33 weeks

1st Big Milestone Achieved!!!  33 weeks is the gestation the NICU doctors gave me in as far as lung maturity.  So I'm incredibly happy to have reached this milestone, especially in lieu of all that has transpired in the last 3+ weeks.

So far so good today.  Its been a busy morning and I've been trying to catch up on a little sleep but keep getting interrupted.

Tomorrow is looking good for discharge and I've been set up with the Antepartum Home Care Program.   The home care will include a nurse who will come by my new 'home' 2 times a week to do the Non-Stress Test there rather than me having to make a trip to the hospital to do so.  I'm still expected to get here for ultrasound (so not sure how much travel time it saves) but I guess I could consider it less time sitting in a hospital bed.

This home care is intended to address the IUGR as I was earlier told that my Placenta Previa didn't qualify me for home care once I had a bleed.  I guess the growth restriction allows me re-assessment.

I finally had my blood drawn today though I'm not sure how relevant it is, whether it will make a difference or not, I'm assuming not but its more a monitoring type of thing.  I'm not even 100% sure of the purpose behind the blood draw and since I'm sort of coasting and on care and maintenance right now at the hospital, I'm not sure if I'll see a doctor today to ask the question (so I doubt I'll have much more to update as the day goes on).

I'm expecting another visit from Dwayne and Livy today (this will be 3 days in a row - so happy about that).   This morning I was on the phone and Livy actaully talked to me. Up till now she's only listened to when I spoke (or anyone spoke) but today she was either repeating me or said a very special "I love you Mommy" (so wonderful).

As mentioned I said I would share my next milestone today.  I'm sure its easy to guess. 

35 weeks is our next goal.  This is the gestation that is required for Payton to be eligible for ECMO (the heart/lung bypass machine).

Now that the possible use of this machine is looming in our near future I'll give a bit of background on why its so crucial.

ECMO - ExtraCorporeal Membrane Oxygenation

ECMO is an extracorporeal technique of providing both cardiac and respiratory support oxygen to patients whose heart and lungs are so severly diseased or damaged that they can no longer serve their function.

To be honest, we hope that the use of ECMO is NOT in Payton's future.  Essentially only the sickest CDH babies require ECMO.  But, if Payton is that sick, we do want to be in a position to utilize it if necessary.

When Payton is born the biggest concern will be her lung function and her ability to oxygenate her body.  Right now we know that Payton's lung size (Pulmonary Hypoplasia) is favourable.  What we don't know is how well those lung (s) are able to deliver oxygen to her body (Pulmonary Hypertension) and we'll only have an idea of her Pulminary Hypertension once she's born.

Payton is expected to be on a ventilator (normal or oscillating) in order to push her little lungs into delivering the adequate oxygen her body needs.  The vent works to push the oxygen into her lungs, essentially forcibly breathing for her.  Depending on how much pressure is needed to provide adequate oxygen to her lungs, the vent can cause damage to the delicate lung tissue, even more delicate in a new born baby.

If the baby simply isn't able to sustain the impact of the vent, often, the baby simply needs a break to rest and allow the lungs to recover (and perhaps grow just a little bit more).  Thus, ECMO is used to bypass the heart and lungs and instead oxygenate the blood outside the body and return the oxygenated blood to the vital organs.   Often times this may be up to two weeks allowing the lungs to recover and grow with hopefully enough time to work on their own.

There are risks with ECMO and long term side effects, thus, ideally relying on ECMO isn't ideal.  But, in some situations its a life saver.

Of those babies who require ECMO, only 10% survive (from one study I read).  Thus, for that 10% its a crucial survival tool.

Again, we hope that ECMO isn't in Payton's future, but we do hope that her future holds the option to rely on ECMO.  So 35 weeks it is.