Perinatology, take 2

Today we met with the perinatologist again. The appointment was overwhelming, emotional and full of scary statistics and information that didn't exactly make me feel better. As the perinatologist pointed out, we're in the roughest month of this pregnancy so far, with the 24wk5d mark coming up, and we'll leave it even more worried than we have been so far.

Before today's appointment, I looked up fetal anemia. The following website explains it, what you do about it, and the risks involved with the treatments:

http://childrens.memorialhermann.org/services/fetal-anemia/

All of this info was confirmed by the perinatologist. We of course had many more questions, and the bulk of the consult was going over them:

Is the progression of my antibody levels what is normally seen? As in, are mine rising too quickly or more slowly? The answer, they're basically right on track.

What are the odds of needing the blood transfusion? We're told less than 50%, however the office we're going to saw 6 others with this issue in the past year, 3 of which needed transfusions.

Does one transfusion do the trick? Nope. We may have to do multiple ones, each carrying the same amount of risk.

What blood is used? The mother's blood type with antigens and antibodies the baby needs for survival once born. This still doesn't make sense to me, but I can ask at my next appointment in two weeks.

The risks of the transfusion? It's like an amnio, but goes straight into the umbilical cord, and can cause cause bleeding at the site of injection. It can also cause preterm labor. And we didn't go over this, but death is also a risk....

So what do we do now? Monitor.

Starting with today's appointment, here is our current plan:

We'll see perinatology for all of my ultrasounds as they are much more high tech and can monitor blood flow. What is being looked at specifically is the blood flow in the brain (an artery I believe). If the baby becomes anemic, the brain says it's need more oxygen and so the blood pumps harder and faster through the brain. The number we want to be below is 1.5, and with today's ultrasound, it is currently 1.16, normal.

We'll have these ultrasounds every two weeks and then see the perinatologist to go over any new questions. If the number goes above 1.5, the transfusion is scheduled immediately. However, they've noticed that the steroid shots given to help Baby Boy 2's lungs develop (just in case we have to deliver early) actually deregulate everything including the antibodies and anemia, but only for a week or two.

If the anemia does not resolve with the transfusions, which would be every two weeks, then delivery is set. If a transfusion is not needed until 34weeks, Baby Boy 2 is delivered early to avoid transfusions as his survival is greater outside of the womb than within it with the risk of a transfusion.

So what can we do? Watch and wait. Hopefully for nothing to happen, but with odds like 50%, I'm not feeling so lucky....

And so we go to the hospital for compensation for all of these appointments as this is something we should not be dealing with (and therefor paying for) in the first place. We should only have to worry about getting to 36 weeks. Not about whether Baby Boy can survive inside of me through to 36 weeks.

I'm grateful the perinatologist recognized the 24th week coming up for what it's going to be for us. Emotional, stressful, scary. And I feel like she understands that a whole new and unnecessary layer of stress and worry have been added to our load to bare. Yet this time when we left she sounded more optimistic, focusing on getting to 36 weeks without any other issues, even scheduling the c-section once February hits, even though anything can happen in the two months between. She even encouraged us to find a pediatrician, something I thought was still months away.

I guess we only have 14weeks to go to hit 36weeks, just a few months really. But every day drags on as I sit waiting for kicks, wondering if my cervix is okay, and now if Baby Boy 2's blood is fine still. Two weeks between each check feels like an eternity right now.

But I just want everything to be fine, and truly do hope that nothing more happens.

Because I got a lotta love to give.

Merry Christmas in Loving a Memory of Korbin

This year we adopted a 1.5 year old boy for Christmas named Said. He is severely ill, and has been in and out of the hospital many times already for heart surgeries. Though selfishly I wish we were shopping for Korbin, I do enjoy being able to brighten this little boy's Christmas morning.

The gifts are things he needs and hopefully some fun toys he'll enjoy playing with for a very long time. And I loved seeing Ryan getting into the giving spirit with me and being so picky about whether or not the toys would be good enough for Said.

Because we got a lotta love to give.

Fucking Antibodies

Excuse the title...but that's exactly how I'm feeling. We found out yesterday that my antibody levels are above the threshold level and it's time to worry about watching for anemia in Baby Boy 2. Joy. Thank you, hospital staff, for forgetting my Rhogam shot. As if we weren't stressed enough in this pregnancy already.

Two weeks ago my levels had remained steady, no need to worry yet. I cried I was so relieved. And just prayed and hoped and wished they'd stay this way till maybe 28weeks, and at least till after 24weeks. I really needed to get past 24weeks without any major hiccups. It will be a hard enough week to get through as it is.

Now I'm just waiting for an MFM to call me to schedule a consult and the first of many ultrasounds specific to monitoring Baby 2's blood flow. We'll need to do that within the next week. So much for a joyful and stress-free Christmas.

I had many questions for my OB. Would I get to see her still? Will she be able to deliver this little guy when the time comes? How much of my care switches now? What's next? What are the odds of needing a transfusion?

Thankfully, I can stick with her for my basic pregnancy management. I really need her by my side through all of this. If anything, all of my following ultrasounds will be with the specialist that way I don't to do two separate ones each week or every two weeks. We still don't know how often Baby Boy 2 will need to be checked, that will be up to the MFM specialist and whatever they suggest is best for our case. It might be weekly, or just every two weeks like what we're doing right now.

What's really getting to me now is the mention of possibly delivering earlier than 36weeks if things aren't looking good. I thought that the only thing to fear was a possible transfusion into Baby 2. But I guess if he's not doing well, my OB will do an even earlier c-section and he'll hopefully so better on his own. Last night I slept horribly, thinking only of extended stays in the NICU and whether or not I'd be able to breast feed this one, or just pump and bottle feed, or will they only allow their own formula (which I am so against as I've heard the horror stories of the necrosis in the intestines causing death and the only possible link so far being hospital feeding versus breast milk). What if my milk doesn't come in again? What if he doesn't latch because he was bottle-fed in the hospital for too long? How long would he have to stay? For whatever reason it had never occurred to me that we may not be taking him home when I am discharged. Could I leave the hospital empty-armed again? Even if I knew this one is alive and being cared for still? I'm just exhausted today.

We have so much to figure still. And again, just so much to wait and watch out for. It's really becoming exhausting, and difficult to keep a positive outlook. Just when I start to feel excited, something else creeps in.

I need some sort of hope to keep looking forward to this new little guy.

Because I got a lotta love to give.

Triage

Well, it was bound to happen, especially now that we're at the one-month-till-the-time-we-had-Korbin mark. I had a strange tightening/pressure throughout my belly, and so I called the on-call doc on Saturday evening just to hopefully get some reassurance. Instead of simple reassurance that what I am experiencing is normal (I still don't know if it is or not) she said I should come right in to get get checked out due to my history.

Ryan was out with a friend getting take-out for the evening. When they got back, I did my best to remain calm while saying sorry we couldn't just watch a movie and hang out but we actually needed to head straight to the hospital. I probably wasn't as calm sounding or looking as I had hoped, and I definitely felt some panic from Ryan as he tried to rush us all out the door without locking anything up.

Once we got to triage, I was hooked up to a monitor that detects contractions, listened to Baby Boy 2s heart beat and had my blood pressure checked. Everything looked fine, even my blood pressure despite the stress of the evening. We had to wait for the ultrasound tech to get my cervix checked (she was monitoring an earlier patient still), and time just felt like it was standing still.

When we finally got in, everything looked normal, again. My cervix is just how it is supposed to be. Baby Boy 2s heart beat looked great, and There is a normal amount of amniotic fluid still. So what the heck do we do? After two hours (felt like way more) we were discharged with instructions to not change a single thing that I'm doing. Eat the same, exercise activity level the same. Work.

I'm relieved, and glad we just went in even though nothing was wrong. What I really need to work on is not feeling like I'm just being crazy or paranoid. I am being realistic as all I know is loss, and we most definitely don't want that again. Better safe than sorry, and we've been sorry one too many times before.

Also, the stomach tightening thing was a major trigger for me to start to panic on Saturday as it was a symptom I had written down to ask my OB at my 24week appointment. The very same appointment that turned into an emergency c-section and the loss of Korbin. All I could think was, 'was this a sign that I completely missed last time?' How could I be so clueless? I can't make the same mistake twice. I just CAN'T.

But that was apparently a nothing symptom that they weren't even worried about. More questions for my OB Wednesday at my actual appointment.

But this time I didn't just wait it out. I got checked out, even if it was all for nothing.

Because I got a lotta love to give.