Week 33: 3rd Feb to 9th Feb 2012

Bean Gets Hiccups
You would have thought that with only a partial diaphragm it wouldn't be possible for Bean to get hiccups.  Not the case at all as we've found out: the rhythmic bouncing of Bean providing some amusement (good thing he didn't get them on Tuesday when they were trying to anethestise him.  As it is he has a tendency to strike out at foreign objects invariably these are sharp so clearly he has his father's intelligence and his mother's obstinacy)




It really is quite incredible

This is the (popped) balloon next to a 5p piece

What is quite difficult to bring across is the impressiveness of the tracheal procedure.  The wound size is smaller than a 5pence piece (one of the new ones!) through which everything is done.  This in itself is quite common, I know people who've had knee surgery and other operations using keyhole surgery.  But then to be able to navigate around a foetus where due to the field of view of the camera it can be very difficult to tell which bit of pink skin you are currently looking at.  Then to open the mouth, get past the tongue, to the back of the mouth (first working out which way "back" is) and down to the trachea.  Once there, to either feed a balloon down the tube, position it correctly, fill it with saline to the correct pressure and then seal it or alternatively feed a wire through to pop the balloon (pressure in the lungs stops it from going back down into the lung), then feed another wire to hook the balloon out.  Utterly incredible procedure, enthralling experience (also nerve-wracking).

We should get a copy of the footage that the film crew took in which case I might see if it can be posted.    


Yesterdays Panic is Todays Success.  Or something.
Yesterday (Monday) the Mother got a call from Kings College asking whether it would be possible for us to arrive several hours earlier than had been previously arranged.  Having already acquired train tickets, made arrangements with various people (including the midwife) this wasn't the best news to hear given both of us were at work in different parts of the country.  After some cafuffeling we negotiated a time that meant we didn't have to get new train tickets saving several hundred quid in the process but did mean that we would go "straight in".  The poor midwife did have to get an earlier train and was really rather tired having been assisting at a delivery the previous day and hadn't had a chance to get much in the way of sleep. The advantage in all of that was that they were waiting for us.  Impatiently.  Well, makes up for last time I suppose!

Bean being an obdeient foetus was - and has been for at least a week - the right way round for birth.  Less useful for extracting balloons from tracheas though.  So now he's back in the wrong place (breach) but with no balloon ( we could hear the collective sigh from medics in the South-West when it came out).

The removal of the balloon is the reverse of the placement.  Bean is drugged, then single-port-endoscopy to first pop the balloon and then hook it out.  We have it in a small pot.  It's a few mm in length (it contained just 0.8ml of saline solution).  The only real difference this time was that along with the crowd of onlookers, we had a Greek film crew.  No really.

The procedure itself went well, and everyone seems pleased.  The Mother is currently comatose on the sofa in London so it's unclear as to what her thoughts on the matter are.  

But did it work (the balloon)?  Well, apparently yes.  Prof seemed very pleased with the increase in size of lungs.  Whilst the LHR (Lung Head Ratio) is a random number generator, we have gone from a value significantly less than 1 ( between 0.2 and 0.5) to about 2.  It should be greater than 1.  Whether the lungs work we won't know until March, but at least there is some mechanism for breathing now!

The only other point was that a large quantity (about a litre) of amniotic fluid was drained.  Whilst we were warned that it would build up because of the balloon, previous measurements had only shown that it was getting larger proportionally to everything else.  Prof disagreed and drained.  This should reduce the risk of pre-term labour (although the procedure to take the balloon out increases it), however the danger to bean of birth at this point is much less now the balloon is out.

And now we wait.
First to see whether the procedure to remove the balloon causes any problems (pre-term labour, infection, etc.).  We'll know in the next couple of days.
And then simply to see when they (Bristol) want to induce Mother.  We have a scan at Bristol next week after which they should start to sort out the arrangements.