Cranio Follow Up

This morning was the last follow-up appointment for Zoey’s cranio surgery.  At least it is for a little while, until after we are settled with the new little one.  Z is doing well enough that we will be able to email her surgeon with updates every few days and not worry about any appointments until we are ready to remove the distractors.  She has about another week of expansion space on them, and then at least 4 weeks of “settling time” for the bone to heal.  I’m going to post a few pictures later on today, but her facial structure is changing so much!  She’s looking more and more like a little girl and less of an infant.  I imagine I would say that no matter what was going on, but it does seem a lot more drastic and dramatic of a change this way.  We are so excited with how well she has responded to this whole process, both physically and emotionally.  She’s a happy camper.

    A Follow-up to the Almost Procedure

    On Friday Michael and I took Zoey back to see Dr. Oiticica.  In the meantime he had spoken with an internationally recognized pediatric surgeon in Cincinnati who works on thousands of imperforate anuses every year.  The possibility of not finding the muscle contraction was puzzling to him as well. For some reason Zoey was so excited about everything that day.  She had a lower abdominal x-ray taken in the main hospital before the appointment in the pediatric wing.  The x ray was taken to look at Zoey’s digestive system a little more closely, and also to search for a possible reason behind her lack of muscle stimulation.  Good news: her stool is passing really well and there weren’t any blockages.  I don’t know how many surprises Zoey has given us in her first four months, but today was yet one more.  In addition to the Cranio, Anesthesia, NICU, Pediatric surgery, and Labor & Delivery departments, Zoey is now famous in Radiology as well.  According to the x ray, a portion of her large intestine is situated on top of her liver instead of below it.  Most likely this has already or will eventually cause a hernia.  We are able to wait until she is older for any corrective action as long as she is free of pain and stool blockages.  It is possible that her rectal muscle is located deeper than normal as a result, which would have been why Dr O couldn’t find it last week.

    We have a follow-up to the follow-up appointment on Sept 7th, when Dr. O will insert a catheter through Z’s fistula to monitor her digestive system from the inside.  This will also help us figure out how the fistula is connected to her colon.  I’m not sure if they will give her anesthesia for that.  I’m so glad she won’t be able to remember any of this when she’s older.  One thing I did find out is that I will be able to give her pureed food on schedule.  Complete solids won’t be possible right now, but it will be awhile before she is ready for solids anyway.  As Scarlett said, “I’ll think about that tomorrow.”

    Side note: As I was typing this Zoey started on my lap and is now lying next to me on the couch.  I don’t even know how she got there!  Lately she doesn’t sit still for longer than 2 seconds, even when she’s sleeping.

      Today. July 30th.

      It started with an early pre-op doctor’s appointment. We got to the small office before the nurse clocked in, and the stand-in was the friendly receptionist. Unfortunately she had never performed the routine check-in procedure before, which includes weighing the patient. After she fumbled unsuccessfully with the scale a minute, I offered to weigh Zoey myself: just over 9 lbs 10 oz with clothes. After a short exam and a dilator measurement of the fistula, the doctor went over all the details with me concerning Z’s pending anorectalplasty. Initially, she has been referred to the anesthesia dept for a pre-op screening on Aug 3rd. As the doctor explained, because Zoey has some different facial features, she may need some specific tools for the anesthesia to work properly. Zoey will be on only “clear liquids” for the 12 hours prior, which is just Pedialyte. I hope she responds well to that and can sleep well that night. The first case procedure will begin at 7am on Aug 8th, and thus far Zoey is first in line. That puts us in the parking lot around 5:15am…ouch. The surgery will last 1-2 hours since a colostomy will not be required. Michael and I will be offered a pager so that we can receive an update if it lasts longer than an hour. Zoey will be sent to the PICU for at least 24 hours following to recover and stabilize. Estimated total healing time is about three weeks, so we will have a few added steps in our daily routine of diaper changes for that time. God-willing, Zoey will be good as new within the month.

      Appointment #2

      This afternoon Michael joined us for a routine pediatrics visit.  Zoey was due for her 4 month vaccinations.  She weighed 9 lbs 9 oz and has grown to 22 ½ inches long.  Her skull is also increasing in circumference, which is a good sign that her brain still has adequate space.  She has remained consistent in the 3rd percentile growth chart, and therefore has relieved a lot of initial concerns for us.

      While we waited for the nurse to administer the shots, I received a phone call from the genetics dept.  The latest round of testing, called a DNA microarray, searched each chromosome on a broad scale for additions and deletions.  They discovered that Zoey’s third chromosome has a portion of base pairs with an extra copy of genetic materical.  The implications of this are inconclusive at this point, but Michael and I will both be tested in this portion of our third chromosomes to determine whether or not we are carriers as well.  If we are not carriers, it is reasonable to infer that some of Zoey’s physical anomalies have resulted from this genetic addition.  I say infer because apparently this mutation form has never been previously recorded in their database for anyone else.  I wonder if we will end up with something they will call Zoey’s Syndrome…

        upcoming surgery

        On Monday morning we met with a pediatric surgeon who will be working on Zoey’s rectal surgery.  After examining her, he decided that she is doing well enough to let her grow a bit before performing the surgery.  We have a pre-op appointment at the end of this month.  Then, we will be meeting with Dr Oiticica on Wednesday, August 8th to undergo Zoey’s anorectalplasty at MCV.   Recovery time is generally only a day or two, so we hope to have her back home on Friday.

          Eye Doctor

          On Thursday we went to the eye doctor with my sister Amy.  The nurse numbed and diluted Zoey’s eyes with this crazy yellow liquid that glowed under black light.  I had to capture it for posterity.  She did a great job of sitting as soon as I realized she needed a bottle.  I’m discovering that milk is a great distraction from most medical procedures and exams.

            Doctor Visit #too many to remember

            So today was my weekly checkup with the OB/GYN – woohoo!  (I never thought I would be so excited about a gyno visit.)  My blood pressure and weight are about the same as last week, and baby’s heart rate is 125 bpm.  I had a good deal of pressure start last night, so I opted for an internal exam as well.  Baby has dropped significantly again and her head it at a -1 to 0 (aka ready for delivery).  I’m also dilated at almost 2 and 40% effaced.  I’ve had a good deal of pressure on my hips and pelvis for about two weeks now, and it was really encouraging to hear that it has been a progressive pressure.  There’s a really big chance that we will see the baby before her due date…possibly even this weekend!  So so so exciting!


              Today was my “Week 37” midwife visit…not terribly exciting.  My strep test from last Friday came back negative, and I gained another few pounds.  Blood pressure and baby heart beats were normal.  I’m getting a little tired of having to constantly go to the doctor these days and report my tiny inches of progress.  It would be nicer if I could enjoy my last month at home before arriving in full labor.  I guess the visits have their purpose, though.  I watched a few episodes of TLC’s “I Didn’t Know I Was Pregnant” today, and it almost made me wish that that could have happened to me.  How awesome to go through eight months of pregnancy and not even be able to recognize it.  It would be nice to for-go months of vitamins, morning sickness, and the hyper-awareness of every internal movement.  Yes…I am at the please just get this child out of me stage.  I thought I was getting better with patience, but I guess I still have some learning to do.  Meanwhile I now have some assigned exercises since the baby turned slightly posterior.  Moving is more of a chore since my center of gravity is off again, plus the additional few pounds of baby.  Not even born yet, and she’s already grounded until she starts teething.

              Everything is ready, except for a few last purchases of cloth diapers and a few diaper covers.  So now, we wait.

                Last Ultrasound

                Yesterday we had our last ultrasound.  I’ve been measuring a little small for the past month, so the midwife recommended that we make sure everything is still coming along alright.  The images weren’t as clear as they were in the first two ultrasounds, and we weren’t able to get any sonograms to take home.  Michael recorded the visit again, but it really isn’t nearly as exciting to see this time around.  We only saw the back of her head, her femur, stomach, heart, and part of her spine.  Granted, everything was much bigger this time around.  Still, I’m glad we have some great shots from the first two visits for the baby book.

                Results. Baby is doing great!  She’s a little over 5 pounds now, and the doctor estimates that she’ll weigh in the lower 7 pound range at birth.  Right now she is in the 30th percentile, so she is smaller than average, but not enough to cause concern.  Her head is completely downward, faced inward, which is why we weren’t able to get a good pictures of her face.  We are sticking with the April 14th due date, and the doctor said to expect her anytime within the next two to four weeks.  Considering our initial date was March 30, I think she’ll be here sometime early April.  Michael is still hoping for a March baby…we’ll see.

                The baby’s recent shift downward has been really nice for me.  I can breathe a lot better and my center of gravity is a lot easier on my back and hips for walking and getting around.  I was wishing yesterday that I could start running again since almost all the pain is gone.  I’ve grown a little restless with all this slow-moving and waddling business.  I didn’t run of course, but it’s pretty significant to me to feel like I am able to again.  I realize that soon enough I’ll have a whole new type of pain to deal with in recovery, but I’m enjoying this break in the meantime.

                  Pregnancy Centering Group Session #8

                  Last Wednesday was our last group session and today I’m at 35 weeks.  Hard to believe the time’s really flown by so quickly.  Two women in the group have now had their little ones, with a third one disgruntled and overdue.  I’ve only gained two pounds within the past month and my uterus measures on the small side (surprise surprise).  The midwife suggested I get another ultrasound to make sure the baby’s developing alright, which is now scheduled for next Thursday.  Considering my mom had three due dates when she was pregnant with me, and I came about a week after the last one, I’m thinking it’s just par for the course.  The baby really does look and feel small in comparison with the other women in my group who are supposedly in the same week and later than me.  Most are also my height and general build, so it’s a pretty fair comparison. The best news I’ve heard so far about the whole situation is that the baby is most likely is not going to be 10 pounds. yaaaaaaay!  I’m completely fine with a small baby girl, I’m just praying that everything is okay and that she’s not small as a symptom of something more worrisome.  She’s still punching and kicking constantly, so it’s hard to be too worried about it.  I keep telling her not to get too comfortable in there, because I am ready to move on and not have a 45 week pregnancy.  I guess we’ll know more next week. Stay tuned 🙂

                    Pregnancy Centering Group Session #7

                    Once again a little late posting, but last Wednesday was another now bi-monthly meeting. Baby’s heart rate measured strong in the 140s, I gained another pound, and my blood pressure a wonderful 118/60. Not too much else to report at this time. We talked about different methods of contraception and their effects on milk supply and ovulation. A pediatric dental student also presented a little schpiel on how to best take care of baby teeth.

                    Things I Learned About Pregnancy and Infant Dental Care:

                    1) Fluoride-use is frowned upon before age 5 since there is a limit of how much can be digested. We were instructed to find non-fluoride toothpaste for the early years.

                    2) Baby teeth are fully calcified during pregnancy, and adult teeth by birth.

                    3) Dentists recommend a first visit at 12 months, which is more to get babies used to the idea of a check-up than anything else.

                    4) All-night bottles of milk, as well as juice, can increase risk of cavities.

                    5) Some dentists are scared to treat pregnant women.

                    6) Dental visits are approved during the second and third trimesters. Some insurance companies will even cover additional cleanings at this time.

                    7) One big caution as you get farther along is to make sure most of your weight stays on your left side when you are in the cleaning chair to prevent dizziness.