Wed., Sept. 21

Yesterday and today were kind of a whirlwind with lots of decisions.  We were admitted at 11am.  The original plan was for Nicole to do the 2 hour blood glucose test, get the steroid shots, do an u/s, and monitor the baby closely for signs of distress.  After another u/s and a lot of conversations with another perinatologist, Dr. Kelly, and then a long conversation with a neonatologist we received a lot of information.  Some was new, some old.  Some was "good" (relatively speaking) and some not so good.  But in general it was helpful to meet and talk to people here at the hospital so they get to know us, we get to know them, and we have a better understanding of how things work at UCSD.   The more people we talk to the more we understand what we are dealing with and the more decisions we have to make,  which in the long run is good but also can be anxiety provoking.  All in all it honestly comes down to trusting in God's plan for this little one and taking it one day at a time, considering it a very big blessing every day we can keep this baby well enough to stay in the womb. There are so many things that can happen in the next few days and weeks but in summary our main prayer is that the baby can stay in the womb as long as possible. If there is any chance of survival the baby really needs to stay in the womb enough time to get large enough and developed enough to do kidney treatments and hopefully have that be the only major complication. The neonatologist described this journey for us like ascending straight up a very large, steep, and rocky mountain.  Even though we know it won't be easy we pray that God will allow us to continue to climb up this steep mountain with him by our side every step of the way and help us up when we stumble on the rocks along the way.  More decisions had to be made as far as what our wishes were, all which can have effects on both the baby and Nicole.  We really appreciate all the prayers for wisdom with these tough decisions.

Medically speaking the u/s looked pretty much unchanged from the previous one, which at this point we don't have a lot of room to get more complications so no change is a very good thing unless something improves.  To much of everyones disbelief Nicole's glucose test came back positive, which kind of throws another loop in things.  We will be monitoring that closely after she meets with the diabetes educator.  This was very unexpected since she does not meet any risk factors beside being pregnant and the doctors were so sure that it would be negative that they almost just gave the steroid before we got the third test result back until Nicole, being on the conservative side, insisted we wait one hour to make sure we get the results before we did the shot.  This is not ideal and just increases some risks and possible complications but the hormones have spoken and we will regulate it the best we can.  Because of this there was a lot of discussion of whether we should get the steroid or not since steroids can make your blood sugar go really high.  Women with gestational diabetes most definitely can get the shots, it just requires tight management of the sugars and a stay in the hospital for about 5 days or more after they are done.  There were many other factors that played a role in making this decision, one of them being our major praise and big answer to prayer.  At this time the baby does not appear to be in distress.  We are cautiously jumping for joy right now and pray that this continues to be the case knowing it can change at any time very quickly. Because it does not appear that we will be delivering imminently, many doctors conversed and we conversed with them and it was decided to hold off on the shots so we might be able to get the best effect of them later when the timing is right.  We also decided to not stay in the hospital until the baby is born at this time.  In a normal pregnancy if a woman came in with amniotic fluid this low, they would not send her home and would keep her in the hospital to be monitored three times a day until the baby is born due to the risk of cord compression.  However, because our situation is a little different we will be diligently checking fetal kicking movement signs every night to try and catch any signs of distress quickly so we can get to the hospital.

The tentative plan going forward at this point is to meet with a gestational diabetes educator, take a class on it for management, meet with the pediatric nephrologist and urologist in the next week, have an appointment with Dr. Moore next Friday, another in depth u/s the following Friday, pray constantly, try to give our worries to God, and continue to put our trust and hope in his plan, whatever that may entail.  Thank you all for your amazing support, love, and continued prayers!  It has all been so uplifting for both of us and we can't begin to tell you how much we appreciate it.

With love,
Jeff & Nicole

In his heart a man plans his course, but the Lord determines his steps. -Proverbs 16:9