You know what really isn't pleasant? Showing up for your first NST (Fetal assessment), and having the person administering the test exclaim that you're being seen a LOT more frequently than most people. Then, having that person look at your chart, and non-challantly say "ooh, that's why". My chart says that I'm high risk due to IUGR.
Thanks, Lady.
Little Miss did just fine on her NST, although she wasn't as reactive as they would have liked, eventually she started kicking up a storm, and they got adequate results. Apparently they don't like to do NST assesments prior to 28 weeks, but I guess they make special exceptions.
Here's my patient itinerary, for the next couple weeks:
Friday, March 11, 2011
9:30 U/S AFI Doppler - 15 minutes
10:00 Fetal NST F/UP- 45 minutes
11:00 MFM F/UP- 30 minutes
13:30 NICU Consult - 60 minutes
Tuesday, March 15, 2011
9:15 Fetal NST F/UP - 45 minutes
Friday, March 18, 2011
9:00 U/S Clinic OB Scan- 45 minutes
10:00 Fetal NST F/UP- 45 minutes
11:00 MFM F/UP- 30 minutes
I know the schedule can change at any time depending on how things go at each appointment, but it sure does amount to a lot of time spent at that hospital.
Our NICU consult is with Dr. A, a neonatologist, who happens to have a phD in ethical issues in neonatal decision-making. A lot of the reading I've done seems to indicate a high likelihood of morbidity (long term health problems) in iugr babies, and our plan of action might be different once we get a chance to talk with this Dr.
I'm glad they give us an hour, I am already planning out all the questions I can think of at the moment.
I had another look at my S/D ratios from last week, and two weeks prior. The resistance levels are definitely increasing, so I'm hoping that by some miracle they go down by Friday, or that they at least stay positive, and not absent-end, or reverse flow. From the research papers I've been glued to, she needs to make it to 28 weeks, regardless of weight, and she needs to do that before her flow goes absent. Only two more weeks.
14 days. If she can get to 31 weeks, she's golden, that's only 5 weeks away.
Tuesday, March 8, 2011
Monday, March 7, 2011
Monday, March 7, 2011
Today was beautiful outside, and I had a looooong nap lying on the chaise longue in my parents' sun room. It was delightful.
Tomorrow is my first (of this pregnancy) non-stress test, and my first at Women's. I know that usually they only take 20-40 minutes or so, and are more boring than anything else.
I haven't noticed Ellie moving as much recently, and I'm hoping that's just because I've been preoccupied. Friday cannot come soon enough.
Now I'm praying that we make it to 28 weeks with good blood flow, at the very, very least.
Tomorrow is my first (of this pregnancy) non-stress test, and my first at Women's. I know that usually they only take 20-40 minutes or so, and are more boring than anything else.
I haven't noticed Ellie moving as much recently, and I'm hoping that's just because I've been preoccupied. Friday cannot come soon enough.
Now I'm praying that we make it to 28 weeks with good blood flow, at the very, very least.
Saturday, March 5, 2011
Saturday, March 5, 2011
I'm so tired. Physically exhausted, and mentally drained. I think I read too much into everything, but honestly, when I think about it, I have a really bad feeling about how this is all going to work out.
It's almost impossible to find any useful information on Dr.Google. I was looking for a chart to convert weight and growth percentiles to actual measurements. I know that Ellie was measuring 23w3-4d yesterday, and her weight was in the 4th percentile.
In my head, all I can think of is what that pediatrician said. Babies born over 750grams do a lot better than babies who are born weighing less than that. According to one calculator, the 4th percentile, at 25 weeks is almost 450grams. According to another, it's 627 grams. That's a huge difference. I think I should really take a pad and pencil with me next appointment so that I can write all this down!
According to one website: Due to many recent advances, more than 90% of premature babies who weigh 800 grams or more (a little less than 2 pounds) survive. Those who weigh more than 500 grams (a little more than 1 pound) have a more than 60% chance of survival, although their chances of complications are greater.
No wonder the mfm yesterday was talking about E not having reached viability. Sure, her lungs and brains are (hopefully, probably) more developed than a 24 weeker, but the rest of her is too small to even stand a chance.
I feel sick to my stomach thinking about it. People keep asking me how I'm doing, you know, mentally. I'm a fucking disaster. Of course, I don't say that. I say I'm doing the best I can (which I am) and whatever happens, happens. I'm not bonding with my baby, I refuse to do anything in her nursery. I won't finish her bedding, I don't want to paint, I don't want to buy clothes, or accessories, or anything else, until she's OUT and she's fighting. I just don't think I can handle it. As it is, every time I walk by her room - which at the moment is overflowing with her brother's outgrown baby clothes- I want to cry.
So, how long is it going to take her to gain that weight?! HOW LONG? Will she gain it before the flow from her to me stops?
For the record, perinatology.com is a good resource.
http://www.baby2see.com/medical/charts.html is a little confusing, and gives lower scores.
It's almost impossible to find any useful information on Dr.Google. I was looking for a chart to convert weight and growth percentiles to actual measurements. I know that Ellie was measuring 23w3-4d yesterday, and her weight was in the 4th percentile.
In my head, all I can think of is what that pediatrician said. Babies born over 750grams do a lot better than babies who are born weighing less than that. According to one calculator, the 4th percentile, at 25 weeks is almost 450grams. According to another, it's 627 grams. That's a huge difference. I think I should really take a pad and pencil with me next appointment so that I can write all this down!
According to one website: Due to many recent advances, more than 90% of premature babies who weigh 800 grams or more (a little less than 2 pounds) survive. Those who weigh more than 500 grams (a little more than 1 pound) have a more than 60% chance of survival, although their chances of complications are greater.
No wonder the mfm yesterday was talking about E not having reached viability. Sure, her lungs and brains are (hopefully, probably) more developed than a 24 weeker, but the rest of her is too small to even stand a chance.
I feel sick to my stomach thinking about it. People keep asking me how I'm doing, you know, mentally. I'm a fucking disaster. Of course, I don't say that. I say I'm doing the best I can (which I am) and whatever happens, happens. I'm not bonding with my baby, I refuse to do anything in her nursery. I won't finish her bedding, I don't want to paint, I don't want to buy clothes, or accessories, or anything else, until she's OUT and she's fighting. I just don't think I can handle it. As it is, every time I walk by her room - which at the moment is overflowing with her brother's outgrown baby clothes- I want to cry.
So, how long is it going to take her to gain that weight?! HOW LONG? Will she gain it before the flow from her to me stops?
For the record, perinatology.com is a good resource.
http://www.baby2see.com/medical/charts.html is a little confusing, and gives lower scores.
Friday, March 4, 2011
Stupid Google
I'm doing a really, really good job of freaking myself out over the cord flow study from today. Bad things happen when you combine a little knowledge and the internet.
In my case, I know that two weeks ago, my S/D ratio was 4.1, this week it was over 5. The Resistance index last scan was 0.80, and this time it's 0.83, which means it's increasing.
When she was talking about the S/D ratio, she said, as long as there is a number, that's all we have to worry about for now, so I started thinking, how do you not get a number? Well, that's easy, if there's no diastolic flow, you don't get a number, instead they call it Absent flow.
Ah, the things I get to worry about until next Friday. JOY.
In my case, I know that two weeks ago, my S/D ratio was 4.1, this week it was over 5. The Resistance index last scan was 0.80, and this time it's 0.83, which means it's increasing.
When she was talking about the S/D ratio, she said, as long as there is a number, that's all we have to worry about for now, so I started thinking, how do you not get a number? Well, that's easy, if there's no diastolic flow, you don't get a number, instead they call it Absent flow.
Ah, the things I get to worry about until next Friday. JOY.
Friday, March 4, 2011
Well, I guess it was okay!
She grew 10 days worth in 16 days, which is acceptable. At least she grew!!
According to them, I'm 25w3d, and she's measuring 23w3d, so two weeks behind. Her measurements were:
BPD <1% (she said not to worry about this number, it only indicates head shape or something...)
HC 18%
AC 4%
FL 8%
They said she's showing signs of head sparing, which is good, and wasn't there last scan. Cord blood flow resistance was higher than last scan, but still okay. My cervix was NORMAL!
The mfm today talked about viability. According to her, it's more based on the baby's size than the actual number of weeks you are gestating at. Ellie is 4 "days" away from viability, but given that she's growing at 62.5%, it will take her closer to a week to reach that magical weight.
So, starting on Tuesday, I'm to go in for twice weekly NST monitoring (looks like Tuesdays and Fridays), and then weekly ultrasounds. Every Friday, they'll look at her amniotic fluid levels (which were a little lower than last scan) and the cord flow . Every other Friday they will be looking at growth, since you need about two weeks between growth scans to be able to tell anything significant.
Depending on how things go, they will either increase the frequency of the monitoring, or decrease it. I don't need to tell you which one I'm hoping for!! Every Friday, after my u/s, I'll meet with the mfm docs, and go over the reports for the week.
She drew out a diagram of what they look for when they do the cord doppler studies. She showed normal, absent, and reverse. We're still normal, but I could definitely tell a difference between this one and the one two weeks ago. It's getting a lot closer to absent...
She talked steroids again. Mentioned that they like to administer them at least 48 hours prior to the birth, and not more than 2 weeks out. She said this week since things were still okay, we'd hold off, but that they'll talk about it again at every appointment.
I asked if I would have to have a c-section if they decide she would do better on the outside, in the nicu (which I'm touring on Friday). She said that if I have to have Ellie because my placenta gives out, then yes, I probably will have to have a section. I'm starting to prepare myself for that. I know all that matters is that our little peanut comes out alright. Today, she was presenting frank breech, with her feet above her head, which was pretty funny to see
So, that's my update. I'm still on bed rest, since it's clearly working. They are going to keep me on bed rest until Ellie reaches 32 weeks (who knows how far along that means I will have to be!)
Thanks for all the support
She grew 10 days worth in 16 days, which is acceptable. At least she grew!!
According to them, I'm 25w3d, and she's measuring 23w3d, so two weeks behind. Her measurements were:
BPD <1% (she said not to worry about this number, it only indicates head shape or something...)
HC 18%
AC 4%
FL 8%
They said she's showing signs of head sparing, which is good, and wasn't there last scan. Cord blood flow resistance was higher than last scan, but still okay. My cervix was NORMAL!
The mfm today talked about viability. According to her, it's more based on the baby's size than the actual number of weeks you are gestating at. Ellie is 4 "days" away from viability, but given that she's growing at 62.5%, it will take her closer to a week to reach that magical weight.
So, starting on Tuesday, I'm to go in for twice weekly NST monitoring (looks like Tuesdays and Fridays), and then weekly ultrasounds. Every Friday, they'll look at her amniotic fluid levels (which were a little lower than last scan) and the cord flow . Every other Friday they will be looking at growth, since you need about two weeks between growth scans to be able to tell anything significant.
Depending on how things go, they will either increase the frequency of the monitoring, or decrease it. I don't need to tell you which one I'm hoping for!! Every Friday, after my u/s, I'll meet with the mfm docs, and go over the reports for the week.
She drew out a diagram of what they look for when they do the cord doppler studies. She showed normal, absent, and reverse. We're still normal, but I could definitely tell a difference between this one and the one two weeks ago. It's getting a lot closer to absent...
She talked steroids again. Mentioned that they like to administer them at least 48 hours prior to the birth, and not more than 2 weeks out. She said this week since things were still okay, we'd hold off, but that they'll talk about it again at every appointment.
I asked if I would have to have a c-section if they decide she would do better on the outside, in the nicu (which I'm touring on Friday). She said that if I have to have Ellie because my placenta gives out, then yes, I probably will have to have a section. I'm starting to prepare myself for that. I know all that matters is that our little peanut comes out alright. Today, she was presenting frank breech, with her feet above her head, which was pretty funny to see
So, that's my update. I'm still on bed rest, since it's clearly working. They are going to keep me on bed rest until Ellie reaches 32 weeks (who knows how far along that means I will have to be!)
Thanks for all the support
Thursday, March 3, 2011
More blood work...
I had completely forgotten that I was supposed to get bloodwork done before my appointment tomorrow. They faxed the requistion a week ago, but I just remembered. I got there at 3:57pm... they close at 4:00!!! So, I got my tests done, no idea when they are going to be back. According to the requisition, they were testing for toxoplasmosis IgM and IgG.
When I got there, the nurse (who is the same one who did ALL my beta draws from the beginning til like 10 weeks) looked up the requisition, and said, "Oh, prenatal? Have you had any other tests done?" I told her that I was 25 weeks, and that my baby wasn't growing enough so they were trying to rule out infection. She looked at me, sort of shocked, and said, "Ah, that makes sense, you're TINY for 25 weeks". Thanks a whole effing lot. I really wish that my outings were more pleasant than just going out for ultrasounds, bloodwork and appointments. Really!!!
Toxoplasmosis is that cat-related disease. EWW. I hate cats. I am pretty sure that it's going to come back negative, but they're just trying to rule out all the reasons that Ellie is little.
Maybe she's grown, tomorrow is coming up quickly, I just want to get it all over with.
When I got there, the nurse (who is the same one who did ALL my beta draws from the beginning til like 10 weeks) looked up the requisition, and said, "Oh, prenatal? Have you had any other tests done?" I told her that I was 25 weeks, and that my baby wasn't growing enough so they were trying to rule out infection. She looked at me, sort of shocked, and said, "Ah, that makes sense, you're TINY for 25 weeks". Thanks a whole effing lot. I really wish that my outings were more pleasant than just going out for ultrasounds, bloodwork and appointments. Really!!!
Toxoplasmosis is that cat-related disease. EWW. I hate cats. I am pretty sure that it's going to come back negative, but they're just trying to rule out all the reasons that Ellie is little.
Maybe she's grown, tomorrow is coming up quickly, I just want to get it all over with.
Tuesday, March 1, 2011
tuesday, march 1, 2011
I haven't posted in days! - forgot my laptop at home and my parents' computer is on the wrong floor and frustratingly slow. - have been keeping busy' trying not to worry about my next appoitment -on Friday, if you were wondering. My mom has been so, so great. She has so many activities planned for jake, that he naps for hours daily. I am feeling the effects of being primarily sedentary. I have gained weight, although I'm certain it is well within the realm of where I should be, it is difficult getting flabby at the same time. My hips are ridiculously sore. Both of them!! I find it brutal getting up to waddle tot the washroom, and then nearly cry when I have to sit down again. Today, I thought about having a bath to ease the discomfort, but the thought of getting into the bath was enough to scare me oyt of the idea...
It is Wednesday tomorrow... we are going home tomorrow evening. I have more work to organize. I love going home, but my stress level definitely rises. I am completely anxious about my ultrasound and appointment on Friday.
It is Wednesday tomorrow... we are going home tomorrow evening. I have more work to organize. I love going home, but my stress level definitely rises. I am completely anxious about my ultrasound and appointment on Friday.
Subscribe to:
Posts (Atom)