As of this morning, we learned that our daughter is scheduled for a health-related precautionary c-section to take place this Thursday. Her birthday will be March 31. 3/31/11. Here are the pieces from there to here.
The weekend before, really getting ready now, I mean it
I woke up on the first day of my 35th week feeling ready and determined. My Mom was coming into town, which would already make me feel better. I knew it was a matter of a couple weeks, at the most, if not just days, before the baby arrived so there was plenty to do. I made a list. And tried to plan stretches of activity alongside stretches of foot-raised rest. My husband went with his family to the Argentina-US soccer game, and I was relieved that he would have some special, happy time with his family after our intense hospital stay. My Mom and I had a nice time together, she worked her behind off doing laundry and cleaning and helping me plan through what I needed to do to become mom-ready in a baby-ready house. And we lounged and talked in the evenings. She stayed for a few days, helping me with so many errands and house activities, and taking me to my follow-up appointment on Monday while my husband was in NY for work.
Monday's appointment
I knew that they were going to find that I was even closer to labor. My Braxton Hicks were almost constant for many hours a day. I was seeing something different in my underwear. And Monday morning the cramping returned. I went to work for a few hours, my very generous boss ordered me to follow doc's orders and return home. Later in the day, my mother and I went to CHOP.
The decision to perform a c-section came about thanks to a perfect storm. First, they saw on the ultrasound that the baby's cyst had fully re-inflated back to its size just before they drained it, which was basically it's largest size yet during the pregnancy. Second, they found that I was still dilated but now 80% effaced, which means significant dissolution of the mucus lining that covers the opening of the cervix. The baby's head had moved down some. Third, my blood pressure soared, putting me at risk for preeclampsia and preterm labor. During the visit, they told me that a scheduled c-section was best with a draining procedure performed just prior so that they could ensure that when they delivered the baby, her cyst would be at its smallest size, ensuring room in her chest for ventilation. Then they would do their diagnostic tests, make a plan, and surgically remove her cyst before it re-inflated again, giving them about 3 days or so. They learned from the draining procedure how much time they had before it re-inflated, that it was definitely an esophageal duplication cyst (good news regarding the ability to remove it), and that it could be fully drained and that her lungs and heart would immediately move into their proper position. It was too much information to ignore, essentially, and with my body moving toward labor, they wanted to have a detailed plan. But, you see, at first the plan was to do all of this in Week 37. But when the perfect storm started brewing, they said they'd call me if it needed to be done earlier. This morning I got the call...Thursday would be the day.
Final preparations
Today felt like a whole different day after that call. While I wish that the baby could spend more time growing in the womb, there are too many confounding variables that might interfere with her and my wellbeing, and having a middle of the night labor just feels too scary. And, so, despite the fact that I have worries about her being born early, I know she's at a good weight, and that her health has been monitored about 100 times more than almost all other babies. She's doing everything right in there--practicing breathing, swallowing fluid, gaining weight faster than other babies her gestational age. There are a lots of strengths on her side. And, when I remember those things, I just get plain excited. I can't believe that I'll be able to hold her in a couple days, that she'll move from inside to the outside. That I'll have the luxury of being on maternity leave so I can spend time with her and support her growth and be with her. Yes, I'm nervous. I'm expecting an intense few days in the hospital as they care for her and support her in her transition to the outside world, but I have great confidence and I feel like she has shown us so many signs that she's very much okay. Yes, she has a "birth defect." Call it that if you want; others do. But it has just been one part of all of this and all of the other parts have been so plainly normal and wonderful. I feel like all of this fits with my life in a lot of ways, that it makes sense that it's me and my husband with this special wonderful baby because we have the kind of thinking and will power and philosophies about the very special differences among people that make us great parents for this little girl. Many months ago, when I felt my worst through all of this, I mourned her. I did. But I never gave up on her. And, at that worst of times, I felt like I did something wrong. Like I created a poor home that led to her having some challenges, but now I realize that really the coincidence of us having this awesome baby is cosmically related to us doing something right, being the people that we are, receiving the gift of a girl who needed a different start and parents who would honor that. I really feel like I know how to honor many different kinds of experiences; my parents taught me that. And so we're lucky to have her, and I think she's lucky to have us too.
I'm looking forward to spending tomorrow night with my husband. It'll feel like Christmas Eve!
Tuesday, March 29, 2011
34 Weeks, Part 2, The Dawn of the Ending
Well, let me tell you: I would not wish any fetal cyst draining procedure on my worst enemy. Not that I know who my worst enemy is, probably ain't even a woman, but if she were a woman, I'd never wish on her the experience of seeing the start of the insertion of a long needle into her womb which fishes around and then sticks and slides in between her baby's ribs. So, yes, I can conclusively say that the procedure was painful and scary and mentally taxing. My husband even said it was one of the most intense and scary experiences of his life. He had to watch the whole thing and keep me focused on cooperating.
I entered the hospital that morning in a seriously foul mood. I was so anxious about the procedure. There was a woman who cracked a joke about going to the same floor as me, hardy har har, because well, I was pregnant, and that's where pregnant people go in CHOP. Nico politely laughed, I just gave her a blank stare and kept pressing the Door Close button, which subsequently kept the elevator doors closing on people. I sort of apologized every time, but honestly, if I could have just had an empty elevator ride to the 5th floor, it would have made me just that much more comfortable.
Once we were among the CHOP doctors, my mood did lift quite a bit. They know me well now and they always seem happy to see me. I made jokes with them. One doctor pretended my fleece socked feet were car shifters, and he "raced" my feet. Another lady doc who I'm especially close with joked that she was impressed with how I even wore pretty underwear for my draining procedure at the hospital. I know, some of this may sound strange to you based on how you know doctors, but I feel close to these people. They have been seeing me at least every other week for months, watched me cry and laugh a million times over, and, most importantly, been stewards of the growth of my baby, which is a pretty goshdarn intimate thing if you let it be, if you embrace it that way. Plus, they just like me. I can tell. We have good rapport.
The jokes all ended though as soon as I saw them pull out that needle. I turned my head quickly to my husband, held on to his hand for dear life, and started to try breathing exercises. They talked me through the early parts, but then left out the scary parts, I learned later. Yes, the needle hurt when they put it in. But that was not nearly as disturbing as when they were fishing for the baby with it, and trying so hard to find the right moment to try to insert it in her. And what was most scary of all was feeling my baby try to get away, curling herself into the opposite side of my womb, away from this foreign object. The whole team became very quiet, I heard them whisper pleas to the baby to stay still and cooperate. My head was dripping sweat. My husband was talking me through it, rubbing me, and the doctors were complimenting me throughout too, telling me I was doing a great job. They reminded me to take deep breaths. And then, soon after my husband said it was almost done, it was done. The whole thing took about 40 minutes. My sense of time was skewed but I looked at the clock enough before and after to know. My husband told me later some of what he saw. It was painful for him to watch both me and what was going on internally on the ultrasound screen. But he did say that once they put the needle in the baby, she stayed very still, like a good girl.
A risk with such a procedure is going into preterm labor. And within 15 minutes, I was cramping. A few minutes later, I started having full on contractions. I only learned later that the fact that I was feeling them so strongly was an indication that they were very active contractions (uncommon for women in their first pregnancy), and this was no surprise because 45 minutes later when they checked my cervix, they said that I was dilated.
I had to stay at the hospital until things slowed down, but they just didn't. I had very active contractions for about four or five hours. There were a few things that people have told me about contractions that didn't stick very intensely until I was experiencing them myself, like the fact that certain sounds are extremely irritating. My poor husband was trying to eat some food, starving, and the sound of him chomping down on salad made my ears burn. I had to tell him to be quiet and stay still a few times while I was having contractions. A couple hours in, they gave me medicine to try to stop everything. Eventually, the medicine worked, things slowed down to an eventual almost stop, but the cramping kind gave way to a rapid on and off succession of Braxton Hicks, which has not yet stopped to this moment. That was five days ago.
They admitted me that night and it was a long, miserable night of constant peeing, an uncomfortable bed, hands swelling around my IV. I remember watching Last Call with Carson Daly in the middle of the night and couldn't help but imagine what company I was in. The nurse had to come in every half hour to reassemble my uterine and fetal monitors after every trip to the bathroom. My husband stayed overnight with me and he was awoken too, every time. I had the nurse take out my IV in the middle of the night because my swollen hand was aching.
The next day though, exhausted, I just begged to go home. I was still having active Braxton Hicks contractions, but not labor contractions. They gave me a cervical exam and I was still dilated, but at 1.5 centimeters, and no more than the night before.
They did an ultrasound and even I could see that the cyst had at least partially re-filled itself. Fortunately, not that much yet--it's original size of 100 mL of fluid was down to 19 mL, but still the fact that it was re-filling was concerning. They sent the fluid to the lab and would have results soon to tell us more about what the cyst actually is.
It felt more clear that this pregnancy was not going to go on for much longer. They let me go home, ordered me to modified bedrest, scheduled me for a visit three days later, and gave me tips to keep from going into labor again. It was the dawn of the ending. I came home and took a five hour nap.
I entered the hospital that morning in a seriously foul mood. I was so anxious about the procedure. There was a woman who cracked a joke about going to the same floor as me, hardy har har, because well, I was pregnant, and that's where pregnant people go in CHOP. Nico politely laughed, I just gave her a blank stare and kept pressing the Door Close button, which subsequently kept the elevator doors closing on people. I sort of apologized every time, but honestly, if I could have just had an empty elevator ride to the 5th floor, it would have made me just that much more comfortable.
Once we were among the CHOP doctors, my mood did lift quite a bit. They know me well now and they always seem happy to see me. I made jokes with them. One doctor pretended my fleece socked feet were car shifters, and he "raced" my feet. Another lady doc who I'm especially close with joked that she was impressed with how I even wore pretty underwear for my draining procedure at the hospital. I know, some of this may sound strange to you based on how you know doctors, but I feel close to these people. They have been seeing me at least every other week for months, watched me cry and laugh a million times over, and, most importantly, been stewards of the growth of my baby, which is a pretty goshdarn intimate thing if you let it be, if you embrace it that way. Plus, they just like me. I can tell. We have good rapport.
The jokes all ended though as soon as I saw them pull out that needle. I turned my head quickly to my husband, held on to his hand for dear life, and started to try breathing exercises. They talked me through the early parts, but then left out the scary parts, I learned later. Yes, the needle hurt when they put it in. But that was not nearly as disturbing as when they were fishing for the baby with it, and trying so hard to find the right moment to try to insert it in her. And what was most scary of all was feeling my baby try to get away, curling herself into the opposite side of my womb, away from this foreign object. The whole team became very quiet, I heard them whisper pleas to the baby to stay still and cooperate. My head was dripping sweat. My husband was talking me through it, rubbing me, and the doctors were complimenting me throughout too, telling me I was doing a great job. They reminded me to take deep breaths. And then, soon after my husband said it was almost done, it was done. The whole thing took about 40 minutes. My sense of time was skewed but I looked at the clock enough before and after to know. My husband told me later some of what he saw. It was painful for him to watch both me and what was going on internally on the ultrasound screen. But he did say that once they put the needle in the baby, she stayed very still, like a good girl.
A risk with such a procedure is going into preterm labor. And within 15 minutes, I was cramping. A few minutes later, I started having full on contractions. I only learned later that the fact that I was feeling them so strongly was an indication that they were very active contractions (uncommon for women in their first pregnancy), and this was no surprise because 45 minutes later when they checked my cervix, they said that I was dilated.
I had to stay at the hospital until things slowed down, but they just didn't. I had very active contractions for about four or five hours. There were a few things that people have told me about contractions that didn't stick very intensely until I was experiencing them myself, like the fact that certain sounds are extremely irritating. My poor husband was trying to eat some food, starving, and the sound of him chomping down on salad made my ears burn. I had to tell him to be quiet and stay still a few times while I was having contractions. A couple hours in, they gave me medicine to try to stop everything. Eventually, the medicine worked, things slowed down to an eventual almost stop, but the cramping kind gave way to a rapid on and off succession of Braxton Hicks, which has not yet stopped to this moment. That was five days ago.
They admitted me that night and it was a long, miserable night of constant peeing, an uncomfortable bed, hands swelling around my IV. I remember watching Last Call with Carson Daly in the middle of the night and couldn't help but imagine what company I was in. The nurse had to come in every half hour to reassemble my uterine and fetal monitors after every trip to the bathroom. My husband stayed overnight with me and he was awoken too, every time. I had the nurse take out my IV in the middle of the night because my swollen hand was aching.
The next day though, exhausted, I just begged to go home. I was still having active Braxton Hicks contractions, but not labor contractions. They gave me a cervical exam and I was still dilated, but at 1.5 centimeters, and no more than the night before.
They did an ultrasound and even I could see that the cyst had at least partially re-filled itself. Fortunately, not that much yet--it's original size of 100 mL of fluid was down to 19 mL, but still the fact that it was re-filling was concerning. They sent the fluid to the lab and would have results soon to tell us more about what the cyst actually is.
It felt more clear that this pregnancy was not going to go on for much longer. They let me go home, ordered me to modified bedrest, scheduled me for a visit three days later, and gave me tips to keep from going into labor again. It was the dawn of the ending. I came home and took a five hour nap.
Tuesday, March 22, 2011
34 Weeks
Well, the first day of my 34th week was my baby shower, which was a most splendid affair that felt really special and wonderful. There is really nothing like spending time with so many of your family and friends all in one place. It happens so rarely in our lifetimes. I'm so thankful for all of the people who hosted and organized and made food (yummmmm btw) and drove an hour and even much longer to come spend time together. I started bawling as soon as I walked in the door--happy, touched tears. I really appreciated the support immensely. I'll post some photos soon enough.
In the meantime, I want you all to have an update from this morning's visit as events are progressing more quickly than I can document them.
In the meantime, I want you all to have an update from this morning's visit as events are progressing more quickly than I can document them.
I went in for an ultrasound this morning and they saw that the cyst grew in the past week and they are concerned about compression of the baby's organs so we scheduled a procedure to drain the cyst this Thursday at 1 pm. They are not sure if they will need to sedate me and the baby--that will be determined on Thursday. They will have docs on hand to do a c-section if for some reason I go into labor or if the baby shows any signs of distress.And, again, xoxo, Amanda. Little, take a bow.
They will insert the needle through the baby's side in between her ribs to drain the cyst. They feel that the cyst may very well refill with fluid but it will reduce compression in the meantime. Depending on how quickly it refills, they may do the draining procedure again right before they deliver the baby. At this point, I am having either a c-section or EXIT procedure. The doctor said that she hopes that by draining it, I will be able to have a regular c-section instead of the EXIT procedure.
My blood pressure increased again and they are not happy with how much my feet are swelling so a shorter timeline to delivery is still what they are talking about. Again, they said likely at 36 or 37 weeks. I hit 36 weeks on Saturday, April 2.
The good news is that the baby's heart and lungs look very healthy, other than being compressed by the cyst so they are happy that the compression will be relieved this week. Also, the stomach looked better this morning than last week so her swallowing seems to have picked up again. That's great news. The sonographer said that the baby's bladder looked full so that was a good sign.
Nico and I are working every night to try to get the nursery ready. We bought a dresser on Sunday and we picked up a crib and changing table from friends. I called the painter and asked him to do one more coat of paint in the nursery--it needs another one--and that's tentatively scheduled for Thursday morning before our procedure so all of the baby items are in the office ready to be moved in to the nursery once that's done. In the meantime, Nico is assembling furniture and I'm trying to organize other things in the house and clean. My Mom will be coming this weekend to help, and I already started making a list of things we will do together, including wash and put away all the baby clothes and pick up final items we need. Whew!
The baby is six lbs so we have a big healthy baby who is ready for whatever happens.
xoxo, amanda
Also 33 Weeks
This week's ultrasound and prenatal care visit brought some news. The baby was moving a lot as usual, and she was practicing breathing the sonographer told me. Her chest was heaving so I was initially worried but the sonographer said that it was a great sign. The doc came in and confirmed that the baby was doing all the right exercises to be ready for life outside the womb.
The baby's heartrate was fine. She is swallowing a little bit less fluid, her stomach looked very small to the doctor, so they suspect that she may be starting to have some swallowing issues now that she's bigger. They measured the fluid in my uterus and it shows very mild polyhydramnios (their cut off for polyhydramnios is a fluid measure of 22, my measure is 23, so very mild). Polyhydramnios was something they mentioned to us a long time ago as a possibility. There is only a slight increase from last week so they are comfortable continuing to monitor it. If they see a drastic increase or if I start to have additional symptoms of severe swelling, then they will do an amnioreduction which is putting a needle in and draining some of the amniotic fluid. The goal of this would be to prevent preterm labor.
At this point, however, the doctor suspects that the baby will be coming early, and it appears that it is more likely that we will be doing the EXIT procedure where they will open me up via c-section incision and then partially deliver the baby, insert an IV and breathing tube in her, and then fully deliver her. They won't do surgery on her at that time but will instead check out how all of her bodily functions are working before making decisions about her surgery.
The doctor said that the goal right now is to keep the pregnancy intact until at least 36 weeks, 37 weeks would be even better. She said that the baby may be coming early because her organs are being more squished and it may be impacting more systems, like her swallowing, for example. We could see her licking the fluid, trying to drink it up, but things may be a bit constricted on the inside, preventing her from fully swallowing like she was able to before. The doctors want her to remain in utero for as long as possible, but want to schedule a procedure before she experiences any harm. For the time being, though, the doctor said she was a "happy baby" because she's exercising and moving normally. Also, her heartrate and blood flow are normal, indicating that her brain function is fine.
The doctor said that we will develop a birth plan by 35 weeks, which is in two weeks from now. We could be meeting the baby in as little as 3-4 weeks if needed. (Whoa!!!) If they have to, they will do an amnioreduction between now and then.
I asked the doctor about the cyst draining procedure. She told me that she was one of the doctors on the "no" side. She said that while they have lots of experience draining cysts (she said they do it at least once a day), there are many blood vessels and nerves in the baby's neck and she doesn't want to do it unless it's absolutely necessary. She also said that while this cyst is most likely an esophageal duplication cyst, there's a chance that it is something else with an interior composition that would be difficult to drain. One example is a kind of "tumor" created by the lymph nodes where they create too many cells. In this case, the substance inside the cyst would be sticky and thick and difficult to drain so it would make the draining procedure worthless. She feels it is an unnecessary risk at this point. She said that it is VERY likely that it is an esophageal duplication cyst with a liquidy substance, but they won't know for sure until the baby is born and they investigate. Either way, they can do surgery to remove it after she is born.
I talked to the midwife about the fact that last Wednesday I had pretty regular contractions every five or six minutes for about 2 hours and immense swelling in one of my feet. They said it's a bit early for that kind of "practicing" that the body does, and it may be linked to the fact that my fluid levels are a little bit higher than normal. From here on in, they've asked me to come in even if I think it's a false alarm because having extra fluid is linked to preterm labor and they'd rather play it safe. I've got a list of symptoms to be on alert for, and I'll head on in to CHOP if any of them pop up. My driving radius is an hour--the doctor nixed a work event I planned to attend next week in Dover, Delaware, which is about 1.5 hours away. The doctor said I should be keeping commitments to a minimum for the next four weeks (I guess she feels the baby will be here by then) and doing a lot of lying down on my left side to promote circulation and reduce swelling. I'm making arrangements at work to get things wrapped up sooner just in case.
Lucky for us, the baby is on the bigger side, she's over 5 pounds by now, which is large for her age so if she has to come early, she's already in good shape.
My next appointment is next Tuesday--I'll be doing weekly ultrasounds and prenatal care visits so they can watch both baby and me even more regularly from here on in.
The sonographer humored me and turned on the 3D ultrasound today so I watched the baby in 3D for a few minutes. She is really, really beautiful. She made lots of cute faces, she looks just like a normal baby now with chubby cheeks. She has very full lips and a perfectly round nose. She didn't open her eyes for me but she did a lot of licking of the fluid, and she even licked the back of one of her hands like she was a kitten. It was excruciatingly adorable! She is a very active baby, and she clearly loves touching her face with her hands. I do have new pictures! They are adorable but they don't do her justice. She is just beautiful.
And, well, with the federal budgetmaking in crisis mode, it's a help to have all of this going on at CHOP. The doctor said I've learned enough about fetal anatomy and pregnancy now to get myself a job there. So, if the new Tea Party congresspeople start cutting federal jobs, I know who I'll call.
The baby's heartrate was fine. She is swallowing a little bit less fluid, her stomach looked very small to the doctor, so they suspect that she may be starting to have some swallowing issues now that she's bigger. They measured the fluid in my uterus and it shows very mild polyhydramnios (their cut off for polyhydramnios is a fluid measure of 22, my measure is 23, so very mild). Polyhydramnios was something they mentioned to us a long time ago as a possibility. There is only a slight increase from last week so they are comfortable continuing to monitor it. If they see a drastic increase or if I start to have additional symptoms of severe swelling, then they will do an amnioreduction which is putting a needle in and draining some of the amniotic fluid. The goal of this would be to prevent preterm labor.
At this point, however, the doctor suspects that the baby will be coming early, and it appears that it is more likely that we will be doing the EXIT procedure where they will open me up via c-section incision and then partially deliver the baby, insert an IV and breathing tube in her, and then fully deliver her. They won't do surgery on her at that time but will instead check out how all of her bodily functions are working before making decisions about her surgery.
The doctor said that the goal right now is to keep the pregnancy intact until at least 36 weeks, 37 weeks would be even better. She said that the baby may be coming early because her organs are being more squished and it may be impacting more systems, like her swallowing, for example. We could see her licking the fluid, trying to drink it up, but things may be a bit constricted on the inside, preventing her from fully swallowing like she was able to before. The doctors want her to remain in utero for as long as possible, but want to schedule a procedure before she experiences any harm. For the time being, though, the doctor said she was a "happy baby" because she's exercising and moving normally. Also, her heartrate and blood flow are normal, indicating that her brain function is fine.
The doctor said that we will develop a birth plan by 35 weeks, which is in two weeks from now. We could be meeting the baby in as little as 3-4 weeks if needed. (Whoa!!!) If they have to, they will do an amnioreduction between now and then.
I asked the doctor about the cyst draining procedure. She told me that she was one of the doctors on the "no" side. She said that while they have lots of experience draining cysts (she said they do it at least once a day), there are many blood vessels and nerves in the baby's neck and she doesn't want to do it unless it's absolutely necessary. She also said that while this cyst is most likely an esophageal duplication cyst, there's a chance that it is something else with an interior composition that would be difficult to drain. One example is a kind of "tumor" created by the lymph nodes where they create too many cells. In this case, the substance inside the cyst would be sticky and thick and difficult to drain so it would make the draining procedure worthless. She feels it is an unnecessary risk at this point. She said that it is VERY likely that it is an esophageal duplication cyst with a liquidy substance, but they won't know for sure until the baby is born and they investigate. Either way, they can do surgery to remove it after she is born.
I talked to the midwife about the fact that last Wednesday I had pretty regular contractions every five or six minutes for about 2 hours and immense swelling in one of my feet. They said it's a bit early for that kind of "practicing" that the body does, and it may be linked to the fact that my fluid levels are a little bit higher than normal. From here on in, they've asked me to come in even if I think it's a false alarm because having extra fluid is linked to preterm labor and they'd rather play it safe. I've got a list of symptoms to be on alert for, and I'll head on in to CHOP if any of them pop up. My driving radius is an hour--the doctor nixed a work event I planned to attend next week in Dover, Delaware, which is about 1.5 hours away. The doctor said I should be keeping commitments to a minimum for the next four weeks (I guess she feels the baby will be here by then) and doing a lot of lying down on my left side to promote circulation and reduce swelling. I'm making arrangements at work to get things wrapped up sooner just in case.
Lucky for us, the baby is on the bigger side, she's over 5 pounds by now, which is large for her age so if she has to come early, she's already in good shape.
My next appointment is next Tuesday--I'll be doing weekly ultrasounds and prenatal care visits so they can watch both baby and me even more regularly from here on in.
The sonographer humored me and turned on the 3D ultrasound today so I watched the baby in 3D for a few minutes. She is really, really beautiful. She made lots of cute faces, she looks just like a normal baby now with chubby cheeks. She has very full lips and a perfectly round nose. She didn't open her eyes for me but she did a lot of licking of the fluid, and she even licked the back of one of her hands like she was a kitten. It was excruciatingly adorable! She is a very active baby, and she clearly loves touching her face with her hands. I do have new pictures! They are adorable but they don't do her justice. She is just beautiful.
And, well, with the federal budgetmaking in crisis mode, it's a help to have all of this going on at CHOP. The doctor said I've learned enough about fetal anatomy and pregnancy now to get myself a job there. So, if the new Tea Party congresspeople start cutting federal jobs, I know who I'll call.
Sunday, March 13, 2011
33 Weeks
The baby's room is painted. The color is called everlasting peach. I love the name of it. In the morning light, the room looks orange, and at night, it looks pink. I suppose that's the magic of peach. I'm enamored with it.
The fact that the baby's room is painted was my only consolation last week when I went into false labor. I've had Braxton Hicks contractions for weeks now, but on Wednesday I was feeling contractions every four to five minutes for about two and a half hours. I was out to dinner with my friend Jess and was brought to silence every few minutes to try to absorb what was going on. It was pretty intense.
Fortunately, after a couple hours of this, I called an OB at CHOP and, wouldn't you know, the contractions slowed down and within an hour or so, stopped. There's something magical about getting the doctor on the horn. Things just seem to start working out again. That happened earlier in the pregnancy when I didn't feel the baby move for a day. After plenty of time to fret, as soon as I got the doctor on the phone, the baby started kicking again. Maybe if I get some serious gas in the next few weeks, I'll just call the docs and hope for the best.
In any case, when I was having the regular contractions at home, I moved very quickly into high gear. I scanned the first floor and lunged at anything that needed cleaning or was out of place. I took out the trash, I threw some dishes into the dishwasher, I folded blankets, all while taking breaks to just get through the contractions every five minutes. I'm sure it would have been a comical sight. Then I sat down on the couch and studied my phone to start tracking them. Fortunately, it was just my body's trial run. We're not ready for the baby yet! I mean, yes, her room has a color. But it has no furniture yet! On Wednesday night though I did think to myself: it's okay, her room has a color...it has a color...it has a color. It was the saving grace of the moment!
Now I'm 33 weeks and officially in the zone where my body takes license to practice labor. Things are getting pretty serious, folks! Baby is on her way. We're very fortunate to have friends and family who will help us get prepared quickly in the next couple weeks, and I'll be so relieved when we have a room (with furniture) ready for her. Even if she has to spend weeks in the NICU, I'd be pained to think that she had no room at home ready for her.
The belly keeps growing. Even when I look at it and think, it couldn't possibly get any bigger, it does. Tonight I ate Indian buffet with Jared. Oh my, I think that's the last of my Indian buffet dinners until after the baby arrives. There's not enough room in my belly to fit five pounds of baby and a plate of curry!
I feel the baby move plenty still but the sensations of her movement have changed. Now that she is bigger, I don't feel her constantly floating around. She's clearly in her spot and whenever she makes a drastic change in position, like turns on her side, it's a very intense feeling for me. I can even see it on the outside of my belly--it contorts and changes shape.
In addition to my growing belly, my mama mentality is expanding. I am feeling more and more like a mother, feeling drawn to mothers, thinking about how mothers identify themselves and how they deal with the moments life brings. I find my thoughts wandering into new directions, thinking about things a little big differently, all the while still feeling like myself and having my own usual thoughts and questions. It's fascinating to hear myself sound like me but also sound like someone different too. A different version of me. I try to picture myself holding my child, and, at the moment it's still hard to envision sometimes, but it's very easy to imagine the thoughts and feelings that I will have. I can only guess it's because those thoughts and feelings are, to some extent, already with me. I hope the difficulty in envisioning myself with the baby is not because of her health but just because it's really the next level and I'm just not there yet.
Last night, I went to Julia's housewarming party and there lots of mothers there who are close to me in age. It was so gratifying to have mama talk. I was completely tuned in and fascinated, craving more information, listening to stories. I loved it all. I was very happy to exchange contact info with at least one mother so I can further broaden my circle of young, hip, city moms whom I can learn from.
The fact that the baby's room is painted was my only consolation last week when I went into false labor. I've had Braxton Hicks contractions for weeks now, but on Wednesday I was feeling contractions every four to five minutes for about two and a half hours. I was out to dinner with my friend Jess and was brought to silence every few minutes to try to absorb what was going on. It was pretty intense.
Fortunately, after a couple hours of this, I called an OB at CHOP and, wouldn't you know, the contractions slowed down and within an hour or so, stopped. There's something magical about getting the doctor on the horn. Things just seem to start working out again. That happened earlier in the pregnancy when I didn't feel the baby move for a day. After plenty of time to fret, as soon as I got the doctor on the phone, the baby started kicking again. Maybe if I get some serious gas in the next few weeks, I'll just call the docs and hope for the best.
In any case, when I was having the regular contractions at home, I moved very quickly into high gear. I scanned the first floor and lunged at anything that needed cleaning or was out of place. I took out the trash, I threw some dishes into the dishwasher, I folded blankets, all while taking breaks to just get through the contractions every five minutes. I'm sure it would have been a comical sight. Then I sat down on the couch and studied my phone to start tracking them. Fortunately, it was just my body's trial run. We're not ready for the baby yet! I mean, yes, her room has a color. But it has no furniture yet! On Wednesday night though I did think to myself: it's okay, her room has a color...it has a color...it has a color. It was the saving grace of the moment!
Now I'm 33 weeks and officially in the zone where my body takes license to practice labor. Things are getting pretty serious, folks! Baby is on her way. We're very fortunate to have friends and family who will help us get prepared quickly in the next couple weeks, and I'll be so relieved when we have a room (with furniture) ready for her. Even if she has to spend weeks in the NICU, I'd be pained to think that she had no room at home ready for her.
The belly keeps growing. Even when I look at it and think, it couldn't possibly get any bigger, it does. Tonight I ate Indian buffet with Jared. Oh my, I think that's the last of my Indian buffet dinners until after the baby arrives. There's not enough room in my belly to fit five pounds of baby and a plate of curry!
I feel the baby move plenty still but the sensations of her movement have changed. Now that she is bigger, I don't feel her constantly floating around. She's clearly in her spot and whenever she makes a drastic change in position, like turns on her side, it's a very intense feeling for me. I can even see it on the outside of my belly--it contorts and changes shape.
In addition to my growing belly, my mama mentality is expanding. I am feeling more and more like a mother, feeling drawn to mothers, thinking about how mothers identify themselves and how they deal with the moments life brings. I find my thoughts wandering into new directions, thinking about things a little big differently, all the while still feeling like myself and having my own usual thoughts and questions. It's fascinating to hear myself sound like me but also sound like someone different too. A different version of me. I try to picture myself holding my child, and, at the moment it's still hard to envision sometimes, but it's very easy to imagine the thoughts and feelings that I will have. I can only guess it's because those thoughts and feelings are, to some extent, already with me. I hope the difficulty in envisioning myself with the baby is not because of her health but just because it's really the next level and I'm just not there yet.
Last night, I went to Julia's housewarming party and there lots of mothers there who are close to me in age. It was so gratifying to have mama talk. I was completely tuned in and fascinated, craving more information, listening to stories. I loved it all. I was very happy to exchange contact info with at least one mother so I can further broaden my circle of young, hip, city moms whom I can learn from.
Tuesday, March 8, 2011
32 Weeks
And then today.
I have to admit that walking into the ultrasound room, I had a feeling that they weren't going to do the draining procedure today. When I walked in, the doctor said to me: you look very relaxed. I said: maybe it's because I don't know what we're getting into today. And he said: well, not very much, not today. And, simply, that was the moment I felt that punch in the gut...they know a lot but they don't know it all. And when he said to me: there's not consensus among the doctors, I wanted to wail. It is absolutely in the baby's best benefit that there's a whole team of very skilled medical professionals concerned about her welfare, but the fact that they are disagreeing about what to do was hard to hear. It reminds me how much of this is unknown, and how they are just simply people trying to do their best. And how good is the best of people who just might be the best if in the end they are just really trying, not perfecting, not knowing for sure? You see, anything but 100 percent certainty is heartbreaking.
I am not sure at all what I'm supposed to feel today. Maybe that's why it has been a long, hard day...the uncertainty.
The baby is clearly trying to cheer me up. I'm lounged in bed with bare belly and every few minutes I feel then see her tracking limbs from one side to the other, like a comet you follow in the sky. She's waving to mama, even with her feet.
With all this distraction, it's easy to forget on these kinds of days that I'm so goshdarn pregnant and so goshdarn close to the baby's due date. When I first learned I was pregnant, I somehow never imagined being this pregnant. I remember seeing how big Sydney's belly got, amazed, but still couldn't imagine something like that on me. Well, it keeps getting bigger, and I'm thrilled because baby is getting bigger and closer to being ready for the outside world. If something in her body triggers her to get the heck out of dodge, at least she's five pounds and more ready to be healthy outside the womb.
Bigger belly isn't all. My feet have gone from a size 7.5 to a 9. I only know that because I allowed myself to pick up a pair of 16 dollar loafers that I'll temporarily wear for the next eight weeks. I have outgrown a few of the maternity items I bought early in my second trimester. I can't wear my engagement ring anymore, and my wedding ring is a bit of a battle too. I walked four miles at the Schuylkill River on Saturday afternoon, in short sleeves nonetheless, and I was worried my feet were so swollen that I wouldn't be able to drive myself home. My cheeks are so wide that you'd guess I'm always smiling. Our cat Nadja always comes hunting to rest on my belly, it's the best full stretch pillow for her. A few times her purrs on my belly have summoned Little into action. The carpal tunnel in my right hand means I'm wearing a brace for sleep and another one for daytime, and I have had barely any sensation in a few of my fingertips for weeks. This is a very interesting place, and I feel like even though so many women have gone through this, it's still so new and like a mystery constantly unraveling. It's really a larger story unraveling since our baby is so special. When I started writing this, I never could have imagined that it would tell this kind of a story. And as much as it is hard sometimes, it still feels like a fairytale.
My husband and I have taken childbirth and baby care basics classes. We've practiced breathing techniques for labor (who knows how much of that I have ahead of me), swaddled and bathed dolls, giggled through strange delivery videos, tested strollers for speed, confounded ourselves with infant car seat contraptions, paced across nursery paint colors at Lowe's, and had long go-nowhere discussions about our baby's future name. We've also cried and hugged and held hands and stopped the car just to talk and process. We've studied fetal anatomy. We've read articles about obscure in utero surgeries. And none of it, even the most regular, expected parts of it, have felt normal or inane. It has all been so very new. And it has all been one big experience, not two separate paths: preparing for baby and preparing for baby's special health needs. Just one path: making a family or, really, just being a family already, the best way we know how.
The doctors decided not to drain the cyst today. One doctor told us that they are not in consensus about when they want to drain the cyst so they did another ultrasound and will talk about it later today. He said that they will call me if they decide that they want to drain it right away. Otherwise, we have another ultrasound appointment in one week.
At least some of the doctors don't want to drain now because the cyst could re-fill itself again before labor and then that would put them back at square one. They want to wait until later in the pregnancy to drain. Another issue is that they are not sure what kind of fluid mass is inside the cyst--will it be very liquidy and easy to remove or thick and sticky and hard to remove? They plan to use a very fine needle and they aren't sure if that will be sufficient to take out the cyst's interior substance. Also, some doctors feel that the lung development won't be negatively impacted in the coming weeks because there has already been lots of time for healthy lung development. And if there is any preterm labor, the baby will be further along.
It appears however that there is at least currently consensus to drain the cyst before the end of the pregnancy because they is concern that the lungs won't have room to inflate once the baby's born. The doctor we met with today (who also saw me last week) said that he is in favor of draining now--he has already made his position clear to me and to the other doctors--but he said that he would bring back info from today's appointment and meet with the other doctors later today.
In any case, the baby looked very healthy today. Her heart rate was fine, she's moving normally, the fluid level was a little bit raised but still fine, and fortunately, they don't see any indication right now that the cyst is blocking her airway. That was some good news.
Unless we hear otherwise, we'll be heading back in one week.
I have to admit that walking into the ultrasound room, I had a feeling that they weren't going to do the draining procedure today. When I walked in, the doctor said to me: you look very relaxed. I said: maybe it's because I don't know what we're getting into today. And he said: well, not very much, not today. And, simply, that was the moment I felt that punch in the gut...they know a lot but they don't know it all. And when he said to me: there's not consensus among the doctors, I wanted to wail. It is absolutely in the baby's best benefit that there's a whole team of very skilled medical professionals concerned about her welfare, but the fact that they are disagreeing about what to do was hard to hear. It reminds me how much of this is unknown, and how they are just simply people trying to do their best. And how good is the best of people who just might be the best if in the end they are just really trying, not perfecting, not knowing for sure? You see, anything but 100 percent certainty is heartbreaking.
I am not sure at all what I'm supposed to feel today. Maybe that's why it has been a long, hard day...the uncertainty.
The baby is clearly trying to cheer me up. I'm lounged in bed with bare belly and every few minutes I feel then see her tracking limbs from one side to the other, like a comet you follow in the sky. She's waving to mama, even with her feet.
With all this distraction, it's easy to forget on these kinds of days that I'm so goshdarn pregnant and so goshdarn close to the baby's due date. When I first learned I was pregnant, I somehow never imagined being this pregnant. I remember seeing how big Sydney's belly got, amazed, but still couldn't imagine something like that on me. Well, it keeps getting bigger, and I'm thrilled because baby is getting bigger and closer to being ready for the outside world. If something in her body triggers her to get the heck out of dodge, at least she's five pounds and more ready to be healthy outside the womb.
Bigger belly isn't all. My feet have gone from a size 7.5 to a 9. I only know that because I allowed myself to pick up a pair of 16 dollar loafers that I'll temporarily wear for the next eight weeks. I have outgrown a few of the maternity items I bought early in my second trimester. I can't wear my engagement ring anymore, and my wedding ring is a bit of a battle too. I walked four miles at the Schuylkill River on Saturday afternoon, in short sleeves nonetheless, and I was worried my feet were so swollen that I wouldn't be able to drive myself home. My cheeks are so wide that you'd guess I'm always smiling. Our cat Nadja always comes hunting to rest on my belly, it's the best full stretch pillow for her. A few times her purrs on my belly have summoned Little into action. The carpal tunnel in my right hand means I'm wearing a brace for sleep and another one for daytime, and I have had barely any sensation in a few of my fingertips for weeks. This is a very interesting place, and I feel like even though so many women have gone through this, it's still so new and like a mystery constantly unraveling. It's really a larger story unraveling since our baby is so special. When I started writing this, I never could have imagined that it would tell this kind of a story. And as much as it is hard sometimes, it still feels like a fairytale.
My husband and I have taken childbirth and baby care basics classes. We've practiced breathing techniques for labor (who knows how much of that I have ahead of me), swaddled and bathed dolls, giggled through strange delivery videos, tested strollers for speed, confounded ourselves with infant car seat contraptions, paced across nursery paint colors at Lowe's, and had long go-nowhere discussions about our baby's future name. We've also cried and hugged and held hands and stopped the car just to talk and process. We've studied fetal anatomy. We've read articles about obscure in utero surgeries. And none of it, even the most regular, expected parts of it, have felt normal or inane. It has all been so very new. And it has all been one big experience, not two separate paths: preparing for baby and preparing for baby's special health needs. Just one path: making a family or, really, just being a family already, the best way we know how.
Thursday, March 3, 2011
31 Weeks
This is the email that I wrote for family. A new turn of events, I suppose, if you can call it that...
So, yes, more news. I'm tired of news. I enjoyed uneventful for a little while there.
I've been trying desperately to find more information online about draining fetal cysts in utero. I may be too mentally exhausted to really look in the correct way. My plan for the moment is just to show up on Tuesday morning and hope for the best. At the moment, I'm most sad that the baby will feel hurt and deem my womb an unsuitable home. My mother reminded me, however, that the baby won't remember any of this. And, really, I think that's the least of my worries, realistically.
I don't know if I'll be able to watch the needle go in, but I don't know if I'll be able to look away either. Maybe I'll take the doctors' advice and do whatever they think is best. I am not even sure why the fluid sac that the baby is living in won't just deflate, leaving her no suitable home in utero. Maybe it's that stick a needle in the balloon trick?
And, now that I received confirmation that the EXIT procedure will require me to be put under, I can't help but obsess over the horror of being the last one to meet my own baby. Being literally asleep when she comes into the world. My husband is right: whatever they need to do to make sure she's safe is what we're willing to do. But I can't help but have a temper tantrum moment in my head--why me? I am so the mom that was going to be gung ho about a natural birth, and take every uncomfortable action necessary to provide for the most comfortable arrival of our little girl. I may be high on painkillers when I first meet my daughter. I suppose that will make for a good story?
I know I'm being selfish here. I really am so lucky to be in the best care in the country, maybe even the world, to have a daughter that has all the odds on her side despite what in some past era could have been fatal, to have a support network that feels hopeful with us and so excited too. I'm so lucky that such a procedure even exists.
But I am still mourning what I thought was going to happen. I'm still grieving my past imagination of how things would go. Believe me, I understand how lucky I am, but it's still shocking. And it still feels unfair.
I can only guess that when I actually see her safely born, none of any of those things will matter. Maybe I'll feel most comfortable curled up next to her little NICU pod, more comfortable than imagining us together on the couch at home.
I have gotten to know her so much more intimately in utero than most people ever do--I look at her move and live in the womb every two weeks. I've literally seen her grow. I have shared something special with her that most mothers-to-be just plainly never will. I know they would never envy my position, but I really am thankful that I have the connection that I do with her, that we're already so close because I've peeked into her space and watched for hours.
I had another ultrasound today. The baby is in good health right now--she is 4.7 pounds, at the 71st percentile so above average for her size. Fluid levels are normal so baby is still swallowing just fine.
Unfortunately, the doctor saw this morning that the cyst has grown in size and it is currently pushing on both of her lungs and her heart. Her heart is currently out of place and a bit rotated although it's functioning normally. Her left lung is pretty compressed. Everything is still working just fine though and she is not in any distress but they are worried that moving forward this will interfere with the proper development of her lungs.
The doctor told me that he believes that the best plan may be to drain the cyst in the next two weeks. I made an appointment to go in next Tuesday morning--during this next week he will consult with the other doctors and they'll come up with a plan. They may drain the cyst next Tuesday or maybe do another ultrasound and then drain it the following week depending on what they see next week.
Even though I feel nervous about the procedure and just plain sad that baby will have to get poked with a needle, the good news about them draining the cyst is that it will reduce some concern about her wellbeing for the rest of the pregnancy. The doc said that he believes that the most likely fluid substance in the cyst will be something that they can easily extract, and they still believe that the cyst is all one structure. The doctor said that they don't know if the cyst will grow back but even if it does, it will be much smaller so it will be more manageable to remove when she is born.
I didn't talk about it with the doctors today but I have heard before that draining a cyst while the baby is in utero can be linked to preterm labor (not necessarily at the time of draining, but prior to 40 weeks) so perhaps we'll be meeting the baby before the end of April. I'll ask the doctor about this next week. I'm very anxious to get everything in our home ready just in case.
I was told today that I will likely have a c-section surgery of some kind when she is born, though regular delivery is still a possibility depending. The doctor spent some time looking at her neck to try to see if they think the EXIT procedure will be necessary but since they will likely drain the cyst, it will still be some time before they know for sure.
I met with the anesthesiologist who explained procedures for c-section and the EXIT procedure. C-section is standard, Nico would be in the room, etc.
If we have to do the EXIT procedure, they will have to put me under general anesthesia (GA). GA is not recommended for pregnant women because there's a risk that the patient will breathe stomach acid into the lungs. This is possible because pregnant women's stomachs are squished by the baby, and all of the muscles that would normally keep stomach acid down are relaxed not just by the anesthesia but also by pregnancy hormones. Because I have acid reflux, this is more of a risk, but the anesthesiologist said that they will take quick, extra precautions to reduce stomach acid and insert a breathing tube to avoid these problems. He said that he's been doing this with pregnant women for a few years now and they have not had any bad situations.
If they do the EXIT procedure, Nico will be in the waiting room. He'll get to see the baby first when she is stable. They will wake me up about 30 mins-1 hour after the procedure but I will be on pain medication so it may be a couple of hours before I get to see the baby. If I'm recovering quickly and the baby is stable enough, they'll bring her to my room to say hello. If not, though, then they will take me to see her in the NICU after I've had a couple hours to recover. I just want someone to give her a hug! Maybe I'll pick my favorite nurse that morning and ask her to do us the favor. :)
AND with all that, my blood pressure was slightly elevated this morning. The midwife said this is not uncommon, especially considering the circumstances. So, she gave me three symptoms to be on watch for, and if any of them pop up, I should call them and come in, any time of day. Generally speaking, I'm absolutely fine. I was even called thin for 31 weeks of pregnancy this morning three times by the different docs so, hey, at least my ego feels great.
Oh yeah and...this morning I saw the baby stick her tongue out and taste the fluid! The doc and I had a nice laugh. I had a cranberry muffin for breakfast so I was tickled to see that she likes the taste as much as I do!
So, yes, more news. I'm tired of news. I enjoyed uneventful for a little while there.
I've been trying desperately to find more information online about draining fetal cysts in utero. I may be too mentally exhausted to really look in the correct way. My plan for the moment is just to show up on Tuesday morning and hope for the best. At the moment, I'm most sad that the baby will feel hurt and deem my womb an unsuitable home. My mother reminded me, however, that the baby won't remember any of this. And, really, I think that's the least of my worries, realistically.
I don't know if I'll be able to watch the needle go in, but I don't know if I'll be able to look away either. Maybe I'll take the doctors' advice and do whatever they think is best. I am not even sure why the fluid sac that the baby is living in won't just deflate, leaving her no suitable home in utero. Maybe it's that stick a needle in the balloon trick?
And, now that I received confirmation that the EXIT procedure will require me to be put under, I can't help but obsess over the horror of being the last one to meet my own baby. Being literally asleep when she comes into the world. My husband is right: whatever they need to do to make sure she's safe is what we're willing to do. But I can't help but have a temper tantrum moment in my head--why me? I am so the mom that was going to be gung ho about a natural birth, and take every uncomfortable action necessary to provide for the most comfortable arrival of our little girl. I may be high on painkillers when I first meet my daughter. I suppose that will make for a good story?
I know I'm being selfish here. I really am so lucky to be in the best care in the country, maybe even the world, to have a daughter that has all the odds on her side despite what in some past era could have been fatal, to have a support network that feels hopeful with us and so excited too. I'm so lucky that such a procedure even exists.
But I am still mourning what I thought was going to happen. I'm still grieving my past imagination of how things would go. Believe me, I understand how lucky I am, but it's still shocking. And it still feels unfair.
I can only guess that when I actually see her safely born, none of any of those things will matter. Maybe I'll feel most comfortable curled up next to her little NICU pod, more comfortable than imagining us together on the couch at home.
I have gotten to know her so much more intimately in utero than most people ever do--I look at her move and live in the womb every two weeks. I've literally seen her grow. I have shared something special with her that most mothers-to-be just plainly never will. I know they would never envy my position, but I really am thankful that I have the connection that I do with her, that we're already so close because I've peeked into her space and watched for hours.
30 Weeks
The baby is in great health. She is 3.5 pounds, growing normally, and swallowing and recycling the right amount of amniotic fluid. The doctor said that the cyst did not grow in the last couple weeks (great news!) and there's no indication that the baby is having anything but a very normal fetal development period. Doc said "she has no idea that this cyst exists" so it's not causing any discomforts, which is a HUGE relief to me. The worry that she feels discomfort or pain has haunted me.
With that said, the doctor said that what they can't see now is her trachea, the air tube from her mouth to her lungs. They are having a hard time since she is so little seeing the exact place where the cyst meets with the top of the esophagus, near the trachea, so there's a possibility that the baby may have breathing troubles when she is born if the cyst is attached in such a way that it interferes with the trachea's functioning. In the past, when these kinds of cysts were not identified in utero, they were identified after birth because of babies' respiratory problems. The doc said they are not concerned about her wellbeing in utero since she is getting oxygen from me, but they will have to monitor to learn more what might come up after she's born. It's a big wait and see.
One possibility she talked to us
about today is an EXIT procedure. EXIT stands for Ex utero Intrapartum Therapy where they start to deliver the baby by c-section, but while the baby is still attached to the umbilical cord, they perform surgery on the baby to clear her airway. That way the baby is secure with oxygen from me via the umbilical cord while they take care of any airway problems. Then they cut the cord and she is fully delivered. CHOP docs have been doing this procedure for some years now and they are some of the pioneers of the surgery. She said that they should be able to know whether me and the baby will need this procedure at about 32 to 34 weeks (that's 2-4 weeks from now). Hopefully, it won't be necessary but it's something for us to learn more about just in case.
All along, I've been very much aware about how unique our baby is--her cyst has confounded doctors or at least represents something "interesting" they've never seen before. Even during today's visit, the doctor said: "has anyone told you how interesting your baby is?" My husband and I said: ummm, duh, yes. Even so, the possibility of this kind of a procedure, so very rare, feels a bit SciFi to me. Just pondering the word intrapartum feels strange. Prepartum, okay, postpartum, even better...but intrapartum? There's not supposed to be any in between for babies! Just outside or inside! Well, not for Little. She's very special, and she may traverse a layer of the universe the likes of which none of us have ever seen. Special little baby.
We saw the delivery unit at CHOP. It looks VERY nice and the staff were wonderful. They were very welcoming, all rushed to say hi and make jokes with us, so very friendly and loving. We really enjoyed everyone we spent time with today. CHOP really does have a special staff. It's certainly a perk of all of this--getting to deliver in a brand new facility with big rooms, excellent equipment, a pull out bed for my husband so he can spend nights (it's shocking that this is not a guarantee at most birthing facilities). And I've tasted the cafeteria food there--definitely not bad!
We also met with the lactation consultant who is an internationally-known PhD in breastfeeding science, especially for high risk situations. I actually met her in past work I did in maternal and child health policy studies I did in grad school so it was a bit funny sitting down with her as our provider. I was a bit star-struck. Lucky us!
Anyway, at CHOP they have developed a process of breastfeeding activities to ensure that the baby will get all the benefits of breast milk even though she likely won't be feeding from the breast right away. This process has been published and it's being copied at hospitals around the country. We're working with the best, here, people! Anyway, I will start pumping right away and staff will maintain and label my bottles and number them, and as soon as the baby is able to start drinking herself, they will feed her the bottles in the same order I pumped them so that she'll have a natural progression of breastmilk benefit as she would if she were feeding from the breast. Apparently, even the order of feedings is ordained by nature to provide the best early benefit to the baby--among the first servings of colostrum, there are many antibiotic properties that are meant to be fed to the baby in a particular order. It's pretty amazing. The staff at CHOP also provide support and therapy of sorts until the baby is drinking from the breast herself. We also will do oral care with breast milk, rub the baby's mouth with it so that she gets some of the early benefits even if she can't drink it yet. They even worked with Medela, a breast pump manufacturer, to develop a specific pumping suction pattern more suited to babies who are premature or have some illnesses or health care issues and can't feed from the breast immediately. So I'll get a pattern of pumping that works hard to really get everything it can out of me and get as much breastmilk as possible to Little. Wow, right?
With that said, the doctor said that what they can't see now is her trachea, the air tube from her mouth to her lungs. They are having a hard time since she is so little seeing the exact place where the cyst meets with the top of the esophagus, near the trachea, so there's a possibility that the baby may have breathing troubles when she is born if the cyst is attached in such a way that it interferes with the trachea's functioning. In the past, when these kinds of cysts were not identified in utero, they were identified after birth because of babies' respiratory problems. The doc said they are not concerned about her wellbeing in utero since she is getting oxygen from me, but they will have to monitor to learn more what might come up after she's born. It's a big wait and see.
One possibility she talked to us
about today is an EXIT procedure. EXIT stands for Ex utero Intrapartum Therapy where they start to deliver the baby by c-section, but while the baby is still attached to the umbilical cord, they perform surgery on the baby to clear her airway. That way the baby is secure with oxygen from me via the umbilical cord while they take care of any airway problems. Then they cut the cord and she is fully delivered. CHOP docs have been doing this procedure for some years now and they are some of the pioneers of the surgery. She said that they should be able to know whether me and the baby will need this procedure at about 32 to 34 weeks (that's 2-4 weeks from now). Hopefully, it won't be necessary but it's something for us to learn more about just in case.All along, I've been very much aware about how unique our baby is--her cyst has confounded doctors or at least represents something "interesting" they've never seen before. Even during today's visit, the doctor said: "has anyone told you how interesting your baby is?" My husband and I said: ummm, duh, yes. Even so, the possibility of this kind of a procedure, so very rare, feels a bit SciFi to me. Just pondering the word intrapartum feels strange. Prepartum, okay, postpartum, even better...but intrapartum? There's not supposed to be any in between for babies! Just outside or inside! Well, not for Little. She's very special, and she may traverse a layer of the universe the likes of which none of us have ever seen. Special little baby.
We saw the delivery unit at CHOP. It looks VERY nice and the staff were wonderful. They were very welcoming, all rushed to say hi and make jokes with us, so very friendly and loving. We really enjoyed everyone we spent time with today. CHOP really does have a special staff. It's certainly a perk of all of this--getting to deliver in a brand new facility with big rooms, excellent equipment, a pull out bed for my husband so he can spend nights (it's shocking that this is not a guarantee at most birthing facilities). And I've tasted the cafeteria food there--definitely not bad!
We also met with the lactation consultant who is an internationally-known PhD in breastfeeding science, especially for high risk situations. I actually met her in past work I did in maternal and child health policy studies I did in grad school so it was a bit funny sitting down with her as our provider. I was a bit star-struck. Lucky us!
Anyway, at CHOP they have developed a process of breastfeeding activities to ensure that the baby will get all the benefits of breast milk even though she likely won't be feeding from the breast right away. This process has been published and it's being copied at hospitals around the country. We're working with the best, here, people! Anyway, I will start pumping right away and staff will maintain and label my bottles and number them, and as soon as the baby is able to start drinking herself, they will feed her the bottles in the same order I pumped them so that she'll have a natural progression of breastmilk benefit as she would if she were feeding from the breast. Apparently, even the order of feedings is ordained by nature to provide the best early benefit to the baby--among the first servings of colostrum, there are many antibiotic properties that are meant to be fed to the baby in a particular order. It's pretty amazing. The staff at CHOP also provide support and therapy of sorts until the baby is drinking from the breast herself. We also will do oral care with breast milk, rub the baby's mouth with it so that she gets some of the early benefits even if she can't drink it yet. They even worked with Medela, a breast pump manufacturer, to develop a specific pumping suction pattern more suited to babies who are premature or have some illnesses or health care issues and can't feed from the breast immediately. So I'll get a pattern of pumping that works hard to really get everything it can out of me and get as much breastmilk as possible to Little. Wow, right?
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