Medical Update (Long Version) 4/29

I think that going to the doctor during even a normal pregnancy can involve a certain amount of joy mixed with trepidation. Naturally, even more so with a higher-risk pregnancy.

We have heard so many good things about our new doctor that we were really looking forward to this appointment. We were also eager to get another look at Annabelle.

On the other hand, the last two times we had been to the doctor (Dr. Doom) they had ended with bad news and us sitting in the parking lot crying . . . so there is that . . .

So. About or appointment with the new medical team:

The sonographer was great. Instead of working in silence and only speaking up when something was wrong, she talked the entire time, "Now we are looking at the top of the head . . . . Now I am checking her lips . . . .Ooooh, how cute!"

Another great thing about her bedside manner was that she told us everything that was "right". "Now I am measuring the right arm which looks normal . . . . now I am looking for the left hand - all five fingers . . ." etc.

She did confirm the "lemon sign" concerning the head. She also confirmed that both feet are turned inward or "club feet". One bit of new info was that she said it looked like little Annie's' legs are bent inward at the knee as well - giving her bowed legs. My understanding is that this is correctable with braces, therapy and surgery if necessary. Not the end of the world but not good news either.

The sonographer confirmed a curvature of the spine and the presence of an opening in the spine (Spina Bifida).

Another condition she noticed is that not only does Annabelle have an opening in her spine, but she has an opening in her skin as well. This is also a symptom of Spina Bifida. It makes sense. If the area down the middle of your back is not developing properly, it could effect not only your spine but the skin that covers it. It sounds pretty gruesome but, once again, it is correctable with surgery. Again, not the end of the world but not good news either.

One a lighter note, she asked if we had done an AFP blood work test at our other doctors and I was johnny-on-the-spot with my magical black binder.

"Why yes, doctor. I just happen to have a copy here . . ." Anal-retentive peoples of the world, rejoice!

The doctor came in and he was warm and kind. "Tell me what you know . . ." is how he began.

Then he took over the ultrasound and showed us something that I thought very interesting. We took a top-down view (cross-section) of each vertebrae in the spine starting from the top and working our way down.

If you touch your thumbs together and forefingers together to make a circle, that's sort of what a top-view of a link in your spine looks like.

As a baby develops, it's spine is not a closed circle to begin with. To get the basic idea, pull your forefingers apart about three inches and slowly bring them together. That's what the developmental process looks like.

In Annie's case, the upper vertebrae have developed normally (thumbs and forefingers touching). But as you progress down the spine, a gap begins to develop (pull your forefingers apart one inch).

With each successive vertebrae, the gap gets wider and wider (pull your fingers slowly apart until they are 6 inches or so apart).

Naturally, it's not good news but it is not new news either as we had already been told there was an opening. Its just helpful to have a visual now.

Though Dr. Doom thought that the opening in the spine occurred at T4 or T5 (around the middle of the upper back) Dr. Cousins (aka "Dr. Hope") thought the opening in the spine started lower - around upper lower back (T7 or T8). This is good news as the lower the point of "splaying", the fewer problems the patient will have (this is still very bad and the standard prognosis is life in a wheelchair but we are continuing to pray for a miracle and lean on hope).

The diagnostic part being over, the doctor recommend we get out of the exam room and sit in an office where we could talk more comfortably.

Not knowing us, or what we had been through with Dr. Doom, he began very cautiously . . .

"Now, has there been any discussion of whether you want to continue on with this pregnancy . . .?"

We assured him that we were committed to little Annabelle and there was no chance of us changing our minds.

A big smile crossed his face and he clapped his hands together, "Good!" he exclaimed.

Now that's what I am talking about - that's the type of doc for Bella.

We talked some more and not only did he answer all our questions but he volunteered an overview of what we can expect.

We are in our 23rd week right now. In about 7 or 8 weeks, we will have a consult with the neurosurgeon who will be operating on Annie shortly she is born.

About 8 weeks later (38-39 weeks along) we will deliver the baby via C-section.

So that's the news. Although it is no fun to have Dr. Hope confirm much of what we were told by Dr. Doom, at least we feel like the doctor is on our side and we had a much better experience.

We are very glad that we made the switch to a new doctor and we want to thank all those of you who worked so hard to help us track him down.

As we stood waiting for the elevator to take us to the ground floor, the wife and I quietly discussed the appointment we had just been through.

"Why did Dr. Doom think it was T4 when Dr. Cousins said it was T7 or 8?" My wife wondered aloud.

I leaned right in close to Holly's face, looked in her eyes and said with conviction, "Because Annabelle is fixing herself."

It may have been my imagination but it looked like I saw the fierce fire that only a mother's eyes can contain leap up . . . , "THATS RIGHT" she responded.

Your prayers are appreciated more than you know . . .