"To eat is a necessity, but to eat intelligently is an art." - La Rochefoucauld

Monday, July 24, 2006

23 Weeks 1 Day

We have good news and difficult news. Again, today is a day I don’t feel much like updating the blog but I know if my family and friends know what is going on they can pray extra hard for our boys.

Good News:

Jake is at the 50th percentile for growth, weighing in at 1 pound 5 ounces. His MVP was at 6.1. The best it has been so far. He is doing GREAT!

Ben is at the 17th percentile for growth, weighing in at 14.5 ounces. Doctors say normal range of growth is between the 10th and 90th percentile, so we are pleased with the 17th percentile. At our 17-week appointment Ben was at the 5th percentile, so this is a LOT better. His MVP was at 4.5, which was his best reading so far. Ben’s doppler reading was abnormal again which continues to be our biggest concern. He has intermittent absent end diastolic flow. Fortunately, it has not changed but obviously we would like to see a normal blood flow.

All in all, things are about where they were last week.

Difficult News:

Our doctor told us as we approach viability we need to prepare for all possible outcomes. This was not an easy conversation to have. If Ben stops growing or gets really sick in the next 4 weeks or so, we have to make a very difficult decision. He told us that every appointment we come to from now on we have to be prepared to make a decision. In our hearts we truly believe Ben is going to be just fine but I guess we need to be prepared for all scenarios.

Basically, we will deliver based on Ben’s progress. The problem is that if Ben begins to have problems at lets say week 24 and we need to deliver, this will also put Jake in jeopardy. Jake would then have to be delivered when Ben does despite how well he may be doing. Some people feel this is unfair to the bigger baby and the doctor suggested if it comes to this, we could do a cord ligation. This means we would clamp Ben’s cord, only allowing Jake to survive and continue to grow. This is very difficult for me to write about let alone actually consider. The doctor told us this is 100% our decision. Obviously, Kevin and I are hoping we never have to make this decision and that Ben will continue to grow. We have faith in God and know he ultimately decides the fate of our babies. I believe that every time Ben gives me a little kick he is telling me “Mom, I am ok!!!”

Below you will find survival statistics for various gestational ages. Each week that passes increases our chances of survival and quality of life.

General Survival Statistics:

23 weeks:
Babies born at 23 weeks have a 20% to 40% chance of survival, if they weigh over 1 pound 2 ounces (500 grams). If they weigh less than 1 pound 2 ounces, the chance of survival is closer to 10% or less.

24 weeks:
Babies born at 24 weeks have a 60% to 70% chance of survival, if they weigh more than 1 pound 10 ounces (750 grams). If they weigh less than 1 pound 10 ounces, then chance of survival is around 50% to 60%.

25 weeks:
Babies born at 25 weeks have a 70% to 80% chance of survival.

26 weeks:
Babies born at 26 weeks have a 80% to 90% chance of survival.

General estimations about the chances of long-term handicaps (as defined on the first page):

23 weeks: (less than 1 pound 2 ounces)There is very little information on these babies. It is safe to assume that almost all will have some degree of handicap. Probably about 50% of them will have mild to moderate handicaps and the other 50% will have severe handicaps. Rarely, is an infant born this early and this small, normal.

23 weeks: (over 1 pound 2 ounces)About 25% of these babies will be normal, 25% will have mild handicaps, and 25% will have moderate handicaps, and 25% will have severe handicaps.

24 weeks: About 25% will be normal, 30% will have mild handicaps, 25% will have moderate handicaps, and 20% will have severe handicaps.

25 weeks: About 30% to 40% of these babies will be normal and 30% to 40% will have only mild handicaps. About 10% to 20% will have moderate handicaps and 10% to 20% will have have severe handicaps.

26 weeks: About 70% to 80% of these babies will be normal, 5% to 10% will have mild handicaps, 5% to 10% will have moderate handicaps, and 5% to 10% will have severe handicaps.

The doctor said the outcome for our babies is very unpredictable. We see “unpredictable” as a good thing. Several doctors have told us “this will progress” and “it is an absolute that you have TTTS” and so far we have not followed suit. These days I tend to go with what I feel in my heart versus what the doctors tell me. My heart seems to be on target so far!

We appreciate every email, phone call, and prayer. I apologize if I have not kept up with returning calls/emails lately. Just know your kind words are always appreciated!!!!


jenny marie said...

That is an extremely difficult decision to make. I know because I had to make the exact same decision.

You will know in your hearts what to do when the time comes. Pray about it, and you will know.

At 23 weeks, my husband and I made a decision together that we would not do anything prior to 27 weeks. In my mind, that was the earliest I could justify delivering my "healthy" baby, too. How we made it from weeks 23 to 27 is beyond me, but we did and you will too.

I know I'm a complete stranger, but please email me if you would like. You can find me through the webpage address I listed. Go to "parenting - babies" and click on "Jenny Marie". I have a guestbook there.

jenny marie said...

I'm sorry - I didn't mean to imply that you need to wait as long as we did. Whatever gestation you decide to deliver is what will be best for you. I just meant from now until whenever you choose will be difficult, but you will make it with God's help.

Angela Babcock said...

Danielle and Kevin,
Just wanted you to know we pray for you and the boys every day. Hang in there!
Love, Angel and Paul

Kathy said...

You are such a caring, warm, smart person that I'm sure you will be able to make the best decisions for you and your boys. It is so hard, but you know your boys better than anyone else and you'll know what you need to do if difficult decisions need to be made. You have the strength of hundreds of prayers to help you along this stretch of your life. Keep the upbeat thoughts alive. I'm here if you need me,

Maria said...

Hi Friend! Hang in there. The good news is REALLY good! Keep your focus on this and when you and kevin have to make your decision, remember how strong your love is for each other and for your boys. Love can move mountains!

Crystal Kalinowski said...

Jeff, Ian and I pray for you guys everyday. I too hope that you never have to make that difficult decision. Ian is a wonderful testament that children are amazing creatures who overcome seemingly impossible obstacles. If I had a nickel for everytime the drs. told me Ian shouldn't be alive. But he showed them!! We love you!!!

Rhonda said...

I remember reading those gestational statistics myself and being scared senseless. Every day your pregnancy continues is another day closer to healthy babies. Your fluid levels and baby growth sounds great. Better than ours usually were. I hope that things will continue to progress smoothly and that you won't have to make any hard decisions for many many weeks.

Best wishes from the Finberg clan

Anonymous said...

Thanks for the update. I know you are struggling with all this information right now. It is overwhelming and unbearable to process. Do not lose faith! Someone has to fight for Jake and Ben. That someone is you and Kevin! Your recent update is good news. Look how much Ben grew. He is a little fighter! And let's not forget the little guy is almost a pound now. The best advice I can give all 4 of you is to pray, be positive and hang onto your faith. Even the slightest piece of good news from the doctor is huge in my eyes. With all the prayers and support you have from friends, family and especially new found friends ... I'd say you are in good hands. Hang in there! We are all behind you 100%! Trish :)

Shannon Cirella said...

Danielle and Kevin,

I am glad to hear of the positive news! We think of all four of you everyday. You and Kevin can do this together. Remember, God doesn't give you anything you can't handle. You and Kevin will make it thru this and you will welcome two wonderful boys into this world. Make sure they know that Aunt Shannon loves them and I said they have to wait four more weeks! Sorry about all the call, don't worry about calling me back until you want to. When I call I just want you to know I am thinking and praying for all of you. If you need to make a decision, God will give you the strength to do so. Remember, only you and Kevin can do what is best for those babies. I love you all and will see you soon.

Shannon Cirella

Anonymous said...

We are soooo happy to hear that both Ben and Jake are developing and growing on a day to day basis. In my heart, we expect that one day our babies will be playing together! No doubt!

Rushi & I admire your courage, perseverance...we are always here for ya.

Love ya,
Rushi, Amisha & Baby A

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