decisions - 8/19/13 - 24w4d

Sorry, we did not get any pictures this week as we had our scan done by a new technician and she was focused more on doing her job than printing out pics, which is a good thing. The scan was very short as she didn't take any measurements this time because the doctor asked for them every two weeks and we had them done last week. After she was finished, Dr. Shields came in to do his own assessment. It was silent for a long time, as usual, while he looked at all the babies. He finally broke the silence by talking about David and then Samuel and just how well they are doing. Then he laid into Joshua. He first looked at the heart and found it to be taking up an abnormally large portion of his chest. We were told that this was more likely an indication of Joshua's small size and that his heart is probably the right size. He also took a look down at where the kidneys are supposed to be and saw two masses that are clearly over sized for Joshua's body. The doc said that if these are indeed kidneys and are malfunctioning in some way, then this explains the lack of fluid for Joshua. He then gave us two possibilities for Joshua at birth. The first is that the placenta has been delivering nutrients this whole time but Joshua's body is just not equipped to process them. The second would be that the nutrients are not being delivered at all and therefore Joshua does not have the chance to grow. These are significant because in the first instance Joshua would still not be able to grow after birth but in the latter he would just need to eat a lot after birth so that his abdomen could have the chance to catch up with the rest of his body.

The appointment then turned even more depressing when we were asked to think about what we would want to do with Joshua after he was born. The doc was trying to be very political about how he said this but what he was getting at was do we want to hold him until he dies or would we like to send him off to the NICU. This was not something that Rob and I have talked about before, we just assumed that they would need to take him right away. We do want to give him his best chance and do the right thing for this little guy but what is the right thing??? There are so many other things to consider as well like the fact that we would want to donate his organs and that would probably mean that he would need to be put on life support to keep his heart pumping so, we don't even know how long he could be with us anyway.

Both of us went to the dark place of playing the "what if" game after this appointment. I try to reassure myself by saying that we won't have to make these decisions until these little guys are out but I might be more concerned with the looming possibility of having to make all of these decisions on the fly. Then I think about things like how we want Nick, our eldest son, to have the chance to meet little Joshua and how we have two more little miracles to think about and do right by. I then find myself trying to find some worldly comfort by saying that I already know I can do twins and maybe this is why we had Matty and Zane for a time. While they were not the same age we got the call for Zane right after Matty went through surgery and was having trouble eating and sleeping. I also know just how long it took our whole family to grieve that loss but in this case there are two other babies who need ALL of us and deserve to feel loved. So what I keep coming back to is that I am asking questions only God can answer and if he can just be merciful and give us the strength to trust in that, our family will make it through.