I had my doctor's appointment on monday with Dr. Adashek. He was awesome. The staff was amazing.
We were shown into an ultrasound room, where another very experienced technician did my scan. She was serious. She had "ultrasound elbow" and wore a splint. Like tennis elbow, but from excessive diagnostic imaging. She confirmed (again) that baby C had anencephaly and looked at my cervix length (which is amazingly long, go me).
Dr. Adashek came in and this is a play by play of the highlights of the conversation:
He gives me a big hug. I love hugs. He sits on a rolling stool 2 feet in front of me.
Dr: So, you've been quite the topic of conversation. I've been talking a lot about you behind your back. I've talked to several of the doctors at Nellis as well as Dr. Bolnick. You understand what's going on. We don't need to repeat that. I understand you've already talked to Olivia (the genetic anomaly counselor) and Dr. Bolnick about the procedure for having a selective reduction and I want to answer any questions you have and talk about risks of all scenarios. Where are you currently in your decision to have a selective reduction?
Me: I'm leaning towards having the reduction but I want to know what the risk of carrying all 3 babies to term (as far as my body allows) vs. the risks of the reduction are. Basically, is the risk of losing all the babies by doing the reduction MORE than the risks to myself and the babies if I carry them?
Dr: Carrying HEALTHY triplets, the risk is way more. Carrying triplets and one of them having anencephaly, the risk is even higher to you and the other 2 babies.
Me: What? Why?
Dr: Your body knows that something is wrong with that baby. It is going to pour more nutrients and amniotic fluid into that baby's sack to try and heal it. Which of course, won't work. Ultimately, that baby will get bigger and occupy more than it's fair share of the limited space in there. It will force preterm labor, possibly earlier than 28 weeks. We are happy when someone carrying healthy triplets gets to 32 weeks, and you are still looking at 2 months in a NICU as well as all of the additional health issues associated with preterm babies. At 28 weeks or earlier, you will definitely lose baby C, and the risk of baby A and B being blind, deaf or both as well as having lung problems or a brain hemorrhage is astronomically high. In addition to that, YOU are at risk for preeclampsia, uterine hemorrhage and whatever emotional distress you have because you lose a baby and may deal with 2 other children with severe lifelong health issues.
Me: Ok. What are the risks with the reduction? What are the odds that I could lose all the babies? Troy and I have already decided that there is no way I can go through fertility treatments again, so if this pregnancy doesn't work out, we're done.
Dr: The risks of losing the whole pregnancy are between 1/100 and 1/300. I have the most experience in the whole practice with reductions, thus the highest success rate. Most people lose the whole pregnancy because of an infection as a result of the procedure within 24 to 48 hours. What are your biggest hesitations about the procedure?
Me: Religious mostly. God blessed us with these children and I don't want to feel like I killed one of them. I'm worried about being judged by my friends or family who feel the same way. I know that this is a personal decision, but I still feel like I want the support and approval of everyone.
Dr: Screw them. You tell them to carry triplets and go through the emotional trauma of losing a child. And then watching 2 of them fight for their lives with underdeveloped brains and lungs while you stand helplessly by, knowing that you could have done something to help them 4 months before. Ultimately, you might feel regret and sadness and guilt now, but it's better to feel it now and give your healthy babies the BEST CHANCE at a healthy life than risk their lives and deal with the emotional trauma of burying a child at the same time and feel guilt for the rest of your life. This is your decision. Don't let the other people in your life GUILT you into making a decision that could effect the health of your other babies for the rest of all of your lives.
Me: Troy...are you ok? You haven't said anything.
Troy: I've been on board with the reduction the whole time. I'll support you either way. This is probably going to be harder on you than me. If you decide to carry the babies, you're the one who has to do it and I'll wait on you, hand and foot.. If you decide to have the reduction, I'll be there praying with you and holding your hand.
Me: Ok, well isn't it too late? I'm 15 weeks today.
Dr: It's actually the exactly right time. People choose to have reductions of healthy babies between 12 and 15 weeks. You actually have cause for health reasons of you and your babies.
Me: Ok, well when can we do this?
Dr: I'll schedule you for tomorrow afternoon as my last patient. I don't want to feel rushed because I have other people waiting and I don't want you to feel like I ran out when the procedure was done and didn't answer your questions or hold your hand after.
Me: Ok, let's do it.
He also gave us his personal cell phone number. He told me to never ever go to the ER, never go to Nellis, and to never call the emergency after hours number. He wants me to deal with him personally through the rest of my pregnancy and ensured that I would remain under his care for the remainder of my prenatal care.
I had the reduction on Tuesday afternoon. The staff was amazing. They held my hands, rubbed my hair, and gave us cell numbers to call with questions. My sister flew in this morning to keep me company. I'm doing well. I'm feeling the other 2 babies move, which is comforting to me. I have been relaxing on the couch and drinking lots of water. As of now, I am on the fence about blogging about the actual reduction. I'm not sure who wants to read about it and who would just rather not know. Based on feedback and levels of curiosity about the procedure, what happens to the baby, etc I will blog/not blog.
Some of our friends brought us meals the day of the procedure and the next day. You guys are awesome. I love you. Troy wants those recipes...you guys know who you are.
Update: And I finally wrote about the procedure...about a year later...
http://barnesdailycircus.blogspot.com/2014/05/selective-reduction-procedure-in-detail.html
Thursday, June 6, 2013
Friday, May 31, 2013
Anencephaly Ultrasound and Doc Update
I had another appointment yesterday and it went better than the one last week. Whether that be because I was in a better place mentally, or it actually went better, I don't know. But I felt better and didn't cry the entire time. I was able to ask questions without my voice choking up and voice concerns without turning into a blubbery mess.
I gained 3.5lbs. Woah. My bad. I have been making an extra effort to eat more food this past week and I've been SUPER conscious of doing very little to help the bleed heal. Goal attained? Eek.
They did the ultrasound to look at the all the heart beats and we got another set of pictures. I didn't share the last ones, but here are the new ones. The tech was like, do you want any pictures of baby C? I was like, UM YES! She said that some people request not to have any pictures or further info about the sick baby because they don't want to get more emotionally attached, etc.
Here's baby A and it's right at the bottom of my uterus, resting with it's back on my cervix:
Here's baby B and its to my right on the upper side of my uterus:
And here's baby C, located on my left, right under my stomach:
Now, if you scroll back up, you can see that baby A and B have round heads and you can see their profiles. While baby C has a perfect little body, he has no profile or slope to it's head at all :( They also did a "frontal view" of this baby and I just couldn't believe it. The doctor said that it had "classic bone formation" of a baby with anencephaly. Its head looked like it stopped at the eyebrows and the eye sockets were very wide set, almost to the sides of it's head. It looked similar to a frog's bone structure. I thought it looked similar to a troll doll because it's brain was completely open and extended very far above it's head like hair.
I will NEVER forget that image. Poor baby.
The doctor wanted to get that view so that before he sent me to see Dr. Adashek there was a definite confirmation of a terminal diagnosis for that baby.
Dr. Bolnick looked closely at my hemorrhage and said that it definitely looked stable. It didn't look bigger. I thought it looked smaller. He said that it could be smaller, but he couldn't tell because the babies had grown a lot this past week and he couldn't tell if the hemorrhage was just getting redistributed as the babies grew and pushed into other areas, or if it was actually smaller. Either way, I was glad that he said it was stable. I haven't had any active bleeding this week, and for the first time since this whole thing started, I am starting to pass actual blood clots.
Dr. Bolnick said that based on Dr. Adashek's experience and the fact that the bleed looks stable, that he feels confident that Dr. Adashek will feel comfortable doing the reduction as long as there are no changes in the next few days. We'll see. We are waiting for a list of risks, pros and cons, and statistics to make the decision. Dr. Bolnick said that the risk of carrying 3 babies to myself and the health of the other 2 is greater than the risk of doing the reduction, but we're going to wait and talk to Dr. Adashek and see what he thinks.
Thank you for all of your prayers and sending happy thoughts our way. We really feel every single one. I cannot tell you how encouraging it is to get messages and texts throughout the week from you guys.
In other news, construction on the upstairs room starts monday! And we bought a new car. I need to blog more...I'm a little behind.
I gained 3.5lbs. Woah. My bad. I have been making an extra effort to eat more food this past week and I've been SUPER conscious of doing very little to help the bleed heal. Goal attained? Eek.
They did the ultrasound to look at the all the heart beats and we got another set of pictures. I didn't share the last ones, but here are the new ones. The tech was like, do you want any pictures of baby C? I was like, UM YES! She said that some people request not to have any pictures or further info about the sick baby because they don't want to get more emotionally attached, etc.
Here's baby A and it's right at the bottom of my uterus, resting with it's back on my cervix:
Here's baby B and its to my right on the upper side of my uterus:
And here's baby C, located on my left, right under my stomach:
Now, if you scroll back up, you can see that baby A and B have round heads and you can see their profiles. While baby C has a perfect little body, he has no profile or slope to it's head at all :( They also did a "frontal view" of this baby and I just couldn't believe it. The doctor said that it had "classic bone formation" of a baby with anencephaly. Its head looked like it stopped at the eyebrows and the eye sockets were very wide set, almost to the sides of it's head. It looked similar to a frog's bone structure. I thought it looked similar to a troll doll because it's brain was completely open and extended very far above it's head like hair.
I will NEVER forget that image. Poor baby.
The doctor wanted to get that view so that before he sent me to see Dr. Adashek there was a definite confirmation of a terminal diagnosis for that baby.
Dr. Bolnick looked closely at my hemorrhage and said that it definitely looked stable. It didn't look bigger. I thought it looked smaller. He said that it could be smaller, but he couldn't tell because the babies had grown a lot this past week and he couldn't tell if the hemorrhage was just getting redistributed as the babies grew and pushed into other areas, or if it was actually smaller. Either way, I was glad that he said it was stable. I haven't had any active bleeding this week, and for the first time since this whole thing started, I am starting to pass actual blood clots.
Dr. Bolnick said that based on Dr. Adashek's experience and the fact that the bleed looks stable, that he feels confident that Dr. Adashek will feel comfortable doing the reduction as long as there are no changes in the next few days. We'll see. We are waiting for a list of risks, pros and cons, and statistics to make the decision. Dr. Bolnick said that the risk of carrying 3 babies to myself and the health of the other 2 is greater than the risk of doing the reduction, but we're going to wait and talk to Dr. Adashek and see what he thinks.
Thank you for all of your prayers and sending happy thoughts our way. We really feel every single one. I cannot tell you how encouraging it is to get messages and texts throughout the week from you guys.
In other news, construction on the upstairs room starts monday! And we bought a new car. I need to blog more...I'm a little behind.
Thursday, May 23, 2013
Another Doctor's Appointment Today
So last night I had a horrid night. My subchorionic hemorrhage decided to rear its ugly head and bleed. All. Night. Long. All night. Like crazy.
So I didn't sleep. I called my doctor's office around 3am and the on call doctor encouraged me to go to the ER. I was like, NO. My husband is on the night shift and I'm not going by myself. Forget it. Instead, I was told to come in to the office as soon as possible.
I slept horrible. It was like every time I fell asleep my body would be like, "NOOOOO, you're bleeding, don't wreck your sheets!"
I didn't know at the time the cause of the bleeding was the hemorrhage. I was thinking it could be a of couple things.
1. The hemorrhage was emptying out before my appointment so that I would be magically healed.
2. I was losing the baby with anencephalopathy. Which, in my mind, isn't a bad thing. It would happen on God's time, I wouldn't feel like I "made the choice" for my baby to die, and I wouldn't have to undergo all the risks of a selective reduction.
3. The hemorrhage is getting bigger and taking over my entire uterus.
4. I am losing all of the babies.
So. As you can see, lots of thoughts to keep me awake.
Troy got home from work in the morning and we left for the doctor's office. We were shown right back and they took my weight, heart rate, and blood pressure. Everything was good. Then they took us into the ultrasound room. And I swear, it was only 5 minutes, but it felt like an hour waiting for her to come in.
The same ultrasound tech from last week came in and asked me about any cramping/pain/bleeding (yes bleeding, no cramping or pain). She started the ultrasound and said all 3 babies heart beats looked great and the bleed looked exactly the same.
I literally could not stop crying. I just felt like a faucet. I really, really felt like the bleed was going to shrink. I really believed it. I have been praying so hard and really felt like God was going to answer my prayers this morning. I just felt SO let down and disappointed. And I could not stop crying. Poor Troy. It was my first time really crying about this situation in a completely uncontrollable way. He just handed me tissues and rubbed my back.
The genetic anomoly and abnormality counselor came in to talk to us about some more tests that she wanted to run on the babies. We took all of the information and brochures, but ultimately, we decided that we don't want to do that. No matter what the tests said, it wouldn't change the outcome. So when we got home, we threw all the information away.
Then the doctor came back in with the ultrasound tech again. They repeated the heart rates, looked at the HUGENESS of my hemorrhage (it's 7cm by 9 cm by 2-3 cm - it kind of felt like a win to me, it was smaller than my biggest ovary!!), and tested my cervix for length and funneling.
And I could not stop crying. Just silent, huge tears rolling down my face.
The doc turned on the light and basically said "nothing has changed."
I was like, "I really wanted to hear something good and positive. This is just awful. I cut my hours at work from 40 a week to 28 and on my days off, I literally sit on the couch all day long. My house is a wreck and I can't grocery shop or do laundry. I just wanted to hear that making changes had an effect on this."
He said, "this IS new good news. Nothing is worse. You are having the active bright red bleeding, which is unfortunate, but the status quo is the same."
He was humble enough to admit when he was in a little over his head and I am seeing him for monitoring for 1 more week and then I am going to see the "boss man." He is the head of the practice and has the most experience. So that appointment is on June 3rd. I'll be exactly 15 weeks when I see "the boss man."
So basically, everything is exactly the same. No changes. Troy and I had conflicting feelings on the appointment. He thought it was great. He was like "there are 3 heart beats, 2 healthy babies, and you're not in any pain. Sounds like a good appointment to me!" And I was like, "I'm bleeding worse than a scene from Carrie, all of our friends and family are praying for us and the changes I made didn't make a bit of difference."
So. Appointment next thursday.
Please God, shrink this hemorrhage. Help me to accept whatever your will is in this situation. Help me to stay positive and keep these babies safe and healthy. I don't understand why this is so hard, but I know that your hand will guide us and comfort us. Please give me the strength to stop crying and be accepting of your plan for my life.
So I didn't sleep. I called my doctor's office around 3am and the on call doctor encouraged me to go to the ER. I was like, NO. My husband is on the night shift and I'm not going by myself. Forget it. Instead, I was told to come in to the office as soon as possible.
I slept horrible. It was like every time I fell asleep my body would be like, "NOOOOO, you're bleeding, don't wreck your sheets!"
I didn't know at the time the cause of the bleeding was the hemorrhage. I was thinking it could be a of couple things.
1. The hemorrhage was emptying out before my appointment so that I would be magically healed.
2. I was losing the baby with anencephalopathy. Which, in my mind, isn't a bad thing. It would happen on God's time, I wouldn't feel like I "made the choice" for my baby to die, and I wouldn't have to undergo all the risks of a selective reduction.
3. The hemorrhage is getting bigger and taking over my entire uterus.
4. I am losing all of the babies.
So. As you can see, lots of thoughts to keep me awake.
Troy got home from work in the morning and we left for the doctor's office. We were shown right back and they took my weight, heart rate, and blood pressure. Everything was good. Then they took us into the ultrasound room. And I swear, it was only 5 minutes, but it felt like an hour waiting for her to come in.
The same ultrasound tech from last week came in and asked me about any cramping/pain/bleeding (yes bleeding, no cramping or pain). She started the ultrasound and said all 3 babies heart beats looked great and the bleed looked exactly the same.
I literally could not stop crying. I just felt like a faucet. I really, really felt like the bleed was going to shrink. I really believed it. I have been praying so hard and really felt like God was going to answer my prayers this morning. I just felt SO let down and disappointed. And I could not stop crying. Poor Troy. It was my first time really crying about this situation in a completely uncontrollable way. He just handed me tissues and rubbed my back.
The genetic anomoly and abnormality counselor came in to talk to us about some more tests that she wanted to run on the babies. We took all of the information and brochures, but ultimately, we decided that we don't want to do that. No matter what the tests said, it wouldn't change the outcome. So when we got home, we threw all the information away.
Then the doctor came back in with the ultrasound tech again. They repeated the heart rates, looked at the HUGENESS of my hemorrhage (it's 7cm by 9 cm by 2-3 cm - it kind of felt like a win to me, it was smaller than my biggest ovary!!), and tested my cervix for length and funneling.
And I could not stop crying. Just silent, huge tears rolling down my face.
The doc turned on the light and basically said "nothing has changed."
I was like, "I really wanted to hear something good and positive. This is just awful. I cut my hours at work from 40 a week to 28 and on my days off, I literally sit on the couch all day long. My house is a wreck and I can't grocery shop or do laundry. I just wanted to hear that making changes had an effect on this."
He said, "this IS new good news. Nothing is worse. You are having the active bright red bleeding, which is unfortunate, but the status quo is the same."
He was humble enough to admit when he was in a little over his head and I am seeing him for monitoring for 1 more week and then I am going to see the "boss man." He is the head of the practice and has the most experience. So that appointment is on June 3rd. I'll be exactly 15 weeks when I see "the boss man."
So basically, everything is exactly the same. No changes. Troy and I had conflicting feelings on the appointment. He thought it was great. He was like "there are 3 heart beats, 2 healthy babies, and you're not in any pain. Sounds like a good appointment to me!" And I was like, "I'm bleeding worse than a scene from Carrie, all of our friends and family are praying for us and the changes I made didn't make a bit of difference."
So. Appointment next thursday.
Please God, shrink this hemorrhage. Help me to accept whatever your will is in this situation. Help me to stay positive and keep these babies safe and healthy. I don't understand why this is so hard, but I know that your hand will guide us and comfort us. Please give me the strength to stop crying and be accepting of your plan for my life.
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