Mini update

Today was the first of my twice weekly appointments. As annoying as I'm sure this will prove to be, in some ways I hope I have to go through with this for a while, as that means that Baby gets a chance to grow more before being born.

On Tuesdays and Fridays I am scheduled to have a BPP (Biophysical Profile) and on Tuesdays I also meet with the pediatric cardiologist for follow-up Fetal ECHOs. The goal is that with more frequent monitoring, they will be able to better decide what steps to take. Next week I am scheduled to meet with the High Risk OB team and the NICU doctors.

Luckily both Chris and I have very understanding bosses who are being very accommodating to our new schedules.

 Having said all that, things have a way of changing.

- We've been following the degree of baby's tricuspid regurgitation and the effects it has had on the overall circulation.  Today the overall heart function still appears to be good, althuogh there is still a severe degree of TR.

- There is enough TR that now the right ventricle is having difficulty opening the pulmonary valve.  This means that the blood going out to the lungs has to flow from the aorta to the ductus arrteriosus and then unto the pulmonary arteries.

- This means that after birth, the baby will need a medicine called prostaglandin E (akak "prostin") to keep the ductus arteriosus open.

- It is possible that the baby could require a surgery to create a stable source of pulmonary blood flow.  This is called a modifies Blalck-Taussig sunt (BT shunt), and it is very much like an artificial ductus arteriosus that does not require Prostin.

- I think the goal will be to get the baby to an adequate weight to try and repair the tricuspid valve.  The possibility exists that for technical reasons this may be impossible.  If this is the case, the baby may need a few surgical procedures over the first few years of life to re-route blood to the lungs.

So, based on today's findings, I am once again being transferred.  It now looks like I will be delivering at Brigham & Women's, which has the benefit of having Children's right across the street.  If I were to stay in Worcester, then the baby would more than likely have to be taken by ambulance to Boston, so it makes more sense for us to be there already with the more experienced team in place.

At this point I don't really know what this will mean in terms of appointment schedules.  Everything mentioned above is what was in place at UMass.  I assume it will continue to be twice a week.  I'm awaiting a call with more details.