12/08/01 11:15 AM
Clara is on a bumpy stretch of road right now.  Early this morning she experienced an irregular heart beat for about twenty minutes.  They did an EKG and tested her electrolytes and both came back normal.  They suspected that the pick line from her leg to her heart may have been "tickling' her heart so they pulled it back a little.  She is still having problems with her oxygen and CO2 levels.  Last night they put her back on the oscillating ventilator.  The doctors told Jacob and Diana not to look at it as a setback, but that they did not want Clara to be on one ventilator too long and become too accustomed to it.  Currently they are running the oxygen level at 100%.  They want to decrease this as soon as possible.  They are considering giving Clara some steroids that will immediately help her lungs to mature.  However, she still has some infection and giving steroids while she has an infection may cause the infection to grow or the steroids can cover up signs of infection.  They are calling in an infection specialist today to examine all of Clara's blood cultures to determine the types of infection she has.  The infection appears to have gone down a lot and tests are showing that it is from the catheter and not from her blood.  We should know late today what course of action they have decided on.  Clara looks very good (new picture on the web site) and she has done well so far.
Thank you for your continued prayers for Clara and her family.

12/7/01 7:15 PM
Clara continues to do well this evening.  They are now giving her milk every six hours.  She is looking very good.  Apparently all the swelling has now gone away.  Her platelet count today was 81000.  This is up from 63000 two days ago and they have not given her any injections of platelets so she is making them herself.  Her CO2 level today was usually in the fifties which is not too bad.  Clara also got weighed today again and was 678 grams or 1 lb. 8 oz.  The doctors had estimated her weight a couple days ago at 1 lb. 11 oz. (770 grams) but that was before all the swelling had gone down.  Her weight today is just where she should be for her age according to the nurse.  Clara's incision from the surgery is healing up very well.  Truly God has worked miracles.

12/7/01 10:40 AM
Clara is continuing to make progress.  She has had two more feedings of milk  It will actually be a couple of days before we know if she can really tolerate it yet.  The small amount she is receiving helps to "wake up" her stomach.  The nurse is going to try to weigh Clara again today.  We are anxious to see if she has gained weight again.  The swelling is now mostly gone.  Clara had her first "beauty shop" appointment this morning when she got her hair shampooed.  Clara's CO2 levels continue to be a concern.  Last night it went up to 70-74%.  She is still on the jet ventilator with a pressure setting of 26.  We need to continue to pray for Clara and specifically that her lungs will mature.

12/6/01 10:30 AM
Diana reported that Clara continues to do well this morning.  Diana was also pleased that Clara, for the first time, was able to have a small amount (0.5 cc) of mommy's milk.  Diana actually gave it to Clara with a syringe into a nasal tube to Clara’s tummy.  She also put a drop of milk on a pacifier and gave it to Clara at the same time to associate sucking with milk.  God continues to bless Clara and the family through everyone’s prayers.

12/5/01 3:00 PM
Clara is still doing well.  She remains on the jet ventilator but they have taken off the billirubin light.  The doctors inserted a new pick line in Clara's leg and removed the pick line from her arm.  Clara has two bacterial infections.  One is in her blood and the other is from her tracheal tube.  They are giving her two antibiotics, which are effective.  Her platelet count this morning was 63000 which is good.  The swelling has gone down more and is mainly only noticeable in her neck.  The doctors are estimating her weight at 770 grams or 1 lb. 11 oz.

12/04/01 1:30 PM
Clara's condition continues to improve.  She had a head ultrasound this morning and it showed that the earlier bleeding on both sides of her brain is resolving and only some residue remains.  There are no signs of any new bleeding.  Her billirubin count is down so they are going to start alternating the light on 12 hours and off 12 hours.  The infection appears to also be declining.  The doctors are going to take two blood samples today for cultures to check for infection.  They will take one sample from the “pick line” that runs up her arm.  Normally pick lines are good for about three weeks and that is how long this one has been in.  This one is still working but to be safe, they will probably attempt to insert a new one soon.  The other blood sample will be taken from the catheter in her navel.  It is possible that the infection came from the catheter or pick line and by doing both they might discover from where it came.  Clara’s last platelet count was 63,000.  This is down from 80,000 yesterday, but still acceptable.  They will be giving her more platelets today.  They are also going to start weaning her off the morphine she has been on since the surgery.  She has also been receiving some sedative to keep her from moving around too much.  They are now going to add it as a drip to one of her IV’s.  Clara laid on her stomach today and tolerated it very well.  Her swelling continues to go down also.  Diana and Jacob are doing well.  Like all the family, they are pleased with the progress Clara has made, but are aware that the journey is still a long one.  Your prayer support makes it possible.

12/3/01 1:10 PM
Clara is continuing to improve.  Last night the doctors replace the catheter in her navel.  The umbilical cord had dried up normally, but the catheter was still in but not working properly.  There was concern about the possibility of getting a new catheter inserted.  If they were unable they would have to run another line up Clara’s other arm.  Dr. Hillman was the attending physician.  She called Dr. Pardalos, the attending physician this past week.  He came back into the hospital to assist Dr. Hillman.  Then Dr, Hillman pulled the old catheter out and Dr. Pardalos inserted the new one without any problems.  Then they attached a new sensor that measures Clara’s CO2 level.  Clara withstood the procedure very well even though they had to move her out of the isolette and unto an open table.  Shortly after the procedure her CO2 level was very stable between 48-50.  Clara’s infection also is improving.  Her platelet count early this morning was 54000 (up from 27000).  The count late this morning was 80000.  Also it appears that some of the swelling in her neck and abdominal area have gone down.  Clara celebrated her three-week birthday today thanks to the prayers of many.

12/02/01 4:40 PM
Clara is doing a little bit better.  The results of the bacteria culture test came back and it is a common staph bacteria that is responsive to the antibiotic Clara is receiving (vancomycin).  The staph probably came from Clara's own skin and entered through some minor breaks in the skin.  There is no evidence that the infection is a result of the surgery.  The chest tube was
removed this afternoon and Clara was moved back into her isolette.  The nurses weighed Clara and she weighed about 2 lbs. 1 oz.  This is not all good because part of the weight gain is the result of retention of fluids.  But she is losing some of this swelling.  Also, she is still getting infusions of red blood cells and platelets.  Her platelet count has improved slightly but is still low.  Clara is resting well and generally is improving.  One of the nurses took a picture of Clara with her eyes open.  As soon as we get the film developed we will post the picture online.  We know of literally thousands of people that are praying for Clara.  Yesterday, we received word that Clara was added to the prayer list of a group of 1500 individuals.  Thank you all.

12/02/01 9:05 AM
Clara is still doing about the same.  Her platelet count is still low, but they are watching it closely and giving her platelets as needed.  The doctors said this morning that they should have a report this afternoon about the bacteria causing the infection.  Exciting news!  Clara opened her eyes last night for the first time.  Thanks for your continued prayer support.

12/01/01 2:20 PM
Clara continues to go up and down on her CO2 levels but is staying in a comfortable range.  Dr. John Pardalos, MD, the attending physcian, is going to leave the chest tube in for a while longer.  Even though the surgery appears to be healing well and there is no drainage from it, the chest tube can also be used to let air out from the chest cavity.  About 10 days ago, Nov. 20, Clara developed a pneumo (a hole or tear in the lung that lets air get on the outside of the lung).  The hole evidently healed over.  But in order to let the air out, the docotors had to insert a needle from the outside.  Because the jet ventilator is running at a higher pressure, there is a greater risk of developing another pneumo.  If it does, the chest tube will be there to bleed off the air.  Clara's respiratory therapist said about 1:10 PM that there was indications that her lung was opening up more.  According to this RT, the lung never collapsed, but air sacs within the lung collapsed and these may now be opening back up.  Clara's platelet count is still low.  It got as low as 12,000 early this morning but at 12:30 PM was 26,000.  Ideal would be 150,000.  The infection is probably causing this low count.  The doctors should know by Sunday morning which antibiotic to use to fight the bacteria.

12/1/01 AM
Clara is doing only reasonable well this morning.  The good news is that there has been no drainage or air coming from her chest tube so it will probably be removed today.  However, Clara apparently does have some infection now.  This is causing some swelling and is affecting her CO2 and oxygen levels.  She is on a strong antibiotic now and a culture test is being run to determine what other antibiotic might work better.  The platelet count has been low the past 24 hours despite getting a couple of injections of platelets.  There was some concern that it might be a blood clot.  An ultrasound yesterday showed no signs of any blood clot.  An infection would explain the low platelet count as well as the unstable CO2 and oxygen levels.  It will take a minimum of 24 hours or as much as a few days to see if the antibiotics are working.  One of Clara's lungs has also deflated.  This is likely due to the placement of her ventilator tube.  The tube has been repositioned and the lung should come back up soon.  Please continue praying.  This infection is one of the setbacks that we were told could happen.

11/30/01 11:15 AM
Clara continues to recover from surgery.  Her surgeon Dr. Ram (Dr. Venkataraman Ramachandran to be exact) said that from his perspective, everything was doing well and she looks good.  The attending physician is responsible for Clara's overall health.  Her lung has reinflated some but not completely which is what they want.  Her CO2 levels increased some during the night but have come back to the 35-40 range.  The jet ventilator pressure was at 24 but is now turned down to 21.  The oxygen level (natural air is 21) was increased for a brief time last night to 100 but is now at 40 and they expect to turn it down more today.  Clara's blood platelet level is good at 100-112, but since they had to open a 500 cc bag of platelets, they are going to give her a few cc more.  A level of about 150 would be ideal.  Clara is still receiving a little morphine for pain, but she is starting to move her hands and feet some.  Diana and Jacob are doing well but are a little tired.  Even though it has been 18 days, the road ahead still remains long.  Thank you for your prayers for Clara and her family.

11/29/01 1:45 PM
Just got an update on Clara.  The surgeon and attending physician met with the family. Clara is doing as well as can be expected.  They gave her some platelets for her blood and are keeping the oxygen level up some.  She still is on morphine for pain.  Very little drainage is noticed from the chest tube.  It is just going to take some time for recovery from this surgery.

11/29/01 9:50 AM
Clara did as well as could be expected last night after surgery.  She has been given some morphine for the pain and is still sedated to prevent her from moving too much.  She needed her oxygen level increased once during the night.  As of 9:30 AM, the family had not spoken with Clara's doctors.We hope to have another report later this morning.  I'll let everyone know as soon as possible.  Thank you for your prayers and support.john316
 

11/28/01 5:30 PM
Clara's surgery is complete and went very well.  She has just a little bleeding which is normal.  Her heart is doing very well and her blood pressure has increased as a result of the closing of this vessel.  The surgery required that her left lung be collapsed to give the surgeon room to work.  There is a chest tube in now that will remain until the lung reinflates.  This will probably be from 24 to 48 hours.  Clara will remain in the operating room for about an hour (until about 6:00 PM) and then will be moved back to her room.  Jacob and Diana are doing well also.  Thanks to everyone for your prayers.  The main concerns now are that the lung reinflates and that no infection sets in.  Please keep praying.  The Lord has been good.

11/28/01 12:06 PM
Clara will be having surgery around 4:00 this afternoon. Please continue to remember her in your prayers. If you have any prayer chains in your
church or community we would appreciate it if you would start them for our little Clara.

Jacob & Diana

11/28/01 10:00 AM
Clara had another good night.  They did raise the jet ventilator pressure from 19 to 21.  Also, they adjusted her breathing tube by pushing it in a little further.  The x-ray taken last night showed a little cloudiness but they said that may have been caused by moving the tube.  Diana overheard the attending physician ask the surgeon when he would be available for surgery should they need to do it before Friday.  The doctors as of 10:00 AM had not spoken directly with the family.  Jacob came home for the first time in over two weeks this morning to do a few jobs around the house and take care of some business matters.  He will be going back to Columbia early this evening.

11/27/01 10:15 AM
Clara's surgery has been delayed again.  The pediatric anesthesiologist is not available until late this evening.  However, Clara is doing very well now.  Saturday and Sunday her x-rays showed some cloudiness and the possibility of a touch of pneumonia.  Today her x-ray is very clear and her CO2 levels are staying around 45.  Also, they have turned the pressure down on the jet
ventilator to its lowest level and Clara is breathing natural air.  One doctor also said that there are some signs that the PDA may be closing.  Therefore, they are scheduling Clara's surgery for Friday.  Both Dr. Russo and the pediatric anesthesiologist will be available then.  They will continue to closely monitor her and if her condition worsens, surgery can be scheduled immediately.  On Friday morning they will also do another echo cardiogram to check the PDA to see if it has closed any.  The family does grow weary with the ups and downs of scheduling surgery, but it is best for Clara, as long as she is progressing, to delay it as long as possible.  Please continue to pray.  Perhaps God's answer in His time will be that surgery will not be required.  We
need to do what we can, and let God do the rest.

11/26/01 10:00 PM
The doctors spoke this evening with the family.  The surgery will be Tuesday morning anytime from 7:30 AM or after.  It depends upon when the anesthesiologist will be available.  Dr. Rahm will be the surgeon.  Originally, Dr. Russo was going to do it, but he is now not available until Friday and they do not want to wait that long.  Both surgeons are considered equally qualified.  If possible, I will let you know the exact time of the surgery in the morning.

11/26/01 5:30 PM
Clara is still doing fine.  The echo cariogram was performed late this afternoon and showed that the patent duct vessel has not closed.  Therefore surgery is expected soon.  The doctors and nurses felt like it would be late this afternoon, but the surgeon was performing another surgery and they needed to talk to him first.  As of 5:00 PM, he still had not come out of the surgery
room.  Now the nurses and attending physcian feel confident the surgery will not be done until Tuesday.  We should find out later this evening when the surgeon wants to schedule it.  As soon as we get any new information, we will let everyone know.  Thank you so much for your continued prayer support.

11/26/01 11:45 AM
Clara is now 2 weeks old.  She "stepped" on the scales again this morning and weighed 1 lb. 4 1/2 oz.!  Everyone was very pleased she has gained 4 1/2 oz. from her low after-birth weight of 1 lb. (For you metric buffs, Clara started at 500 grams, dropped to 450 grams, and is now at 580 grams.)   Her CO2 levels have remained fairly stable the past 12 hours but she is
still on the jet ventilator.  The echo cardiogram has not yet been done.  It is expected to be done by 1:00 PM.  One resident doctor gave his opinion that if it shows that the vessel has not closed any, then surgery will probably be done today.  I will let you know as soon as we find out.

11/25/01 4:00 PM
Clara was thirteen days old this morning.  She is still doing pretty good.  She is having a problem with her CO2 levels.  Normally her level is around 49-55.  During the past 36 hours it has risen to as high as 83.5.  That was about 3:15 PM today.  It then fell to 52.5 at 4:00 PM.  I know there are some doctors, nurses, and respiratory therapists that may be reading this and they may snicker at some of my inaccuracies.  Earlier I said that Clara was on a jet ventilator.  Well, actually she was on an oscillating ventilator.  There is a jet ventilator that is, as I would put it, a little less aggressive.  Last night Clara was moved from the oscillating ventilator to the jet ventilator.  She has been very active and moves her arms and legs a lot.  The doctors have given her a mild sedative to help calm her down.  Please pray specifically that Clara's CO2 levels will remain at a good level for her and that the patent duct vessel will close at least some.  Tomorrow another echo cardiogram will be taken to check this vessel.  If it has not closed any at all, surgery most likely will be scheduled.
 

11/24/01 10:30 AM
Clara is now 12 days old.  She had a pretty good night.  Her CO2 levels started increasing about 3:00 AM.  This may be due to her lungs cleaning out some small blood clots formed when she had the earlier problem with air on the outside of her lung.  At 9:45 AM they put her back on the conventional ventilator.  All her other signs look good.  We still are praying that the patent duct vessel will close some by Monday morning so surgery can be delayed or even not needed. We should know something by noon on Monday.

11/23/01
    Clara's condition remains stable. She is doing well. The doctors are continuing to monitor her closely and letting her mature as much as possible. She is still on the jet ventilator. They will probably keep her on this until a decision is made about the surgery. If surgery is required, the surgeon wants to use this ventilator. We are praying that the vessel will close some before Monday. All things are possible through prayer!

11/22/01 from Jacob & Diana
Jacob and I just got done spending some time with our precious daughter, Clara.  We want to thank all of you for your love, support, and especially prayers during this difficult time. Clara is a fighter and a miracle from God. We are blessed each day to have her in our lives. Your cards, emails, thoughts, and  prayers mean more to us than you know. It gives us comfort and strength. We are especially praying for a miracle this weekend for the PDA vessel to be closed before turning to surgery. We know that all things are possible through God. Continue to keep all of us in your prayers!

Love,
Jacob & Diana

11/22/01
    Clara has had a good Thanksgiving Day.  All of her vital signs remain good. She has not experienced any breathing problems today.  Her chest x-ray did show the possibility of a small infection.  She is on antibiotics which should clear this up.  Jacob & Diana had Thanksgiving dinner with the Smith family in the Ronald McDonald Family Room in the hospital.  This evening they are eating leftovers brought by the Swearingin Family and are in the Gene & Iris Phillips home in Columbia where their daughter Calesse lives.  Special thanks to the Phillips and to everyone for their prayers.

11/21/01 9:15 PM
     The cardiologist and Dr. Russo, a cardiothoracic surgeon, met with the family about 5:00 PM today.  Dr. Russo is very experienced in pediatric surgery and has successfully operated on babies as little as 350 grams, about 3/4 of a pound and 100 grams less than Clara.  However, he said babies this young do not have strong or mature blood vessels and there is always a risk of bleeding.  Because Clara is stable and doing well right now, he wants to wait until at least Monday to let her mature even more.  He is on call every day and should the situation change, they can do the surgery immediately.  Another reason to wait until Monday is that maybe the best pediatric anesthesiologist in the nation will be available for the surgery then.  Also, Dr. Russo said that in rare cases, the vessel begins to narrow and close on its own.  He said that if it just closes a little, it buys more time and the surgery can be delayed even longer.  Clara's skin, lungs, and blood vessels are maturing little every day and the longer we can wait the better her chances are for a full recovery.  They plan on doing another echocardiogram on Monday to check the duct again.  It would be a miracle and answered prayer if it has closed some.

     Jacob & Diana want to thank everyone for their prayers and support.  They hope to be able soon to send an email to this list and tell you just how much they appreciate everyone.

11/21/01 3:15 PM
     The time is about 3:15 PM on Wednesday.  This computer clock may be off.  Clara  is still doing reasonable well.  She is still on the jet ventilator but may go off of it later today.  The echo cardiogram was performed about 1:30 PM today and the doctor spoke with the family about 2:30 PM.  The patent duct vessel has not closed.  The only medical option left now is surgery.  A cardiologist will see Clara later today.  He will then contact a pediatic cardio-vascular surgeon.  It will depend upon their schedules as to when the surgery may be done.  It may be any time between now and next Monday.  Clara is strong and the time will not be a problem.  Jacob and Diana took the news well.  It was pretty much expected.

     The hospital staff also had a conference with the family earlier this afternoon about visitors.  They are concerned about the flu season and other possible infections that may affect Clara and her surgery.  They have asked us to let family and friends know that it would be best for Clara not to have visitors at this time.  Jacob and Diana are available only on a limited basis for visiting because they need to be with Clara as much as possible as well as getting more rest than they have been getting.  The hospital staff suggested sending cards or helping out in some other way.  Everyone's prayers are really the best thing we can do for Clara right now.  Jacob & Diana mailing address is shown on Clara's website which can be reached by clicking on the link below.

11/20/01 10:45 PM
     Aunt Becky just got home from Columbia. Clara had a pretty good day. She is still on the jet ventilator, but they were able to decrease the pressure. They expect to take her off of it tomorrow morning and go back to the regular ventilator. The doctors plan on doing the echo cardiogram tomorrow morning also. One doctor said that if it shows that the duct has not closed, that they may perform the surgery on Wednesday. They said they will give the family at least a two-hour notice. Diana & Jacob are holding up well. Your prayers are working and will be very important tomorrow if surgery is performed.
p.s. 11:50 PM Just received word that Clara got her first pacifier tonight. They used a small premie one and then cut it down even smaller.
11/20/01 10:45 AM
     Clara is now 8 days old. She had a fair night. The PDA problem continues to cause problems. She had two episodes last night where her carbon dioxide levels got too high. The third dose of the third round of medication for PDA is scheduled for noon today. They will probably take another echo cardiogram shortly after that. Clara's lung problem yesterday evening was further explained as air getting on the outside of the lung through a small hole. This caused pressure on the outside to partially collapse the lung. The doctors took a needle (ouch!) and inserted it through her chest to let that air out. The positive news is that the lung immediately re-inflated. They were prepared and thought they might have to insert a tube into the lung to inflate it back, but it was not necessary. Clara remains on the jet ventilator which applies continuous pressure to the lungs to keep them inflated. The doctors said the hole that developed in her lung was very common and that it would repair itself. Jacob and Diana were able to rest last night after staying up late with Clara. Their mailing address is on the web site. They are not checking their email yet. Too much else to keep up with. They are aware of the many, many prayers being offered by all of you. Thanks again.
11/19/01 8:20 PM
     Clara had a little setback this evening. She got air in the wrong part of her lungs. The doctors had to put her back on a special jet ventilator (the same one she started on when she first went to Columbia). She was quickly stabilized, but it was another scare for the family. She has taken the first of three dosages for her PDA with the second one to be at midnight and the third one at noon tomorrow. It would be a wonderful miracle if this round of medication would work and she would not have to face surgery. That's what we are praying for now.
11/19/01 10:45 AM
     Clara is now one week old.  She continues to do very well for her age and size.  The "patent ductus arteriosis" or PDA is the main problem as of now.  The doctors said this morning that they are going to try the medication the third time.  Even though the odds of it working are very low, the risk with it is less than surgery.  The third round will be administered just like the first two with three dosages administered every 12 hours.

Clara is being given proteins and lipids and has accepted them very well.  Her heart, lungs, and kidneys are all doing well.

Again, thanks for your prayers.  We don't always know God's plans for us, but we know He loves us.

11/18/01 1:35 PM
    Clara had another good night.  Jacob & Diana seem to be getting more wore out but are still holding up well.  Clara had her echocardiogram about 9:00 AM.    Dr. Hillman, the chief pediatric doctor spoke with the family about 11:00 AM. The medicine to close the patent duct vessel has not worked.  Because the vessel has not closed, it requires that Clara remain on the ventilator at a little higher pressure than normal.  This probably has not caused any harm yet, but may lead to come chronic lung problems later.  For now, the doctor wants Clara to have a day of rest from any medication.  Then on Monday the team will re-evaluate the situation.  They may choose to give a third round of medication and in a different form.  Another option is surgery.  The university has a new, highly qualified, pediatric cardio-vascular surgeon.  This would not be open-heart surgery, but rather a vessel outside the heart.  The surgery itself is very simple, just tying off the vessel.  The greatest concern would be Clara's toleration of the anesthesia and the trauma of surgery.  Please pray for the doctors that they will know the best thing to do. The rest of the news is good.  Apparently the slight bleeding, Grade 1, in the brain, has improved.  The doctor believes Clara is over the hump there and will continue to improve.  Also, her heart, lungs, and kidneys are all doing very well.  The doctor says that Clara has done “remarkably well” so far. Clara “stepped” on the scales for the first time this morning since her initial weighing.  And even though some ladies wouldn’t want it to be told, she weighed 450 grams (1 lb. = 456 grams).  She is down slightly from her beginning weight of 500 grams, but this is very normal. Clara now has her own website.  Aunt Becky and Grandpa are working on it.  You can see some pictures there and some of the earlier emails if you missed them.  Just go to: http://www.carolnet.com/clara
Jacob and Diana appreciate all the support they have received.  They are not always up to visiting because they stay with Clara all day and much of the night.  The grandparents and brother and sisters help out also, especially at night.  Clara’s visitors are being limited.  Infection is always a concern. We continue to trust in God.  Thank you for your continued prayers.

11/17/01 4:28 PM
    We are attaching a picture of Clara and Mom & Dad.  Hope you are able to view it.  Clara continues to do well today.  She got her final injection of the second round of medication to close the patent duct vessel at noon today.  They may now do the next echocardiogram on Sunday.  She also gets to start eating today - sort of!  They will begin at 5:00 PM giving her TPN - some form of protein.  Tomorrow she may then get some lipids (fats).  Jacob said it is her first steak dinner! Care in the Newborn ICU is labeled as Level 2 to 5.  Clara started off as a level 5.  She has improved enough that she is now at level 4.  Level 1 is when you get to go home. Everyone enjoys these good days, but we are always aware that there will be some bad days also.  We continue to lift Clara and her family up to the Lord in
prayer.  Thanks for you support.

11/17/01 11:44 AM
    Clara celebrated her 5 day birthday this morning.  She had a very good night. They have been able to take her off many of the IV's she was getting.  She is now only receiving some glucose and oxygen.  She gets the 3rd dose of the 2nd round of medication to close the patent duct vessel at noon today.  They may wait until Monday to do the next echocardiogram to see if it has closed.  Jacob & Diana had a good night's rest and look good.  We are all encouraged today, but are very aware the road is still very long. God is blessing us all.

11/16/01 9:41 PM
    The head sonagram results came in about 6:00 PM.  There continues to be some small bleeding in the brain.  It is what they refer to as a Grade 1.  There are four grades, with Grade 4 being the worst.  They will continue to monitor this very closely. As of 7:15 PM, Clara was resting and doing very well for this stage of her   maturity.  She was getting a blood transfusion to replace the blood that is taken for the various tests needed.  Usually this is about 5 cc which is about a teaspoon full. Diana and Jacob are doing well.  It was a difficult afternoon but they continue to trust in the Lord for His strength.  All of us appreciate the prayers and support given.

11/16/01 4:14 PM
    The doctors met with the family again this afternoon to report on Clara's progress.  Even though they are very pleased with the progress she has made in the last four days, they wanted to remind us that this is kind of like the edge of a forest that she must go through.  There are many potential pitfalls.  One of those they will be watching closely is infection.  We got a quick and sudden reminder this afternoon about 1:30 on just how tiny and sensitive Clara is. Her breathing tube either moved a little or became clogged.  Her oxygen level immediately dropped and her heart rate fell.  A Code Blue was signaled and about ten doctors and respiratory therapists rushed to her room.  They quickly gave her oxygen manually and got her back stable.  They then had to replace the breathing tube.  This was very traumatic for the family. The head sonagram was completed later this afternoon, but we have not received the results. Again, thanks for your prayers.

11/16/01 10:53 AM
    Clara was four days old at 9:19 AM Friday.  She had another good night.  Her blood sugar, potassium, calcium, and sodium levels are all good.  Her skin color is looking better also.  This morning she had an echocardiogram on her chest to see if the medication given on Thursday had closed the patent duct vessel.  We don't yet have the radiologist's report, but the technician and the doctors believe that it has not closed any or very little.  This probably means that they will start her on another round of the medication which they say is very normal.  Later today she is scheduled to have a head sonogram to detect any bleeding in the brain. Diana & Jacob got a pretty good nights rest and are holding up well.  They and all the family are appreciative of all the support they have receive and especially your prayers.

11/15/01 2:44 PM
    Just a quick note before sister Tracy and I head out for Columbia.  We have several new people on the list. Clara is doing very well.  Her potassium, sodium, and sugar levels are all very good.  They plan on giving her the last treatment for the patent duct vessel at 6:00 PM.  Tomorrow morning they have scheduled echograms on her chest and head.  The chest exam will show if the medicine has worked to close the vessel to the lungs.  The head exam will show if there is any bleeding in the brain. Diana & Jacob got to almost hold Clara this afternoon.  They helped change her bed linens and helped lift her while it was being done.  Diana got to put her socking cap back on.  Everyone is encouraged. Thanks for the prayers, they are working.

11/15/01 10:27 AM
    Clara had a very good night.  At 6:00 AM Thursday, her potassium had gone down to 4.0.  Also her blood sugar is down and her kidney flow is very good.  She seems to be resting more comfortable which may be a sign that the patent duck is closing like it needs to.  The doctors gave Clara her second of three dosages of the medication to close the duct at 6:00 this morning.  If the potassium levels remain good, she will get the third and final dose at 6:00 PM today.  They are planning on taking an echogram Friday morning to see if it has closed.  They will also be taking an echogram of her head to check for any bleeding. God has been very good and we continue to ask for your prayers.

11/15/01 12:21 AM
    Peggy, Tracy, and I returned home this Wednesday evening about 11:00 PM. Little Clara had a pretty good day.  She is now about 62 hours old.  She was  given the first of three dosages of a medication designed to close her "patent duct", a blood vessel that flows to the lungs and closes normally in full-term babies.  Her potassium level at 8:00 PM Wednesday was 5.2 , very good.  Her sugar count is somewhat high, but the doctors believe it can be controlled. She has many more hurdles yet to jump starting off as a 1 lb. 1 oz. baby only 23 weeks old, but it has certainly been a miracle that she has come this far and is doing as well as she is.  Diana and Jacob are doing well, but their emotions also go up and down with the various reports. Thank you all for your many prayers.  We know of at least six church prayer chains that have been praying along with many family and friends.

11/14/01 7:48 PM
    Potassium level is now low enough to start the medication for closing the patent duct which needs to be done asap.  It comes in three dosages with 12 hours between each dosage.  Hopefully her potassium level will remain low enough so they can stay on schedule for her dosages.  If not, they will just have to give them to her when her potassium level is ready for it.  Then if 3 dosages doesn't work, may try repeating the three dosages, but then may have to do surgery.  And though it's not a difficult surgery, with her small size, everything is a major procedure.  So please be praying about this present situation.  She's had a good day.  We have certainly felt the prayers going out for her and us.

11/14/01 5:15 PM
    The potassium levels have come down to 6.2 as of 4:00 pm.  This is very good.  Everything else is looking good.  Thanks for your continued prayers.

11/14/01 9:32 AM
    Clara is now 48 hours old.  She had a pretty good night.  The biggest current concern is her potassium level.  At 8:00 PM Tuesday it had dropped to 5.8 which is good.  At midnight it had risen to 5.9.  However, at 4:00 AM it jumped back up to 7.7 and then 7.8 at 8:00 AM.  They are giving additional treatments this morning to help control it.  Most other vitals are good.  Thank you all for your prayers.

11/13/01 4:51 PM
    Clara is now 29 hours old.  She's still critical, but has been upgraded to a 50% chance of survival.  She is 11 3/4 inches long and a tough fighter.  But please continue to pray for her and all her family.  We know the Lord is with all of us and He is in control. Diana was discharged from Marshall hospital this morning and was able to come be with her daughter.  Jacob and his mom spent the night with Clara last night.  David & I stayed with Diana last night.

11/13/01 6:28 AM
    Diana Smith gave birth at 9:19 AM, November 12, 2001, to a baby girl.  She came about 4 months early and weighed about 1 lb and 1 ounce.  Jacob and Diana have named her Clara Frances Smith.  Clara has a strong heart but the doctors only give her about a 25% chance of survival.  She was Life-flighted from Marshall hospital to the Neonatal unit at University of Missouri Hospital in Columbia.  She has survived now for 21 hours.  Her condition has not gotten worse.  Diana & Jacob have turned things over to God.  Please pray with us. Diana is doing well.  Jacob spent the night in Columbia with Clara and we will be taking Diana there this morning as soon as she is released.