A Tough Day

Kelly checked into the hospital this morning and is resting comfortably. She is in no pain whatsoever, and we are assured that there is no risk to her greater than that of a normal pregnancy. She is also not on bed rest and is even able to wear her civilian clothes as opposed to the hospital issued gowns. She is free to move about the floor and the hospital as well; they just want to keep her close for observation since the amniotic fluid is gone. Low fluid can cause umbilical cord compression which can seen through a drop in the heart rate. The good thing he has going for him now is that is heart "looks great," as the doctors said.

We saw the high-risk OB - MFM (Maternal Fetal Medicine) doctor this morning, as well as one of the doctors from her primary practice. No hiding it, they are not optimistic like they were before. We had several discussions about end-stage renal failure, as well as dialysis. It was a shock to us, but not completely unexpected given the results of the last ultrasound. The doctor from her practice is typically light-hearted and tries to give hope when he can. I didn't see that side of him today. I saw a person who was obviously concerned for the baby as well as how we were dealing with it.

The plan for tomorrow is to have a discussion with the pediatric urologist that we saw before our first visit to Cincinnati, as well as a neo-natologist to discuss the matters of our greatest concern.

The first, and foremost, concern is lung development. We believe there was fluid up to, or at least very close to, 24 weeks which is of the up most importance. The period of gestational time prior to 24 weeks is a stage in development where lung development will simply never happen if there is no fluid. We may have cut it awfully close on that one, but we may have dodged that bullet. The fluid levels have been up and down since then but there has been fluid and she also received a sequence of steroid injections at 26 weeks. The purpose of those injections is to push the lungs along in the absence of fluid or the presence of low fluid. She also got another steroid shot today and will get one the next two days.

The second concern is the kidneys. Both kidneys are being force fed fluid by the bladder because the ureters are dilated from the pressure. If this were to happen to you or me, meningitis would be a typical result because of the infection. He is being protected by Kelly right now but, if this condition continues, his kidneys will certainly begin failing.

The third concern, which is what we had on our hands already is the bladder. It has been dilated for extended periods of time, causing the walls to thicken and become more muscular. That is not a good thing because intead of decompressing evenly like a ballon, it is decompressing like a crumpling piece of paper; unevenly in both size and pressure. It's possible that its new found strength was enough to force through the valves in the ureters, causing the fluid to go back to the kidneys. This is not that big of a deal compared to the lungs and the kidneys. As long as they can clear the obstruction after birth, the fluid will get out.

So, how do we get to there from here? We find out on Monday. We are going to have the mother of all ultrasounds that will be used to measure his chest cavity in relationship to the size of the heart (to check for lung development) as well as a detailed look at the kidneys. Once the doctors get the data from that, we are going to get everyone in a room and talk about delivery dates. Yes, the lungs have to be properly developed but they may not be able to do much for him if he comes out too early and the kidneys have failed. The options they can offer us to help the kidneys only come into play after he has reached a certain gestational age and weight. What that is, I do not know but I am sure I will find out soon.

I sent out an e-mail this morning with Kelly's contact information at the hospital. Obviously I can not share that here, but if you did not get it, shoot me an e-mail at john.carlson06@gmail.com and I can let you know how to get a hold of her.

Despite what we found out today, we are still hopeful and determined. We've been on this roller coaster for ten weeks now but we are not giving up. We will do what ever it takes to get the best shot at life, as long as we are still here to do it.