In cases of likely brain injury, scientists have found that inducing hypothermia within six hours of birth improves outcomes. When deprived of oxygen, the body begins looking for energy wherever it is available. It will detonate those cells and release that energy to be used elsewhere.
The cells then degrade and release harmful cellular instructions to the surrounding cells as they die, and this process can be halted and altered by lowering the body temperature. The goal is to allow the brain to reboot and restore before the secondary degradation of cells is fully underway. It's why you read about sledding or ice-fishing accidents where people are getting pulled out of the river after being trapped under ice, and miraculously recovering.
"Clinical and experimental studies have demonstrated that neuronal death occurs in two phases following a reversible hypoxic-ischaemic global insult."
"Therefore, a therapeutic ’window of opportunity’ exists in the interval following resuscitation of the asphyxiated newborn before the secondary phase of impaired energy metabolism and injury (Gluckman 1992;Lorek 1994;Penrice 1996)."
Liz out of OR, Calvin just chillin'
Blood gas levels and Ph determine the probability of damage to the brain, and Calvin was also put on an EEG to monitor for seizures. His physical and physiological condition improved quickly; muscle, motor, and his pupils responding to light and movement. His hearing appears normal as well. There may have been a brief seizure recorded of 10 seconds, but similar recordings occurred during later hiccuping so it's hard to know. Regardless, medical staff are more concerned by longer durations lasting several minutes.
The hypothermia protocol is 72 hours, and then warming begins. This is where many infants begin having more seizure activity as their brain "starts up" again.
One the morning he started the warming procedure, it was a warm sunny morning after a few days of thunderstorms and menacing clouds. I interpreted this as a Good Omen, much like the butterfly slowly working it's wings on the mirror of my mother's car.
Mundane things suddenly taking on prophetic qualities
Liz and I sang "Here Comes the Sun," softly to Calvin to commemorate the start of the process.
Warming went well, no seizures, which wasn't expected by the Neurologists. It's very common to have seizures and they were expecting them to occur. They had suggested the possibility of using seizure medication prior to warming to control them but it seemed better to wait and see if he actually had them first rather than give him medicine that may not be needed. The neuro team wasn't winning me over, which is doubly frustrating considering they have a crucial role yet to come. Most of them have the bedside manner of a diesel mechanic that just realized they will be getting that new boat after all.
After Calvin bravely assumed normal body temperatures that evening, and the neurology team accepted that he wasn't having seizures, they had the EEG leads removed. We got to hold him.