>> Thursday, May 7, 2009
Than to have an appointment like we had today! It was nothing short of outstanding! We saw Dr. Zaretsky, our Maternal Fetal Medicine doctor and both twins are doing exceptionally well for 31 weeks. Brooke is over 4 pounds now which is actually further along than she should be at 31 weeks. Kamryn is right on target for a singleton pregnancy weighing 3.13 pounds. We were scared that Kamryn would start to drop off a bit due to being a twin, but she's holding her own.
We were concerned about the amniotic fluid level around Kamryn and it did come back higher than we wanted at a little over 9 cm's. Normal range is between 2-8 and she has always been closer to the 8 cm mark than the 2 cm mark, but she went over at this visit. Basically, because of the CDH situation, Kamryn isn't able to cycle the fluid as well as Brooke through swallowing and respiration. I know Kamryn is trying her hardest to do her part, but her little organs are just not in the right place. Fortunately, the elevated fluid level is somewhat to be expected and it isn't a cause for immediate concern. If it continues to increase, it could potentially be an issue that we will need to address, but right now it is fine.
Then it was time for THE measurement.......... Lung to Head Ratio (LHR - we would like this to be above 1.4 as it can indicate a better prognosis). For all of you CDH families out there, hold on tight because you won't believe this. Lung area was 8cm and head circumference was 26cm. Divide those numbers and you get an LHR of 3. I know, I almost fell out of my chair also. I think Dr. Zaretsky did also and he indicated she really does have a lot of lung tissue on the right side that you can clearly see on the sonogram. We re-measured and made sure we could clearly see all four chambers of the heart (standard and accurate LHR measurement has to be taken when you can see all four chambers of the heart on the screen). Just because the right lung is large doesn't mean there won't be severe pulmonary hypertension or tell us how many alveoli are present, but larger size does help. We were still unable to see any liver above the diaphragm which is terrific news. We were thrilled and CAUTIOUSLY optimistic. We have another MRI in two weeks and I think we will have definitive measurements at that point.
And then, Dr. Zaretsky needed to talk with us about something in June...... I could tell where he was going before he even said it. Vacation! Our MFM is going on vacation in June when we are 36 weeks. I really did almost fall out of my chair with this news. It's hard to put into words what he has meant to us through this journey and I can't imagine him not being in the room to bring these two little girls into the world. He is a doctor like no other and we sincerely believe he is a true blessing in our lives. At the same time, we are thrilled that he gets to take a much deserved vacation and this will prove to be an incentive to make it to 37 weeks when he gets back!
It's been a great day for our family and we continue to appreciate the thoughts and prayers everyone is sending our way! It's working!