Monthly Archives: November 2008
posted by Mel
Yesterday’s NST went very well. She was surprisingly reactive for 29 weeks, which wasn’t expected for this gestational age apparently. Blood flow through the cord was improved this week, so they opted not to do the biophysical profile. I have to go back on Monday for another NST, and then they’ll look at her on u/s and do another check of the cord and a growth scan next Thursday. It’s going to be like this from here on out– an appointment every 3-4 days. The peri was at least confident enough to say she thought I’d make it to 30 weeks, but she is giving no guarantees beyond that. I’m just going to have to live 3-4 days at a time. She at least seemed hopeful and said she did not think it was time to think about administering any shots to mature Simone’s lungs. Even if cord blood flow starts to degrade, the first step will be to put me into the hospital and monitor me all the time. I’m actually thankful for that. I feel like I’ll at least get a little warning before Simone arrives– even if it’s only 24 hours.
I did find out that I’ve got a much higher chance of ending up with a C-section, so that’s something I’m going to start mentally preparing myself for. She said she thought there was a 50% chance but that, when it’s time for Simone to come, we’ll put me through a stress test with pitocin to simulate labor to see how she would tolerate a vaginal delivery. Crossing my fingers that she’ll be strong and healthy enough, but I’ll do what I have to do.
This morning my baby is alive, kicking, and staying put until at least 30 weeks.
posted by Mel
Now that the numbness has worn off, now that the acceptance of new circumstances has begun to set in, I am coming back to the me that is a demanding control freak of a patient. We see the peri again on Wednesday, and I am beginning to collect my questions. I’m going to list here what I have so far, and if anyone thinks of anything to contribute, let me know.
1. What’s the metric that would cause you to call for an induction immediately?
2. If Simone were to come right now, what kind of complications would we face (at 29 weeks)?
3. How old do babies need to be before they can usually breastfeed? Will she get my expressed breastmilk in the NICU, or will she probably have to be IV-fed?
4. Should I get a shot to mature her lungs? When would you administer that?
5. Do growth restricted babies ever have growth spurts, or can we expect her growth rate to continue to decline only?
6. Could sleeping on my back have contributed to taxing the cord?
7. Does the baby’s ethnicity make a difference? The doctors have referred to my ethnicity and genetic makeup, and I think they just assume that the donor was white, but he wasn’t.
8. Should I be trying to consume more calories or increasing my iron intake?
9. What percentile was Simone at 23 weeks compared to her percentile now? Was the 4% mentioned her growth or just her size for her gestational age? Is it tracking lower or the same?
posted by Mel
Rough ultrasound yesterday afternoon. I am fine. Simone is fine-perfect for now. Just small (a little over 2 lbs right now and in only the 4th percentile over-all). But definitely growth-restricted and, as a result, stressed out. The umbilical cord is not keeping up as well as we’d like it to with its single artery. The doctor said that they will, best-case scenario, take her at 37 weeks. There’s a 50% likelihood that she will have to be taken before that. The short-term goal is to get to at least 34 weeks.
From now on I have to go into the hospital twice/week for non-stress tests (to monitor her heart rate) and biophysical exams-short ultrasounds where they take a look at her movement and blood flow through the umbilical cord. Blood isn’t moving through it fast enough, and that’s why she’s not growing as she should be. At some point it will probably begin to fail and the blood might start moving in the opposite direction. If that happens it will be crucial to get her out as soon as possible. One of these days I will probably go in for a biophysical exam and they’ll tell me I have to be induced either right then or within 48 hours. Worst-case scenario it has to be immediate and I have to have a C-section for some reason. If that happens, because the blood thinner will not have had time to cycle out of my system and I can’t be given a spinal block, I’d have to be put under general anesthesia, so I’d be asleep for the birth. I would HATE that. She’d go straight to the NICU, and I wouldn’t even get to see her.
The odd thing is I feel great, and the doctor said there was no reason for me to go on bed rest-won’t help. There’s nothing I can do to make it better or easier on Simone. The perinatologist says that stressed out babies like Simone fight, kick, and get strong earlier than babies that are not stressed out. Her body will throw crucial development into overdrive; so her lungs are probably maturing earlier than other babies. We could see her practicing breathing yesterday on the ultrasound. When she comes out, she’ll likely be pretty healthy despite being early. Unless she can make it to 5 lbs before she’s born (unlikely), though-she’s going to spend some time in the NICU. They won’t let her come home. I’m very unhappy about that. It’s not how I planned on spending our first few weeks of life together, but we’ll do what we have to do.
I went in thinking everything was fine. I even got through the entire ultrasound believing things were fine, even if she was small. I had no clue anything was wrong until the doc came in and told us, with a bright grin, that this baby was coming early whether we liked it or not. For the first time in my reproductive history, I was speechless and unable to listen and interact proactively with my care provider– unable to process what I was hearing. Vanessa had to ask all of the questions. She was really wonderful, and I’m so glad she was there. I had to go over the information with her a couple of times with the doctor out of the room before I could begin to process it. This morning I sat down with her again to review what she heard and what I heard.
I think Simone’s going to be OK-eventually. It sounds like, if we can make it to at least 34 weeks, there are unlikely to be any long-term effects. What I’m most upset about is the loss of my dream for our early weeks together. She’ll be in the hospital. That’s how I’m going to spend my maternity leave. I worry that we’ll have problems establishing our bond and that breastfeeding is going to be a huge struggle. I am trying to adjust my expectations.
Tempering all this, I have looked at her 4-D ultrasound pics from yesterday a million times. Sorry– no time to post them at the moment. She is absolutely beautiful. She has gained flesh and has a long upper lip. Her thighs and calves are delicately curved and perfect. My favorite part of her is her long skinny well-formed foot. Cannot wait to touch and kiss those tiny toes.
posted by Mel
Thank you kindly for removing yourself from the little cave you were excavating in the left side of my pelvis. 5+ hours in one position is long enough, and frankly it was putting me in a very nasty mood. Hope you enjoyed the hot chocolate. Sorry about the sugar buzz, but I was fucking desperate.
posted by Mel
27 weeks today. One of the sites I check out to see what’s going on with Simone every time I hit a weekly milestone says that I am 3rd trimester today. That’s not possible, is it? Tell me I have another week. Bwahhhhhhhhh!!!!!!!!!!!!!