Rademaker, Jonathan Luke

[left:6fd0853bdb]http://www.cherubs-cdh.org/Album/new/rademaker-jonathan.jpg[/left:6fd0853bdb]It is hard to know where to begin, so I will start at the beginning. Pete and I were married September 23, 1995. Shortly after our one year anniversary we decided to start a family. We conceived in February, with a due date of Nov. 6, 1997. The pregnancy started out fine. We had our first doctor visit with the usual exam.

At 6 weeks along, I became very sick. We made a trip to the emergency room late one night around midnight. I was diagnosed with hyperemesis. Hyperemesis is severe uncontrollable vomiting to the point of dehydration. I was given fluids, some Compazine for the vomiting, and sent home. We returned to the hospital on April 10, and stayed the whole day. They gave me more fluids, Phenegan, a different kind of compazine, and prescribed B vitamins. I was put on a strict diet, and had to teach my body to tolerate food again. I slowly recovered, and began to feel better.

We had our first ultrasound on April 25, at 12 weeks to check the size of the baby, because I had been so sick. The ultrasound showed a placenta previa. This is when the placenta is over or partially covering the opening to the cervix. The medical reports show that the heart rate was 171, that the stomach and bladder were seen, and that the abdominal wall was intact. The pregnancy progressed normally. We had our second ultrasound on August 13, at 28 weeks to see if the placenta previa was still there. It had cleared up, and moved out of the way. The medical reports show that the heart rate was 139, that the kidney, bladder, and stomach were seen, and that the abdominal wall was intact. At this time they estimated the due date to be Nov. 18, due to the baby's small size. (The small size of the baby was never mentioned to us.) I continued to go by the Nov. 6 due date, as I had kept good records, and that was 40 weeks.

About 3 weeks before my due date, I began having severe Braxton Hick's contractions. They were high in my back between the shoulder blades. The only relief I could get was if I walked for 2-3 hours in a local park they would subside. The contractions would last from a few hours to several days.

I went into labor early in the morning on Friday, Nov. 7. Pete went to work, just long enough to pick up his paycheck, and call me. I asked him to return home. We timed contractions, and waited at home until around 2pm, when we decided to go to the hospital.

I was examined and it was determined that I was 4 cm dilated. They were keeping us, so we called our parents. I labored for several hours. I was on monitors most of the time, with the exception of walking the halls, and a whirlpool bath, which was wonderful. I lost my mucus plug after the nurse examined me. The doctor broke my water a short time later. They inserted and internal monitor into the baby's scalp. Labor continued to progress. At one point, the alarms on the monitors sounded, and everyone came running. The heart rate dropped to 80. They turned me on my side, and then my other side. They put an oxygen mask on me, and started an IV of saline. The heart rate then went back up, and we continued with labor. The doctor administered Lidocain and performed a 4th degree episiotomy. I received a small dose of Nubain for pain. Another doctor was called in to help turn the baby's head down. After a few more minutes of pushing, Jonathan Luke was born at 7:42pm, weighing 4 lbs, 15.7ounces, and 18 1/2 inches long. His hair was brown, and slightly curly.

They laid him on my belly, he shot out a stream of urine at Pete before he cut the cord. He made only a few small attempts to cry, and he didn't open his eyes. I didn't touch him. I said out loud that he should be crying more, and screamed at the nurse to take him, take him!

The nurse took him, and they began to work on him. He had an apgar score of 2. They called in a pediatrician, a neonatal nurse, and another doctor. They immediately began to bag him. They tried to intubate him and had difficulty, but finally succeeded. They administered oxygen the whole time. The other doctor told me he opened his eyes, but I couldn't see. His apgar improved to 3. They continued to bag him, and ordered a chest x-ray. I sent Pete out to let the family know that the baby was a boy, and that he was having trouble breathing. While they waited for a radiologist, his heart rate fell, and they started CPR. They gave him epi to stimulate the heart. They decided to move him to the nursery to work on him further. His apgar was 1.

My doctor and Pete were the only ones who stayed with me. They gave me some pitocin to shrink the uterus. Meanwhile in the nursery, they continued to work on him. They placed a UVC line in him, (IV through the umbilical cord) and administered multiple doses of Epi, Bicarbonate, Glucose, Atropine, and Plasmanate with no response. They put him on a ventilator. His heart rate dropped and then declined to 0, and they stopped all efforts. He died at 8:42pm, and hour after he was born. They were never able to stabilize him to do a chest x-ray.

The doctors and nurses all came back into the room, and they called in our families to tell us he was gone. I thought that they had just come back into the room to tell us they were going to transport him to the neonatal unit at Blodgett. I was in total shock when the pediatrician said he was gone.

We were able to hold him for awhile, take pictures, and make decisions about funeral arrangements etc. We decided to have an autopsy performed to find out what happened. The autopsy was performed Saturday, the next day at 2pm, about the same time I left the hospital and went home. My doctor called later that day with the results.

The autopsy and chest x-ray showed that there was a defect in the right side of the diaphragm, Bockdalek type, with the small bowel, portion of the colon, right kidney, and an ectopic lobe of the liver herniated up into the lung cavity. The right lung was hypoplastic. The heart also had a interarterial septal defect of the foramen ovale type. Basically, the diaphragm had a hole and the organs moved up into the lung cavity and crowded out the right lung from forming properly.

The funeral and burial was on Monday the 10th. This is the day my milk came in, and everyone wanted to hug me.

We do not know why God allowed this to happen. We do know that he has a plan and purpose far beyond what we can understand. We know that Jonathan is safe in the arms of Jesus and that we will see him again in Heaven!

Jonathan's first birthday would have been a little over a month ago. We remembered the day quietly with a trip to the cemetery. We purchased a gliding rocking chair and donated it to our church nursery. We both agree that we worried more about how bad the day was going to be, than how bad it actually was.

Jonathan now has a little brother or sister on the way, due in 10 1/2 weeks. So far everything looks all right, and we are keeping our hopes up that everything will go smoothly.



Written by Jonathan's mom, Amy Rademaker (Michigan)
1999

Update as of Sept. 24, 2007:

Jonathan has 3 younger brothers:

Allen, 3/13/1999
Trevor, 2/02/2002 (positive AFP, but all is well)
Brent, 4/19/2004

Wow Amy, all those boys! Keep going and you could have your own basketball team. Cherub Jonathon could be the the mascot :) Anymore likely additions?

What does positive AFP mean (if you don't mind me asking)?

NO, no more. The doc said it probably wasn't a good idea, seems my body got tired of going into labor after 4 pregnancies in 7 years, and with my youngest Brent, I had to be induced, as my body wouldn't start labor on its own. My water was broke for almost 2 weeks with no labor. We had a lot of similarities during labor with Brent and Jonathan. I ended up with an oxygen mask and his heart rate started to decel, just like Jonathans did. I freaked out. Also Brent's labor was longer than Trevor's (middle child), by like 8 hours. Trevor was only 4-1/2 hours from first real contraction to delivery with only like one push. Brent, I was pushing for almost an hour, with decels and the doctors face looking real scared as he watched the monitors. Not going to do that again. Brent was only 1/2 pound heavier at 8 pounds. I can't know what my next child would have weighed...

Plus, I have had trouble with my monthly period and ended up having a Novasure endometrial ablation. Basically they burn out the lining of the uterus, so it doesn't shead as heavily each month. So far I'm two months out with minimal bleeding, still have pain, but I can deal with that if I'm not gushing everytime I stand up. You are not supposed to get pregnant after that procedure. My husband had a vasectomy after Brent was born and we knew he was ok.

AFP, stand for Alpha Fetal Protein test. It is now called the Quad test I believe. It is an indicator test that is done on the mother's blood around 16 weeks gestation. An elevated or too low of a level can indicate Down's Syndrom or Spina Bifida. Some also think that it can be an indicator of CDH or other birth defects. They test for like 4-5 different things now. Sometimes you get a false positive indicator. It is not a definite yes or no, just an indicator that something might be wrong. Trevor had an elevated level, so we went for a level II scan (best available at the time, only a few 3D machines in the whole US then.) It showed an enlarged ventrical in the brain that holds spinal fluid. They gave us 3-4 really bad, it could be diagnosis. As it turns out, they watched me closely and he is fine. He had an MRI at 6 days old and 2 months old, and then again at 5 years old. I'll answer almost any question. I'm really an open book when it comes to discussing my pregnancies and children's health. The workers at my doctor's office hate me, because I'm a know it all, but I'm usually right! I had the same doctor for all pregnancies and he is still our whole families doctor. We never had a pediatrician etc.