We had another ultrasound today. As I have said before, I don't like that room, it will always bring me back to Diagnosis day! The ventricles have once again increased, to 18mm (left one) and 21mm (right one). Don't love this news, but it isn't concerning of anything with the baby. There is no damage occurring from this since the pressure isn't building and stressing out the brain as it would in someone older. We were told that his head is small though, in the 3rd percentile, which is odd for spina bifida, but really it is hard to measure a baby's head who has spina bifida because the U/S machine has a pre-set shape it uses to measure head circumference - a circle - but babies with sb have an elongated head more like an oval or ellipsis, which makes it difficult to get an actual reading when you only have a circle to try to fit it into. Even though I know this and the logical side of me says pay no attention to the numbers b/c they mean nothing at this point in time, I find myself obsessing over what it could mean. If his head is too small, the pressure will build on his brain easier b/c where will everything move to if the ventricles continue to swell? Why do logic and reason seem to go out the window when your child's health is on the line?
He is also measuring small overall, the 26th percentile for overall weight. I know that John and I make small babies - 6 lbs 9 oz and 5lb 11oz respectively at full term - but hearing that he is small made me nervous. Will he be too weak for surgery? Is he malnourished? They even did an extra reading with the doppler to make sure the blood flow through the placenta is strong - which it was and it looked fine - but that stupid little emotional devil on my shoulder keeps yelling louder than the logical guy on the other shoulder.
Sometimes the emotional guy helps out though. The baby's lesion is flat, there is no sac sticking out from his back that has the nerves all bundled in it, his nerves are still flat in his back, but just open to the fluid. The logical side of me knows this could mean nothing, the nerve damage could still be pretty extensive, but the emotional side of me says, if the nerves are flat maybe they are safe, maybe the amniotic fluid can't get to them and he will have minimal nerve damage. No one knows either way what the chances are, but I can convince myself on any given day that it is good...or bad!
The other decision looming is how to deliver. This could be decided for us based on various things, but right now it seems like it is still up in the air. There is no good evidence, that I can find, about one being better than the other, as far as vaginal vs. C-section for babies with sb. Some people seem to think that vaginal is better since it will get the baby's cortisol level up and make him stronger for the surgery that he will have to go though very soon after birth, not to mention the normal benefits of vaginal birth. But I have also read that a C-section could save some 'level' of damage on the nerves. There is no definite answer and both have pros and cons. Currently I am leaning toward C-section, but that scares me b/c the recovery is harder (with two little ones to already be taking care of) and I won't be discharged until days after so I won't be able to get to the NICU to see our little man for days...I want to breastfeed him, will that make that harder? With all the meds he will be on and the stress he will be under, it is so important for him to get good nutrients. Luckily, we have our meeting with our neurosurgeon scheduled for July 1st. Dr. Vogel. He will be the one who will have the most answers of anyone we have met yet. He is a sb expert and will be in charge of little guy's care for most of his life. Hopefully he will have some answers or at least a better idea of some guidance for us and hopefully he will be ready to deal with me and my logical AND emotional side.
Next appointment, Monday June 9th.
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