I was not really looking forward to having an OB appointment on Neil's birthday, but this one was worse than I had hoped but not as bad as it could have been. First, Emmie did not pass her BPP. She moved just fine, but she refused to show off her breathing. So we were going to have to go to the hospital for a non-stress test. Second, they checked growth, and Emmie seems to have fallen off of her growth curve. Her overall percentile was 16%. It had been in the 30s. Like her siblings, her femurs are short, which will drag down the percentile. (Although short fetal femurs mean little to height as she ages. Lucy had short femurs, and her height is in the 90th percentile at 2.5 years.) We're also not sure that they're getting an accurate head measurement because of her position. That would also drag down the percentile. Her abdomen is around the 50th percentile. At 4.5 pounds, her weight is in the 30s percentile-wise. So there are enough excuses to believe that she's not really at the 16th percentile. And we were told that the abdomen size is a better predictor of her health than the other measurements. But we are us, so they did two more ultrasounds and some blood work to check for infections. The ultrasounds were to check for blood flow in her brain and umbilical cord. The umbilical cord blood flow was fine, but they had trouble getting a good angle on her brain because of how low she is. Dr. Reynold's response was to have them follow up with a vaginal ultrasound to see if they could see the head better from that angle. They tried and tried and tried, which irritated Emmie enough that she was punching, kicking, and moving her head around to make it impossible to record anything about her brain. So they gave up on checking brain blood flow and sent us to the hospital for the NST. Emmie did really well on the NST. The nurse, who I recognized from Lucy's birth because she LOVED Lucy, was impressed with her heart read-out. Emmie fought the fetal monitor a little, but I think she was worn out from protesting the vaginal ultrasound. The lab tech who took my blood was really nice and took extra just in case they thought of something else to test, which knowing doctor Reynolds was a good idea.
Dr. Reynolds decided that we should start going for BPPs twice a week and despite whether Emmie passes them or not, we'll also go to the hospital for non-stress tests (NSTs) every time. We had weekly appointments already set, but they had to scramble and double book ultrasounds for the Thursday appointments, which they couldn't always get at times which work well with Matt's schedule. So he's going to have to cancel classes, and we're going to have to find childcare for Lucy because we can't expect Shawn and Susie to drop everything twice a week for keep her. And we won't know for sure how long we'll need someone to watch her each time. If they've double-booked the ultrasounds, I'm not sure how long we'll have to wait. The BPPs can take as long as 30 minutes. Then we'll see a doctor. Then we'll check into the hospital for an NST that takes at least 30 more minutes. And hopefully, they find nothing wrong at any point, or they'll admit me to the hospital to get Emmie out. And taking Lucy with us isn't a good option with the NSTs being done in the hospital, even if Matt was willing to miss the ultrasound to keep Lucy in the waiting room. He'd have to keep Lucy out of the hospital, too. And both Matt and I want him present for anything in the future because there's actually a chance they'll find something and get Emmie out. And we'd have to do something with Lucy if they admitted me to the hospital. If it was an emergency, Matt might not get to be in the OR because he would be keeping or transporting Lucy. It's a lot to deal with and plan for.
I was pretty bummed by all of this and cried quite a bit. I was not emotionally ready for any bad news. They did admit that almost all of the precautions they are taking are because of Neil. Emmie's situation without our history would not cause this much alarm. But the last time we had a small baby, he died. He didn't die because he was small, but ultimately the problem was a blood flow issue. And if Emmie isn't growing, she might have a blood flow issue, too. The specialist in Louisville considered that I just have consistently under-performing placenta. If I had any doubt before (and I didn't really), today convinced me that this is my last placenta. We're not going through all of this again.
On the bright side, I lost a couple of pounds last week because of increased consumption of fresh produce and increased activity in my garden. And my blood pressure was fine and got better each time it was taken. And my fluid level was a little higher but still at the lower end of normal. If fluid dramatically increases or decreases, they'll get Emmie out. In fact, we're now doubting that we'll make it to 38 weeks. If they find the least reason to get her out at or after 36 weeks, they'll do it.
Lucy had a better day today than she did last Tuesday. She still cried when she was put into the red car. She legitimately does not like to ride in a car that is not her blue car. Because she had done it last week and she wasn't in quite as bad of a mood today, the crying was not as severe. She was also heading to the park with Shawn, which may have helped a little, too. She had already told us this morning that she wanted to go to the park. According to Shawn, they had a pretty good day. There were a few tantrums and other two-year-old behavior, but she didn't melt down or destroy anything. And she seemed to have a good time.
Now I just want to go to sleep. I'm worn out. Tomorrow I'll try to find someone to watch Lucy. Tomorrow I'll try to get more done around the house just in case. Tonight I'm taking a Tylenol PM and getting as much sleep as possible so that I have the energy to deal with tomorrow's problems.
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