Hospital Bedrest Day 13

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On the 14th, Siena was measuring in the 10th% for weight/age at 1 lb even.  Now she is in the 41.9%, estimating at 1 lb 10 oz.  Of course these things have a fairly large margin of error, but in any case she is obviously still growing.

Best news from my ultrasound first.  My previa HAS resolved.  My placenta is still low and close to my cervix, but not covering it.  This means it is not a barrier to VBAC or a low C-Section incision.  Baby will still have to dictate what options actually exist at the time  of delivery and we will have to see what is safer for her, but what is safer for me is no longer a factor.  This also means, recurrence of bleeding is not longer a concern.  Still possible, technically, but not anything to worry about.

During the ultrasound, I had a new tech who had apparently never even read my file and didn't know that kidneys hadn't been seen before.  She is scanning the abdomen and quickly marks the stomach (which we have seen before) and then marks kidneys.   She was so nonchalant about it I almost bounced right off the table.  Unfortunately, after she heard that no one else thought they had seen the kidneys she backed off again and was all wishy washy.  I guess in her final report she stuck  by the fact she did see them, but my doctor said she still isn't completely convinced.

I had a bit of a get-me-the-heck-out-of-here-I-just-want-to-go-home meltdown after my ultrasound.  I was hoping for something definitive to say that I did not need to have the MRI tomorrow.    (That was also partially related to a miscommunication that means I thought the previa was NOT resolved.)  I was just done.  Tim wasn't here and my doctor couldn't come give me results right away and I sort of lost it.

I don't want an MRI, one of the things that bothers me about it is that it only tells us about the kidneys, not really much of anything else.  Tells us nothing about PPROM, only allows us to make more educated guesses.   I'm also worried about unclarity in results and then them being used against me to not help baby at the time of delivery.  For some reason I just feel really uncomfortable with the whole idea.

When I finally reviewed the ultrasound with my dr. we talked (again) about doing the amnioinfusion dye test.  In this test they will inject a synthetic amniotic fluid with a blue dye in it.  Then they will use a tampon to see if the blue dye leaks and while they are waiting they will be able to do a complete anatomy ultrasound which to date has never been done, but at 25 weeks should give us all the information we need about kidneys and bladder.  The advantage is that this test will actually give us a lot more information.  The disadvantage is that there are some risks to baby that don't exist with the MRI.

For some reason, I feel more comfortable with the dye test.  When we left it, she was ordering the dye for the test for tomorrow, but not canceling the MRI either and we will decide in the morning.

At some point tomorrow we will also have a conference with both our doctor and the neonatologist.  Tim and I both have significant concerns about failing to doing something that has the potential to be helpful at the time of delivery.  We get very mixed messages from doctors about what they consider "standard" versus other levels of care (either increasing to "full resuscitation" or down to only "palliative").  We don't want to be locked into a pre determined level.  We want decisions made at the time of birth based on how she is doing.  Period.

My doctor pointed out, however, that we can't leave all decisions open now because deciding nothing could cause time consuming delays, especially in the case of an urgent delivery if Tim is not available and I can't make decisions.  The neonatologists have to have a good sense of what we want in case they have to make decisions for us. My doctor seems to understand what that means, but she is going to help us explain that to the NICU people tomorrow.  (Despite her non pro-life views she has grown on me through all this.)

This all just goes away from everything I've always felt about babies and birth.  Even when I've had lots of interventions or monitoring or testing (which has gotten more common since Kenna died), there was never all this production about something that hasn't happened yet!  I'm so much better at dealing with something as it comes up versus this constant analyzing of every set of options, risks, and benefits.

Today was a roller coaster of emotions and I expect tomorrow will be just as bad, possibly worse.   I know that what we really got today was good news, but for some reason I don't feel like we had good news.  It feels like more *maybe* and I want something definitive.  Anything definitive really, I just want to get off the ride.

After 7 weeks, I feel like it's time.

Days 14-15


2 comments :

Andrea said...

As I read this, Heidi, I just shake my head because I simply cannot imagine going through the ride you have been on for the past 7 weeks!! What a roller coaster! As always, you are in our prayers, especially tomorrow!

Cheryl said...

Please know that we are keeping Sienna, you and Tim in our prayers. In terms of making decisions, Allen and I encourage you to "stay the course." We agree that some decisions just need to be made "when you get there." Trust in the Lord and also remember that, "All things work together for good for those that love the Lord." Romans 8:28 It's often so hard to see what good can come out of something at times like this, but hindsight is such a great thing. Just trust in the Lord. So easy to say and so hard to do, but our only real hope.