With the countdown still a-go, we had another good round of appts today. Her Nonstress Test looked very good yet again, and she's definitely a baby-on-the-move which is also very very good. Dr. Byrne is letting us skip Tuesday's NST, since she's really not worried as much anymore about the arrhythmia. We're still dilated at 2cm, but we're now 50% effaced, so our induction on the 21st may not require as much "help" to get things going labor-wise. And there's no indications that we'll be going earlier at this time.
She had one of the Neonatologists come in to explain a bit more of what we can expect once the baby arrives. First, we should get to hear a screaming baby once that first breath happens -- believe it or not, I was worried about that. Then, they'll pass her through the "window" and they'll get 2 central lines going through her umbilical cord, since that's where they can get the biggest lines in. However, it doesn't always work, so she may have to have a line her arm. Through those lines, they'll give her glucose (in place of breastmilk) and the prostaglandins (the hormone that will keep a fetal heart duct--the Patent Ductus, from closing). Since prostaglandins can hinder lung function, she may need to be intubated and on a ventilator, but she may do fine on her own -- it's 50/50. As well, they'll give her an echocardiogram at that time and hopefully, they won't find any further complications. That will be her first hour and fortunately, we'll be right next door in the delivery room while all this is going on.
And if she requires oxygen, they won't give her 100% of what a normal baby needs; rather, they'll keep her at or below 80%. Normal oxygen levels tell the Patent Ductus that it's OK to close (as it would with a normal baby--usually within 10-12hrs of life). But since the duct is what will be helping to circulate/oxygenate her blood until she receives the heart shunt, they keep her oxygen limited, and give her the prostaglandin hormone to keep the duct open.
So, after that initial hour or so, they'll get her over to Primary Children's and into the Cardiac Unit of the PICU -- if there isn't a bed available, they'll keep her at University Hospital (with me) in the NICU until a bed opens. Once they have her at Primary's, she'll be assessed by the Cardiac Team, and we'll find out who her surgeon will be. They anticipate her surgery will be 5-7 days from her delivery, but if they find any serious complications, they may do it sooner.
She won't be allowed breastmilk until after her surgery; since she'll be on glucose and other things in place of milk, she won't drop the usual few pounds that other newborns do. And, she'll be pumped full of fluids during surgery, so they said we can expect her to look quite bloated for a few days after. Once surgery is over and she's stabilized, they'll be able to see how well her digestive system is doing and if she's ready to tolerate breastmilk. And of course, there will be a number of things they'll be on the lookout for once her surgery is complete - like the chest swelling we saw with little baby Ammon during our PICU tour.
So, that's the "clinical" update. Personally, we're trying to imagine and prepare for what the upcoming weeks will bring. Dr. Byrne started me on Zoloft about a week or so ago; it's takes 2-3 wks to work into your system and I have to say ....it's draining me! Of course, getting up around 5-7 times to pee every night doesn't help; I tend to spend at least one of those pee breaks lying in bed worrying for about an hour or so. Funny enough, Cate's late night visits to mommy's bed have been welcomed (we're trying to get her transitioned to the big girl bed, but she ends up in my bed by about 2am). Somehow, cuddling with her in those "wee" hours has been therapeutic (HA, get it ..."wee" hours?! Geez I crack myself up). And good thing Daddy is sleeping downstairs on the couch ...with all the late night activity, he'd never get any sleep! Speaking of Daddy, he recently learned that I am not the only gaining baby weight, so he's started back to the gym. I think it's quite unfair but in less than 2 wks, he's already dropped 4lbs (that will take me a month most likely). I'm so glad he's doing that; he's worried about me, the baby, how Cate will do through this, let alone the worries of work. He's good at coping, but this is an awful lot to tackle. I'm glad the gym is proving to be a good outlet for him.
I guess that's it for this update! Please keep the prayers coming; we appreciate any and all we can get!