baby update 13

Wow... Where do I begin? =) Well, let's see... I have been in the hospital now for 10 days. Seeing that I have a ton of extra time to kill (or to try to redeem)... and seeing that Bill has been super busy, doing a super job I might add, caring for William, working, taking care of the house, and bringing William here (and dinner!) everyday so I can see him... I am going to do my best to share what has been going on before too much else happens and everything becomes a blur. My mind is blurry enough when there's nothing going on. SO, I will be attempting to record all that has happened as I piece together Bill's update emails and the fragments from my own memory. =) Hope it all makes sense...

Last, last Tues, (2/24), we went to see the high-risk ob (perinatologist) for a follow-up appt from my previous visit to the hospital. There, they did an ultrasound and found that the baby has:
- Low birth weight: Josiah appears to be 3.5 pounds, about 4 weeks behind where he should be.
- Low amniotic fluid: Most of this consists of urine, and since Josiah doesn't appear to be getting the nourishment he needs, he's urinating less.
- Doppler: showed that the blood flow in the umbilical cord and brain is minimal. However, the fetal movements are strong, so we should not be worried at this point about developmental issues.
- There was one more thing they measured, but I can't remember what it was at this point.

All these points were at the bottom end of the charts... around the bottom 5% or so. They were all on the edge so that if just one thing got worse, the perinatologist would push for an immediate c-section.

The perinatologist also spoke in a lot of analogies. He's Jewish and reminded Bill of Jesus speaking in parables. He's also really funny and honest, but very caring. (I would highly recommend him to anyone in need of a high-risk ob. We love him.) The two analogies he most often talked about were that this is a war going on, and we're in a safe house right now. But if the war escalates, then it might be time to leave the house. So basically, we are waiting to find the right time to leave the house. The other analogy he used is that we're a giant boulder on the edge of a cliff. We're holding steady for now, but the smallest thing could push us over.

At the time, the perinatologist said his gut feeling was that I'd have to deliver sometime this week, and the baby would have to stay in the NICU for a while. But the max that they would let this go is 37 weeks.

Because my blood pressure was also high, the perinatologist sent me to the hospital right away to get things checked out and to make sure I didn't have pre-eclampsia (pregnancy-induced hypertension).

Our ob decided to keep me overnight for monitoring until all the testing could be done. He wanted to be sure everything was ok before sending me home.

Wednesday, 2/25
Originally, I would have been released on this day, but I began to have contractions late the night before. They put me back on an IV, and the fluids seemed to be slowing them down to 4/hour. But I would not be allowed to leave until the contractions stopped for an hour or 2.

Another ultrasound was done and the baby looked good. We got an amazing view of his face and watched his eyes turn towards the ultrasound instrument that was poking him. The ob also said the blood flow through the umbilical cord was not a consistent thing and with repositioning, the flow would increase, but not up to normal levels.

We had a NICU consult, and it sounded encouraging. He explained the likely risks the baby would experience being pre-term, but said they were all manageable. He even said that if Josiah makes it to 4 pounds and doesn't have any complications, he might go to the nursery instead of the NICU. We're not sure how likely that is, but it's a possibility. Much of the prognosis will depend on Josiah's size ratios after he is born. Assuming there are no developmental/neurological issues, he said Josiah should be able to catch up in 3-6 months.

Thursday, 2/26
Not a ton of new stuff today. My contractions had lessened to about 3-4/half-hour, but I had begun to slightly feel a few of them. My test results also had come back, and I do not have pre-elampsia. However, I have borderline hypertension (high blood pressure).

Friday, 2/27
The perinatologist came today and did another ultrasound. Found that the amniotic fluid decreased from 6.5 mm to 5.0 mm. If it had gone below 5, they would have done a c-section right away. I guess anything below 5 is considered life-threateningly low. However, there was positive blood flow across the umbilical cord. So that was something to be thankful for.

We had a doc come in from our ob practice whom we hadn't met before, and she was an absolute gift from God. She took the time to have us tell her our understanding of what has been going on. And she said she was trying to figure out herself at what point we just go ahead and do the c-section. She was seriously tracking with Bill and speaking his language. He had been struggling/thinking about that all along. So here's what came out of our conversation with her...
- The continued contractions have not affected the baby and his movements are still good.
- My blood pressure is borderline, right below official hypertension. It has been going way up and way down, but if it should increase and stay consistently high, that would be reason to do a c-section regardless of how the baby is doing.
- Normal fluid levels for a pregnancy this far along is somewhere in the teens, measured by millimeters. Right now, we are at 5.0 mm, even with me pounding water and having a continuous IV.
- Reasons why they would do an immediate c-section are if the fluid levels drop below 5, the baby's heart rate drops for a minute or more during a contraction, I go into labor, or if I begin to actively bleed.
- She seemed to agree with the other docs that it probably won't be more than a week, but I will most likely be at the hospital until I deliver.

Tuesday, 3/3
- My blood pressure continued to be all over the place, but not dangerously high yet.

- Over the weekend, my contractions started to pick up and 2 of them caused decelerations in Josiah's heart rate. Our ob came rushing in as that is definitely one of the big things they are keeping an eye on. The baby was able to recover well on his own. In God's kindness, we haven't seen any decelerations (decels) with the contractions since then.

- My contractions were still occurring, but not as regularly as before. They had been pretty up and down... as many as 4/half-hour to 1/hour or two... or sometimes none for an extended period of time, just considered "uterine irritation."

- Due to the decels and blood pressure spikes, the perinatologist wants me to stay at least until next Tuesday (3/10) to see if there is any growth in the baby. He also found that the fluids are up now to 7.5 mm. He also said that the fluids had never gone down to 5, but that he could see why the other doc would think so depending on how she looked at the ultrasound. The good news is that the fluids have increased, which hopefully means that the baby has been receiving more nutrients. God is indeed kind.

- Because of my higher blood pressure spikes, they are doing another 24-hour test for pre-eclampsia.

- The ob that delivered William (via c-section) works on Tuesdays, so she might be bringing in the next Davidson baby, either at 36 or 37 weeks. Next week is 36, and if the baby hasn't been growing well, she said she'd be doing the c-section that day. She even asked me not to eat anything that morning, just in case.

We would love your continued prayers for our family, especially to walk faithfully through what He has for us.