Wednesday, August 18, 2010

Answering Questions about Brigham

The visit yesterday with the Perinatologist went well. Actually, I guess not really, because it's officially confirmed, Brigham does have a diaphragmatic hernia and will require surgery after birth. I had the smallest inkling of hope that we would get to the specialist and they wouldn't find anything... Overall though, we feel pretty calm and secure that things will work out for the best.
I tried to find some good pictures on the internet to show you, but my search didn't turn up very much. So I played around in "paint". (Don't laugh)
This first picture is what a healthy baby should look like. The diaphragm is the bright blue line in the middle. It keeps the heart and lungs above (in the chest) and the stomach, liver, and small and large intestines below (in the abdomen). The only thing that goes through the diaphragm is your esophagus and the hole that it goes through is only barely big enough to fit it.

Now onto a diaphragmatic hernia. Notice the bright blue line (diaphragm) doesn't go all the way across?... That's the problem. The hole in the diaphragm is letting the stomach come into the chest, where it doesn't belong. This puts pressure on everything else in the chest. The left lung has almost no room to grow and the heart is being pushed from the middle of the chest way over to the right.
.This is what Brigham looked like yesterday. As of now, only his stomach is up in his chest. As he grows, this may (likely) change. Some small intestine will also come up eventually.
I will have an ultrasound every time I go to the doctor to check on how he's growing and changing. My next regular appointment is in two weeks where I'll not only meet with the Perinatologist (high-risk MOM doctor), but I'll also meet with the Neonatologist (high-risk BABY doctor). Eventually we'll need a Pediatric Cardiologist consult too (sometimes the increased pressure puts stress on the heart).
The doctor said based on the looks of things in the ultrasound the defect looks "pretty sizable" but technology has come a long way and we will be prepared to take care of Brigham the best we can.
The doctor also said his size is right on for his due date and there doesn't appear to be any other deformities in his body. Just to double check though, he recommended they do an amniocentesis to make sure he doesn't have any chromosomal abnormalities. In general, I tend not to like the idea of an amniocentesis (mostly because it freaks me out - sticking a needle through my tummy into my uterus?!) However, I agreed, because this is not an "in general" situation.
Lucky for me, Justin had a couple of hours of sick time left this month and had come with me to this appointment because they did the Amnio right then. (TOTALLY WEIRD FEELING!!!) I definitely needed his hand to hold!
While they were getting prepped, I told the doctor, "This is worse than an epidural, the anticipation at least... At least when I had my epidural I was in pain and I didn't care what had to happen to make it stop. Right now, I'm feeling just fine, and would keep feeling just fine even if you didn't poke me!!" We were all laughing. :)
The doctor said they will likely induce me around 39 weeks. They want Brigham to be as big as possible, but want to be prepared for his birth. We'll have several "teams" of people at the hospital to take care of us when he's born. The doctor also said they more often prefer to do a C-section, but sometimes they'll consider a "regular" delivery. Not only for my own recovery time, but for future pregnancies' sake I'm going to try to deliver naturally (with an epidural of course). If they agree that it's safe to try, that's the goal. If they think it's safer to do a C-section, I'll do what they recommend.... The real ultimate goal is to get Brigham here safely and be able to bring him home with us as soon as possible.
**Side note- Every time I ask Carrie "Where's Brigham?" she comes right over to my belly and gives him big kisses. I love being a mom..... :)


Heather F said...

Wow! Luckily you are near all the specialist that you will need with this situation. We'll pray that little Brigham grows as healthy as possible and makes it as close to full term as possible!

Brittney said...

Does going through the birth canal help get excess fluid out of the lungs? You're the nurse so you tell me. I would think that would help in the situation post delivery, but I don't know? Wow, it sounds like you have a lot of competent people on your side to help make your experience the best it possibly can be. I know it will probably be hard though. I know you can do it and there is a reason that you have to go through this experience. Maybe you'll be a nurse to a mom in the future that has a similar situation. Keep us updated. I hope Brigham can cook in there as long as possible so that everything is as well developed as it can be. I guess this would be a situation where you wish you could count on going a week over due like I did with Belinda:) But I guess you never know and it's better to be prepared!!!

Brooke said...

Thanks for all the thorough details, we had been wondering! Keep letting us know everything you know, and we'll keep baby Brigham in our prayers. Yea for modern medicine!

Aubri said...

Oh gosh, that's scary! Thankfully you're all prepared for it... let us know the amnio results, you're definitely in our prayers!

::long-distance hug::

Elise said...

first, I love the paint pictures. Second, you are brave. Good luck with everything. I'll be praying for you! Much loves.

Jimmy, Diane and Bentley said...

WOW. That must be really hard to hear. Good luck with everything! I hope he does ok!! Poor little guy :(

Coleen said...

Thanks for showing a picture of exactly what is going on in this little baby's body. Please keep us posted as you continue to learn more each visit with the doctors.
You are all in our prayers and of course his name has been put in the temple. I know you and Justin will truly be blessed with the wisdom and inspiration you need throughout this pregnancy.
We love you all! NanaGreer