Tuesday, December 16, 2008

Monitoring, Monitoring and More Monitoring...

Today I saw Dr. Davis. I probably should clarify what seeing Dr. Davis entails: first of all, unless there is an issue, I usually see one of the very skilled ultrasonographers in the Antenatal Testing Unit for any combination of studies including, fetal growth scans, cervical measurements and amniotic fluid level checks (AFI). The images are then transmitted via computer to his office and usually after a pretty long wait (I don't mind, he's worth the drive and every minute I've spent waiting in his cramped waiting room) he calls me back to talk. He reviews the images, takes his own measurements, answers my questions and never makes me feel rushed. The visits usually end with a hug and he walks me out to the desk with my chart and gives my follow-up instructions to Lisa, the scheduler.

All of Dr. Davis' techs are great and I like them all, having confidence in each of them. However, that being said, Patty is still my personal favorite as she was there at my preconception consult. She performed my scan today and I explained to her that I was concerned I didn't receive an accurate AFI on Friday. After a quick peek at Baby Boy, Patty moved on to assess my fluid level. There was a big black area that could have been mistaken for fluid (I really learn something new each time I get a scan) but once Patty turned the color on, highlighting what I imagine to be blood flow, it was determined that the big mass of black was not fluid but a lump of cord. This technique was not employed during my Friday scan when my AFI came back at 15.

Bottom line, my fluid is nine this week, up from last week's seven. This is an improvement but nothing like the 15-16 range which is considered "normal". After my ultrasound I was hooked up for a non-stress test (NST) where both the baby and I were being monitored: he for heart rate and me for contractions. It really was painful to hear the nurse say that Baby Boy is still real small and that it may be hard to pick up heart rate accelerations because he is still "neurologically immature". Janice is a very nice woman also and very knowledgeable, I might add. I explained to her how much it hurts to hear something like that as My Girl was born exactly four weeks earlier at 24w 5d gestation. Moments like these are really sad and painful reminders of just how much My Girl was gypped by not getting more time in the womb. It's an open wound for me.

Anyway, Baby Boy looked great and I informed everyone I saw that I've had a really good week. I then saw Dr. Davis who confirmed that things are looking good but it's in my best interest and my baby's to continue to monitor things with weekly AFIs and NSTs. I couldn't agree more when he commented about how much we've invested in this pregnancy (as does any expecting mom, I would hope) and that it would be a shame to have something that is presenting as a potential issue slide past us and become an issue such as growth restriction or fetal demise. He is being extra cautious with me and I really appreciate that approach!

So, this leads me to my big dilemma which I imagine more light will be shed upon tomorrow when I meet with Dr. C: do I drive all the way to South Jersey each week or will my local group be willing to support this aggressive approach to monitoring?

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