Thursday, July 29, 2010

Baby B - An update and a surprise preview

It has been a long day, but all told, not nearly as stressful as it could have been. First, let's get to the fun part. After almost an hour-long diagnostic ultrasound, our technician surprised us by producing a 4D ultrasound wand, and this photo of our beautiful goober, uber-fighter, baby B:

We don't have a shot of Baby A, as she her back was to us, facing my spine.

Cute as hell, right? 

And what of her story?  We have some more chapters to include, thanks to our long meeting with the doctor today at the General.

Where to start?  Well, both babies have had a good growth week, and Baby B especially, so she is now no longer in a low weight concern category, so Mommy is pretty pleased about that!  She was also incredibly active during the ultrasound, which we loved seeing too. 

She, and her twin sister, had both shifted to be in a breech, or feet down position, so that meant that all those crazy kicks were from both of them, when I actually thought it was only baby A...

And what of her condition?  Well, here's the scoop, as we understand it.

What our little goober has is called a Diaphragmatic Hernia. There are a couple things in our favour, we found out.  First, the hernia is located on the left side, which has a better outcome than if it were on the right. Second, the liver has NOT also relocated to inside the cavity, and this is also very very good, we are told. The stomach and part of the bowels are there at this time, but the above is apparently good news.  On the slightly negative side, the lung measurements were sub-par relative to the growth of the baby's head, which is not great, but then, last week, baby B was considered underweight, and this week, she'd had a growth spurt and there are no issues, so...we hope this will change.

What else?  Well, the doctor, looking at our original IPS nuchal fold measurement, combined with today's measurements, said that baby B looks great, and the chance that she has Down's is still very low.  So, rather than risk bringing on the onset of early labour by doing an amnio, he recommends against it but feels pretty positive that her chances are very good on that front.  Congenital defects like this DO tend to drive up the chance of issues like Downs, but this type of issue doesn't affect the ratio/chances all that much.  So this has helped us relax a bit too.

So what now?  Well, now we meet with CHEO surgeons, neonatal specialists, and go for appointments and ultrasounds every two weeks at The General. We also wait to see how strong baby B can get, and how well her lungs are able to develop in this small space.  But really, we wait for the delivery to see if she can breathe... From what we are told, there is about a 60-80% chance that she will be able to breathe enough to survive, that we can stablize her, and then get her into surgery to fix the problem.  But really, we won't know this for sure until after she is born.  Plain and simple.  And not so simple, emotionally, but still better to know where this all stands.

The nice bonus today?  The doctor has placed back on the table the possibility that we can try to deliver naturally, and not have to have a scheduled C-section.  If both babies are head down, he doesn't see a reason why we cannot try, and if baby A is head down, he would still consider it.  Mommy is VERY happy about that, and I am sure our doulas will be happy to know this also. If this doesn't work out, then great, but at least this is still a possibility.

So.  Yes, we have a little girl here fighting for her life, but she has a good chance.  And I just have to believe that because Mommy is strong, positive and in love with her two little miracles, that this will be enough.  Only time will tell.

Wednesday, July 28, 2010

On the eve of our next appointment - Chinese Food!

It has been a REALLY long week.  Ups and downs, and a lot of attention paid to my sometimes moving, sometimes not moving, belly to see if Baby B is going to kick.  Lost weight initially and have only just now gotten back to my weight over a week ago. Eating plenty, so that's worrisome.  Just trying so very very hard not to worry too much, but it's mentally exhausting.

I won't get into our issue with the new carpeting, which was supposed to be done yesterday and enable us to start decorating the nursery.  More delays at a time when we don't need them...

So yeah.  Ultrasound tomorrow followed by meeting with the doctor at the General Hospital, our new care location from now forward.  Have a LOT of questions and really hoping to have a way forward and a few answers, even though I know we won't have all.  We're tired and anxious and so happy this day has finally arrived.

Until then, our wonderful neighbours have taken pity on us, and have suggested we go for Chinese food for dinner. 

I.

AM.

IN!

Addendum from our meal:
I picked a fortune cookie with two fortunes inside, and hubby found a single packages fortune cookie with an accidental two fortune cookies inside...I'm liking those signs, my friends!

Tuesday, July 20, 2010

Saved by the dragon - can love, courage and concentration affect outcome?

So last night was the first night since very early childhood I can recall sleeping with a stuffed animal.  Dylan, the interactive dragon, has found a very soft spot in my heart and is waiting, patiently, to have a little baby or babies to love it. Dylan provided me with some comfort yesterday after a miserable day.


What's up? Well, the day started wonderfully.  We were excited to have another ultrasound and see our lovely twin daughters again. Mommy has been loving pregnancy and feeling great, and the kicks were a great sign that all was well.  And at first, it was.  My parents were with us to see their grand-daughters for the first time, and the Civic high-risk unit was very receptive to having them there.  Boy, they were thorough.  So thorough, in fact, that after a lengthy time, and after my parents left excited and happy, I had a second ultrasound with the doctor on duty in the unit.

It was then, after he looked around for another 5 minutes or so, that he was forced to look at us and say "there's something wrong with one of the babies".

You never want to hear these words folks.  You really, really don't.

The optimist in me kept trying to come up with questions and things to say that would make things better.  Was there any possibility that this situation could rectify itself? No. Could I still try and deliver vaginally? Unlikely. When will we know for sure if she was going to be okay?  Not sure if we will have any good answers until the birth, if she makes it that far...

You see, baby B had somewhere along the line developed a  hernia that meant there was a hole in her diaphram.  Not a severe issue in and of itself, except that at some point, as I understand it, her tiny developing stomach migrated through the hole and took up residence beside her little heart, which is a spot normally reserved for her lungs.  IF it is just a hernia, and not a sign of some other contributing issue (it might be a sign that the baby has Downs and now we must have an amnio in order to find out), and IF somehow the baby's lungs are able to develop enough, we MAY be able to save the baby with a quick surgery after birth, but there's a real chance, from what we gather, that she won't make it. And there is nothing we can do about it, except pray for a significant amount of luck.

So what do we do?  We are now being tranfered to the General, and to CHEO as necessary, and will have a number of appointments with specialists, surgeons and go through a number of tests and monitoring ultrasounds to watch and wait.  We can, at the very least, get the amnio to obtain an answer there, but it won't mitigate the possibility that even if she survives, she may have some level of disability or handicap. I no longer have an OB, but the hospital will be my doctor.  Not sure what will be the outcome for my doulas...

And what is doubly hard (or a comfort, depending on my mindset at any given time) is knowing that baby A is fine, and healthy, and barring early onset of labour, should be with us, and with Dylan the dragon, in due time. We have to keep going as if we are fine and are having twins, because...at this point, we ARE, and thinking otherwise is thinking worst-case scenario.

Yes, by the way, after three miscarriages and now this, my natural sense of optimism is being severely tried.

Um, what else?  Oh, yes. There is a chance that due to this hernia issue, baby B's amniotic sac will develop too much fluid, which could affect my belly size, which could in turn increase the possibility for delivering prematurely, which, with this scenario, is doubly dangerous.  This means I have to be off work very soon - as soon as two weeks from now, and possibly earlier than that, in order to take it easy and focus on eating healthy and resting a lot. Thankfully, no requirement for bedrest as of yet...

So here's my question.  Can concentrating on all the beneficial things I can do to help the girls grow, can my intense love, and can a certain dose of courage to face what might be a very hard reality help affect the outcome here? 

It seems to be all I have to offer. Anyone who thinks you control what happens in life is fooling themselves.

AND...to add insult to injury, after our unexpectedly lengthy appointment yesterday, we got a parking ticket.

Thank god I have my wonderfully strong husband, my caring parents and Dylan, the stuffed dragon, to get me through the next few months. I'm going to need all the help I can get.

Tuesday, July 6, 2010

The calming influence of chaos - who knew?

The 'transition' has begun. It's sheer and utter chaos in our home right now. We've torn up, torn down and moved around everything in order to start all the renos necessary to prepare for the twins. What's best is that the vast majority of the chaos is being led by my baby-boomer generation parents, who know no end to the energy stores needed to work towards tackling even the most massive projects.  Where others intimidate, my fabulous parents dive in.  God bless them.

So what do we need to do? We are painting the entire upper floor, including all bedrooms (and the nursery of course). We have ripped out the two closets in the two spare rooms to make way for some custom solutions - can't wait to make a cool cubby-rich option for the twins with little bars for the occasional dress and lots of great solutions for storing their little socks, toys, etc. We have ordered the new carpet and the thickest underpad possible for the entire upper floor and stairs, so the painting has to be done, then we will rip out the carpet and get ready for that installation.

What else?  Well, we are having a great friend of ours, a master custom carpenter Tobias create a wall storage, entertainment unit and bookshelf solution for our main floor that will hug three walls spanning the living room to the dining room - if we gotta stay in our great little home for a while longer, we need STORAGE!

We totally have to clean and organize our garage and buy some shelving solutions - it's gonna become a massive storage and workshop area - it never did fit a car in it anyway (stupid builders)...

Oh yeah - and we have to fully renovate and redo the basement to make room for an office/entertainment area and playroom for the twins.  We CANNOT have the big toys etc. on the main floor - no room.  So, we are gonna try get this done before they arrive.  Any great suggestions for awesome contractors? Please feel free to recommend!

Ah yes, and BTW, I will be creating a photo album for the nursery transformation.  Can't wait to see THIS...



...become a lovely, fun, vibrant nursery with white and bright stunning photography and colours.

And yes, the chaos means that things are getting done, and that makes Mommy start to relax, because that list above?  ... is long, and Momma don't have much time left!