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Thursday, April 28, 2011

Search for Linc's Pediatrician

This past week, Dan and I interviewed two possible pediatricians for Linc. The neonatologist at Children's recommended we have one chosen before Linc is born so that the doc can be informed and meet with Linc in the hospital. The doctors at Children's will be overseeing all of Linc's care and his primary pediatrician will see him after he is discharged for vaccinations, check-ups and to help monitor his development along with the specialists at Children's. Both of the practices are comparable in size and near to our house, but neither of the two practices were a slam dunk. Both had things we liked, and things we didn't like so much. We have one more interview lined up, so we will see if this next one will be it! Of course, I can always take Linc to see Dr. Proffitt (my family PCP/OB) at least for a while if I cannot find a pediatrician close to our house that I feel comfortable with by delivery time. She is fully informed of our situation and I am comfortable with her. It would be nice to have a pediatrician a little closer to us since Linc will be going to the doctor frequently for shots and little sniffles, so we will keep searching.

34 wk appt

Today was my 34wk appt at MFM Barnes. Dan and I met with another OB in the team following my pregnancy (we have now met 5 and there are still more!). Meg met us in the exam room, too. We talked a little bit about delivery and what the possibilities may be. We cannot make a plan for Lincoln's birthday, or even for future appointments more than one week out since every step is dependent on the previous weeks results. The only thing we can count on is going to Barnes for an appt weekly until delivery day (which could be anywhere between 2-4wks from now). 


The OB explained that vaginal delivery is first choice, but the chance of c-section is increased a bit for me due to Lincoln being small. He said that smaller babies sometimes do not handle labor/contractions very well, and can require emergency c-section so it is a good idea for me to plan on having an epidural just to be ready for anything. Otherwise, if I do not have one started already, and a c-section is necessary, I will need to be fully knocked out and will miss Linc's birth (which would be terrible!). At least I don't have to worry about painful contractions. :)


My blood pressure and weight are good, and Linc's heart beat sounded good, too. The OB commented on Linc's side-ways position that he has had for the past 6 weeks and he felt around to see if Linc's head down. The doc said he would just verify Linc's position next week at the ultrasound.


Meg helped schedule an ultrasound to check Lincoln's growth (hopefully he is at least 2kg!) for next week and an OB appt to discuss the next steps based on the results. I'm excited to see his cute little face again! We will just have to take things week by week...

Tuesday, April 26, 2011

Shower 2.0

Last Thursday, the ladies at work threw a baby shower for Lincoln and me during an extended lunch hour. It was really nice! There was a delicious cake, punch and fruit plate with dip. My whole department came, as well as several people from other departments. I got more, much needed baby items and received some great advice from all of the parents. I think that we now have all of the essentials (except for our furniture, which is still on order!). It was really nice to have everyone together to celebrate Lincoln. Thank you all!

Friday, April 22, 2011

Shower Photos

Here are a few of the many photos from the shower that Jenell was so nice to take for me!


The two hostesses, Amanda and Jen


Beautiful elephant cake to go with the theme of Lincoln's room


Diaper cake made by Amanda and Jen (with the cutest shoes!)

Elephant cookies that where hand painted by Amanda, Jen and me!
(They turned out so good)
This was part of a game to see who's "baby" would be "born"
first by melting through the ice cube.
(They kind of looked like they were drowning, but it was fun!)

Mom and me

Kathi (Dan's Mom) and Jen

Jenell (Jen's Mom) with Aubrey
Sisters-in-Law

Adorable baby Aubrey  (Jen's daughter)

Layla had a good time too! (Jen's Daughter)

Grandma T and Grandma O

Cousin Christina, Aunt Kelly and Taylor

Aunt Val, Mom, and sister Chris

Debbie (Dan's Godmother), cousin Rose, and Aunt Carla
Girlfriends! (Sarah, Lauren C, me,
Kelly, and Jackie)

More Girlfriends! (Lauren B, and Trish)

Lincoln and I got so many great gifts!
A few of the highlights are below:

Travel system - Stroller and carseat

Rock 'n Play sleeper - bassinet and play seat

Diaper bag
("manly enough" for Dan's approval - he will be carrying it too!)

                                                 Like father, like son...
"Stroller today, Porsche tomorrow"
And monkeys!

The Olds Traveling Overalls
I was fighting back tears when Kathi gave these to me. These have been
worn by all of the Olds children from Dan's brother on, and have every
one's name embroidered on the legs. As soon as Aubrey is finish with
them, they will be passed to Linc!

This was the last straw for my tears!
Kathi gave me several bodysuits with "OLDS 98"
(Dan's hockey number) embroidered on the back.
My favorite by far!

Layla giving Linc a kiss. So sweet!

Tuesday, April 19, 2011

Shower for Lincoln!

This Saturday, Jen and Amanda threw a baby shower for Lincoln and me at Kathi's house. It was really wonderful! It was so nice to see friends and family and to celebrate Lincoln! Amanda and Jen were great hostesses and everything when very smoothly. They had an elephant-shaped cake (elephants are the theme of Lincoln's room) and elephant cookies (which I got to help decorate the night before!). We played a few games that I suggested, even though I am not sure many people enjoy shower games! We receive a lot of really nice things and are so grateful for every one's support! (I don't have any pictures yet, but I will post some as soon as I get them from Jen!) Thank you everyone!

During the shower, Dan, Pat and Greg worked on getting Lincoln's room ready. They moved the big heavy treadmill down to the basement and installed new baseboards and a fan. It felt good to get things done around the house to prepare for Linc (even though I mainly supervised). The room is coming along nicely. After the work on Linc's room was finished, we brought home all of the gifts from the shower. Dan was pretty interested in checking out everything. It's great to see that he is getting excited too!

Wednesday, April 13, 2011

All Day at the Hospital

Today was our full day of appointments at Barnes/ St. Louis Children's Hospital. We started the day with meeting the Nurse Coordinator for the Fetal Care center at Barnes. She coordinated all of our visits to the hospital and is the common link between Dan and me and all of the teams of doctors that will be involved in Linc's case. Meg accompanied us to all of our appointments and helped to relay info from each visit to subsequent doctors so everything was up to date. 


9:00 am - Ultrasound
Lincoln's ultrasound today was consistent with past ultrasounds. He is still a little on the small side, but his growth curve is the same shape as the normal, just a little below the low end of "normal." So he is still growing steady! Lincoln is 3lbs 2 oz and he has hair on his head! His heart beat is 131bpm, which is lower than it has ever been. (A good sign that he is growing up - says the OB). His genitals still look different, but they are functioning and that's all that matters now! My amniotic fluid is measuring high, which is something we were told could happen. Due to Linc's organ's being displaced, they are putting increased pressure on the esophagus, causing him to not be able to practice swallowing as much as he is urinating. The increase in fluid doesn't cause any harm to Linc, but if it gets too bad, it can cause premature labor. They also did what is called a biophysical test and Linc got 8 out of 8 points! The biophysical checks several things including movement, heart beat, and practice breathing (opening of the mouth and chest movement). Yay Linc!


10:30am - Maternal Fetal Medicine 32wk Check-up
I passed the glucose test so I do not have gestational diabetes. :) My weight is good and my blood pressure has returned to 120/60 (down from two weeks ago when it was slightly elevated, probably due to stress). We saw a doctor at MFM that we haven't seen before, but he was very nice and informative. He explained that the increase of fluid around Lincoln can get to a point that it is too much for the membranes to handle, and the response is labor. There is nothing I can do to reduce the fluid amount, but if pre-term labor does occur, the docs are very good at slowing and/or stopping it to keep Lincoln from coming too early. The OB explained that in order for Lincoln to be able to take advantage of the full range of help from Children's (like the bypass machine ECMO) he will need to be about 4.4lbs at birth. Best case scenario, the team would like me to carry Lincoln to 39wks and then induce. Statistically, there would be no increased benefit for Linc to stay inside any longer. The OB also said that Non-Stress Tests (NST test the babies heart for abnormal beats) could be in the future for us, but that has not been decided yet between the OB's and Pediatric docs.


11:00am - Tour of Barnes Labor and Delivery / Children's NICU
Meg took Dan and me to Barnes South, where Labor and Delivery are located. We got to see where to go when the day comes and she walked us through the series of events that will happen that day. I will labor in a regular L&D room, but actually deliver in one of two OR's they have on the floor. The number of doctors that will need to be present requires the larger room even if I deliver vaginally. Dan, Lincoln and I will be together in the OR as the docs clean Lincoln and put him on a ventilator to help him breath. I will be able to see him and touch him for a few minutes before they take him to Children's NICU where he will stay until he is healthy. Dan is able to go with Linc and the doc's as they transport him, but I will need to recover for a few hours until I can be wheeled over to see him.


Meg took us on the path that Linc will take from L&D to the NICU, which takes about 5 minutes. At the NICU we were able to see the overall environment of what to expect and also could see a few of the machines Linc will need (ventilator and feeding tube). There was actually a baby in one of the rooms that Meg pointed out as having been born with CDH. This baby was recovering from his hernia corrective surgery, but was still on a ventilator. He never needed ECMO. It was great to get an overview of how our delivery day will go and to see a CDH baby doing so well in the same NICU where Linc will be!


12:00pm - Lunch and a well deserved break!


1:00pm - Meeting with the Pediatric Surgeon and Neonatologist (baby doc)
Meg took us to a conference room where we met one of the several Pediatric Surgeons and Neonatologists on the teams that will care for Lincoln. They when through the several possibilities for Lincoln after he is born and how his condition is assessed along the way. They explained that things may seem to progress slowly, but that they are just giving time to assess him at every stage and collaborating on what to do next. Children's sees about 8 babies per year with CDH and have a survival rate of about 60% (close to the national average of 50% or so). They reminded us that Barnes sees the sickest of babies and are very familiar with CDH. They confirmed a lot of info Dan and I had already looked up online, like the right sided hernia patients have a better survival rate than the left. They also said that the average stay in the NICUCDH babies at Barnes is 3-4 months, with the majority of that time being concerned with feeding. Since CDH babies do not have the normal opportunities to breast feed, they lag on their learning of mouth feeding.


The Neonatologist also suggested that we choose a Pediatrician for Linc to go see for regular weight and measurement check-ups and vaccinations. He will still need to visit Barnes for specialized care in conjunction with his primary pediatrician. They were both very nice and concerned with how we have been handling this whole situation. They told us that there are teams of people cheering for Lincoln and that they are prepared for his arrival and will do everything they can for him.


2:30pm - Fetal Echocardiogram
Meg took us to the Children's Heart Center for a second fetal echo. After an hour and a half of Lincoln turning and squirming, the technician was able to get all of the data she needed for the doc. Everything looked good according to the cardiologist which is great news! The pediatric docs wanted to be sure that Linc's heart still looks normal, since heart complications are the most common additional problem with CDH babies. Looking at the heart can also help the docs to get somewhat of an idea about how severe Lincoln's condition may be, but nothing can be known for sure until he is here.


5:00pm - Finally home!


Even though the day was long, it was great to finally hear the plan for Lincoln (whether he sticks to it is up to him!). It was good to hear the possibilities for him so as not to have any surprises along the way and to get a sense of what delivery day will be like for us. It was nice to see some of the docs that will work on Linc and to see that everyone was well informed of our case. I almost feel a little more at ease with the whole situation, which I am sure will chance as delivery day approaches, but that's to be expected.


My next appointment is with MFM for 34wk check-up where Meg will meet us at the office.