Answers (Part 2)

First off, I want to say a very heartfelt thank you for all the prayers regarding yesterday's appointment. They of course were answered. The perinatologist answered ALL of our questions; most before we even got the chance to ask them. The answers were not all exactly want we wanted however.

She immediately started the appointment by saying, "this is why your daughter died." While this may sound strange we desperately wanted and needed that information to go forward so a gigantic weight was lifted immediately. I feel so sad for some many who will not get an answer.

The following information was not as easy to hear. Basically, three things can happen to babies of diabetic mothers with high blood sugars. One they can pee off that blood sugar to adapt and cause what is called polyhydramnios (high amniotic fluid). This is dangerous and can cause preterm labor if it gets out of control. I had it very badly with Henry and some with Amelie. A lot of people have questioned why we have had two healthy pregnancies and then this. The fact is I have yet to have a healthy pregnancy.

The second is an increase in blood sugar will cause a fluid accumulation in the belly causing ascites and a fatty liver. This is when we see a super large belly on a diabetic baby. Big babies run in this family, so how do you know if that is caused by the diabetes?  Basically, a big baby that is just big cuz well mommy has big babies is big everywhere (head, legs, stomach). A diabetic big baby will often have an averaged sized head and a very large belly. In other words, the proportions are off in a baby with maternal diabetes.

The third thing that can happen is that fluid can form around the heart and continue to put pressure on the heart until the heart enlarges and goes into failure, very similar to what happens to congestive heart failure patients. This is what Claudette had. The body will compensate by putting massive fluid in all two or more compartments (hydrops fetalis), hence her ascites (fluid in the belly) and pleural effusions (fluid in the lungs). This process probably happened within minutes to hours. That is why even though I had an ultrasound with a day or so of her death no one detected it. The heart  however was getting enlarged most likely around 30-36 weeks of gestation and could have been detected by a perinatologist but not usually in a biophysical profile (BPP) like I was having done.  Here is the really hard part: if interventions were immediately performed when seen, the baby would most likely have lived since the cardiomegaly would have resolved quickly after delivery. This is hard information. Claudette's death could have been prevented.

At this point I was very upset. Basically, my daughter's enlarged heart was caused by my diabetes and not only that my uncontrolled diabetes. So I asked how with this information can we possibly in good conscience conceived another child. I did not expect her answer, "you absolutely can but many things have to happen first." First, I have to see if I can get my blood sugars in control. While I realize this seems like an easy task to many, it has caused me 22 years of struggles. I have a horrible time with control, but Dustin and I are committed fully to giving it our best shot. (And NO it is not as simple as eating less carbs.)  In a way I see this as a real blessing because there is nothing that will drive a woman into a healthy lifestyle more than the goal of having a child. Frankly, I needed this push whether or not we have more children. So Dustin and I are very committed to making this happen.

We also have to change our level of screening in the next pregnancy. I will not only have twice a week BPP but I also would have CSTs twice a week wherein they would stimulate contractions to make sure the placenta is staying healthy. In other words, I would be watched VERY closely more than I already have been.

The last thing that would have to happen is the hardest: I would have to be okay with loosing another child. No of course, no one is "okay" with loosing a child, but not go into the loony bin okay. This one is a hard one not just for me but for all of my family and friends who have suffered this loss with me. In some ways I think it would actually be the least hard on me because my heart can't be broken again in the way it already was been. The chances of loosing a baby like this again will be very little because of the interventions, but having another miscarriage or the like is a real possibility. So
as Dustin and I continue on this long journey to improved health (mentally and physically), please pray that we may glorify God in this process and seek His wisdom and not our selfish desires.

Oh and HAPPY TWO MONTHS today Claudette Elyse. They say babies smile "for real" at two months old so I hope you are smiling for real at how mommy is handling life without you.