Brendan Comes Home!

Belle meets Brendan

Too tiny for his bed

After nearly 3 weeks in the hospital, our little Brendan finally got to come home from the hospital on June 26, 2008. He came home weighing in at a whopping 5 lbs. 5 oz. (1 more pound than when he was born). He was discharged because he finally figured out the eating thing. Soon after he was settled we learned that he has some pretty substantial acid reflux (very common in preemies). Unfortunately, it makes him pretty fussy after his feedings and sometimes wakes him up in between. The poor little guy looks so miserable sometimes. But upon visiting the pediatrician we were give a perscription that has helped tremendously. We still have to help him out with things like elevating the head of his bed and having him sit up while feeding but all in all we're doing all right. He is a great overnight sleeper--he usually only wakes up once in the middle of the night. Daddy is really thankful for that as he has already gone back to work and really needs his beauty rest. He is also eating very well, it's almost time to change sizes in bottles already. At his doctor's appointment 3 weeks after arriving home he had gained a little over a pound. Our little man is doing great!

Brendan finds Daddy's hands

Brendan's Birth Story

Thank you Mom (and new Grandma) Pelhank for helping us put this together.

Birth of Ryan Brendan Pelhank-

Date: June 6, 2008
Time: 12:39 am
Weight: 4 lbs. 5 oz.
Length: 18.5 in.
Approximately 5 weeks early

Father: Kevin Ryan Pelhank (28 years old)
Mother: Amanda Faith (Cole) Pelhank (27 years old)

Obstetrician: Dr. Pamela Campbell
Pediatrician: Dr. Laquita Graham

1st child

Place of birth: St. John's Mercy Medical Center, 615 S. New Ballas Rd., St. Louis, MO 63141, 314-251-6000

Tuesday, May 20, 2008
Amanda (Mandy) and Kevin (Ryan) are advised during an obstetric visit that Mandy's blood pressure is elevated to a degree that caused concern. They are advised to keep monitoring her blood pressure and return in 2 days for a further checkup.

Friday, May 23, 2008
Mandy is hospitalized for observation and monitoring of her blood pressure and other vital signs. Although her blood pressure remains high during observation, it is deemed not so high as to cause undue concern, and blood work further confirms that she and the baby are in no danger. The doctor feels that she can go home provided that she remains on complete bed rest with feet elevated and continues to monitor her blood pressure. She feels that Mandy is in danger of developing a condition known as Preeclampsia:

Preeclampsia, a narrowing of the blood vessels, is a dangerous condition unique to pregnancy. Because of this narrowing, women with preeclampsia can have decreased blood flow to the kidneys, brain, liver, retina, and placenta. Symptoms of preeclampsia include high blood pressure, swelling of the hands and face, and protein in the urine. Preeclampsia can cause fetal complications such as stillbirths, premature births, and low birth weight. The only definite cure for preeclampsia is delivering the fetus.

Monday, May 26, 2008
Family and friends descend on the Pelhank home and help with everything from barbecuing to washing clothes, putting away clothes, painting the baby's room and providing general moral support for the almost panicking couple.
Mandy continues to monitor her blood pressure, which by now is hovering between 140/90 and 160/95. The couple also goes back to the hospital twice weekly for fetal ultrasounds and observation.

Thursday, June 5, 2008
Mandy gets up around 6:30 in the morning. While showering she begins to experience contractions which are about 6 or 7 minutes apart. She is not too concerned as the contractions are mild, but "this could be Braxton Hicks contractions or the real thing," she is thinking. They arrive at their regularly scheduled appointment at the hospital at 8:00 am.
Upon arrival at the hospital, Mandy is monitored again, and is sent to the Women's Evaluation Unit due to her elevated blood pressure. The contractions have not stopped, and her blood pressure is high. While in the Women's Evaluation Unit, the nurses observed that the contractions are about 5 to 7 minutes apart and Mandy is 2-3 cm dilated. Mandy and Ryan are then moved to the Labor and Delivery area of the hospital and the obstetrician begins to talk of inducing birth and getting this delivery over with.

7:00-8:00 pm
The Coles and Pelhanks are waiting patiently in the delivery waiting room as Ryan runs out frequently and tries to keep them updated. Present are Mandy's mom and dad: Gary and Christy, sister: Jess, brother: Shane and his girlfriend: Lilly; and Ryan's dad: Kevin, and sister Tory and Ryan's friend: Brad. Ryan's mom, Suzi, is in New Jersey away on business, and is unable to come. Ryan's brother, Johnny, is leaving for Florida the next morning and is also unable to come.

8:00 pm
In the delivery room, potosin is administered to induce birth and immediately Mandy's contractions become closer and harder. At the same time, however, she is given magnesium sulfate which is for the mother's benefit and is supposed to keep her from having seizures due to the elevated blood pressure during birth. The magnesium also conflicts with the effects of the potosin because it is often used to delay contractions. The nurses make it clear that because of the conflicting effects of the 2 drugs, labor could be significantly prolonged and a cesarean section is likely. Unfortunately, one of the side effects of magnesium sulfate is a migraine headache for the mother, which Mandy immediately gets once the drug takes effect.

10:00 pm
So...battling with a migraine headache (the worst headache Mandy has ever gotten in her life) and dealing with contractions (the worst pain of her life), becomes the next order of the night. In between contractions, (when a normal mother having contractions could look for some relief), Mandy can only focus on the excruciating pain of the headache. The only relief from the headache is another contraction. She is vomiting from the headache, then trying to do her Lamaze breathing through another contraction. The only thing on Mandy's mind is breathing through the contractions to distract her from the constant pain.
Meanwhile Ryan is rubbing her head and holding her hand trying to help her focus on breathing during the contractions. He is feeling sorry for his wife and worried about the outcome of the surprise ordeal. They both just want Mandy and the baby safely through this birth and are hoping to avoid a c-section.

11:00 pm
Mandy is checked and is 4 to 5 cm dilated. The anesthesiologist administers the epidural. At this point, the obstetrician is still not at the hospital for delivery yet. Nurses are monitoring Mandy closely and her contractions continue to be strong and close together. The epidural has effectively relieved the pain of the contractions but the headache remains.

Friday, June 6, 2008
12:01 am
Finally the obstetrician is on her way since the nurse notices that Mandy is fully dilated and ready to push. Just to check, she prepares Mandy do a practice run, and immediately tells her to stop before she can even push since she can see the baby's head crowning. Now the protocol is to stop pushing since they don't want the baby to be born before the doctor gets there. Mandy's new objective is keeping her legs together and focusing on slowing down the birth process.

12:30 am
Thank God the doctor enters the room and pushing can continue. The delivery team of at least 7 doctors and nurses enter the room, the push is on, and with only about 4 good pushes, little Brendan is born at 12:39 am and the umbilical cord is cut. He immediately cries upon birth, which is a very good sign that his lungs are developed enough to sustain him.
Brendan is cleaned up and put on Mandy's chest for a few seconds before he is whisked to Neonatal Intensive Care (NIC) for observation and care.
Mandy and Ryan feel relieved that a c-section was not required and even more relieved that their new son appears to be healthy (although very small). They are both extremely tired and overwhelmed at the speed with which the series of events unfolded.

1:00 am
Ryan informs all the waiting relatives of the new birth and they are allowed into the delivery room to see the smiling Mandy. Although relieved the birth is over and Brendan is doing well, she is extremely hungry since she has not eaten in almost 24 hours...and she still has that awful headache.
Gary is dispensed to the local hamburger joint to get Mandy the hamburger she is craving. He races off in pursuit and finally finds one at Steak N Shake to bring back to the starving mother.
The doctor is saying that Brendan's vital signs look very good. He will need to stay in the NIC unit for a few weeks until his sucking mechanism develops to the point where he can take the breast or the bottle. In the meantime, he will be fed through a tube to the stomach so that he can get the nutrients he needs. Other than that, all his other signs look good.
Mandy will be kept for observation for a couple of days to make sure her blood pressure is stable.

Saturday, June 7, 2008
A new day dawns as the happy couple begin the process of caring for their little Brendan.