Dear Friends,
Things continue to go well and we had our appointment with the doctor today. Things looked so good we all agreed it was time for Jennifer to go home and continue the pregnancy at home under home bed rest. The AFI was over 12 today and everything looked absolutely great. How much things have changed over the last few weeks when we thought we might be delivering at 26 weeks!
The insurance company approved a home IV for Jennifer (always subject to review after the fact!). We will still be coming down to Fargo three times a week for the PR interval test for the heart and the Doppler Cord study like we have been doing for several months now.
Please continue to be in prayer that the AFI (Amniotic Fluid Index) stays up. We have about 8 more weeks until the baby is here!
Sincerely,
Dave
Friday, September 25, 2009
Thursday, September 24, 2009
Consistent Stability
Dear Friends,
There isn't really too much to report since last time regarding updates to Jennifer and the baby. The AFI has generally been between 8 and 10 cm which is a good number and the PR interval is steady around 117. There doesn't seem to be any major concerns at the moment which is great. They did a growth study and our little girl was tracking at 29 weeks and 2 days weighing in at around 3lb and 7oz! Our intention is to have a c-section around 37 weeks which would put a tentative delivery date of November 19th, a week before Thanksgiving.
Jennifer remains down in Fargo, 70 miles away from our town of Grand Forks. For those of you who haven't read the previous posts, this is because there are two tests that need to be run that cannot be done at the local hospital, the PR interval checking the speed of communication between the upper and lower chambers of the heart and the AFI which is an Amniotic Fluid Index that they want to be above 8cm ideally at this point in the pregnancy. They do a doppler study on the flow of blood in the cord which is something they are not yet trained to do here in Grand Forks also. One other concern, when this all started they feared a very early delivery for which Fargo had the neonatal intensive care facilities that can handle severely premature babies.
At the rate that Sophia is growing we might not need to pull out the premie clothes if we come close to that 37 week goal. We'll keep you posted. We are meeting with the specialist tomorrow to find out if he wants us to keep this strategy up or try something else. We'd love nothing more than for Jennifer to come home but we don't want to risk it if the stakes are too high. We need reasonable assurances that things will continue to remain stable.
Sincerely,
David Monreal
There isn't really too much to report since last time regarding updates to Jennifer and the baby. The AFI has generally been between 8 and 10 cm which is a good number and the PR interval is steady around 117. There doesn't seem to be any major concerns at the moment which is great. They did a growth study and our little girl was tracking at 29 weeks and 2 days weighing in at around 3lb and 7oz! Our intention is to have a c-section around 37 weeks which would put a tentative delivery date of November 19th, a week before Thanksgiving.
Jennifer remains down in Fargo, 70 miles away from our town of Grand Forks. For those of you who haven't read the previous posts, this is because there are two tests that need to be run that cannot be done at the local hospital, the PR interval checking the speed of communication between the upper and lower chambers of the heart and the AFI which is an Amniotic Fluid Index that they want to be above 8cm ideally at this point in the pregnancy. They do a doppler study on the flow of blood in the cord which is something they are not yet trained to do here in Grand Forks also. One other concern, when this all started they feared a very early delivery for which Fargo had the neonatal intensive care facilities that can handle severely premature babies.
At the rate that Sophia is growing we might not need to pull out the premie clothes if we come close to that 37 week goal. We'll keep you posted. We are meeting with the specialist tomorrow to find out if he wants us to keep this strategy up or try something else. We'd love nothing more than for Jennifer to come home but we don't want to risk it if the stakes are too high. We need reasonable assurances that things will continue to remain stable.
Sincerely,
David Monreal
Friday, September 11, 2009
Things Keep Looking Good
I just got today's results from our Amniotic Fluid Index (AFI) and the p-r interval. Both look absolutely great! The AFI was at 10.18 cm and the p-r was steady at 117 on all three tests. This is incredibly good news and gives us a lot of hope and confidence that we will carry the baby to term which is better than it was just a few weeks ago when it looked like we might have to deliver incredibly early.
On a discouraging note, Jennifer's grandmother on her mom's side had a stroke yesterday. She is in the hospital and there is a bit of swelling on the brain, she took a hard fall and broke her nose and as of last night weren't able to fully assess the damage. She is 85 years old and in moderately good health otherwise. Please continue to pray.
I was also saddened to hear yesterday that the younger brother of one of my best friends from high school passed away early this week from an undiagnosed heart condition at age 37. My prayers go out to the family at this time as they grieve and if things were different with our situation I would be out there to share this time with them. Life truly is brief.
Sincerely,
Dave
On a discouraging note, Jennifer's grandmother on her mom's side had a stroke yesterday. She is in the hospital and there is a bit of swelling on the brain, she took a hard fall and broke her nose and as of last night weren't able to fully assess the damage. She is 85 years old and in moderately good health otherwise. Please continue to pray.
I was also saddened to hear yesterday that the younger brother of one of my best friends from high school passed away early this week from an undiagnosed heart condition at age 37. My prayers go out to the family at this time as they grieve and if things were different with our situation I would be out there to share this time with them. Life truly is brief.
Sincerely,
Dave
Wednesday, September 09, 2009
No news is good news
Dear Friends,
It has been a few days since my last post. First of all, let me say that things are very stable at the moment even though Jennifer is in the hospital and will remain there for the foreseeable future. We might try to get her back home sometime soon but the unborn baby's safety is our first concern. I'll let you know how that progresses as we continue.
We have gone back to three full tests a week, Monday, Wednesday and Friday unless there are problems that develop during one of the tests. Due to the holiday we are doing tests on Tuesday and Friday.
Yesterday's tests results were all great! The p-r interval was between 113-125 (110-140 is normal range), and the Amniotic Fluid Index (AFI) was at 8.14-10cm which is also great. 10 is ideal so we are doing fine.
By the way, I am a teacher at heart so I try to make these blogs both informative and educational (gee, I sound like PBS). So if you want to learn more about what is going on or why they are doing what they are doing please read the earlier posts. Also, to find out all the details about the situation we are facing with Jennifer and baby Sophia or to find out how things worked when this happened with Grace you can click on the 2005 May-November posts.
All the other stuff is just my ramblings about life but it might we worth a read if you're bored. Thanks for thinking about us, checking up and most of all for praying. Without the grace and strength of our Lord Jesus Christ we are week, frail and fearful people.
Sincerely,
Dave
It has been a few days since my last post. First of all, let me say that things are very stable at the moment even though Jennifer is in the hospital and will remain there for the foreseeable future. We might try to get her back home sometime soon but the unborn baby's safety is our first concern. I'll let you know how that progresses as we continue.
We have gone back to three full tests a week, Monday, Wednesday and Friday unless there are problems that develop during one of the tests. Due to the holiday we are doing tests on Tuesday and Friday.
Yesterday's tests results were all great! The p-r interval was between 113-125 (110-140 is normal range), and the Amniotic Fluid Index (AFI) was at 8.14-10cm which is also great. 10 is ideal so we are doing fine.
By the way, I am a teacher at heart so I try to make these blogs both informative and educational (gee, I sound like PBS). So if you want to learn more about what is going on or why they are doing what they are doing please read the earlier posts. Also, to find out all the details about the situation we are facing with Jennifer and baby Sophia or to find out how things worked when this happened with Grace you can click on the 2005 May-November posts.
All the other stuff is just my ramblings about life but it might we worth a read if you're bored. Thanks for thinking about us, checking up and most of all for praying. Without the grace and strength of our Lord Jesus Christ we are week, frail and fearful people.
Sincerely,
Dave
Friday, September 04, 2009
The Latest on Jennifer and Baby Sophia
Dear Friends,
Here’s the latest information about Jennifer and Sophia. We met on Wednesday with the specialist and he understands that our desire is to do whatever works and will be helpful to see the baby come to full term. It was very different from the situation on Monday for which we are both very grateful.
It does not follow the normal pattern that being on an IV should have as dramatic of an impact as it is having. However, there is a possibility that the dexamethasone that Jennifer is taking somehow makes it less effective for her to hydrate orally and it have a direct impact on the amniotic fluid index (AFI). But there is a lot we don’t know about this particular dosing which is higher than for other types of difficulties in pregnancy so perhaps this higher dose has different characteristics than at lower doses.
Her AFI was at 8.7 on Tuesday and 8.5 on Wednesday. Today her AFI was at 8.2 which is still an acceptable reading. Since it seems to have stabilized with the IV we have scaled back taking the AFI every day and will only do it on Mondays, Wednesdays and Fridays along with the p-r interval. That was great on Wednesday and today it was between 113-119, which is perfect.
Another amazing answer to prayer a friend from San Diego is going to fly out here and help us with the kids until Jennifer is released from the hospital or the baby is born. She has cared for her children and grandchildren and is wonderfully qualified to help us. She and Jenn are wonderful friends and our children know her from her time in the church nursery with her. She will be here in just over a week. I cannot even begin to express how blessed we are that she would be willing to minister to our family in this way. (We have warned her the winter is a little more brisk than San Diego.)
What are the possibilities that Jennifer might be able to come home under home bed rest? That is a good question and one that we will be exploring in the next couple weeks. We are hesitant to suggest another strategy which might put the baby at more of a risk especially when we have found a strategy that is working and would allow us to continue to full term (or a few weeks early with a c-section which is most likely).
If things continue to go well we might explore seeing if perhaps Jennifer could hold a good AFI without an IV or we might see if it is possible to have home nursing with an IV. Again, the concern is that we wouldn’t have the same level of care and it is much harder to have true “bed rest” when you are at home which we found out with our first child. Our first priority is doing everything we can to have a healthy full-term baby. It isn’t ultimately about our comfort or convenience if it means sacrificing our baby’s wellbeing.
We appreciate so much your love, prayers and practical support. For those of you from around the country and overseas reading this blog let me brag on the church family here for a few moments. They have organized daily meals for us since Jennifer went into the hospital, a few ladies have come over to clear, others have volunteered to help clean and another gave us gift certificates for several hours of cleaning. Also, they have lined up childcare every day so that I can be free to visit with Jennifer since taking the kids every time is difficult for the kids. I could go on and on sharing how our church family has rallied to our side during this trying time and you can imagine how much this has encouraged and helped us.
I’ll share more in a few days. We won’t be doing more tests until Tuesday so it is unlikely that things will change much between now and then but if they do I will let you know. Otherwise, look for a blog post sometime on Tuesday or Wednesday of next week.
Thank you for your love and prayers,
David Monreal
Here’s the latest information about Jennifer and Sophia. We met on Wednesday with the specialist and he understands that our desire is to do whatever works and will be helpful to see the baby come to full term. It was very different from the situation on Monday for which we are both very grateful.
It does not follow the normal pattern that being on an IV should have as dramatic of an impact as it is having. However, there is a possibility that the dexamethasone that Jennifer is taking somehow makes it less effective for her to hydrate orally and it have a direct impact on the amniotic fluid index (AFI). But there is a lot we don’t know about this particular dosing which is higher than for other types of difficulties in pregnancy so perhaps this higher dose has different characteristics than at lower doses.
Her AFI was at 8.7 on Tuesday and 8.5 on Wednesday. Today her AFI was at 8.2 which is still an acceptable reading. Since it seems to have stabilized with the IV we have scaled back taking the AFI every day and will only do it on Mondays, Wednesdays and Fridays along with the p-r interval. That was great on Wednesday and today it was between 113-119, which is perfect.
Another amazing answer to prayer a friend from San Diego is going to fly out here and help us with the kids until Jennifer is released from the hospital or the baby is born. She has cared for her children and grandchildren and is wonderfully qualified to help us. She and Jenn are wonderful friends and our children know her from her time in the church nursery with her. She will be here in just over a week. I cannot even begin to express how blessed we are that she would be willing to minister to our family in this way. (We have warned her the winter is a little more brisk than San Diego.)
What are the possibilities that Jennifer might be able to come home under home bed rest? That is a good question and one that we will be exploring in the next couple weeks. We are hesitant to suggest another strategy which might put the baby at more of a risk especially when we have found a strategy that is working and would allow us to continue to full term (or a few weeks early with a c-section which is most likely).
If things continue to go well we might explore seeing if perhaps Jennifer could hold a good AFI without an IV or we might see if it is possible to have home nursing with an IV. Again, the concern is that we wouldn’t have the same level of care and it is much harder to have true “bed rest” when you are at home which we found out with our first child. Our first priority is doing everything we can to have a healthy full-term baby. It isn’t ultimately about our comfort or convenience if it means sacrificing our baby’s wellbeing.
We appreciate so much your love, prayers and practical support. For those of you from around the country and overseas reading this blog let me brag on the church family here for a few moments. They have organized daily meals for us since Jennifer went into the hospital, a few ladies have come over to clear, others have volunteered to help clean and another gave us gift certificates for several hours of cleaning. Also, they have lined up childcare every day so that I can be free to visit with Jennifer since taking the kids every time is difficult for the kids. I could go on and on sharing how our church family has rallied to our side during this trying time and you can imagine how much this has encouraged and helped us.
I’ll share more in a few days. We won’t be doing more tests until Tuesday so it is unlikely that things will change much between now and then but if they do I will let you know. Otherwise, look for a blog post sometime on Tuesday or Wednesday of next week.
Thank you for your love and prayers,
David Monreal
Wednesday, September 02, 2009
Good News, More Good News and Hmm?
Good News
First the good news. Everything looks great with the baby. Jennifer went back on an IV on Monday afternoon and the Amniotic Fluid Index (AFI) was 8.7 yesterday and 8.5 today and it also visually looked good as well. It seems that the IV has helped bring the fluid level up and stabilize it like it did with our first pregnancy. In some ways this defies expectation because good hydration only accounts for 10% of the amniotic fluid. However, it seems to have an almost immediate and dramatic effect in bringing the level up.
It looks like we have found a strategy that both helps the baby’s heart develop without heart block as well as deal with the issue of low amniotic fluid.
More Good News
Without much discussion whatsoever the doctor agreed with this strategy and is pleased with the results of what is happening. We had hoped to be transferred to Grand Forks where we live but they are unable to do two of the tests (The Doppler color blood flow study of the umbilical cord and the p-r interval reading). There was also talk of Jenn going down to Sioux Falls, SD to be under the daily care of the perinatologist but we determined that this wasn’t necessary.
Hmm?
It looks like Jennifer is going to stay under hospital bed rest with an IV for the foreseeable future. Our due date is December 10th and it seems like a very real probability that Jennifer will be in there until the baby is born. Most likely we will deliver by C-section around weeks 36-38 which would put us around November 12-26 depending on the size and lung development of the baby. Wait a minute! It is only September 2nd. Exactly! Hmm.
What does that mean for the kids and me? Honestly I haven’t quite figured that out yet. But what is most important is that Jennifer is healthy and the baby is doing well. Everything else is but a momentary hassle. Please keep us in your prayers, especially for the kids who have to deal with the absence of Jennifer here to love and nurture them. Also, pray for me that I can stand in the gap and be extra sensitive to their needs during this short period of time.
Sincerely,
Dave
First the good news. Everything looks great with the baby. Jennifer went back on an IV on Monday afternoon and the Amniotic Fluid Index (AFI) was 8.7 yesterday and 8.5 today and it also visually looked good as well. It seems that the IV has helped bring the fluid level up and stabilize it like it did with our first pregnancy. In some ways this defies expectation because good hydration only accounts for 10% of the amniotic fluid. However, it seems to have an almost immediate and dramatic effect in bringing the level up.
It looks like we have found a strategy that both helps the baby’s heart develop without heart block as well as deal with the issue of low amniotic fluid.
More Good News
Without much discussion whatsoever the doctor agreed with this strategy and is pleased with the results of what is happening. We had hoped to be transferred to Grand Forks where we live but they are unable to do two of the tests (The Doppler color blood flow study of the umbilical cord and the p-r interval reading). There was also talk of Jenn going down to Sioux Falls, SD to be under the daily care of the perinatologist but we determined that this wasn’t necessary.
Hmm?
It looks like Jennifer is going to stay under hospital bed rest with an IV for the foreseeable future. Our due date is December 10th and it seems like a very real probability that Jennifer will be in there until the baby is born. Most likely we will deliver by C-section around weeks 36-38 which would put us around November 12-26 depending on the size and lung development of the baby. Wait a minute! It is only September 2nd. Exactly! Hmm.
What does that mean for the kids and me? Honestly I haven’t quite figured that out yet. But what is most important is that Jennifer is healthy and the baby is doing well. Everything else is but a momentary hassle. Please keep us in your prayers, especially for the kids who have to deal with the absence of Jennifer here to love and nurture them. Also, pray for me that I can stand in the gap and be extra sensitive to their needs during this short period of time.
Sincerely,
Dave
Tuesday, September 01, 2009
Medical Update #6 on Jennifer and baby Sophia
Dear Friends,
A bit of good news amidst the confusion. The Amniotic Fluid Index (AFI) was back up today to 8.7 but the doctor is concerned that it is only "artificially inflated." We are still confused as to why having the fluid up through hydration and an IV is worse than doing nothing and having the baby in duress and possible being delivered dangerously early.
What really bothers us is that when we had this situation with our daughter our doctor in San Diego was glad that he could find a strategy that worked and kept the fluid level up even if we weren't able to keep it up without an IV. It seems to me that it is better to have it up even if it is through an IV than having one more negative factor that might adversely affect the baby.
We are meeting the doctor tomorrow and I am hopeful he can explain his rationale and strategy in this pregnancy. Over and over again I have reiterated that we want to take the safest and wisest course of action to ensure the best possible outcome. I am coming to wonder if there are not other factor or considerations that are affecting the recommendations of the doctor other than the well being of Jennifer and the baby.
At present we are happy with the results of taking a cautious approach to the situation but frustrated and confused why the doctors are not excited that the very outcome we'd hoped for is actually happening. I suspect it is going to be an interesting conversation we have with the perinatologist tomorrow. I will keep you posted on how that goes.
Dave
A bit of good news amidst the confusion. The Amniotic Fluid Index (AFI) was back up today to 8.7 but the doctor is concerned that it is only "artificially inflated." We are still confused as to why having the fluid up through hydration and an IV is worse than doing nothing and having the baby in duress and possible being delivered dangerously early.
What really bothers us is that when we had this situation with our daughter our doctor in San Diego was glad that he could find a strategy that worked and kept the fluid level up even if we weren't able to keep it up without an IV. It seems to me that it is better to have it up even if it is through an IV than having one more negative factor that might adversely affect the baby.
We are meeting the doctor tomorrow and I am hopeful he can explain his rationale and strategy in this pregnancy. Over and over again I have reiterated that we want to take the safest and wisest course of action to ensure the best possible outcome. I am coming to wonder if there are not other factor or considerations that are affecting the recommendations of the doctor other than the well being of Jennifer and the baby.
At present we are happy with the results of taking a cautious approach to the situation but frustrated and confused why the doctors are not excited that the very outcome we'd hoped for is actually happening. I suspect it is going to be an interesting conversation we have with the perinatologist tomorrow. I will keep you posted on how that goes.
Dave
Subscribe to:
Posts (Atom)