Yesterday, the Bun was two months old. We had her check up, and she is doing fantastic. She has gone from 5 pounds 4 ounces at her first pediatrician visit at three days to 10 pounds 13 ounces at two months. She is round — almost chubby! For as much anxiety as she gave us in utereo, the Bun is spectacularly normal on this side of the womb.
When I am 20 weeks pregnant, we head to the hospital for the 20-week sonogram, a routine part of pregnancy. DearDR, if he decides to ditch the whole licensed psychologist thing, could be a sonogram tech, he’s that good at reading them. (It helps that with Monkey I had quite a few of sonograms; I’ll tell that story another time.) So as we’re looking at the miracle that is a baby on the sonogram, DearDR innocently inquires, “What is that bright spot around her chest?”
The sonogram tech, Nicole, hems and haws a bit. “Oh, I think that’s just part of the lung. Or maybe something is up with the equipment. It’s unusual to see such a bright spot there.”
This does not set off alarm bells. She plays it off very smoothly. Basically, on an ultrasound, bones and hard structures are supposed to be bright white; everything else is gray, with spaces (like a full bladder for instance) showing up black.
Aside from this spot, everything else appears normal on the sonogram: fingers and toes; a strongly beating heart with four chambers; bladder and kidneys; brain and face and head; umbilical cord, etc. Nicole finishes up and says she is going to send in the doctor.
Now, Dr. RT is the most awesome perinatologist I have ever met. He is the perfect complement to my midwives: he doesn’t condesend, he is patient, and he answers all the questions he can. We know Dr. RT pretty well because of the events of my other two pregnancies. Since this is not those stories, I will sum up by saying: we lost a son, Gabriel, at 37 weeks of an uneventful pregnancy, and we delivered Monkey a bit early because of low amniotic fluid.
Dr. RT comes in, greeting us with real warmth. He sits down and takes a look at my baby. Then he gets a little serious. He returns to the “bright spot” — not so much of a bright spot after all.
This, he explains, is a CCAM, a congenital cystic adenomatoid malformation. In layperson’s terms, it is cystic tissue where lung tissue is supposed to be. Instead of one of the lobes of her lung, my baby has this cyst.
He goes on to tell us that although at this point the CCAM poses no danger to the baby, that may change. If the cyst continues to grow, it could compromise the operation of other organs, most specifically the heart. If that happens, if the baby develops what they call hydrops — the term for fetal heart failure — drastic measures would need to be taken. For example, fetal surgery to remove the CCAM or (after 28 weeks) early delivery.
On the other hand, the cyst could resolve itself, i.e. disappear, and my pregnancy could procede normally.
To review: my baby could die, could need fetal surgery, or could be just fine. I am not crying yet.
DearDR and I start asking as many questions as we can think of in our shock. Why did this happen? They don’t know what causes CCAM. Is there anything we can do? Nothing will prevent the CCAM from growing if it’s going to grow or help it disappear if it’s going to disappear. What do we do next?
Next is a repeat sonogram in three weeks. And then another two weeks after that. And two weeks after that. And so on until… well, until what is going to happen, happens.
Dr. RT sits with us as long as we continue to have questions. He is sympathic, matter-of-fact and comforting. He says, with real sadness, “Nothing’s ever easy for you, is it?” Uh, no.
I don’t know how long we were with the doctor. He tells us to make the follow-up appointment. He tells us to call if we have other questions. He tells us to try — try — not to worry. In the meantime, he will find out as much as he can. CCAMs are rare, so he needs to learn more, too. He leaves, and I start to cry. I also call in sick to work.
Giving It Up
The hardest part of the CCAM (well, okay, the second hardest part) is having to tell everyone about it. And we do tell people about it. The main reason we tell everyone is so that they will pray. Pray for the Bun. Pray for DearDR and me. Just pray, or if you don’t roll that way, think good thoughts.
I roll that way; I believe in God and in the power of prayer. Although my initial reaction to news of The Spot, which is how I think of the CCAM, is fear and guilt, I turn immediately to God (I’m Catholic) and say, “Here you go. You take this, and I’ll trust you with it.”
I was having a lot of guilt because when I finally admitted to myself that I was probably pregnant, I was dismayed. I didn’t want to be pregnant. We weren’t ready to have another one, not emotionally or physically. I had just started a great job! DearDR was ready to start his studies for his license. We were planning to try for another baby the following year. Everything in me was crying, “Not now!”
And now, after 20 weeks and getting used to the thought of having another baby shortly after Monkey turned two, and starting to look forward to having her, we are in danger of losing her. And we can’t do anything except get sonograms and wait. And wait.
All I have is prayer and faith. I can’t do anything else. I could be angry; I could be anxious; I could say, “Why us? Do we deserve this?” But I don’t think it works like that.
They say that God doesn’t give you more than you can handle. I had to — still have to — believe that I could handle this, too. And that DearDR could, too. And so for His faith in me, I have to have faith in God.
The best came from my mother. She called after hearing the news from my dad. “The baby’s going to be fine,” she told me. “I talked to God, and she’s going to be fine. I’m just praying for you and DearDR. You need it.”
I was unaware of my mother’s direct line to God, but her comments do not surprise me. My faith is based on my parents’ faith. What I believe about faith is that it sustains you. My belief in God gives me the strength to face what I have to face, and to do what S/He wants me to do, and the patience to wait to know what that is.
The CCAM was nothing compared to the scare we had at 34 weeks when Dr. RT thought the placenta was breaking down. Bun had less-than-optimal bloodflow through the umbilical cord; her amniotic fluid was on the low side of normal; and there were signs on the ultrasound that the placenta was aging prematurely. I was to go on bed rest (modified, not total) and get non-stress tests and weekly sonograms.
Looking back, the CCAM may have saved Bun’s life. Without all the sonograms we were having, we may not have seen these danger signs. Incidentally, after growing a little bit, the CCAM remained stable for the rest of my pregnancy, not growing and not going away.
We “left” Bun in the oven (I’m sorry!) for another three weeks. We induced at 37 weeks, and after almost three days (!), Bun finally joined us in the world.
And now Bun is two months old. And healthy. And we love her, that way that you love your children. Whether or not you’ve been told you can lose them. That love, that indescribable language of the heart, that joy and hope and ache and faith; that hit-by-a-truck feeling. We wouldn’t trade for anything this love for our children.
In three days we are going to have a CT scan to see if the CCAM is still hanging around. A chest X-ray about three weeks ago was clear. The CT scan will be definitive, and depending on the result, could lead to surgery.
But we are praying not.