Contractions

My NST today was still showing quite a few contractions despite the procardia. Thankfully, they were not really painful or coming at regular intervals like they were last Friday. They checked my cervix after Tuesday's NST and it was still closed, but I can't help but to be a little nervous that it will all change very soon. I just really want Andrew to make it to at least 37 weeks if at all possible.

My friends and neighbors have all been so wonderful, bringing by different meals and "calcium supplements" of Ben & Jerry's! It's so hard to admit to needing help sometimes, but everyone has been beyond wonderful in helping out and checking on us! Gene and I cannot thank you enough!


Two of the CDH babies that have been born recently are now on ECMO. Their names are Ireland and Max- please keep these babies and their families in your prayers.

I am still just taking it one day at a time and am thankful for each day that Andrew is still okay! Thanks so much for all the prayers and support! Hope everyone has a great weekend!

Bed Rest

So I woke up feeling envious of my husband who was going out of town for the day for a business meeting. I've been told not to do any traveling for a while now and its been hard not being able to go anywhere fun this summer. It was Gene's last trip out of town and since my fetal fibronectin came back negative on Monday and Gene was only going to be gone during the day, I didn't feel too uneasy about it.

I did not go to work yesterday for the new four hour shift because it was a light surgery schedule and they offered me the day off since I had so much activity with my NST the day before. The extent of my activities included a hair cut, grabbing a quick lunch and getting about 5 items at the grocery store- certainly not over exerting myself by any means. I came home and took a nap which usually helps my contractions slow down or go away for a while. Except this time, when I woke up I had 6 contractions in a 20 minute period all spaced at regular intervals. I called L&D triage and they said I could try drinking another glass of water (I was up to 7 glasses already that day) and see if that helped, but that they would definitely want to have me come in if they didn't slow down. I continued to have two more contractions still spaced equally apart, so I headed out the door trying unsuccessfully not to cry. I let Gene know what was going on and he was trying to catch an earlier flight home. I was praying that I wouldn't have to go through Andrew deciding to come without Gene being here. Gene has this great way of calming me down and making me feel like everything will be okay- it's one of the many great reasons why I love this man I married. We are very good for each other.

Gene was able to make it into L&D for about the last half of my 9 hour stay. They tried giving me i.v. fluids which didn't help at all. My cervix had not changed since Monday's exam, but the contractions were still continuing to come every 3-4 minutes. The next step was two separate doses of nicardipine. This is a medication that helps the uterus relax by blocking the calcium that is required for the contraction of the uterine muscle. They still couldn't get things to slow down right away, so they gave me a shot of steroids in case Andrew should decide to make his grand entrance in the next week or two. We ended up staying there until about 2am before they saw a seven minute break between contractions. They rechecked my cervix which was unchanged and sent me home with a prescription for nicardipine and instructions to come back to L&D tonight to get a second and final shot of steroids. Needless to say, working is out of the question now. The good news is that I have had very few contractions today, so maybe the nicardipine is doing it's job! Andrew handled all of this with flying colors. In fact, he was so active with good heart rate variablility that they ended up monitoring only my contractions for the rest of the stay.

So my journey of modified bed rest begins! Can I just say how much I love Netflix and their instant download section, not to mention the local library. If anyone has any great books they have read lately, please let me know the titles so we can get them at the library. Hopefully, we can stretch this out for another 5 1/2 weeks until our induction day! Charlie and Lucy are going to love having someone home during the day, be we worry how they'll adjust when Andrew is born and we are hardly ever home for a while. Thankfully, we have good neighbors that have offered to take them to play with their best friends down the street when that time comes.

Hope everyone is enjoying their weekend and doing something fun! Will post if anything changes!

NST

So this morning I went in for my 2nd NST (my lst one was last week) and was thinking I would do pretty well. I usually just feel the occasional contraction in the morning and it's not until the afternoon that I really start feeling a bunch of contractions after I've been working. So I was completely taken by surprise when the nurse came in at the end and said do you realize how much uterine activity you're having- WHAAAAAAT?. Not at all what I was expecting! Then she really got more concerned when I told her I only felt the occasional contraction this morning and that it usually is really bad in the afternoons after being on my feet all day. My fetal fibronectin test came back negative from Monday, so that was good news and that's all I knew to tell her. She sent me to ultrasound with a second cup of water to drink and told me I should start taking it a little easier.

After they checked my amniotic fluid levels, Candace (the ultrasound technician) said she was going to show the doctor my pictures and she would be back. This is routine for us after every ultrasound- so again I was thinking not a big deal. My AFI was 21 which has been that way for the last two weeks. When she came back in the room, she said that the doctor wanted to speak with me in a conference room! PANIC!!!!!! Let me also say that Duke has many ultrasound technicians, but this happened to be the same one that did our 17 week ultrasound where we found out Andrew had CDH! And to top it off, I was alone, because I thought these appointments wouldn't be a big deal and told Gene it would be fine if he wanted to go on to work instead! I was frantically text messaging Gene who was trying not to freak out- I told him I would call as soon as I spoke with the doctor. After seeing the look on my face, Candace quickly added that she didn't see any hydrops on the ultrasound. This made me feel a little better, but it seems like there a lot of surprises along this CDH road.

So after all the worry, Dr. Boyd came in and said that I was having a lot of uterine activity and in combination with my increasing blood pressure, it was time to try and reduce my work hours to see if this would help. So big relief in that I was expecting so much worse! Not great that I'm having so much activity, but Andrew seems to be handling it well with his heart rate and movement and if it was really severe, then Dr. Boyd would have put me on bedrest all together. So maybe going to down to 4 hours a day at work won't be so bad. It helps to keep my mind off everything and I really enjoy my job, so I'm hoping the extra time off with not wreak havoc with my mind!

Also, more big news! We have our induction date set! It's still not decided if I will have a c-section or vaginal delivery at this point so they have reserved two different times. September 29th at 2:30pm is when we are to go into the hospital for induction if a vaginal delivery is planned, hoping to deliver on September 30th. If a c-section is planned, then 10:30 am on September 30th! There a lot of different emotions that run through my mind when I think of that day. I'm terrified to let him go, knowing that I will no longer be able to protect him- that is the scariest part for me. At the same time, I am really hoping we can help Andrew kick this thing, and I can't wait to get to meet him and finally start our lives together! Someone at work said something that really helped me- being a parent is a life time of learning to let go. Whether its letting them cross the street by themselves for the first time, their first day of school or taking them to college- a parent's life is filled with moments of letting go and trusting. Obviously this fight for his life is on a whole different scale, but I must learn to let go and trust just the same. For now, living one day at a time and knowing Andrew is safe and happy and kicking like crazy is all I need to know!

33 weeks

So, it's been a busy couple of weeks! On Friday I was able to meet baby Carter who is a CDH survivor. Brad and Kellie (Carter's parents) were really helpful and had some great tips for surviving the NICU and this whole process in general! Thank you so much you guys for taking the time to meet with me and for allowing me to meet Carter and see how absolutely fantastic he is doing! That visit did so much for my spirits! Gene was disappointed he wasn't able to get out of work to meet you, but maybe next time it will work out!

I had a great birthday yesterday! Andrew was kicking up a storm during church! He absolutely loves the music and reminded me by kicking me in the ribs and lungs for about a solid 45 minutes! I guess it will be too early to start music lessons in the NICU though! Gene and I really felt like the message was directed completely at us. I may never understand why God has chosen this path for us and for Andrew, but I was reminded yesterday that in the midst of uncertain times, God is still in control. I pray that ultimately in the end, his plan is to allow Andrew to have a long, healthy and productive life.

So, today we had a growth and development ultrasound again. The big boy is measuring at 5 lbs and 1 oz already! He is in the 64% for size according to one chart they used and 71% according to a different chart- bottom line- we think he's going to be a big boy! Head circumference was measuring at 37 weeks 5 days (>99%)- I'm thinking we are seeing a c-section in our future, but the doctors haven't committed to either way at this point other than to say everything looks structurally normal and they do not think he has any sort of syndrome or hydrocephalus. My amniotic fluid levels are starting to rise some- up to 22cm, but Duke does not consider it polyhydramnios (too much fluid) until it reaches at least 30 cm. So hopefully Andrew will still be able to swallow and digest the fluid and it won't get any higher! Other good news- his liver, gall bladder, kidneys and spleen were all pretty clearly visible and are down in his abdomen where they should be. His stomach and some intestines were still up in his chest. He was taking lots of practice breaths- which is always encouraging for a mom to see! Way to go Andrew!

My blood pressure was borderline high and I was given instructions to check it at work and that I would have to come in and be seen if it gets any higher. Still having a ton a braxton hicks contractions and some real contractions, but they checked my cervix and said it still looks good and we are waiting on the fetal fibronectin results (if these results are negative, it is very likely that I will not deliver in the next two weeks). We are still hoping to make it to 39 weeks! We couldn't be any happier with the care we are receiving at Duke- they are truly a fantastic group of people! Thank you for keeping our family in all of your prayers- it means so much to us to have all of your support going through this! To those of you who left comments, thank you! Gene and I really found them so encouraging! Hope you all have a great week and I'll keep you posted if anything changes!

31 weeks 3 days

So today we met with the pediatrician that will be taking care of Andrew if we are fortunate enough to get to bring him home. He explained that his role in the beginning will basically be to just check in and visit Andrew while he is in the NICU and then will be extremely involved if we get to the point of approaching discharge to home. He said that babies like Andrew are why he does his job. He's happy to take care of the healthy little guys as well, but taking care of Andrew and hopefully getting him to the point of being a healthy little guy one day is his whole reason for going into pediatrics. That was such a relief to hear as I'm sure we will get to know each other extremely well during those first few months that we get to bring Andrew home.

We also had an OB appointment and an ultrasound to check for fetal hydrops and polyhydramnios. Everything on the ultrasound looked status quo. His liver is down in his abdomen and his stomach along with a lot of his intestines are up in his chest. Duke does not do the fetal lung to head ratio that a lot of centers do simply because they have not found it to be predictable at all for how well a baby will do after they are born. We did get to see him taking practice breaths though! I would love for them to tell me that his case is not severe, but we know that there is a lot of stuff up there in his chest and this battle will not be an easy one for him.

On the ligher side- he has a ton of hair! Gene was born with a head full of hair, so he must be getting that from him. Instead what he gets from me is a huge head- great! Just what a mom approaching delivery wants to hear. Babies with big heads run on my side of the family. I am 31 weeks 3 days and his head is measuring at 37 weeks! Please don't tell me that I'm going to give birth to a 2 month old! They reassured me that this does not indicate any sort of syndrome and will do another growth and development scan in two weeks.

I have a non stress test scheduled for next Friday and another ultrasound for August 17th. We'll keep you all posted! I want to thank everyone who is checking in on us and keeping us in their prayers. We couldn't make it through this without all of your support!

No News is Good News!

Its been a while since any major updates. I'll be 31 weeks on Monday. I'm continuing to go every two weeks for ultrasound visits. At this point, there is NO evidence of fetal hydrops or polyhydramnios. Fetal hydrops is like congestive heart failure for a fetus where there is so much compression of the heart from other organs in the chest, that the heart has trouble keeping up with the circulation and fluid begins to back up to other places that it shouldn't be. Polyhydramnios is extra amniotic fluid that could occur if Andrew were to begin to have trouble swallowing and digesting the fluid. This can occur with CDH babies because the stomach and intestines are compressed in the chest rather than having more room to develop in the abdomen. Thank God that so far Andrew is having neither one of these problems!

As far as lung development goes, there are two areas of lung tissue that we have seen on ultrasound. The lung on the left appears to be bigger than the lung on the right which seems kind of crazy for a left sided CDH, but nothing seems to be predictable with this defect. I am thrilled that there are two lungs visible though and hoping for the best!

Gene is in Florida this weekend for his last weekend diving before Andrew arrives. He is having a great time and getting in some wreck diving and some cave diving! My mom is visiting from Florida while Gene is away and we are having a great time shopping for baby things, getting the nursery ready and seeing chick flicks! I will post pictures of the nursery once we get the wall paper border up- I've been told that is not a task for a married couple to do together- so we are going to hire someone for that part only. Gene had done a great job painting the nursery and putting the furniture together! It makes me feel so hopeful when I see it coming together like this that we will be able to beat this horrible diagnosis and be able to bring Andrew home!

Fetal ECHO

May 22, 2009

So today we had a fetal ECHO done to evaluate Andrew's heart. From the ultrasounds he has had up until this point, they think everything looks structurally normal, but it was hard to get good views of his heart due to the stomach and intestines being in his chest. When we walked into the children's hospital, the first people we saw were our friends Wendy and Craig who were there with their baby Cameron getting his follow up visit from his big heart surgery he had last week. Cameron has really done well and amazed everyone by going home less than a week after open heart surgery! I know Andrew's story will not be the same, but we are hoping that he will be able to have a quicker than expected recovery as well!

The cardiologist was able to get a good view of Andrew's heart and told us that everything at this point looks structurally normal. The only defect that they are not able to rule out until after he is born is a coarctation of the aorta. The other great news is that because he does not appear to have a heart defect and everything other than his hernia looks normal on ultrasound, the chances of him having a syndrome are very slim! The cardiologist did sort of say to himself as he was reviewing everything, "he sure does have a lot of stuff up there" which was not great to hear from a parent's point of view. His liver still appears to be completely down in his abdomen at this point and when I asked the cardiologist how severe his hernia looks he told us middle of the road. I do appreciate his honesty and am hoping that things will stay this way and not get any worse.

After our appointment, we met up with Wendy, Craig and baby Cameron at Fridays for lunch! It was so nice to spend time with another family who have been down a long road with medical problems and still have a great sense of humor! Gene and I really had a great time!