Perinatologist & Cardiologist, Sacramento

Yesterday, November 25, Greg & I had two appointments. In the morning we had an ultrasound at the perinatologist office. After the ultrasound tech did the scan, we had a new perinatologist come in to talk with us and go over what he saw. Since he hadn't seen us before, he had reviewed the reports from previous ultrasounds and echos before coming in the room. We talked about what had been seen initially compared with what he could see as of today. He agreed the heart looked good: he couldn't see any VSD and he thought the valves looked okay. He also commented on the small amount of fluid around the heart (the radiologist at Stanford had noticed it as well) but didn't seem to think it was very much and probably didn't need to worry about it. And, the other thing he made mention of is that the heart appeared to be on a normal axis now. In the first ultrasounds, they all showed the heart tilted to the left, due to the diaphragmatic hernia. So this is a new development and very interesting.

In the afternoon we saw Dr. Van Gundy for another fetal echo. We had been waiting for this appointment ever since leaving Stanford last week because we wanted to know what Dr. Van Gundy would see or tell us. We didn't want to bias him in the echo, so we didn't say very much about our visit at Stanford until he was finished. But, he also said he couldn't see any VSD and the aortic valve looked normal (when he looked up the z-score, it was -1 which is within "normal" range). He was still mildly concerned about the mitral valve because it did appear to be slightly small, but not like it used to be. And, he felt that it would continue to grow just like the aortic valve has. He also said that the heart was on a normal axis and he did see the fluid around the heart. He didn't feel that the fluid was too much to be concerned about and that it was probably due to the diaphragmatic hernia closing off and creating more room in the chest cavity. He said he didn't know what we were doing to make these things happen but to keep doing it! Greg & I looked at each other and smiled because we plan on doing just that: praying!

Then we launched into the discussion of where to deliver... The ever-elusive answer to our question... He still seems to be most comfortable with us delivering at Stanford. However, he said if we were to deliver in Sacramento, he says it needs to be UC Davis and absolutely NOT Sutter Memorial. We feel he is an unbiased party because he has rights at all the facilities and can go wherever he chooses. In addition, he doesn't receive any stipend or money from any of the hospitals so he can be objective about it. We would have talked to him for much longer than we did, but he had other patients to see. As it was, he spent a long time talking to us and also told us to come at the end of one of his clinics so we could talk some more if we wanted to. We absolutely wanted to talk to him some more, so we scheduled to see him next Tuesday afternoon to discuss the situation further.

We felt our appointment with Dr. Van Gundy was very important and we were so glad we were able to meet with him and get his input. In the meantime, we're in a dilemma because Dr. Sweeney told me as of last Friday she was transferring my OB care to a new perinatologist group in Sacramento because the one we've been going to doesn't deliver at Sutter Memorial. However, the group we have been going to does deliver at UC Davis so that is an option to stay with them. But as of this morning our referral hadn't come through at the new perinatologist group and we were supposed to be receiving NST's through them. But, there isn't any point in changing groups if we don't need to. I tried to call Dr. Sweeney's office this afternoon to discuss it with her but she is on vacation until next Wednesday. So, in the meantime, I'm left without anybody for primary OB care or anyone set up to do my NST's. It's a little bit stressful, to say the least! Especially because we feel our time is running short and we might not have enough time to figure things out if I go into labor soon.

Please pray for us that my cervix does not start dilating and that Caden stays put for as long as possible! And, please pray that we are able to get some resolution about where to deliver. Just when we think we have an answer, we get more information and things change again.