Week 30 Begins (with a Roller coaster Ride)
Hello to you all.
We had our NST and OBGYN appointments this morning. This was the first time we made our Tuesday appointment on time (we were :30 minutes early!), and the first time there was no snow storm hampering our journey to our Tuesday appointment. We even stopped at Einstein's Bagels for breakfast. Wow.
What excitement as we got to the NST station thirty minutes early! As I type this in, I am reminded of my one and only Space Mountain experience: I was afraid of roller coasters, but the first several minutes of Space Mountain was rather fun. Just as I thought to myself "this isn't so bad," that's when the car plunged into the spiral descent into the darkness. That sets the tone for this morning's exam. We got in early and things were looking good, then the plunge! But, like my Space Mountain experience, we came out OK.
Rebecca got "strapped in" to the monitoring devices. The nurse found Xavier quickly, propped the sensor with a rolled towel (normal because of the angle it takes to read his heartbeat). Rebecca was handed he "I felt him move" button and the nurse stepped away. Xavier's heartbeat started out around 145 bpm and stayed there for some time. Every so often his heart rate dropped below 110 and once to 98. The nurse popped in a few times to check the ticker tape, taking concern for the large dips in heart rate and the fact Rebecca had not registered any baby movement.
A few frequent checks later and the nurse tore the strip from the machine and went to see the attending doctor (Dr. Yong, the doctor we first met at the Perinatal clinic). Because of the concerning data, we were sent over to L&D (that's Labor and Delivery) for longer-term monitoring. L&D is the same place Rebecca spent her first three weeks at University Hospital). We spent nearly two and a half hours there.
Arriving, Rebecca gave a urine sample, then was strapped in to the monitoring harness again, plus the added bonus of the arm cuff for blood pressure. Xavier's heart rate stayed between 128 and 131 for a very long time. Rebecca's first BP measured 148/98, which was not too bad. The nurse left us to wait out the monitoring, saying she would return in :15 minutes to retake the BP measurement (she did not like the 98 diastolic value).
:15 minutes turned into nearly ninety while we watched Xavier's heart rate range from 102 to 149, while it centered around 130. Very rarely did Rebecca feel Xavier move. Rebecca was quietly concerned and I sat there watching the ticker chart fluctuate in ways we have never before seen. As I watched Xavier's heart rate fluctuate so widely and not have him show any movement, I fought back concern and fear.
Rebecca and I spent time speaking to Xavier and encouraging him. I read to him the story of Jonathan and his armor-bearer (1 Samuel 14, a great history of a man with incredible faith in God and His covenant). After that, Rebecca kinda zoned out as she listened to the heart rate ramble (I was totally impressed that she could tell, with great accuracy, what decade range his heart rate was in just from listening to the beat). I sat in front of the machine and watched the monitor and the growing pile of paper tape.
After a long time (maybe :45 minutes) Xavier began moving very occasionally. Though rare, still it helped encourage us. At one point, Rebecca looked down, cupped her tummy in her hands and told Xavier, "You need to be at least two pounds. Don't you force us to make a decision today!"
Our nurse, Gwen whom we have had the pleasure of working with when Rebecca was an in-patient, eventually returned. She brought Rebecca apple juice and gram crackers, and she thought to bring me a glass of water. As promised, she took Rebecca's BP again. It was 135/88, values she was comfortable with. At this time, she also tore the ninety minute plus paper heart rate tape to take to the attending doctor of that ward. By this time, Xavier was moving around a lot more and his heart rate had raised to the high 130s.
At this point, we asked her about the many dips in Xavier's heart rate and his seemingly (to us) erratic and far-ranging heart rate. Gwen unfolded the paper tape and looked over the graph (note: even though Rebecca and I were in a room alone for a very long time, the nurses were monitoring things from their station just outside the door). She smiled, and said there was nothing on the graph to worry over, and that this was normal for a baby in his thirtieth week. She continued to explain to us the "deep troughs" that so concerned Rebecca and me, how she expected to see them occasionally and what she would expect to see if there was some reason for concern.
This was a great relief for Rebecca and me. Both of us were privately churning over the thought that the placenta had finally reached its limit. Gwen gave us some more encouragement, then left to show the tape to the doctor. Shortly after, a woman came in rolling a mobile ultrasound unit. Her name was Pam, the resident mid-wife for the ward. She came in to measure Xavier's amniotic fluid. This woman was fantastic and completely shattered the pall which the out-patient folks put over us.
Pam was all over Xavier; nothing he could do to hide from her! She hunted all over to find four pockets of fluid. Her method of measurement was so different from what we have seen in the past, I had to ask her why. She explained that the doppler folks generally like to find a typical pocket and measure it, then multiply that number by 4 to get the actual amnio number. Pam likes to find four pockets of amnio and sum the measurements. She explained it's basically two ways of doing the same thing. The purpose of the amnio measurement was to rule out a number of bad things which also show the deep troughs in a heart rate graph. She explained a baby's amnio should be in the 8 cm range. Xavier's worked out to be close to 9 cm. Thank you, Jesus!
We watched Xavier's heart beating, saw his hands and arms, saw his feet and knees, saw his partly full bladder, his stomach, his rib cage. Even got a good view of the placenta. We got to view him from many angles today. It was as when you wait for a good friend to deplane: you wait and watch and wait and scan, and then you see them and you smile with great joy.
We asked Gwen later about the different mentalities of the doctors we encountered today. She happily helped us understand why the out-patient folks were so alarmed, but the in-patient folks stayed unflappable. The out-patient folks, she explained, are used to seeing the normal, text-book pregnancies and babies, so seeing abnormal things tends to upset them. The in-patient folks are used to seeing the not-so-normal pregnancies and babies. Also, the in-patient folks are very familiar with Rebecca's case and know better how to interpret the data.
We signed our papers, thanked Gwen and Pam and headed for lunch.
So, getting off the "Space Mountain" ride we thank our God and Father for His goodness! Xavier is healthy and his heart rate activity is normal for a baby at 30 weeks. Our concerns about the placenta quickly nearing the end of its ability to support Xavier have been assuaged. In fact, we learned Xavier has far more amnio fluid than we thought and the placenta is still strong in its support of him! We are looking forward to Thursday's doppler and growth exam. I am also thankful the start date for my contract was delayed a week. I would have missed this ride, and, more importantly, I would not have been there to stand with Rebecca during this ride.
Today is a wonderful example to point to and thank you all for your prayers! Great is our God, and awesome is He!