Briella - 4 days old

Today, Briella is four days old. She is such a sweety and it is already getting hard leaving her in the hospital! The CPAP was turned off yesterday and she is still getting some extra oxygen via a little cannula under her nose. I've been able to hold her (yay!) and she loves snuggling. Yesterday she cried when I put her down at the end of visiting hours :( 

Medically speaking, things are moving along slowly. Briella has been seen by most of the specialists who need to evaluate her and the prognosis seems good. The two things that we are waiting for before we can bring her home (in my understanding) is 1) her breathing needs to improve a bit - she's still having some "insucking" around the rib cage when she breaths, meaning that she's straining a bit. She also has some stridor but chances are she'll have that for a while. I still think that her breathing is stronger than Maddy's was at birth, and the doctor who was looking after Maddy agrees. 2) she is still being fed by the NG tube. She needs to start feeding orally. I'm HOPING that this will start taking place next week. 

Apart from that, everything else, I believe, will mostly be done as an outpatient. The ENT is not insisting on an immediate bronchoscopy (unlike our situation with Maddy) and is happy to follow up with that later. Orthopedically, her x-rays of her spine don't completely rule out every issue, however they don't raise any major red flags either so we will be cautious and follow up with that later too. Her hips, like Maddy's, are not fantastic - however unlike Maddy, our current ortho sees no benefit in using a pavlik harness. 

Her feet are going to be a difficulty though. Maddy has fantastic feet for her diagnosis and I don't know why, I just assumed that Briella would too. Briella however has the more "typical" diastrophic club feet that often are very difficult to correct. At this stage, our ortho is planning to start serial casting for them when she is around a month old.

Briella is drinking more and more these days and so in the next day or two should be able to have her IV removed - yay for one less cord! We still haven't been given any particular time frame for how long she will be in, but we are praying and keeping our fingers crossed... it is exhausting pumping, looking after two older kids and running back and forth from the hospital sometimes multiple times a day. I can't wait until our family of five is together!

Briella Faith

As the title of this post suggests, we have decided on a name for our little one: Briella Faith. "Briella" is a short form of the name "Gabriella" meaning "God is my strength".

Today, I will be discharged from hospital to recover from home. I'm doing very well - both physically and emotionally. The cesarean was not as painful as I'd imagined and certain aspects of the recovery are also significantly easier. When I was admitted to the hospital, I requested that I could recover in the prenatal ward rather than the postnatal ward. The prenatal ward has some postnatal patients as well, and I knew that it would be easier on me emotionally than being in the postnatal ward with 50 newborns. Thankfully they were able to accommodate my request as my hospital stay here has been so much easier than my previous two experiences!

Briella is still in the NICU. Like Maddy, her main issue is her breathing and airways. She had other medical needs such as cleft palate and clubbed feet (which are new to us, Maddy's feet are great!) But these are not what is keeping her in NICU.

It will take at least a few days or so for all the necessary specialists to see Briella and they need to consult with each other about the management plan. Although the doctor told Bernard perhaps only a few weeks, this is just a guess until we know what the plan involves...

In the meantime, Briella has started feeding through a tube, so I am pumping again. Thankfully my milk has started to come in so I'm able to meet her needs. Every time that I've seen her, she's been asleep. Since she is still on the CPAP, we are not yet able to hold her. Hopefully we can hold her soon! Also, until she is discharged, Bernard and I are the only ones able to visit her. Lana is quite upset about that, and for me, that has been the hardest thing so far :(

Please continue to pray for us, especially little Briella...

Welcome, baby girl!

After a lot of waiting, our third daughter (still unnamed) was born today at 1:17pm via cesarean section. She weighs 3.4kg and had apgar scores of 7 (1 minute) and 9 (5 minutes). She needed a bit of help starting to breathe due to wet lung syndrome (possibly due more to cesarean delivery than her dwarfism) and was taken quickly after birth the NICU where she was put on oxygen. Other than that, she seems healthy and strong. The doctors estimate that she may be home within 2-3 weeks which would mean she's likely to be home for Christmas! I haven't spent much time with her yet since I am still recovering from the cesarean. She looks so much like Maddy did at birth!

Thanks so much for your prayers, messages and other support. I will continue to update as we learn more.

The day before D-Day

Having a scheduled cesarean is a strange thing, knowing the birthdate of your child sometimes even weeks in advance. It's so crazy for me to think that by this time tomorrow, I'll have a newborn! 

Today, I had my last appointment with my private doctor. He confirmed that yes, the baby is still breech. She seems as though she's a big one, maybe 8lb or so already. The estimates aren't always accurate, but based on the scans, it seems as though if I'd gone another week or two, she would have been my biggest! That might be the reason why she just didn't want to turn around. He said "Seems like she wanted to be born by cesarean!"

After a great lunch with three of my closest friends here, I headed up to the hospital for a few hours for the last pre-op things. I met with the anesthetist again who confirmed that they will try the spinal block first. There is a chance that it may not take due to my spinal surgery and if that's the case, I'll need a general anesthetic :( I'm praying that is not the case! I also saw the obgyn and got some blood taken in case I need a transfusion (it's rare but better safe than sorry!) 

Tomorrow morning, I need to be up at the hospital at 7am. I am the 2nd surgery of the day, so generally speaking, it will be possibly around 9:30-10am. Emergencies take precedence over scheduled cesareans though, so it could be later than that. I guess we won't know until tomorrow for sure... 

Usually with cesareans at this hospital, you need to stay 4 nights afterwards, so I probably will be in until Saturday. Depending on how I'm doing and how the baby is doing, I might stay shorter or longer. If she obviously needs significantly longer in NICU, I'd prefer to recover at home. If she is doing great and can come home say after 5 or 6 nights, sometimes they allow the mother to stay longer so they can go home together. We'll play it by ear.

I'm very nervous about tomorrow - both about the procedure and recovery, and also about the health of the baby. If I could have one "wish", I'd wish that she could come home with me. How likely is that? It's impossible to say. She'd need to be healthier than Maddy was in order for that to happen... It wasn't until a day or two after that I'd packed my hospital bag that I realised that I hadn't even packed any clothes for her :( I have now - in faith ;)

I was talking to Lana yesterday, trying to prepare her for the birth, my hospitalisation and the possibility of her maybe not meeting her sister for a few weeks. She told me in a wistful voice, "I hope the baby can come home quickly because I REALLY want to hug her..." Made me cry - me too Lana... 

Please be praying for us, and especially baby, tomorrow - and we hope to update soon with good news!

26 November

Two posts in one day! I haven't done this since Maddy was little!

Yesterday, I posted about my experience with the ECV. Since it failed, we will need to schedule a cesarean. Yesterday, the hospital gave me the date of December 4 which was a week after the doctors had verbally advised me that it would be. I had some concerns and so I emailed the doctor.

My main concerns were these:

- if I went into labour naturally and the baby was still breech, I would need an emergency cesarean

- emergency cesarean is not preferable for the mother OR the baby and the risks are a bit higher than if it were planned (just depending on how "emergency" it truly was). 

- since the baby already has known health issues, it would be preferable to have the team of doctors ready and prepared in advance, rather than using whichever doctors were on call at the time. 

- (selfish reason) - if I had an emergency c, Bernard would not be allowed in the theatre and I would be alone for the birth of the baby. While it might not be as big of an issue in a routine pregnancy, we don't know how her breathing will be until those first few minutes and I would not want to go through that without my husband.

In addition to the above, my due date according to LMP is December 7 - however according to all of my early ultrasounds, the baby has consistently measured between 6-10 days ahead, putting my due date by ultrasound to somewhere around November 27 to December 1. 

So as mentioned in my previous post, I contacted the doctor last night and he replied within a few hours saying he would review my file and get back to me. This afternoon, I had a call from the hospital advising me that they have moved the date to November 26. 

So unless a) I happen to go into labour within the next 5 days, or b) the baby happens to turn within the next 5 days, we will be meeting our little girl next Tuesday. 

Please continue to keep us in your thoughts and prayers - this is the end of one journey, but the beginning of another...

Maddy update

It's been a long time since I updated about my 2nd daughter! Much of this blog in the past few months has been focused on my pregnancy and the potential medical needs of my 3rd daughter. But I did want to update a few things about this gorgeous little one:

Maddy is growing well and still is extremely healthy. It has been nearly two months since we have seen the orthopedic doctors and we are still waiting for a CT appointment for her spine. I think the stress of this pregnancy (which is no where near as bad as the stress of my last pregnancy!) has taken my attention off Maddy's needs in some ways, because I'm sure I'd be more worried about it if I weren't focused on the new little one. I've figured though that the CT scan would at least give us more information about her spine and whether or not the suggested surgery is viable. Even if the suggested surgery is not viable, more information cannot be a bad thing! 

With regard to the DAFOs mentioned in the last orthopedic post (linked above), we have had some made - however they are not the hinged kind that I was expecting. The kind we have are thicker at the ankle and are extremely difficult to buy shoes for. Instead, the orthotist added a sole to them so she can wear them without shoes. Maddy has currently been wearing the new orthotic about half the time and continuing to wear her old orthotic insoles the rest of the time. Here is a picture of her funky new "shoes" (taken before the sole was added onto them) ;)

Since September, Maddy has been going to not one, but two new schools. It has been a hard transition - it took a few weeks for her to stop crying at drop-off time, but now she is mostly good. She prefers her regular school to her special needs school, but her special needs school is helping us so much at this critical age with her self-help skills. She has been working on things like pulling up her pants and putting on socks. Given that her fingers are inflexible and her arms barely come to her belly button, this is a bit like you or me learning to do these tasks with our elbows!! She has been experimenting with a few different methods and a few different tools. All in all, I think these schools are perfect for her current needs so it's worth the busy schedule and the (few) tears that still pop up from time to time. 

The other week, Maddy had an appointment with the cleft team at the dental hospital. She had back to back appointments with the dentist, orthodontist and oral surgeon. She was AMAZINGLY good - opening her mouth wide when asked, following instructions, allowing them to scrape the plaque off her teeth, even allowing them to stretch her lips out to take photos of her teeth. I wasn't expecting her to be so compliant - I know that when we took Lana to the dentist earlier this year, Lana wasn't anywhere near as compliant, and she's usually my easy-going child! We had all the staff at the hospital talking about how good Maddy was and they have never seen a child this young with that much ease. I think a lot of it has to do with the number of doctors appointments and therapy sessions that she has had - it's been her whole life really! I'm so proud of her :) (and her teeth are crowded, but they are healthy strong teeth. We'll start worrying about the spacing issues once she starts getting her adult teeth!)

ECV results

Today, I spent the day in the hospital attempting to turn the baby from breech to head-down. It was a full day with a lot of monitoring and a lot of waiting! The doctor usually does two attempts, but because we are a little more "high risk", he only tried once. The baby didn't turn so is still breech, but thankfully we didn't experience any complications and so did not need an emergency cesarean today.

Because the baby is still breech, they have scheduled a cesarean for December 4. I'm a bit concerned that it is too close to my due date (only 3 days "early", usually they do it 1-2 weeks early) - I don't want to go into labour and then need an emergency cesarean which will be more risky for me and the little one - plus Bernard will not be able to accompany me. I've contacted the doctor to ask if it is possible to move the date closer but I'm not holding my breath - I'll see what he says. 

All in all, I think I'm glad we tried. If we hadn't, I probably would have wondered "what if"... although of course since she didn't turn, it does feel in some ways like a waste of a day, and unnecessary discomfort as well - but we would have never known if we hadn't have tried.

There still is a (small) chance that the baby will turn by herself before the scheduled cesarean, in which case they will cancel the surgery and wait for her to come naturally. We'll just have to wait and see what happens. It is surreal to think that in just a couple of weeks, she will be with us!