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04/30/2002 Archived Entry: "Missing Pieces"
So there are some things I've been leaving out, mainly with the hope that they'd go away by themselves. But they haven't, and in fact they've become more insistant, so I'm going to have to write them down.
During the April 2 ultrasound when they found out the baby is a girl, they also found some fluid in her chest cavity -- referred to as "pleural effusion". It was only on the left side, around the outside of her lung. There was also the possibility of a malformed intestine -- referred to as "intestinal atresia". That is a marker for Down Syndrome, in 1 out of 5 cases.
So my OB rushed me into an amnio center, to see what we could see. He also took about a gallon of blood so that tests could be run to see if I had been exposed to any viruses that might have caused this. The amnio was done on April 4, and came back clear -- she's not suffering from any chromosomal damage. And the blood tests all came back clear.
That was good news, but it also meant that there was nothing we could do but wait to see what would happen. In about 20% of cases, pleural effusion resolves itself; the fluid gets absorbed. And the intestinal atresia, while not good, would be treatable after birth -- they can operate to take the bad part out, and rejoin the good ends.
Today I had a follow-up ultrasound. The same dr. who did the April 2 sonogram did today's -- he's very good, and has a good reputation. From the outside, she looks really good. She's almost 2 pounds, and she's actually measuring to deliver a week earlier than they previously estimated. She moved around a LOT, and when the technician pushed around with the transducer, she shoved back hard a couple of times.
Then they looked inside of her. The fluid has actually expanded. There's more on the left than there was, and now there's some on the right side as well. In addition, they found cysts in both of her lungs. They spent a long time watching the baby's heart, which looks normal. It's been displaced a little by the fluid; it's a little further to the right than it should be.
Dr. Cochran (who did the sonogram) is very concerned. He isn't able to give us a prognosis -- and I wouldn't have asked him for one. Dr. Match (my OB) is supposed to be referring me to a specialist at Children's Hospital -- I'm supposed to see Dr. Match next week. Instead of waiting, I'm going to call this afternoon and get that dr's name, so that I can go ahead and make an appointment.
It's possible that they might be able to operate in utero, to remove some of the fluid. The risk is that it will just re-form. They could also possibly put in a shunt, to provide continuous drainage until she's born. We have NO idea what they can do about the cysts in her lungs. And my guess is the prognosis there will depend on whether they spread. I mean, look at all the smokers in the world -- they exist at less than 100% lung capacity. So if the worst news is that she'll never be a soccer star, Geoff & I guess we can get over that. ;) We hope that that's the worst it means.
Oh -- the intestinal atresia? It's not there. The blockage he was seeing that day may have been one of the cysts in her right lung -- it took him and the tech about 15 minutes to isolate the cyst, to figure out whether it was in fact in her lung or her intestine. So we have that going for us as well.