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.
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