Tuesday, April 19, 2011

Brain fluid beats heart holes?

A series of events that has left me longing for my overworked West Virginia OB/GYN who never had quite enough time for me and his other healthy patients:
-I'm old (technically AMA, of "advanced maternal age") so my (generally great) obstetrician schedules an appointment for me with the super-duper sonogram (in Norman, an hour and a half away) and the MFM specialist (maternal fetal medicine), which is now routine for all old mothers.
-I start bleeding and am diagnosed with a subchorionic hemorrhage the week before the appointment (January).
-Super-duper ultrasound reveals a baby growing great, but blood in the uterus which should be tracked (January).
-Return to super-duper ultrasound end of February. Blood is gone. Hooray! Baby is a great size, hooray! But wait, doctor may have seen a hole in Rutherford Robinia's heart. Look again. Baby is uncooperative, can't see anything. Come back in six weeks and we'll check out this possible hole.
-Return to super-duper ultrasound first week of April. Heart is intact. Heart is pumping great. Hooray! But wait, one of the ventricles on Rutherford's brain is enlarged. "Your baby has ventriculomegaly but don't worry, it's not hydrocephalus yet. Do you want to do an MRI?*" "No, okay, come back in three weeks."

Grrrr. It seems that RuthRob could have a brain tumor, a brain hemorrhage, major developmental problems, a fetal infection, or chromosomal abnormalities; or, much more likely, extra fluid in the ventricle in the brain that needs to be shunted after birth; or, much much more likely still, a slightly enlarged ventricle in the brain that will never lead to any observable symptoms.
How the next visit next week could go: Heart still great! Brain normal. Hooray! But wait, what's that? Your child has three tails! Want amnio? No? Okay, come back in three weeks and we'll see how well the wings are developing!

*I'm not exactly sure when a doctor is supposed to offer further diagnostic options, but immediately after alerting someone to the presence of a condition she's never heard of is not the time that she's most likely to make a well-informed decision. Still, I did ask the pertinent question, "Would we do anything differently based on the MRI?" and, the answer being, well, we'd still need to monitor it closely, I think I made the correct choice for us.


Beth said...

That is really frustrating. You can crash with me if you want to visit my obgyn for a second opinion with their fancy dancy ultrasounding equipment. I know the have a high rez one in the office suite. Did they give you any stats or extra information about it or just well come back in 3 weeks. It's a little strange that nothing they see at this place is still there for the next one... ((hugs)

Sparkling Squirrel said...

To be fair, I really like the MFM. The blood clot definitely was there (why I was bleeding), and I stopped bleeding, so it was reassuring that the blood was gone. He also was very clear that the heart hole was only suspected from one view, and he really couldn't get another good look that day (and I was there as he tried). The enlarged ventricle was identified by two different poeple with two very different views, so it is real. He was clear that the condition itself is not problematic, but it could be symptomatic of lots of different causes with lots of different other effects. He didn't give me any stats at the time, but I probably couldn't have taken in any more information (I couldn't remember the name of the condition when I returned home).
I've never felt that I'm not being taken good care of-- rather sometimes wish that I would know a little less. Dianthus could very well have had enlarged ventricles or a hole in the septum that didn't heal until birth, but because I wasn't being tracked by the super-duperest of equipment I only knew that he was growing normally and his heart was beating and that was enough to know.

Sparkling Squirrel said...

Oh, last time Dianthus saw the pediatrician, she mentioned, "You don't need to see a surgeon about his pigeon chest yet."

Jennifer said...

WTF? Pigeon Chest? Surgery? I am confused.

I am hoping so much for a safe and healthy delivery for you and Robina.

Sparkling Squirrel said...

Pigeon chest is this strange placement of sternum and pectoral muscles that makes the chest stick out (like a pigeon). True pigeon chest can lead to respiratory problems.
Far as we can see, Dianthus just has a skinny waist, making him relatively pigeon chested compared to his ample waisted family and peers, but not actually pigeon chested.