I had two appointments at Duke on Friday. One was a regular OB check and ultrasound, and the second appointment was to meet with one of the doctors from General Surgery to discuss Gavin's stomach surgery.
The OB said that she would expect to see my amniotic fluid level increasing around now, due to Gavin's duodenal atresia and his inability to swallow. However, my fluid levels were completely normal, and Gavin's stomach wasn't as inflated as they expected it to be. This may mean that SOME things are passing through from his stomach to his intestines, and instead of a complete separation of the two, his pancreas may be wrapped around the area narrowing the passage way. The surgery to repair this is the same as if there was a complete separation, but if my fluid levels aren't elevated and his stomach isn't too inflated, it reduces the chances of preterm labor. So that's good news!
We are blessed to have another fantastic Duke surgeon on our side. The general surgeon that I met with had prepared a powerpoint presentation just for us and for the challenges that lie ahead for Gavin. He was extremely thorough and answered every single question I asked. I even gave him some new questions to throw into powerpoints for others. :) The team enviornment is strong and really helps calm your nerves in a stressful situation. The doctor told us repeatedly that everything he does and when he does it, will depend on what the cardiologist says and how Gavin's heart is looking. Once Gavin is born, they will take him back for an X-ray of his stomach and a fetal echocardiogram, and within 6-8 hours we should have a plan for when each surgery (stomach and heart) will take place, as well as a better understanding of Gavin's exact health situation.
Once the duodenal atresia is confirmed by X-ray, Gavin's stomach will be pumped and they will give him an IV for nutrition. After the surgery, he will continue to be fed by a tube for about a week or two. Then they will begin slowly introducing milk to him. While duodenal atresia is a relatively rare condition, the surgeon we met with has performed two of these surgeries within the past month and one was on a 2 lb baby! Gavin was measuring 3.5 lbs two weeks ago so he should be much bigger by the time he makes his entrance. The area the surgeons will be operating on is about the size of the tip of a ballpoint pin. They will surgically connect the stomach and the intestines, and that repair should hold the rest of his life even as his stomach and intestines grow larger. That is so amazing to me!
I am scheduled to be induced. The teams are ready to take my little man and get to work on saving his life. Most days are good for us right now. We are in the last stretch of waiting, and while Gavin stays inside he is growing stronger and has my body to give him everything he needs. There are times when I feel overwhelmed with fear and helplessness when I think of the fight and uncertainty he has ahead of him, but knowing that he is in such capable hands at Duke and that everyone seems to truly care about his well being is comforting. Chris has been gone for about a week now, and we still have no idea if he is going to be granted emergency leave to come home for Gavin's birth and surgeries. So for now, we would really appreciate prayers that Gavin continues to grow strong and waits to make his grand entrance until his due date, that Chris remains safe and out of harm's way, and that he will be able to come home and be with us during our upcoming hard times.