Most of you know everything up to this point, but for those who don't know the specifics, here they are...
Tuesday March 23, 2010 (almost 18 weeks)
I had a routine follow up appointment with my OB, Dr. Cook. Jason was busy at work & he had been to every appointment so far, so I told him to skip this one. After sitting in the waiting room for over an hour & then the exam room for another 30 minutes, one of the nurses asked if I would be willing to see one of the other doctors since Dr. Cook was so busy. I said "yes, please" & Dr. Boone came in a few minutes later. She examined me, did a quick ultrasound, asked me to get dressed & walked out of the room. One of the nurses came in, escorted me to a conference room & told me Dr. Cook would be in to speak with me. I knew something was up, but thought it couldn't be too serious. I heard the baby's heartbeat when Dr. Boone did the ultrasound & I had just seen Dr. Cook a week & a half earlier & he told us we were going to have a happy, healthy baby.
Dr. Cook came in & told me that there was very little amniotic fluid around the baby. He told me to immediately go to Dr. Palmer, a specialist, so that she could do a better more detailed ultrasound. I asked him if the baby was OK & he said "I think so, but we have to find out." I called Jason & drove to Dr. Palmer's office where he met me. While we waited for an exam room, Dr. Palmer explained what was going on. Basically it had to be one of two things 1) either I was leaking amniotic fluid or 2) the baby was not producing the fluid (amniotic fluid is the baby's urine). I was sure that I had not been leaking fluid, so it seemed to be the baby was not producing fluid. During the ultrasound, Dr. Palmer explained some of the things that could cause this (absence of one or both kidneys and/or bladder, blockage, etc). She thought that she could see both kidneys & the bladder. It also looked as though there was blood flowing to them. She reiterated how tiny the baby was at 18 weeks & the difficulty she was having looking at the organs (the baby's heart was smaller than a nickle).
After the ultrasound, we sat down in Dr. Palmer's office again & she gave us her diagnosis. She started out the conversation by letting us know that this was a long shot & most other doctors would tell her that she was wrong. She believed that there was some sort of blockage or clotting in the placenta. This would prevent the baby from getting the proper fluids & nutrients from me. She said that this was very rare to see this early in pregnancy, but since it looked as though the kidney's were present & functioning (blood was flowing to/from them in the ultrasound). She also told us that most other doctors would tell us that this is not a viable pregnancy. She ordered me on bed rest & prescribed daily Lovenox injections - a blood thinner.
Thursday March 25, 2010
After speaking with Dr. Palmer & hearing her diagnosis, Dr. Cook wanted to send me to another specialist, Dr. Reiter, for another ultrasound. During the ultrasound, Dr. Reiter told us that he could not see any kidneys or bladder. He explained to us why he disagreed with Dr. Palmer's diagnosis of clotting in the placenta - all of the baby's organs would be significantly smaller, as well as the baby's overall size, not just the kidney's & bladder. Our baby was growing a normal rate & seemed to doing just fine other than the lack of fluid. He explained Potter's syndrome - a term that describes the effects of Oligohydramnios (insufficient amniotic fluid) resulting from any number of renal (kidney) abnormalities or a rupturing of the amniotic sac. He said this appeared to be Classic Potter's syndrome, which is the result of bilateral renal agenesis (BRA), or the absence of both kidneys. He told us that due to the lack of fluid, the baby's lungs are compressed and cannot develop properly. The baby would die of respiratory failure within one or two days of delivery, most likely a few minutes to a few hours (if the baby survived delivery). There are no treatment options & there has not yet been a BRA baby that has been reported to survive more than a few days past birth. He told us to be thinking about whether or not we wanted to continue the pregnancy & we could wait a couple of weeks to allow the baby to get bigger & see if anything changed. We were obviously devastated. This diagnosis was completely different from Dr. Palmer's finding only two days earlier.
Dr. Cook called to check on me that night, after speaking with Dr. Reiter. He told me that Dr. Reiter's diagnosis made more sense given all of the evidence. He told me to wait two weeks & he would send me to a different specialist, Dr. Gei for a third opinion. At twenty weeks, the baby would be big enough for them to see all of the organs.
Wednesday April 7, 2010 (20 weeks)
Dr. Gei performed another ultrasound. Afterwards he explained that he had to agree with Dr. Reiter's diagnosis. He showed us that not only were there no kidneys or bladder, but the arteries that branch off from the spine going to the kidneys were absent. He explained our "options" with continuing the pregnancy just as Dr. Reiter had. I told him that we would not be taking any actions to alter this pregnancy. He also told us that some of his other patients that had been given similar news had continued the pregnancy & acted just as they would with any other baby - pictures, grandparents, family & friends at the hospital during delivery. I immediately knew this is what Jason & I wanted for our baby. He assured me that I was in no danger, there were no risks to me & I just needed to continue my prenatal care just as I would for any pregnancy. He also had me discontinue the daily Lovenox injections that Dr. Palmer prescribed (to treat blood clots).
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