Thursday, July 2, 2009

Wednesday and "The Plan"

Good day yesterday, fairly uneventful: the NST showed a great active heart rate, but our whirling dervish was hellbent on bee-bopping his way through the test, so the nurses couldn't get the resting heart rate they needed. So, we went off to have another biophysical profile, just so they could double-check that everything was OK as they'd predicted. And it was. The best part? I always greet Rafa whenever we have an ultrasound, and yesterday was no exception. Except yesterday, when I said, "Hi, Nug," he turned his face toward my face, and we saw him in all his baby glory! It was positively magical.
Then, we saw Dr. Wilkins-Haug, and it was more of the same. No formal plan, though it seems as though everyone is leaning toward an EXIT-to-ECMO procedure for delivery. I know this because Big Ouiser spent a great deal of time explaining how it works, and I'm a pretty quick study ;)

Here's how it happens:

1. I go under for general anesthesia for what is, for the most part, a regular c-section at the start.

2. They will deliver the baby head and shoulders, still attached to the placenta via the umbilical cord, and attach him to an ECMO machine. They do this by placing two cannulas (basically catheters) in his neck, one for de-oxygentated blood and one for oxygen-rich blood. This is meant to take pressure off his lungs and heart while they are taking time to heal and expand.

3. All the while, the general anesthesia is fooling my uterus into thinking that there's still a baby in there so that it won't contract and the placenta won't separate from the uterine wall. The surgeons have about a 45-minute window to deliver the baby, attach him to ECMO, and then, fill my uterus in on the plan so that the placenta can be delivered and they can close up shop. No pressure though...

I don't know how long the whole operation takes or how long I'll be under, but it's a pretty big deal in its entirety. The one thing I'm mourning the loss of is the opportunity to see him when he's born, if only for a few seconds, and without all of the tubes and tape. However, many of the CDH blogs I read talk of mommies and daddies being able to see through all that and still know that their baby is their baby.

That's the kind of vision we're hoping for.

P.S. Sorry there are no pictures yet--they're coming!


  1. You are in such good hands. I'm amazed by what technology and medicine can offer... what a world!

  2. This process is truly amazing! Do they give valium to your mother and Juan while you and Rafa are going through this process? What a special little boy Rafa is, he is already making his mark on the world. Again, love, thoughts and prayers are with all of you.