Wednesday, September 15, 2010

Today was a LONG day!

Here's how the schedule was supposed to look.
7:45 (try to arrive at 7:30)   Ultrasound
9:30 MRI
11:00  Fetal ECHO
1:00  OB appointment
2:15  Ultrasound and BPP

Yeah.  I think the theme of the day was that we (or the doctors) were always running behind schedule.  We didn't finish up until 5:00.  And we didn't really get a break at all except for about half an hour between the MRI and the ECHO.  We got a couple of cute ultrasound pictures, which I'll have to scan and post later.

So how did it go?

Ultrasound went well.  Last week at my BPPs it was sometimes hard to get a good look at some things because Baby wasn't really moving around that much.  So in preparation, I had lots of OJ on our way to the hospital so that Baby would wake up.  It worked.  Baby was moving around a lot, doing lots of practice breathing, etc.  I'm not sure if she actually did an official BPP or just quickly looked at those items, but she said we got an 8 out of 8.  Also, based on measurements that she took, she estimated that Baby currently weighs about 3 pounds, 14 ounces.  And I think in general, everything looked good (other than the heart).

Next up was the MRI.  Very weird experience.  I've never thought of myself as being one who is claustrophobic.  I had closed my eyes on my way into the MRI machine and opened them briefly once I was in.  I had to close them immediately.  Very tight space.  So I kept my eyes shut and tried to focus on my breathing.  I would start to doze off a bit, and then there would be loud noises and I'd wake up.  Not really sure how long it took- I think about 20 minutes.

We didn't get a chance to speak with the doctor who performed the MRI, but the cardiologist spoke with her and said everything looked ok.  After the MRI, we had a little bit of a break so we went and got a snack.  We thought we would have enough time to grab lunch before the OB appointment, so we kept it light.

So next up was the ECHO.  Overall not too bad.  Not sure what the difference was, but he seemed much more personable today.  He didn't feel that things had worsened at all since last week, which is good.  And we had plenty of time to go over the list of questions that we had.
  • After delivery, how much time would we get with the baby before he/she has to go off to Children's?  Essentially none.
  • What are the odds like?  Last week he mentioned the baby may not survive the pregnancy or delivery.  Really no concern from him at this point re pregnancy or delivery, but he'd estimate that post-delivery, there's a 70-80% chance the baby may not make it.  There are multiple options for things they can try once the baby is born, and probably won't be able to really decide what to do until after Baby is born.
  • Any reason to deliver early?  How would that be determined? At this point he felt the only reason to deliver early would be if there were a benefit to immediate surgery.  He did not feel that there would be a benefit.
  • C-section vs vaginal delivery?  Going into this I was kind of assuming I would have to have a section.  We kind of figured that a normal birth would stress the baby out too much and be bad for the heart.  Although he said it's ultimately up to my OB, he didn't feel there was a need to go with a section based on Baby's heart.
  • After the baby is born, would Boy Chris be able to go with Baby to Cardiac ICU?  Yes!  I know it's probably completely unfounded, but I had this fear of him not being able to go with the baby, and then me not being able to find him/her.
So the next stop was to go over to the Brigham to meet with one of the OB nurses.  We had been told that none of the OBs would be available, but this would at least give us an introduction to the practice, etc.  Well we get there, running at least 20 minutes behind scheduled.  The nurse asks a few questions, really just trying to get a sense of my medical history- at least in regards to this pregnancy.  And she mentioned that she was hoping that one of the OBs would be able to meet me after my ultrasound.  Time for a few questions.
  • I forget exactly what we asked, but it came up re inducing.  Basically, without a medical reason, not before 39 weeks.  And it could be up to me.  If I want to wait and see what happens, they can do that.  There are some benefits of being induced in that the medical support team that we'll need for the baby will know when it's happening, but if I were to go when be baby's ready, it wouldn't be a problem to get the necessary people to the delivery room.
  • Another interesting comment, was that she said the baby would go first to the NICU at the Brigham.  This was surprising, because our sense from the cardiologist was that that the baby would pretty much be going straight to the Cardiac ICU at Children's.
Time to go for my ultrasound and BPP.  Keep in mind it's after 2:00 at this point.  Possibly closer to 3ish.  I haven't eaten since a chocolate croissant at 10:00. Baby was not co-operative.  They ultimately were unable to see the baby take a practice breath.  Didn't matter that Baby had done so earlier in the morning.  Also, based on the measurements that they took, they estimated that Baby weighs 3 pounds, 4 ounces.  So although the measurements from the morning may have put Baby in the 50th percentile, they were showing Baby as being in the 5th percentile.

Since they couldn't get Baby to do a practice breath, they sent me for a Non Stress Test (NST).  What this measures is Baby's heart rate.  They try to compare a normal rate vs any change in rate when Baby moves around.  But again, we had the issue where Baby didn't want to move.  By now it's 3:30/4:00ish.  I still haven't eaten.  So I failed this test as well.

After the NST it was back to meet with the OB.  First there was some confusion re where one piece of my paperwork went.  Then they wondered if there had been any weights given at earlier ultrasounds.  You would think, with as much as I've been going in for one test or another this would have been frequently measured, but apparently that wasn't the case.  They found one ultrasound from back in July that had a weight.  But it's hard to tell if the low weight estimate is because the baby is just generally growing at a slower rate, or if the heart problems are impeding the weight gain.  And then there's also the 10 ounce discrepancy between the measurements taken at Children's and those taken at the Brigham.  So what's next?

I get to go back tomorrow (Thursday) for another BPP and NST.  But since it was now 5:00, they couldn't schedule it as everyone has gone home.  So I get to call in the morning and have them tell me when to come in.  Hopefully it's not at a really inconvenient time.  At least I should be able to eat before hand.  Hopefully that will help things.

As to other follow-up.  Back in a week to meet with the OB again (still needs to be scheduled) and also back on Wednesday for another ECHO.  Don't know yet if there will need to be other BPPs and NSTs scheduled in there as well.  I hope not!

When we finally left, we grabbed some dinner at a local Bertucci's (Chris really wanted their rolls and oil) and then we headed home.  In the end of rush hour traffic.  Blech!  I think we were both very glad to finally get home- about 13 hours after we left this morning.

3 comments:

  1. Ugh! Yeah, definitely the downsides of the big Boston hospitals is that almost nothing there is on time, ever. (I have learned to have a snack on me at all times!) I will say from our experience that fetal weight estimates are far from exact. Small differences in the measurements can add up to big differences in the weights, and the measurements can be hard to get depending on positioning and activity. I hope tomorrow is better.

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  2. Chris, you and the wee baby are in my prayers for a safe and healthy delivery... Hang in there..

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  3. I hope today goes a lot smoother than yesterday does...I also hope that today's appointments give you the information you need & that it's all positive! If you need anything, please don't hesitate to ask! If you need to talk/vent - I'm here!

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