scared

Wednesday, August 12, 2009
i dont really know why im doing this.

Two Vessel Umbilical Cord/Single Umbilical Artery
A single umbilical artery, two vessel cord, is a fairly common finding in Obstetrics. In fact, it is present in about 0.5-1% of fetuses. It is also more common in twin fetuses. Normally, the fetus has one vein bringing the baby blood from the placenta in the cord. Two arteries leave the fetus and return blood to the placenta. Sometimes, however, only one artery develops. More frequently, the artery may develop but clots off early in pregnancy.

A two vessel cord is present in 0.5- 1% of pregnancies. Though most pregnancies are uncomplicated, several issues can be of concern in a pregnancy affected by a two vessel cord. A two vessel cord appears more commonly in fetuses with other malformations, especially of the heart and kidneys. In fact, there have been studies stating the incidence of major birth defects in fetuses with a two vessel cord is abut 20%. Therefore, a detailed "Level II" ultrasound in an experienced center is mandatory when a two vessel cord is suspected. Specifically there is data that fetuses with a two vessel cord are more likely to have chromosome abnormalities. If there are associated abnormal findings, consideration of an amniocentesis should be undertaken. If this is an isolated finding, and a mother is otherwise low risk for chromosome abnormalities, then an amniocentesis may be avoided. In addition to chromosome disorders, defects in the urogenital, cardiovascular, and nervous system of the baby have been reported.


Growth restriction of the fetus has also been reported with a greater frequency in fetuses with two vessel cords. Finally, initial studies did show an increase risk of perinatal mortality, or fetal death, however the impact of other anomalies in this data was unclear. These two complications, however, are difficult to study secondary to the impact of the other anomalies seen with a two vessel cord. In addition, this is a more common finding in twins, and again they are also at risk for growth restriction and stillbirth. To be safe, consider fetal monitoring in the last 4-6 weeks of pregnancy as well as growth scans through the third trimester.

If a two vessel cord is diagnosed, the first step is a detailed Level II genetic ultrasound to examine for other anomalies. Particular attention should be paid to the fetal heart and kidneys, since these are common areas for associated malformations. The fetal growth profile should be followed. Close third trimester surveillance for stillbirth should also be undertaken as above. The vast majority of cases, however, progress without incident resulting in a successful pregnancy outcome.


so, we are the "vast minority" although nothing about this guarantees that kathlyn's death is related to the cord, though it sure sounds like it from this. we had the level 2 genetic ultrasound at an experienced center. her heart and kidneys were normal, as were all her organs. there were no chromosomal abnormalities seen. growth was in the small normal, and was monitored in the third trimester like this says. we also had that "close third trimester surveillance" with Non Stress Tests (baby heart monitor) every week for EIGHT weeks (4-6 are suggested here), having the last one just 2 days before she was lost. 2 days or less, actually.. she may have died the same night of that test.

the author of this and my doctors dont have an answer and dont understand. i dont either.


no new notes
August 14 at 10:53pm
ive had a few comments and messages that i havent written in a few days. optimism.. "i hope that means you are keeping busy." no. im sorry but it doesnt mean that.. i am caught in this place where i dont want anyone to worry about me, but at the same time i dont want you to think im ok, because im not. i still need so much help and prayer because i am deeply depressed. i spent 21 hours of august 13 in bed, mostly asleep. sleep is all i want to do. i dont have to think when im asleep. i dont have to be awake and alive without kathlyn. it doesnt feel right to do anything without her. john made me go for a midnight walk after i was in bed for so long. i cried the whole time. i dont want to walk without her. i dont want her things to go to waste. we still owe money to the hospital for july 2nd and july 16, from when i was short of breath and they wanted to check on her, and for the attempted version. why couldnt your heart have slowed those days, scaring the doctors enough, so you could be delivered? i am so scared that my body failed her and i wish we had delivered her early. would she have survived as a premie.. or was she going to die as a full term newborn anyway? it all just feels wrong.. paying the hospital when there's no baby. walking without a stroller. such beautiful, unworn baby clothing. infant tylenol that will expire before it's possible to have another baby in this house. i was ready with everything.. everything. and so i sleep.



Sunday August 16, 8:33pm

i am scared..

i was scared to go out to eat with the rock group the other night, but i did it. i was scared i would cry in the middle of the mexican restaurant in front of everyone. scared i wouldnt want to eat. scared that i would see an infant or a pregnant woman. i did cry, but quietly, so quietly i dont know if john even noticed. i ate. i saw infants. we got ice cream afterwards, and then all walked in the park together. my heart felt lighter for the moment. i can fake it for a little while. "fake it until you make it", said my brother's wife on the phone, since she couldnt make it to the funeral. get up, go out, take in my wonderful support.. i can do it. but my heart is still broken.

in record time, i am 15 pounds under pre-pregnancy weight. grief is the world's unhealthiest yet most effective diet. i gained 21 pounds during this pregnancy, said my daughter's "Report of Fetal Death".. under the same section where it said i didnt smoke or drink, and that the cause of death was unknown. "Now living, 0. Now deceased, 1." i imagined, in a time where multiple births are so common, what it would be like for a mother if some of your babies had lived and some had died. or if all of them died. "Now living... 0".. is that including the parents?

there is no birth certificate and therefore no death certificate. to the government, our daughter never existed. our tax form shows a deduction for a child for this year, as we expected to have one, that we will have to change. it will be wrong, and we will owe on our taxes again this year. i dont really care that much in comparision.. these things more tug on john.. it's just another cruel joke.

i have lots of support, but i havent checked any of the support groups out there yet. there are also individuals who have lost term infants who have been offered to me personally, who i havent contacted yet. i know they are there. i try not to have any expectations for them. it's just another thing to be scared of. the parents' groups and organizations are there too, waiting for me. some are free, some arent. most are offered in the evenings, when john and i normally work. i cant think about going to any of them without him yet. it's also overwhelming because there are so many groups out there and i dont know which is right. from what i read so far, i think it will be most helpful to talk to other parents who've had a similar loss of a full term baby, because each grieving person is so different even when the situations are similar.. it's even more overwhelming to try to relate to a loss that is drastically different. i have found a few blogs online of women who write about their babies who have died.. some as stillbirths.. some after birth.. some expected and some unexpected.. many of them know the cause of death whether it was congential or a cord accident. i am both addicted to these blogs and extremely frightened of them. i have read them for hours and hours at a time and then needed a few days break from them. i dont know if its harder or easier to know that so many people have gone through this. harder because i wouldnt wish this on anyone, but easier because we're not alone. some of them have other children, some are pregnant again, some are still struggling to get pregnant and some dont ever want to try again. some are angry, some have faith, some do memorials, some have found the ability to smile again and can write freely about it.

i am scared. im scared to leave the house, but once i do it, im scared to go home. im scared to go to bed, scared to get up. im scared to eat, because it makes my stomach sick, but im scared not to eat because it makes me even weaker. im scared to cry so loud, but scared to hold it in. im scared to say what i want to scream all the time - that "my baby died for no reason", because im scared that's what the autopy will show.. absolutely nothing. i want to see my doctors again, but scared to make the appointment, because then it will be over. thats the same reason im scared to contact the women to support me.. i like knowing that the option is there and i dont want to exhaust it. im scared to share her pictures, but i want everyone to see how beautiful she is. im scared to be pregnant again.. to be exposed to all those diseases at work again, scared to lie flat on my back, scared to do kick counts, scared to eat hot dogs, caffeine, deli meat, scared to take medications, to drink tea, scared to call the doctors every day. im scared that i wont get pregnant easily. scared that i'll get pregnant too fast. scared my uterus wont be healed yet. but im scared not to be pregnant again already... i want it so bad. but im scared to do anything without my little girl. anything. everything. scared to walk without her. scared to have another baby without her. scared to let her sister wear her things.. scared to give them away because they are too pink for her brother.

im so scared. i think about my baby girl every second. i think about her diapers, clean and unused. the baby bathtub that's still in the box. i wonder if her belly button would have fallen off yet, or if she would have smiled. i wonder what her cry sounds like. i wonder if the pediatrician notices that we never followed up after the prenatal visit. i want to open the back door of johns truck every time i get out, and carry her carseat in. i want to show her off at church. i want people to fawn over how cute she is. i want to touch her. i want to love on her and coo at her. im not suppossed to have all this time to sleep and nap. i havent done laundry in 2 and a half weeks. im supposed to have 2 and a half loads or more per day. i want john to hold her and be sweet to her and kiss her and feel more love than he's ever felt. i want my baby here. i have never known "want" like this before. i dont think anyone knows "want" until they want for their child to be alive again. every second.. every second. and if im distracted for a second, it only means i think about her twice in the next one.

please God, rewind time for me. i want to relive tuesday, july 28, at 4:30 PM. i will fall to my knees at dr. campbell and insist that something is terribly wrong. please deliver her now.. so i can hold her alive and she can be mine.

or please God, fast forward time for me. fast forward to a time where i feel at peace.. at peace while pregnant, or at peace with a baby, or at peace with a house full of healthy and rowdy preteens and teenagers. or at peace in heaven with You and with my katie.. holding her and kissing her or watching john hold her and kiss her.

i miss you.. i love you.. my heart is broken.. i am scared.. every second.