The waiting is the hardest part…

Monday morning I had the whole enchilada of testing – NST, Ultrasound, and Office Visit. The NST was uneventful: I had virtually no contractions while I was hooked up, Boston slept through the whole thing, and my blood pressure was normal. All good things. Boston would get zapped with the stimulator, do what he needed to do, and then promptly fall back asleep. I told Julie, the RN, that he was taking after his dad, who is nearly impossible to rouse when he is sleeping.

I am a big fan of Tom Petty and the Heartbreakers. I bought their greatest hits when I was high school and spent many a day singing along to their lyrics. Often those songs will come to mind, as one did this morning. It’s the chorus to “The Waiting” by Tom Petty (sing it with me):

The waiting is the hardest part
Every day you see one more card
You take it on faith, you take it to the heart
The waiting is the hardest part

That pretty much sums up how I feel right now. Boston could come at any time within the next three weeks. We don't know when, and there is no way to know. I have trouble making plans beyond today because I don't know if I will be able to keep them. We just have to wait -- take it on faith and take it to the heart.

The ultrasound revealed five noteworthy things:

1) Our prayers for Boston's growth have been answered in abundance!!! Yay God!!! If he does have any sort of congenital nephrosis, his size will give him a great head start on the growth that is needed for him to reach transplant size. Right now on the ultrasound he is measuring 8 pounds 5 ounces, give or take a pound. The fact that he is somewhere between 7 and 9 pounds makes me soooo happy! Trust me, I can feel how big he is; he is definitely taking up a lot of room in there.

Because of his size, the docs think he could come any time. He is head down and in position. They have scheduled another growth scan for three weeks, if I am still pregnant then. If during that scan he measures, say, 10, 10 and a half pounds, they are going to punch his ticket and induce. This gave me at least some measure of comfort to know that there is an end date in sight, even if it is still three weeks away.

2) Boston's amniotic fluid level is high. We have been praying "that the level of his amniotic fluid will stay normal in order to allow his lungs to develop and to reassure us that he does not have complications." That prayer was answered as his level stayed normal/high normal throughout the pregnancy; however, he has moved out of the "high normal" range into the "high" range. Normal levels are between 5 and 25; Boston's is 34.11. The sonographer called it his "swimming pool." High levels of amniotic fluid occur in about 1% of pregnancies and while it is not harmful to either Boston or I, it could indicate an underlying problem, such as a congenital defect or block in his gastrointestinal tract. High levels of fluid happen because he is producing a lot of fluid, or not swallowing enough fluid, or a combination of both. The complications I have experienced so far include discomfort for me, because he and his fluid are taking up so much space and squishing everything, and uterine contractions (ouch!). High levels of fluid also indicate that labor could happen soon -- I am basically a water balloon that could pop any time. The doc told me to expect him any time and to keep extra towels in my office and car. High levels of fluid also increase my risk for an emergency c-section, if the placenta ruptures or the cord enters the birth canal before Boston's head does.

3) The doc spotted a fluid-filled cyst in front of his tailbone. Boston has gotten so big now that it is hard to see anything clearly on the ultrasound, but the doc thought she saw something in front of his tailbone. She did a thorough check to make sure that his back and spine were closed, and she was reassured that they were, but still saw the cyst. This is not something they have seen before. We discussed the possibilities of what it could be: nothing, part of his intestine that has dropped down, or a block in his rectum. This finding doesn't change our plan for labor and delivery, but we added a pelvic sonogram to the list of tests that Boston will have once he is born. He also will not be able to eat until they can rule out a block in his rectum.

4) The ventricle in his brain was still enlarged: anything over 1 cm is large and his was 1.2. Because it has been consistently just a bit over 1 cm throughout the pregnancy, we were already planning on doing an ultrasound of his head.

5) Otherwise, Boston looked great. We got to see his chubby cheeks and all the fat he has put on, his big head of hair and his hands and feet. His kidneys looked normal, but to remind everyone, that doesn't mean he doesn't have kidney problems. Boston's AFP level was 65 times too high, and 98% of babies with an AFP over 10 are born with abnormalities. That percentage increases as the level increases. From a medical article: "the difficulty in confirming congenital nephrosis before the baby is born is the lack of ultrasound findings. Although bright and slightly enlarged kidneys have been described, in most the kidneys appear normal, the amount of amniotic fluid is normal, and a large placenta, which may occur, does not appear until late in the pregnancy." Basically, what the article says is that if you have an extremely high AFP and everything else looks fine, you can't rule out congenital nephrosis until the baby is born.

These statistics encourage me to put my faith in God. They tell me that medically, logically, it is likely that Boston will not be born okay. Because the odds are against him, and his chances by the world's standards are not good, it makes me realize how important God's intervention is. We cannot do this without Him. This is too big for us; we cannot do it on our own. God will have to heal Boston.

That's the nice thing about waiting -- it gives you more time to pray :)