Anatomy of a Tough Decision

At the meeting yesterday the majority of doctors seemed to think the best idea was to try to wait another two weeks. This would give the baby the chance of going from a micro-preemie (under 3 pounds) to a preemie. Doing that would give the baby a much better prognosis. However, Professor G, the head of the department, is very concerned. Dr. S explained her concerns to me this morning. Previously the medical community has always believed that in a case of IUGR when the baby went into distress there would be a sequence of events that would happen that, if identified, would give doctors time to intervene and save the baby from fetal demise. However, recently there have been a few papers and studies coming out saying that this is not always the case, especially in babies who are suffering from severe IUGR. Our baby is in that category being in only the 3^rd percentile.

Professor G feels that our baby will most likely not go through the sequence if it goes into distress. Therefore today when I go for an ultrasound it will be done by a doctor and Dr S and Professor G will come in and observe the ultrasound. (Dr. S is the doctor who admitted me and also happens to be an expert at ultrasound. He has taken a special interest in our case and we have come to trust him very much.) Based on what they are seeing they will hopefully be able to decide one way or the other.

Another problem they are facing is that as the brain sparing effect stops there have been changes in the dopplers (ultrasound measurements of blood flow in the baby’s brain, umbilical cord, heart and the vein connecting the umbilical and heart.) This is something else that will have to be taken into consideration.

Additionally, just to complicate matters, I am having a lot of pain against the incision site from my hernia surgery and that along with a few other symptoms have the doctors concerned that my hernia may have returned. This is a very rare complication from hernia surgery, but since I have hit so many of the really rare conditions and complications with this pregnancy, nothing will surprise me at this point.(Maybe I should by a lottery ticket.)

So, I am waiting for the ultrasound with the doctors, the surgeon to asses my hernia and the surgical site in general, more monitoring, plenty of meds and all of this while we await the doctors to make what is a tough decision. While this is a stressful and somewhat scary time for us, our doctors are just as stressed and worried. This shows me just how good they are. They are really taking us into account and have made it a point to keep us informed. I can see that they are agonizing over the decisions as well, each one determined to do what is best for me and the baby. No one is taking this lightly. I feel that I am not just another patient, but someone that they care about. This has gone a long way towards keeping me healthy and in good spirits and has been more effective than any medicine. IY”H (With the will of G-d) they will be able to help us towards a favorable outcome for everyone.