Friday, February 22, 2013

27 weeks 5 days - 6 weeks til Baby Day!

Today was a big day for doctor appointments - the whole week was. Jake had 2 appointments Monday for this cough that just won't leave him alone, I had an appointment Monday with the urologist who will help with my surgery, and with the endocrinologist yesterday and we had 3 appointments today at Evanston. The urologist (who looks a lot like Aaron Rodgers; it's a shame I will only have to see him once more and it'll be while I'm asleep :)) was very reassuring. He has done this procedure 8-10 times in the past year, and has done this at both Evanston and Northwestern - our top 2 choices. He noted that both handle the procedures the same way, which I was happy to hear.

Today we met with our doctor, had an ultrasound, toured the ISCU (Infant Special Care Unit), and met one of the neonatologists. Our doctor noted that all looks to be on track. We discussed the pain I continue to have on my right side, and the new Braxton Hicks that are now accompanying it. We're watching it at this point, but unless there is bleeding, we just wait and see.

The Ultrasound was really great today - we got to see him stretching, and got a great picture of his face. He looks like a 'real baby' now, and not so much like a 'monkey' like Mia thought at our December appointment. He was 2 lbs. 9 oz. today, so he's gained almost one lb. since our last appointment.

The neonatologist gave us a lot of information, mostly reassuring. The baby will be delivered at 34 weeks 5 days, assuming he follows the rules - something he hasn't done to this point. Assuming he does follow the rules, he will be just over 4 lbs. when he is delivered. Babies that are born at this age, called late preterm babies, are considered 'feeders and growers'. The first thing they will want him to master is breathing. At this age, he should only need a nasal canula, or possibly a mask to breathe. Once he has that down, we'll work on eating. If he needs it, he'll have a tube down his nose to his belly to help him eat, but he'll be offered a bottle at every feeding. Once he masters the eating and breathing, at the same time, we'll see if he can maintain his temperature. When he accomplishes all of these things, he can come home. Now for the good news - usually babies master all of these things in tandem between 35-36 weeks. So hopefully, he's only in the ISCU for a week or two! It will all depend on him, and his motivation. He's pretty feisty right now, so we're hoping that's an indication of things to come. Of course, if he comes earlier, none of this is relevant.

We got the downlow on the different floors of the hospital, the rules of visiting the ISCU, and what to expect while we are there. Overall, another good appointment. We go back on the 5th to meet with the interventional radiologist and the gynecological oncologist, who will handle the surgery.

video
I'll leave you with the video they gave us - Baby Jack stretching.

Monday, February 11, 2013

Placenta Accreta - we made it to 25 weeks!

We had another doctor appointment on Friday. This was the first appointment in Evanston, as all others have been in Gurnee, so this was a whole new experience for me. I was impressed by the team - they have assigned me a nurse who will see me each visit, and they are arranging for me to see a specialist, or more than 1, per visit when I am there. At this point it appears we only have 5 more doctor appointments before baby comes. The perinatologist was there, and I was able to ask her some questions in terms of what we should prepare for with baby J coming at ~35 weeks. She said that it will really depend on him, but that 35 weekers have a lot less issues than babies that come earlier than that. The biggest concern we will need to be prepared for is breathing - he will most likely be on a nasal cannula (air) or a face mask; there should be no need for a breathing tube. Once he has that mastered, we'll focus on his eating and his ability to maintain his body temp. If we are lucky he won't be in the ISCU long, maybe just a few weeks. However, we're preparing for him to be there up to 6 weeks.

As you may know, the issue that is causing all of this trouble is Placenta Accreta (http://americanpregnancy.org/pregnancycomplications/placentaaccreta.html). Because of the risks associated with the PA, we are seeing a specialist through Evanston Hospital. We are blessed to have 2 of the top 15 hospitals in the country within an hour and a half from us. The #5 in the country, Northwestern, is in downtown Chicago. They deliver over 1000 babies per month, and only see one case of this per month. Evanston is #15 I believe, and they deliver 3-4 of these cases per year. Because of the high risk of complications, we are making a lot of plans, as far in advance as we can.

We were very blessed to have this discovered at our 20 week ultrasound - the risks of life-threatening complications are significantly higher if not discovered until later, or not discovered at all. Right now, the following precautions are being taken:
- The urologist, gynecological oncologist, and interventional radiologist will all be in the room, as well as blood from the blood bank. There is high risk that there will be some damage to the bladder, so the urologist will be there to assist. Because of the complexity associated with the hysterectomy during pregnancy, the GO will handle the surgery once the baby is delivered. The IR will handle placement of different medical devices to help reduce bleeding prior to it starting. However, I've been advised that I could lose up to half of my blood.
- Baby J will be delivered at 34 weeks, so there is no risk of my body going into labor. If my body were to go into labor, the risk for hemorraghing is very high, and thus a huge risk we aren't going to take.
- The Perinatologists will be in an adjoining delivery room, to immediately take him and work on him if he is sleepy. He'll then camp out in the ISCU (NICU) for the next sevearl weeks.
- We see the doctor every 2 weeks right now, and then weekly come approximately 30 or 32 weeks.

In continuing to feel blessed, we've had an amazing offer to organize a blood drive on our behalf. I spoke with the doctors about this as well, and they gave me some information so we can begin to set this up. I will share more information on this when it is available. (thank you Diane!!!). People have asked if I can donate my own blood in advance. I've been told yes, but it wouldn't be enough to meet my needs during the surgery.

Our next appointment is set for 22 February. We will have another ultrasound, and have a tour of the ISCU. We will then set up all of the appointments moving forward, including those with the specialists I mentioned above. I was able to meet with the social worker this past week as well and she addressed a number of my questions and concerns.

This is a very scary situation for us, as you can imagine. Given the limited number of cases it's hard to find others who have gone through this to relate to. We haven't told the kids anything about the risks to me, obviously. We're working on how to tell them that their brother will be in the hospital for a while - since we don't know how long, we are trying to figure out what is best. The social worker was great with that information as well. We appreciate your continued prayers.