Monday, June 29, 2009

We set a goal!

We had a great appointment today. Emmy looked great on ultrasound and actually had a reactive section on the NST. I might have found the secret....drink juice for the hour before the NST. We'll see on Thursday if that plan works. I was only on the monitor for 30 minutes. That is a first. I'm usually on for an hour. Then we went into the exam room and had the door open. Dr Fosnot (my favorite doctor) walked by and said hi as she was going by, then backed up and came in. She was kinda talking to me about plans and then told Dr Young (who my appointment was scheduled with) that she was just going to finish and take over the appointment. I was really excited because she really sits and explains things. All the doctors conferenced this morning and came up with a plan for me. Here's what they told me:

I'm back on strict bedrest for the rest of my pregnancy. There's no chance of coming off of it.
We're still doing bi-weekly NST, weekly ultrasounds, and weekly visits. We're still worried about the chance of another spontaneous bleed. They are sending me to a High Risk doctor for a more extensive ultrasound and recommendation for delivery. My OB's couldn't come to an agreement when it comes to delivery plans. Some want to induce me at a certain point, others want to let me go into labor spontaneously. So they decided to get the High Risk doctors input and they'll pretty much do what they suggest. We're hoping to get an appointment with them next week so then we'll have a good idea as to whats going on. If the high risk guys feel like its in the best interest to deliver the baby now, thats what we'll do. If they say let me go into labor on my own, thats what we'll do. If they say induce me, that's the plan. So we'll learn a lot next week.

Dr Fosnot says there is a good chance I could make it to term, or close to it because I've been so stable over the past few weeks. She doesn't think I'll make it to 40 weeks but she thinks there's a reasonable possibility to make it to 36 weeks. She's nervous for another bleed because she thinks it will be a substantial one if it happens. She also voted for letting me go into labor on my own because she doesn't want to hyperstimulate my uterus with the induction. All of these things increase the risk for my bleed. She thinks that even if I go into labor on my own I'll come in bleeding but at least it won't be because my uterus is so overstimulated by pitocin. Unfortunately its all a waiting game and like she reminded us, "there's no true right or wrong choice"

Our ultimate goal is to get to 34 weeks and any day past that is icing on the cake. They won't stop my labor after that point because Emmy's lungs should be mature enough to handle life. If I go into labor before 34 weeks, they'll try to stop my labor to give me steroids to help mature her lungs. The good thing is that we're over a lot of the long term problems associated with prematurity (cerebral palsy, retinopathy/blindness, severe developmental delays). We're looking at respiratory problems if her lungs aren't developed enough (oxygen supplementation, possibly intubation/ventilation). We're also looking at some feeding issues since her sucking reflex won't be completely developed so she may need a feeding tube until she can learn to suck on her own. I'll take those complications over any long term complication any day. But each day she stays inside me is a day in the right direction.

Thats all for now. We'll see how she does on Thursday and what my fetal fibrinectin says. Oh yeah, they did another one since its been over a week since the last one just to be on the safe side. Hopefully its still negative.

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