Tuesday, August 21, 2012

Ultrasound and Perinatology Appointment

Today Aaron and I had another level 2 ultrasound to get another look at Natalie's NTD and check on the hydrochphelus. Everything looked good with Natalie. The fluid is still building up in hear head, which is to be expected and the cerebellum is pulled down further into her spinal column, which is also normal. Last time Natalie was still so little that it was hard to get much of a look at her spine. Today they were able to view it really well. Last time they did not view much of a menengocele (sack of fluid at the point of the defect) and today they were. The perinatologist said it is not a huge protruding sack, but it is noticeable now. Everything else still looks great with all her other organs.

Here are a couple shots from the ultrasound:

Profile:


Defect:

After the ultrasound we were able to talk with the perinatologist about the delivery and how this is all going to come together. This is what we discussed:

What date are we looking at for the c-section? What time of day? When will it be scheduled?
It looks like October 31st is the best date right now. The perinatologist who I have been seeing is the head of the department and apparently either wants herself or one other doctor to deliver Natalie. She doesn’t want to schedule the section until after I am 39 weeks along but not too close to my due date and the neurosurgeon wants it to be in the beginning of the week, so this leaves very few options. I guess she is schedueled for l&d for Nov. 4th which is a Sunday and too close to my due date. The other doctor is on schedule for the 31st… so that is when she prefers. The genetics counselor who handles our case sent a message to the neurosurgeon to see if the dates are okay for him (since he will need to come evaluate Natalie on the 31st and then do her surgery the following day.) If he is not okay with this date, then it goes back to the perinatologist who will give a couple other dates, back to him for approval until we have everything scheduled. I was really not expecting to hear that she would be delivered on Halloween, so I am a bit shocked and disappointed at the moment. We won’t know the time of day until everyone agrees on the day and then it will be in the books. I am supposed to hear back tomorrow. We’ll see.

How long will I have to be admitted?
It depends on how my recovery goes. She said some women get discharged 2 days after surgery others need to stay longer. It just depends.

How much will I be able to be in the NICU with Natalie?
Because I will be a patient, I will have to have my vitals checked multiple times a day, be in my room for rounds, and all that stuff. So, I may not be able to be with her as much as I would like until I am discharged.

Will we need to do an amnio to check lung function before delivery?
No. The plan is to not deliver until 39 weeks so Natalie should be fully developed. If, for some reason, she is going to have to be delivered early and it was before 37 weeks, then they may do the amnio to check her lungs. Otherwise, no.

What is the contingency plan if she starts to come early or if I develop complications?
If I go into active labor I am to go to a local Kaiser to be checked. Then, if there is enough time, they will transfer me via ambulance to Roseville.

How often will we need to be back here for monitoring?
Not at all. There is nothing that could happen with Natalie in utero that will change their plan, so there is no more need for monitoring from the perinatologist.

We talked to Dr. McNatt about delayed cord cutting and he said it is fine with him. How do we accomplish this with a c-section?
It is fine for us to do delayed cord cutting provided there are no complications with Natalie or my health that require them to cut the cord earlier. The example she gave was if the placenta was cut or something like that. She said they will allow only 1 minute before cutting the cord, which I guess is better than nothing. I believe she said they will actually lay her on my tummy.

Can Aaron cut the cord?
No. It is a sterile field that he will not be allowed to go into.

Can I have Aaron and my mother in the OR? Or when Aaron leaves to go with Natalie can my mother then take his place?
Only one person can be in the room at a time. So, when Aaron leaves for the NICU with Natalie my mom can come in, but they cannot be in the OR at the same time.

Friday, August 17, 2012

Time Goes On...

The last couple weeks have been rough for me. I've been trying to keep my mind and body busy with sewing and crafting for Natalie's room, but it's still been pretty hard....

Next Tuesday we have a repeat ultrasound with the perinatologist to check on the fluid building up in Natalie's head and also to try and get a clearer picture of the neural tube defect. At the same time we are supposed to be doing the delivery planning, setting a date for delivery and getting all that stuff set up. I am anxious to get this over with so we can move forward with the last several weeks of this pregnancy.

So, as I said, I have been sewing and crafting for Natalie's room and today I was able to finish the curtains for her room! They are lined with blackout fabric so her room can get nice and dark during the day, keep out street lights at night (for when she eventually uses it for night sleeping) as well as helping regulate temperature in that room. We don't have the curtain rod yet, so I just hung them up in the office to see how they draped and make sure everything lined up and looked nice and.... I LOVE THEM! Yay! I also have the crib skirt mostly completed. I don't want to finish it until we have the crib up because I want to make sure they fit perfectly.

The crib... that's a whole issue in itself. *sigh* We finally got her room done this week (new window, removed and replaced baseboards, new closet doors, painted) and had a carpet cleaner come in to make her room safe and clean. On Wednesday we opened up the box the crib was in only to find one of the legs was broken :( I called Babies r Us and was able to take the piece in and get a replacement piece. The next day (last night) when we went in to put it together we found that the headboard piece was defective. The trim along the top was pulling apart from the main piece. So... I called, once again. At this point we asked them to just send us a brand new crib from the manufacturer, which they origionally said they could do. But, suddenly the story changed and our crib was not available for order at the moment. So, the resolution was to order the defective piece and give us a 20% refund on the price of the crib. Of course, now we have to wait 7-14 days to get this piece which does not make this momma happy AT ALL. But, it is what it is.

Anyway... here's a picture of the curtains :)