Tuesday, February 7, 2012

Another Visit, Another Obstacle

Our parade of doctors’ visits started on Monday, February 6 and it was what I will call "not my favorite visit".  Monday’s appointment consisted of an ultrasound consultation with Dr. GB, the Maternal Fetal Medicine doctor.  Dr. GB was very straight forward, which I appreciated because as Jen mentioned we are looking for information. However, with information comes more understanding of the challenges JD could face along the way.  As we meet with more specialists the conversations become more blunt which is something we are preparing ourselves for moving forward.

In a previous ultrasound with Dr. S, he told us there were slight ASD and VSD (please check the “Medical Jargon” section for definition of medical terms) heart issues. However, in our ultrasound with Dr. GB the heart did not show any signs of either ASD or VSD. I am not sure how it could fix itself, as it was made clear that it would not mend before birth.  Yet, Dr. GB did mention it may not have shown up, but could still exist.  She set up an appointment for us to meet with the head of Pediatric Cardiology to get a fetal Echocardiogram. His heartbeat is strong, loud and consistent.  I figure as long as his heart is strong maybe the other developing areas will be inspired to get stronger.

Dr. GB also informed us of some new findings.  The first was the discovery of Fetal Pleural Effusions, which we did not really understand beyond "fluid surrounding the lungs." After a few quick searches online, I am holding off doing any more research until we meet with another doctor and get more information (damn internet). 

The second discovery was within the brain.  Dr. GB mentioned some of the measurements for the different areas within the brain were not measuring properly. She recommended we consider a fetal MRI before the baby is born.  According to her, some doctors will recommend waiting until after birth as there is nothing that can be done prior.  This will be something to discuss at the next stop in the doctor parade. 

The final discovery is regarding JD’s growth. He has always been around the 10th percentile for weight but now he is slightly under that level. This puts him about 3-4 weeks behind the average baby at 27 weeks. I continue to maintain a positive outlook standing by the mantra "a child who can and will.” After each visit it gets harder to stay positive. With the barrage of tough news it sets me into the whole "one step forward, two steps back" circle.  However, after a few days I have found that strength again as I begin picturing JD breaking barriers and bringing joy to those around him.

Before we left the office (after 1.5 hours ultrasound) we opted to do more “surveillance,” as Dr. GB calls it, with a Biophysical.  This 30-minute test consists of four areas which each receiving 2 points if he passes. There are no half points as it is all or nothing.
1)   Movement
JD has been moving from about week 16 and is quite active, which is great.  You can see Jen’s stomach move throughout the evening. He easily received full credit and scored a 2 for movement.
2)   Muscle Tone and Flexing
Throughout the ultrasound JD was able to move his legs and arms back and forth as well as flexing his arms and hands. Give this boy another 2.
3)   Amniotic Fluid
Thanks to Jen downing water (and making us refill our 3 Gallon Brita about twice a day) he received an easy 2.
4)   Breathing
This was a difficult one to capture as babies do not breathe the way we breathe as they have the placenta to do most of the work for them. They watch to see if his diaphragm contractions for 30 straight seconds. JD gave us a few breaths but not nearly enough to pass the test. Michelle, the tech, mentioned it can be very hard to see at 27 weeks as it is still early.
Dr. GB said normally if they baby does not receive the full 8 we would have to come back in 24 – 48 hours for another test; however, as it is still early for the breathing she said we could wait until our next surveillance ultrasound in 2 weeks (it takes about 2 weeks to notice changes in growth). So as of now, JD has an A- but we have full confidence this kid will be on the Dean List’s next time.

As long as JD keeps kicking and punching Jen (sorry babe) and we continue to hear a solid heartbeat at each appointment then I have high hopes.  JD is a champ and fighter. Keep praying.

1 comment:

  1. Thank you so much for the detailed update. The Gawel Gang has not left my thoughts or prayers. JD is a fighter and is so blessed to have such dedicated parents in his corner. xoxo