The doctors have finally collaborated and agreed upon a due date and arrival method for Miss. Brynn. August 17th at 7:30am by scheduled C-section! Tony and I were relieved and excited to finally have a time frame in mind and to know how Brynn will arrive. At least if everything goes according to plan...
This last week has already brought several surprises and unexpected forks in the road. As you might have read on Facebook earlier this week, all of the "back spasms" I have been having are actually contractions. This was discovered at 12:30am last Saturday after they started happening every five minutes. A trip to labor and deliver and five long hours on the monitor confirmed this. Luckily, IV fluids and a very low dose of morphine was able to slow, then completely stop, the contractions. They are not entirely sure what was causing the contractions (blood and urine work ruled out a kidney stone or UTI) which is a little scary because that means they could come back. I am trying to stay hydrated and as well rested as possible.
This is proving to be somewhat difficult since my OBGYN has refused to allow me any disability leave before the C-section. The August 5th date we had agreed upon last week was changed to August 15th (yes, two days before I am supposed to deliver) after the C-section was scheduled. Luckily, I am blessed to have very understanding co-workers and supervisors who are looking the other way at my coming in to the office for only 2-3 hours a day.
We were also informed on Tuesday that the cardiology team now believes that something environmental must be causing the PDA to restrict. They have asked me to start keeping a strict food journal and to stop all medications. This news is frustrating since the first question I asked six weeks ago was "Is there anything I could be doing or not doing that might be causing the restriction?" and was reassured over and over again that there was nothing to support this claim. There still isn't any literature or study that supports the claim but the doctors are trying anything they can in an effort to stop the restriction.
Today was a somewhat difficult appointment at the Heart Center. Dr. Doom is proving to actually be much more caring and knowledgeable then we originally gave her credit for but she still likes to give us bad news so the name has stuck. :) The scans confirmed continued PDA restriction. Luckily, there is still no fluid around the heart and the pulmonary artery is only slightly smaller than it should be (indicating that the restricted PDA hasn't restricted blood flow and growth to other areas of the heart).
The doctor shared that she has spoken to several pediatric cardiologist from Canada to Florida, including the "grandfather" of pediatric cardiology who literally "wrote the textbook" and that none of them have ever seen PDA restriction in HRHS babies. For this reason, the doctors simply do not know what will happen after Brynn is born. She is currently being exposed to prostaglandins in utero but the hope is that they will be administered at a higher dose after she is born and this will allow the PDA to stop restricting long enough (hopefully several weeks) to give her the best chances for a successful shunt operation. If her oxygen stats are too low (say in the 30s) she will need immediate surgery (they have blocked off the OR the morning of her delivery to prepare for this scenario). However, this can be difficult since the shunt they will have to use might be too big for her premature heart, causing too much blood flow and causing her heart to work too hard. She will then most likely need tube feedings on special formula to speed her growth so that she can grow into her shunt. The doctor told us it is reasonable to believe that even a very sick baby like Brynn might be will be able to gain enough weight quickly to decrease the strain on her heart.
Best case scenario, her stats are stable enough (at least in the 60s or 70s) that she can spend a few more weeks growing after she is born before undergoing the operation. In the meantime, the continued restriction still worries the doctors so they are going to have me take steroids to help mature Brynn's lungs in case they decide to deliver her early. They are hoping that the restriction will have not progressed even more when we go in next week, increasing our chances of a crash c-section.
Tony and I are of course hoping for the same thing. I wasn't sure we would make it to 36 weeks when they gave us the news six weeks ago about the PDA so if we do make it to our scheduled delivery date it will be a miracle in and of itself. We continue to prepare for her arrival, and are so grateful for the time we have been given to get as prepared as possible for her birth and delivery. Please pray that Brynn is able to hang in there a few more weeks and that the doctor's predictions and hopes for a stable delivery are correct. We are holding on to the fact our baby's kicks and movements are strong and that her premature arrival is just another sign of how she simply can't wait to be with us.
Erin -
ReplyDeleteI think it is really wrong that your OB won't "grant" you maternity leave until 8/15. California law allows 4 months of paid disability leave during pregnancy in the case of complications (even severe morning sickness counts!). It certainly seems like you qualify for a complicated pregnancy, especially since you had to be hospitalized to stop contractions at 33 weeks! It is a well known fact that rest is one of the treatments for early labor.
In any case, you and Tony are incredibly strong and handling this so well. I am so proud of you and Brynn is a very lucky little girl to have you for her parents. All three of you are in my thoughts and you have my very best wishes.
~Carolyn