A change in plans

January 5, 2010
I won't post my NST appointments with Dr Wells in seperate posts because there's not a lot to report really. His appointment last week went great- he was very active for most of the test and then he fell asleep! It was ok though because we got enough information about how he's doing that "passed" the test!

I asked Dr Wells too about how Ripplet must be feeling. Does he feel the pain of his intestines swelling? In the last ultrasound the tech said he was holding his intestines- which was really cute, but also made me sad. I don't want him hurting in there and I can't do anything about it. She said keep in mind he's had this his whole life so he doesn't know anything different. Yes, after 30 weeks babies can feel pain because the nocireceptors are formed, but there's probably not that understanding of what pain is yet. Also, abdominal pain is different than pain would be if there was a cut on his arm for example. His stats show us he's not in distress so he's ok. I asked if taking small doeses of Tylenol would help him any (I just feel helpless not being able to do anything!) and she said no, he's doing fine enough.

Over last weekend I started having REAL contractions- I forgot how bad they hurt!! Definitely not the Braxton Hicks I had been having! And when they pass, you're so exhausted! It really wiped me out that day. Luckily they got further and further apart until they were finally gone, but it was a huge wake-up call for us- we have so much to see get done!! So we went out and got clothes for me for the hospital stay and NICU visits (and comfy enough to pump in until Ripplet can finally nurse), got the old baby clothes and blankets down, washed and put away, as well as some general cleaning in case we had to go in. I feel much more prepared now!

So during our Dr Dobak visit yesterday we were told of a change in plans... This whole time we had been counting down to 36 weeks as the week of delivery (so he was developed enough to sustain outside of my belly but his lungs weren't so big that they intestines would have a hard time getting back in). The new school of thought for 2011 (as Dr Dobak put it) is to go longer as long as the baby is still thriving and not in distress. He said after they all attended the pediatric conferences and then met as a team, this is their new approach based on the most recent research available. They try to follow what the well-respected children's hospital in Houston does so I feel like we're getting close to the same quality care. So we're going to shoot for 39 weeks instead.

I guess it's good because the more he can develop, the better his recovery will be, but was looking forward to getting him out so his intestines don't swell any more and getting him on the path to coming home.

Good news from the appointment was his estimated weight is now 4lbs6oz at 34 weeks and he's in the 33rd percentile (anything above 10 is normal). His echocardiogram looked great, he practiced breathing (once we woke him up!) and bladder function was working (if you know what I mean!). No pics from this appointment because he had his arms over his face the whole time. I think he just wanted to sleep in peace!

Frustrating news is that his intestines continue to swell. Now we're at 19mm and 20 mm for internal and external. The tech did make an interesting point, the intestines continue to fluctuate depending on what's going through them. His first measurement of the internal intestines was just 8mm so I got excited that it went down. But then later in the scan it swelled up to the 19mm listed above. So maybe they're not permenantly like that yet? Not sure what it all means. I could definitely pick out the external intestine- it looked like a huge sausage. :(

But since Ripplet is gaining weight, his stats don't show distress, and he's moving well, the dr believes he's ok to stay in for now since he's still thriving and his intestines are still working fine. I'm a little conflicted because I want him out so there's no permanant damage, but I know getting him out early means other organs or systems might experience complications or infections so it's best for him to stay in so we only have one organ to focus on (hopefully!) when he gets here.

He had another NST while at Dr Dobak's but this time he slept the WHOLE test. The nurse needed to see some movement and heartbeat fluctuations so she stuck a vibratiing instrument up to my tummy and boy did that get his attention!! He was mad! Heart rate went up and he got very busy moving all around, but we got the results we wanted and were free to go.

So it looks like the count down continues! Now we might deliver at the end of the month/ beginning of February. Unless he has other plans for us or his stats start going down. I'm going to be more closely monitored from here on out since we're going longer so I go to TWO NST appointments per week now, one in Pensacola and one in Fairhope- our insurance company is gonna love me!

Next up is a very busy appointment day next Tuesday. We get a NST done at Dr Dobak's, meet the OB Dr Duke to review the birth plan and get questions answered, meet the pediatric surgeon Dr Lewis to consult about Ripplet's surgery once his intestines have gotten back into his belly (takes about a week-12 days), and then a steroid shot for me to get his lungs to further mature in case he has to come out before term. Then I get a second shot in Fairhope in 24 hours and finally another NST with Dr Wells at the end of next week.

My in-laws will be in from Australia next Tues so we'll have back up on-site from here on out- whew!