AFI Update and 4 Weekaversary

First things first: I had an ultrasound today to check on my AFI and cord Doppler.  The cord Doppler was fine but the AFI was down to 4.6, after being at 8.6 just three days ago.  Sigh.  These fluctuations have been happening the whole time I’ve been here, so nobody is really surprised.  The doctors say that as long as the LW continues to look good on the monitor, then we stick with the same plan.  Everything else is pretty much the same.  Extra-abdominal bowel distension, full bladder, stomach out.  The doctors still say that none of these things are red flags that would cause us to deliver the LW early.  

I should explain how they measure the AFI.  Basically they visually inspect each quadrant of the uterus (left top, left bottom, right top, right bottom) for pockets of fluid, which look like dark spots on the ultrasound.  They can’t use any pockets that have cord in them.  They measure the lengths of the biggest suitable pockets they can find and the computer spits out the AFI.  So it depends on what pockets the technician can find that day, which can be influenced by the baby’s position and how much she’s been moving around and stirring up the fluid.  It can also be tough to find big pockets with gastroschisis pregnancies because there is other stuff in there getting in the way.  So obviously there are a lot of variables and it’s not an exact science, which could partially explain why my AFI fluctuates so much.  

Today also marks 4 weeks that I’ve been here in the hospital.  The good news is that if I make it to 38 weeks, I’m more than half way there!  But I won’t lie.  As time goes on, this whole thing gets harder and harder.  I have good days and bad days, and I’ve figured out that ultrasound days are almost always bad days.  It’s just so hard to see my tiny baby on the screen with her organs all rearranged, and her bowels getting more and more distended, and know that there’s nothing I can do.  Even though I know I’m seeing things that everyone expects to see at this point, it’s impossible to keep doubt and fear from creeping into my mind.  As the ultrasound images pile up and D-Day gets closer, I get more and more nervous about what we’ll encounter when she’s born.  How damaged will the intestines be?  Will there be additional complications and/or surgeries?  There is no way to answer these questions right now.  All I can do is surrender to God and trust the advice of our doctors.  

I saw the hospital’s senior perinatologist today after my ultrasound, and he told me that when the day comes for us to take the LW home, and all she’ll have as a memento is a little scar on her belly, I’ll laugh when I think of all the worrying I did.  He reminded me that these babies almost always do just fine.  You just deal with things one day at a time as they arise.  My ob/gyn stopped by after that and reminded me that the LW has already shown us how strong she is during her monitoring.  All the signs show that she is going to be one tough cookie who will beat whatever is placed in front of her.  So many of my nurses have said the same thing.  So why do I still worry when the people who know what they're doing are so positive?  I guess I'm just a mom, and I’m allowed to have bad days and cry it out when I need to.  But when that’s over, it’s my job to make sure this little girl knows without a doubt that her dad and I love her and believe in her strength.