Sunday, May 1, 2011

Prenatal Post

Since I wasn't able to start my blog when I wanted to, I'll catch everyone up in this post... at least on the prenatal part of our adventure.

I found out I was pregnant on May 7th, 2010. I had my first OB appointment with Dr. Martin of OB-Gyn Associates of Montgomery on June 7th, and they did an ultrasound to confirm my due date. Everything was normal, and we had a healthy little "Nugget" as I referred to him at first. (Later on, we started referring to him as "Slick" since his initials were BP (Baby Piatt) and BP caused the giant oil slick in the gulf.) On August 30th, I had my 20 week ultrasound. Typically this ultrasound is where you find out the gender, and I was so excited to finally know so I could start some serious shopping! You never think going in that the ultrasound tech is going to freak because she can't see anything. My mom, dad, and Josh were there for the US, and as soon as she started we could tell something wasn't right. She said she was going to ask the doctor something, and would be back. This resulted in automatic tears for me (and my mom). She came back, took several more pictures, and took us to the room to wait for Dr. Martin. He explained that they thought the baby had either an omphalocele or gastroschisis. Both conditions consist of organs being outside of the baby's body. He said there was nothing to worry about, that it could be very easily taken care of, but that they wanted me to go to Birmingham to have a targeted US done just to make sure the diagnosis was correct. So we made our first trip to Birmingham on September 9th, and saw Dr. Owen and his resident Dr. Wetta. They performed the US and said that it was definitely not gastroschisis or an omphalocele, but that the baby's bladder was not releasing fluid, possibly due to a blockage. At this point, we still didn't know whether Slick as a boy or a girl, and they said that knowing could help them determine exactly what was going on. There was very little amniotic fluid around the baby, since it was all inside his bladder, which was extremely stretched and protruding. This was scary, because the amniotic fluid cycle is what develops a baby's lungs. They swallow the fluid, and then literally pee it back out swallow it again. Another aspect was that there might be major kidney damage done from the bladder not functioning correctly. They decided to do an amniocentesis to draw as much fluid off as possible and to run some tests for kidney function and chromosome defects. This would also determine gender, and give them a better idea of what was going on. They said blockages are very common in little boys, but that if it was a girl the defects could be much more drastic, such as cloacal exstrophy. We went back for the follow-up and test results on September 14th, and were thrilled to find that we were having a sweet little boy, and that he had normal chromosomes and great kidney function with consideration to his condition and the fact that he had only one kidney! They explained to me that they could perform a procedure to place a shunt through Carter's bladder wall that would help it drain. We were willing to do whatever they deemed necessary to get Carter here as healthy as possible. So, with much prayer, and much anxiety (I HATE NEEDLES!) we went back to Birmingham two days later for the procedure. First, they did an amnioinfusion to give Carter some fluid around him so they'd have some room to work. Right after they made the incision and began to enter with the shunt, they watched on ultrasound as his bladder began to drain on it's own. The doctors were baffled! They decided to pull back and not place the shunt and see if he could cycle fluid on his own. We were on pins and needles until our follow up a week later on September 23rd. The US confirmed that Carter had a hole somewhere near his umbilical cord that was allowing the fluid to drain. Dr. Owen explained that while it wasn't normal drainage, it was better than no drainage. Our next big appointment was on October 7th at UAB. This was a renal consultation with doctors from Children's, where Carter would be transferred almost immediately after birth for surgery to repair his blockage. Dr. Herndon, urologist, and Mary Jane Gillum, nephrology CRNP, watched our US and told us what to expect after Carter was born and for the first few years of his life. Dr. Herndon was confident that the repair could be made, and said they see this alot. Mary Jane told us that they wouldn't be able to give an exact plan for his kidney until he got here, but that we could be in the hospital for two weeks or two months, that it could have nearly perfect function, or we may end up on dialysis - there was just no way to know! This consultation really gave us some peace, because these experts seemed so at ease with his condition.

I went to UAB for ultrasounds every two weeks or so until December 1st. At this appointment my fluid started looking low, but Dr. Owen said that from there on out I could just have ultrasounds done in Montgomery. Carter's fluid level dropped drastically from 12.8cm on December 6th, to 5.6cm on December 13th. 5cm is when they typically consider delivering. Dr. Martin sent me to Baptist East to be hooked up to the monitors overnight. I guzzled water all night, and by my US in the morning it was back up to 8.9cm. I had my fluid checked every three days or so, and I drowned myself drinking so much water. On December 27th, they checked me - only 1/2cm dilated - and my fluid was low again, so I had to be monitored for a few hours again. I was SO ready to deliver! I went to my January 6th appointment at the wrong time, and Dr. Martin was already gone. His sweet nurse, Kathy, called him and asked him to talk to the doctors at UAB about setting up my inducement (this was after a hug and some tears). Dr. Martin made the call, and they gave me a date! January 10th, and 7am, we were to report to Birmingham!

On January 9th, Alabama got some major snow. Me, Josh, my Mom, and my Aunt Melanie went up the night before and stayed in a hotel less than a mile from the hospital. The next morning, the snow was so thick that we were scared to try to drive. I was determined to deliver even if I had to walk to the hospital! We managed to catch a shuttle that was transporting nurses and we made it there on time. The greatest part of my labor was that I had the same nurse that I had for my shunt procedure. Kelly was such a blessing! She helped me through 3 hours of being stuck on, and encouraged me when I couldn't get the epidural (rotational scoliosis). Unfortunately, she got off before anything got too bad! Everything else is a blur... and Carter was delivered at 5:35am, January 11th. I saw him from across the room, and heard his sweet whimpy cry, and then they wheeled him to the NICU to be kept sterile, and ready for surgery.

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