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!

"No change is good news."

Yup - an alien-looking baby face for your viewing pleasure :)

It's the one time when I can agree with the Hubster: no change is good.

Today we met again with a perinatologist at Froedtert for another ultrasound to check on baby. Baby looks good (weighs almost 2 pounds - yay!), and is head down finally (yay!!). He or she moved around a lot, and we were amazed at how much bigger they looked. One upside to seeing  your baby every two weeks is you can  really get a good view at development.

Since baby has gotten bigger, the mass has also gotten bigger. I'm not sure how many can remember from my last post, but the way to measure the mass in terms of a projected red zone, is to take the CVR, which is basically a ratio. A CVR of 1.6  is where heart failure becomes a real concern. Our doctor told us we're at a 1.5, but to him, that's still fairly consistent and stable with where we've been. To you or me, (definitely me), a  progression from 1.2, to 1.3, to 1.5 would be slightly alarming, but he considers it stable, and that's good enough for me! So, no change as far as how baby is doing, which is good :)

He also said, "We'll obviously be wanting to have you deliver here at Froedtert.", which is the first time we've gone definite in terms of where I'll be delivering baby. With each delivery I've gotten quite efficient at progressing, to the point where #3 was basically a couple of pushes away once we got to the hospital. No big deal, except we're doubling our drive, and there is no guarantee the Hubster will be with me when I go into labor, which means an additional 30 minute drive from work. Doc told me that although it's usually a good thing to want to experience as much labor at home as possible, I should unlearn that habit and let the Hubster know at my first contraction. He also agreed that a spontaneous labor would be ideal - wooo! :) But, we'll cross that bridge when we get to it (I'm sure there's some sort of joke about a canal/bridge I could make here, but I've got three midterms to cram for... ah haha... probably another joke there as well.)

ANYways, we've got all of our ultrasounds scheduled for every two weeks until my due date, and we're also meeting with pediatric surgery next time.

It's weird how this has gotten to be pretty much routine, and I definitely feel much less worry in between appointments. My good post-appointment mood tends to last a lot longer. Not that there aren't moments of "Is baby ok?? F***, I won't know for another 5 days!!", but they fade.

I do know that this experience has really opened my eyes to the trials and tribulations that some families have to face when it comes to the most precious things in your life: your kids. I've always donated whatever we could afford to places like St. Jude's Children's Research Hospital, and the commercials for it just kill me (pregnant or not). Boy Wonder has recently taken an interest in the Ronald McDonald House because he had a notepad with artwork from a cancer patient and was reading about it. I'm not sure in what regard I'd like to put more of my own resources into organizations that help sick children and their families, but I know I'd like to do more when we can get over this hump. It's something I've always wanted to do, and I feel like this has been a catalyst to get that started.