Saturday, April 4, 2009

2nd opinion in Columbus, Thursday, April 2

During our 4 hour drive to Columbus, Dr. De Lia, called me and asked if I'd spoken to Dr. Jaekle, the MFM who'd done my amnioreduction but who we hadn't seen again since that day. I hadn't yet but Chris agreed that I should try to see what he thought as well. I called Dr. Jaekle and explained what had happened on Tuesday and our concerns about doing surgery when the girls are looking so good by every other indication. I asked him about the possibility that the equal fluid levels could be due to an inadvertent septostomy. He told me that he did not believe he'd poked a hole in the dividing membrane between the girls. He assured me that the other indicators the girls had did not look like the equalization was merely b/c of septostomy. He said if Elise was not getting enough blood flow she would not be producing urine as her full bladder indicated. He also confirmed that he would not move to surgery based on one number. The Tei index, he said, is imprecise and fuzzy. Different doctors figure and interpret and use it differently. He thought that we were absolutely making the right decision. He went on to say that he is by nature contrary so that the fact that he was agreeing with us meant that he really does think we're being wise and not just trying to make us feel good about our decision. So, now we had 2 doctors in agreement with us.

We went in for our appointment next and had another ultrasound. Again, fluid levels were good, bladders full in both girls, and no apparent physical changes in Anne-Claire's heart. Elise did have persistent absent flow in her cord, however. Dr. O'Shaughnessy came in and said something that no doctor had yet said. He said that God had created these girls and made them to share a placenta. The sharing of the placenta was in a way helping Elise and to disconnect her from Anne-Claire would leave her vulnerable. He agreed that her absent flow was largely due to placental insufficiency and that everything he saw indicated that little or no tranfusing was going on currently. He said that we were absolutely making the right decision. He said that if we went to surgery and lost Elise as a result we would find it very hard to not second-guess our decision. We would have lost her after making so much progress from the amnioreduction. He also said that when he figured the Tei index it was normal, but again, doctors figure it and interpret it differently. The bottom line is that the Tei is imprecise and currently the only measurement that caused the doctors in Cincinnati to suggest surgery. We're very glad we decided to wait and get another opinion--now 3 doctors are in agreement with us.

The best thing we could do now was to concentrate on my getting proper bedrest, which he defined as only getting up for the restroom and to shower. He emphasized that the next month is critical for the girls and that getting to 28 weeks (we're at 24 1/2) will be tough. He also told us that he would be praying for us and the girls, which meant more than all the medical information.

We are so thankful that God opened the doors for us to talk to some other smart people and the wisdom to realize we needed time to process and think before doing the surgery. We do not take any credit for this decision but rather give the Father praise for leading us in this and for keeping our girls in His hands. He's continuing to knit them together perfectly and knows exactly how many days they have. My prayer is that we will be allowed to love and hold them in our arms and to watch them grow into beautiful women of God.

2 comments:

Lauren said...

Michelle,
I am praying for you and your family. I am glad you are in Indy now so that you can really focus on bed rest now.

...we are weak, but He is strong.

Love,
Lauren

Rachel Pierson said...

Michelle,
We are continuing in prayer for you and your family.

Love,
Rachel