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Wednesday, November 24, 2010

Kaylyn's Umbilical Granuloma and other Concerns

10 Days Old!
Today we returned to our pediatrician's office to have Kaylyn's weight checked again, to see that she was gaining weight normally. She weighed in at 8 pounds 5 ounces! Dr Tony was pleased (and impressed) at her weight gain since her last appointment just last week. No concern there! I asked him to take a look at her umbilical cord site as I was concerned with the amount of discharge I was finding on her clothing and I was worried it had become infected despite my efforts to keep it clean and treating it with rubbing alcohol to encourage drying it up.

Her cord stump had fallen off just yesterday but prior to that it was hanging by what looked like a dark red string. Now it looked more like a regular bellybutton with a pink fleshy ball inside of it. Dr Tony explained that Kaylyn had what is called umbilical granuloma. An umbilical granuloma is a small piece of bright red, moist flesh that remains in the umbilicus after cord separation when normal healing should have occurred. It is a small piece of scar tissue, usually on a stalk, that did not become normally covered with skin cells. It contains no nerves and has no feeling. It was normal for this granulation tissue to ooze fluid and have a slight yellow-green discharge,  but it is not accompanied by swelling, redness, warmth, tenderness, or a fever associated with infection. Basically the cord has dried and fallen off but there is still healing tissue in the new belly button.

To treat it, he used what looked like a long matchstick with silver nitrate on the tip. It cauterizes the area. He said this should resolve any discharge and I can continue to care for Kaylyn's new belly button just as I have been. Very rarely the cord will continue to ooze despite the apparent healing of the stump which is a condition called a patent urachus. The fluid that leaks is actually urine. The treatment is of course surgical closure of the connection. Another potential cause of persistent discharge from the umbilicus in young infants is a persistent yolk stalk (also known as omphalomesenteric duct, umbilical duct, or vitelline duct). It can leak intestinal contents because it is a direct connection from the small bowel to the umbilicus. Again, treatment is surgical. He highly doubts either of these conditions are anything to worry about now, but to keep an eye on Kaylyn's belly button just to be sure.

Dr Tony continued to do a normal newborn physical examination including checking Kaylyn's eyes, nose, ears, mouth, heart, and extremities. Part of checking the extremities included Dr Tony performing special maneuvers of the hip joint in which he was concerned that Kaylyn's left hip clicked during the procedure, indicating that her hip was out of position. I explained that I noticed before when I tried to put Kaylyn in footed pajamas that she always pulled her left leg up to the point it would get caught in the crouch area of the jammies instead of being inside the pant leg. He then ordered for a hip ultrasound to assess the hip joint. An x-ray does not show the bones in a young baby until at least 6 months of age, and therefore a hip ultrasound is preferred. The hip ultrasound will show the doctor the position and shape of the hip joint. Instead of the normal ball-in-socket joint, the ultrasound may show the ball outside of the socket, and a poorly formed (shallow) socket. If Kaylyn shows signs of some type of hip dysplasia then a special brace would need to be worn.

Another concern was that Dr Tony said he heard what appeared to be a faint trace of a heart murmur. He mentioned something about pin sized holes in the heart could be the cause. He went on more in detail but I was fixated on the words "heart murmur" and was already panicking a bit. He must have seen my alarm because he kept assuring me that it was probably nothing, and that these things correct themselves over time. To be sure, he also scheduled a echo cardiogram or "echo" of the heart. Due to Kaylyn's young age, he was able to get both appointments in for tomorrow.

My little ray of hope here is that Kaylyn was examined twice prior- once when she was a day old in the hospital and again just last week on the 17th and neither of those doctors found any issues. So I don't know if it was just them overlooking the problems, if the problems were not present then, or if Dr Tony is mistaken. I trust Dr Tony entirely. He was my brother's and my pediatrician growing up and Shaylee's pediatrician now, and I always found his prognosis more accurate than other doctors we have seen. So I am hoping that these issues, if present, really are nothing to worry about. But if there is an issue, you bet I am going to find out how they were overlooked by the other two doctors!

So tomorrow we have the appointments for the ultrasound and the echo. Its gonna be several hours of sitting at the hospital. Pray that all goes well!!

Monday, November 22, 2010

Video: Kaylyn 9 Days Old

Saturday, November 13, 2010

ANNOUNCING THE BIRTH OF KAYLYN MONROE LAUFER!

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Waiting....Waiting...Waiting

7:07 am 11/13
Its been 12 hours of contractions...still no baby yet. They are waiting for me to dialate more before I get the epidural...FINALLY got some sort of pain relief after two hours of waiting...it was really getting intense!

9:12 am 11/13
Still waiting...and waiting...and waiting.

9:34am 11/13
They served me a light breakfast of cereal with milk and a yogurt cup. In a few minutes they are gonna start my Pitocin drip and break my water! Hurray!

10:04am 11/13
Pitocin drip started....baby Kaylyn will be here soon!

1:41 pm 11/13
They finally broke my water and now its more laying here waiting...and waiting...and waiting..... epidural is going its job, but surprisingly I am not as dead-numb as I was with Shaylee. With Shaylee I could not feel ANYTHING or more anything. This time I am able to feel pressure and can just barely lift and move my legs. Hopefully this won't hurt that bad! I have been laying here twisting in pain for so many hours, I just want to be painfree again!

Contractions Have Begun! Off to the Hospital!

11:00 pm 11/12
So I finished the castor oil shake at 7pm last night....and the contractions have begun (I don't think the shake had anything to do with jump starting the contractions...Nils and I, uh, did something else that is said to induce labor...how baby got in there is how baby is gonna get out, LOL!)  The contractions are about 3 to 5 minutes apart, my water still has not broken, but we are contemplating whether we should go now, or wait it out a bit longer.

12:02 am 11/13
Called doctor to see whether or not we should go. The doctor said its a very very busy night so traige is going to be full (is it a full moon? Everyone is having their babies tonight!) but since the contractions are so close, and its my second baby (which are said to come quicker than the first) we should get down there. The worse they can tell me after examination is that I have time and send me home.

12:26 am 11/13
Off to the hospital. Have to drop Shaylee off at my parents' house first. Looks like Kaylyn might be born today!

Friday, November 12, 2010

38 WEEK CHECKUP

Weight: 192 lbs
Dilated: 3 cm
Enfacement: 70%
Station: -1

At today's doctor's appointment, they had to hook me up to a monitor since Kaylyn has not been moving around as much. After reviewing the results, they said she does look sluggish but nothing that appears to be of concern.

On the way home, we picked up a half gallon of Publix Mint Chocolate Chip ice cream (my favorite!) so that I could whip up on of my good ol' castor oil shakes tonight! I am planning on having my baby by tomorrow! It worked for Shaylee so I am hoping that it will work for me again!