Pippa, Rowan, and a little bit of other stuff...

Yup, it's true, she turned one on May 25. Crazy. Some of the pics (the bigger ones) don't get any bigger when clicking on them (they're from my 'rent's ofoto account) (so click on the smaller ones if you want to see full size versions). You can see more of them here.



Her birthday party was a HUGE bash on Saturday with about 35 people (at least 12 of those were kids 5 and under) and we had a blast. Thank goodness my parents were here to help get ready and clean up!

Labels: pippa

We had our follow-up sonogram yesterday, and the news was pretty good. The cyst is still there, but it hasn't grown in proportion to her head, and the amniotic fluid level is fine. They caught pictures of her swallowing so it isn't impeding that function yet, there is still no vascular activity, and it's "floppy" (apparently, this is a good thing). The rest of her is looking normal. So the current plan is to monitor her every two weeks for the rest of the pregnancy -- the first appointment of each month will be a quickie sonogram to do a visual check on the size of the growth and measure amniotic fluid levels, with a follow-up appointment with one of my doctors to check on the pregnancy in general; the second appointment of each month would be a more in-depth sonogram to measure the growth of the cyst, swallowing, fluid levels, etc. I'm glad they're monitoring it so closely even though it's more of a pain to get in for that many appointments.

Pippa seems to be adding other words to her vocabulary. Today "bird" ("buh") made an appearance, and yesterday she started saying "up" which she says backwards "pu". We'll see if they stick around.

Labels: pippa, rowan

Pippa has a lot of words she uses now. Most of them consist of dog. For instance, at the zoo today, we saw bears (dog), wolves (dog), goats (dog), sheep (dog), and a great big cow (dog dog). She also says Mama, Papa, Dada, more (w/ the sign language sign), no, Pippa, hi, bye, and book. "Dog" is still definitely the most popular, followed by "hi" which is said to us, the dogs, strangers, trees, etc.

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Now that we know Finale is a girl, and with all that's been happening, we felt like doing something proactive. We'd been tossing around names for a while, and we just kept coming back to Rowan (which had been on our 'name list' when we were picking Pippa's names). We both really liked it, then started looking into the meaning and some of the lore surrounding the Rowan Tree and it just seemed to fit. Here are just a few of the things that seemed to make it work:

• The rowan is the tree most often cited as the "tree of life"-- the image engraved on our wedding rings
• Rowans are traditionally seen as magically protective-- something this little kid could use right about now
• The rowan tree in 'Celtic Astrology' is the symbol for early to mid-October, when she'll be making her appearance in the world
• In Greek mythology, the rowan was guarded by a dragon-- James used to collect dragons as a kid and has a dragon tattoo on his shoulder
• And silliest of all-- there's an online quiz "What Tree Are You", and James scored as a rowan tree and I tied between a rowan and an ash. Take the quiz and see what you are :)
  

So anyway with all that and, of course, the fact that we like it, we've decided one of her names will be Rowan-- Still not sure if it will be her first or middle name, and definitely not sure what other name we might pair with it, but that's what we're calling her now.

Here is a 3d ultrasound image of Rowan from last Monday's scan:

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So we just got off the phone with our Doctor-- They had their case review with the entire practice this morning, and the general consensus is that this is a 'ranula' which is a cyst formed by an obstructed salivary gland under the tongue. There is an interesting synopsis of this condition here.

Overall, this is a pretty positive diagnosis, as these aren't typically associated with any other kind of birth defects or syndromes, and the treatment can be very successful. They also reiterated that the facial development (nose, lip, palate, jaw, etc.) was all just fine.

Because this is a 'differential diagnosis' (medical speak for a best guess when weighing all the options) things could change radically. However, if this indeed proves to be the correct diagnosis, we will need to monitor the size of the cyst as all the treatment options will hinge on how it behaves. Treatment could include regularly draining off amniotic fluid if the cyst grows large enough to interfere with swallowing, surgeries at birth (intubation to allow breathing if it interferes w/ that, and surgery to remove the cyst immediately or within a couple days after birth), and if it gets really bad then in-utero surgery to try and reduce the size of the cyst. Of course, as we get more info other treatment options might be considered.

In any event, this was about the most positive diagnosis we could have at this point, and now we just have to monitor things to see how the situation will unfold.

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So we had our 18 week detailed anatomy scan and Finale is a girl! Great news when it comes to reusing clothes, toys, etc...

The examination did turn up something somewhat concerning: there is a fluid-filled cyst inside Finale's mouth under the tongue, large enough to push her tongue to the roof of her mouth. What this means or indicates though, the doctors really don't know at this point. This type of growth seems to be very rare (no one in the practice has had any experience with it), and there is no good way right now to know what the longterm prognosis will be. If the cyst continues to grow it could interfere with the baby's ability to swallow the amniotic fluid, and thus regulate her fluids, which might require prenatal procedures such as drawing off some amniotic fluid, or possibly an operation in utero (though this is doubtful). If it interferes with swallowing, it could also possibly interfere with breathing, and might require immediate surgery when she's born, with possible follow-up surgeries. There is also a chance that it will stay the same size and just need a relatively minor procedure post birth. Obviously we're hoping for the latter option. We'll be meeting with the pediatric surgical team soon to discuss the birth and subsequent scenarios. This does mean Emily will almost definitely be having a planned C-section because if the mass interferes with breathing they want Finale out quickly so they can immediately perform surgery.

In any event, our doctors' practice has a case review this Friday and they'll be focusing on Finale's case and will pool information, expertise, and opinions. We will be having a follow-up ultrasound in two weeks and again in a month to see how this progresses, and hopefully we'll know a lot more then.

To end on a truly positive note, Finale's tracking right on target for size and development; hands feet, heart, brain, spine, etc are all just fine. Even more important, the lip, nose and palate are all well formed, and the rest of the mouth area seems to be developing fine, too. We'll post pictures from the sonogram soon.

Labels: rowan

Labels: pippa