Saturday, April 27, 2013

The God of the good times


The day of Jacob's Norwood Surgery I posted that his lovely nurse Vanessa had covered his open chest with a Super Baby symbol.  I wanted to share the image with you all - this has become one of my favourite symbols and that piece of gauze one of my most prized possessions   There is also a batman version that was made by Vanessa the day Jacob had his emergency surgery - I'm saving that one for another post!

This journey  has been a roller coaster - ups and downs, spirals and moments of heart stopping terror - but the past two days have been on the up swing, thankfully!  The day after my last post Jacob's fever broke, his white blood cell count returned to normal, and he was a  much happier baby.  Today Jacob got the final drainage tube out of his chest, so now all that remains are 3 IVs in his legs.  It is possible that 2 of these may come out tomorrow, but there has to be one IV line left in to administer his medicines.  As of today Jacob is off the TPN nutritional supplement, and the Lipids (fat) that were being given in place of breastmilk, and is up to full feeds with my milk through his feeding tube.  That's a giant step in the right direction! Jacob is still on Sipap, so he's breathing on his own but needs extra oxygen and relief of the pressure with this Sipap machine.  In order to take him off of Sipap his oxygen levels need to stabilize - this has been a real issue ever since Jacob's Norwood surgery.  We can't move to 4D or come home until this is resolved.  Jacob is my super baby, I have no doubt that he will reach that point, but I think he is determined to do that on his own timeline.  If you are looking for a focus point for your prayer when thinking of Jacob, these oxygen levels are our biggest concern at the moment.

On a lighter note, Jacob did the largest poop of his life today - it shot right out of his diaper and ruined a receiving blanket! The nurse had fun cleaning that one up!  My big boy is too long for 0-3 onesies or sleepers, so I had to head to the store and get him some bigger clothes - I think he may take after his Poppa with his height.

My Mom and Georgia returned to NL 2 days ago, and they are sorely missed.  Mom, I would absolutely love to sit down for a cup of tea and some chocolate with you right at this moment.  Thank you for everything, most especially for keeping my sweet girl happy! Everything has been too quiet and too tidy without Georgia here, and I miss the smiles that she always brings to the room.  I love you baby girl, try not to give Nanna and Poppa too much trouble :)

As I was thinking about the day, and Jacob's progress, these words popped into my head:

The God of the good times is still God in the bad times
And the God of the day is still God in the night.

I have been singing these words in church all of my life - and it was only today that I truly understood what they meant.  Through Jacob's highs and lows I have been taught this lesson over and over again.  Thank you God for your faithfulness!

Thursday, April 25, 2013

3 weeks old today!

Jacob's Pacemaker surgery was a success - the surgeon came out after three hours in the OR and said he was pleased and that there had been no complications.  They had to use the smallest pacemaker which has a battery life of 3-5 years, which means there are more surgeries in store for Jacob - to replace the pacer and the permanent wires - but this is minor in comparison to his Norwood procedure.  The greatest risks associated with the pacer surgery were bleeding when the wires were attached to his heart (which didn't happen!) and infection.

Last night around 4 am Jacob took a turn for the worse and started having trouble with his breathing, which brought his oxygen levels down too low, an elevated white blood cell count and he developed a fever - all markers for a possible infection.  Today was a very rough day for my baby boy.  His breathing is still laboured and although he is breathing on his own he needs the Sipap machine to provide extra oxygen and take some of the pressure off.  Jacob also has fluid build up in his lungs again, and he has been very agitated all day.  This morning one of his draining tubes worked itself free of of its stitches and came out of his belly - this meant that he was open to the air for a short period of time.  After covering him up, an x ray showed that Jacob now had air buildup outside his lungs, which was putting more unnecessary pressure on him when he tried to breathe.  This explained his agitation because the tube coming out causes a burning sensation and what should have been a quick tug free was a prolonged working itself free period, completely unknown to the nurses.  After a long day of being fussy, Jacob seems to have calmed down thanks to morphine, tylenol and probably just plain exhaustion.

After days of holding Jacob whenever we wanted to, it was very tough for me today to not be able to hold him.  Especially when he was agitated and crying and staring straight at me.  I have to confess that I spent most of yesterday and all of today feeling defeated and depressed - I seem to have hit a wall in terms of my personal strength.  Yesterday and today I said to those I loved - I don't know if I can do this.  When I left the hospital today Jacob's fever had broken, but his white blood cell count was still elevated and his is still on Sipap and having issues with his fluid levels and the air buildup in his chest.  It's such a feeling of despair when you finally manage to climb over a mountain only to find that there is another huge mountain blocking the path that leads to health and happiness.  I'm hopeful that Jake will have a good night and will be alert and pain free when I walk into his room in the morning.  Please Lord, let this be.  My dear boy has known very little happiness and comfort in his 3 weeks of life.  

I was very encouraged today by a verse shared with me today by my pastor.  It seems the name Jacob has many encouraging verses in the bible that I was not aware of - It seems to be a fitting name for such a strong little fighter.  Continue to fight, my sweet boy, and soon we will be home and surrounding by those who love you.


Psalm 44:4

New International Version (NIV)
You are my King and my God,
    who decrees[a] victories for Jacob.



Tuesday, April 23, 2013

Surgery #3



Tomorrow morning my sweet little boy is heading back into the operating room once again.  Jacob will be 20 days old and heading into his third surgery to receive his pacemaker and permanent pacing wires on his heart.  Thankfully this time it is not an open heart procedure - although there are some risks associated with attaching the wires to his heart.  The surgeon visited us today to outline the procedure and possible complications, which include infection, bleeding and arrhythmia.  The risk is highest for infection - and that is about 2% - so compared with Jacob's last two surgeries this one is much less complicated.  The surgery should take about 1.5 hours, and Jacob is in the second surgery slot for the day.  I don't know what time, but the nurses guessed it would be mid-morning when Jake is taken into the OR.  One thing I'm thankful for - they decided not to reopen his chest, but are going in through his upper side under his arm instead.  I asked the surgeon what made the team finally decide that Jacob needed this pacer, and his response was that they went with the safest option - just in case.  Thank you Lord for guiding these doctors to the safest decision for my boy.

If Jacob had a normal heart and had developed Complete Heart Block, with his backup rhythm being steady in the 80s, he would not be receiving this pacer.  Also, if Jacob had a different type of heart defect he likely would not be receiving this pacer, but with a single ventricle defect there are not enough case studies to prove that it is safe to rely on his backup rhythm so the doctors are erring on the side of caution.  Another good thing - his pacer will be set to backup mode and will kick in only if his heart rate drops below 70, which should mean fewer long term complications from the pacemaker itself.

We are still in CCCU, but hopefully in a few days will be moving up to step down and 4D.  The doctors are still having issues with Jacob's oxygen levels - up until last night Jake was regulating this well all by himself, but today they have been very low and he was hooked up to the nose oxygen tube.  A chest x ray showed no issues and his blood work is normal, he has no markers for a problem other than general fussiness.  It's incredibly frustrating when something is wrong, and your baby is acting like something is wrong, but the doctors and nurses all just shrug and say they have no idea what is causing the problem.  Please pray!  The other new issue is acid reflux which is causing him to gag  when his belly is full, even though nothing is being given orally.  Jacob is still being fed through a feeding tube, he receives my breast milk and a supplement called TPN through the IV.  Jacob was weighed today and he has hit his birth weight again - exactly 8 lbs 5 oz.  Today he got to wear clothing for the first time in his life - I was so happy to see that blue onesie on him! It's 0-3 months (the only size I brought up with us) and it's so tight that the middle button couldn't be done up - he's too long for the onesie!

I'm claiming Psalm 46 for my Super Baby as he faces tonight and tomorrow:


1God is our refuge and strength,
an ever-present help in trouble...

7The Lord Almighty is with us;
the God of Jacob is our fortress.


Sweet dreams my little man.  Soon we will be able to spend the nights together.  

Friday, April 19, 2013

Today is a good day.

The doctors were able to successfully close Jacob's chest two days ago.  Since then we've been on a roller coaster ride of temperatures, possible infection or inflammation, high blood pressure, low oxygen levels, fluid buildup in his left lung, and so on.  It's one step forward, one step back in perpetuity.  Today Jacob's x-ray revealed that there was fluid buildup in his left lung, so he was started on physio to help his work the fluid out and to help the nurses be able to suction the fluid out.

After a depressing start to the day things began to turn around.  Two physio sessions later, the doctor decided that Jacob could have his atrial tube (which has been in place since his Norwood) removed and this procedure went really well - only five minutes! Then they decided to turn his external pacemaker to backup mode and let his little heart beat on it's own.  If he tolerates this well the plan is to let him do his own beating for two days, and this testing will determine if he gets his pacer next week or on another trip.  When I left the hospital today he was doing really well on his own - beating in the 100-110 range! The icing on the cake is that they plan to extubate Jacob tonight or early tomorrow and he will then be off the respirator.  I can't wait to see his little face without the respirator in his nose and all that brown tape holding it in place.

So, at the moment I am cautiously optimistic.  Maybe we'll get in a few good strides forward without being interrupted by a setback.  I'm believing! Jacob spent a large portion of today wide awake, looking up at me with his beautiful eyes, squeezing my finger tight and sucking strongly on his pacifier.  Every day I read him the story Love You Forever, usually 2-3 times a day, and I think he likes it :)  

Georgia is doing well here - she has made Ronald Mcdonald House her home away from home and the other people in the house have nicknamed her "Princess".  Nanna is working hard to keep her occupied, we are really going to miss her when she leaves.  Poppa is very much missed - especially his early morning time with Jake and his Egg in a Hole breakfasts!  At Sick Kids there is a Playroom and a Starlight Room that keep Georgia happy while we take turns sitting with Jake.  Last night Georgia and Nanna took in the musical Tails at Sick Kids, performed by doctors, nurses and volunteers.  Georgia helped them with the sound check :)  Next Thursday I would like to go see it!

Tuesday, April 16, 2013

I have a Maker, He formed my heart...

Jacob holding tight to Momma's hand

Time for a quick update...I'm so bone tired that I can hardly keep my eyes open - but I know there are many people reading this blog waiting for the latest news.  I apologize if my thoughts seem somewhat scattered tonight.    After Jacob's second surgery, which fixed the kink that had developed in his newly reconstructed archway, the doctor's struggled with his blood pressure and oxygen levels for a few days.  These levels are now relatively stable but his blood pressure tends to shoot up when he gets upset with his nurses - which happens pretty much whenever they poke at him, so quite a lot! The good news about his blood pressure is that Jacob is now managing it himself with no medication, and although it might go up high he is able to bring it down himself shortly after.

By Sunday morning, 3 days post-op, Jacob was ready to have his chest closed up but there was an emergency in the CCCU that bumped his procedure to Monday.  By Sunday evening Jacob had developed a fever, from an infection that still has not been identified.  Jacob responded well to the antibiotics and his fever broke and his white blood cell count returned to a normal range by today (Tuesday). When the fever and infection started Jon and I were quite upset - it seems like every step forward is met with another step backwards.  When I expressed my frustration to the surgeon, Dr C. said to me "I told you in our first conversation that there would be setbacks.  And this is not the last time that Jacob will test your patience!"  Oh dear.  If patience is a virtue than after raising this child I might be a saint :)

So, at 10 AM tomorrow Toronto time the doctors are hoping to close Jacob's chest.  Since his Norwood surgery I have been able to watch my son's heart beat inside his chest - his heart has been covered over with only a clear piece of plastic for the last seven days.  It's such a  humbling experience to be able to see his tiny heart beating hard inside his little body.  The experience gives new meaning to the song "I have a Maker, He formed my heart...Before even time began, my life was in His hands."  I'm pretty sure I will never be able to sing that in church again without crying.

There has still been no decision about Jacob's pacemaker.  The plan is to close his chest, take him off the ventilator and most medications and then disconnect his external pacemaker.  The doctors will then track the beating of Jacob's heart over a period of time and use this information to decide if he needs his pacemaker right now, or a few years down the road.  If Jacob had a normally functioning heart, and then developed Complete Heart Block with a stable heartrate in the 80s-90s than he would likely not need a pacemaker until he was in his teens.  With a single ventricle heart though, the surgeon thinks he needs his pacer now.  There is a team of about 30 doctors with various specialities who will meet to make this decision for Jacob.  Another factor to be considered is that we live in NL - and would need to travel by air ambulance if Jacob needed immediate attention.  The heartbreaking part of this process, for me at least, is that if Jacob needs his pacemaker than his little chest will have to be reopened in the operating room.  He needs to be closed up soon regardless to help reduce his likelihood of infection in his chest.

Jon and I are spending long days by Jacob's bedside - talking, singing, reading and trying to comfort him with our touch whenever possible.  It has been 7 days since I last held my baby, and with each passing hour it gets harder and harder.  I still get the urge to grab him and run away - especially when the nurses start poking him and he is crying so hard but is unable to make a sound because of the tube in his throat.  It will be such a sweet sound to hear his cry again.  Tomorrow marks one month in Ontario for myself and Jon - I wonder how much longer we will be away from home?


Friday, April 12, 2013

Lord send your angels to watch over Jacob

The first night after Jacob's Norwood surgery, his blood pressure dropped dangerously low and a team of cardiac doctors was called from their beds at home to come.  They managed to get him stabilized again, and a series of new tests revealed that Jacob's reconstructed archway had developed a kink.  This meant an emergency open heart surgery, just one day after his first open heart surgery.  Our whole family was devastated - this time the risk was lower but it was still risky. The surgeon explained to us that there were two options, and he would try the less invasive option first.  If that failed then he would again have to cool Jacob's body temperature and he would likely need another blood transfusion with the second option.  Once again Jon and I walked our hearts to the operating room, feeling completely devastated.  We sat in the waiting room crying and praying, feeling defeated, for 2 hours...and then the surgeon walked out with a smile on his face! The team had been able to take the simpler approach and Jacob had had basically the equivalent of a "tummy tuck" done on his archway and secured with a few stitches.  I cannot describe the elation I felt at that moment - and the thankfulness to God was overwhelming.  

Now, 1.5 days post op Jacob is doing alright.  They are having issues with his blood pressure and oxygen levels, but we are hoping that the ups and downs soon turn to all ups.  In the meantime, whenever I sit by his bed I sing him my version of an old chorus that my Mom taught me:

Lord send your angels to watch over Jacob
I'm so afraid of the night
Lord send your angels to watch over Jacob
Wrap him in your loving arms

This has become my mantra.  I'm heading back to Sick Kids now for another day with my sweetheart.  Jacob's Grammy and Pop arrived in TO yesterday so now he has two more people to sit by his beside and be with him.  Welcome Grammy and Pop!


Tuesday, April 9, 2013

Super Baby

This morning Jon and I were up at 2 am and at Sick Kids by 3 am in order to squeeze in a few hours with our boy before walking him to the operation room.  In all honesty, handing Jacob over to the nurses at the operating room was one of the hardest things I ever have had to do.  All I wanted to do was pick him up and run as fast as I could in the opposite direction.  I do realize that that was an irrational thought, and broken heartedly signed him over to the team.  After a 8 hour ordeal, baby Jacob came out of surgery and went back into the Cardiac Critical Care Unit.  The surgeon, Dr. Calderone, said everything went generally well.  The surgery was complicated by the fact that Jacob's archway was not normally shaped, so it was difficult to reconstruct.  The concern the doctor had was that Jacob's oxygen levels had dropped down to the 70s following a blood transfusion (100 is the normal oxygen level).  The team was unable to place Jacob's pacemaker, but put temporary wires on his heart to be hooked to an external pacemaker until  his chest is closed.  When the doctor's go back to close up Jacob's chest the permanent pacemaker will put in with new wires.  If all goes well from this point on, the doctor thought this could happen in 4-5 days.  And guess what? Jacob's heartrate (both higher and lower) is in the 150s! 

  In terms of risk level, Jacob is out of the riskiest zone but his condition is critical over the next week.  He is being monitored 24/7 by a cardiac nurse, and is hooked up to so many machines with almost every part of his body covered by an iv, line, or monitor of some type.  There are small patches of bare skin showing where we can gently rub him to let him know that we are there and we love him - i think he particularly likes having the top of his head smoothed down.  On thing I did appreciate - his cardiac nurse at CCCU drew a superman symbol over the gauze that covers his open chest, and wrote Super Baby underneath.  It gives the superman symbol a whole new meaning for this Momma.  Jon and I are hoping to grab a few hours of sleep before heading back early tomorrow.  Jacob's Nanna and Poppa are visiting with him now.  I am so thankful... I know full well that Jacob is not out of the woods by any means, but according to the doctor's and nurse's once again Jacob is doing really well.  Jacob has been exceeding expectations since his diagnosis - and I can only thank God for that -  he really is the Great Physician!

I am sorry for not responding to the many messages that have been sent to us over the past week or so - I want you all to know that every thought and note has been appreciated, and many of them have brought tears to my eyes.  So now I think we are on to stage two of our journey - recovery from the surgery.  I can't describe the feeling that comes over a Mother when she sees her five day old child breathing through a ventilator, hooked up to an impossible number of machines, while his heart beats through a chest that is covered only in plastic.  I feel like I need to rely on God now more than ever to help Jon and I through this stage - we know Jacob can hear us and he opened his eyes earlier and looked directly at me when I spoke to him, but he is sedated and unable to move at the moment.  Personally I'm feeling right now that I need to be at his bedside 24 hours a day, and feeling a lot of guilt when I leave to pump my milk, have a meal, or sleep.  For those of you who have been so faithfully praying for baby Jake, please continue to pray - it's a long journey for him back to health, and the nurses keep telling us that it will get worse before it gets better.  I am so thankful for the way this day has turned out, and can't wait to be back at Jake's bedside so I can tell him again how many people love him, most of all his Momma, Daddy and big Sister.  God  please watch over my baby boy tonight, and keep him safe from all harm..    

Monday, April 8, 2013

The Norwood

Jacob's surgery has been scheduled for tomorrow morning, 7 AM Toronto time.  When the surgeon, Dr. Calderone spoke to us about our options he said there was no clear benefit of one approach over the other but he did recommend the Norwood approach over the Hybrid.  Jon and I also felt this was the best way to go because we are getting Jacob's biggest hurdle out of the way.  We have spent the day cuddling and loving our perfect baby boy.  I keep stroking his little chest, knowing that after today it will never look the same.

I am having a very hard time trying to stay positive and keep the faith.  My Mom has assured me that she can believe enough for both of us for the next couple of days.  If you are reading this, please remember Jacob in your thoughts and prayers especially tomorrow morning and in the coming days of recovery.  This diagnosis is brutally unfair and impossible to understand.  How can a baby who looks so perfect on the outside be so sick on the inside? Jacob's new cardiologist told us today that he has a single ventricle patient who just had a healthy baby, and others who are living normal lives.  He also said that he has patients who are on 4D in Sick Kids waiting for a heart transplant, and most of those are teenagers.  All I know is that my only option is to take it one day at a time.  Starting tomorrow with the Norwood procedure and pacemaker.  There are only so many tears that I can cry, and I need to be strong for my baby boy and my precious Georgia.

So here we go.  This chorus has been echoing through my head all day:


I have a maker
He formed my heart
Before even time began
My life was in his hand


He knows my name
He knows my every thought
He sees each tear that falls
And hears me when I call


Jacob is now 4 days old!

Good Morning world, I'm quickly typing an update as I drink my morning tea.  It's nearly impossible to find the time to sit down and type these days.  My sister updated on the day Jacob was born, and since then the days have been a whirlwind of tests, beeping machines, sitting by Jacob's bedside and squeezing in some time with Georgia.

The birth itself was incredibly scary for Momma, but it turns out that the worst fear was all in my head.  I was discharged from Mt. Sinai on Saturday, 48 hours after delivery.  This seemed very fast to me, as I was not feeling ready for discharge, but the nurses informed me that in Ontario it's a 48 hour period in hospital after a section.  I am doing fine now - walking slowing and my feet and lower legs swell up each day to resemble Professor Klump's, but that too will pass.  Jacob was born with a big cry, and amazingly when he was about an hour old myself, Jon, Georgia, Mom and Dad all got to see him before he was taken to Sick Kids.  And I got to hold him! Those five minutes felt like the greatest gift I had ever been given when they placed him on me.

Overall Jacob is doing very well.  His lower heart rate has remained at the steady rate of 80s-90s, he is handling all the poking and prodding, IV lines and feeding tube amazingly well.  One gift that has been a blessing for him is the Sleep Sheep sound teddy that Auntie and Uncle gave him - it seems to soothe him to sleep when all else fails.  It also helps to drown out the constant machine noise - also appreciated by Momma and Daddy.  Jacob has had an echocardiogram, ultrasounds, EKG, and x-rays since his birth, combined with the multiple IV sites that he has had (both hands, umbilical cord, and now his right leg) and his feeding tube.  And he rarely cries.  How amazing is that! At Sick Kids they have a Bravery Bead program where children get a bead for each procedure performed, and at 4 days old he already has quite a collection.  It will be a nice thing to have to show him when he's old enough to understand.  Another big accomplishment has been his feeding orally (with a bottle! So normal!) and he seems to be always ravenous for more.  He is on a restricted feeding schedule because children with single ventricle heart defects often have problems with digestion, but he is really being a strong and brave boy through it all.  Jacob has even had his first haircut already - the nurses had to shave a small area on his head in case it was needed for the IV line.  I missed the haircut but I have the lock of his hair as a keepsake at least.

Today is a big day, as the Doctor's are meeting to decide a path for his surgery.  Our options are the Norwood or Hybrid procedures, and there are a couple of choices for his Pacemaker as well.  When we hear from the doctor's about this I'll post an update about his surgery.  I'm going to do my best to get a few pictures off my camera today as well, and share them with you.

Simply too much has happened for me to put it all into words but I'll try to fill in the gaps as the days go on. We received a care package from a perfect stranger with a big heart yesterday.  It was a huge gift bag filled to the top with things to occupy Georgia, a beautiful blanket and sleeper for Jacob, Tims gift cards for us, a journal and pen for me, and freshly made chocolate chip cookies.  It was brought right to us at the critical care waiting room - what a big gesture from a perfect stranger!

Yesterday was Jacob's Dedication day, with the ceremony performed by his own Poppa in a private room down the hall in CCCU.  And they decided to let Georgia come in - because Jacob was in an isolated room! It was the most heart warming moment when I saw the two of them together - Jacob being held in his little sister's arms as she told him "I love you, Baby Jake!".  That moment deserves it's own post - so I'll save that one for tomorrow.

Off to the hospital now to hear from the Single Ventricle Team about what our choices are.  Please continue to pray for baby Jake and for guidance for Momma and Daddy as we listen to the doctor's today.

Thursday, April 4, 2013

Happy Birthday Jacob!



This is Auntie Laura posting a quick update. Jacob arrived at 1:42PM weighing 8lb 5oz. His heart rate was stable at 88 bpm. The transition to Sick Kids went smoothly and he is now undergoing lots of tests to make a decision for his surgery.  Thank you for all your thoughts and prayers.

Wednesday, April 3, 2013

The last day of my pregnancy...

I am sitting here in the hotel bed eating my french toast, and feeling completely overwhelmed by tomorrow.  Ever since my eyes opened this morning I have been unable to stop the tears.  It's 9:00 here, so at this time in 24 hours I will be registering at Mt. Sinai for my C-Section.  I have never in my entire life been this scared.  But I'm guessing that about a week from now when my baby boy goes into the operating room for open heart surgery that I'll be completely terrified compared with my feelings about tomorrow.

I am so thankful to God for keeping Jacob stable and happily still in utero, bringing him now to 38 weeks 3 days gestational age.  Georgia was born at 38 weeks as well, so I am feeling alright with Jacob entering the world at this point.  I am trying to center my worried and anxious thoughts on God and my faith in him, but at this point today my mind and heart are like a whirlwind - I can't seem to settle on one thought long enough to find comfort.  That being said, I cannot wait to see the beautiful face of this little one.  To be able to hold his tiny hand in mine, and tell him face to face how much his Momma loves him.  To tell him that he is not alone, that he has a Momma, Daddy and Sister who love him.  To tell him that he has a whole family waiting to meet him back in Newfoundland, and a community of friends who love and support him even though they have never met him.  To tell him how strong and brave he is, and to touch his perfect chest before the doctor's give him his scars.

This morning I was telling a friend how scared I am feeling, and this wise heart Momma gave me the great advice of looking at the physical and emotional pain as being done for Jacob, and reminded me that it's minimal compared to what Jacob will be going through in his young life.  Thanks for that reminder, I can do this for my baby boy.  Like the song from an earlier post says:


"You're gonna have all of me
'Cause you're worth every falling tear
You're worth facing any fear
You're gonna know all my love
Even if it's not enough
Enough to mend our broken hearts
But giving you all of me is where I'll start

I won't let sadness steal you from my arms
I won't let pain keep you from my heart
I'll trade the fear of all that I could lose
For every moment I share with you"



To everyone reading this, and to those who have been praying for us - please find time in your busy mornings tomorrow to uphold Jacob in your thoughts.  I am scheduled for the section at 11:00 am EST, so at 12:30 pm Newfoundland Time.  Pray for a stable delivery, and a smooth transition from Mt. Sinai to Sick Kids.  Pray for wisdom for the doctors and the single ventricle team who will be doing further tests and making final decisions in preparation for his open heart surgery.  Pray for peace of mind for myself and Jon, Jacob's grandparents and his Auntie and Uncles in Newfoundland.  Either myself or Jon will provide a short update at some point tomorrow.