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Pawlowski Family Blog - page 2
Monday, April 13, 2009, 11:30 PM CST - by Todd (39 weeks)
I know I should be in bed by now but the mind is working overtime. We will be heading to the hospital tomorrow morning around 7:30am and Kristin is still on schedule for a 10AM c-section. Hard to believe we are FINALLY at this point...wheww...what a journey! I'll celebrate once baby is here safe and sound as well as when Kristin is in recovery.
I will do my best to post an update here as soon as possible. It might be a few hours after delivery because I plan on following baby up to the NICU and getting the report from the specialists.
It will be tough to leave Kristin while she is finishing up the surgery and heading to recovery. Once I know she is safe...then I will follow baby. I know both our parents will be at the hospital so it will be nice to have them around for support.
We had a really nice Easter weekend and it was great to spend time together one last time before Baby P. joins the group. Sam enjoyed hiding and finding eggs this year and got all dressed up for Easter service.
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Friday, April 10, 2009, 9:45 PM CST - by Kristin (38 weeks)
Well, I'm hoping that this will be the final update until the baby comes......we'll see about that.....
At 3:15pm yesterday the doctor's office FINALLY called with the results of the lung test and the lungs were indeed still "transitional". So, we had what we think were our final OB appointment this morning at 9:00 and our final ultrasound and BPP test at 10:30.
We are now officially scheduled for a c-section at 10:00am Tuesday morning. Barring baby coming early on his/her own, that is the day to plan for. I have to say it's just a relief to know that NOTHING should (at this point) stand in the way of the Tuesday morning time, and we have something definitive to look forward to. Thanks again for all your kind messages and well wishes. You guys are the best! I hope you all have wonderful and relaxing Easter weekends with your families (I know I will).
Thursday, April 9, 2009, 4:20 PM CST - by Todd (38 weeks)
Apparently I just needed to vent a little more about the lab and then they would call. Our doctor called and said the results were 'negative' so that means 'no go' for tomorrow. Jeepers creepers....we've been a nervous wreck for two days for no reason. Go figure!
So we are back to regular appointments tomorrow...one with the OB at 9am and then one for an ultrasound at 10:30am. From what we gather on the phone this afternoon is that our OB will now make the decision for whatever day next week will work in their schedule as well as for the pediatric cardiology team. It may be Monday, Tuesday, or Wednesday....we will let everyone know once it is on the schedule. HOWEVER...don't be surprised if it changes because we have now had five c-section times re-scheduled during the past ten days.
We will have plenty of stories to share with Baby P. when it gets older. This little stinker wants to hang out with Mom as long as possible. :-) That should be it for today from me. Thanks......
Thursday, April 9, 2009, 3:00 PM CST - by Todd (38 weeks)
Do you hear the circus music....because I do. After 37 weeks of smooth sailing the past two weeks have been a little bumpy...especially the past 48 hours. All is ok in baby's world...so that's good...but the 'trying to plan' world is a joke. I know it doesn't help to fan the flames but boy-o-boy this stinks right now. :-) I know everyone has the best intentions at heart so I will just keep telling myself that until the baby is here. The real frustration lies in having very little if any valid information from the lab in Utah. It feels like our amnio sample was sent to a remote base in Antarctica and we are waiting for the sole worker to arrive by dogsled before we even hear anything.
I'll stop venting and just say that we still do not know the results as of 3pm. Kristin is on the schedule again for c-section tomorrow but that is dependent on the test results....which we waited all night for last night. And to top it off we do not know when they will actually have the results.
As usual...we will post here the next time we know any more details.
Thursday, April 9, 2009, 9:50 AM CST - by Todd (38 weeks)
Well the waiting continues. We just spoke with our doctor and apparently it will be late this afternoon before we know the test results from the external lab. It's a little frustrating because had we known they weren't even going to run the test until this morning we wouldn't have worried all night wondering if we were going to receive the phone call. So Kristin has to remain on no foods/fluids just in case this afternoon/evening they say it is a go.
Part of me wants it to happen today so we can get baby here safely and not worry about all this stuff anymore. But then another part of me thinks it would just be best if we wait until after the weekend. That way we can enjoy Easter as a family and build up some of the excitement again for the delivery....which has frankly been a little zapped because of the recent events. Either way I know it will be a very special event and we just want it to get here safely.
I know many of you are checking our website to keep up to speed. We will continue to update it with current information so we ask that you hold off from phone calls if possible. Feel free to post a message on our guestbook because we do check it several times a day for motivation. Thanks again for your prayers.
Thursday, April 9, 2009, 4:25 AM CST - by Todd (38 weeks)
Grrrrrrrr....we never received 'the phone call' last night so here we sit at 4AM wondering the what **** we are supposed to do. After waking up a few doctors with our own phone calls it has been decided to scrap the 7am delivery because we have not heard back from the lab in Utah. (Thought it was California but it is actually Utah.) Read the post below to understand what the heck I am even talking about.
So for now we are heading back to bed and there is still a remote possibility delivery could be rescheduled later today if the results show 'mature' from the external lab tests. Otherwise we will reschedule delivery for a different day. I'll leave it at that and say good night...for now.
Wednesday, April 8, 2009, 9:30 PM CST - by Todd (38 weeks)
Alright....long story with a short explanation...
It is 9:30pm Wednesday night and as of right now we are scheduled for a 7:00AM c-section TOMORROW...YES THURSDAY MORNING! However...that is subject to change any time between now and 5:00am. We are waiting for a phone call yet tonight to verify the actual status. So if you are reading this in the morning we may already have Baby P. with us...or I will be posting to say it has been moved back again. Please hold off on the phone calls and I will make sure to post an update here as earlier as possible in the morning.
After the amnio on Tuesday our doctor sent the sample out for a more definitive test since the 'quick test' results came back as transitional. IF this test comes back with different results that show the lungs are mature enough then we will deliver tomorrow (Thursday) morning. The crazy thing is the sample was sent overnight to a lab in California so we thought we would have results some time during the day today. Unfortunately we are still waiting for the results so everyone is asking us to act as if they will come back mature and delivery can continue for tomorrow morning. If that's the case we have to leave around 4:40am to go to the hospital....guess I need to get to bed NOW!
It has been a little crazy around here and the one thing that stinks about it is the added stress for Kristin. She is being a champ but I can't help but think it is eating at her too. The last day or two my stomach has been in a knot so I am ready for this to go to the next stage. Who knows...that may be tomorrow!
Good night. Please say some extra prayers tonight/tomorrow.
Thanks.
Todd
Tuesday, April 7, 2009, 3:15 PM CST - by Todd (38 weeks)
Quick update...the amnio results for today came back as 'transitional' therefore it is a "no go" for tomorrow morning. The schedule is back up in the air and we will write tonight/tomorrow when we have more info to share. Sooner or later this baby is going to get here but right now it seems to be in control of that task and wants us to stir a bit longer.
Friday, April 3, 2009, 9:35 PM CST - by Kristin (37 weeks)
Well, "take two"....We had another ultrasound today (hopefully our last appointment) and all continued to be well with Baby. We finalized what we think is the new schedule for next week, and here's what the next week will look like for us....
Tuesday--amnio at 10:00am, monitoring after that for an hour to verify contractions don't start, probably know results after an hour or an hour and a half.
Wednesday--If amnio comes back "mature", c-section scheduled for 10:30am. We have to be down to the hospital no later than 8:30am that morning.
Thursday--assuming Baby is doing well, this will be the day for the pacemaker surgery. No scheduled time of day yet that we have been told.
The doctors are trying to 'plan things' in order to make sure the various teams are available once baby is ready...but Baby P. seems to enjoy calling the shots right now. We'll let you all know how the amnio turns out on Tuesday. The results will determine if this is the schedule for NEXT week, or the week after that. We'll keep you posted......
Wednesday, April 1, 2009, 12:50 PM CST - by Todd (37 weeks)
SURPRISE....Baby Pawlowsk is here! OK....April fools!
Baby P. has decided that it wants to stick around with mom for at least another week. We had the amnio performed this morning to check on the status of the lung development. More or less the test results come back in one of three ways: Mature, Transitional, or Immature. Baby P's results showed that the lungs were still 'immature'. That doesn't mean anything is wrong...it just shows that baby needs to continue hanging out inside the womb and Kristin can enjoy a few more Shamrock Shakes from McDonalds. HA! However I must say that Kristin does look amazing at 37 weeks and other than the 'baby bump' you would never know she was pregnant. This time around I went ahead and added 15 pounds of my own 'pregnancy sympathy' weight and bulked up before delivery. With Sam I lost 12 pounds in like three days...gee...maybe I was a little stressed. The problem I'm starting to see is that I might run into some struggles losing the extra weight this time. Darn it! My plan might backfire!
If the results would have indicated 'mature' then we would have delivered tomorrow as scheduled. If they were 'transitional' we would have waited one week and then delivered. Since they were 'immature' we have to reschedule another amnio next week and perform the test again. At that time if they are mature we will deliver the next day...otherwise they will just schedule Kristin for delivery at 39 weeks regardless of the second amnio results. Now comes the fun part of having to work with the variety of doctors to reschedule the delivery....add even now we still don't have a set date pending next week's amnio.
Oh well...so we are back for a regular ultrasound this Friday. YEEHAA! Baby Pawlowski just wasn't ready to say goodbye to the nice staff at Dr. Drake's office. In all honesty we're a little surprised and disappointed today but certainly not with baby. The baby has been doing wonderful and we couldn't ask for anything more given the situation. It continues to grow and will have a chance to fatten up even more. I know Kristin put a lot of time into getting lesson plans ready for her substitute teacher and we've been crossing things off our to-do list preparing for delivery. The thing I have to remember is that Baby is not in distress and is just going about its business...so there is no need to worry about it.
We will keep everyone posted once we know more. Thank you very much for your prayers and we ask that you continue to keep us in your thoughts as we stretch out the suspense a little longer. :-)
Tuesday, March 24, 2009, 4:35 PM CST - by Kristin (36 weeks)
My how the time is flying by! As of yesterday, I've reached the 36 week mark! Things are going very well, and we continue to be humbled by our many blessings. Today we had our 27th ultrasound, and once again all was well with Baby P. The exciting part about today was getting to find out how big Baby P has grown. Drumroll please..........Baby P is officially 'estimated' at 6 pounds, 6 ounces! You go, Baby! That puts Baby P in the 50th percentile for size, and we couldn't be happier. The sonographer guessed that Baby P might be as big as 7 pounds next week when we deliver. I can't ask for more than that. Baby has definitely been holding up his or her end of the bargain during this pregnancy.
As for the remainder of Baby's time "inside", we have another ultrasound scheduled for Friday and then one last ultrasound next Tuesday. Then on Wednesday an amnio is scheduled for 8:30am. Assuming the lungs show they are "mature", the c-section is scheduled for Thursday afternoon at 1:00. When we met with the surgeon last week that will be implanting the pacemaker, he thought that surgery could be performed on Baby as soon as the next morning (April 3rd). After surgery, Baby will be spending the first night in the PICU (Pediatric Intensive Care Unit), and then the following nights would be spent in the NICU (Neonatal Intensive Care Unit). His thought was that, assuming everything goes smoothly with the surgery, Baby could come home in as soon as 3 or 4 days. How amazing!
We will continue to keep you posted on the final days of our journey. Although one journey is ending, another adventure is about to begin. We thank you all again for your continued support and love throughout our pregnancy. God is good.
Monday, March 16, 2009, 9:15 PM CST - by Todd (35 weeks)
Short and sweet...things continue to move along just fine. Status quo is good. We have our regular appointments on Tuesday and Friday this week. It was at this stage that Sam decided to join us five weeks early. However the surgeon who would be responsible for putting in the pacemaker at Mercy is actually gone until March 23rd so we need Baby Pawlowski to NOT follow in the footsteps of older brother. We aren't worried because we do have things covered and fully believe that baby will maintain the 'status quo' for a while longer.
Kristin is on spring break this week and Sam is home with her as well since our day care provider is also 'on spring break' sort of speak. So I'm not sure how much of a break Kristin will really get...but spending time with Sam will be rewarding. In the last week he has really started to be more verbal and trying to say all sorts of things. He cracks us up and is so much fun right now. The big boy bed adventure continues and we finally had to just put up the gate in his doorway at bedtime. Overall he's been pretty good about it and he is getting close to sleeping through the night again without trying to come out. We *think* last night he didn't open his door until just before 6am so we are calling that a victory. The weather has been awesome here the past few days and today he was outside for 5+ hours so hopefully tonight he will sleep well. He actually has a little color to his fair skin now. :-)
Take care everyone.
Friday, March 6, 2009, 9:35 PM CST - by Kristin (33 weeks)
As we conclude our 22nd ultrasound today, we find the "end" drawing nearer. We started the morning today at my OB appointment. This was the first time we had seen my actual OB in many weeks (thanks to him always being on call), so we had a lot to update him on. We updated him on our visit with the electrophysiologist from Iowa City, and showed him the sample pacemaker we had been given. We brought up the two issues still "in question" from our visit with the Iowa City docs. We asked my OB about the possibility of a vaginal delivery vs. a c-section, and his exact words were "No freakin' way". (So you're sayin' there's a chance.....) Needless to say, that looks like it's not going to happen for us. Then we talked to him about the possibility of NOT doing a scheduled amnio/delivery at 37 weeks, and just seeing how long I could go beyond that. He didn't have a strong opinion at the time, but definitely hesitated to be too "unplanned". As we were leaving his office to head to the ultrasound downtown, he said he would call the perinatologist and talk to her about the possibility of going beyond 37 weeks.
The ultrasound went fine, and everything was once again status quo. We got to see some close-up pictures of baby's face today, so that's always a treat. Once again baby passed the BPP with flying colors, and spent much of the ultrasound trying to get its fist into its mouth.
After the ultrasound we met with the doctor and discussed our OB visit. She had already spoken with the OB on the phone, and they agreed that they still want to schedule an amnio for the 37 week mark, with a c-section the next day if all looks good. They both feel as though the benefits of having things scheduled at that point outweigh any potential ounces that could be gained by baby in another two weeks. That being said, we're all in agreement that baby's growth measurements at the 36 week mark (March 24th) will help guide our plan for a date of delivery. Our hope is that baby will be a "chunky monkey" at that point, and be able to provide a soft, chubby home for the pacemaker.
So.....mark your calendars. I'm scheduled to have an amnio on April 1st, and the c-section is scheduled for April 2nd (assuming baby's lungs show they are mature enough). That will be here before we know it. If baby's lungs come back "borderline", the plan is to wait a week and then schedule the c-section. If baby's lungs come back immature, the plan is to wait a week, do a second amnio, and see what those results are. Lots to consider, I know.
Well, that's the update for now. We'll post again sometime next week. (It might not be until Friday, depending on our sleep deprivation level throughout the week :). Long live Sam in the big boy bed!
Friday, Feb. 27, 2009, 11:40 PM CST - by Todd (32 weeks)
Where is the update????? Come on Todd...get with the program! HA. Ok...long one below.
Man the time seems to fly by faster every week. I haven't been staying up quiet as late as usual this week because we're in the middle of transitioning Sam to a twin bed as described in an earlier post. On Monday we decided he has had a few days to get used to the new bed and mom and dad were no longer going to be hanging out in his bed until he was alseep. :-) Time to crack the whip and do the whole talk to them the first time they come out of the room and then give them the ol' silent treatment every time after that when returning them to the room. The first ten minutes REALLY stunk because he was crying so hard and we made about a dozen or more trips taking him back into his room. Then we realized that he would open his door but would no longer come out. He just stood there and would lean out to look around the corner. He stood there quietly for almost 15 minutes before finally returning to his bed on his own and then falling asleep. We were amazed and proud of him. He woke up in the middle of the night and we did the same routine which really does work. Finally when 6am rolled around he got up and was SO EXCITED when we met him at his door. High five's, knuckles, and hugs all around.
For the most part each night this week has gotten better and he really only cried on Monday night. It's pretty comical because he will open his door and then just stand right at the line of where his room ends. We've told him to stay in his room and he toes the line...literally! Kristin and I have caught him on the video monitor picking his nose and wiping it on the door frame/wall. BUSTED! All in all...he is doing very well and we are pleased with the progress. It has been an adjustment getting used to not sleeping quite so soundly knowing he is free to get out of his room. We usually hear his door handle rattle when he tries to open it up so then we are prepared to see what he does next. Just thought I would share a Sam update.
Now for Baby Pawlowski...
On Tuesday we had an ultrasound and during this one they took measurements to estimate the baby's growth. They figured baby was around 4 lbs. and ranked in the 40th percentile based on various size measurements. It was very good to see baby growing but at the same time it was hard not to notice the drop from the previous 60th percentile ranking now down to 40th. Dr. Drake said at this time it did not concern her and that she would only start to slightly worry if baby was in the < 20th percentile. There is a margin of error when taking measurements so a half pound difference could change the percentiles a bit. She said it is common for babies with heart conditions to grow at a slower rate and that they are typically smaller in size when born. We had another ultrasound on Friday and the baby continued to pass the BPP's with flying colors. No new fluid was present around the heart or in the abdomen area.
Today we had the opportunity to meet Dr. Law and his team from Iowa City since they were in Des Moines for their monthly visit to Mercy. These are the guys responsible for monitoring and maintaining the actual pacemaker settings etc. Kristin and I were extremely pleased to meet them and felt very good after the visit. Of course we have a ton of new questions now but we will get answers as time progresses. We asked Dr. Law how many pacemakers does Iowa City put in infants or young children and he indicated it was only around 20 - 30 per year. Most pacemakers are installed in adults but his speciality is in pediactrics. He travels around quite a bit to help cardiac centers in other cities/states and serves as their pediatric specialist. He said that he has an engineering background and got into this medical field because of his desire to figure out ways to use machines to optimize the quality of life for humans. Big picture...he's smart and we liked him. HA!
When we met with Dr. Law we talked about what to expect during the remaining pregnancy, birth, and after care. It was interesting talking to him about the strategy for the remaining pregnancy. We told him the currently discussed plan was to make it to 37 weeks and then do an amnio...if this comes back showing the lungs are developed then go ahead with a c-section that day or the next. I could tell by his initial reaction that he had a different perspective on it. So I asked him to share his thoughts openly with us. More or less he said that if baby has been doing fine (ie. no fluid and steady rate in the 60's) and continues to do fine then he would not be in a rush to have the baby delivered early. He said the longer you can go the better. He explained that if the baby is stable then it has already adjusted to its environment and it would be ok to go as close to full term as possible. He also indicated that he wouldn't have a problem with Kristin having a natural birth instead of a c-section based on his experiences in dealing with similar conditions. All of this kind of threw us for a loop and now we must talk to Kristin's OB doctor as well as Dr. Drake to share with them his comments and see what additional discussion needs to take place. Dr. Law was very clear that he wasn't trying to say this is what you need to do...but rather he was sharing what his experiences have been and what he would recommend...."if it were his own wife in the situation". So that does hold a great deal of weight and we will dig into this for more details.
As far as when the baby is born...if the baby's heart rate is in the 50's or below then it may be necessary to immediately install the pacemaker or as soon as possible. If the rate is in the 60's/70's then for the first 24 - 48 hrs they would administer various drugs to the baby via a tube/lead inserted into the umbilical cord and many times this can help increase the rate a bit. After the baby has adjusted out of the womb for the couple days then they would go ahead and proceed with putting in the pacemaker. If the rate is 80 or above he said they may not even need a pacemaker at this time.
Assuming the baby does need a pacemaker...there are two different sizes and which one they use is determined by the size of the baby. The smaller one has a single wire coming from the unit and is used for pacing only the ventricle at a set rate. The battery life on the small unit in a child usually runs about two years and then would be replaced. The larger one has two wires coming from it and one goes to the atrium and the other to the ventricle. This allows the pacemaker to 'sense' what the top and bottom halves are doing and provide the appropriate pacing as needed. The battery life on the larger units can last up to 8-10 years. Ideally you would like the larger one but this will have to be determined once they see the baby and if it would fit. They sent home an example of the larger pacemaker so we could show our family. It's about the size of a fifty cent piece so not really that big considering all that it does. He said that if baby receives a pacemaker and experiences no other health issues while at the hospital...then it could go home in roughly a week. That was great to hear because we were worried it could be weeks and weeks.
The pacemakers have wire leads that need to be attached to the heart. They attach these by securing them to the surface of the heart with stitches. He talked about one of the biggest challenges with pacemakers in kids is that the leads move or get displaced. Later on when the person is older they insert the leads inside a vein and into the actual heart but you can't do that on children. He said replacing the actual pacemaker unit is a minor procedure and just involves making an incision where the current one is at...slide it out...unhook it...hook up the new one...slide in the new one...and stitch ya back up.
For monitoring and working with the Iowa City team for after care much of it can be done remotely. We talked to his nurse about this item as well as after-care stuff in general. They are now using a new generation of machines which allow for an unbelievable amount of data to be transmitted via a phone connection. The team in Iowa City can actually see a real-time EKG while we are here at home once we 'link-up' to them. We saw an example of how it works and it's pretty cool. We really enjoyed talking to her and feel like she will be great asset as we go forward with any questions we might have.
I know we discussed many more things at the meetings but this post is long enough. :-) It serves to update all of you thorougly but it also helps document the progression so we can print it out for Baby Pawlowski to read many many years down the road. Thanks again. Next week we have our usual two ultrasounds and will post an update.
Sunday, Feb. 22, 2009, 10:25 PM CST - by Kristin (almost 32 weeks)
We had another ultrasound this past Friday, and all was well in the world of Baby P. The heart rate was "status quo", and Baby passed its BPP assessment in the first few minutes. Believe it or not, Friday was our 18th ultrasound! I try to appreciate every one, but I would by lying if I said that two trips a week downtown weren't starting to wear on me. We've got an appointment on Tuesday and Baby will finally have another growth check. I'm always anxious to see how much Baby has grown. I know that 4 weeks doesn't seem like very long to wait in between growth checks, but when that adds up to 8 ultrasounds in between the growth appointments, it feels like eternity. Baby sure looks like it's gotten bigger on the ultrasound pictures. Baby is pretty "scrunched" these days, and I'm wondering where the extra room is going to come from for the next 5 or 6 weeks :) He/she is definitely active, however, and the confined space doesn't seem to be a bother when it comes to moving at will.
On Friday of this coming week, we have an appointment with the electrophysiologist from Iowa City who will be in Des Moines at Mercy. He will be the doctor that will be helping with Baby's pacemaker, so we're anxious to meet with him and ask some more questions....(How soon will they put in a pacemaker? Will it be a single lead or a double lead? How long will Baby need to be in the hospital? What are the restrictions?) We'll be sure to post newly-learned information after that appointment.
This past Friday we took apart Sam's crib and moved the pieces to the basement. He helped us and we explained that he was now getting his "big boy bed". We had some friends recommend completely removing the crib from view instead of putting it directly in the baby's new room. Good advice so far! He has done a really good job and we hope it continues this week. We are SO GLAD we are doing this transition now because we couldn't imagine doing it with a new baby in the house. We haven't lost too much sleep yet but it has been good practice for 'altering' our normally reliable sleep schedule. HA!
Well, I guess that's all for now. Thanks for your continued prayers, phone calls, emails, and well wishes. They are all welcomed, and truly appreciated.
Tuesday, Feb. 17, 2009, 11:45 PM CST - by Todd (31 weeks)
The ultrasound went smoothly today and Baby Pawlowski scored 8/8 on the BPP test. During the ultrasound both Kristin and I commented on how it looked like the baby has grown a lot and space inside is getting a bit tight! I know Kristin agrees because she can feel baby moving all the time trying to stretch out and make room. Next week they will do actual measurements to see how much the baby has grown since the 28 week appointment. It should be interesting.
Time continues to pass by and seems to be going faster each day. Kristin's sisters were in town this past weekend and they all started to go through the 'essentials checklist'. The baby's room is pretty close to being ready...I need to finish staining the main hall door otherwise we should be good to go. We bought paint today for Sam's room as we continue to get ready for the 'Big Boy' transition period. The plan is to have him help take apart the crib this Friday and bring in his
new twin bed mattress. We have mixed feelings about trying to transition to the Big Boy stuff but want to give it a go with plenty of time before baby arrives. I know it will be sad to see him out of the crib but WE'LL survive. HA!
That's it for tonight. Our next appointment is on Friday.
Monday, Feb. 16, 2009, 2:00 PM CST - by Todd (31 weeks)
Wow! It has been almost two weeks since our last update...where has the time gone?!? First of all...EVERYTHING IS FINE! The baby is still passing all the BPP tests with scores of 8/8 and we are excited to have reached week 31. We have an ultrasound tomorrow and will post a more detailed follow-up sometime in the evening. (It may be late evening because that is when I seem to get most things done!)
Sorry for not at least posting a quick update the past few weeks. I know a few of you were starting to wonder/worry and we can't blame you. I'll make sure to post at least once a week. :-)
Wednesday, Feb. 4, 2009, 11:35 PM CST - by Todd (29 weeks)
We had an ultrasound on Tuesday and everything was status quo. The baby scored 8 out of 8 on the BPP tests so things continue to look stable at this point. Nothing really new to report so we will just keep thinking positive and see what the ultrasound on Friday brings.
Sam update...I know Baby Pawlowski usually dominates the recent conversation but I thought I would take a moment to share some Sam news and a couple photos.
Photo 1:
He turned two this past Saturday and we had a very nice birthday party at our house with family. Right now he loves the song Old MacDonald and sings/says E-I-E-I-O so Grandma Ferguson decorated a special cake for him. He was soooo excited to see the cake and really loved it.
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Photo 2 & 3: Here are a couple of the official pictures from his 'photo shoot' at a local photography moneypit...I mean store. Man you just can't get out the door without buying more pictures than you really need! (This is not due to sales pressure but rather the foolishness of parents who think everyone will want multiple pictures of their kid! LOL!) We will upload the rest of the photos on our Shutterfly account and post a link here within the next week or so.
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 Photo 4: Tuesday morning we had to wake Sam at 5:30am in order to get to the clinic for a 6:00am check-in for his surgery. SURGERY? HUH? What now? Well during Christmas break Sam decided crayons weren't cool enough for drawing so he grabbed a mechanical pencil on the table. Apparently two year olds lack a bit of depth perception and coordination because he stabbed himself just above his right eye. Thank goodness it missed his eye by less than half an inch but the pencil lead did break off under his skin. A few weeks passed and the doctor tried to get it out after numbing the local area but was unsuccessful. Let me tell you that was a fun visit...I don't know who was sweating more after that attempt...me or Sam?!
So we headed to the clinic yesterday to have a quick surgery...ok...let's call it a procedure because surgery sounds fairly intensive. Yes he did have to be put to sleep but it was pretty quick. He was a complete champion about it and never once shed a tear that morning. He's kind of a celebrity at the clinic because Grandma Ferguson happens to work there and she just might talk about him once or twice...an hour...every day! It never hurts to receive some VIP treatment...I know we appreciate their great staff and feel comfortable putting our child in their hands.
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Thanks again.
Monday, Feb. 2, 2009, 1:40 PM CST - by Kristin (29 weeks)
Well, today marks the 29 week mark! So far so good....We had another ultrasound on Friday of last week, and all went well again. Baby passed the biophysical profile (BPP) with 8 out of 8 points again. (That's my A+ student). They will be doing BPPs each ultrasound now, rather than Non-Stress Tests (NST) down the road. The NSTs are not an option because if you hook me up to the monitor, it will never look "regular" due to the heart rate, and it will be hard to assess if the baby is doing well. Plus, good luck tracking my "non-stress" these days :). They've also concluded that they will no longer be assessing the umbilical cord resistance (which was the test that had come back "funky" on last Tuesday), because that's not something that will come back normal for us either. Ultimately, if they wanted to do that they would need to cut that number in half, but it's still not something that they think they need to follow at this time. One less test is always fine with me.
The doctor talked a little on Friday about possibly doing an amniocentesis at the 37 week mark. The reason for this would be to check for Baby's lung maturity. If the lungs appeared to "ready", they would schedule the c-section for either that day or the very next day. The doctor's reasoning for that is to be able to better plan for the delivery and line up the team that will assist, rather than have me come to the hospital in labor in the middle of the night sometime. The more planned they can be, the better it will be for everyone.
On Friday they also gave me the assignment of beginning to do my "kick counts". Each day I need to find some time that baby and I can have some quality time together, and I can count the number of movements that Baby makes. Baby needs to move/kick 10 times in an hour. Then I have to bring the kick count slip in with me to each of the appointments.
This month, all of our ultrasounds are on Tuesdays and Fridays. As I said, they'll be doing the BPP assessments at each ultrasound, and growth won't be checked again until the end of February. In the meantime, we'll keep having regular OB visits (today being one of them) and tracking the kick counts. Busy, busy, busy. Oh, and did I mention that we officially have a 2-year old now? Sam's birthday was Saturday, and he is officially a "big boy" now. We had a great time celebrating with family, and he LOVES all of his new presents. He's definitely been our saving grace through all of this, and he reminds us DAILY how blessed we are as a family.
Thanks again for your continued support and prayers. We appreciate them more than words can say....
Tuesday, Jan. 27, 2009, 11:30 PM CST - by Todd (28 weeks)
Grow Baby Grow! Baby Pawlowski must be feeding off the prayers!
So yesterday we hit the 28 week mark and today we had an ultrasound appointment where they finally measured for growth. The last growth check was at 24 weeks and the baby weighed 1 lbs. 9 oz. and was about 50th percentile...so right on track. We are excited to report that today they now estimate that Baby Pawlowski weighs 2 lbs. 12 oz. and has climbed into the 60th percentile! So hypothetically they said that puts the baby about a week ahead of schedule but we are not looking to 'move things up' regarding the due date! We were extremely relieved to here the news and just so happy that the baby has been stable for almost a month now with no fluid changes and continued growth.
During the ultrasound they also performed a biophysical profile (BPP) for fetal assessment. It sounds like they will do this once a week from here on out. A biophysical profile test measures the health of a baby during pregnancy. The BPP measures muscle tone, movement, breathing, and the amount of amniotic fluid around the baby. They said the baby has a 30 minute window to complete/demonstrate the various items in order to receive 'credit' for that item. Each of the four items can receive a score of 0 or 2 since it's an 'all-or-none' approach. We are happy to say Baby Pawlowski scored an 8 out of 8 and it only took about five minutes for the ultrasound tech to verify/witness the items. I know the teacher in mom was proud and said 'good job'!
Dr. Drake was upbeat and seemed pretty positive today after seeing the results. She is very pleased that the fluids have stayed away and that the baby continues to grow well. She expressed again how glad and thankful she is that we continue to see her and allow her to help guide us through these times. We know the whole team in the office is aware of our situation and even talk about it during their daily/weekly meetings.
Of course whenever the day is filled with positive news it seems like there is something that makes you go 'hmmmmmm....now what?!'. During the ultrasound they also checked the resistance in the umbilical cord and Cerebral artery using Doppler. In a nutshell they were checking to see the rate/flow through these areas and the Doppler can be used to give them some sort of a 'ratio' to determine the health status. (A high number would be bad because it could show potential for growth related issues for the baby in utero.) After the sonographer completed the initial ultrasound we waited for Dr. Drake. She came into the room and we talked about all the positive things like growth and BPP results. Then she said she would like us to go back into the ultrasound room so the sonographer could bring up the Doppler stuff again. Dr. Drake said the ratio just didn't seem right and that she wasn't sure what was going on. Basically a ratio of 5 was considered very high and we had ones that ranged anywhere from 6 to 10. They continued to look at the Doppler readings and seemed puzzled by it. While thinking out loud they wondered if the ratios (or formulas used to calculate the ratio) were completely off because the standards are based on a normal heart rate and our baby has a much lower one. They have some homework to do this week and are going to do research to find out if they need to include some sort of an adjustment to the number given our situation. HOWEVER...Dr. Drake did NOT seem worried about this at all. She said the baby is growing and currently showing no signs of growth related problems. It's something she needs to figure out but it's not something for us to worry about.
Kristin starts another round of 'preventative' steriod shots tomorrow morning to help spur lung growth and maybe give a little extra kick to fight off fluid development. She will be receiving them on Wednesday morning, Wednesday evening, Thursday morning and finally Thursday evening. Kind of a pain to drive downtown for each one but it's certainly better than being admitted to the hospital for 48 hours like last time they gave the steriods. She's a trooper through all this and I am extremely proud of my wife!
Whewwww....I think I can call it a night for now. Overall we were very happy with the news today. We know things can change at any time but for now we are going to enjoy the extra smile. Our next ultrasound isn't until Friday and then that evening we are going on a date. Ha...ok so maybe it's only her work Christmas party but we are going to treat it as a date! Not sure if she'll count it as one but I'm gonna try. :-) We thank you again for all your prayers and know they're helping guide us to a successful outcome.
Friday, Jan. 23, 2009, 9:15 PM CST - by Kristin
Well, all was well at our 10th ultrasound :) Still no fluid build-up in the baby's abdomen or around the heart, and the heart rate was the same as our last visit. We got to see a bunch of profile pictures again today, which we both loved. We even got a 4-D print out of the baby with its finger up its nose. We're so proud :).
Monday will be the official 28 week mark, so we're excited to have reached our first milestone "must have". Now we can focus on 29 weeks, then 30 weeks....you get the idea. One week at a time. We have our next appointment on Tuesday, and we're both anxious to find out how much the baby has grown in the last four weeks. We'll find out the size on Tuesday, as well as do some biophysical assessments on the baby.
I'll start another round of steroid shots on either Wednesday or Thursday of next week, and go downtown for shots 4 times in a 48 hour span. The shots are another attempt at furthering baby's lung development in case he or she decides to make an early entrance into the world.
Well, just wanted to keep you all posted. Thanks again for the well wishes and wonderful additions to the guestbook. We love reading them!
Tuesday, Jan. 20, 2009, 4:20 PM CST - by Todd
Quick update from our ultrasound yesterday...nothing really new to report. I guess that's good news because we hope things will continue as 'status quo' while the baby grows. Actually it was kind of nice yesterday to take a peak at the baby because it was opening and closing it's mouth plus sticking the tongue out over and over. I think the baby was practicing for having one of my 44oz big gulps of Diet Pepsi!
We have another appointment on Thursday and then next week they will take measurements to check on overall growth. The doctor did comment to us that see can tell the baby has grown quite a bit over the past week or two when looking back at the ultrasound pictures. That's nice to hear so we will see how much next week.
Some people have asked if we know whether or not we are having a girl or boy...we don't...and as of right now we would like to not find out until the day we meet the baby face-to-face. Some days it's hard not to ask the ultrasound tech considering we see them twice a week but it's more fun trying to guess whether or not we 'see something down there'. :-) Kristin laughs at me because at one ultrasound I will swear that I see something down there and then the next time they've seemed to have disappeared. I will go out on a limb and say that it is either a girl or a boy...that much we know.
Thursday, Jan. 15, 2009, 9:45 PM CST - by Kristin
Well, Todd has been doing such an amazing job with his posts that I hesitate to do one myself. He’s a hard act to follow. That being said, I thought I would take a day to post when there’s not too much to add :)
First and foremost, thank you to YOU ALL for your unbelievable support! You are all our dearest friends, and the response through prayers, emails, and phone calls has been overwhelming. We “feel the love”, and it’s been an awesome lift to our spirits. I really do believe that God never gives you more than you can handle. We are truly grateful to have such abundant blessings in our lives, and you all are counted among them.
Now......Yesterday I had my monthly OB appointment, and all went well. I took my glucose test and passed (I didn’t even study), and the nurse practitioner said I’m measuring “right on”. Today we had another ultrasound at Methodist, and it went well. The atrial rate was in the 140s, and the ventricular rate was in the upper 60s. Still no fluid in the baby’s abdomen or around the heart, and the thickening on the right side hasn’t changed. All of that was good enough news that we DIDN’T HAVE TO SEE THE DOCTOR TODAY. As much as we enjoy visiting with the doctor, it’s always a good day when there’s not a change that she needs to talk to us about.
It had been several appointments since we had gotten to really look at Baby P’s cute face, so we specifically asked for some profile shots today in addition to the heart analysis. They did some 4-D pictures so we could see just how adorable Baby P is (no one is surprised by that).
As of this Monday, I will be 27 weeks pregnant. At the 28 week mark they are planning to do some biophysical assessments on the baby. This will assess the baby’s activity and responsiveness. They will also measure the baby to see its size at that time, and do another round of steroid shots for me. The shots are designed to help with lung development in the baby, should he/she decide to arrive early. The good news is that this time around I can do it on an out-patient basis and just stop in four times during the 48 hour period to receive the shots. That’s about all we know for now.
Again, keep up the prayers and good thoughts. They’re working!
Monday, Jan. 12, 2009 - by Todd
Today we met with Dr. Drake at Methodist for an ultrasound. We were curious to see the heart rates today since they were different at Friday's ultrasound from what our previous two had shown. Sure enough the atrial rate (top of the heart) was around 140 and the ventricular rate (bottom) was in the 60's. This was sort of a surprise to Dr. Drake and we were kind of glad she was able to see what we witnessed on Friday. It was good to continue to see a higher rate in the top part but things are still considered a 'complete block' since no communication is occurring between the top and bottom halves. Now if the bottom starts beating at a higher or more normal rate then we can all celebrate and really believe that there is such a thing as Santa....I mean the tooth fairy...or was it Cupid. Wait...you mean Santa isn't real...then who ate the cookies Sam set out for him this year? Other news...no fluid was present in the abodmen region and very little around the heart so she was pleased that things remain stable.
Unfortunately she had not yet heard the report directly from Dr. Mooradian (Mercy) since they were not able to touch base. We were sort of bummed about that but all in all that was ok because the news was generally good. We shared with her all the different comments from Dr. Mooradian and his thoughts that it does not appear to be a physical defect but instead an electrical one. I'm sure by our next appointment this week they will have talked about our case. We probably won't see Dr. Mooradian for quite awhile unless something were to change for the worse or it's at a delivery time WAY in the future!
At this point we will take 'status quo' updates from one appointment to the next. We really like Dr. Drake and can tell she is very interested in our case. I'm sure she does that with all patients but it's comforting to feel like the doctor is 'rooting' for you and doing what they can to help you achieve success. We'll write more after our next ultrasound which is currently scheduled for Thursday.
Thanks again!
Friday, Jan. 09, 2009 - by Todd
(FYI...long post below so if you want the short version jump to the last paragraph of today's post.)
Today we had Kristin's appointment with Dr. Mooradian, a pediactric cardiologist at Mercy. This was the first time we met him but had heard several goods things from other friends. The meeting went well and we were comfortable after talking with him.
He did an ultrasound to take a look at the baby and overall he was pretty 'optimistic' about the outlook. He did not see any physical defects and also believes the complete heart block is due to an 'electrical' issue concerning the AV node. (The part that talks between the upper part of the heart and the lower part....or as he puts it...the traffic cop controlling the signals that pass through it.) Today the top parts of the baby's heart (atria) were beating around 155 and the bottom parts (ventricles) were around 67. This was interesting to Kristin and I because the past two ultrasounds at Methodist revealed that the top and bottom were BOTH beating around 60-70. Way back at our 22 week ultrasound the top part was beating faster than the bottom and then it changed to both be equal. Now today they appear to be different again. The doctor was somewhat surprised when we told him about this change and said he would have to consult with Dr. Drake, the Methodist specialist, to compare results before coming to any conclusions. We kind of wonder what this may mean but aren't too worried because we see Dr. Drake on Monday for the first ultrasound of next week. It will give us a good opportunity to ask her what her thoughts are regarding this matter.
We asked him about the thickening of the heart and he said at this time from what he sees it is not something that greatly concerns him. I'll spare everyone from me getting even more technical but in a nutshell he said the heart is a muscle and if you work a muscle harder than usual it will react by getting thicker/bigger. (Just like your 'regular' muscles.) We also asked about blood flow volume/rate through the body and if there were any neurological concerns since the heart rate is lower than usual. He said that it's usually not a concern because the volume of blood flow is probably close to normal levels even though the heart rate is slower...this is due to the ventricles working/pumping harder than usual. (Leading to the thickening.)
Dr. Mooradian felt that if conditions remained stable for the baby that Kristin could carry the baby almost to full term. They will continue to monitor everything and if the situation changes then they will take action. But he stated the best place for the baby is in the womb until they absolutely need to help it along. I know that was good news to hear for Kristin. At the same time she looked at me and said..."No Todd that doesn't mean you have until week 39 to paint the nursery." So after posting this message I will be going into the nursery to paint a second coat plus painting the chair rail!
He stated they only see maybe three cases each year of congenitial complete heart block. I continue to be amazed at the low numbers so I did more research on the internet. From the quick searching I have done so far it does appear the frequency is pretty low. Most of the abstracts for the 'medical studies' I located all seem to include something like between 5 and 30 subjects/patients and that is usually over a span of MANY years. Interesting stuff out there but I told myself not to spend hours upon hours reading it...just enough to know what questions to ask.
In regards to what would happen once the baby was born...he stated that it was not a guarantee that the baby would immediately require a pacemaker. It would be likely that the baby would need one at some time but they would have to monitor the situation to determine what was required and when.
So bottomline at this point there is no concrete 'this is what will happen and this is how we treat it' for our situation. We've come to understand that and will just deal with things as they progress. But today's appointment was certainly good news and he recommended we stay positive.
On another good note...Sam was FINALLY healthy today and made it to daycare to play with his friends. She said he had a good day and he must have played hard because he seemed pretty wiped out at home this evening. And when I say 'wiped out' I mean didn't want to eat dinner, threw the fork, slammed his milk, whined, whimpered, and was in bed asleep by 7:25pm. We all know how those evenings go. :-)
Not much else to report. Our next appointment is Monday so I will probably post something that evening after Sam goes to bed. Thanks again everyone for the nice emails and postings on the guestbook. They are enjoyable to read and provide motivation.
(PS. I just re-read this post and man-o-man I get kind of wordy. A simple 'The appointment went well and we remain positive' could have been all you really wanted to read. By the end of this adventure you will all be ready to pass the Medical Exam...or at least say 'No but I did stay at a Holiday Inn Express last night.' when asked how do you know so much about CHB. If you don't get the Holiday Inn joke it's based on the TV commercials. And with that I will say GOOD NIGHT!)
Tuesday, Jan. 06, 2009 - by Todd
After our appointment last week at Methodist they indicated that they would like to do ultrasounds twice a week in order to monitor the baby more closely. So today we had the first one for this week and received some good news. (See...all those positive emails and prayer chain requests just might be helping!) The ultrasound went pretty quickly and then they had us wait for a few minutes while the doctor reviewed the films/images. The doctor then stopped in and said she hadn't planned on meeting with us but wanted to share some good news. Previously the baby had some fluid around the heart and within the abdomen region but based on the ultrasound today they did not notice any of the fluid. She indicated that fluid build up typically either gets worse or gets better...and once it changes a certain direction then it usually stays that way. So she is hopeful that since the fluid does not appear then maybe it will stay away and make things easier for the baby. It was nice to hear this news even though she said they will still monitor it closely just to be sure.
Like any good doctor she gives you the good news in order to prep you for the opposite news. She told us that over the last couple ultrasounds she has noticed the right side of the heart appears to be thickening slightly. This would most likely be due to the heart having to work harder since the heart rate is still in the 60 - 70 range. She didn't really go into much detail about this thickening because she said we would learn way more info at our Mercy appointment this Friday with the pediatric cardiologist. During that appointment they will do more indepth analysis of the heart and try to determine what is really going on in there. Plus she said they would talk to us about what to expect for aftercare once the child is born. We are anxious for the Friday afternoon appointment and have lots of questions. I'm sure we will have more questions following it but at least the process is moving forward.
Our Methodist doctor said it has been probably seven or eight years since she has last seen a complete heart block like the one we have presented to her. That was a bit surprising but it just indicates that it is not something they regularly face. She has been communicating with doctors over at Mercy as well as Mayo Clinic, University of Iowa, University of Texas, and other locations to learn what are the latest treatment options while in utero. Unfortunately there is not much they can do at this point so now they focus on monitoring and trying to maintain a healthy environment for the baby to grow as long as it can.
A few people have asked us why are we seeing someone at Methodist and also at Mercy. Let me try to explain. Kristin delivered Sam at Methodist Hospital and we had planned on delivering this baby at Methodist as well. Her OB doctor recommended we see the specialist at Methodist in order to monitor Kristin's pregnancy since she was classified 'higher risk' due to Sam coming early and some previously known antibody issues. Therefore we started seeing the specialist at Methodist. As time progressed and the baby presented some heart related issues our doctor at Methodist told us we needed to be seen by the Mercy Pediatric Cardiology team since they specialize in kid's heart issues. She also told us that we would now have to deliver at Mercy because that is where the baby would receive treatment once it is born. We really like the specialist at Methodist and she said she has no problem working with the team at Mercy even though she will not be able to be there when we actually deliver. But that is not a big deal because she said her job is to get us to the point where she says the baby needs delivered and then her job is done. Based on all this we have elected to stay with her because we feel really comfortable with her and know she is giving us that extra attention. It's a learning opportunity for her as well and she seems to thrive on expanding her medical knowledge. (side note...we have nothing against delivering at Mercy so those of you who are reading this and delivered babies there...please don't take the last paragraph the wrong way. They are both good hospitals.)
Well that should be enough rambling for now. I'm hoping Sam sleeps through the night because he has been sick the past three days with a darn cold. He was healthy all of Xmas break when Kristin was home for two weeks...so that was really nice. But of course when it was time to return to daycare the bug had to catch him. We are really lucky that we have family so close to help out and a big thanks goes out to Kristins' parents for watching Sam the past few days. We will post an update following our Friday appointment.
Thanks again for all your well wishes and prayers. We are blessed to have such a wonderful network of family and friends.
Wednesday, Dec. 31, 2008 - by Todd
(Below is a copy of the original email we sent out talking about the current situation.)
Hey guys,
We wanted to drop an email to some of our close friends to give a heads-up about Baby Pawlowski. A few weeks ago at Kristin's 22 week ultrasound they did a fetal echocardiogram to check on the baby's heart. The specialist at Methodist shared some concerns about the heart and that it appeared to have a partial heart block. She ordered some blood work on Kristin as well as scheduled a January 9th appointment with the pediatric cardiologist team at Mercy. The blood work results showed that certain antibodies were positive and as a result the baby had a higher risk of congenital heart defect.
Tuesday this past week we had another ultrasound at Methodist and the appointment did reveal that things have changed for the baby and what was a partial heart block now appears to be a complete heart block. She doesn't believe it is a 'mechanical/physical' heart block but when they say 'block' they are talking about the 'electrical' part that instructs the heart muscle to beat at a certain rate for the top and bottom chambers. The baby is growing on schedule which is positive but the heart rate is only around 60 to 70. They admitted Kristin to the hospital on Tuesday for 48 hours in order to give her a sequence of four steroid shots that will hopefully help the baby's lungs develop a little more quickly than usual. This is a precaution in case they have to do a c-section as early as 28 weeks and she is just over 24 weeks right now. There is also a remote chance that the steroids could help break through whatever is causing the electrical block in the heart.
Her OB doctor stopped by the room during her short stay and said that the mystery or challenge with situations like this is trying to determine when is the best time for the baby to be delivered. They will be monitoring Kristin with ultrasounds twice a week to make sure the environment 'inside' remains the best place for the baby and until things change that is where we want the baby to continue growing. Once the baby is delivered it is highly likely that they would have to implant a pacemaker which would be required for the rest of his/her life.
We know that the immediate road ahead is going to be a difficult one and we can only take one day at a time. Things are in God's hands and all we can do is pray for a successful outcome and stay positive. More than one time the doctor at Methodist has said she is amazed that we had Sam without any complications and that he is a healthy boy. She put it best when she said we were 'blessed' to have him...and we feel the same way. He is a terrific kid and we couldn't be more lucky to be his parents!
(Quick Description and Local Birth # Facts)
Autoimmune-associated congenital complete heart block (CHB) is a rare but important disease that can now be diagnosed in utero using fetal echocardiography. The overall incidence of isolated CHB has been reported to be approximately 1:15,000 to 20,000 live births. Last year approximately 4,500 babies were born at Methodist hospital and 5,000 babies at Mercy. Given the statistics you can see that this isn't a real common issue and the doctors involved are trying to find answers to many questions. Unfortunately there are not as many medical studies completed regarding this situation so they (we) are trying to determine what if anything can be done to improve the outlook. Our OB doctor shared with us that he currently has one other pregnant patient that had a positive test for the antibodies and they are monitoring her as well.
(End)
Overall Kristin has been healthy and remains emotionally strong. Everyone knows that I am the 'worry wart' but I told her not to be stressed about me. Yes my head and heart hurt...but I know that there is nothing I can physically do about it so we will just say our prayers and hope for the best. Please keep us in your thoughts and prayers and make sure to give the people around you a good squeeze and tell them you love them.
Thanks.
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