>> Thursday, February 12, 2009
What an afternoon! We had a couple of appointments today and received good news all around. I want to start off and tell everyone that Brooke's exam was boring (we love boring) as everything looks fantastic. With everything going on with Kamryn, I sometimes forget to count our blessings with a child who is completely healthy. Brooke is doing fantastic!
Ok, so our afternoon started with Dr. Zaretsky (hi-risk OB) for a sono and amnio. The sono went well and he still can't see that the liver is up. Again, hard to confirm with the sono, but it isn't jumping off the screen that it is there so that's great news. The MRI on April 3rd will give us a definitive answer. The right lung looked good and is growing well. There isn't a lot of left lung right now which is not good, but not unexpected. He did some quick calculations on the Lung to Head Ration (LHR) and came up with 1.3. From what we understand (if any CDH parents want to weigh in on this please do), this number could get better with time. LHR of 1.4 or greater typically indicates a very favorable prognosis while an LHR of less than 1.0 presents substantial challenges for survival. We will know a more firm number when we have the MRI, but we will take the preliminary 1.3 for right now. This was definitely good news.
The research is somewhat mixed about how useful indicators are for prognosis in CDH babies, but the two things we are tracking and will keep you up to date on are 1) LHR (>1.4 is great) and 2) Liver down. We are doing ok on both indicators right now.
Here's what we know: Stomach and intestines are in the chest cavity on the left side for certain. Heart is pushed to the right (expected), but not compressed (good). No indication of liver up (very good - one of the biggest predictors of survival). LHR of 1.3 (good preliminary number).
Next, Stef had the amnio. I have given her so many shots over the years for infertility that I was happy it wasn't me doing it one more time. I was surprised that the needle was as big as it was (22 gauge - same size we used to inject progesterone into her hip). She was such a trooper as usual. It was uncomfortable, but you wouldn't have known by her reaction. We were blown away at what happened next. Just before he was ready to insert the needle into Kamryn's sac, Brooke's foot came flying over right where the needle was going to go. I swear, she was protecting her sister. You could tell that their sisterly bond already exists. We all just kind of stepped back and thought that was really special. We got the fluid drawn and sent off to the lab. We will know the preliminary results (Down's, Trisomy, etc) this Monday. We get the final results 10 days from now. If we get good results on Monday, it is incredibly unlikely that any problems would come back on that 10 day test.
Next up was the Cardiologist. Dr. Day was incredible and is a Texas Tech fan. That's all we needed to know to be comfortable with him. Seriously, he was incredible and just a really good guy. The sono on their hearts took about an hour total. If movement in the womb is any long term indicator of health, these babies are going to be just fine. Both doctors kept commenting on just how much they flip around. Both hearts look really good and there were no defects that he could see. He wants to see us back in 5 weeks just to make sure, but everything looked great. This was a huge hurdle because CDH babies have such a hard time with their lungs that it would be compounded greatly with a heart defect and survival deteriorates substantially if problems in both are present. We posted the new ultrasound pictures in the slideshow at the top right and they were able to take a couple 4D shots.
We were blessed with a terrific day today and we were able to gain even more hope that Kamryn will beat this condition. Thank you so much for your continued thoughts and prayers. The comments and emails we receive from you all keep us going and we can't thank you enough for the support. Each one of you is appreciated more than you will ever know.