Friday, Sept. 9 u/s Appt.
Yesterday we had another in depth ultrasound. Thankfully Jeff was able to come with again and we have been so blessed with having a cousin (Al's cousin), Rachel, and her husband, David, down here that have so graciously offered their time and energy in taking care of Mikayla and Malachi during all of these appointments. The kids have taken up such a bond with them so quickly and love being with them. There is no doubt that they were some of the reason why we ended up in the location and house we did (we are only about 10 miles away from them without even knowing that until we moved here).
After the u/s another perinatologist, Dr. Tarsa, came in and talk to us about the findings and measurements. Overall there was minimal change (which is what we were hoping) except there was one new finding. We are still considering it a pure miracle that despite how bad the kidneys look (the one 'better' one looked a little worse as far as we could see) the baby is still producing amniotic fluid which means that in some miraculous way there is a little kidney function left and the baby is able to continue to practice breathing to help develop the lungs. There was also another structural defect they had been concerned about since they were unable to get a good look last time and that appears normal as well. We can't tell you how much we are rejoicing about these things and continue to hope and pray for this to be the case. However, we are unsure of the significance of the new finding. There is a rim of fluid around the inside of the belly. We did not see this last month so it is either new or we missed it since it is mild (the doctor said she would've missed it in a quick office u/s). So the question is, what does this mean? It could mean that because of how distended the bladder is, the amount of pressure, and what the tissue of the bladder is made of, fluid is an exudate (leaked through the bladder walls) and is collecting in the belly. Although this doesn't sound good, this is our hope of what is happening compared to what else could be the cause. The other cause could be that the baby is in the beginnings of heart failure. As of now the heart looks healthy and there is no valve regurgitation, another huge praise and we hope and pray that this also continues to be the case. So the next question is, how does this change things? During our conversation with Dr. Tarsa we had to decide how aggressive we wanted to be with this finding. In a 'healthy' pregnancy we would've immediately been admitted to the hospital, monitored closely, and given steroid shots to develop the lungs faster and prepare for a premature delivery with a 50% survival rate for an infant this young. Again, that would've been the case for a healthy infant with no other defects. After much discussion we decided that it would not change the prognosis of our baby and taking the chance to deliver the baby vs. continue carrying the baby would be worse off for the baby because any additional kidney treatments needed would be near impossible on an infant this small along with all other disabilities caused by having such a premature baby. Also, the type of delivery Nicole would most likely go through when the baby is this small may determine whether we would ever be able to have any other babies in the future if we would choose to do so. Had the prognosis been significantly improved we would've taken the risk and went ahead with it. But since it's not, we have decided to continue on the same path and fervently pray. Heart failure can happen fast and the baby's life could end quickly in the womb so as of now we continue to be on our knees, trusting in God's will for this baby and for wisdom and guidance for both the doctors and us in these decisions.
Nicole has a regular OB appointment on Tuesday and then another appointment on Friday with the perinatologist Dr. Moore. We continue to receive so much love, support, and prayers and cannot thank you all enough. Some people have asked whether it's ok to tell others and we say absolutely. Prayer is so powerful and no matter what the outcome is, it is much needed and appreciated.
On a lighter note...GO BLUE! (for our fellow Michigan fans) :)
With love,
Jeff & Nicole
"And those who know your name put their trust in you, for you, O Lord, have not forsaken those who seek you." Psalms 9: 10
"Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths." Proverbs 3:5-6
After the u/s another perinatologist, Dr. Tarsa, came in and talk to us about the findings and measurements. Overall there was minimal change (which is what we were hoping) except there was one new finding. We are still considering it a pure miracle that despite how bad the kidneys look (the one 'better' one looked a little worse as far as we could see) the baby is still producing amniotic fluid which means that in some miraculous way there is a little kidney function left and the baby is able to continue to practice breathing to help develop the lungs. There was also another structural defect they had been concerned about since they were unable to get a good look last time and that appears normal as well. We can't tell you how much we are rejoicing about these things and continue to hope and pray for this to be the case. However, we are unsure of the significance of the new finding. There is a rim of fluid around the inside of the belly. We did not see this last month so it is either new or we missed it since it is mild (the doctor said she would've missed it in a quick office u/s). So the question is, what does this mean? It could mean that because of how distended the bladder is, the amount of pressure, and what the tissue of the bladder is made of, fluid is an exudate (leaked through the bladder walls) and is collecting in the belly. Although this doesn't sound good, this is our hope of what is happening compared to what else could be the cause. The other cause could be that the baby is in the beginnings of heart failure. As of now the heart looks healthy and there is no valve regurgitation, another huge praise and we hope and pray that this also continues to be the case. So the next question is, how does this change things? During our conversation with Dr. Tarsa we had to decide how aggressive we wanted to be with this finding. In a 'healthy' pregnancy we would've immediately been admitted to the hospital, monitored closely, and given steroid shots to develop the lungs faster and prepare for a premature delivery with a 50% survival rate for an infant this young. Again, that would've been the case for a healthy infant with no other defects. After much discussion we decided that it would not change the prognosis of our baby and taking the chance to deliver the baby vs. continue carrying the baby would be worse off for the baby because any additional kidney treatments needed would be near impossible on an infant this small along with all other disabilities caused by having such a premature baby. Also, the type of delivery Nicole would most likely go through when the baby is this small may determine whether we would ever be able to have any other babies in the future if we would choose to do so. Had the prognosis been significantly improved we would've taken the risk and went ahead with it. But since it's not, we have decided to continue on the same path and fervently pray. Heart failure can happen fast and the baby's life could end quickly in the womb so as of now we continue to be on our knees, trusting in God's will for this baby and for wisdom and guidance for both the doctors and us in these decisions.
Nicole has a regular OB appointment on Tuesday and then another appointment on Friday with the perinatologist Dr. Moore. We continue to receive so much love, support, and prayers and cannot thank you all enough. Some people have asked whether it's ok to tell others and we say absolutely. Prayer is so powerful and no matter what the outcome is, it is much needed and appreciated.
On a lighter note...GO BLUE! (for our fellow Michigan fans) :)
With love,
Jeff & Nicole
"And those who know your name put their trust in you, for you, O Lord, have not forsaken those who seek you." Psalms 9: 10
"Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths." Proverbs 3:5-6
Comments
Post a Comment