Thursday, May 16, 2013

Anencephaly

In full disclosure, I promised myself that I would be truthful to this blog and the people reading it when I started it almost 1 year ago. This is not going to be a fun post to write or to read.

I had my first high risk doctor appointment this morning. We assumed that everything would go great and we would be introduced to our medical care team for the next 6 months. Wrong. We met the whole office because of our unusual circumstances.

We went in and filled out the usual "first patient" paperwork and they took us back and took my blood pressure and weight. Everything was great.

We were shown to an ultrasound room with a tech. She did an abdominal ultrasound and we chatted a bit about my fertility history and family. I told her about my subchorionic hemorrhage and the bleeding I've been having. She pointed out where the bleed was and said it was pretty large. She was "ultrasounding" for about 20 minutes. No weirdness or anything.

Me: So how's everything look?

Her: Well, I'm worried about baby C up here in the upper left quadrant.

Me: Ok...

She spans to baby B and says: Do you see here how there is perfectly clear, black amniotic fluid? And the bones of the baby are all white around it's head?

Me: Yeah

Her: Ok... (she spans back up to baby C) look at this baby. Do you see how it has grey fuzziness in the fluid? And then look at the head.

Me: It kinda looks like it has hair.

Her: Yeah. It looks to me like it has anencephaly. That means the skull bones aren't properly formed and it's a severe neural tube deficit. The skull bones where hair would be aren't formed at all. What you're looking at is the brain free floating in the amniotic fluid. Children with this severe of a deficit aren't genetically designed to live outside the womb. They normally do wonderful inside, but when they're delivered, they die within minutes.

The face looked completely normal. It was really really weird.

She leaves and Troy and I immediately turn to one another with looks of horror on our faces. And shock. We couldn't believe that moments ago, everything was fine, and now we were losing one of our babies. Like, it didn't even have a chance.

A MILLION things went through my mind. Does that baby endanger the other 2? Do I deliver all three? How bad of a person am I if we "selectively reduce" a baby that will die the moment it is exposed to oxygen to help save the other 2?

I voiced these in one breath to Troy and he just looked at me with tears in his eyes. "I've already thought all of those things. You aren't a bad person."

The first person sent into to room was a genetic anomaly and abnormality counselor. She was amazing. She talked through all of our options with us.

Basically, we could do nothing. Wait and see.

We could opt for a reduction and give the other babies more room to grow and stay inside longer and avoid medical and health dangers to the remaining children.

We talked for about 20 minutes.

She left and then the doctor finally came in. I immediately apologized. I don't know why. It was my first visit and I was being a "difficult patient." He was so nice. He just said, "you're here for a reason and we're going to take care of you. That's why we're a high risk facility. For people like you."

The doctor and the tech redid the ultrasound and really looked at and measured my cervix, the location of all the placentas, and the sheer size of the hemorrhage. They did a test where they applied pressure to my abdomen to see if my cervix started to shorten or funnel and it looked good.

Troy and I decided to opt for a "selective reduction" for several reasons. We want to give the other 2 babies the best chance possible. The emotional and physical attachment to a baby that wouldn't make it could be devastating at the birth of our other 2 (God willing) healthy children.

And here's when the complications got worse. STUPID HEMORRHAGE. I am not currently a candidate for the reduction because the bleeding I am currently having is coming from underneath the placenta of baby C and it is slightly shared with the placenta of healthy baby A. They are worried that the reduction could result in loss of one or all of the babies.

So right now we are doing a sit and wait. I will be monitored every week to monitor changes in the size of the hemorrhage. If the hemorrhage stays the same size (stable) or shrinks, they'll be able to continue with the reduction. If not, I'll carry all three babies as long as possible and deliver 2 healthy babies and 1 that will become an angel within minutes.

As far as work, they said I can keep working. They said that there is no proof that bed rest helps heal a subchorionic hemorrhage but they figure it doesn't hurt. I told them I would cut back from 4 10 hour shifts to 3 8 hour shifts. They seemed happy with that.

The doctor was wonderful. I had SO many questions and poor Troy just sat there and listened while I yammered and yammered. I was just so shocked and concerned about the babies and what our options were and timing, etc.

So for now, there's really nothing that we can do. We are waiting. I am just hopeful that we come out of this with a baby. ONE healthy baby.

This has been a day of bad news.

PS. DO NOT google images of anencephaly. Seriously don't. I'm scarred for life.


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