We had a couple of appointments today; one at Kelly's primary care clinic, and the other at the Perinatal Center at Meriter Hospital. Neither appointment revealed any new information, but we did make some slight changes to the birth plan and we got to meet the neonatologist that will be present when Jonah is born.
The first appointment was for the final ultrasound which was easily the shortest we have had and it did not reveal anything new. The purpose was to give us one more chance to look at him prior to the birth. Like the other ultrasounds, it was an emotional experience, but we are grateful to get whatever chance we have to get a look at him. The profile view of his head always gets me choked up because I see Evan's facial features when I look him...
The appointment was also a pre-op visit with a nurse and the doctor who will do the c-section. That was routine, going over procedures and signing a release form. Nothing of note came out of the visit, other than we picked up a grape sucker for Evan. At least someone got some enjoyment out of it!
The appointment at the hospital was more interesting because we got to meet again with a nurse that serves as one of the infant loss coordinators, and we got to meet with the neonatologist. She was quite a comforting presence to us, and she went over a variety of possible scenarios and what options we may have when he is born. We are both glad that she will be there for Jonah, and for us.
I have to start out with what we have known for some time -- Jonah will not be with us for very long. How long? It depends on his lungs and how much they expand after he is born, and their ability to release carbon dioxide. The last time we had his chest cavity examined on an ultrasound, the images showed a large heart in a small chest cavity. That means small lungs, which is not a good sign. As a result, they don't know how long his lungs can support him after he is born. It may be an hour, it may be longer. We won't know until he is here, but the unique circumstances of his development and pre-natal care may put him into a "gray area," as she put it, that would allow him to survive a little while longer.
The "gray area" was not new information, but it was re-enforced by the neonatologist today, which caused the slight change to the birth plan. Instead of just focusing on comfort care, we are going to let Jonah guide us down the best path. If he is struggling significantly at birth, he will be given enough breathing support so that we can spend some time with him as a family. If he is doing better and can get by on his own (or with just oxygen), we will go with it and be flexible with our care plan for him.
So now we wait. We are still on schedule for noon on March 20th if Kelly does not go into labor before then. Unfortunately, I can not make any promises about when I can update the blog after he is born. I know that this may be your only source of information and I will do my best to update it when I can. Jonah will decide that too.
John and Kelly
