37 Week Doctor Appt

This morning we had our final doctor's appointment of 2008! Yeah! We are so happy Caden has decided to be a 2009 baby. Of course that means I still need to get through the next few hours...

Anyway, we talked to the doctor briefly about inducing me next week. She said they would talk to the neonatologist to make sure she was okay with doing the induction on the 9th, in case I hadn't already delivered Caden by that point. She said they will often induce right around 39 weeks if the baby looks like it's big enough. So, we don't know for sure what will happen, but we will see. We got a call this afternoon from the hospital asking us to come by and pick up a pre-registration packet to fill out in order to schedule the induction. So, Greg needs to go pick that up. Once they have that completed, they will call to set up a date to induce.

However, Greg tells me I need to stop planning because things never go according to plan. Caden can still decide he wants to make his entrance sometime in the next week and so making a plan is irrelevant. Greg's right, of course, but I can't help but make some plans. At least this is the backup plan in case Caden isn't born before the 9th. : )

At this point, he looks great on the non-stress tests and appears to be gaining weight steadily, even if he is on the small side. The doctor seemed to be happy that his growth was progressing and he would probably be over 6 pounds next week. My goal all along was to make it to 38 weeks (which is next Monday) and anything past that would be great. So far, we're looking good. This afternoon I was having a LOT of discomfort, more than usual. And, my lower back was really starting to hurt. I was a little concerned I was going into labor today (I had back labor with Kyler). But the back pain has subsided and I am not showing any other signs of labor. So, we will continue to pray for him to stay put for another week. Thank you all for your prayers. May you have a peaceful close to 2008 and a joyful start to 2009!

Ultrasound Etc.

Today, December 29, we had another non-stress test and ultrasound. As usual, Caden looked great on the NST. We had our ultrasound immediately following that and I was anxious to know how much he had grown since our last ultrasound almost 2 weeks ago. At that time, Caden weighed 4 lb, 11 oz at 35 weeks. Now, today at 37 weeks (and 12 days since the last ultrasound), he weighs 5 lb, 10 oz. So, he gained 1/2 pound/week which is typical weight gain at this point in the pregnancy. That was great news for me to hear. That means, if he keeps it up, he will weigh over 6 pounds when I get to 38 weeks. Also, the ultrasound technician mentioned that it's very likely he weighs more than the ultrasound shows because they take the weight from measuring the circumference of the abdomen. And, because part of Caden's liver is not in the abdomen, it makes the circumference smaller than it would be otherwise. So, if anything, he weighs more than 5.10 right now.

My OB/perinatologist came in to review the ultrasound with us and thought things looked good. Even though Caden is only 15th percentile, she was okay with that. When the ultrasound tech asked if we needed to schedule another scan in 2 weeks and the doctor said it wouldn't be necessary because I wouldn't still be pregnant in 2 weeks. She said since she was my doctor, she could make that decision. She said we could talk about dates to induce if I hadn't had Caden by a certain point. I told her I thought a birthday of 1.9.09 sounded like a good date, so she said she would make a "reservation" for that. That would make me 38 1/2 weeks. So, unless Caden comes before then, he will be born on the 9th. I would really like to make it to that point, so I am going to stick to my bed rest and aim for that day.

So, right now, we have NST's scheduled for the 31st, the 5th, and the 7th. And, we see our doctor this Wednesday, the 31st. And, if nothing else changes in the meantime, we will have Caden on the 9th. We'll try to keep everyone posted as things progress. After our appointment on Wednesday, we might have more details on all our doctor's reasoning for wanting to induce earlier than 40 weeks. We'll let you know what we find out. Thank you for your prayers as we start the final countdown.

The Latest

Thankfully, not too much has happened since my last post. So far, Caden has not been born yet. But, since it has been over a week, I thought I should update those who are following along on our journey. We have been settled in our room now at RMH for over a week now and are pretty comfortable. Sure do miss my own bed though!!! Last Sunday, Greg's parents and sister came over and celebrated Christmas with us and Kyler. We had a lot of fun with them and it was so fun to watch Kyler open his gifts. This is such a great age for it as he seems to get it and understand what it's all about.

On Monday and Wednesday, I had non-stress tests done at the hospital and Caden looks fantastic. I was happy that where they had placed the monitor, it wasn't really showing my contractions. They always make people nervous, so I was glad they weren't showing up because I didn't see any point in everybody worrying about it. Also, on Wednesday, we saw our perinatologist. Greg and I had prepared ourselves ahead of time in the event that she would want to check my cervix. We decided we were not going to let anybody look. They told me when I was in the hospital at 35 weeks that they wouldn't stop labor, even at that point. And, every time someone checks, it puts me at risk of infection as well as possibly speeding up the dilation/labor process. Neither of these are options I like. So, we were prepared to say "no" if the subject came up. However, we were pleasantly surprised that she didn't bring it up.

On Christmas Eve, Greg's sister brought Kyler back to stay with us and my parents arrived to visit for several days. My mom had prepared a wonderful Christmas dinner for us at our house in Sacramento and brought it over to us to share. RMH provided brunch and dinner on both Christmas Eve and Christmas Day, however, the main dishes had meat in them, and so we couldn't enjoy the whole meal. It was nice to be able to enjoy my mom's cooking and have a taste of home. Natalie left that night to go home and Kyler stayed in our room with us while my parents stayed in a local hotel for 3 nights. Christmas morning, they came back over to RMH and we opened Kyler's gifts. Many toys had been donated to RMH and we were allowed to choose 3 to give to Kyler for Christmas. The volunteers wrapped them and had them waiting under the tree for all the kids in the morning. It was very cute!

Kyler was definitely overstimulated with all the toys he got. And, that is even considering that we didn't buy him anything from us! He absolutely loves his battery-operated quad, his workbench/tools, and most especially his Mack truck from the movie, Cars. It is made of lego pieces he can take apart and put back together and that is by far his favorite gift at this moment. But he has so many new things to play with, it was a little overwhelming for him.

My parents left this afternoon with Kyler and went back to our house. My dad will head back down to Southern CA tomorrow to work at his old dental office for the next week before he heads home to Coeur d'Alene, ID. And, my mom will stay at our house with Kyler. She is planning on bringing him back over to see us mid-week next week and again next weekend.

We have been so blessed to have family helping us out with Kyler. Natalie was so kind to get him enrolled in the day care in the building where she works and take care of him evenings/weekends for 3 weeks. And, it is so great that my mom is now able to take over and have him at home. His therapy appointments (speech, music and occupational) start up again the first full week of January and it will be nice for him to get back into that routine.

As for me... I am having increasing discomfort. My pelvis is really separating and the ligaments are loosening up incredibly! It makes every position uncomfortable. Turning over in bed is quite painful and walking is very awkward. If Caden wasn't so low it might not be so bad, but he is pushing down with all his might. And, every time I get up or down, or turn over, etc., it causes more contractions. Every day it gets slightly worse. I realize it is for a good cause because Caden needs to stay put. But, I am sure "done" with being pregnant! However, I would be happy if he stays right where he is for another couple weeks. I will be 37 weeks on Monday which is great news. However, since he was measuring so small on our last ultrasound, it would be nice if he stays put longer.

This Christmas season, I am so grateful for all our family and friends. We have had so much support, we are blown away by it all. We are also glad that I have been able to stay on bed rest so Caden can continue to grow inside me. With my official due date being January 19, we are hoping we can make it to the first week of January at least. Anything beyond that would be great, but at a minimum we're hoping to make it to January 5. We'll see what Caden has in mind. We have another ultrasound on Monday and hopefully we will see some significant growth for Caden which will help us feel better about his weight. We'll keep you all posted. Thank you for your prayers as we continue our waiting game.

Room Move

Since I typed out the last blog entry, we got a call from the housing director at Ronald McDonald House telling us a permanent room had opened up for us. We weren't originally scheduled to move until tomorrow, but because this one became available unexpectedly, we were able to move this afternoon. It's nice to be in this room because it is bigger and we are able to actually unpack and get settled. We can start to make it feel a little more like home since we'll be here awhile.

But because of how the afternoon has progressed, Greg decided he would wait until tomorrow to get Kyler and bring him back here to spend the night. We really miss him and are looking forward to seeing him tomorrow and having home overnight. Then, Greg will take him back to Natalie's house on Saturday. Anyway, it's nice to be in a more permanent room and get settled since we're likely to be here for awhile.

Stanford Update

A lot has happened since I last posted a blog entry. On Tuesday, December 16, we packed everything up and drove over to Palo Alto to move into the Ronald McDonald House (RMH). We checked in around 4:30 pm and were placed in a temporary room (it is the weekend manager's room). So, on Friday, they will be moving us to a more permanent location. In the meantime, the room we are in is quite small, but it is adequate for a short-term basis. We have been very impressed with RMH and the amenities, services and programs they provide. They provide a continental-type breakfast every morning, and 4 or 5 nights/week, various organizations provide dinner. In addition, the kitchen is stocked with a supply of non-perishable food items which is available to all house residents. Overall, we are quite happy with our accommodations.

On Wednesday morning, we went to our appointment with the perinatologist. She did a cervical exam and determined I was dilated 1.5 cm. This was a change since Monday, because when examined then, my cervix was tightly closed. So, because of the dilation and the contractions, she wanted me to go to labor and delivery at the hospital for extended monitoring. In labor and delivery, I wasn't having a lot of contractions and the doctor came in to check my cervix again after I'd been on the monitor for a couple hours. She said I was now dilated to 2 cm and because of that, she wanted to check me again in another couple hours to see if I was continuing to progress. In the meantime, I had an ultrasound appointment to go to. So, they took me up in a wheelchair for the ultrasound and said they would come pick me up again when I was done.

The ultrasound went well. There was nothing new to really talk about. The pediatric radiologist thought the diaphragmatic hernia looked relatively minor and the outcome was probably going to be good. But, she said, as they all do, that you never really know until the baby is born how the lungs will function and how baby will do. We asked her about the heart and she thought it looked good, but again, it wouldn't be possible to really tell until he is born. The only thing that came up during the ultrasound that caused us any concern was his size. It appears he weighs only about 4.12 lbs. This is only the 14th percentile and is a little concerning because the doctors have said it is best if he weighs at least 6.6 lbs when he is born. But, the umbilical cord is only 2 vessels instead of 3. This isn't necessarily a problem, but it can be associated with decreased growth.

When we were done with the ultrasound, a nurse from labor and delivery came back up to get me and wheel me back to their unit. I went back on the monitor and at this point, I started having more contractions. However, when the doctor came back in to check me, I told her I would really rather not have her check again because I didn't want to stir things up and speed up the dilation process. She said that was fine, but if they didn't check me, they would want to keep me overnight. Also, they were worried that Caden's heart rate had been dipping periodically and they wanted to be able to continue to monitor that. I told her I thought it was only because he was moving around so much that the monitor wasn't picking up the heart beat consistently. It turned out that was the case, because as soon as they adjusted the monitor, he looked just fine. No problem there.

Anyway, because I didn't want her to check my cervix again, they admitted me for the night and said they would reevaluate in the morning. Greg stayed with me until a little after 8 pm before he headed back to RMH for the night. I was actually able to get a pretty decent night's sleep in the hospital. They had me in a private room. It was definitely small, but it was pretty quiet and I had it to myself, so I didn't care how small it was. The nurse woke me up a couple times during the night to give me medication, but otherwise I slept pretty well until about 7:30 this morning.

I had a fetal echo scheduled for 9 am and got ready to go to that. In the meantime, the doctor came in and checked my cervix again and thankfully I hadn't progressed. I was still at 2 cm. She told me they would take me down for the echo and when that was over, they would bring me back. She wanted to talk to one of the other perinatologists about my situation to make sure he thought it would be okay to send me home.

So, we went in for the fetal echo and Caden wasn't cooperating very well. He was moving a lot and wasn't in a great position for scanning. The technician had me roll onto my right side and that seemed to help her get better images. When Dr. Silverman came in, he looked at the screen and said things still looked really good. He said it was impossible to tell if Caden would have a coarctation or not. But if he had to guess, he would say no. But until he's born, there is just no way to know either way. We told him we had decided to deliver at Stanford and had already relocated to the RMH so we could be here when Caden was born. He thought that was fine and at least we would be here in the event that there was a coarctation. The surgery for it is considered vascular surgery, not heart surgery and they would go in from the back between the ribs to do the repair, if necessary. He thought it looked like a relatively good outcome for us.

Once done with the echo, they wheeled me back to labor and delivery where I waited to see the doctor again. Three of the doctors came in to consult with us and they decided they would discharge me because there hadn't been a change in my cervix for close to 24 hours despite all the contractions. That was fine with us because we figured we are staying about a mile from the hospital and if I go into labor, it's not going to take that long for us to get here so we should be fine. We were out of the hospital before 10:30 this morning and headed back to RMH for me to lie down.

The only downside for me being at RMH is we are not allowed to have any food in the rooms. It makes sense because they have many children staying here with suppressed immune systems and they can't risk having pests in the rooms. They can't spray to get rid of pests due to the risk of causing harm to other residents. We understand and respect this, however, it does mean that I have to be up more. I have to walk to the dining area, eat, and then walk back to our room. So, it just means I need to be extra vigilant about staying down the rest of the time.

Anyway, after the drama of the last couple days, it is nice to be able to relax in our room at RMH. Greg is going to pick Kyler up today and bring him to stay with us for a night or two. We really miss him and look forward to spending some time with him. Then, on Sunday, we'll have a family Christmas celebration here at RMH with Greg's parents, his sister, and my parents. It will be nice to at least have some sort of Christmas since we have to be away from home and away from family on the actual day.

Thank you all for your prayers. We still need them as we want to ensure that Caden stays put for a little longer. Although I am 35 weeks now, he is just not big enough to come out just yet. That is the latest update with us. Hopefully we'll have an uneventful weekend and I will not go into labor.

Housing

Well, at long last, our wait is over. We got a call this morning from the social worker at Lucile Packard Children's Hospital in Stanford to let us know that we have a room at the Ronald McDonald House as of tomorrow, December 16. So, we are using our last night at home to finish up the packing, finalize all our financial items and get ready to go. We will check in sometime between 3 and 6 pm. It was nice to have a few more days at home to get more prepared to go. But, it will also be nice to be settled over there and be done with it.

Also, this afternoon, I had another NST (I go for them twice/week). Unfortunately, my uterus decided it needed to have a lot of contractions. I was on the monitor for 20 minutes and had 6 contractions. That makes everyone very nervous. So, the nurse called the doctor in, who just happened to be the same doctor who admitted me over night before Thanksgiving. I was so worried he was going to admit me again because when he looked at the monitor, he didn't like what he saw. He asked me when the last time I had my cervix checked and I told him it had been just over a week ago and I wasn't dilated at all at that point. He asked me if I wanted him to check it today and I told him I would be happy for him to do it if it meant I would get to go home. I told him we were relocating to Stanford tomorrow and really didn't want to spend tonight in the hospital. So, he checked my cervix and said it was still tightly closed (yay!) and that he thought I was only 50-75% effaced. This would mean that my cervix is getting longer and thicker, which is good news. He said since I was going to Stanford tomorrow, he would let me go home today. I was so happy, I practically ran to the car before he changed his mind.

Things are falling into place right now and we feel really good about it. In the last week or so, we have been so blessed by church members bringing us meals. This made things so much less stressful on us and made it that much easier for me to maintain strict bed rest.

Your prayers are still very much appreciated as we head to Stanford. We are hoping Caden stays put until 38 weeks. Based on how things have been going, I think we have a chance at it as long as I stay on bed rest. We'll keep the blog updated as things change and as we get more information.

Relocation Update

I wanted to give an update on our relocation to Palo Alto. Beginning Friday and over the weekend, Greg & I were trying to coordinate childcare for Kyler during the day while Greg was at work until we moved. Once we got the word we could get into Ronald McDonald House (RMH), we were going to take Kyler to Greg's sister's house and leave him with her until my mom could return on December 20. However, we were having some trouble arranging childcare so we decided Greg would take Kyler to Natalie's house on Monday night. She has arranged for him to attend the day care center at her work. This will allow me to rest during the day and Greg to continue to work without the stress of juggling childcare. Our church members have signed up to bring us meals every day until we leave, which is so incredible and really helps us out!

I got a phone call from the social worker at Stanford this afternoon. She said she asked the director at RMH to give us a call this afternoon to let us know if we could get in on Tuesday or not. She said if I didn't hear from him by 4 pm, I should give him a call. I hadn't heard from him, so I called him and asked if they were going to have a room for us. He said they didn't have one available on Tuesday, but possibly Wednesday and I should call him back again late tomorrow afternoon to find out. So, we still don't know, but we are just taking it a day at a time until we can get in. My contractions really slowed down over the weekend and I am feeling pretty good as long as I stay off my feet as much as possible. I can definitely tell a difference in the amount of contractions I have in connection with how much I am doing. The days I have doctor's appointments, I always seem to have more contractions than the days I am home all day. So, as long as things remain stable, I can relax at home until a room opens up.

Perinatologist Update

This afternoon, December 4, I had another appointment with Dr. Chyu, the perinatologist. She did another ultrasound just to check things out again. Nothing new to note there really, except one thing. She mentioned that the umbilical cord is around Caden's neck twice. This is mildly concerning to us, but it is also not uncommon. And, I don't know that it will prevent a normal birth. Of course, it's good to recognize so that if Caden does go into distress during labor, they can do a c-section quickly and get him out. And, God has taken care of us so far, I know this is a minor concern that can be dealt with.

She also checked my cervix and said I am still not dilated (great news!) and she said it actually seemed like my cervix got thicker again. I'm not sure that's typical, but God has already worked miracles, so why not make my cervix thicker again? He's certainly capable! But, with the amount of contractions I am still having, bed rest remains for me.

After my appointment with Dr. Chyu, a very kind friend from church picked me up and drove me to my next appointment which was at a different office downtown. She was so sweet to do that for me since I am not supposed to be driving myself places right now and Greg couldn't take the time off work this afternoon to take me. My non stress test went well and Caden is flourishing in-utero. He is performing beautifully when they monitor him which means his central nervous system is mature and doing well. All good things!

And, as a follow-up on relocating to Stanford... I have spoken with the social worker at Lucile Packard Children’s Hospital a couple times this week and she has been working on getting us into the Ronald McDonald House sometime next week. She told me yesterday they were unable to get us in starting on Monday, but there was a possibility of us getting in on Tuesday, Wednesday, or Thursday. We will have to wait to hear from her Tuesday morning to see if we got in on Tuesday or not. If not, it will be a day-by-day wait until we can. We'll just have to play it by ear and see what happens. God is in control and will take care of the situation for us. We just have to have faith in him. Keep us in your prayers as we prepare to pack and relocate our family temporarily. There are a lot of details to work on in the meantime.

My Mom will be leaving us on Saturday to head home and off on a trip of her own for the next couple weeks. So, we will be needing some additional help at home, especially with Kyler, until we are able to move over to Palo Alto. But, it will all work out and we'll keep you all posted on our progress.

Final Appointment with Dr. Van Gundy

This afternoon, Greg and I had our last meeting with Dr. Van Gundy. When we had our echo last week, we still had so many questions for him and we was willing to meet with us today just to talk. So, we sat down and discussed where we were at and where we had decided to deliver. We told him we had decided to deliver at Stanford after all and he seemed to think that was a good idea. He said it made the most sense because we don't know what to expect when Caden is born. His heart could be totally fine, or he could have coarctation of the aorta which would require surgery. With that being said, he said it would be better to be at Stanford in the event of surgery being required because if Caden was born in Sacramento, he would have to be transferred to Stanford for the surgery anyway. And, when you're talking about transfers, that can be risky depending on how stable the baby is.

It sounds like if Caden does have coarctation, it would most likely be a single surgery fix. He said there's a less than 10% recurrence rate of it and if it did recur, it could be taken care of with a catheterization instead of surgery. That sounds pretty good to me. Of course, we don't know how the diaphragatic hernia or eventration will complicate the situation. This is another reason for us choosing to deliver at Stanford. They have all the surgeons we could need right there in one place.

We told Dr. Van Gundy how much we have appreciated his input and willingness to talk to us throughout this whole process. I feel we are so blessed to work with him through this experience. I don't know if we would have been referred to him if we didn't already have a relationship with him because of Kyler's heart issue. But, we are very grateful he was our cardiologist and the one to work with us through this journey. God has definitely been putting the right people in our path!

Another Cardiologist Opinion

Today, December 1, Greg & I had another fetal echocardiogram with a different cardiologist. Dr. Chyu, the perinatologist we saw last week, wanted us to get another opinion on what we were looking at with Caden's heart. He did a very thorough echo and discussed what he saw with us when he was done. In his opinion, everything looked really good. The only concern he had is the potential for aortic coarctation once Caden is born. However, he said this can't really be predicted ahead of time. He said it's possible everything will be completely fine and it's also possible that the coarctation will occur and surgery will be necessary.

He asked where we were planning on delivering and we told him we were planning on going to Stanford. He said that would make the most sense because if Caden was born in Sacramento and an echo showed a coarctation, they would transfer him to Stanford for the surgery anyway. So, he thought it best to not take the chance and deal with the transfer, and just deliver at Stanford in the first place. It reaffirmed the decision Greg and I made to deliver in Stanford.

After we were done with the cardiologist appointment, we headed to Sutter Memorial for me to have a NST and amniotic fluid test just to make sure everything looked good with Caden. After registering, they did the ultrasound to measure the amniotic fluid level and it looked great. When that was done, they hooked me up to the monitor to make sure Caden looked good. He performed beautifully and my contractions were minimal, so Greg and I headed home.

Since I've been home this evening, I've had quite a few stronger contractions, so I took both kinds of medication to get them slowed down. I've only been taking one of them that I was prescribed because it seemed to be working fine. But last night, and again tonight, the contractions have picked up and gotten stronger, so I took a dose of the other medication as well. I think the problem for today is that I had to go to two different appointments and it was just too much for my body. So I really need to take it easy tonight and tomorrow!

This week is going to be busy with trying to pack for “moving” to Palo Alto and arranging housing for our stay there, etc. Today I talked to the social worker handling our case at Stanford to let her know we were planning on coming there to deliver. And, I made her aware of my pre-term labor symptoms as well. So, she contacted Ronald McDonald House (RMH) to see if they could possibly get us in there next week instead of waiting until the 21st. They will have a better idea Wednesday afternoon as to what might be available next week. But it seemed like it was a possibility so that is good and she will get back to me late Wednesday afternoon. If that doesn't work out, we'll have to check into other options for temporary housing until we can get into RMH. We'll keep you all posted on what we find out and how things progress. Thank you for your prayers!