28 week Update

I had another ultrasound and doctors appointment yesterday.

After my last appointment, two weeks ago, I left feeling very confused. Every doctor and nurse I have spoken with suggested that with a known vasa previa (some have this but have no symptoms and it goes undetected until they inspect the placenta post birth) that the standard procedure is early admission at 32 weeks and an early c-section around 35 weeks.
So when my doctor said she was holding out hope that I would carry this baby to term and have a vaginal birth - we left feeling very optimistic but then very confused.

This last ultrasound and appointment have cleared a few things up - which is what I was really hoping for.
The ultrasound yesterday showed that the exposed vessel and placenta have not budged an inch. In fact the exposed vessel is still right over the cervix. The chances of it moving enough to safely have a vaginal birth are pretty much gone at this point.
So - the plan right now is ultrasounds at 30 and 32 weeks. At 32 weeks if things are still looking ok and there are no signs of early labour she says that I might be able to stay home until 33 weeks (approx. May 5) And then they will look at taking baby by section in the 35th week (May 20-23).

I asked, why early admission? Why take baby early by section?
- the rationale for these things has mostly to do with things that happen in late pregnancy and any remote chance of early labout putting baby in grave risk. The risks increase the later into the pregnancy we go.
- If something goes sideways in the hospital, baby can be delivered and resucitated within minutes. If something goes sideways at home and I have to go by ambulance or drive be driven there is a chance that we can lose the baby.
- Because the exposed vessels are still right over the cervix, we do not want baby to drop (as they do in the final weeks of pregnancy), to engage in the pelvis and place extra pressure on the vessels.
- If my water were to break with those vessels in their current location they would likely break and cause baby to bleed.

The good news?
This is going to be another really big baby. As I mentioned in my last blog entry, Jack was 9lb 13oz at birth, just 3oz shy of 10lb.
Two weeks ago at the 26 week ultrasound this baby was estimated to be 2lb (average is 1.4lb).
At the ultrasound yesterday baby was estimated to be 3.7lb, and is now off the charts!!! He gained 1.7 pounds in 2 weeks. (The generic 'he', as opposed to 'It', we don't know the gender). This is great news considering baby is measuring 4 weeks bigger than gestational age and will be taken 4 weeks early. And the really great news is that I don't have to push this one out a key hole.

Thank you all, for your continued support. We could use continued prayer that the rest of the pregnancy goes well. That there is no further bleeding over the next month or I will admitted even earlier. And that the birth is uneventful and uncomplicated.

Lots of Love.

A Very BIG and Humble Thank YOU !!!

Thank you to everyone for everything that you have been doing to help us through.
You have definately made the past few weeks more bearable.

Thank you for helping watch Jack.
Thank you for all of the yummy food and treats.
Thank you for your kind and encouraging words.
Thank you for asking how my day is.
Thank you for asking if we need anything.
Thank you to my prayer warriors (your prayers are changing things).

We had another ultrasound on Monday March 10 and a doctors appointment right after.
There was much good news.
The placenta and vasa previa continue to move away from the cervix. This means that the chances of bleeding are decreasing and they are still holding out hope for a full-term vaginal birth (as opposed to by section).
The doctor has canceled some of the activity restrictions. Although, I have been unable to walk or stand for very long because I have another condition of pregnancy (yes there is more, lol) called neuro-cardio genic pre-syncope. If I am standing, walking, exerting myself, or if baby starts to kick my guts, I start to experience heart palpitations, chest tightness, lightheadedness, nausea and shortness of breath. I had this same condition while pregnant with Jack and it went away pretty much as soon as he was born.

I think this baby is going to be big like Jack was. Jack was 9lb 13oz. Just 3oz shy of 10lb.
The normal weight for a baby at 25 weeks is 1.4lb or 600grams. They estimated our baby to be 900grams or 2lb, which places it above the 90th percentile for weight!!!!

I left their office on Monday feeling quite confused.
She had mentioned the possibility of a full-term vaginal birth - we had been told that it was completely out of the question.
She mentioned the possibility of therefore not requiring early admission back to hospital at 32 weeks.
She said there were no need to be completely sedentary.
All of this made us question whether we had jumped the gun with hiring a nanny? How had things changed that much?
Wholly emotional roller-coaster.

I have corresponded with her since by email and realise now that the risks seem to lie somewhere in between.
The risk of bleeding is a little less than it was at the last ultrasound - but it still exists.
Only time will tell - if things continue to move, then there is the possbility of a vaginal birth (though, it is remote).
I will likely require early admission to hospital - this is a standard precaution with a known vasa previa.
Depending upon how much things shift - baby will very likely be taken early by section.

A Day at a Time.

We're taking things a day at a time. That's all we can do.

And baby's survival goes up with each day that we get through. We are currently 24 weeks. The longer we can cook this critter the better. 

Thank my lucky stars that we have such a great healthcare system.

I am part of the Calgary Antenatal Community Program. Without this program ,I woul be in hospital right now. So although it feels like house-arrest, I'll take it! It means a few more weeks at home with my boys before being readmitted back to hospital, where I will remain until baby arrives. 

I have nurses that phone in daily to check on me and come to the house once a week. The lab comes every four days to draw my blood. They come right to the house. No need to drag myself and Jack to the lab - a lifesaver. 

I'm on modified activity. The restrictions are no standing longer than 20 minutes, no walking longer than 10 minutes, no housework (oh darn), 9 hours of sedentary rest during the day (with a toddler? hahaha). With being set up at home with the life line (panic button) they have advised me to stay at home as much as possible. And not to leave the city limits until baby has arrived. 

We hired a nanny yesterday. She'll start on Tuesday. Such a relief! 

I need someone to help with Jack, help with housekeeping, and to be present with Jack in the event that I need to be taken to hospital. And to care for Jack, once I am in hospital, while Peter is at work.

A very BIG thank you to everyone who has helped and has offered to help. We're not done yet, and may still need to call on you. You really are helping to make things easier and we appreciate you very much. 

We have another ultrasound and doctors appointment on Monday March 10. The ultrasound will tell us if the placenta and exposed vessels are moving away from the cervix; which may decrease the risk of a bleed. 

Baby Thomsen

There have been a few complications with this pregnancy that many of you loving people have asked to be kept informed about. It's not very personal, but I do find blogging to be the most effective way to disperse the information.

I'll try to be as chronological and sensical as possible. 

At our 19 week ultrasound it showed placenta previa. Meaning that, the placenta had grown over the cervix. Not ideal - how will the baby get out? It has the potential to move away from the cervix as the growing uterus expands and stretches. It comes at an increased risk of bleeding because the placenta is highly vascular. 

Two weeks ago, on Tuesday February 4, I went to hospital for assessment because of some light spotting (bleeding). It stopped on it's own and was very light. They assessed me and sent me home within a few hours. Stating that if I had two more episodes of bleeding that I would need to be admitted. 

This past Tuesday, February 25, I had a more significant bleed. When I went to hospital for assessment they decided to admit me. NOT what I was expecting. I spent the last two nights in hospital for assessment and observation. During my time there they have discovered that the placenta previa has developed into a vasa previa. 

What does THAT mean? 

The part of the placenta overlying the cervix likely did not have good blood supply (the cervix is not as vascular as the rest of the uterus). So this part of the placenta shrivelled up and disappeared. However some of the blood vessels (the veins and arteries) that were in this small part of the placenta, remain. The protective tissue of the placenta is gone and these blood vessels are exposed. They are currently situated between baby's head and the cervix. Vasa - meaning blood vessels, Previa - meaning in proximity to the cervix.

What now?

If I bleed again I need to get to hospital ASAP. The exposed vessels are fetal, and if ruptured the baby could lose it's entire volume of blood very quickly. They need to determine quickly if the blood is fetal or maternal. If it is fetal, it means an emergency c-section to resuscitate baby. If it is maternal they will decide on interventions depending on whether it is slowing or increasing and how much has already been lost. Interventions such as IV fluids, blood transfusions or a c-section. 

In any case, if I bleed again I will be in hospital until baby is born. 

I am home now with weekly home care visits and a life line panic button. Press the button and EMS is dispatched to our home and we go directly to the hospital (no pit stops at Dairy Queen, even if this preggo begs). 

The likelihood of a vaginal birth at this point is very very remote and likely too risky. 

Best case scenario is a hospital admission at 32 weeks and a scheduled c-section at 35 weeks.

Why 32 weeks? As baby gets bigger there is an increased risk of these blood vessels being disturbed. And if something happens in hospital, baby's chances of survival are greater. 

Why a section at 35 weeks? A scheduled section at 35 weeks helps eliminate the chances of going into labour which could be dangerous.  

Baby Pants from an Old Shirt

Ingredients:
One shirt - long sleeved knit, or sweater, sweatshirt.
Piece of elastic - long enough for babies' waist.
Sewing machine
Thread
Scissors

Cut the arms off the shirt.
Find a pair of pants that fit baby.
Use the inseam of the pants to gauge how far to cut the inseam into the sleeves. Add another inch or so on the top to leave room for folding it over. Mark the length with a pin (see photo).
Cut down the inseam.
Sew the inseam right sides together using a stretch stitch. I used a surger to finish the edge or you could use a zig zag stitch.
Finish the top edge with a surger or zig zag stitch.
Fold over and sew the top leaving a pocket big enough for the elastic to run through.
Leave an opening big enough to run the elastic through.
Fasten a safety pin to the elastic one end. And run the elastic through the waistband.

Quiet Book Project

Such HOPE.

LOVE IT! 

Check out this interview with Lillian Greckol, an Albertan living with cystic fibrosis who just celebrated her 75th birthday! 

Her longevity is one of the many reflections of the outstanding progress made by the CF community in research, advocacy, fundraising and so much more.

http://video.citytv.com/video/detail/2148858484001.000000/a-cystic-fibrosis-patient-celebrates-her-75th-birthday/