Today we met with the perinatologist, which I will refer to as MFM from now on (maternalfetal medicine) because it's quicker to type, for the first time. And had our 20 week level II anatomy ultrasound. AND had bloodwork drawn. All in the same afternoon. I was gone for 5 hours while my sweet friend Virginia stayed at my house and played with all 5 of my kids while our sweet friend Amanda stayed at HER house and watched Virginia's kids so that we could go alone and no one would be at risk of catching last weekend's bug in case it's still lingering around here somewhere. And Virginia scrubbed out my fridge while I was gone.
Isn't that amazing? I know you're here to hear about the appointment, but none of it would have been possible without those two, so....well...super love and prayers for them!
Okay, MFM. I kind of don't know where to start. This might be a long one...
We didn't realized we'd be getting the full level II anatomy scan today, but we did and we were glad. Do you know what's hard? Using an ultrasound machine with no fluid around the baby. But luckily the u/s tech was pro, pro, pro and managed to find and measure almost every single body part and organ. Incredible. One of the only things she was a little iffy on was, you guessed it, the gender. Dagnabit! But she kept trying and after a bit she said "If you maaaaaaaaaaaaade me guess, like if I HAD to say one or the other right now, I would say this is a boy." Insert arrow onto screen.
And then I was all "I see it! Yes, I agree."
Of course this probably means it's really a girl and she'll throw another loop into this story on her birthday, but until then little dude will be named Nicholas Robert Borobia.
Niiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiicholaaaaaaaaaaaaaaaaaaaaaaaas! (like those Ricola commercials, claro que si.)
As for fluid levels, they were basically nil. Like, immeasurable at the beginning. But even in the span of the ultrasound, they increased enough that she could have measured almost a centimeter (AFI level of 1). Pee baby, pee!
The other bummer is that he has, until now, measured right on with his gestational age. But now he is starting to measure small because it is difficult for him to grow against the sides of uterus as opposed to growing against fluid- too much resistance against his itty bitty body.
But otherwise he looks totally healthy. Look at all those little organs! Look at that beating heart! Look at all them brain sections! It was so fun to see. I could have watched him all day long. Happy happy.
After the ultrasound of many many moons, it was time to chat with our new specialist. It's hard for me to remember the order of how things went, so maybe I can just give you my list of questions and the answers he gave afterward? Bueno? And then maybe if one day someone with the same condition (PPROM) is reading this, they can have some questions answered, too.
Q: Is there a cause or a way to prevent subchorionic hematomas, the devil behind the ruptured membranes?
A: Unfortunately, and fortunately, no. You did nothing wrong to cause them and there isn't anything you can avoid doing in the future to prevent them.
Q: What are the best things we can do from now until viability and then beyond?
A: Fluid. Hydration, hydration, hydration. If you had no other children at home to take care of, I'd tell you to lie down during the day. There's no guarantee that will help, but it certainly wouldn't hurt.
(NB: so even though I have 5 children at home, I'm going to do this as much as possible anyway)
Q: What are the health challenges we can anticipate if baby is born after 24 weeks?
A: The biggest concern is going to be respiratory problems. Aspirating the amniotic fluid is mandatory for proper lung development. If baby can aspirate enough in the next four weeks (by week 22), then a steroid injection at 24 weeks will help baby be ready to breathe outside the womb. If the lungs are not physically developed to begin with, a steroid injection won't do anything.
Q: Is there likely a single tear or an overall degradation of the amniotic sac? Is it possible that it will heal itself?
A: When PPROM is caused by a subchorionic hematoma, the reason the sac fails is because your body sends white blood vessels to break down the blood clot. In breaking down the blood clot, the white blood vessels also break down the amniotic sac, which the clot was pressed up against. Because of this, there is probably no chance that the hole in the sac will heal itself.
Q: Will I have to be hospitalized?
(insert hyperventilation followed by catatonic state here)
Viability day, 24 weeks, is August 2nd. If we make it that far, and I can't imagine why we wouldn't given that we've already made it THIS far, mama (that's me) and baby (that's Nicholas) will be admitted to the hospital until delivery.
Two things I do not like: 1) being trapped and 2) being away from my family. I hate that growing in holiness, in any way really, requires doing the things you don't like to do. You don't get fit by lifting weights that aren't heavy for you, ya know? And man....these are my heavy weights for sure.
But we have a good 6 weeks before all that happens. So I have to just take one day at a time. Figure things out. Get things in order. And you know what else? The amazing laundry room project you guys have going on doesn't really seem as much like a luxury now as it did a few days ago. You know why? Because if in 6 weeks my husband is single parenting 5 children (somehow. I don't know how. We'll figure it out.) and people and family and friends and someone is going to be helping with the laundry, I can't really also ask them to empty a dirty water bucket, can I? Or tell them there's no dryer, you know? It's enough that they're going to be doing our chores for us! OR, my kids can actually do the laundry on their own, which they cannot do now with said bucket + potential electrocution situation. Providential, my friends. Providential.
Alright, this is getting long. What have I missed? Oh! We were stoked to confirm that the MFM is proudly a pro-life Catholic- he announced as much during the meeting before we ever mentioned anything about it. That gave me a lot of peace, knowing that he wouldn't bat an eye at us having our priest visit or on hand to baptize the baby or anything like that. Aaaaaaaaaaaand he prayed for us at the end of the meeting. It was very sweet and wonderful and I've just never had anything like that happen before.
So. Deep breath. Heeeeeeeeeere we go!
|unrelated photo of Mary eating her first cupcake on her first birthday....|