[Previous entry: "Practicing Punctual Perinatologists"] [Main Index] [Next entry: "Lights, Camera ...."]
05/31/2002 Archived Entry: "Georgetown Again"
Last night a nurse from Georgetown Hospital called to tell us that Dr. Lewis would like us to meet with Dr. Keszler today. Since our schedules are theirs to command, this is what we did.
Dr. Keszler is the head of the neonatology unit. These are the folks who, after the baby is born, whisk her away to NICU (Natal Intensive Care Unit) and do what needs to be done in order to let her breathe. We didn't get much *new* information from Dr. Keszler, but it was still a very worthwhile visit. He talked to us about the risks involved in the surgery which will happen next week, and we agreed with him that these risks are outweighed by the potential benefits. He explained that the catheter they'll be inserting won't pose any difficulty in a vaginal birth — in fact, one of the risks is that it may fall out on its own before she even comes to term, or she may pull it out herself. If this happens, it won't pose any threat to her or to me. We may see her waving it around in a later sonogram. If it does come out either before or during the birth, she'll probably need to have it replaced as soon as she's born.
We asked him about the likelihood of a c-section, and he answered that he doesn't believe it will be necessary. It won't help HER any to be removed surgically; babies delivered via c-section often have problems of their own, including fluid in their lungs (which would have been squeezed out during vaginal delivery), jaundice, and heart problems. We don't want to add to her troubles at all -- so there will not be a scheduled birth.
He showed us the NICU nursery -- this is the first we've been able to go into. The babies there were mostly preemies, and there was one who was on a respirator. Dr. Keszler explained to us the different equipment. They have 2 different types of respirators -- one is a baby-sized "regular" respirator, and the other is a high-frequency unit that provides lots of smaller breaths, rather than fewer bigger ones. They also have an ECMO unit, and they know how to use it.
Just outside the doors of NICU, Dr. Keszler pointed out the high-risk delivery room. That's where I would end up -- that way, whatever her condition at birth, they can be ready to help her.
All of this basically adds up to the conclusion that we'll be delivering at Georgetown. It just makes more sense to deliver her in a place where she can be treated right away. Children's Hospital is wonderful, and if they had a maternity ward I'd be registered there already — but they don't, and we don't have $3 billion to endow one. Delivering at Sibley would be nice, if this birth weren't promising to be as complicated as it is. I'd love to be in a comfy, low-lit room with relaxing music and a Jacuzzi bath ... but all of that is really just icing. And I'd trust them to deal with smaller issues than she has, and transport her to Children's. But with Georgetown, we don't have to worry about what will happen between birth & respiratory support.