Everything is still looking good. The MRI confirmed last week's measurements and this week's measurements were pretty much the same. (The CVR, for those of you who even remember how we are measuring, is at about .3.) The MRI showed that Baby's right lung is at full capacity--it has recovered well from being squished by the heart. The heart is almost back to where it belongs. The radiologist was able to see some lung tissue on the left side (this is a first), but even on the MRI, it was hard to distinguish between the mass and lung tissue, so we don't know how much lung tissue is there. The MRI also confirmed what we've thought all along--the mass is a combination of BPS and CCAM. Because of the good things we've seen in the last couple of weeks, we are back to thinking that we can wait for Baby to grow a bit before doing surgery.
You may remember that a couple of weeks ago, we decided to switch to the U of M for delivery. Now the transfer of care is actually happening. I'll see my midwife for the last time later today, and from here on out we'll do everything at the U of M. We'll see the same team of doctors who have been monitory Baby, but there are a few more of them at the U of M, so we'll probably be seeing some unfamiliar people again. It's really strange to be "starting over" at this point. The location is different; some of the doctors are different; scheduling is really different, since I can't just call for an appointment--I have to have a doctor request the appointment, since it's not a normal OB/GYN. It makes me a little nervous, but I know there's no reason to be. We made sure to get the phone numbers and instructions for when we go into labor or have questions, so as long as we have a route mapped out to the hospital, we'll be fine. Six weeks (or less) left! Can't wait until we're on the other side of delivery and I can say, "Remember how nervous and confused I was? If only I'd known how well it would all turn out..."
Wednesday, March 30, 2011
Wednesday, March 23, 2011
33-Week Ultrasound and MRI
Between driving the kids to where they needed to go and getting to appointments today, I managed to arrive everywhere almost on time and not once did I drive into a snowbank! I also didn't have too much trouble with the "no food or drink after 11:00" rule for the MRI. I was worried, since I knew my ultrasound would take from 10:15 until about 11, but I munched on granola and yogurt all morning and then I snuck granola bars in to the ultrasound room with me and it worked out just fine.
The ultrasound was very encouraging today. For some reason, they were able to get a better look at the BPS than last week and were able to measure it. It looks like it has shrunk dramatically in the last two weeks--to about half it's previous size. It's strange, since it had remained the same size for so long before that. But we'll just chalk it up to the fact that God is God and he'll take care of this thing however he sees fit. :) The doctor said that, given this turn of events, she expects Baby to have significantly less breathing trouble than she was anticipating before.
I didn't have too much trouble with the MRI, which was great. My sinuses are doing pretty well, but I took Sudafed beforehand, just to be sure. On the machine I was in, the tube was open on both ends, so that made me feel much less trapped. I figured I could wiggle my way out in an emergency. :) It also helped to keep my eyes closed most of the time and not look at the tube I was stuck in. They let me lay on my side (couldn't have made it that whole time on my back) and listen to KTIS. Unfortunately, KTIS is doing a fund drive this week. Bummer. But it really didn't matter much, since the noises and vibrations from the MRI were louder than the radio and very distracting. I tried to pray, but again, it was too hard to ignore the clicking and whirring. So I just laid there and thought about how uncooperative my wiggly baby was being. :) I was getting restless by the end and was tempted to be uncooperative, too, but all in all, it wasn't so bad. We will hopefully find out the results tomorrow, so I'll put another post up when we know more.
The ultrasound was very encouraging today. For some reason, they were able to get a better look at the BPS than last week and were able to measure it. It looks like it has shrunk dramatically in the last two weeks--to about half it's previous size. It's strange, since it had remained the same size for so long before that. But we'll just chalk it up to the fact that God is God and he'll take care of this thing however he sees fit. :) The doctor said that, given this turn of events, she expects Baby to have significantly less breathing trouble than she was anticipating before.
I didn't have too much trouble with the MRI, which was great. My sinuses are doing pretty well, but I took Sudafed beforehand, just to be sure. On the machine I was in, the tube was open on both ends, so that made me feel much less trapped. I figured I could wiggle my way out in an emergency. :) It also helped to keep my eyes closed most of the time and not look at the tube I was stuck in. They let me lay on my side (couldn't have made it that whole time on my back) and listen to KTIS. Unfortunately, KTIS is doing a fund drive this week. Bummer. But it really didn't matter much, since the noises and vibrations from the MRI were louder than the radio and very distracting. I tried to pray, but again, it was too hard to ignore the clicking and whirring. So I just laid there and thought about how uncooperative my wiggly baby was being. :) I was getting restless by the end and was tempted to be uncooperative, too, but all in all, it wasn't so bad. We will hopefully find out the results tomorrow, so I'll put another post up when we know more.
Wednesday, March 16, 2011
Just when I thought we would start getting more answers than questions...
As the pregnancy progresses and this little guy grows, the mass is getting harder to measure. We've known this for a couple weeks, but I was surprised today when they said they weren't able to get a clear enough shot of the
BPS's margins to measure it. The tissue is losing it's bright appearance on the ultrasound that set it apart from normal tissue, so they can't distinguish between BPS and normal lung tissue anymore. The MRI next week should help us figure that out. Otherwise, it sounds like the weekly ultrasounds will simply check for normal growth and heart function. The heart continues to shift back into place, which gives it a better and better chance of continuing to function well.
The MRI and next week's ultrasound are both scheduled for Wednesday, but we won't know results of the MRI until Thursday. Please pray that I do ok with the MRI. I'm not exactly claustrophobic, but I'm not excited about tight spaces and not really comfortable with the idea of being in such a small space and having to keep my uncomfortably pregnant body still for so long. I also have a nasty cold/allergy flare-up right now, so my sinuses are a mess. Pray that I'll be breathing well by Wednesday--if I'm having a hard time breathing in there, I'll panic for sure.
For all my apprehension about having to do the MRI, I'm excited about getting information from another source. Hopefully we can get some good shots of the BPS and learn a little more about what we're up against.
BPS's margins to measure it. The tissue is losing it's bright appearance on the ultrasound that set it apart from normal tissue, so they can't distinguish between BPS and normal lung tissue anymore. The MRI next week should help us figure that out. Otherwise, it sounds like the weekly ultrasounds will simply check for normal growth and heart function. The heart continues to shift back into place, which gives it a better and better chance of continuing to function well.
The MRI and next week's ultrasound are both scheduled for Wednesday, but we won't know results of the MRI until Thursday. Please pray that I do ok with the MRI. I'm not exactly claustrophobic, but I'm not excited about tight spaces and not really comfortable with the idea of being in such a small space and having to keep my uncomfortably pregnant body still for so long. I also have a nasty cold/allergy flare-up right now, so my sinuses are a mess. Pray that I'll be breathing well by Wednesday--if I'm having a hard time breathing in there, I'll panic for sure.
For all my apprehension about having to do the MRI, I'm excited about getting information from another source. Hopefully we can get some good shots of the BPS and learn a little more about what we're up against.
Wednesday, March 9, 2011
U of M, Here We Come!
The results of today's ultrasound where at the same time both expected and surprising. It looks like we are going to transfer to the U of M. We weren't going to make the official call until next week, but a couple of things are making it clear that that is where we need to deliver. That is the short story; now here is the long story with some details that I've probably explained before, but for clarity's sake, I'll reiterate:
The CVR (the increment that is used to measure the mass) is still holding steady, which is what we have come to expect. The length of time that the mass has remained a consistent size indicates that it is mostly bronchopulmonary sequestration (BPS). If the majority of it was CCAM, the doctors would have expected it to continue shrinking. Also on this week's ultrasound, they were able to get a good look at what they call a "feeder vessel." They've seen what they suspected was the feeder vessel before, but haven't confirmed that that is what it is until now. What that means is this: a BPS has a dedicated vessel that feeds it; a CCAM does not. So seeing this vessel is further confirmation that the baby does indeed have a BPS and it's not going to shrink any more. This means that we will deliver at the U of M.
Our doctor also told us that based on the size that the BPS is now and will likely be at birth that we should mentally prepare ourselves for Baby to have surgery sooner (within a few days of birth) rather than later. She said it is likely that he will need help breathing, but how much help is (and probably will remain) a big mystery. I guess that's not new news, but I think I'm just wrapping my mind around the idea that this is really going to happen.
Another thing that we were not expecting today was the news that we are going to go ahead with an MRI in utero. I'm not sure about this; the surgeon said he didn't think that would be helpful. But the doctor thinks it will be for various reasons, so we have it set up for two weeks from today.
We've actually been wanting to just make a decision to switch to the U of M for a while now. Regardless of the size of the BPS at birth, the U of M just seems like the safer choice and we've been tempted to make the call even before the doctors did, just so that we'd have the decision out of the way. But we also didn't want to be paranoid and impatient. So we've been waiting for this decision. Even though it's what we expected and it's a relief to finally know, I find myself processing it as if it were a surprise.
I'm also processing the idea that Baby will likely have surgery early in life. This is starting to feel more real.
I don't know if I've talked about it before, but another concern of mine is that Baby might come early and fast. Carter was nine days early and his delivery was normal. Logan came sixteen days early after a 2.5-hour labor. With a record like that, I'm afraid of going into labor early and fast and ending up not making it to the hospital. I know that a fast labor for #2 doesn't necessarily mean fast labor for #3, but I'm worried about it anyway.
So, prayer requests this week: Continue to pray that Baby stays healthy and the doctors will know what needs to be done and when. Pray that as we near the end of this pregnancy that I will not be anxious about getting to the hospital. (And while you're at it, pray that we do get to the hospital in plenty of time!)
The CVR (the increment that is used to measure the mass) is still holding steady, which is what we have come to expect. The length of time that the mass has remained a consistent size indicates that it is mostly bronchopulmonary sequestration (BPS). If the majority of it was CCAM, the doctors would have expected it to continue shrinking. Also on this week's ultrasound, they were able to get a good look at what they call a "feeder vessel." They've seen what they suspected was the feeder vessel before, but haven't confirmed that that is what it is until now. What that means is this: a BPS has a dedicated vessel that feeds it; a CCAM does not. So seeing this vessel is further confirmation that the baby does indeed have a BPS and it's not going to shrink any more. This means that we will deliver at the U of M.
Our doctor also told us that based on the size that the BPS is now and will likely be at birth that we should mentally prepare ourselves for Baby to have surgery sooner (within a few days of birth) rather than later. She said it is likely that he will need help breathing, but how much help is (and probably will remain) a big mystery. I guess that's not new news, but I think I'm just wrapping my mind around the idea that this is really going to happen.
Another thing that we were not expecting today was the news that we are going to go ahead with an MRI in utero. I'm not sure about this; the surgeon said he didn't think that would be helpful. But the doctor thinks it will be for various reasons, so we have it set up for two weeks from today.
We've actually been wanting to just make a decision to switch to the U of M for a while now. Regardless of the size of the BPS at birth, the U of M just seems like the safer choice and we've been tempted to make the call even before the doctors did, just so that we'd have the decision out of the way. But we also didn't want to be paranoid and impatient. So we've been waiting for this decision. Even though it's what we expected and it's a relief to finally know, I find myself processing it as if it were a surprise.
I'm also processing the idea that Baby will likely have surgery early in life. This is starting to feel more real.
I don't know if I've talked about it before, but another concern of mine is that Baby might come early and fast. Carter was nine days early and his delivery was normal. Logan came sixteen days early after a 2.5-hour labor. With a record like that, I'm afraid of going into labor early and fast and ending up not making it to the hospital. I know that a fast labor for #2 doesn't necessarily mean fast labor for #3, but I'm worried about it anyway.
So, prayer requests this week: Continue to pray that Baby stays healthy and the doctors will know what needs to be done and when. Pray that as we near the end of this pregnancy that I will not be anxious about getting to the hospital. (And while you're at it, pray that we do get to the hospital in plenty of time!)
Thursday, March 3, 2011
30 Weeks
We've made it to thirty weeks! I feel that's significant, even though it's not. There's just something about being out of the twenties and into the thirties that makes me feel like we are on the home stretch. My mom helped me to rearrange car seats (not to mention cleaning out a pretty messy car) and three car seats DO fit! We don't have to buy a new car...at least for now. I also found a cute cradle on Craig's List and picked it up today, so now we have a place for Baby to sleep. We are making some exciting progress on the kitchen this week, too, and an end seems to be in sight. Not only that, but The Great Name Debate seems to be winding down to a conclusion. I'm starting to feel ready for this kid.
Again, our ultrasound this week showed very little change. The CVR is just above .9. This is further evidence that the mass is a BPS/CCAM hybrid. BPSs don't shrink away as much as CCAMs tend to do. I don't know why I'm obsessed with knowing what exactly the mass is since treatment is the same for both, but I tend to latch on to any little bit of information that we get that indicates one way or the other.
The heart is more in the center now than to the right and the doctor says it's looking less compressed. We can also see the baby "practice breathing," which is good, but it doesn't tell us much. While amniotic fluid is getting in and out the lungs, that doesn't really tell us how well air will get in and out when the time comes. Our doctor is still waiting to make a decision about where we'll deliver--if we continue to see the numbers stay the same in the next couple weeks, we'll be transferred to the U of M.
Also, this week I was able to get connected to anther mom who had a CCAM baby (who is now in elementary school). I'm excited to be able to ask questions and hear about someone else's experience.
Again, our ultrasound this week showed very little change. The CVR is just above .9. This is further evidence that the mass is a BPS/CCAM hybrid. BPSs don't shrink away as much as CCAMs tend to do. I don't know why I'm obsessed with knowing what exactly the mass is since treatment is the same for both, but I tend to latch on to any little bit of information that we get that indicates one way or the other.
The heart is more in the center now than to the right and the doctor says it's looking less compressed. We can also see the baby "practice breathing," which is good, but it doesn't tell us much. While amniotic fluid is getting in and out the lungs, that doesn't really tell us how well air will get in and out when the time comes. Our doctor is still waiting to make a decision about where we'll deliver--if we continue to see the numbers stay the same in the next couple weeks, we'll be transferred to the U of M.
Also, this week I was able to get connected to anther mom who had a CCAM baby (who is now in elementary school). I'm excited to be able to ask questions and hear about someone else's experience.
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