Monday, October 6, 2014

Week 20: Fetal Echo

One of the challenges I'm finding about having a baby when you already have a child, or two in my case, is that working the baby's fetal schedule into the already complicated, busy family day is actually harder than it sounds.  With 19 weeks to go until baby #3 truly requires his own car seat, planned dinner and established bath routine (remember, I'm not allowed to go past week 39 without induction), his doctor appointments are already clashing with GW's school hours and GV's nap schedule.  Granted, it's pre-school for big brother and nap time can still happen pretty much any where for little miss, but the fact that I'm starting to get a taste of what juggling activities is going to be like and baby bump isn't even baby yet is somewhat comical

As the pre-ramble suggests, I had to move some things around today to get up to a doctors appointment in NOVA.  Due to the elevated AFP levels that we've been seeing over the last several weeks, my MFM is requiring that I see a pediatric cardiologist to examine baby's heart thoroughly with a fetal echo to rule out heart defects as the source of the abnormal numbers.  Given that diabetics with poor glucose control during the first trimester, notably the first seven weeks of gestation, can directly impact the formation of the baby's heart as a result of untreated hyperglycemia it is a logical concern of theirs (and, rightly so, one of mine) that is easily confirmed or ruled out with this exam.  So, taking the first availability we could to see the MFM's  preferred fetal cardiologist, we scrambled our selves and our typical Monday schedule to find out what we could: HB took the morning off of work, GW forfeited his morning school and romp session, GV resigned herself to a reclined rather than prone daily siesta and I held my breath for the ride north in extreme hope that the morning would prove an exercise in multi-child parenting, aka flaming-hoop jumping, rather than necessity.

We arrived at the Child Cardiologist Associates office with just enough time to fill out all necessary forms and initiate a sibling fight over the best child sized chair and waiting room toy before we were directed back to an exam room.  Finding the room to be exactly what you'd expect of a cardiologist, HB immediately began to field four-year old questions about "what's this?""can I touch that?" "do I have one of those?" about the various posters, replicas and kid-friendly props scattered about the counters adjacent to the table on which I impatiently perched.  Showing the kids the "foramen ovale" and various chambers of the heart from his inexplicable daddy-memory, HB kept the kids occupied just long enough for the doctor to come in, squirt the goo on my belly and begin our exam.

whub-whub-whub-whub... click, click, click, click... whub-whub-whub... click...

If you didn't know this already, it's torture watching someone who knows what they are looking at look at something important, like your baby, without commenting about it is they are seeing.  Giving the medical student with him a chance to drive the echocardiogram, two two white coats began to quietly discuss what parts are what, why they conduct sonograms in particular ways and how to check for this, that and the other malformation...  all of which, I then found out, were fortunately not present in my belly and therefore very ho-hum vanilla as teaching-aids.  I would have apologized to the poor student if I actually felt such disappointment were warranted, but frankly my boring belly and I were more than happy to be a non-noteworthy case study and deprive her for one more appointment of something to call home about. THANK GOD!

So, wiping my belly off, bundling the feisty siblings in their coats and scooting HB towards the door, we emerged from this high-stress, directly relevant to my self-/baby-care appointment with a sense of relief.   We're pretty much up-a-creek with the high AFP levels at this point as we've ruled out the main complications it could be leaving it as a likely indication of a prematurely aging placenta, but as I went through this process with GV I at least know what this could imply and the knock on affects we could see with baby #3s development.  The MFM will keep a very close eye on the placenta from this point forward to check for calcification and will monitor baby's growth to ensure we aren't seeing significant growth restriction due to inadequate function of the placenta, neither of which I can change or impact out of sheer will power.

All in all, it was a hectic morning that'll take the remainder of the day to recover from, but I'm happy we were all there.  I know we'll each need to sacrifice things as the kids get bigger to be there for each other's big moments - soccer games, piano recitals, science fairs - so the fact that we're starting it now is kind of nice.  We care about you, baby #3, and wish you nothing but congratulations on your big win today - just keep in mind that I'd prefer your next family togetherness moment be for something far less pressure filled than an fetal echo... like birth! Well, maybe not the labor process, but the clean baby snuggling right after doesn't sound half shabby to me.

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