Amelia is doing so great at home. Last Wednesday she went to the pediatrician for the first time and she weighed 4 lbs 6 oz! Her little cheeks are filling in (I hesitate to call them chubby, but I suppose you might say that) and she seems to be livelier. I am still waking her up every 3 hours to breastfeed, pump, and feed her a bottle of fortified breastmilk. The whole process takes about an hour, and while it is exhausting, I am hopeful that we won't be doing this much longer. It is much much easier for her to take a bottle and she definitely doesn't tire as much, but I really want to be able to breastfeed her like a normal baby. I don't want to give up just yet!
My parents are still here (going on 9 days now) with no real idea of when they will leave. They were supposed to leave Saturday and when my dad went to go start the car to start packing it up, it made a wretched sound. Yep, some fool stole the catalytic converter off the car. Welcome to Atlanta. So for now, the Honda dealership is still looking for a replacement part and can't find one. Hopefully they will find one soon so my parents can get home!!
Monday, June 25, 2012
Saturday, June 16, 2012
Monday is the day!
It looks like Monday is going to be the day Amelia will get to come home. She is doing so well right now, and while things could change, she is on track to be coming home!! She is now 1875 grams (4 lbs 2 oz) and has no more IV. She is eating well from me and from the bottle and she continues to eat more each day. They decided not to fortify my breastmilk because apparently I am making 26 calorie milk! Apparently, most people only make 20 calorie milk, but not me. I'm the milk machine. :-) The NP today she could see a difference in her body size today and even made the statement that her cheeks were getting chubby. Now I wouldn't necessarily call her cheeks chubby...
On a more serious note, it was noted that Amelia had a slight murmur upon admission. Apparently it is very faint and everyone thought it was innocent, but still wanted cardiology to check it out. Yesterday, cardiology came by and did an echo and found a VSD (ventricular septal defect). This is a small hole in the heart and could cause problems later on and require surgery. Ventricular septal defect is one of the most common congenital heart defects. The baby may have no symptoms, and the hole can eventually close as the wall continues to grow after birth. If the hole is large, too much blood will be pumped to the lungs, leading to heart failure. Of course, we hope that her hole will close up and will not require surgery, but for now, she will be followed by cardiology. And just to be clear, a symptom of VSD is not sudden death (for those of you who knew Sarah, you should be relieved).
Amelia also has some funny little things going on with her. She has hypoplasia of her left pinky finger and hypoplasia of her left 4th toe and pinky toe. It basically looks like they didn't form all the way. She doesn't have a fingernail on any of those and the tips are slightly shortened. Because she has three minor anomalies and one major anomaly (the VSD), we will probably be referred to a geneticist at some point. All those things could be nothing, or they could be something. For now, it's just part of who she is. :-)
I do know that I am tired of going to the hospital and am ready to get her home. My other kids are ready to meet their baby sister!!
On a more serious note, it was noted that Amelia had a slight murmur upon admission. Apparently it is very faint and everyone thought it was innocent, but still wanted cardiology to check it out. Yesterday, cardiology came by and did an echo and found a VSD (ventricular septal defect). This is a small hole in the heart and could cause problems later on and require surgery. Ventricular septal defect is one of the most common congenital heart defects. The baby may have no symptoms, and the hole can eventually close as the wall continues to grow after birth. If the hole is large, too much blood will be pumped to the lungs, leading to heart failure. Of course, we hope that her hole will close up and will not require surgery, but for now, she will be followed by cardiology. And just to be clear, a symptom of VSD is not sudden death (for those of you who knew Sarah, you should be relieved).
Amelia also has some funny little things going on with her. She has hypoplasia of her left pinky finger and hypoplasia of her left 4th toe and pinky toe. It basically looks like they didn't form all the way. She doesn't have a fingernail on any of those and the tips are slightly shortened. Because she has three minor anomalies and one major anomaly (the VSD), we will probably be referred to a geneticist at some point. All those things could be nothing, or they could be something. For now, it's just part of who she is. :-)
I do know that I am tired of going to the hospital and am ready to get her home. My other kids are ready to meet their baby sister!!
Wednesday, June 13, 2012
Frenectomy
Yesterday, the lactation consultant came in and was assessing us for the trillionth time and she noticed that Amelia was tongue tied. Being tongue tied can cause all kinds of problems latching, eating, talking, even kissing! We got an ENT consult for them to assess the degree of tongue tied-ness and they said that she had "quite a bit of ankyloglossia and they recommend cutting it." of course I consented and it was done at the bedside. She fell asleep in my arms and that is where she is now.
Hopefully she won't gets tired now while eating (one pamphlet made the comparison of trying to eat a bowl of soup with a baby spoon...that is what it is like to be tongue tied) and can latch longer and eat more.
On another positive note, Amelia is now 1830 grams!
Hopefully she won't gets tired now while eating (one pamphlet made the comparison of trying to eat a bowl of soup with a baby spoon...that is what it is like to be tongue tied) and can latch longer and eat more.
On another positive note, Amelia is now 1830 grams!
Tuesday, June 12, 2012
6 days old
Amelia is 6 days old today! I am sitting in a chair next to her open crib (she graduated from an incubator to an open crib yesterday!) watching her rest. She is now 1825 grams, so just a smudge over 4 lbs, which is pretty awesome. She is just about the cutest thing ever, with her perfectly round head and teeny tiny body. She is literally a miniature baby.
Her main issue is really gaining enough weight and getting some fat on her body to maintain her glucose and temperature. She is still on hyperal, but they dc'd her lipids today. Her sugars have been pretty great lately, high 80s and 90s. With the decrease in fluids, she needs to eat more, which is a problem. She expends so much energy eating, so she gets tired. A tired baby doesn't make for a vigorously hungry baby. She is tired because she is small. It is a vicious cycle.
Unfortunately, we haven't even begun to talk about discharge. We just wait and see.
More good news, she had an eye exam yesterday (which was very traumatic) that showed no problems and no signs of a virus that could have caused IUGR.
Her main issue is really gaining enough weight and getting some fat on her body to maintain her glucose and temperature. She is still on hyperal, but they dc'd her lipids today. Her sugars have been pretty great lately, high 80s and 90s. With the decrease in fluids, she needs to eat more, which is a problem. She expends so much energy eating, so she gets tired. A tired baby doesn't make for a vigorously hungry baby. She is tired because she is small. It is a vicious cycle.
Unfortunately, we haven't even begun to talk about discharge. We just wait and see.
More good news, she had an eye exam yesterday (which was very traumatic) that showed no problems and no signs of a virus that could have caused IUGR.
Saturday, June 09, 2012
Day 4 in the Intermediate Care Nursery
Amelia is doing well. Her main problems are: blood glucose stabilization, temperature regulation, and feeding issues. She also had an issue with high bilirubin and low platelets in the beginning. Amelia is on IV fluids right now with extra protein and lipids. Her little IV is in her foot. She also is in a little incubator. As for feeding, we are working on breastfeeding, but she isn't really all that into it. She take breastmilk from a bottle super great though. Right now, we are trying to breastfeed (and then supplement with my breastmilk) every 2 hours (and then I'm pumping every 3 hours). It's quite a schedule!
She has also gained 43 grams, so now she is 1743 grams (her birthweight was 1700).
She has also gained 43 grams, so now she is 1743 grams (her birthweight was 1700).
Baby Amelia is here!
Amelia Grace Mitchell was born on 06/06/12 at 11:11 am via c-section. She weighed 3 lbs 12 oz (1700 grams exactly) and was 18" long.
Here is the story:
We were scheduled to be induced for a vaginal delivery on 06/06 at 7:30 am and got to the hospital about that time. They set us up in the room and hooked us up to monitors. Immediately they were concerned that her heartrate was staying exactly the same the entire time. There was no variability in her heartrate at all. It's not really an emergency type of concern, but just a concern. It just shows that she is not necessarily happy where she is. She also slightly decelerated once without any provocation. Finally, I was concerned because I felt like her movement over the past 24 hours had decreased. On Tuesday evening, I mentioned to Brad that I felt like she had not moved as much as she usually did and on Wednesday morning before the induction, I was feeling the same. She just wasn't moving as much. Based on those factors, our doctor told us that he thought it would be better to just have a c-section because the likelihood of her actually getting into distress and then having an emergency c-section would have been quite high. We agreed and we were put on the "urgent, but not emergent" list for surgery. I was wheeled away and given my spinal, prepped for surgery, and was staring at the ceiling of the OR suite all in less than an hour.
Amelia was born at 11:11 am. Her initail Apgar score was 3 (although 5 minutes later it was 8). She was a little blue and wasn't really crying at all. And she was tiny - very very tiny. 3 lbs 12 oz tiny. 18" tiny. But she perked up a little bit and had a little cry and was breathing fine on her own. They still took her to the intermediate care nursery to live for the next couple of weeks.
We do have a quasi-maybe answer for the IUGR though. During the surgery, the OB and resident asked me if I knew if I had a fibroid as big as the baby's head. I was shocked to hear this and said 'no, I did not know." About a minute later they realized that they weren't looking at a fibroid. My uterus apparently has a very thin section and in that section my placenta attached. When it grew, it made my uterus jut out (kind of like a mickey mouse ear), which, I guess, looked like a fibroid upon first impression. So, the uterus did not give good blood flow to the placenta which did not give enough nutrients to the baby, which could very well be a cause of IUGR. Unfortunately, the thin uterus is definitely a problem and the OB said that if I had gone into labor or tried to induce that my chance of uterine rupture would have been incredibly high and if that had happened, things could have been horribly bad. So, I do feel fortunate that I had a c-section: we found a cause (perhaps) and I didn't die during labor. So good news all around:-)
We do have a quasi-maybe answer for the IUGR though. During the surgery, the OB and resident asked me if I knew if I had a fibroid as big as the baby's head. I was shocked to hear this and said 'no, I did not know." About a minute later they realized that they weren't looking at a fibroid. My uterus apparently has a very thin section and in that section my placenta attached. When it grew, it made my uterus jut out (kind of like a mickey mouse ear), which, I guess, looked like a fibroid upon first impression. So, the uterus did not give good blood flow to the placenta which did not give enough nutrients to the baby, which could very well be a cause of IUGR. Unfortunately, the thin uterus is definitely a problem and the OB said that if I had gone into labor or tried to induce that my chance of uterine rupture would have been incredibly high and if that had happened, things could have been horribly bad. So, I do feel fortunate that I had a c-section: we found a cause (perhaps) and I didn't die during labor. So good news all around:-)
Friday, June 01, 2012
6 + 6 = 12
Yep, that's our new due date. 06/06/12.
You may be wondering why...well, here it goes. First, everything is fine still. We had another BPP and doppler this morning and everything looked great. No worries there. Take a deep breath, everyone.
As some of you may know, IUGR is a strange beast. Lots of people with IUGR have answers for discrepency in size - like preeclampsia in the mother, infections in mama or baby, chromosomal disorders, etc etc. Lots of different things can cause problems. Still, in a lot of cases, no cause can ever be determined and so that makes it difficult to know how to proceed. In some cases, the baby is just plain small. To quote Ben, "That's the way God made it."
We are still crossing the line between baby is just plain small and baby has an issue that we just don't know about. Almost all the literature in IUGR states that if baby is doing well (passing all BPP's, growing, blood flow looks good), you may proceed to between 37-39 weeks gestation. Well, that's confusing if you can get that far...because how far should you go? Should you go to 37 weeks and just take the baby out then (and deal with the baby OUTSIDE of the womb, perhaps in the NICU or other nursery type setting)? Or should you wait until 39 in hopes that nothing bad happens INSIDE the womb (like death...)? See, it's confusing.
Last week was our growth scan. Obviously the baby grew (or else she would already be out of me). She grew 3 weeks worth of growth and was measuring something like 32 weeks 6 days - (4 lbs 2 oz). That is a 3 week growth in 3 weeks; however, it wasn't enough to keep her on the 3rd percentile and she dropped percentiles to the 1st percentile.
We have two different sets of doctors that we see. We see an OB (Dr. Horton) and have seen him regularly since 16 weeks gestation. It's been awesome to have the same doctor every single time (highly unusual for the type of practice Emory is set up to be). We also see MFM (maternal fetal medicine) specialists, who are consultants (more specialized) to an OB. They are the doom and gloom OB's. They tell you your baby is going to die or that they will be messed up or whatever. They aren't the happy OB's. And that's ok - there is a need for that for sure.
Well, the MFM's at Emory are in the conservative camp. Get the baby out sooner than risk stillbirth. The OB's are not quite that conservative - if everything looks good, keep baby inside. Obviously, this puts us in a tough position. We were previously scheduled for delivery for June 13th (which would have been exactly 39 weeks), but today that MFM fellow (who was out of vacation last week at our growth scan and we had a different one that day) was shocked and basically told us we were "playing with fire" by delaying delivery. The MFM told us to go home and decided what we wanted to do (which I think is stupid....how can Brad and I make this decision?!?). So, we got good ole Dr. Horton to come and see us and we basically talked it over and split the difference. He could see we were anxious about it. We have never called him and not been problem patients except for this one time today. It was apparent that this is the right thing to do and we were all happy about it.
So 6/6/12. Mark your calendars. Here comes another Mitchell!
You may be wondering why...well, here it goes. First, everything is fine still. We had another BPP and doppler this morning and everything looked great. No worries there. Take a deep breath, everyone.
As some of you may know, IUGR is a strange beast. Lots of people with IUGR have answers for discrepency in size - like preeclampsia in the mother, infections in mama or baby, chromosomal disorders, etc etc. Lots of different things can cause problems. Still, in a lot of cases, no cause can ever be determined and so that makes it difficult to know how to proceed. In some cases, the baby is just plain small. To quote Ben, "That's the way God made it."
We are still crossing the line between baby is just plain small and baby has an issue that we just don't know about. Almost all the literature in IUGR states that if baby is doing well (passing all BPP's, growing, blood flow looks good), you may proceed to between 37-39 weeks gestation. Well, that's confusing if you can get that far...because how far should you go? Should you go to 37 weeks and just take the baby out then (and deal with the baby OUTSIDE of the womb, perhaps in the NICU or other nursery type setting)? Or should you wait until 39 in hopes that nothing bad happens INSIDE the womb (like death...)? See, it's confusing.
Last week was our growth scan. Obviously the baby grew (or else she would already be out of me). She grew 3 weeks worth of growth and was measuring something like 32 weeks 6 days - (4 lbs 2 oz). That is a 3 week growth in 3 weeks; however, it wasn't enough to keep her on the 3rd percentile and she dropped percentiles to the 1st percentile.
We have two different sets of doctors that we see. We see an OB (Dr. Horton) and have seen him regularly since 16 weeks gestation. It's been awesome to have the same doctor every single time (highly unusual for the type of practice Emory is set up to be). We also see MFM (maternal fetal medicine) specialists, who are consultants (more specialized) to an OB. They are the doom and gloom OB's. They tell you your baby is going to die or that they will be messed up or whatever. They aren't the happy OB's. And that's ok - there is a need for that for sure.
Well, the MFM's at Emory are in the conservative camp. Get the baby out sooner than risk stillbirth. The OB's are not quite that conservative - if everything looks good, keep baby inside. Obviously, this puts us in a tough position. We were previously scheduled for delivery for June 13th (which would have been exactly 39 weeks), but today that MFM fellow (who was out of vacation last week at our growth scan and we had a different one that day) was shocked and basically told us we were "playing with fire" by delaying delivery. The MFM told us to go home and decided what we wanted to do (which I think is stupid....how can Brad and I make this decision?!?). So, we got good ole Dr. Horton to come and see us and we basically talked it over and split the difference. He could see we were anxious about it. We have never called him and not been problem patients except for this one time today. It was apparent that this is the right thing to do and we were all happy about it.
So 6/6/12. Mark your calendars. Here comes another Mitchell!
Subscribe to:
Posts (Atom)