Doctor Appointment Today - 35.5 Weeks

I had another appointment today with my OB. I'm going once a week now. She checked my cervix and found that I'm dilated 1cm and my cervix is starting to soften and thin out. She was surprised that my cervix was already dilating and ripening. She could feel Elam's rear end and she could tell he was putting a lot of pressure on my uterus.

Because I'm dilated 1cm already and my cervix is starting to thin, she thinks I will be a good candidate for labor induction. She suggests inducing me right around my due date (unless I go into labor on my own before then) and trying for a normal delivery, even if Elam is still breech. She suspects that he will still be breech because he's not very active and my amniotic fluid is low. But she doesn't think it will be too traumatic for him. Her main concern is that his head would get stuck in my cervix as he's being delivered. There are things they can do to help his head get through, but it can be risky. She thinks it would be good to avoid a c-section because my uterus will probably still be so small that they have to do a classical incision, which would mean that I have to have c-sections in the future. But a c-section would be less risky for Elam. She's still willing to do whatever we decide, and she's very understanding that I don't want to have any regrets. She's going to talk to the high-risk OBs to see what they suggest. It's very difficult-- there's no obvious right answer.

Elam's heartbeat is still healthy. I've gained a total of 18 pounds so far! The doctor is very impressed that I've still managed to gain a decent amount of weight given Elam's condition. Everything else is still looking good so far. The doctor said that she still expects Elam to make it to full term.

I can't believe I've only got four and a half more weeks to go until my due date! It's almost time to meet our little boy! Very exciting! Please continue to pray that Elam would be healed of his triploidy and all his birth defects. The hole in his heart is large enough that it may cause heart failure. And please pray that Elam will move into a head-down position and that Ben and I can make the right decisions regarding his birth and his care afterwards. I'm trying a few things that may help coax Elam to move into a better position. Hopefully it will work!

Ben and I both are feeling more and more anxious as we get closer to my due date. This whole experience has been very wearing on our emotions. It's been hard, knowing that every day for the last 4 months could be "the day". God has given us a lot of peace and patience, but it's still hard and we sometimes feel like we're running out of emotional energy. So please pray also for our emotional/mental well-being as we're nearing the end of my pregnancy. Thank you!

Ultrasound Today

Our ultrasound today went well. It was another quick ultrasound to evaluate Elam's growth. As I had suspected, he's still in the frank breech position. He was also still low in my pelvis, so he was hard to see. But he has grown. He's now about 2lb. 6oz. We were excited to hear that! While he's still very behind in his growth, he's grown almost a pound in the last four weeks. We got to see the front of his face, but couldn't get a good view of his profile or much else. We could see his eyes moving around, which was neat!

We may post the video from this ultrasound. We'll have to watch it to see if it really shows much. You never know how much the sonographer actually records.

We have another ultrasound scheduled in four weeks. The sonographer said that it would be very important to have an ultrasound soon before I deliver him so they could determine his position and so the NICU could be prepared for his size.

Doctor Appointment Today

My appointment with my OB went well today. My blood pressure is still great and I'm still gaining about a pound a week on average. Elam's heartbeat is still normal. I asked the doctor about the neonatologist's comments regarding c-sections. She said that it is typical for neonatologists to be against c-sections. We talked a little about the risks and about my likelihood for having to do more c-sections in future pregnancies. It sounds like if I have a c-section that I should plan on having more in the future. Vaginal births after c-section (VBAC) are possible, but still not typical. My doctor is willing to do the c-section if I want it, and she's not too worried about the risks. We discussed all the different possibilities. I think the best option will be to wait until I go into labor, whenever that is (even if it's a little past my due date) because laboring is important for babies. At that point, we'll try for a normal delivery and monitor Elam's heartbeat closely. If he is distressed at any point, then we would do a c-section. But it is possible that he could do fine with a normal delivery. I'm excited about possibly doing a normal delivery, but I'm also fine with doing the c-section if that is what Elam needs. As with everything else in my pregnancy, we're just going to wait and see how he does.

My next OB appointment is in two weeks. After that I have one every week until my due date. Not too much longer now!

We have another ultrasound Thursday afternoon. We're looking forward to seeing Elam again. Please pray that he will cooperate. He's never been in a good viewing position and he doesn't move much, so we have a really hard time seeing his various body parts. We'll probably talk to the high-risk OB there about the hole in his heart. Please pray!

Visit to the NICU

We visited the neonatal ICU on Sunday afternoon. We talked with the neonatologist for a while and then took a tour of the NICU. The neonatologist was very honest with us about what to expect. She's been a neonatologist for over 30 years and she has only seen one triploid baby. That's how rare it is for them to survive to term. She reminded us that Elam still may not survive to be born alive. I have been very aware of this-- it's something I've thought of every day for the last 3 months. It seems that every doctor we meet (except my regular OB) wants to make sure we fully understand the seriousness of Elam's diagnosis, and so they are not hopeful or encouraging at all. But I know that the doctors are trying to be helpful and make sure we have realistic expectations.

So it was hard to talk to the neonatologist because her outlook seems so negative. She told us that because his condition is lethal, they usually try not to intervene medically. I told her that I do want the doctors and nurses to do what they can to keep him alive so we can spend time with him. She told us that they will probably not be able to intubate him because his mouth will probably be too small. So we'll just have to see how much he can handle when he's born. It's been hard for me because it seems like everyone, especially the doctors, aren't wanting to help him at all, but I do. I don't necessarily want him to be kept alive like a vegetable, but I do think we should help him if he's fighting to live. I think the doctors and nurses at the NICU will eventually do whatever we want, but I think we just might have to fight for it.

The doctor also told us that we should seriously reconsider having a c-section. Recently, I had finally come to the decision that that's what I wanted to do. It has been a hard decision-- I know there are risks and scars, and recovery is a lot longer. But it looks like Elam will still be breech and regardless of his position, a vaginal delivery could be too stressful and kill him. The neonatologist told us that there are a lot of risks for me and our future children if I have a c-section. She really thought that a c-section would be a bad idea, even if Elam is still breech. This was also discouraging for me. I think she was just very opinionated, like many people are, about how birth should be. I'll ask my regular OB if she thinks I should reconsider, but otherwise, I think I'm going to stick with my decision.

She did tell us about some things that were helpful and encouraging. They will be assigning us a nurse just for Elam while I'm recovering in the hospital. She'll be at our beck and call 24-7. In cases like Elam's, they will keep him with us, as opposed to in the NICU, as much as we like. They like to help the families enjoy their babies while they have them, and they try to help you preserve their memories. They have a photo studio so you can take nice pictures and they provide belongings for them to keep.

We took the tour of the NICU. They have recently remodeled and redesigned their facilities. They are very nice! They have a room we can stay in during the day to visit him if he is still there after I am discharged from the hospital. The doctor showed us a baby that was a little over 2 pounds so we could know what to expect, as far as Elam's size. The baby was so precious! It was comforting to see her. She just looked like a miniature newborn. So sweet and so tiny!

While we were at the hospital, we went to labor and delivery to preregister for admission. We also filled out Elam's birth certificate information. It was nice to get that stuff done! We'll go back pretty soon for a tour of labor and delivery.

So, overall, the experience was somewhat helpful. Talking with the neonatologist was discouraging, but the tour was nice. Seeing the tiny baby was definitely the highlight of the experience for me! We just have a lot of difficult decisions ahead of us if Elam is born alive, but I think it's worth it if we get to spend some time with him.

I have an appointment with my OB on Monday and an ultrasound on Thursday next week. Please continue to pray for Elam. We know that God can do whatever He wants with Elam's life. While I know that the most likely outcome is that God takes our little one before he is born, I also know that a miracle is not out of the question! Our trust is not in doctors, statistics, or ultrasounds, but in the Lord.

Another Update

I realized that I forgot to mention something else that I talked to my doctor about yesterday. I asked her about the hole in Elam's heart. My last ultrasound confirmed that the hole was still there and I was wondering if it would be life-threatening. I asked my doctor, but she was not sure. It depends on how big the hole is. Babies are born all the time with ventricle defects like Elam's and they're fine as long as the hole is small. If it is large, blood can flow backwards in the heart, which would lead to heart failure. So I will ask the high risk doctor about it at my next ultrasound. Please pray that the hole will be small, or better yet, that it would heal completely.

Also, I have another update since yesterday. My doctor called me last night after hours to let me know that she had talked to the neonatologist and that the neonatologist would be calling me in the next few days to set up a time to visit the NICU. I am very blessed to have a doctor who is so helpful, even after hours! I didn't expect to that she would contact the neonatologist so soon. To my surprise, the neonatologist called about 15-20 minutes later! She was very kind and told us to come any time on Sunday. She wants me to have the doctor's office fax over all of Elam's records so they will be prepared for him. Another blessing! I'm very grateful to be working with yet another person who is so helpful. It is very nice to know that they will be completely informed and ready for Elam if he is born alive. Please pray for our visit to the NICU and our time with the neonatologist. This will be a great chance to ask questions about decisions we may need to make and any other ways we need to prepare. And it will be good to be able to see the NICU and know a little more about what to expect in case Elam needs it.

Doctor Appointment Today - 31.5 weeks

This morning I had another doctor appointment. Elam's heartbeat is still good. Last week, I noticed that I had finally gained a total of 10 pounds. I've had a hard time gaining weight, so it was exciting to finally reach the 10-pound mark. Soon after I noticed that, I suddenly gained another three pounds! It seemed to happen in just one day. I was a little concerned about that because rapid weight gain can be a symptom of pre-eclampsia, but the doctor said that it was probably fine. My blood pressure still looks good and I haven't had any other symptoms. So I'm excited to finally be gaining some more weight!

The doctor is going to call the neonatal intensive care unit at the hospital to arrange a time for us to take a tour. It will be a good time to ask questions about any decisions we may have to make once he's born if he is born alive (such as any life support we may or may not want him to have). I'm looking forward to this time so we can feel a little more prepared in case Elam does survive for a little while.

Elam has still been moving some. I can tell he's usually still sitting very low in my pelvis, but I have been feeling movement every day. I'm not sure if I'm feeling distinct kicks... I'm having a hard time distinguishing them from normal tummy-rumblings. But it is nice to still feel him move (pressure in different parts of my belly) every day.

I'm 31 1/2 weeks now. As I get closer and closer to my due date, it's exciting and scary all at the same time, thinking about what is in store for us very soon. I'm very much looking forward to meeting our little Elam, regardless of the circumstances. I've been thinking about him so much-- I'm excited to finally be able to see him, hold him, and kiss him. I was concerned for a long time about how I would react when I saw him, knowing that he has so many visible birth defects, but as time goes by, I care less and less about that and more and more about just holding and kissing my baby boy. Of course, I would absolutely love for him to be born alive so we can spend time with him.

Please continue to pray for Elam's complete healing and that we would be as prepared as possible for his arrival. Thank you!

Ultrasound

We had our ultrasound today, this time in the afternoon, hoping that Elam would be awake and more cooperative. No such luck! He is still in the frank breech position and he's very low in my pelvis. So he was not easy to see. The ultrasound was fast, just mainly checking his measurements. He weighs about 1.5 pounds now. He's about 5 weeks behind in his size. We could see a front-view of his face, but we didn't get a good view of much else. I asked about his heart and brain, so she tried to check on those. She couldn't get a good view of his brain. She explained that it is hard to see the brain well once the bones in the skull have calcified more. When she checked his heart, she could immediately see the hole in his heart. It did not appear to have improved.

I think that's all we learned today. We're feeling pretty good about the ultrasound. We've come to expect that with his disorder, he will continue to get a little more behind at each ultrasound. So learning that he was another week behind was not surprising. We just enjoyed seeing him and hearing that he now weighs a pound and a half. I'm not sure that we are going to post the video of the ultrasound online. It's very short and hard to see. We have another ultrasound scheduled for four weeks from today. Thank you for your prayers!