Friday, February 24, 2012

30w5d ultrasound and other notes

(x-post from my other blog, so if you read there, nothing new here)
I’m not used to being quite so nervous before what should be a routine ultrasound. As you know, I was a bit worried that they would tell us there was something else wrong with our little Truffle.
DH and I were both a bit concerned as the tech was doing the u/s; the cerebral ventricle she was measuring was at about 1.5cm (because Truffle is nicely head down, they couldn’t get a good shot of the other one), whereas they had told us before it was 1.2-1.3, so we were thinking that had maybe gotten worse. And there seemed to be a bit more fluid in the kidneys. But when the doc came in, she told us that the ventricle was measured at 1.5cm on the MRI, and the change in the kidneys was within measurement error, so all in all things seem to be stable.
Although going from 1.3 to 1.5 puts the ventriculomegaly into the ‘severe’ category rather than ‘moderate’. Choosing to ignore that particular fact at the moment.
And the best news – no additional findings. PHEW.
Truffle was measured (based on head diameter, 30w4d, belly size, 31w, and femur length 30w6d) at 3lb10oz. That’s a gain of a pound over the last three weeks, which is nice. Amniotic fluid was also at a good level, continuing to indicate that the kidneys are functioning reasonably well, and if there is an obstruction, it’s partial rather than complete (=bad).
His head was down, back along the left side of my uterus, with feet and hands over to the right. I find this interesting, because when I get a strong BH contraction, my uterus totally bunches up on the right hand side. I would have thought that was where most of the baby was! (Although I almost exclusively feel kicks from the middle to right of my belly).
Lots of other questions for my doc this time, mostly relating to what we can plan for and expect surrounding his birth.
The neurologist had said we should do another MRI post-birth. I was thinking this probably wasn’t necessary – we will deal with whatever may happen, and finding out there’s something else to worry about? well, I’d rather not. Dr. B said that she would defer to him, but her guess was that it would be to get a more accurate measurement of the ventricles to determine whether a shunt would need to be placed or not. I did not want to do it (because it requires sedation of my brand new munchkin) if it would not change anything, but if it could lead to a potentially helpful intervention I think it is a good idea.
As far as Truffle’s birth, there is no reason based on the kidney or brain findings at this point that we couldn’t have another vaginal, natural birth. I did promise we’d get to the hospital a little sooner this time (with T we arrived 30 min before he was born, and by the time I was on the triage table I needed to push, so especially as there was meconium that had come out when my water broke, things were a little hectic).
We should expect that the pediatric team would be on hand to do an immediate post-birth evaluation, but at this point there is no expectation that he would need to go into the NICU. She said perhaps one of the NICU step-down nurseries where the nurse to baby ratio is higher so they could keep a close eye on him – but hopefully he will be able to room with us right away.
He will have another ultrasound both of head and kidneys, and may need to take antibiotics prophylatically if the kidneys are still fluid filled, as that often leads to UTIs. I have found D-mannose quite helpful in fighting UTI’s, I wonder if there might be a way to use that instead. Will look into that.
He will also most likely have a test called a VCUG, something to do with the kidneys that I have not looked up yet.
So he will most likely be away from us more than we would like in the first few days, hopefully we can at least go with him to the tests/procedures so he’s not all on his own.
At least one procedure he will not be having is circumcision – we have been very happy with our decision not to have that done for A&T.

Saturday, February 04, 2012

Two weeks later...

We're just going about our daily existence at the moment.  We have all the information we're going to get, nothing we can do but wait and see.

I have told a few people face to face, and as settled as I am with trusting that we will enjoy and love our little Truffle no matter what, saying that there's something missing out loud is still really hard.  I can't do it without crying.

I feel like I have so many other things I want to say but I'm afraid that they come out in ways I don't intend.  And sometimes I can't even find the words.

I want to talk about how I find myself wishing we never had that ultrasound.
But that it probably is good to have an inkling beforehand that things might not go as hoped.
I think it would be harder, if Truffle does have challenges that our other boys have not, if we were trying to figure out why that was.  Now we know.
I wonder if it is worth it to have another MRI after he is born.  We know what the possibilities are, do we want to subject him to that when he's just a few hours old?  What will it really get us?  It's not going to change anything.

I don't wonder at all whether we will love him.  I know the boys will do so unconditionally.  I hope that we all can find it in ourselves to do the same.  I hope that I don't find myself looking at other kids and thinking 'why didn't we get that?'.  I hope that I am able to enjoy Truffle for who he is and not worry about what he is or isn't doing.

I also find myself hoping that I don't end up never being able to work again.  This part-time stay at home mom thing was never intended to be permanent, and I'm afraid that going back to work again might not be possible.  I often feel like I fall so far short of other stay at home moms in terms of the enrichment I offer my kids when I'm home with them, so many days feel like all I'm doing is whatever it takes to get through the day.  I don't know that I can live with feeling like that for the rest of my life.