choose cremation, how do we receive the ashes of our child?
OTHER STUFF:
- Can we camcorder the delivery in the operating room (c-section)?
- Pictures—have a couple cameras to use, along with plenty of batteries. Buy extra disposables, just in case.
- Is there a Now I Lay Me Down To Sleep photographer available?
- Do I need to supply the material for the casting of his feet and hands? (Kits available at Michael’s. Buy a few since they don’t always turn out perfectly. I did one of each hand and feet.)
- What does hospital provide as far as making memories?
- Finalize a birth plan. Make several copies. Have doctor read it at each visit as it is updated.
- Make sure staff knows how to spell and pronounce Dekar’s name.
- Take a special blanket to hold Dekar in.
Even now, I still feel I covered everything as well as I could–however, I admit I have some regrets. I don’t dwell on them. I don’t beat myself up for them. If they pop into my mind, I think about them, deal with the emotions that are tagged to them, and thank God that I really did do as well as I could at the time, given the circumstance. If I let these regrets overtake me I would be miserable and bitterness would rule. I have to give myself grace. Besides the hard diagnosis, I had a c-section and on pain control. My thought process was not as sharp as it is on a “normal” day. I was tired and trying to make the most of the whole situation. Sigh. All that said, here are my…..
THINGS I WISH I COULD GO BACK AND CHANGE:
- Have an extra outfit to change Dekar into before he was taken off to funeral home. When I got Dekar’s clothes back they didn’t smell like him any more–they had taken on the funeral home smell. That made me sad.
- I wish I had spent the whole night holding Dekar after his death–allowing the nurse to cool the baby at intervals as needed.
- I wish I had changed at least one of his diapers.
- Clarify what “standard suctioning” is so that I knew we were on the same page with that instead of assuming we were.
- Not allow the dr. to go do an exam on Dekar. Looking back, there was simply no need for it.
- I wish I had taken off the hat that the nurse put on him and replaced it with the one I brought right away.
- I wish I had been prepared to know how Dekar’s ashes would be delivered. Because we didn’t purchase an urn right away, we received his remains in a thick plastic bag which was in a cardboard box. I just wish I had known that beforehand. I would have been more proactive about getting a permanent “resting place” for Dekar.
**My oldest son is almost sixteen years old and a cancer survivor. He had hepatoblastoma with metastasis to the lungs.
babydekar.com 
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