Tuesday, August 21, 2012

8-21-12 visit

We went back to Indy for another appointment at University Hospital to check fluid levels in Baby M along with Kim's cervix length.  We were the first appointment at 8 am! We had the ultrasound and after some measurements were taken on Baby M's fluid level it was determined after 3 different measurements to have decreased from a width of 1.15 cm wide to roughly 0.85 cm wide! This was great news!!!   This means that whatever caused the leaking of the fluid has stopped and Baby M is trying to rid himself of the extra fluid in his belly. 

Now, the big question is....What caused the fluid to be there in the first place?  That is the million dollar question, or will that be our medical expenses? I had to have some fun with this, anyway Baby M is getting the best treatment possible.  So, the doctors best guess based on clues from tracking and following Baby M is that it came from his bowel.  There is calcification spots on the bowel seen via the ultrasound that could be from a twisting of the bowel to a kink to a hole in the bowel.  The good news is that this is all treatable and fixable through surgery or surgeries after he is born.  The surgeries will take place at Riley, which have some of the best doctors in the world!!  We go back every two weeks for monitoring. 

Onto the cervix issue, it is no longer fluctuating but is still only about 0.8 cm closed and should be in the ballpark of 3-5 cm closed.  Due to this, they are also going to monitor the length of the cervix every two weeks.  Kim is still on bed rest but can get out and do a few things to ensure her sanity such as pedicures, manicures, an occasional visit to the movie theater for the matinee, dinner out but nothing that requires standing on her feet for long periods of time, lifting, cleaning, cooking, laundry, etc.  She still cannot do stairs except for once down and once up a day at the house. 

On to some even better news, Baby M is a healthy looking baby based on the ultrasounds and measurements they have done.  He is currently weighing 1 lb and 6 oz (a little big and is measuring 5 days ahead of schedule which is good if we need to deliver early or in case Kim goes into early labor).  He is also in the 67th percentile in terms of growth and of course the femur is a little on the short side (as if Kim and I are 6'5").  :-)

The plan is to keep Baby M in as long as possible so he can develop and be as strong as possible in case he has to have surgery.  The longer he stays cooking the bigger he gets which makes it easier for the NICU doctors to work on Baby M due to the fact things are simply bigger and easier to see.

Kim and I also got the results of the blood work drawn last week and we are both not carriers of cystic fibrosis.  Therefore the chances of Baby having cystic fibrosis are highly unlikely but we are still awaiting on the final test results which may take 7-10 days. 

We want to thank everyone who has sent us positive thoughts, prayers, etc and keep them coming as we are not out of the woods yet.  Let's hope for a December 17th baby. 

Sunday, August 19, 2012

on the move...

Remember from the last posting I said that I could feel maybe 1 out of every 20 kicks.  Well the baby must have read what I posted.  Since then he's been on the move!  I wake up and it feels like he's doing laps in my belly.  It's so funny to watch him move around and feel him.  Ben has been able to feel him kick a few times too!

Wednesday, August 15, 2012

The past month...

  •  July 19th (18 weeks) I experienced some bleeding.  I freaked out, called Ben.  We had an ultrasound to check on baby and everything me.  (They even checked to see if he was a boy or girl...he was being stubborn).  I was then seen by my ob and examined.  Both the ultrasound and exam checked out.  They couldn't determine the bleeding and I was told I needed to slow down a bit.  At this visit, the cervix measured 3 cm. I explained my job and she told me I could go on as normal with work, just use my head.  She wanted to see us in 2 weeks for our scheduled 20 week ultrasound.
  • August 3rd we went in for our 20 week ultrasound.  The ultrasound itself was great!  He was very proud from the beginning of the ultrasound and showed us in fact he was a HE.  They took all kinds of pictures and measurements.  He was 13 ounces at this visit.  We got done and went down the hall for our doctor visit.  And that's when our ob called us in to her office to discuss the ultrasound.  She saw some things that concerned her.  So she was referring me to a specialist.  And we'd hopefully be seen in the next week or so.
    • My cervix is a cm or less closed...which it should be 3 to 5 cm closed.
    • Baby has a calcium deposit on his heart. 
    • Baby has ascites (fluid) in his abdomen around his liver.
  • August 6th (21 weeks) I got a call at work telling me that the specialist wanted to see me right away and to bring a bag in case they admitted me.  We got there, they did two types of ultrasounds.  From the ultrasounds they saw the issue with my cervix and also the ascites.  So then that's when all the "WHAT IF'S" started.  Basically the state my cervix is in, I could go in to labor at any point. So that is when I learned I was officially now on bed rest.  Then the calcium deposit on the baby's heart.  They didn't see it.  So to be sure they scheduled a fetal echo for the next day.  Then the ascites...is a bigger issue than what we thought from our August 3rd visit.  Basically a lot of reasons could be causing it so we then had to undergo lots of tests.  Our doctor is very open and she told us about every possibility.  From miscarriage, delivering early, genetic disorder, going full term, etc.  We decided to do an amniocentesis to run a few tests.  They took blood and ran all kinds of tests.  So they decided to admit me at University Hospital (on IUPUI's campus) for monitoring and to do a few things the next day.
  • August 7th We had the fetal echo at Riley Children's Hospital, the pediatric cardiologist came in and went through the pictures and took some more.  Baby's heart is just over 2 cm, WOW!  The doctor said that he does NOT see the calcium deposit or anything that would be causing the ascites in the abdomen.  Heart looks and is functioning as it should! After that we went back to my room and waited.  Finally saw my doctor and she said that the NICU team was dealing with a difficult case and couldn't meet with us until tomorrow or we could meet with them when we came back in next week for our next appointment.  We decided to go home and rest in our home.  
  • We got the test results back during the week. So...we continued to cross things off the list that could be the cause of ascites, they still do not know the cause at this point in time. The doctors tested several possible reasons for the ascities that include viral, genetic & toxins.  These all resulted in normal results for the genetic makeup and negative for viruses and toxins.  We still do not know why the fluid is there.
  • August 14th (22 weeks - 6 months) Had ultrasound, we got to see the baby have hiccups. The placenta is in the front, so I can hardly feel the baby when he moves.  I watch him kick, punch, roll over, etc on the screen and I maybe feel 1 out of every 20 kicks.  His heartbeat was 151.  We saw that the ascites was still there from the ultrasound.  The doctor came in and talked with us and did another ultrasound to get an exact measurement of the ascites.  It has grown in size.  It was roughly .7 cm and is now 1.15 cm wide.  Which wasn't something we wanted to hear.  She also said there was now an abnormality next to the baby's stomach...which could be anything from a blocked bowel to lymphnomatic fluid.  She also talked to us about Cystic Fibrosis.  Ben and I both gave blood yesterday and they still had amnio fluid so they will be testing for cf.  That will be 7 to 10 days before we know those results.  Our doctor had also talked about draining some of the fluid off the baby to see if the fluid would come back and also to test the fluid to see what it is we are dealing with.  However, after talking with the NICU person, we decided against that at this time.  She said that developmentally right now, the fluid isn't causing harm to the baby.  Now, if it were around the lungs then yes, we'd want to drain to relieve pressure.  The NICU also talked about premature babies in general, with no ascites.  She said at 24 weeks a baby has a 40% chance of survival, and with each week it increases.  Even to 28 weeks the baby now has a 85% chance of survival.  But with any premature baby, there are developmental and cognitive issues that range from severe to mild.  So the longer he stays developing in utero, the better chance Baby Murray has.  So the goal is for him to stay right where he is for right now.  We were also informed we would in fact deliver at University Hospital.  That way Baby Murray has immediate access to Riley Hospital NICU.  My doctor said I'm not a candidate to have surgery to stitch up my cervix, but I am a candidate to take progesterone, which is a steroid hormone, to help my cervix stay as is for as long as possible.  They also want to do a fetal mri to get a better picture at the abnormality, however with as active as our baby is they aren't sure they'd get the picture they'd need until the baby has less room to move around.  We will be making a weekly trip to University Hospital to monitor the fluid.  At this point, there are still a lot of unknowns.  But Ben and I believe we are in the best care possible.  We may only see our doctor, but she is working with a team of specialists to give us the best care possible. Our next visit is next Tuesday morning at 8am:)