Friday, Sept. 30th Appt. Update
Yesterday we had another appointment with Dr. Moore. Overall it's what we would consider now as a "good" appointment. Dr. Moore answered a lot more of our questions again that we thought of with all the information we were given last week and then he did another very quick u/s.
What we found out is that unfortunately gestational diabetes prevents the lungs from maturing as quickly then if Nicole wouldn't have it, which is just another obstacle against the baby's lungs developing. In babies that go full term you can't differentiate between this lung development, but in premature babies you can so it's just another reason we are fervently praying to go as long as possible without hurting the baby more by staying in the womb. No matter how long we go before delivery they will be giving the steroid shots at some point to try and develop the lungs as best as we can. If we don't have the lungs to help this baby there's not much we will be able to do with the kidney function and everything will just be compounded.
The next big question is what type of delivery are we looking at now. We are right on the teetering point on being able to have a normal c-section. If we were able to wait at least another two weeks this would obviously increase these chances. The baby is breach right now and seems to be liking it that way and with little to no fluid the chances of changing positions is pretty low so we are preparing ourselves for a c-section.
We then talked about the plan moving forward. Nicole will continue to diligently do fetal kick monitoring, bring her homework in to the appointments so he can check it, and go to the hospital as indicated if needed. Lots of research has been done and fetal heart trace monitoring doesn't become super reliable until 32 weeks. If we are able to make it to that point Nicole will start going in two times a week to do that for an hour or two as well. We will also continue to have u/s appointments to get measurements to make sure the baby is growing, another reason we would have to deliver early. The best way to monitor a baby's growth is by the abdomen but of course our baby's abdomen is extremely off the mark so we will be going by the femur and head circumference. We also want to measure how much lung tissue there is and get a good look at the heart function. Our next one is this Thursday. Dr. Moore warned us to be prepared for more thoughts and advice because we will be meeting another new perinatologist and our u/s is pretty impressive (medically speaking, not in the positive way) that anyone who sees it for the first time are going to get pretty jumpy.
When we did the quick u/s the big thing we saw was an increase in the ascites (fluid inside the belly). The bladder appears the same size but the fluid between the skin and organs has increased. We would ideally like this fluid to be going outside of the body but in our situation we have to look at this as a positive thing because it may mean that we have a small amount of kidney function left. Any fluid being produced is going to follow the path of least resistance and in this case this path is leaking into the abdominal cavity rather then out the normal urinary tract piping. That being said we are on our knees singing praises that we may still have kidney function and praying that this isn't going to cause too much pressure which would compress the lungs and heart and again be an indication we need to deliver the baby.
Thank you all for the extra support and prayers during this time. Those prayers are so powerful and without those and God's love and hand in every step of the way we wouldn't be in the emotional and physical state we are in. We continue to put our trust and hope in God and the plan he has laid out for us and the baby, knowing that as hard as it is to accept it may not be the same as our desires. We are very grateful for each and every day that passes that we are able to cherish the time we have with this little one here on Earth.
With love,
Jeff & Nicole
What we found out is that unfortunately gestational diabetes prevents the lungs from maturing as quickly then if Nicole wouldn't have it, which is just another obstacle against the baby's lungs developing. In babies that go full term you can't differentiate between this lung development, but in premature babies you can so it's just another reason we are fervently praying to go as long as possible without hurting the baby more by staying in the womb. No matter how long we go before delivery they will be giving the steroid shots at some point to try and develop the lungs as best as we can. If we don't have the lungs to help this baby there's not much we will be able to do with the kidney function and everything will just be compounded.
The next big question is what type of delivery are we looking at now. We are right on the teetering point on being able to have a normal c-section. If we were able to wait at least another two weeks this would obviously increase these chances. The baby is breach right now and seems to be liking it that way and with little to no fluid the chances of changing positions is pretty low so we are preparing ourselves for a c-section.
We then talked about the plan moving forward. Nicole will continue to diligently do fetal kick monitoring, bring her homework in to the appointments so he can check it, and go to the hospital as indicated if needed. Lots of research has been done and fetal heart trace monitoring doesn't become super reliable until 32 weeks. If we are able to make it to that point Nicole will start going in two times a week to do that for an hour or two as well. We will also continue to have u/s appointments to get measurements to make sure the baby is growing, another reason we would have to deliver early. The best way to monitor a baby's growth is by the abdomen but of course our baby's abdomen is extremely off the mark so we will be going by the femur and head circumference. We also want to measure how much lung tissue there is and get a good look at the heart function. Our next one is this Thursday. Dr. Moore warned us to be prepared for more thoughts and advice because we will be meeting another new perinatologist and our u/s is pretty impressive (medically speaking, not in the positive way) that anyone who sees it for the first time are going to get pretty jumpy.
When we did the quick u/s the big thing we saw was an increase in the ascites (fluid inside the belly). The bladder appears the same size but the fluid between the skin and organs has increased. We would ideally like this fluid to be going outside of the body but in our situation we have to look at this as a positive thing because it may mean that we have a small amount of kidney function left. Any fluid being produced is going to follow the path of least resistance and in this case this path is leaking into the abdominal cavity rather then out the normal urinary tract piping. That being said we are on our knees singing praises that we may still have kidney function and praying that this isn't going to cause too much pressure which would compress the lungs and heart and again be an indication we need to deliver the baby.
Thank you all for the extra support and prayers during this time. Those prayers are so powerful and without those and God's love and hand in every step of the way we wouldn't be in the emotional and physical state we are in. We continue to put our trust and hope in God and the plan he has laid out for us and the baby, knowing that as hard as it is to accept it may not be the same as our desires. We are very grateful for each and every day that passes that we are able to cherish the time we have with this little one here on Earth.
With love,
Jeff & Nicole
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