Week 27 and surgery scenarios

Would really like to be able to wear flip-flops now.

Today I turned 27 weeks and we had another ultrasound. Baby is looking big and strong - almost 3 lbs and the technician said we'd probably have another 8-9 pounder. And yes, I know those estimations are always off, but they're fun to hear about :)

The mass itself looks stable. I mentioned it in my other posts, but for some reason lung development and these masses associated with them tend to slow in growth, stop growing, and in some cases, some even shrink around 28 weeks. It's not likely ours will shrink, but it's not likely to explode in size either. It looks like we're on a very steady pace and baby is in a good spot. (On a side note, baby is back to breech - damnit!!)

We also met with a surgeon after our ultrasound to go over what's going to happen when baby is born. Like I said earlier, it's very unlikely this will go away on its own, but it's also very unlikely to get out of control before baby is born. But first, a couple of things about this mass:

1) It is an actual part of the lung that has gone haywire. The left lung is made of two lobes, and essentially one lobe in that lung goes crazy during development (again, for no apparent reason). This means an entire lobe will be removed during surgery.

2) Leaving the mass intact could cause complications later on. One of the major, most common complications, is repeated bouts of pneumonia. Our surgeon said occasionally a teen will come in after many episodes of pneumonia and it will be discovered that they had a mass that went undetected since birth. Another very, very rare complication is cancer (much further down the line in the baby's adult life). So, needless to say, it is our best bet to have it removed.

3) Our mass is not outrageously huge, but it's not small, either.

So, the mass will be surgically removed, most likely after birth (thank-you, Jesus.) Fortunately, babies are resilient in many, many ways, so his or her body will be able to adapt and he or she should live a very normal life. We have a few scenarios after birth:

1) Baby is breathing and eating fine. In this scenario we take baby home on a normal timeline, and come back when it is 3-6 months old for surgery. The surgeon we talked to said she would anticipate this outcome for us, but she said she can't be certain.

2) Baby is not breathing well after birth and needs to be on respiratory support. This is basically the opposite end of the spectrum from the first scenario. Baby would then have surgery a couple of days after birth and would spend a little more time recovering than they would in scenario one.

3) This scenario is kind of between the first two. Baby could be breathing fine, but have difficulty feeding due to their heightened respiration. In this case, baby would also have surgery a few days after birth and would require a little longer hospital stay.

None of this was really a surprise to us, or at least me, since I've been doing a lot of research. One of my only concerns would be an interruption in breastfeeding. I've had less than perfect breastfeeding experiences with the first three kids due to the fact that I produce enough milk to feed a small country and it shoots out like a fire hose on crack. Wonder Boy once turned blue during a feeding because I let down like a bat out of hell and he couldn't keep up. After trying every trick in the book (yes, I tried them all), I had to resort to pumping for 12+ months to give them breast milk. Yes, I'd do it again in a heartbeat, but part of me was hoping for the right combination to *finally* get this right. Fortunately, I'll still be able to breastfeed, but it will more than likely be a combination of bottle and breast, and that's fine. And like the Hubster said, forcing a baby with breathing problems to feed from my maniac breasts is like giving a person with no hands a ping-pong paddle. Not quite fair.

We'll be meeting with a neonatologist and several other people as time goes on. We were also asked to take part in a study about pain management when baby undergoes surgery, but I'm pretty sure we're going to decline that one. It's probably completely safe and won't affect any care the baby receives  but it's one less thing for me to worry about when that time comes, and I'm pretty sure that's the best way for me to go.

Time is going super quickly right now. In one week we'll be in the third trimester, and soon I'll be going to my regular doctor every two weeks. Life is about to get a lot more hectic, but we're pretty used to that by now!


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