Summary of June

The winner of our latest injury report is Carter. While he was at the sitter's the other day, he and his little buddy were using a sled to go down the slide (something they had done several dozen times the day before). The difference on this day was that the rope on the sled accidentally got around Carter's neck AND the sled got wedged into the slide so we had a bit of a near lynching moment. The pictures don't really do justice, but he had a pretty nasty rope burn along the front of his neck. Good thing his annual check up isn't for another 2 months; I'd hate to explain that one! ...and the rope has now been removed from the sled and all is well.

Logan's last tball game was the last week in June. He really enjoys baseball...and the large helmets on these little kids are hilarious!

Father's day: Logan made a book comparing him to his dad. Apparently Logan's favorite sport is bowling. Who knew, considering he's never bowled (except on the Wii)?!

And for those of you that are aware of Carter's obsession with rocks, he made a rock for daddy that had Carter's picture and "Daddy, you rock" engraved on it.

Fun in the Midnight Sun games in Nikiski. Games were in the rain, so a change of clothes was needed. We were drenched!

Logan running a race with other 5 & 6 year olds.

Carter during his race. He was very sad when he was done, saying "The other kids ran faster than me."

And the latest craze at our house...strategically placing our dirty clothes on the dog when we get dressed in the morning (yes, the underwear is ALWAYS on her head). She's a pretty good sport about it as it gets lots of giggles, but I'm quite sure she's relieved when we leave for the day.




Baby Info.
I’ve had a few friends email me, wondering about some things I posted last time with regard to our little one, so I’m going to try to keep updates at the end of our blog posts (when there’s actually something to update). That way, I’ll hopefully keep those informed that wanted more details without sending the info to those that really aren’t interested and without having to repeat myself too many times. So, if you want to be spared the additional information, you can just skip this part.

Amniotic band syndrome: This is the diagnosis that was ruled out by Dr. Richey (perinatologist in Anchorage). This is usually associated with severe birth defects for those babies that even survive to birth (most do not). Like I said, this is NOT at all a concern for us anymore.

Circumvallate placenta: What this means is that my placenta does not lay flat against the uterus. Instead, the edges curl up towards the center. In my case, they actually curl up and reattach to each other, forming a little shelf. What I meant by this not posing any direct danger to the baby is that the baby cannot become entangled in this in anyway (a question I had). The risk that DOES exist is that this type of placenta is associated with placental abruption and premature labor. This type of placenta is the number one reason babies die during the second trimester, but they didn't tell me how often that actually happens. Placental abruption occurs about 15% of the time with this type of placenta (only 1% with a normal placenta), and when this occurs, the babies die more than half of the time. With those that don’t abrupt, there’s about a 40% prematurity rate. This can range from 3-4 weeks early to 20 weeks early; there’s no way to predict this. Dr. Richey’s nurse said that I’m at an even higher risk for prematurity because both of the boys were early. I’m not sure I agree with that because the boys were early due to my liver complications; I don’t have any reason to believe they would have been early if I hadn’t had the liver problems, but who knows for sure, I guess. Regardless, they’re keeping an eye on me.

The heart condition: First, there is no official heart condition yet – just the potential for there to be one. When looking at the baby’s heart (specifically the left ventricle), there was an additional “wall” formed that reached about 2/3 of the way across. If this closes off to form an additional ventricle, we will be referred to a perinatal cardiologist (baby heart doctor). What this means is that the baby’s heart would function in such a way that the baby would develop congestive heart failure. This can happen within days of birth…or years later. Typically, they do surgery within the first year, depending on the severity of the heart function. It’s actually VERY TREATABLE with surgery. It’s the kids that don’t know they have this that become very ill or don’t survive because when they do become sick, it can often be missed initially and then it becomes “too late” (Who looks for congestive heart failure on a little kid?). That is why we are going back at the end of August. If that “wall” looks the same, then we have nothing to be concerned about and that’s the end of that. I don’t know what the likelihood is of it closing off, given that it stretched across more than half of the ventricle already. In the meantime, baby is fine as he/she gets oxygen from me and not from its’ own heart function.

My usual liver stuff: The intrahepatic cholestasis (liver congestion) that I had with both of the boys will most likely show up again. It repeats 97% of the time. It doesn’t usually start until third trimester. However, it’s usually earlier and more severe each time but I did some dietary and herbal things with Carter and it started 3 weeks later and was much less severe than with Logan. The downside is, my diet to prevent the liver stuff is the opposite of what I’m doing (dietary-wise) to help with the placenta right now. Kind of a trade off, but I figure I have to be concerned with keeping myself pregnant long enough before I need to work on preventing a potential complication towards the end. Babies have anywhere from a 10-30% chance of dying with this, but we already know I develop this and watch for it. They watched me closely at the end of Carter’s pregnancy, which is why they took him early when things didn’t look good anymore.

The good points:
1. Despite a lot of risks right now, the good news is they are JUST RISKS at this point; nothing is actually wrong yet.
2. Circumvallate placenta gets missed often and that’s when tragedies tend to occur. We are fortunate Dr. Barton caught this. We know that if any bleeding occurs, Dr. Richey will be called right away and I would likely go to Providence in Anchorage. For women who aren’t aware of circumvallate placenta, they tend to go to an emergency room when they notice bleeding and are told everything looks fine on ultrasound and they get sent home. We know that won’t be our case. Also, when bleeding does occur, it is often not an emergency that requires the baby be born right away, although that is always a possibility. More often, it means hospital bedrest with constant monitoring, hopefully long enough to get steroids to develop baby’s lungs and then the baby’s born. Also, by knowing we have this going on, they’ve put me on restrictions to reduce my risk (no hiking, no fishing, no jogging, no inpatient work, etc.). Also, I’m thankful I don’t have a kiddo that needs picking up and that I’m not working full time so it’s easier to follow what Dr. Richey says. There is also a high incidence of the umbilical cord only having one vessel (should have three) with circumvallate placenta, but both Barton and Richey have confirmed that our baby’s cord has the normal 3 vessels.

3. If Dr. Barton (my OB) hadn’t picked up on the placental abnormality on ultrasound, we wouldn’t have seen the potential heart condition. This was not visible on Barton's ultrasound but I could see it right away at Dr. Richey’s (before she pointed it out). So, again, we’re aware, which could prevent something not turning out so well. If this develops into something, we would plan on our baby being born in Anchorage, rather than having a baby here and suddenly having a baby that unexpectedly gets ill and an emergency (and stressful) Medivac trip from our local hospital is needed.
4. Baby looks great. He/She is measuring ahead of gestational age and has no signs of anything being wrong and we’re going to assume that will remain the case until something in my body tells me otherwise. I feel more and more movement every few days and as soon as I put Ryan's hand there to feel it, baby goes still (a classic sign of a very healthy (and sneaky) baby).
5. Potential diet help. Like any typical western medicine doctor, Dr. Richey said there was nothing I could do to prevent the likelihood of placental abruption. I don’t really buy that; I think insurance doesn’t pay for prevention of things, therefore, doctors don’t spend a lot of energy learning about and sharing information on prevention. So, I did some research online and mostly found advice like “Stop smoking cigarettes” and “Stop using cocaine” to prevent abruption. So, while I was detoxing from all of my habitual drug use, I also found some information on Dr. Brewer’s diet, which has a lot of research to support its’ claim that there are far fewer placental problems (abruption, preeclampsia, etc.) with women who are on this diet, so I’m giving it a try. Basically it comes down to eating 80-100 mg of protein a day…so I’m now force feeding myself high protein foods every 2 hours. I don’t know if it’ll help, but if it gives me a chance that my placenta will hold on a little tighter, I figure I don’t have anything to lose! Also, because not all of the placenta is attached, the baby often doesn't get all of the nutrients the mom consumes anyway, so if I consume more than normal amounts of protein (which is what "builds a baby"), the baby has the best odds of receiving a lot of protein and "beefing up" a little. I’ve had placental abnormalities all 3 pregnancies, so apparently this is just something my body needs help with.

6. I believe in women's intuition. Up until my 18-week ultrasound with Dr. Barton, I told Ryan I had a really strong feeling this pregnancy and delivery would "go off without a hitch." That's my story and I'm stickin' to it...need I say more?
7. Lastly, the biggest bonus is that all odds are still very much in our favor. The liver condition I develop in pregnancy occurs in 0.5% of women. Circumvallate placenta occurs in 1-2% of women…and somehow I managed to develop something rare all 3 times. So although we have more risks than the normal pregnancy, we still have much greater odds of me going full term with no problems at all. Dr. Barton told me Logan’s conditions in utero “were not compatible with life” (we later found out my placenta had abrupted right at the cord insertion) and Carter “didn’t have one more day in there” and yet they’re both here and just fine, so everything was caught and remedied in time. I believe the same will happen this time as well.

I do not believe anything is happening to this baby that has not passed through God’s hands and His purpose will be served with this, regardless of outcome. It's very true that this is on our mind a lot, but we are not worried. Worry accomplishes nothing other than draining energy. We are hopeful we will still have a November baby, but are mentally prepared for an early baby and time in a NICU. Although that would be very hard on Ryan to manage two little boys and their school schedules alone along with his early work hours, it's something we'd deal with, obviously, if needed. In the meantime, I’m holding off on picking up any baby things just in case. Our possibilities of scenarios of how all this plays out fills the whole range from "perfectly normal" to "tragic".

I hope that helps those of you that seemed to have more questions than answers after my last post. Basically, we pray and we wait. It’s all in God’s hands, which is the best place for it.