Baby Yost #3 is a BOY!!!
We had our 20 week Ultrasound scan on Dec 23rd, and received some tough news. I knew something wasn't right during the ultrasound, because the tech stopped talking about after 5 minutes into it. After a few measurements, she told us that we weren't going to be able to find out the gender today and that we would be having another ultrasound soon. Ben and the kids were in the room with us, so he took them to the car while I waited to see Dr. Kurtz. They don't sit too still in the office.
I kept trying to keep calm while waiting for the doctor to come in, but my heart was racing. When the nurse took me to check my weight, I saw the ultrasound tech and my doctor having a serious conversation. It was the longest 15 minute wait ever. Dr. Kurtz came in, and told me that we have a problem with our little one. She told me there is likely a bladder outlet obstruction which is causing a very enlarged bladder and kidneys that were pressing up onto the heart and lungs. In addition, they found that the amniotic fluid level was low. She told me I needed to see a perinatologist to see what they could do, if anything. She said the best case scenario is that they would go in and place a shunt into the baby's bladder to release the urine, but she was unsure. I asked her what the worst case scenario was, and she said that our baby might not make it. Hardest news I've ever heard.
That appt was on Tuesday morning, and they said the soonest I could get in to see a perinatogist was the following Monday in Grand Rapids and set an appointment for me. When we left, we headed down to Harrison... and I was quite emotional. I decided to call my doctor back and see if we could get in somewhere else sooner. They made some calls and made an appointment for the next morning (Christmas Eve) at 9 AM at U of M.
When we got to Ben's parent's house, we did a lot of praying. Jim and Amy and their friends who are elders in their church came over and we all prayed together. I started to find some peace feeling that God was in control of this. I later found out that over 500 people were praying, including 2 churches during their Christmas Eve Services. There is serious power in prayer.
I slept maybe 3-4 hours total that night, and we woke up early to head to Ann Arbor. The ultrasound tech took us back and did a full anatomy scan that was an hour long! She was able to explain things as she went, which was very nice. She showed me the kidneys, and the normal size of them. They were about twice the size they should have been. She told us that she was looking for cysts which are signs of kidney damage, and she couldn't see any which was good. The bladder was about 4-5 times normal size. She checked the amniotic fluid, and it was normal!! I was shocked at that, because we were told it was very low the day before. Power of prayer?! She also said she was pretty sure we were having a boy :) After she was done, Dr. Chames came in and did some scanning as well. He pointed out the same things the tech told us. In addition, he said one of his feet was mildly clubbed, which could be due to several things. He also said the placenta was thick, which also could be due to several things. Also, he was measuring a little bit small. After talking for a few minutes, he asked us.... "Is ending your pregnancy an option?" Most heartbreaking question I've ever heard in my life. Almost lost it. Ben immediately said, NO... and the doc said, alright, well that changes how we go about this. I had to take a few minutes and pull it together before I could speak again.
After the ultrasound, we headed into a room with a genetic counselor. She told us some things all of this could be caused by... and honestly, I wasn't sure what any of it really meant at the time. If these things are being caused by a genetic defect, it wouldn't change a thing we did. After about 5 minutes of listening to her, the doctor came in again. I went and grabbed my parents who were in the waiting room. He went over everything again, and he said he was pretty skeptical about our baby's chance at survival. I didn't know what to say.... didn't know what to ask. He said we could do the bladder shunt, but the main reason they do that is to increase the amniotic fluid around the baby which wasn't a problem. He said our case is unique, and he suggested we come back the following week and see if anything changes. So we set another appointment for the following Tuesday, Dec. 30.
On Tuesday, we headed down to Ann Arbor with Jim and Amy. Had the ultrasound, and it was much shorter this time. She checked the amniotic fluid levels, which were normal. Nothing changed with the kidneys or bladder. The heart was still functioning well. A different doctor came in this time, Dr. Treadwell, and she was fantastic. She did a little bit of scanning, and then we headed in to a room to talk.
She explained to us 4 different things that could be causing the enlarged bladder and kidneys. The most likely cause is posterior urethral valves which occur in boys and it is a developmental obstruction that forms... or a small extra fold of tissue. That's it... and it blocks the flow of urine near the end of the urethra. The second thing could be Prune Belly, and then there were 2 more options that I can't remember the names of. They had to do with the bowel and urinary tract developing improperly. She said it is very likely the posterior urethral valves. She thought that there is probably a pinhole-sized opening somewhere in the blockage that is allowing some urine to pass once the pressure builds up enough. That is why there is fluid around him. She said there may have been a period where there was very little fluid, which is dangerous for lung development... but we don't know when or if that happened. 17-23 weeks is critical to lung development, so if it happened during that time, then we may have lung issues to worry about. The club foot could have been caused during a time of low amniotic fluid when he might have been constricted space-wise. Could be something else too. The thicker placenta could be a sign of distress for the baby, but also could be something else too.
She said the kidneys did not have cysts, which is good... but they were reflecting back some brightness in a certain area which usually indicates some degree of kidney damage. We don't know how much. She said many kids function just fine with some damage, and there are things that can be done if there is more severe damage, like dilation or a transplant down the road. Also, kidney damage typically happens before 20 weeks, so it likely won't get much worse during the rest of the pregnancy. She said after birth, they would asses the degree of damage. They would also likely do surgery right away to remove the obstruction and possibly repair the bladder if needed. The club foot is a minor issue, and can be fixed with casting and/or bracing. She said weekly ultrasounds will be necessary to monitor the amniotic fluid and make sure the compression on the heart and lungs isn't too much. If fluid starts to form around the heart, that is a sign of heart failure... and then we would likely opt for the shunt to relieve that pressure. So far, the heart is doing well, so that isn't necessary right now. I asked about possibly early delivery to get the problems fixed sooner.... and she said that if there was any lung damage due to low fluid at any point, then the baby would not do well if born too early. So the goal will be to get as close to full-term as we can.
We decided to do ultrasounds every week, back and forth between Traverse City and Ann Arbor. The next one will be in TC, and they will be checking the same things. Definitely helps with not having to make the 4 hour each way drive every week. I felt so much better after this appointment than the last. I know nothing changed, but I felt that we were really explained our options and I had a lot more hope.
There are still a lot of question marks... like, was there any lung damage? How severe is the kidney damage? What about the bladder? Could there be something genetic causing all of this that might be more serious than all of the other things? We just don't know. Sure, we could go in and do amnio testing, but there are always risks with that. Water could break, I could go in to early labor, risk of infection.... and it really wouldn't change anything. I have been reading so many medical websites about this, and I feel that I have a really good understanding about the condition and possibilities. I've read stories about kids who have had this and have been ok, and others who have not. Because we never saw a point with no amniotic fluid, my hopes are very high. My biggest concern is pressure on the heart at the moment... and what labor/delivery is going to be like. We will most likely be delivering in Ann Arbor (possibly Grand Rapids). Like I said, there are still many unknowns. We will continue the weekly ultrasounds and most importantly, PRAYER!
I know God's got this. He is the ultimate healer and he is in complete control. There's nothing I can do to change anything, and I have to often remind myself of that. God loves this little boy even more than I do, and he has a plan for him. Trust in the LORD with all your heart and lean not on your own understanding. Prov. 3:5. We are fully relying on the Lord!
18 Weeks
20 Weeks
