Updates and a Baby Date

It's been a big week of appointments and we continue to be encouraged and hopeful about Clara's arrival!  On Tuesday we had another ultrasound and got some more looks at Sweet Clara's face.  The sonographer (Kathy, who we love love love) has now pronounced that she not only has Robert's head size, but that she looks like him in the face too.  She certainly has chubby cheeks and sweet tiny ears.  We didn't get as good of a look this time as last because her arm was in front of her face for much of the time, but I kind of think she might have my chin.  She does have hair (bets are yours on straight vs. curly) and we saw her opening her mouth, sucking on her arm and fingers and displaying a pitiful pout that melted Robert's heart and made me threaten time out already.  We also saw her chest rising and falling (good breathing practice motion) and hiccups (more breathing evidence, plus a strong diaphragm).  The doctor said that he could even identify some viable right lung tissue and since lung is very difficult to see on an ultrasound the fact that he could see any at all is a sign there must be a significant amount.  All great news!  The only thing that was even sort of a concern is that the amniotic fluid measurements were on the high side of the normal range.  But he was not super concerned about it and after meeting with our regular OB today, it sounds like it's probably okay.  They measured 23cm and our doctor said she's not usually worried until it's 30cm or higher.  Too much amniotic fluid could be a sign that the baby isn't swallowing effectively, but again - they don't think we're in that range yet.  They'll do another measurement the next time  we go back and keep an eye on it.  And we'll keep praying that Clara's swallowing reflexes continue to develop and that she'll be able to feed well.  Her current weight (at 30 weeks, 1 day) is THREE POUNDS, NINE OUNCES!  I was pulling for at least three pounds, so nine ounces over that was delightful!  She's about 60th percentile, so she's growing really well.  If she keeps gaining at this rate and pace we're looking at probably about an 8 pound baby.  The bigger the baby, the better the surgery, so we'll take it!  And she's still head down and likely to stay that way at this point, so we're preparing for a scheduled induction instead of a C-section.  That was the report from yesterday's perinatologists.  Overall - stable and good!  Next ultrasound: three weeks.

Last night we went to our second birthing class at the hospital.  The two nurses that teach it are both very experienced in Labor and Delivery, Cesarean, and Newborn Nursery.  When we told them what we were facing they were both very positive and encouraging as well.  We love to hear medical professionals (any medical professionals) tell us that things will be okay.  One of them was very surprised that we already had a diagnosis.  She said that most of her experience with diaphragmatic hernias were babies that were not diagnosed until after birth.  That made us thankful once again for the time we've had to prepare and the excellent pre-natal care that we have received the past few months.  When we told her that the liver and spleen were still below the diaphragm she also said, "Sounds like you've got the best case scenario!"  Now granted, she hasn't looked at our records and she's not a pediatric surgeon, but still - a positive attitude like that from anyone in the medical field is very encouraging and hopeful to us.  Last night was also "Meet the Doctors" for folks trying to choose a pediatrician.  We've already chosen a pediatrician and met with him and like him very very much, but the Q & A last night was still helpful.  When we explained to the panel of doctors about our case and asked about the likelihood of being able to transition to breast feeding at some point, they were also very encouraging.  None of them had terror or horror on their faces when we said "diaphragmatic hernia" and they all nodded encouragingly about her eventual recovery and return to "normal."  So, again, while there's no way to predict the future or for them to know details of how Clara will do, we're overall encouraged by some general positive medical vibes.

Today I had an appointment with my regular OB.  I got to see Dr. Scherer who has cared so exceptionally well for us from the beginning.  I taught her daughter in kindergarten last year and got to know her very well, and am so deeply grateful for God's hand in placing their whole family in my life in His perfect timing.  She has continually gone above and beyond to take care of us and I feel so special to be receiving this high level of personal care.  She was also positive and encouraging about the pregnancy in general.  Although I'm still sick some, the Zofran is mostly managing that and aside from nausea, vomiting, heartburn, and other typical third trimester aches and pains, this has been a very healthy pregnancy.  My glucose test came back with good blood sugar levels, I haven't gained too much (or too little) weight, there are no signs of preclampsia or other risk factors and like I already mentioned, Clara is growing very well!  It was a good visit with Dr. Scherer today and even though I start going every 2 weeks now, I won't get to see her again until March.  So, we went ahead and picked a tentative date for this baby to be born!

The official due date is March 28.  As I've mentioned before, we're wanting to balance letting Clara grow and get as big as possible with not wanting my water to break or for me to go into "unplanned" labor.  So we're tentatively planning a scheduled induction for WEDNESDAY, MARCH 23.  Mark your calendars. :)  Hopefully she'll be here sometime that day or the next.  Dr. Scherer still has to check with the pediatric surgeons and make sure that date works well for them and that everything at Baptist will be ready.  Assuming they are, we'll let the neonatalogists and pediatric cardiologists and everyone else that needs to be involved know to be on standby and we'll have everyone ready to give this baby the best possible care once she's on "the outside."  It's a little weird to have a more specific date than just a due date and know when we'll really be doing this thing.  But my type A control freak personality is delighted to have something penciled in on the calendar.  Obviously, we'll be monitoring things between now and then and it could be subject to change...

Okay!  Enough medical updates.  Let's cut to the chase and see some more photos of Clara!  Like I said, these aren't quite as good as last time, but in three weeks we'll get another look.  Kathy was frustrated with Clara's lack of cooperation but we still think she's the best.

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Ear shot

We know that she can already hear and recognize our voices with that little ear.  I wonder if she can hear all the prayers being said on her behalf...  Keep 'em coming.

Prayer Images

A Bible Study that I participated in last year read Richard Foster’s Celebration of Discipline.  The chapter on Prayer discussed (or at least led us to a discussion of) prayer images.  It had never occurred to me to pray in this way before – I’m a verbal person, not a visual one.  But it was a powerful idea that took root in me and that I’ve tried to practice some since.

A friend from church shared with me shortly after our diagnosis that when she prayed for us she had a prayer-image that I loved: “Imagining Robert and you encompassed in the womb of God receiving the hope, peace, and nourishment you need right now for daily life.”  What a beautiful picture of who we are and what we need right now (and always for that matter!).

When I pray for Clara, I find myself repeating the same words and phrases over and over again.  I hope God doesn’t tire of hearing me say, “Please heal my baby” or “Give Clara a fighting spirit” or “Let us bring her home safely and wholly.”  But it’s refreshing to sometimes try to step away from words, especially when I feel at a loss for them, and instead dwell on an image that I believe can also be a powerful form of prayer.

Some of my prayer images for Clara involve all of you.  We have felt so loved and surrounded by the family of Christ through this, that I truly feel that we are facing this with an army of people hoping and fighting and praying and believing.  So one of my images is that Clara rests in the middle of this enormous circle of people who are all holding hands and standing around her.  It’s especially powerful because there are many faces in the circle that I do not even know.   There are people reading this blog and praying fervently for Clara that I have never met.  It is a testament to the power and glory of God that strangers from all over the world can come together with a singular hope and prayer.  I love to image you.  Another image I pray that involves all of you is one where we are lifting Clara up to our Heavenly Father.  We’re holding her, but each of us has just one finger on her tiny body.  One of us alone would not be able to sufficiently support her, but all of us together is more than enough for her to be lifted up to the one great Healer. 

I also image God directly caring for Clara.  Psalm 139:13 is a verse that we have turned to and had shared with us many times in the past few months.  “For you created my inmost being; you knit me together in my mother's womb.”  It’s a silly image, but I sometimes imagine God with giant knitting needles, working furiously on Clara’s small body.  I image Him creating her in other ways too though: sometimes He is painting her or sculpting her or building her like a jigsaw puzzle.  In all those images, I can nearly see the expression on His face-less face.  It is one of deep concentration, attention to detail and most of all enormous compassion and love. 

My mom has had a prayer-image for me and my brother for many years and it is one that I have borrowed for Clara, too.  The image is of God’s hand – His giant, strong, and steady hand – gently holding my child in its palm.  He’s got the whole world in His hand, right?

Sometimes my prayer images are almost just daydreams and they feel more practical than theological.  I just imagine Clara here, at home, with us.  I imagine her in her crib, resting peacefully.  I sit in the glider of her room and imagine holding her in my arms and rocking her to sleep.  I imagine giving her baths and feeding her and hearing her cry and changing her diaper and making silly faces at her and singing songs to her and reading books to her.  I imagine our lives here being normal and pray that image will become a reality for us.  I know that most expectant mothers probably imagine all of these same things, but for me it’s not just a meandering glimpse into the future; it’s a plea with God for it to come true.  Perhaps that’s why preparing a space for her has taken on such significance for me.  Her stroller arrived today and as we were playing with the levers and handles, I prayer-imaged lifting her in and out of that seat and taking her for walks outside and her little lungs filling up with fresh air and taking in the sights around her.  It’s beautiful.  I offer it up to our Creator with a hopeful expectation that it will be so. 

So, I guess my question is this: Do you prayer-image?  Like my friend, is there an image that comes to your mind specifically when you pray for Clara or for us?  I’d love to hear what they are and record them and share in them with you.  Maybe I’ll even image a little box filled with all these images.  And give it to our God who has the power to make them tangible.    

Her Heart, Part II

We've just gotten home from the fetal echocardiogram and Clara's heart is healthy!  They were able to see much better this time, since everything is bigger, and got to take a good look at some parts of her heart they were unable to see at our last fetal echo.  The cardiologist said that everything looks perfectly normal and healthy and strong at this point.  Praise be to God!

She could still develop heart complications after birth.  The pulmonary hypertension that accompanies diaphragmatic hernias will potentially take its toll on her heart as well.  However, going into birth knowing that her heart is healthy and appears complete and strong means that she will stand a better chance of fighting this.  We are so relieved and encouraged to hear this good news along the way and give God the glory and praise that all belongs to Him. 

She was also head down today, and although that could change in the next nine or ten weeks, it means as of now she's getting ready for a normal vaginal delivery too.  Bring on the epidural.

Next week we have another level II ultrasound at Forsyth Hospital (Tuesday) and our regular OB appointment on Wednesday.  The time is ticking quickly now - our little girl is going to be here before we know it.

We've done some more work on the nursery this weekend too, so new photos of that are coming soon.  Stay tuned.

Thanks for your faithful prayers.  God hears them.  He has answered them.  We believe He will continue to do so.  Please keep praying.

Her Heart

The more that I have read and heard about CDH it seems that it is quite common for there to be complications with the heart as a result of the hernia.  Many babies with this condition have varying degrees of heart trouble since the heart is typically deviated (shifted and rotated) because of the misplaced stomach.  We do know that Clara's heart is deviated, but so far all of the reports on her heart have been positive.  Her heartbeat always sounds strong, it looks okay on the level 2 ultrasounds, and when we had a fetal echocardiogram (another ultrasound that takes an extra close look at just the heart) at 19 weeks everything seemed okay.  However, that was very early and she was very small at that point, so it was difficult to really see each valve and confirm that her heart is completely normal.  Tomorrow, we go for a second fetal echocardiogram at 3:00.  As so often before with this appointments, I feel some anxiety and worry about what we will find out.  If her heart is still looking as good as strong as we think it is (and pray it is!) then we will be very encouraged that she will do a better job facing treatments and surgery after birth.  If we find that there is something wrong with her heart, we will have time to further involve the pediatric cardiologists prior to delivery and know that her case will be more severe and complicated than we are hoping.

We ask for your prayers today and tomorrow, specifically for Clara's heart.  Our hearts are already so full of love for her and we hope and pray that she can somehow sense that.   Pray that her heart is complete and that all the valves and chambers are working the way they should.  Pray that the sonographer and doctors will be able to get a good look at her heart to confirm this for us, even though it is deviated.  Pray that God continues to heal her and make her whole, in His perfect loving way.  Pray that we will have the peace and strength to hear whatever news we may get tomorrow and continue to glorify our God through it. 

I will praise the name of God with a song; I will magnify him with thanksgiving. This will please the Lord more than an ox or a bull with horns and hoofs.  When the humble see it they will be glad; you who seek God, let your hearts revive.  For the Lord hears the needy and does not despise his own people who are prisoners.  Psalm 69:30-33

2011

The past couple of years, instead of “making resolutions” per se, I have taken some time at the beginning of the year to reflect on what’s ahead and to “goal set” in specific areas of my life (Spiritual, Family, Health, Work, etc.).  For some reason, just calling them goals instead of resolutions seems to make them more likely to be achieved and not entirely dismissed by Valentine’s Day.  I write them down and I refer to them throughout the year to track progress.  I like it and it works for my very goal-driven personality.

This year feels different though.  I am so excited about 2011.  It’s sure to be a year that we will never, ever forget.  But I can already feel the shift of focus that everyone says happens with parenthood.  I feel less compelled to set goals for myself, and find myself instead just thinking, “I want Clara to be okay.”  There’s not much I can actively do to ensure that goal is met, other than continue praying for her and constantly giving her over to God.  But that’s all I want for 2011.*  I want Clara to be okay. 

For all of my adult life one of the greatest fears that I have grappled with has been: “what if I cannot have children?”  I’ve wanted to be a mother all my life.  I feel like it’s one of the few things in this world that I can say with certainty that I will do passionately and that I will be good at.  I feel like I’m hard wired to be a mother.  It is my heart’s greatest desire.  When we got pregnant quickly, I felt enormous relief.  My worry that wanting something too badly would mean I couldn’t have it wasn’t coming true.  My desires were going to be fulfilled.  Now, I’m facing that fear again, but with a twist.  “What if I become a mother, but lose my child?”  “How will I endure the pain of having something so good and perfect taken away from me?” 

I guess what I am trying to learn is that God has continually provided for me (for us) with much, much more than we deserve.  I believe fervently that God gives us the desires of our hearts (Psalm 37:4) and that all I need do is delight in Him.  So, I guess that’s my goal for 2011.  Delight in the Lord that He might provide for Clara.  And thus, provide for me. 

* I’m far too practical to not have given SOME thought to those “typical” New Year’s goals.  It’s a great relief, for one, to be pregnant and probably for the first time EVER to NOT have the goal of “lose weight.”  But I will say that Robert and I have talked some this week about other types of goals for our family – many relating to significantly trimming our budget (and subsequently our lifestyle) in order to save and pay for the medical bills we will soon face.  But even this is not for us, it’s for Clara.  And that’s a [refreshing] shift in thinking.