You know, medical records are fascinating. I've been reading (and re-reading) my last growth u/s report for the last twelve hours and am just enthralled with it. I want to point out the following:
(measurements were taken 7/30 @ 34w5d):
BPD (biparietal diameter - the measurement between both sides of the head. Don't worry, I had to look this one up, too. BPD in my world means Borderline Personality Disorder): 38w5d (>95%)
Head Circumference: 39w2d (>95%)
Abdom. Circumference: 39w3d (>95%)
Estimated fetal weight: 3363 grams (or 7lbs, 9oz) (>90%)
Impressions:
Fetus is measuring 37w 6d by this u/s (EDC = 8/14/2009 - today! [EDC = estimated date of confinement (such a weird term, I know).])
Ultrasound:
The biometry indicated the AC and head measurements were in the 95% percentile
Estimated fetal weight was > 90th percentrile
The biometry indicated possible macrosomia (ob term used to describe a newborn with excessive birth weight)
All measurements were >90% percentile for gestational age
So, just in case you don't speak ob/gyn (thank you, Google, for your help), let me explain: the head and abdomen circumference were measuring over 5 weeks ahead at the time of the u/s. The doctor noted that based on all of the measurements, an estimated date for confinement (or DUE DATE) would be August 14th, 2009. *(gulp). He recorded no less than 9 times that the baby was measuring in the 90th or 95th percentile and even used the term 'macrosomia.'
Obviously, I'm not going to type out the whole report, but the information I am choosing to omit is stuff about the placenta (yawn), amniotic fluid (boring) and the fibroid (nothing exciting). Oh, and in case you are curious, my blood pressure that day was 118/82. I am not omitting any important details, just the fluff.
Okay, so to summarize: this is a big baby. I'm sorry to beat a dead horse, but what the heck was George reading (or not reading???) Where is he getting "82% percentile"? I'm trying desperately to let this whole subject go, but I will say, it bugs the heck out of me that George wants to dispute these findings. (And for those of you who don't know me in real life - I know there are lurkers out there since I'm averaging 100+ hits a day on this site - imagine a Jack Russell terrier attacking your favorite sweater. That little jaw chomping down and not letting go, even when you swing the dog in the air and pull with your might - yup, that's me when I'm mad. I'm nothing if not stubborn, especially when it comes to facts. Your sweater doesn't stand a chance.)
The only theory I can come up with is that George did not receive the report (and that's me being gracious and the bigger person and giving him the benefit of the doubt). Maybe he didn't get the report, and was reading the report from July 1st, when the baby was much smaller and there was less known. But even still, you would think he would stop and ask, "Hey Kim, I notice the date on this report is July 1st. When was your last u/s?" instead of forging ahead and essentially placating us and insinuating we were making a mountain out of a molehill.
I guess the thing that bugs me so much is I would never treat a patient like this - and I never have. I'm quick to accept responsibility when I screw up in practice (and trust me, it happened often enough) and would never belittle or talk over a patient. I know that overall, the baby's weight really doesn't matter ALL that much - he's big, I think we can all agree on that - but it just irritates me. I'm a ruminator, I know, and it's a character flaw, but gosh...c'mon people. This pregnancy stuff is a big deal and when mistakes like this are made, it makes me lose faith and trust in my providers. I'm already fairly unstable - I don't need any additional nudges towards the ledge.
In other news highlighting my instability, I did a BPP on Emma yesterday. A BPP (biophysical profile) is just a quick u/s of the baby that I have done 2x/week - they check for fetal tone, movement, breathing, and then measure amniotic fluid. It takes about 5 minutes and is totally non-invasive. Like Apgar scores, you can score as high as 8 on a BPP test (2 points for each area).
Emma is an especially deep sleeper and as we all know, she kind of an old cat (shh...don't tell her that). I have this constant fear that one day I'm going to come home and she will have..er, expired. So I'm usually pretty quick to check on her, make sure she's still breathing, and poke her if I can't tell. (and for what it's worth, I'm not the only one who does this. We've had many cat sitters report mild heart attacks when she is unresponsive for the first few minutes). Evenw hen I couldn't go up and down the stairs in the early days of bed rest, I would send Brian upstairs to check on her when he got home from work. I seriously considered using our baby monitoring on her to track her breathing until I realized that was probably kind of weird.
Well, yesterday, I went upstairs to check on Emma while she was sleeping in her green bed, and my first thought was, "Hmm...breathing, two points. Movement, two points. Tone? Who knows? I'll give her two points for that." (obviously, her scale is adjusted to a maximum of 6 points since there is no amniotic fluid). She scored a nice 6/6, which made me happy.
Anyways, Brian and I made some fairly substantial decisions last night. (and no, committing me was not one of them). We both decided to let this child bake as long as possible. Because of his size, we both feel most comfortable with a schedule c-section and would like to do it on or around September 3rd. I've done a quick Wikapedia search, and nothing significant seems to have happened on this day (a good thing, in my opinion). I mean, it's Flag Day in Australia, but I'm willing to share. So, baring any complications, today is T minus 20 days.
(measurements were taken 7/30 @ 34w5d):
BPD (biparietal diameter - the measurement between both sides of the head. Don't worry, I had to look this one up, too. BPD in my world means Borderline Personality Disorder): 38w5d (>95%)
Head Circumference: 39w2d (>95%)
Abdom. Circumference: 39w3d (>95%)
Estimated fetal weight: 3363 grams (or 7lbs, 9oz) (>90%)
Impressions:
Fetus is measuring 37w 6d by this u/s (EDC = 8/14/2009 - today! [EDC = estimated date of confinement (such a weird term, I know).])
Ultrasound:
The biometry indicated the AC and head measurements were in the 95% percentile
Estimated fetal weight was > 90th percentrile
The biometry indicated possible macrosomia (ob term used to describe a newborn with excessive birth weight)
All measurements were >90% percentile for gestational age
So, just in case you don't speak ob/gyn (thank you, Google, for your help), let me explain: the head and abdomen circumference were measuring over 5 weeks ahead at the time of the u/s. The doctor noted that based on all of the measurements, an estimated date for confinement (or DUE DATE) would be August 14th, 2009. *(gulp). He recorded no less than 9 times that the baby was measuring in the 90th or 95th percentile and even used the term 'macrosomia.'
Obviously, I'm not going to type out the whole report, but the information I am choosing to omit is stuff about the placenta (yawn), amniotic fluid (boring) and the fibroid (nothing exciting). Oh, and in case you are curious, my blood pressure that day was 118/82. I am not omitting any important details, just the fluff.
Okay, so to summarize: this is a big baby. I'm sorry to beat a dead horse, but what the heck was George reading (or not reading???) Where is he getting "82% percentile"? I'm trying desperately to let this whole subject go, but I will say, it bugs the heck out of me that George wants to dispute these findings. (And for those of you who don't know me in real life - I know there are lurkers out there since I'm averaging 100+ hits a day on this site - imagine a Jack Russell terrier attacking your favorite sweater. That little jaw chomping down and not letting go, even when you swing the dog in the air and pull with your might - yup, that's me when I'm mad. I'm nothing if not stubborn, especially when it comes to facts. Your sweater doesn't stand a chance.)
The only theory I can come up with is that George did not receive the report (and that's me being gracious and the bigger person and giving him the benefit of the doubt). Maybe he didn't get the report, and was reading the report from July 1st, when the baby was much smaller and there was less known. But even still, you would think he would stop and ask, "Hey Kim, I notice the date on this report is July 1st. When was your last u/s?" instead of forging ahead and essentially placating us and insinuating we were making a mountain out of a molehill.
I guess the thing that bugs me so much is I would never treat a patient like this - and I never have. I'm quick to accept responsibility when I screw up in practice (and trust me, it happened often enough) and would never belittle or talk over a patient. I know that overall, the baby's weight really doesn't matter ALL that much - he's big, I think we can all agree on that - but it just irritates me. I'm a ruminator, I know, and it's a character flaw, but gosh...c'mon people. This pregnancy stuff is a big deal and when mistakes like this are made, it makes me lose faith and trust in my providers. I'm already fairly unstable - I don't need any additional nudges towards the ledge.
In other news highlighting my instability, I did a BPP on Emma yesterday. A BPP (biophysical profile) is just a quick u/s of the baby that I have done 2x/week - they check for fetal tone, movement, breathing, and then measure amniotic fluid. It takes about 5 minutes and is totally non-invasive. Like Apgar scores, you can score as high as 8 on a BPP test (2 points for each area).
Emma is an especially deep sleeper and as we all know, she kind of an old cat (shh...don't tell her that). I have this constant fear that one day I'm going to come home and she will have..er, expired. So I'm usually pretty quick to check on her, make sure she's still breathing, and poke her if I can't tell. (and for what it's worth, I'm not the only one who does this. We've had many cat sitters report mild heart attacks when she is unresponsive for the first few minutes). Evenw hen I couldn't go up and down the stairs in the early days of bed rest, I would send Brian upstairs to check on her when he got home from work. I seriously considered using our baby monitoring on her to track her breathing until I realized that was probably kind of weird.
Well, yesterday, I went upstairs to check on Emma while she was sleeping in her green bed, and my first thought was, "Hmm...breathing, two points. Movement, two points. Tone? Who knows? I'll give her two points for that." (obviously, her scale is adjusted to a maximum of 6 points since there is no amniotic fluid). She scored a nice 6/6, which made me happy.
Anyways, Brian and I made some fairly substantial decisions last night. (and no, committing me was not one of them). We both decided to let this child bake as long as possible. Because of his size, we both feel most comfortable with a schedule c-section and would like to do it on or around September 3rd. I've done a quick Wikapedia search, and nothing significant seems to have happened on this day (a good thing, in my opinion). I mean, it's Flag Day in Australia, but I'm willing to share. So, baring any complications, today is T minus 20 days.
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