Verses to Remember

From birth I have relied on you; You brought me forth from my mother's womb. I will ever praise you.

Psalm 71:6

Thursday, April 28, 2011

It's baby time!! (updates & details)

It is almost time to meet our sweet Annabelle Grace!!
Jeff & I will be going to Legacy Emanuel tomorrow morning (Friday, April 29th!) at 8am to check in, which means a very early morning for us to fight the traffic, but I can't think of a better reason! :) The C-section delivery is scheduled for 10am, and from there it should only take about 15-20 minutes until we get to finally meet our precious girl! Then depending on how well she is doing, she will be able to stay with us in the OR for a little while as they continue the surgery, after which she will go into the R-Room with Jeff & the doctors to get assessed.

At that point Jeff will be able to go to the other door and bring in the grandmas, one at a time, so they can see Annie and spend a couple minutes with her. After that I will be taken thru the R-Room to see Annie on the way to recover in Labor & Delivery, and Annie & Jeff will go to the NICU where they will get her situated and continue to make sure she's doing everything she's supposed to. Annie should be all settled in the NICU by around 12 or so, around the same time I am moved to my postpartum room in the Family Birth Center (where I'll be staying until discharge).

My room will be on the 2nd floor, and the NICU is right across the main hallway. We are allowed to have visitors, but we are limited in the number of people who can visit the NICU at a time, so please call ahead before coming. You can reach us either through the hospital switchboard or on Jeff's cell phone 503.764.8776. Friday will be quite a hectic day so we are asking only immediate family to visit then, but Sunday & even Saturday should be fine for short visits from others. After that I will be doing much better & Annie will be able to handle more stimulation & interaction, so early in the week would be the best time to visit for longer than a few minutes.
I will be staying in the hospital until Monday or Tuesday, recovering from the C-section (and bedrest!) and we expect Annie will be coming home sometime between that Friday to the following Friday. We are planning to be there each day that she is there, but the timing might vary, so to visit please check when we'll be there. There is a slight chance she might be doing so well that she gets released before the 1 week point, but most likely it will be between 1 & 2 weeks after she's born. She will be 6 weeks early, born at 34 weeks exactly, and itt is truly amazing that we were able to keep her growing this long! Because we made it this far as well as received the steroids to help her development, we don't expect Annie to have any long term health issues or complications due to her prematurity! God is SO good!

The main issues we expect her to be working on in the NICU are maintaining her body temperature and mastering the suck/swallow/breathe reflex that will allow her to take her feedings by mouth (either by breast or bottle, called nippling her feeds, as opposed to being fed thru IV or a gavage tube in her tummy). Once she is able to take all of her feeds by mouth and is taking in enough calories to gain weight, we'll be able to bring her home!
If you are wanting to help out with meals or things, we would certainly appreciate it! Being on bedrest does not allow for a lot of preparation, and we will be spending most of our time at the hospital even after I am discharged. Because we won't have a lot of time to thaw things out or cook, at least until we bring Annie home (and probably not for a while after that!), sandwich & salad making, picnic type food would probably be the best.

Jeff will be home by himself for the first 4-5 nights, and then I'll be home in the evenings and at the hospital during the day, so things that are easy to pack would be best- Roast beef or ham for sandwiches, rolls or soft bread, potato salad, fruit salad. Small containers of soup would be easy to take along to the hospital or eat in the evenings. Snacky food like cheese/crackers would be easy for Jeff. I have been loving baked goods lately :) so any sort of muffins, oatmeal cookies, brownies (Jeff loves rice krispy treats!) would be wonderful!

The thing that would be the most helpful of all, of course, would be if you could continue to be praying for our little girl! Specifically that the delivery will go well with no surprises (we've had enough of those with this pregnancy!), that she will be breathing on her own & showing good reflexes and signs of sucking/swallowing. We expect her to be over 4lbs, but the bigger the better, and we're praying she doesn't lose too much of her body weight over the first week. Being a good feeder & able to gain weight is what will dictate her hospital stay, so please be praying for good indications all around!

I'd also appreciate your prayers that I can recover quickly so that I am able to spend as much time as possible with Annie in the early days after her birth, and that nursing and pumping will go smoothly for me as well. Our biggest goal is that Annie gain weight so if we need to supplement her with something other than my milk we will, but I would love to be able to provide what she needs.

Because I know I do not have everyone's email or phone numbers, please feel free to forward this to anyone who would be interested. We will try to update everyone as quickly as possible once our darling girl is here, but if you have questions please contact either Jeff or the two grandmas, since I will be recovering as well. We hope to post pictures on facebook first, and then on my blog within the first few days.

God is so good! He has been faithful throughout this entire pregnancy, every time the doctors brought up a new problem he healed our Annie and kept her growing! I feel so blessed that he has protected our daughter, and that we can trust him to continue taking care of her once we are finally able to hold her in our arms. God truly deserves all the glory for Annie's health & recovery, and because of him we are now preparing to meet our daughter in less than 24 hours! Thank you, Lord!

Wednesday, March 9, 2011

Almost to 27 weeks.... & a NEW little cousin!!

Today we hit 26 weeks, 6 days.
(By the way I don't know what is up with the formatting, no matter how many spaces I put between paragraphs, blogger is apparently deleting them... I apologize & thank you for reading!)
That is so close to 27wks (tomorrow for those of you who don't like math) that it's making me quite excited. Of course we'd love to keep Annie inside for 3-5 weeks past the 27wk mark, but once we officially hit 27 we not only will be past the worst of the statistics for viability and long term difficulties, we will finally get to find out how she's doing in there! We'll get to see how much she's grown over the last 3 & 1/2weeks, and we'll be able to assess her umbilical blood flow to see if her AEDF has stayed the same (intermittent) or has progressed, and if so how much. I can't believe we're almost there!
3 weeks ago when I was sitting on the exam table and the doctor told us that his recommendation was to go home, rest as much as possible and then come back in 3 weeks to check our little girl; I had no idea how I was going to make it through 3 long weeks without knowing anything about how she was doing, if she was getting the blood & oxygen she needed, or if she was growing. 27 weeks seemed like this huge goal, almost unreachable when we hadn't even hit 24, but God is good and we are almost there! And not only did we make it, but God was good enough to give us one big dose of reassurance by starting to feel our Annie move.
When we first got the news that there was a major problem with her blood flow, I was only showing if I really tried, :) and I had not yet felt a flutter. (This was due to her being small for her age as well as having an anterior placenta, which basically buffers the movement until she's bigger.) Being told that our little girl was at risk of needing to be born months early, and that the best option was just to wait & check her again was really difficult. We agreed to follow his advice, with no way of knowing if she would even survive the 3 weeks. The doctor's best estimation was that her complications wouldn't progress that quickly, but there were no guarantees. We pretty much went home in shock.
Over that weekend I began feeling a little odd fluttering while lying in bed on my side. I wasn't quite sure what I was feeling, but on that Monday it was like Annie decided (or God did, more likely!) to remove any doubt and make it very clear that what I was feeling was HER. She started kicking and not only did I recognize exactly what it was, but it was so strong that Jeff was able to feel it as well. I cannot tell you how reassured we were by that. Not only did it mean she was stronger and bigger than she'd been the previous week, but also that we'd have some way to know how she was doing over the next 3 weeks.
While we still don't know how much she's grown or the exact status of her AEDF, we are going into this appointment tomorrow with the knowledge that our little girl is at least big enough and strong enough to make her presence known several times a day (and sometimes all night, not that you'll find me complaining!). We know that while the news might not be as good as we are hoping for, we also will not be getting the news every parent dreads to hear, that our little girl didn't make it. Because if these jabs in my ribs and tickling on my side tell me anything, it's that our little girl IS making it! She's a fighter. And we thank God every minute of every day for that!
What happens next is very hard to predict. There are several different possible outcomes based on Annie's status, size, and many other factors. The most likely of options are: a) that I will be hospitalized to allow the doctors to monitor us both on a more constant and consistent basis, with the goal to delay delivery as long as her health holds out, b) that I will be hospitalized due to a worsening of Annie's blood flow problems, and that she will be monitored while I receive shots of corticosteriods to prepare her for early delivery, and c) that Annie's situation will be stable enough to allow me to continue with home bedrest, along with follow-up clinic visits to monitor her once or twice weekly.
We, of course, are praying for the third option, because it means Annie is doing well despite her condition, and would allow her more time to grow & develop before we move toward delivery. Whatever happens, however, we are confident that God is preparing her even now for what is going to occur, as well as giving her doctors and us the wisdom to make the best decisions. If she does need to be delivered within the next week or two, she would have over an 80% chance of surviving, with good long term odds for normalcy. It would mean a long NICU stay, most likely months, but most babies born between 27 &29 weeks do very well. If I am able to receive the full 48 hours of steroids prior to her delivery, that would increase her odds & help to significantly decrease the amount of time she will need to be in the NICU.
It's amazing, but even with the possibility still there of her needing to be delivered soon, Jeff and I both are feeling pretty good about this appointment. We are anxious to see our little girl again, but we are much less stressed than we expected to be. We trust our doctor to know the best route to take, and to give us all the information we need to make our decisions. And we know, of course, that the One truly in charge of the outcome never makes mistakes!
Now on to the other news :) Our little Annie isn't the only baby with a surprise or two up their tiny sleeves! My brother Chris & his wife Lisa were expecting their third little one, and because they live quite a ways from any hospital (over an hour in any direction!) and their first two came early (one in the ambulance!), they decided to schedule an induction almost a week before his actual due date, just to be safe. Well, apparently someone forgot to tell the baby that his arrival was scheduled, because at midnight exactly one week before the scheduled birth, my sister-in-law Lisa's water broke. Thankfully they were able to get to the hospital by 2 and their little man made his appearance shortly after 4 am.

Introducing Ezra Brian Fisher!
Welcome to the world, little Ezra!
And apparently Annie was anxious to come out and play with her newest cousin,
because the day he arrived was her most active day yet! I don't blame her,
this little sweetie is just too adorable to not want to cuddle & play with!
And while Annie will get to play with you soon, little Ezra,
we're all praying that it won't be too soon!

Wednesday, March 2, 2011

A Blanket of Blessings!

I have learned a lot about preemies in the last few weeks, and I am currently reading about what we can do to prepare for Annie's delivery & hospital stay, and specifically what Jeff & I will be able to do to help Annie grow as much as possible once she gets here.

When premature babies are born, they are taken from either Labor & Delivery (for vaginal births) or the Operating Room (for C-sections) into a room known as the R Room, or Resuscitation Room (this is the procedure for our hospital, though most NICUs follow a very similar pattern). This room is kept warm & humid to help with their breathing, and the babies are placed on an incubator (also called an isolette) under a warming light, so their temperature stays stable while the docs & nurses monitor their status.

The incubators they use in the NICU are very versatile. They remind me of a gift box that can be unfolded to lay flat, or folded up to seal up tight. When the baby is first brought in the table is "open," meaning the top or "lid" is raised up high, above the doctors' heads, and the sides are folded down from the bed. Then when the baby is ready to be moved to their spot in the NICU (and no longer under the warming light) the sides are folded up and the top is brought down to seal the incubator. The sides have portholes that nurses, doctors and parents can reach through to touch and tend to the baby, but depending on the baby's age & needs the incubators are most often left closed until babies are able to maintain their own temperature. (Babies can be taken out of the incubator to be held skin-to-skin or be fed by parents once they are stable enough; this usually occurs within the first week, and can even happen if the baby is on a ventilator!)

The environment in the NICU is kept dimly lit & quiet to help prevent overstimulation of the babies, but still needs to be bright enough for nurses & doctors to perform their duties. Because of this, parents often bring blankets from home to cover the lid of their baby's incubator overnight or whenever the baby needs less stimulation. This also helps the baby's "area" or room to feel more like a real nursery, and less like a hospital. There are also blankets & positioning devices inside the incubator, but those are only used for the baby to lie on. Obviously anything that is thick enough to keep out some light & noise would work for a cover, but most parents like to use a blanket either from their child's nursery or that has special meaning to them.

In hearing & reading about this, a thought began to develop. If this blanket is going to be covering our baby during this critical time when she is trying to grow and finish developing, wouldn't it be great if it was something meaningful. Something scriptural, even. And I came up with this idea of creating a blanket covered with Bible verses; verses with God's promises to his children, verses of blessing, of protection and of peace. I just love the idea of Annie being "covered," literally, with God's promises while she is in the hospital.

So this is where you guys come in. :) I would love to create this blanket with verses that our family and friends find meaningful, hopeful or reassuring. You can either email or comment with verses that you think would be perfect for this purpose, or if you would like to actually write (or even embroider) your verse on a piece of fabric that will be added to the blanket, let me know that and I can give you the specifics.

We feel so blessed that our little girl is not only going to be surrounded by loving family and friends, but also that she is cherished & guarded by the King of the universe! And while we of course want to do everything in our power to keep her safe and help her grow, her Heavenly Father is actually the only one who can protect her fully! After all, he created every tiny part of her and has kept her safe this far! I trust that he won't stop now.

Tuesday, March 1, 2011

Monday's outing to the hospital

We're already 25 weeks & 3 days!

Yesterday was a long day for a girl used to bedrest! It's surprising how 2 weeks of bedrest makes such a difference in my energy level and lightheadedness/shortness of breath when I'm up and around longer than my normal very short time limits! We had an appointment with Dr Jenkins, our favorite perinatologist, and walked around the birth center at the hospital. Everything is going fine, but the reason for the appointment was that some test results from a couple weeks ago had shown a bit of concern regarding possible Preeclampsia (pre-e), which is a pregnancy complication that can be very serious, and can also inhibit a baby's natural growth in utero. Since Annie is already small, the doctors were checking for any possible issues with my health that might also affect her.

When we first discovered her AEDF 2 weeks ago I went through a bunch of labs, including a 24 hour urinalysis, to check pretty much everything that can go wrong during pregnancy. Everything came back normal except that the urinalysis showed a slightly elevated level of protein. That can indicate pre-e, so our initial perinatologist (Dr Robertson) called us early the next morning and wanted me to go to the hospital for 24 hours so they could monitor my blood pressure. Pre-e is usually diagnosed by both protein (usually higher levels than mine, every pregnant woman will 'leak' some protein into their urine) and high blood pressure.

Normally I wouldn't think there could be any downside to being hospitalized, other than being inconvenient, but after our conversation with Dr Jenkins the day before we really didn't want to do that. Dr Jenkins had informed us that once I am hospitalized, the chance that Annie will be delivered early is much, much higher. The reason for that is that when they are monitoring both Annie & I around the clock, they are much more likely to find a "red flag" that indicates a problem. Often times these issues resolve themselves within a few hours, but being in the hospital at the time might increase the chance that they will take action to deliver, rather than waiting to see if the issue resolves.

Once I am further along and Annie's chances are better, this will be more a relief than a concern, because being labeled as an extremely high-risk pregnancy causes them to take any red flags very seriously and to move quickly to save her if there are problems. However until she grows & has a better chance of viability, staying out of the hospital can help to prevent an unnecessarily early delivery.

We called the doctor on-call at the hospital (since it was the weekend) and told him we'd rather do the 24 hour blood pressure monitoring at home. He basically said alright and to call if it is ever over 140/90 (and that we should expect Dr Robertson to be annoyed--we thought it was weird that he said that but we've learned that the other doctors and even the nurses seem to think Dr R overreacts to things.) That made us feel better, and after my bp never even got close to 140/90 (averaged 110/65 with the highest being 121/80 right after the dr called!), we felt even better about our decision to monitor at home. Dr Robertson had her nurse call us first thing Monday and we went over the blood pressure readings. She said the immediate concern was no longer, but she wanted me to keep up with daily bp readings (only 3 a day, much better than hourly!) and come in to get my labs re-done in a week to be sure that pre-e doesn't sneak up on us.

Luckily we were able to see Dr Jenkins for that appt, and hear his take on the pre-e issue. The best news is that all my labs from yesterday looked perfect, so while we will still probably keep checking for preeclampsia every couple weeks, Dr Jenkins does not think I'm at high risk for it, or that it is likely to be what is causing these problems. All good news! (Pre-e can progress very quickly & is a common cause for very premature deliveries.)

My mom drove me to the appt (since the hospital is close to Jeff's office, he just met us there) and afterwards we went for a (short) walk up to the Family Birth Center, Labor & Delivery and NICU. I had toured the NICU with Jeff and the neonatalogist at our first meeting with him 2 weeks ago, but I hadn't really noticed much more than the tiny babies in the isolettes, since I was still reeling from the news that our baby will most likely end up there soon. I was hoping to tour it again, with my mom this time, so we could both get a better mental picture of what is likely to be Annie's home away from home, as well as things we can do/get to prepare for her stay. I also wanted to show my mom the areas that I would be in once I was hospitalized (Family Birth Center), and then for the birth (L&D).

It was very reassuring to visit the Birth Center and Labor & Delivery, since the nurses that we spoke with were very encouraging and sympathetic. They were able to give me quite a bit more detail regarding what my perinatal stay (before the birth, basically hospital bedrest) and postnatal stay would entail, as well as my C-section delivery & recovery. I was able to see the actual rooms I would be staying in, and even ask questions of the lactation supervisor regarding pumping while Annie is in the NICU, and getting a good hospital grade pump to use at home. We weren't able to see the NICU because our timing coincided with an emergency delivery, but they did say that if we call ahead the next time I come for an appt, they would have someone free to give us that tour as well (the normal tour guide was busy with the emergency).

I was pretty pooped after all that, but it was a very good kind of tired! I feel more prepared for the time I am in the hospital, as well as getting ready for Annie's possible extended stay. It was nice to talk to nurses who see problems like mine every day, and often see much more serious problems that are still able to be handled well. I feel very blessed that God is giving us the opportunity to prepare for the upcoming hospitalization/birth/NICU stay, because most moms in that situation have no idea that they might need such specialized care (or deliver their baby so early) until they are rushed into delivery. They have to learn what is happening with their baby while trying to recover from delivery and the trauma of learning something went wrong. I really do thank God that our situation is not that emergent, and we are able to prepare, as much as you can for a situation like this.

Wednesday, February 23, 2011

Baby Steps to Annie!

This pregnancy has not been simple. Or straightforward. Or easy.

But it has been amazing.

I did not expect it to be easy, I hoped it would be simple, but I did not know how amazing it would be. I expected the birth to be awe-inspiring, and bringing our girl home to be wonderful, but I didn't know how amazing I would find the little things.

Things like hearing her heartbeat, seeing her kick her legs & suck her thumb on the ultrasound, watching my stomach grow (finally) and change almost from day to day. Things like feeling her kick for the first time, and being able to share that with her Daddy. These things ARE amazing, and I feel grateful every day that God chose us to parent this little girl.

But it has not been easy.

Let me back up. From the very beginning, and even before the pregnancy began, I have been afraid of, and almost expecting, complications. Maybe because I was seeing a fertility doctor & had already had trouble getting pregnant. But for whatever reason I was expecting issues, expecting hurdles we would have to cross, expecting problems. So I told myself that I wouldn't blog about this pregnancy until I was sure things were . . . okay. Normal. Until I had only good news to share.

First that meant waiting for a blood test to confirm pregnancy. We had to do several because the first one said "maybe." I didn't even know a blood test COULD be inconclusive! However after several tests we were finally sure that I was pregnant. (Who would've known it could be that difficult?!) :)

Then the doctor said my progesterone levels were low, so I needed to supplement in order to maintain the pregnancy and keep the embryo growing. We did that. Let me just say, they were not oral supplements. Fun times.

Because I was being seen by a fertility doctor, rather than a typical ob-gyn, I was able to get early ultrasounds to confirm the pregnancy. At 6 weeks we saw a heartbeat. That was amazing, a milestone I had been hoping and praying for. But because of the low progesterone issue I still didn't feel "safe."

At 9 weeks we saw our tiny gummy bear moving on the screen. My hormone issues were gone so I was able to stop with the supplements, but I still didn't feel safe because I was still within that first trimester window. I wouldn't feel sure until I passed 12 weeks & all was still well.

At 12 weeks I said goodbye to the fertility doctor's office and "graduated" to the regular OB's office. My first appt went really well, we heard the heartbeat on the doppler for the first time, and I left feeling great. The next week I went in for my End of 1st Trimester Screening, which is a combination of ultrasound and bloodwork. That ultrasound was the best yet, completely amazing as we got to watch our tiny sweet baby move around and bounce and kick on the screen. The tech & the doctor both said there were no structural issues or problems, and I really felt reassured. I had passed the dreaded 12 week mark and things were going well. I literally went to the baby section in Target the next day and bought an adorable (though gender neutral!) newborn outfit. I almost felt like it was too good to be true. We spread the news (or at least continued spreading it, most people already knew I was pregnant, just still very early) and I began to pick out which crib styles I liked the best.

4 or 5 days later I got a call that the bloodwork had come back. I wasn't worried because the Dr we met with had told me that when the structural scan looks good, the bloodwork usually does too, and he said someone would call with the all clear soon. Unfortunately the person on the phone did not get the message that they were supposed to give me the "all-clear." To make a long story a tiny bit shorter, there were a couple markers that showed up in the bloodwork that weren't problems in & of themselves, but did point to a higher risk of Down Syndrome. Since I was only 13 1/2 weeks along our only option if we wanted to know for sure was to wait 2 weeks and get an amniocentesis. The center that does them is very specialized and their risk level is one of the lowest in the country, but it was still not an easy decision to make.

After God arranged several things to fall into place for us we were able to get the test scheduled and our insurance to pay for the additional testing that would allow us to get the answer in 2 days rather than waiting the full 2 weeks. We got the call 2 days before Christmas that we were having a healthy baby girl. It was the best Christmas present we could ever have imagined!
The point in rehashing this is not to highlight what a rough road this pregnancy has been. What I am learning is that there is never a point when you know that your pregnancy (or anything else for that matter!) is going to work out perfectly. Not when you hit a certain trimester, not once the tests have been done, not even once the baby has been born! Problems can still, can always, come up. And that is the time when you most need support. Especially Christians! Sharing the hard times is so much more necessary than sharing the good times. Yes we need to show others what God has done in the good times and the ways he has blessed us. But if you don't share where you started from, no one can see how far God has brought you!
So, even though I have no guarantees now, and we are not sure of what the next few months, or even weeks or days, may hold, I am going to share our journey. No more holding back until I can answer every question perfectly or give a happy ending for every situation. I want to have an outlet to share my concerns, my fears & my questions as well as what I'm learning, the small victories (or the large) and any other things that come up along the way. I want you to see where we started so that weeks or months or even years down the road, when we look back at all God has done for us and our precious little girl, you can see how far he has brought us!

That brings us to where we are today.

I am currently 24 weeks & 6 days along. We had an ultrasound at 18 weeks where the dr thought there might be an issue with Annie's placenta or umbilical cord, so he ordered a follow up 6 weeks later. We went in for that follow up last week, at about 23 1/2 weeks. We spent about 4 hours in the Maternal Fetal Medicine clinic getting test after test and meeting with Perinatologists. They are the ones who take care of mom & baby up until baby is born. They are basically specially trained high-risk OB's. Neonatalogists are the baby doctors who take over at the moment of birth as well as helping make decisions regarding when to deliver & telling us what we can expect at different gestational ages (GA).

What they determined is that Annie is small for her GA, and even though she is still growing, she is not growing as much as they'd like to see. They also found that I have a condition called Vasa Previa which means there are blood vessels (either the umbilical cord itself or other fetal blood vessels) across the opening of the cervix. This is not a dangerous condition in & of itself during pregnancy, unless something were to happen that caused those vessels to be in danger. Something like my water breaking or my cervix beginning to dilate. To prevent that, it is "treated" by a C-section delivery before the chance of going into labor is likely, usually around 33-35 weeks.

The more critical & time-sensitive issue, however, is that they saw a problem with the umbilical blood flow between Annie & the placenta. It's complicated but basically Annie is having to pump harder (with more force) in order to get the blood from her heart back to the placenta (where it gets cleaned & filled with nutrients), than she should have to. This is causing her to not get as much blood back from the placenta, which in turn means not getting as much oxygen & nutrients as she should be. They believe that is why she is smaller than she should be, and not growing as quickly as other babies at the same GA.

A few days later we met with a different Perinatologist who was able to give us a bit more information, and make a game plan. He believes that the Vasa Previa (vessels over the cervix) is linked to the blood flow issue (the other doc thought they were two very rare & completely separate occurrences), and that both were caused by a problem with the formation of the umbilical cord when she was implanting in the uterus (at around day 7 of gestation!). If this is correct it is good news because it means that the cause of the blood flow problem is controlled (rather than wondering what is causing it and therefore if or how quickly it may worsen) and is less likely to worsen as quickly as it would if it was caused by an issue such as Preeclampsia or some other systemic problem.

His advice to us was, basically, to wait and check again. Over the previous 5 weeks, Annie had grown the equivalent of 4 weeks worth. While not ideal, her interval growth was not that bad. If she were to stop growing, for example, we would know that the blood flow issue had worsened and it would be time to talk about early delivery. He said he believes (no guarantees) that we are still in the early stages of the blood flow problem (which is called intermittent Absent Ended Diastolic Flow, or AEDF) and if he is right about the cause, it very well could be something that she has been dealing with from the very beginning. She has always been measuring small, it's just that the percentages are only now getting into the worrisome ranges.

That being likely, he felt we were "safe" in waiting 3 weeks and checking again. That is enough time that we should be able to tell if she is growing at the same rate as before, or more quickly or less quickly. By checking her blood flow we will also be able to see if the AEDF is getting worse, and if so, how quickly. At the last ultrasound it was intermittent, and best case it would still only be intermittent at the next one. The other reason for waiting 3 weeks is that since Annie is small for her age, that will be the first point that she would have a good chance at viability (& limited longterm complications) if we did see a problem and needed to deliver her that early.

In the meantime I am doing everything that could possibly help a) Annie get as much blood into her little body as possible and b)help her to grow & gain weight. That means bedrest (limiting my activity so that the blood stays where it's needed; with her!) and getting in as many calories/nutrients and fluids as I can, to give her the best chances of growing. My weight gain has been very slow this pregnancy (I'm actually still below my starting weight), and while it is not a cause for Annie's small size, the more calories I take in the more she has to work with, basically.
So that is where we are. It was quite a shock to hear that our healthy little girl might not make it another month inside, especially when we had no idea anything was wrong. However after talking with the 2nd Peri and discussing what could be causing this, we feel much better about things and are taking this all one step at a time. It is quite likely that I will be hospitalized after our 27 wk checkup, so that they can monitor Annie more closely and give us meds to help her prepare for an early delivery.
We are praying that she will be doing well enough that we can hold off on hospitalization a couple more weeks, but even if that is the case, it's very unlikely that I will get to 29 or 30 weeks & not be hospitalized. Once Annie's chances outside the womb are better, the doctors will likely take her out if there is any worsening of her situation. And while that is hard to hear, I feel like God is preparing all 3 of us for that outcome. Even if the AEDF were to clear up I would still be delivering by C-section prior to 35 weeks because of the Vasa Previa.
We of course would appreciate your prayers for our little Annabelle, that she continue to grow and that her AEDF does not progress. You can be praying for me for patience with the restrictions of bedrest & soon-to-be hospitalization, and for both Jeff & I for peace and wisdom in the decisions that we might soon be needing to make.
I promise that not all posts will be this long :) but I thank you so much for reading this, and for caring for our little family. I am looking forward to using this blog as a place to post updates on our status, things I'm learning about preemies and their needs, and even ways that family and friends can be of practical help with meals and such.
Oh and one last thing to leave you with: I knew that these 3 weeks of waiting would be difficult for us, particularly not knowing if Annie was doing better or worse. I believe God knew this too and he answered in such an amazing way. Because Annie is small and my placenta is on the front of the uterus I had not yet felt her moving. The weekend after we met with the doctor & got this news, I began to feel her move and kick. And not just tiny movements, these have been big enough that Jeff & my mom can feel them, and even see my belly move from across the room! I feel like God gave me an extra special gift of reassurance by being able to feel her inside me. As long as she keeps growing & getting stronger I will continue to feel her movements, and that is helping me feel (and sleep!) a whole lot better! God is good!