Ultrasound and MRI at Stanford

Yesterday, November 14, I drove over to Lucile Packard Children's Hospital at Stanford to have an ultrasound and MRI. I spent the night before with Greg's sister, Natalie, in Walnut Creek. Kyler was staying with her while I went for my tests. I was worried about traffic, so I left at 6:15 am in order to make sure and have enough time (it's only about 50 miles from Natalie's house to the hospital). But, traffic was fine at that time of the day and it only took me an hour to get there. So I found a little cafe in downtown Palo Alto and got some food, sat down, and read. It was nice to get there and be relaxed and not stressed about traffic or running late. About 8:15 I headed to the hospital. I was happy to see that they had free valet parking which I gratefully took advantage of! The less walking I have to do the better. Once inside, I had to find my way through the maze of unfamiliar hallways up to the Perinatal Diagnostic Center where my ultrasound would take place. I checked in half an hour early and they took me back almost immediately, which was nice.

The ultrasound technician was very friendly and very informative. She talked to me all throughout the scan and told me about the things she was looking at and what she saw, etc. That was nice because very often the techs are quiet and don't say too much to you. Of course, it made me wish all the more that Greg could have been there with me. I'm sure he would have liked to be able to ask questions during the ultrasound. She pointed out some fun things during the ultrasound as well. She showed me Caden practicing his breathing; you could see his chest moving up and down. And, when she was looking at his face, we could see him opening and closing his mouth. When he was opened his mouth, she pointed out that he was sticking out his tongue. It was nice to have an ultrasound be light-hearted at times instead of stressful as they have been.

When she was done with the scan, she paged the Pediatric Radiologist, Dr. Barth. It was nice to see a radiologist because up until that point, we haven't had one look at any of our ultrasounds. He reviewed the ultrasound and then came in to meet with me and go over some things with me. He said it looked like from the reports he had received that initially there had been some concern regarding the shape of the skull and other potential neurological problems. He said from what he could see, and they had great images, there was nothing wrong with the brain or the skull and that everything was completely normal. He was very confident about it. This was so reassuring to hear because at our previous ultrasound the Perinatologist hadn't seemed 100% confident about it. But, Dr. Barth was very confident so that was great!

Then we started talking about the diaphragmatic hernia. We looked at the diaphragm on the left side of the chest and everything on that side looks great. You could clearly see the line of the diaphragm and the location of the organs below it like they should be. Then we looked at the right side of the chest and we looked at the partial line of the diaphragm and where it ended. He showed me where the liver was pushing into the chest cavity. But from the images he could see, he thought the hernia looked "minor" and that there was only a small portion of the liver in the chest cavity. When I asked him what that meant, he said it was definitely less than half the liver in the chest cavity. However he did want to see what the MRI showed to be completely sure of the severity and also get a good look at the right lung and it's development. In the ultrasound the view of the right lung was blocked by the liver so he couldn't give an accurate assessment.

Lastly, we looked at the heart. He didn't get into too much detail about the heart. In fact, he hardly talked about it at all. He said the best diagnostic tool for that is the fetal echo which we are scheduled for next Tuesday at Stanford. But the one thing he did mention is that it appeared there was fluid around Caden's heart. I don't remember Dr. Van Gundy, our cardiologist, mentioning this to us before. So I'm not sure if I just don't remember, or if this is a new development. Hopefully we'll get more clarification once we have the echo. Dr. Barth did ask me if I planned on delivering at Lucile Packard Children's Hospital and I said we hadn't made our final determination, but probably. He said, in his opinion, because we are dealing with the cardiac abnormalities in connection with the diaphragmatic hernia, he would definitely recommend delivering there. So, again, another push in that direction.

Once I was done with the ultrasound, I went down to wait for the MRI, which was scheduled for 11. I ended up waiting a long time for it and by the time they finally got me in it was probably 11:45. I have never had an MRI done before and was a little concerned about being in a small tube because I have some claustrophobia. But I figured I would do whatever I needed to do in order to accurately assess Caden's diaphragmatic hernia. So in I went... It really wasn't too bad except they kept having me hold my breath for various images. Sometimes I would have to hold it for 13 seconds all the way up to 33 seconds. None of which is too terribly long. But because I had to do it so many times, I was feeling a little light-headed like I wasn't getting enough oxygen. They tried to give me a little bit in between each breath holding session, but sometimes they were closer together than I would have liked. All in all though, the MRI was pretty non-eventful. One of my biggest concerns was that Caden wouldn't hold still and they wouldn't be able to get the images they needed. After all, there isn't really anything I can do to keep him from moving around. And, the whole time I had been waiting for the MRI, Caden had been moving around like crazy. But during the MRI, it seemed like he was really calm and didn't move around too much so I was relieved about that. They had said if the baby moved around a lot it could lengthen the time by half an hour or more because they would have to re-take images in order to get good pictures. When it was over, the technician had me write down my cell phone number and told me that Dr. Barth would be calling me with the results as soon as he had finished reviewing all the images. The tech also told me that they got amazing pictures and that Caden had been very still which was great. Even so, I think the whole MRI took almost an hour. I left the hospital right around 12:45.

By this time I was completely dehydrated and starving! They wouldn't let me eat or drink anything after 9 am because they didn't want my digestive tract in motion during the MRI. And since they had taken me back for my ultrasound early, I hadn't had anything to drink since before 8:30. That is too long for me to go without water. So as soon as I was done, I started gulping water from the water bottle I had with me. Then I went down and waited for the valet to bring me my car and I drove to downtown Palo Alto to get some food. Thai food was very appealing to me so I stopped at Thai restaurant. Before they brought me my food, I had gulped down two glasses of water and was still feeling dehydrated. But gradually I started feeling better. And, getting some food in me helped as well.

Once I was done eating, I got in the car and drove back to Natalie's house. I didn't expect to hear from Dr. Barth that day, I figured it would probably be Monday before I heard anything. So when he called me later that afternoon, I was so surprised. He had great news to share!!! He said there really was only a very small piece of the liver in the chest cavity like he had suspected in the ultrasound. And, the even better news was that he said it looked like the right lung had developed fairly normally. He said it probably wasn't 100% normal because of the liver, but he thought it would be very functional. He even added that he wouldn't expect Caden to have any breathing or respiratory problems due to the diaphragmatic hernia. He said there could be some breathing problems related to the heart defects, but in regards to the hernia, he thought it was great news. He said given the fact that our baby has a diaphragmatic hernia, this is the best possible scenario we could be looking at under the circumstances, and he thought fixing the diaphragm would be an easy fix. Such incredible news!!!

Later that night I talked to all my family to give them the update and when I was talking to my sister, Cheryl, I commented on how great it was that Caden was calm and quiet during the MRI. She said she had prayed for that specifically all week long. She wanted to make sure they were able to get good images of him so she had been praying for that specific thing. God is so good to us and he answers even the simple prayers like keeping an active baby in utero calm during an MRI. Right now we feel so incredibly blessed to be in the position we are now. We still feel there are a lot of unknowns as we wait to meet with the specialists next week. But we are so happy right now and feel so much hope and optimism. It's a far cry from where we started and we are blessed!

On another note, when I got home on Saturday, there was a message on our home answering machine from someone at the Cardio Thoracic surgeon's office saying they needed to reschedule our appointment for next week. I am currently scheduled for 9 am on Wednesday, November 19. Please pray that we are able to reschedule the appointment during the time we are over there on Tuesday and Wednesday. I left a message for them today and asked them to call me back as soon as possible and hopefully we can get it taken care of. So, prayers for getting that done would be much appreciated.