The Ervin Family Year End Letter 2009

HOLY CRAP AND I THOUGHT LAST YEAR WAS BAD!

…This year was so bad that I have to preface this letter with the statement that the only reason I can even remotely maintain my sense of humor about it is because my family has been at the center of a No Bullshit-Honest to God-Worthy of A Hallmark Christmas Special…

MIRACLE!

We live in a cynical age (I can be quite a cynical bastard myself) so I feel like I have to write that really big so that it sinks in. But we’ll get to all that a little later. For now, you might want to grab a cup of coffee. This is likely to be a long letter.

As we ended last year the status of our family was thus –Mostly everything was great BUT…

-Isaiah was diagnosed with an Arachnoid Cyst in his brain
-Brynn was diagnosed with Arnold Chiari Malformation in her brain
-We got stuck at Chicago O’hare for three days on the way back from Indianapolis.

But we entered 2009 raring to go, with all kinds of wonderful plans. Brynn was excited to be teaching the 3rd grade; we enrolled the two oldest in soccer for the first time and I began to rip up the grass in the front yard so that I could create a ‘water wise’ landscape. OK – That pretty much covers all of January through April. Wow, 4 months in one paragraph…I’m getting good at this.

One of my big projects for the year was also to get my garage somewhat organized and cleaned up. With that in mind, I built some new shelves, moved some things around and went through all of our storage containers ridding us of all the baby clothes that we would no longer need. Exactly two days after taking multiple trash bags of baby clothes to Goodwill Brynn discovered that she was pregnant again. What can I say….Is it my fault if I’m irresistible?

Unfortunately, the pregnancy was a tough one from the start. Brynn was horribly sick with morning sickness. It was so bad that she was making lists of foods that tasted OK both on the way down and on the way back up…that’s just nasty.

To make matters worse, Brynn hadn’t even gotten over her Hyperemesis (that means barfing a lot) when we found out that she tested positive on a screening test for Down’s syndrome. After having a hi-definition ultrasound at UC Irvine, it was also discovered that the baby was not growing at the rate that he should be. This was another indicator for Down’s, so in order to prepare ourselves we decided to have an amniocentesis. Fortunately, the amnio came back negative for genetic problems…but we still had a baby that wasn’t growing at the proper rate. We went every week to UCI for ultrasounds to monitor his growth. After several weeks in which he continued to not grow at a good rate, Brynn was put on disability and home bed rest by her ObGyn.
This was actually OK for a while. It meant that she wasn’t able to do very much but she was still able to go to the kids’ soccer games and make the occasional trip to Disneyland so long as we put her in a wheel chair. And the home bed rest seemed to do the trick for a bit, as his growth was good for several weeks. However, after about 4 or 5 weeks his growth was again not up to par and in addition it was found that Brynn’s amniotic fluid was low. She was admitted to the hospital on November, 17 and placed on total bed rest.

Unfortunately, due to the H1N1 virus, no children under 16 were allowed in the hospital. Many of you will understand that, for my wife, this was an impossible situation. For those of you who do not know my wife I will explain it like this: Brynn would rather face a root canal from a sadistic dentist every day for a month than be stuck in a hospital away from her kids for two weeks.

Luckily, My wife, being the lady that she is, befriended many of the nurses in Labor and Delivery, and they helped us to bring the kids in once to visit her. After that, I went and bought a new laptop for Brynn, so that she could ‘Skype’ the kids from her hospital room (For you old fogies, Skype is an internet video phone call service). This was especially nice as she was able to ‘be there’ for Isaiah’s big 5 year old birthday party at Pump-It-Up.

Even on total bed rest, however, Brynn’s amniotic fluid kept getting lower and lower. Beyond that, she was having preterm contractions that the baby was sometimes not tolerating very well. We all spent two weeks listening to the swish-swish-swish of his heart and staring at the screen of the fetal heart rate monitor terrified every time his heart rate would drop that it would not return to normal. There were two occasions in which we got all geared up to have a c-section only to be told that we were going to hold off for a little longer.

To top it all off, She spent Thanksgiving Day in the hospital. The kicker was that the cafeteria somehow messed up her order and she didn’t even get turkey and mashed potatoes. No Turkey on Thanksgiving!!! Can somebody say ‘Malpractice’.

Finally, after only 35 weeks of pregnancy and a little over two weeks of being poked and prodded and restricted to a bed in a noisy hospital, eating crappy hospital food, the Doctors were not willing to hold off any longer. The ultrasound showed that Brynn’s amniotic fluid was now at zero and it was time for us to have a baby.
This was an incredibly tense time. The baby’s reactions to contractions were worsening, but the c-section room was being used, so we had to wait until the room and the doctors were available. In the meantime we had several instances in which we could not find his heart rate at all. We’d move the heart rate monitor all over her belly, add more gel, move it again desperately trying to find the swish, swish, swish of his heart. Our own hearts were pounding against our rib cages as all we could find was silence. We would get a reprieve of a few heartbeats swishing and then be unable to find it again. Finally, the nurse (now almost as frantic as we were) decided to whisk Brynn off for surgery prep.

To shorten what is already a very long story I will say simply that the surgery went off without a hitch. Anthony Alan Ervin came into the world weighing 2lbs 12ounces and measuring 15 ¾ inches. Yeah he was little, but there was nothing wrong with his lungs. He came out screaming.

Brynn and I were, of course, a bit concerned for our newest child, now in the NICU. We were contemplating things like ‘how soon we could get him onto breast milk’ and ‘were his lungs developed enough’. As it turned out, he was in excellent shape. We were both excited to learn that he was removed from supplemental oxygen the day after birth.

Knowing that there was not much for me to do at the hospital, I decided to go into work for a few hours and take care of some things. Brynn called me around noon to ask me if I could come to the hospital so that her dad could see Anthony (One of the parents had to be there). I came right over.

Unfortunately, Alan had to leave without seeing Anthony because the baby was having an IV inserted at the time. But I decided to hang out with Brynn for a bit in her room. Dr. Wigi (The Perinatologist that helped to deliver Anthony) came in to check her sutures to find that she was healing fine. He left and she got up to take a pee. After helping Brynn back from the restroom the nurse left us alone. Brynn was sitting in the chair and I was playing solitaire on the computer.

I need to stop here because I want for everyone to understand that what follows is the most horrible and yet the most wonderful experience I have ever had (and am likely to ever have) in my life.

I turned from my computer to see my wife, her back arched, staring up at the ceiling. Brynn had been through fainting spells before and so this is what I thought had happened. I called out to the nurse to tell her. She came in and attempted to wake her up with smelling salts. Unable to wake her up, the nurse sent me to get help.

Dr. Wigi was still on the 5th floor, filling out paperwork and was able to respond immediately. He came into the room and it was obvious by his demeanor that he knew my wife to be in great distress. I helped him and the nurse get her onto the bed. She had not simply passed out, she was having some sort of seizure. She seemed to gasp for air but was unable to get any oxygen. It was as if she were drowning. I then left the room so that they could work. I remember being somewhat sedate at this point. I knew something was wrong but I was unaware of just how wrong. I think that the “This could never happen to me” part of my psyche was still in control.

My memory, from this point on, is a bit choppy. Information seemed to come at me in random and sporadic bursts of visual and audio. There is no chronology to my memory. There are only memories that I later had to paste together as good as I could.
Nobody was telling me anything directly. What I learned I picked up from the conversation around me. And, as I said, what I remember here is in no particular order.

“Call the code.” Said the doctor

“This phone doesn’t’ work.” The anonymous reply.

“I don’t care go find one that works and call the code! ”

“Begin CPR” This stood out in my mind because it was these words that shattered my illusions that ‘everything would be all right.’ In those words was the truth that, up to that point, I hadn’t quite come to terms with. And with my illusions shattered like so much rock candy crashing onto the sidewalk I began to pray.

“We’ve talked about this! We’ve had this discussion! I can’t do this without her! You know this! I CAN’T DO THIS WITHOUT HER!”

“Code Blue Tower 5…Code Blue Tower 5” (It wasn’t until later that I learned Code Blue is Hospital talk for ‘Patient in Cardiac Arrest’).

All hell broke loose. Her room soon filled with a multitude of people in scrubs. Doctors, nurses I couldn’t tell you.

“Please God let them be amazing…Let them be amazing…let them do their finest work…let them be amazing.” It became my mantra and I mumbled it to myself and my God as I paced up and down the hallway. “Let them shine…let them be amazing.”

“I can’t find a pulse.”

“There’s a weak pulse.”

“She’s breathing. If she’s breathing she has a pulse.”

“Where’s the ER Doctor.”

“Coming from the first floor”

“The elevators aren’t working.”

“I ran up here from the first! They should be here!”

“Where’s your Crash Cart?”

“Would you like me to get you a chair? You should sit down”

“I couldn’t possibly sit down.”

“She’ll be fine. Everything will be fine.”

“She’s purple! Look at her! She’s purple!”

The ER Doctor finally arrived. “Whoa what’s going on in here? All non-essential personnel get out.”

Dr. Wigi had given control to the ER doctor and came out to speak to me. This was when I learned that she had probably suffered a pulmonary embolism. He explained that they were trying to stabilize her so that they could move her to CT to get a picture of the clot and then to surgery to remove it.

I made phone calls…Alan and Holly (Brynn’s Parents), my parents (who were in town helping us to prepare for Anthony’s arrival). I think that was it. It was certainly all I could manage. Repeating what had happened became a physical impossibility as the words seemed to stick in my throat like food that hadn’t been chewed.

Her bed came out into the hall. It was surrounded by people. I think there was somebody straddling her giving her chest compressions as they wheeled her down the hall to the elevator. I followed in another elevator…or maybe I took the stairs…I couldn’t say.

On the first floor I was led to radiology where they were performing the CT (I learned later that they would normally NEVER move a coded patient to CT. Normally they would “Call it”. Nobody did. Let them be amazing. By this time, the clot had been there for probably 30 minutes or more and hence, Brynn’s body had been without oxygenated blood for that long. Normally they would “call it”. Nobody did. Let them shine. One courageous doctor continued to perform chest compressions without radiation protection throughout the scan. Let them do their finest work.

My parents arrived with Grace, Isaiah and Noah. I broke down in my father’s arms as I haven’t since I was a small child. “It’s bad dad. It’s really bad. She was without oxygen for a really long time. It’s so bad.” I held no illusions. I was certain that I had lost her. Everything that I knew about human physiology told me that my wife was gone. And then I had to explain to my children how their mom was very sick and that she might not live.

From the CT she went straight into surgery. The heart surgeon just happened to be there. He had actually been on his way to another hospital to perform a surgery but that patient expired. He was ready to go as soon as the CT was finished. The Pulmonologist was also there. And the Hospital’s entire team of Perfusionists (These are the people that run the heart and lung machine) was onsite for training. As I understand it, under normal circumstances it would have taken about 4 hours to organize the people necessary for the type of surgery Brynn underwent. They were all ready in under an hour. Let them shine.

69 minutes on the heart and lung machine…69 minutes to crack open her chest, open her heart remove the clots and sew her back up, check for any leaks. 69 minutes. Many doctors approached me afterward to sing the praises of the heart surgeon for having been able to this in 69 minutes. Let them be amazing.

A doctor…“Mr. Ervin, we’ve done what we can. They are trying to wean her off the heart and lung machine now. The good news is she’s survived the surgery. The bad news is she’s been without oxygen to the brain for around 45 minutes.”

A nurse… “Mr. Ervin, we’d like to try a hypothermia treatment for your wife. What happens with the brain when it is without oxygen is that a chain reaction occurs. It’s kind of like a wild fire in the brain. Cooling her body will help to reduce or even stop that fire.”

There are two nurses in the entire Hospital that have been involved with hypothermia treatment before. One of them happened to be on duty that night and was now talking to me.

“Where do I sign?”

“Well you need to know the risks involved. Blah blah …bleeding out…blah blah… we don’t have the high tech equipment but we can do it with cooling blankets…blah blah…”

All I kept thinking was My wife’s been without oxygen to her brain for 45 minutes…If ever there’s a time to take a risk it’s now.

“Where do I sign.”

“Right here.”

Here is where the story gets really cool (Pardon the pun)… The manager of the Cardio Vascular Unit or CVU(The unit my wife will go to post-operation) is cousins with the CFO at Mission Hospital. MISSION HAS THE HIGH TECH HYPOTHERMIA EQUIPMENT. She gets on the phone and tells him about this mother of four that has just suffered a pulmonary embolism. Mission agrees to allow Anaheim Memorial to use the equipment and also provides support in the way protocols and advice. The nurse I mentioned before, drives to Mission that night to pick it up.

For three days Brynn was in a medically induced coma with a core body temperature of 32°c or about 90°F. On the day they brought her into the CVU her pupils were (As the nurses say) 8 and fixed…or large and non-reactive to light. On day two one doctor saw no pupil reaction but another saw a sluggish reaction. I’m going to believe the ‘sluggish’ reaction and live on that for today. By day three her pupils were (as the nurses say) 5 and brisk…or normal sized and reacted to light quickly. That’s the news I’m going to live on today.

They began to warm her up and bring her off sedation on the 3rd day. It was on this day, (and I can’t even remember the circumstance) she opened her eyes for the first time. Unfortunately, she had a seizure and they had to sedate her again. She opened her eyes! That’s all I needed…she opened her eyes.

On that Saturday I spoke to a neurologist on the phone. He had seen the first CT scan of her brain and the most current EEG. And he was very blunt. He told me there were three possible outcomes…1) That she could die. 2) That she would remain the same (no significant recovery). Or 3) Miraculous recovery. He was not optimistic of the 3rd option.

However, the very next day the same neurologist came into the hospital to see her follow up CT scan. My dad and I sat in the hospital waiting room talking to him and we were both encouraged by what he had to tell us…he had fully expected to come to the hospital that day to deliver horrible news. He could not deliver that news because he could see no signs of ‘significant’ brain damage. He added that the CT was limited in what it could see, and we were still a long way from any sort of substantive recovery, but from what he could see there was not the mass destruction he had expected. I’m living on this today…baby steps…baby steps.

On the sixth day of this ordeal they attempted to bring Brynn off the sedatives again. She was now on seizure medication but we were fretting over her EEG that was showing signs of ‘chaos’. Another neurologist said that on a scale of 1 to 10 he was ranking Brynn at a 1 or a 2. This was incredibly discouraging news for me. My wife, the love of my life, who had opened her eyes not 3 days before, was being ranked as a 1 or a 2 for brain function. This news forced me to contemplate the most awful possibility… that at some point in the very near future I might be forced to cease life support for my wife.

Brynn and I had discussed situations just like this. Neither of us ever wanted to live in any sort of vegetative state. Neither of us ever wanted to live dependent upon machines. But having had the discussion didn’t make the decision any more possible to make. I knew what I was supposed if she did not progress from this point. But my wife HAD JUST OPENED HER EYES. How could I do this after she had opened her eyes?!

I had so much fear about this possibility…fear of losing her…fear of the responsibility of letting her go…fear of what her family might think of me if I had to do this. I prayed… “God, either take her or heal her. But none of this middle of the road bullshit.” Perhaps it’s blasphemous to cuss at God but at the time he was not on my ‘good’ list. In fact, I was so incredibly pissed off at God that if I had seen him walking down the street I’d have walked up to him and punched him in the face.

At some point that same day, it came to me…and whether it was my own imagination working feverishly to keep me in a positive mood or an angel whispering in my ear I couldn’t tell you. But the truth of that really doesn’t matter. What matters is, it came to me. And what came to me was this…

I had already known that we needed a miracle. I knew this the moment I was told she had been without oxygen for 45 minutes. To be truthful, I knew this the moment I saw her, laying on her hospital bed, purple from her chest up. And I finally realized a very simple truth… this would not be a miracle if she was not defying all of the odds. This would not be a miracle if it was not absolutely clear to all involved that she SHOULD NOT SURVIVE. God was going to have to write this story with a very bold stroke. This is the thought that kept me going that day.

The days rolled into one another, blending into a surreal amalgamation of suffering, prayer, defeat, hope. And almost every day, another tiny detail of God’s miracle was revealed. First she opened her eyes. Then she was moving her legs…then her arms…opening her eyes when I asked her…Blinking to communicate…smiling…sitting up…mouthing words…talking…walking. One day at a time, one inch at a time the progress kept coming. It’s hard to say where in the timeline that it happened, but at some point I just got this feeling that it was inevitable that she would be OK. And even with this feeling of inevitability it was incredible to watch and to see each step….each baby step.

As I sit here and write, this miracle is still unfolding before me. Tonight I got to lie next to my wife, in her hospital bed and fall asleep while watching a movie. I look forward to doing that many more times throughout our lives together.

OK – Not that I want everybody to ball their eyes out but if you don’t have at least a tear in your eye right now, you might want to consider ‘Stone Cold Assasin’ as your next career choice. I hear the money’s good. That being said, I can’t end this letter with a bunch of people crying soooooo…….

ON THE BRIGHTER SIDE WE WILL START FROM YOUNGEST TO OLDEST…
Anthony is doing amazingly well. While at the NICU he got the nickname Benjamin Button because he had absolutely zero fat, so his skin just hung on his skeleton and he had an uncanny resemblance to the ‘baby’ in the movie. But my newest son is packing on the pounds like a Sumo Wrestler prepping for a big competition. He’s also figured out how to find his way into his old man’s good graces by pooping for everybody but me. I swear I’ve only changed one poopy diaper since he’s been home. That is nothing short of FABULOUS. His nickname now is Squeaky McSqueaks because he grunts and squeaks just about 24-7. Poor aunty Katie is getting introduced to the realities of parenthood in an extraordinary fashion. I’m beginning to think she’s might be feeling a bit nostalgic for the ridiculous grind of trying to get a PhD in Chemistry.

Noah, as I have been told by my mother ad nauseum, is the carbon copy of his old man at the same age. He is full of piss and vinegar and charming smiles. His old man (having played that game) doesn’t fall for the charming smile quite so easily and so his favorite things to say to me are… “You be nice a me! You be nice!” And “Meany!” These exclamations usually follow an argument over whether he can wear his Star Wars underwear AGAIN. He just simply not accept the fact that he cannot wear the same pair of underwear day in and day out. But overall, he is a very sweet boy and has taken on the BIG BROTHER role with open arms.

Isaiah is my sensitive shy guy. But boy does he come alive on the soccer field. I was amazed at how seriously he took his role. You see, His team was not very good (it was mostly 4 year olds whereas the other teams had many 5 year olds). I think they won one game all season. But Isaiah’s defensive prowess, at the very least, kept the scores respectable. The pressure did get to him at one point though. At half time of one game, he came off the field, his face bright red with exertion and said, “I’m tired of doing all the work!” I just had to smile. He’s definitely got some of his old man’s competitive nature. From his mom he got the ability to say just about anything with his eyebrows. The other day, he said to Holly, “You know Nana, when boys see pretty girls they do this with their eyes.” And he raised both eyebrows up and down like the wolf in the bugs bunny cartoons…Friggen hilarious.

Grace has been fortunate enough to find an excellent program in the school she’s at. The program is a K-3 combined class that she has been in since Kindergarten. The first two years were great but it is becoming apparent in her 3rd year just how special this program is. The teachers are nothing short of remarkable and she is thriving in the environment they provide. She will be playing the Goose that laid the Golden Egg in their upcoming class rendition of Jack and the Beanstalk. It is a singing part and I can tell you with no small amount of fatherly pride that SHE KILLS IT!!!! I cannot wait for the recital. Beyond that she has now learned to spell all the good cuss words. Growing up in our household, She may end up lacking decorum, but, by God, she won’t be illiterate!

As for me…I’m tired of writing so I’ll just say…I’ve been incredibly blessed. Few people get the opportunity to learn just how loved they are. Brynn and I have now had the opportunity (though neither of us would have wished for it) only to find that we are loved beyond measure. The outpouring of support has been tremendous and we are so thankful.

So I end this year with a mighty thankyou…thank you for your prayers, thank you for your help, thank you for all that you have done to help me an mine get through a most trying time.

We love you.
The Ervins
Brynn, Kyle, Grace, Isaiah, Noah, Anthony