The day of my second MFM appointment I again left work early to get to my 3:30 appointment. I was somewhat looking forward to this appointment, because I had a bunch of questions ready that I wanted answers to. I was quite anxious to talk to the doctor.
Russell met me a little before 3:30, and we were taken back by the sonographer a little after 3:30. I got on the table and began the routine. It was the same tech that had done our sonogram almost 3 weeks ago and had done our gender reveal sonogram too.
This sonogram did not take nearly as long as it did 3 weeks ago. After she was finished she told me to stay on the table 'gooped up' in case when the doctor came back she wanted to take more pictures. She left to get the doctor.
Russell and I were left alone in the room. We sat and chatted for a bit. After a while I was starting to wonder what was taking so long. I finally got tired of laying there 'gooped up' and used the towel to wipe off. I was in the middle of this when she finally walked in. "Don't wipe up yet!" she said.
She sat down, gooped me up again, put the machine back to my belly, and gave us the news, able to show us at the same time. The Dandy-Walker gap had gotten larger. While she did not believe that it was getting worse- it was still classified as variant- the issue was the gap was filling with fluid rapidly. So while the extra fluid would make it appear worse, she didn't really think that was the case; more so the fluid was pushing brain tissue aside. What has happened is that our Ally has developed hydrocephalus. Right now, from ear to ear across the top of her head, her head is measuring at 29 weeks- 3 weeks ahead of where she should be. This means she will definitely require a shunt shortly after birth, and her head will likely be abnormally large, at least at first. The shunt may completely bring her head to normal size/shape, or may just help it somewhat. Again, there is a lot of unknown with this, and it is something they will have to continue to watch and see.
I asked if there was any possibility that the fluid would stop building up. She said that although that was very unlikely, it may stabilize somewhat and not be as bad as it could be. I asked when the shunt would be placed, and she said that would be up to the neurosurgeon performing the surgery depending on the severity of it when born. I asked if there was a good possibility of an earlier birth being necessary because of the possibility of this being very dangerous and causing more harm without the shunt, and she said most likely not. Unless Ally shows some other issue later or turns out to have some other serious condition we don't know about yet, it would be better to have a term baby needing a shunt rather than a pre-term baby needing a shunt.
Then came the big blow, one I had been expecting since I heard the doctor say her head would be large: there was a very likely chance that this delivery would require a c-section.
I know, I know, so many women may read this and think, what's the big deal about that? I had one/two/three babies by c-section and survived, you'll be fine. I even know one mom who had 4 c-sections. Voluntarily. And wanted more kids, but her husband convinced her it was too risky for her. I think she's crazy. (No offense.)
The thing is, the one thing I had hoped for in all this craziness was that I would be able to have a natural birth like I did with my boys. One thing is for sure: I am good at getting pregnant (obviously), have had relatively easy pregnancies (even this one, with all the complications, has not been difficult physically for me at all), give birth with relative ease and no interventions (as much as you can say 'ease'- it is called labor after all and it was not the most fun time I've had in my life for sure), and make enough breastmilk to nurse and pump for a full year.
With Luke, I didn't even know I was in labor. I was having 'stomach pains' all day that Saturday (a week before my due date) but brushed it off as Braxton-Hicks because they weren't regular or particularly painful. After I threw up dinner and the pain got worse, we called the doctor, who thought I just had a stomach bug! Finally he had me come to the hospital to get checked out, and I was 7 centimeters dilated! I'll never forget the frightened glances Russell and I exchanged when the nurse told us "Looks like you're going to have a baby tonight." We got to the hospital around one in the morning. At 3:03, we had a 7 pound baby boy. I never got an epidural, and even if I had it may not have really had time to work (which is why I ultimately decided to not get it- remember the fear of needles? I had wanted to try without it anyway.)
With Ben, at dinner the night after my due date I felt some contractions, then they went away. I wondered if this would be it. With that in mind, I didn't eat much (I knew I would just throw it all up). I went to bed but woke up a few hours later with more contractions. I laid in bed for half an hour to see if they would go away; they didn't. I got up and decided to grade some tests I had brought home; after all, if I was having the baby I didn't want to leave them with the sub! They were a great distraction for me, because they took several hours to do, especially with having to get up and take breaks. Russell came out around 4 in the morning asking what I was doing- I told him I was having contractions and to go back to sleep. At 5:30 I couldn't handle it anymore. I got him up, told him to get ready, get Luke up and ready, and take him to the sitter, then come back and get me and take me to the hospital. We got to the hospital around 7:30, I was dilated 8 centimeters this time, and we had a 6 pound 10 ounce baby boy about an hour later. Again, (obviously) no epidural.
I wanted this experience again, seeing as I had to give birth. My recoveries were so much faster, there was little intervention, and it just all went so well. I just wanted SOMETHING about this pregnancy to go the way I wanted, and now it probably wouldn't. I'd probably have to have surgery, and if that was the case my hospital stay and total recovery time would be significantly longer, not to mention the fact that a needle in my spine would be a guarantee. I was ok with the fact that more people would be present due to Ally's condition (when you're in that much pain you just don't care; I wouldn't have cared if my students had been in the room and seen every gory detail) but I just wanted as little interference as possible. I didn't even like the idea of being induced, (which I was informed would probably be the alternative) but would take that over the c-section any day. I am still mourning this possibility but I know that if this is what's best, I will get through it and it will all be ok in the end; the goal is always a healthy baby and safe delivery and if this is what it takes, then so be it.
A c-section is not a guarantee, it depends on the head growth and when I deliver. If she has to come early (which obviously I don't want) then a natural delivery (though possibly induced) may be possible. Or, if her head growth stabilizes and I deliver at term (which will be 39 weeks, I don't believe they will let me get to 40 weeks at this point) it may be possible to have a natural (induced) delivery instead of a c-section. At this point, this is the option I am hoping for, because in the long run it is best for both of us. Needless to say, the doctor will be keeping a close eye on the head size at all subsequent appointments.
The other thing we learned at this appointment was that there were still questions about genetics and what is 'causing' the Dandy-Walker. Having the amniocentesis could give us some answers about them, or at least rule out some possibilities. Apparently there is a new technology called a SNP Array that looks not just at each chromosome of the baby, but individual parts of each chromosome that can tell about conditions and issues a baby may have. This would also allow a retest of the tests from the blood work at the last MFM appointment to give definite answers about genetics and infection, though the doctor did say that while the liver spots were still there, they had not changed and were probably nothing. While having the amniocentesis is still optional, it may give us some clues about what is going on and better prepare us for Ally's birth and what to expect later.
We left the appointment at 6:45, more than 3 hours after we got there. We really appreciate the time our doctor and genetic counselor takes with us, her patience (we had a TON of questions, some that we came in with and some that popped up with the new results, which is why we took so long), and her intuition, since much of the information is not set in stone but based on her experiences and her gut (which I have come to trust very much). We are waiting to hear from her office next week to make our next appointment and to schedule the amniocentesis, since we believe that more answers sooner will be better for Ally in the long run than waiting until after she is born.
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