Cautiously Optimistic

We had another scan of baby Thor this morning and met with another doctor at the Evanston Hospital Maternal-Fetal Medicine department. No one is giving us any indication that we can start celebrating, but to us the numbers look a little better.

During our twice weekly ultrasounds, they're looking at several indicators:

1. the size of the mass
2. the functionality and formation of the heart
   
3. any fluid accumulation where it's not supposed to be
4. the blood flow through the ductus venosus, a vein that leads into the heart

Here's a little bit on info, as I understand it, about each indicator:

1. We're looking at the size of the mass compared to the size of the baby and hoping that the baby is growing faster than the mass, thus shrinking in relative size and allowing the lungs to develop a little bit more healthy tissue. The measurement is called the CVR. If it is over 1.6, there is a good possibility that the baby will need fetal intervention, most likely in the form of surgery. The first measurement put us at 1.5, Monday's was 1.34, and today's was between 1.25 and 1.3. To us, that sounds GOOD! To the doctors, that's within a margin of error and we still need to keep a close eye on it.
   
2. Thor's heart is pushed a little to the left of where it should be, but we're glad it's on the correct side of his chest at least. So far the mass isn't big enough that it's squishing his heart, but that is an important reason to watch the growth of the mass. Squishing the heart could lead to big problems, like hydrops.
   
3. The reason they're watching for any fluid accumulation is because that's the first sign of hydrops. Hydrops just means fetal heart failure. The docs told us NOT to google hydrops. He said you'll see some pretty horrible looking babies and that even if things start to turn in that direction, they would not allow our baby to get that far and turn out that way. Signs of developing hydrops would be a definite indicator that we should strongly consider fetal intervention. So far there is no fluid accumulation.
   
4. The ductus venosus is the vein leading from the umbilical cord into the heart. They're looking for signs that blood is moving fast enough, forceful enough, and in the right direction through that vein. Dr. Ouyang told us on Monday that blood is still moving in the right direction, but that the heart has to work a little harder to make that happen. Dr. Silver said this morning that he was going to compare his findings with Dr. Ouyang's and call us later today. So it might be a little bit of a concern, but nothing to panic about yet.
   

Dr. Silver was mostly comforting today, telling us that there are still lots of ways that this could turn out very much in our favor. He said that they've seen CCAMs (that's what the mass is called) do lots of amazing, even miraculous things, including disappear completely. While ours is probably not going to do that because it's pretty big, the more we see and talk with the docs, the better we're feeling about Thor's chances of good health.

We found out this morning that insurance will cover a consultation in Cincinnati, but the 7 doctors in the practice here are advising that we try to schedule a virtual consultation instead so that we don't have to travel there. If Cincinnati won't do that, then we'll travel on Tuesday.

Our next scan is scheduled for Monday. We're also planning on meeting with the neonatologist then, so he will be able to answer some of our longer-term questions and worries then.

We'll keep you updated!