Friday, October 28, 2011

Life rarely goes as planned

The last ultrasound I had in early October, showed signs of Symmetric Intrauterine Growth Retardation which basically means the baby may not be growing right. When I saw my doctor on Oct 24th, he mentioned that if the baby did have IUGR, we would have to consider terminating the pregnancy. The doctor mentioned termination as cooly as if he'd just asked us out to lunch!! My husband and I looked at the doctor like WTF?!! The doctor explained that terminating meant an early delivery, not aborting the fetus. PHEW!! At 30 weeks gestation, the fetus was viable outside my womb, but I wanted to keep the baby inside as long as possible.

That same day, I also went for a consult with an anesthesiologist to see if I could have an epidural or spinal injected into my back so I could have a vaginal delivery. What I was told at the consult was the last thing I expected to hear. If anything, I thought doctors would be hesitant about inserting a needle into my back because of the physical implications of Cerebral Palsy. However, the anesthesiologist was concerned for me on a neurological level, since I also have Dandy Walker Malformation, a rare congenital brain malformation involving the area at the back of the brain that controls movement and the fluid-filled spaces around it. The anesthesiologist's concern was the unknown about what could happen and he was worried about possible neurological damage following a spinal insertion. He was also concerned about the possibility of too much pressure on the brain, since I already have a larger amount of fluid in the brain than a normal person and having the epidural could increase brain pressure and cause neurological damage

The anesthesiologist's recommendation for delivery was a C section under general anesthesia, which meant I'd be asleep during my baby's birth. It also meant surgery and I never want to go through surgery again after having so many. What sucked even more was hearing that my husband couldn't be present during the C section since it would be under general anesthesia. My husband was near tears hearing he would miss his baby's birth. Because not much is known about Dandy Walker Malformation, the anesthesiologist agreed to thoroughly review my case with other doctors and let me know what they thought safest and best.

My other option is to try for a vaginal delivery without an epidural or a spinal. I nixed that option because I'm not THAT strong=) We left the consultation very disheartened. Gone were the images I had of a normal birth and welcoming our baby the way most people do, but one thing the anesthesiologist said made me laugh. He said the fact that I have moderate scoliosis is actually a blessing, because it is what's keeping me upright. If I didn't have the scoliosis, I wouldn't be able to stand at all, so I just thought it funny that a spine deformation is a really good thing in my case!

Finally after a long and emotionally draining day, we headed home. As we pulled up to a gas station, I started laughing. My husband asked why I was laughing so hard. I told him I found it funny that again I was in the minority. For one, Dandy Walker Malformation is rare. Two, I was in the 1-2% of patients who was undercorrected following eye surgery back in 2002, and lastly if my baby did have growth issues, those also only occured in 10% of the population! Was I missing a message here or something??!! My husband said I'm unique. I don't want to be THAT unique thank you very much! In the midst of my laughter, I got an email from my OBGYN saying that after consulting with the anesthesiologist about my condition and the possibility of the baby suffering in utero if it wasn't growing correctly, he wanted me back in the hospital that night for closer observation over a few days. My laughter immediately turned to tears as I showed my husband the email. I was scared for my baby.

My husband stayed with me in the hospital till I was settled in, which included blood tests, a urine culture and monitoring baby's heartbeat. By the time he put me to bed in the GYN unit, it was after 2 AM and he was exhausted. I was petrified of being in hospital, but I tried to be brave, said goodbye to my husband and tried to sleep, but sleep eluded me.

I was trying really hard not to freak out, panic and hyperventilate that I was spending one night maybe more in a hospital.  I wanted out now!! I also wished my husband was with me. I was in a room with 5 other women but I felt like the only pregnant one since I was constantly getting up to pee and in between I was munching on food. Everyone else was sound asleep. Because I was admitted so late, I got the center bed which had no electricity outlets by it which sucks because there was no way I was getting a wink of sleep and the one thing which kept me from totally freaking out, was IM'ing with my sister. I struggled to keep my eyes open but the feeling of panic and fear were winning over....sorta....eyes closing. God please let my baby be ok. It's certainly kicking me enough! I finally got some sleep and before I knew it, I was woken up at 530AM to have the baby's heartbeat monitored. 530 AM??!! really? can't we do this later?

fetal heart monitor

 Over the next 2 days, I had detailed ultrasounds done to rule out any growth issues. Thankfully everything was fine. The baby's heartbeat was monitored twice a day and birthing options were also discussed again with my OBGYN and another doctor. One doctor asked me to open my legs as wide as I could so he could see if I could have a normal birth, but apparently I'm 10 degrees short of being able to open wide enough to deliver vaginally. They said a vaginal delivery wouldn't work even if someone held my legs open.  I asked about different birthing positions, but was told it wasn't really possible. However, if I wanted to try for a vaginal birth, it would have to be without medication and in the end if it didnt work out, I'd need to be rushed to a C section, so why wait to see if something goes wrong?

I understand the doctors position, but at the same time, I want to make sure I explore all my options and my OBGYN understands that. He set me up for an orthopedic consult next week to see if I can physically try for a vaginal birth. I'm also reading a book called The Disabled Women's Guide to Pregnancy and Birth. In that book are the experiences of 90 women, all of whom have disabilities worse than mine. I'm talking major spinal injuries, paralysis etc, and a majority of the women had vaginal births with medication, so why in my case is everyone saying my only option is a C section under general? I understand that every case is different and the main concern in my case is the Dandy Walker Malformation, but I want to go into the birth-whichever method I decide on-knowing that I exhausted all my options, so I'm trying to find any cases of people with Dandy Walker Malformation who delivered vaginally with medication. However at the end of the day, I will do what's safest and best for my baby and myself. If that means we miss the birth and I have a very hard recovery, so be it, as long as we have a happy, healthy baby at the end.