This letter will most likely be written over a number of days but I thought I would start it today – in the waiting stage of this journey that we are on.
And I’ve chosen to send this letter to many of you on our mailing list who are not consistently on our monthly letter list but with whom we want to share the things our family is experiencing and to ask for your thoughts and support.
It will come as a surprise to those of you that have not heard from us since our Christmas letters that we are expecting a baby girl to join our family in November. Kali has been eagerly anticipating for months becoming a big sister and has already welcomed the shifting of furniture in her room to make way for the crib. Every time we go around and say what we are thankful for before a meal her response is “I’m thankful for Drimpy!” (Drimpy is her chosen name for the baby).
The expected arrival of a new member in our family and the continued process of remodeling our home has put off indefinitely our planned open house/party weekend that we had initially projected for our birthday weekend this year (September 28-30). And for the time being planning much of anything future oriented feels very difficult for Jason and I to think and dream about.
At our 20 week appointment (we are at 30 weeks today), they noticed minor pyelectasis (urine retention in the kidney) in the baby but were not overly concerned. This is fairly common and they just recommend a follow up ultrasound around 28 weeks. We had that ultrasound 2 weeks ago and the pyelectasis had diminished and was no longer a concern. However, they checked her growth and that became an immediate concern as she fell below the 10th percentile which immediately gave her the diagnosis of “IUGR” – Intra Uterine Growth Restriction. And it put us in the high risk category and we got to look forward to coming into the office 2 times a week – once for a non-stress test and once for an ultrasound to do a biophysical and Doppler flow studies.
At the time, this felt like a lot to soak in and the tears for me flowed easily as we learned the whole spectrum of possibilities – early delivery, increased risk of both induction and cesarean birth, possible complications in late pregnancy, some long term issues for the baby. But we also held on to the hope that maybe she would hit a growth spurt or maybe she fell in the 40% of IUGR babies who are just tiny. For me, there was the recommendation to slow down, limit exercise and activity, get my feet up and rest as much as possible, eat at regular intervals including extra protein and try to make as much of what I take in available to the baby. Some of these changes were also feeling quite challenging as I seem to thrive on being on the go and, yes, on doing. And keeping up with Kali is not normally a “put your feet up” kind of job.
This past week was our first week of more in depth monitoring and the baby passed the non-stress test great on Tuesday. I was also feeling more movement as the week progressed and with increased movement came increased hope. When Friday came I did not expect new bad news. We actually decided to have Jason move forward with his work plans for the day and Aunt Karen met Kali and I at the midwives for the appointment.
What we were to learn in the next hour was that although she passed the biophysical and the Doppler flow studies looked good, she had now fallen below the 3rd percentile and the ultrasound tech noticed 2 things in her brain that “don’t look right.” Before letting me go for the day, they also did a non-stress test to make sure the baby was not under stress which she was not. And that is all we know at this point and the waiting and worrying and fear at times feels almost unbearable.
Tomorrow, Jason and I head to the University of Virginia in Charlottesville for a more in depth ultrasound and to meet with a perinatologist. Kali is looking forward to a fun afternoon and evening with Aunt Karen and Aunt Sue and we are so grateful for their presence and support during this time.
This letter will continue after tomorrow’s appointment. For now we wait, worry, cry, hope but dare not to, etc… And for now, Kali and I head to meet Karen, Sue, Grandma and Grandpa Myers, and Daddy at Taste of Thai for lunch together.
Tuesday, September 11, 2007
Jason and I fell into bed exhausted last night after several hours in the car and close to a 4 hour appointment at UVA. We left UVA feeling somewhat confused about where we were at in this journey and how hopeful or not we should feel. The short run down of the appointment:
Our little girl put up with being watched and poked and monitored for 2 good hours by ultrasound. And she put on a show: she opened and closed her little hands, kicked her feet, turned the wrong way at times when they wanted pictures of certain things, practiced her newly found breathing skills, opened and closed her mouth, and overall acted just as a baby of her age should act. But she is undoubtedly tiny. Her heart looks good, all her other organs look good, the placenta looks good, the blood flow in the cord is good, the amniotic fluid is good, and most surprisingly of all, the doctor could not see anything in her brain that caused her alarm. That was not what we were expecting to see. While we probably should have felt elated we felt kind of confused – what did this mean now?
They had called a genetic counselor up to meet with us which also kind of made the whole thing feel more unpredictable and scary as they talked about the whole range of possible outcomes and went over a few possible scenarios. But as we left basically all we were given was that everything checks out fine, but your baby is very tiny and we don’t know why. They wanted to see us back in 3 weeks for a follow up and we are to continue with our appointments with the midwives in Harrisonburg. They did talk about recommending that I deliver at UVA but did not feel that early induction would be necessary and also weren’t recommending that I go on complete bed rest at this point.
On our way home we talked with our wonderful friend and midwife, Donna, whose enthusiasm and hopefulness at the report couldn’t help but wear off on Jason and I. It was just odd for us to be feeling happy and hopeful about being back at the “pre-Friday” news that had seemed so grave only a few weeks ago. So, the roller coaster ride continues… (Donna did not think that delivery at UVA was a must which was very encouraging in and of itself)
We slept, got up and were off to our appointment at the midwives. This morning she also passed her non-stress test. She was a wiggler and gave them a few good accelerations. She might have been responding to my increased heart rate as we talked with another midwife Anne (also a good friend), only to learn that in consultation with the doctor they are recommending that I move to bed rest to really maximize this baby’s growth. Again, we were faced with news that I had not been expecting. Thankfully, with only a little pleading, I’ve been given this week to prepare and wrap things up at work and start figuring out how to make this sustainable and hopefully in some ways positive and life-giving for our family (and I’m particularly thinking of Kali in all of this – though she seemed quite happy at the prospect of Mommy not having to go to work!!). We will have another ultrasound this Friday and appointment with the midwives and at that time will be given more complete instructions and a game plan for what is ahead. So for now, we do some more waiting and hoping and I do more breathing deeply and trying to slow up and rest and prepare myself for whatever lies ahead (lots of book reading, puzzle playing, games, and watching and absorbing Kali’s cuteness – I guess there are worse things).
And for now, I try to get things tied up at work (which means I have meetings most of the rest of today and need to get moving). I have felt so supported by family and friends and very much too by my work colleagues. While I am assured by many of them that I need to be focused on this baby and our family right now, my sense of responsibility and commitment to my work and the people I work with and for is making this a hard transition for me, when I had fully anticipated having another 2 months plus to “get things in order.”
One of the things I was told this morning is that I will get good practice at asking for and receiving help from others. This is not a skill I’ve honed well yet in my life. I thought our house project was stretching me enough in that arena but it looks as if that may not have been the case. I’m sure that Jason and I and Kali will grow in ways we couldn’t have imagined months ago and while that will not be easy all the time, we are hoping for grace as we take it a day at a time.
Love, Janelle
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