In the Silence

In my absence, the world has continued on. I have been behind on updating my blog, and perhaps purposely so. So much has happened since February that I'm not even sure where to begin, or what I wrote last.

I've walked through the valley lots this pregnancy, the valley of uncertainty. We've overcome stress on my heart, ruled out heart defects in my body, stressed over blood pressure issues that have resolved themselves.

I've taken three trips to labor and delivery, two for contractions. One for a possible fluid leak. We've watched our baby go from the 66th% to the 24th% and prayed that God would protect this miracle. We've sat in the Doctors office discussing duplicated collecting systems and fetal pyelectasis and what this means for our baby.

And me, well my body has gone through a fire of it's own kind. As my uterus has expanded, so has my pain. As my baby has grown, so has the ache in my back, the swelling in my hands and feet, the headaches that plague me. The contractions have gotten worse, the pressure is great. On Monday we were given a reason: I have polyhydramnios (excess amniotic fluid.) 

But there have so many good moments. So many joys. Laughing as those first dainty movements shook my belly. The smiles and squeals from my girls when the little child in my womb kicked them. The utter confusion and shock on my husband's face as he stared at the wall-screen in the ultrasound room and asked "What's that?" And how that turned to sheer joy and elation when he was told by the Tech that he was having a son. The chuckles that exploded as we realized that the lump in the top of my stomach was NOT a hernia, but is in fact the face of our child wedged between my rib cage, and how funny I must look every time I sit up.

God is good and faithful. Our boy, our precious Silas, may have some struggles when he enters this world. We won't really know for sure until he is actually here, but God is faithful in this season. As I drove to my appointment the other morning, praying for my child, God put this on my heart:

Sometimes Gods greatest glory is not in our divine healing, but in our being divinely upheld in our greatest trials.

Never Dull

Life is full of surprises. From that unexpected gift under the stocking to the car battery that dies overnight with no symptoms to tell of. I woke this morning and was impressed with myself, having gotten both kids dressed, fed, and out the door by my 715 deadline, headed to drop them off. We didn't make it past the driveway.

The battery died. Some days, you just have to be thankful for all the moments you missed. Today, I missed my appointment for my ultrasound, but I caught up with a friend and enjoyed a long afternoon nap. All in all, a good day.

Appointment rescheduled for next Monday.

Maternal Fetal Medicine: A Brief Overview of What to Expect

Monday is just around the corner.... Things they will check.

Nuchal translucency, this is the fluid at the back of the neck. If the NT number is high, it could mean a disorder of some sort.

They'll also take measurements of the baby's arm bones, femur, head circumference, distance across the head (biparietal diameter), circumference of the baby's abdomen. They'll measure fluid pockets around the baby. You hope for at least 10 ML of total amniotic fluid. My numbers usually are below that, which means the baby is at risk for complications later in pregnancy. They'll look for signs that the baby is swallowing fluid. This can be determined by looking at the kidneys. They'll check the four chambers of the heart, and the stomach.

They'll run a measurement of the blood flow through the umbilical cord and the placental pulse. These give an indication as to whether the baby is getting sufficient nutrients to sustain life and growth. I've run into problems here in the past as well. A decrease in blood flow can be dangerous, a reversal in blood flow is fatal in hours. With my oldest, her blood flow would stop intermittently near the end of pregnancy. They induced because the risk of it reversing once it stops is quite high.

They'll look at the placenta. In the past my placentas have been small, usually malformed. My youngest daughter's cord was too short. My oldest daughters placenta was over half dead at birth. This can be very dangerous. It's another factor that inhibits growth. When a placenta is too small or not functioning well, the baby's body will sometimes grow the vital organs at normal rates while the other organs suffer. The brain, heart, and lungs often develop faster than the kidneys, etc. This is why both my girls had trouble with blood sugar and body temperature after birth. It is also why my youngest had severe acid reflux at birth. Her body wasnt ready yet. Sometimes, in very sever cases, this kind of growth restriction can lead to multi-system organ failure.

After all that is done, they will watch for activity of the baby.

When you add all this up, calculate all the measurements. Assess all the risks, they will determine the following:
The gestation my baby measures at.
The likelihood of death in utero.
The overall health of my baby.
A treatment plan, if needed.

In the past, my babies have measured 2-6 weeks behind. Two weeks is not such a big deal, but as I get further along in the pregnancy, the numbers become more skewed. Six weeks is dangerous. To give an example, the difference in 6 weeks could be whether a baby can breathe on his own or not. Or whether he has a fully functioning brain or not. I've only lost two babies, and both were very early on, likely due to placenta problems. They weren't viable.

Even with all the risks, my babies generally do really well once they are born. It's the incubation inside my womb that seems to be the struggle.

Bedrest, lots of water, walking daily, and a balanced diet have always been the plan in the past. Oh yah, and no stress. Hahaha!

Sprouting Up!

Well, everything looked really good at my appointment on the 7th with my OB. Blood pressure was good 122/82. Weight was 193.6, down a few pounds from my pre-pregnancy weight. Happy for that. Also received good news about all my labs. Everything came back clean. No Gall Bladder Disease. No thyroid problems. No pre-eclampsia. Yay! We had a hard time getting the baby's heartbeat on the doppler, so the Nurse brought in a portable ultrasound and I saw the baby. Squirming around, that one is. Heartbeat was there, a little blink on the screen. So happy for that. Didn't get an actually heart beat per minute count, but I'm sure I'll get all those details on Monday. Monday's the big ultrasound. They'll take all the measurements, check the fluid, analyze the placenta, measure the baby. It's going to be good, I hope. Can't wait to see how this one is growing. :) All in all, a good appointment.

We are CONSTITUTIONALLY SMALL afterall!

So the girls had their 4 and 6 years well check ups, and once again I broached the issue of height/weight with our daughters' pediatrician. Dr. Ott is wonderful, and he sat down and explained to me why I don't have to be even a bit worried right now. The girls are both in the 3rd percentile for height. Hailey is also in the 3rd percentile for weight, and Clara is in the 25th for the same. However, when you factor in my height and my spouse's height, you come up with 5'3. Now, subtract 5 inches because they are girls and you get 4'10" as their GROWTH POTENTIAL. If you find 4'10" on the growth chart, it is the 3RD PERCENTILE for an adult female! How's that for special math! Yay! So, they'll monitor their growth and their weight and see what happens. More than likely, they will just be normally petite. But if they deviate below the 3rd percentile we may consider HGH supplements. But there's a good size window before we have to worry about that. So thankful for some relief in this realm of littleness.

Baby Gear Dilemma

With each of our girls we were so blessed to receive all the items we needed, and as our children grew out of those things, we passed them on to others in need. Over the years I have been able to pass on cribs, bassinets, pack n plays, swings, high chairs, car seats, strollers, clothes, boxes of diapers, etc. It is a wonderful feeling to know they are going to a family welcoming a new child into the world, one who needs the kindness of strangers. That leaves me in a pickle. With my youngest being four, I've passed forward all of our baby and toddler gear to people who could use it. So now, it's my turn to take a spin around the block again. Because we will be moving shortly before this baby is born, I hesitate to buy anything right now. But I am setting aside the funds to do so. At the same time, I don't want to wait til the last minute, have this little sprout early, and not have anything ready. What's an expectant mother to do? Do I buy the stuff now and have it all shipped to the new house, or do I store it in the walk-in closet until we move? Or do I just wait until after we move? Oh the choices.

Writings from Today

**These writing are not entirely true occurrences. They are part the rambling of my own conscience and part past experience, but very well depict how I feel and what I'm struggling with right now, for that, they are post-worthy**

A Mother's Worries

The day before Valentines Day, I will enter the office of a Maternal Fetal Medicine Specialist, for the second time in my life.

I will fill out pages of forms, sign my name a dozen times, and give my weight in blood. They will usher me into a room where I will wait, to speak to a Nurse about the possibilities awaiting me. And then, I will put on a gown and lie on a table, a cold, lifeless table. The Doctor will enter the room, almost cheery but more somber. She will spray blue gel on my flabby stomach and tell me two seconds too late that it might be cold. The screen above me will be on.

And for a second, I will see a whole life flashing before my eyes. It will be beautiful, precious, and scary. Because the moment I see this precious thing, this alien of my own blood and DNA, I will realize all my worst fears.

The news will filter through my ears like the teacher from Charlie Brown's cartoons. "Wah. Wah. Wah wah."

The gel will be wiped off, the screen turned away, and I will be left on the table to dress and wait some more. The Doctor will meet me in a sterile room with a desk, to talk about our "options" and "plan of treatment," as if there really were any other option than coming to grips with the reality that my perfect little creation is imperfect, and perhaps dangerously so.

The drive home will be a blur. I'll likely run a red light, or maybe only a yellow one, for the second time in my life.

But when I get home and all is quiet, the ache will begin in my heart. I will cry.
Not because I'm scared of the possibilities, but because sometimes loving hurts more than I can bare. Love is forever and unconditional.

So no matter what the ultrasound showed the morning before, on Valentine's Day I will get up and put on a smile. I will wear my heart on my sleeve and decorate Valentine's cards, for all of my children. The ones I've lost, the ones I've gained, and the ones I have yet to meet. Because love is forever, for me.

Stained Red by Life

Valentine's Day is fast approaching, and I'm dreading it. This year anyway. The truth is, it's mostly been a wonderful time in the past, but this year it feels tainted, somehow lost in the somberness of that appointment, in the reality that high risk is yet again the name for me and this child. That loving also means letting go, maybe sooner than you ever hoped. I love against all odds, and hope against all science that this baby will grow. That all the vital organs will be perfect. That small is the only problem we have. I hope against medicine and blood tests that chromosomal abnormalities will not happen to us. But the odds are stacked high, and not in our favor.

I've been through this before. I know how to navigate the appointments. I understand the risks. It's like a worn dirt road with familiar bends and pitfalls.

No one quite seems to understand it. My friends dismiss my worries, even the diagnosis from the Dr becomes some cute little reassurance in their ears, echoed back to me in my own. It hurts, a dull knowing ache for their ignorance. For them, it really is bliss. "Your babies are just small" they chime. It gives me migraines every time I hear the words. They seem to fail to understand the very definition of the diagnosis: Intrauterine Growth Restriction is the failure of a fetus to grow to its potential size, NOT excluding genetic factors.

Yes, we are small people, but the diagnosis takes that into account. And there are other markers, other complications, that we have to handle. It's not so cut-and-dry as my friends make it. "Your babies are just peanuts," they remind me when I tell them of my appointment at the specialist office. I just smile and walk away, thankful for their optimism, how ever unfounded it may be.