Another month, another round of appointments down and we’re now heading into the home stretch. I’m 30.5 weeks, the baby weighs almost 4 lbs. and has jumped from the 40th to 60th percentile for size. He is one very active baby and despite the heart defect, this has been such an easy pregnancy.
Today’s visit included a scan with my new perinatologist and I met my new OB. All of this is done at the Institute of Maternal Fetal Health, a program partnered with University of SoCal and CHLA. My blood pressure is elevated and has been for the last few months, so I’m now on watch for gestational hypertension. If there are any signs of pre-eclampsia, they’ll plan to induce me at 37 weeks, pending nothing goes wrong earlier. The baby needs to grow inside of me as long as possible to ensure that his little heart and lungs are ready for war when he makes his arrival.
I also met with my cardiologist, Dr. Pruetz and had a surprisingly good report from my echo! First, Dr. Pruetz found another defect in the atrial septum in the form of an extremely small hole in one of the bows of that septum. In a baby with a normal heart, this defect would not be good because it’d allow blood to pass through opposite of the way that it should. However, baby Luca’s heart already forces blood to pump the opposite way because there’s no left side of the heart. This hole just serves as additional opening to get the blood through, thus alleviating some of the pressure going back in the lungs. Because the hole is so very small, Dr. Pruetz said they probably wouldn’t have even picked it up as a defect on a heart healthy baby. But in our case, we’ll take whatever we can get. This is good!
Second, the numbers have changed for the better! Since the problem has been that blood is pushing back through the septum the opposite of how it should, there’s been pressure on the valves going back into the lungs. That was where the lung problems came in and why they wanted me to have the in utero surgery. Here’s the good news (and also where I lack the ability to explain all this medical jargon): there are two stats/numbers Dr. Pruetz focuses on during the echos. In my last two visits, the first stat gave a rating of 3 and now it is a 1 (the lower the better). The other stat is something about the ratio of pressure going back to the lungs and has been at 3:1, but today was at 5:1 (the higher the better). Dr. Pruetz said that the restriction doesn’t look much different, aside from the newly discovered tiny hole, so he had no hard explanation for the change in numbers. I smiled and said “that’s God” and he laughed and responded with “it might just be”.
We’re grasping at any positivity we can, but our doctors always bring us back to reality. At the conclusion of the echo, Dr. Pruetz reiterated that the septum is still very restricted and that we should still plan for an immediate atrial septectomy surgery for Luca after birth, and, of course, gave a friendly reminder of where we stand with a shot at Luca making it through and after surgery. But, today’s echo showed such a sign of unexpected positivity and to think that he still has two months to go for more is a good thing!
I went into today’s appointments really hoping for some kind of base plan on what to expect for delivery. Although they’ve started to form our team of doctors and surgeons and we’re “on the schedule”, we still have to wait to know more. What all the doctors have agreed on and confirmed is that once the baby is delivered, they’ll hold him up for me to see before they take him away, and that’s it. No holding, no touching. Since CHLA is not connected to the hospital, I won’t even get to see baby Luca until I’m discharged. If all goes well with my body, this can be up to three days. Though a c-section is not yet confirmed, they’ll definitely induce me. So, if you think of it, here’s how you can pray for us in the coming weeks:
- That baby Luca will continue growing. We need him to be 6.5 lbs. for surgery.
- That my blood pressure would not get higher and that I am not heading in the direction of pre-eclampsia. The longer Luca grows inside of me, the stronger he’ll be when he arrives.
- That I’m not scheduled for a c-section and that when I’m induced, my body will move along in labor on its own in the timeframe given to me by the doctors to avoid an emergency c-section.
- That Luca will do a quick somersault before birth. He is breech and has been at all my sonograms for the last month. Of course he still has plenty of time to flip around, but I’m not a candidate for external cephalic version, a massage that will assist in flipping him head down before delivery. If he’s breech, it’s just another reason for them to do a c-section.
- The doctors and surgeons in general as they are starting to the plan for Luca’s arrival.
- And selfishly, please pray for me. I am struggling most with the fact that the first time I’ll get more than just a glimpse of my baby with be in a CTICU while he’s intubated with an open chest and hooked up to all sorts of machines. And AJ, too, because though he’ll get to visit with the baby right away, he’ll have to face the same things all while having the pleasure to deal with me and my anxiety. 🙂
When nothing is certain, everything is possible… and the power of prayer is clearly working, so please don’t stop!
P.S. – Me or AJ?