I never ever thought I would say "Go Duke!" However, I would like everyone to note that I intentionally wore an NC State polo shirt to show where my real allegiance lies.
Our visit went well and took a long time. We met with our Dr. at about 8:30 or so and didn't leave until 11:45. We really liked talking with him. He got a run down of Joy's medical history, current pregnancy symtoms, and concerns. Then he asked what we knew about the Momo twins. Joy deferred to me because of course she doesn't do her research :). I dumped out a lot of the concerns involved in this type of scenario. He then went over each one with a little more detail. He was then in and out of the office a couple of times. If he didn't have answers he ran out and got them! He even congratulated us on investing the time to weigh UNC and Duke as well as the research that we had done.
One example of going beyond was that Joy really wanted to see the stats on premies at the 24 weeks marker. He had mentioned some stats earlier, but Joy really wanted to see them. At first he thought we were talking about stats for momo twins. We clarified that we wanted to see, regardless of twins or singleton, what Dukes stats were. So he ran off and was back with his laptop and some slides with their stats on them. Wow huh? Most doctors would have just blown off the request or made notes. Not this guy. He seemed genuine in his concern to help us through this. He even answered questions about some hard topics to sensitive to cover in this blog. His background was even in handling multi-birth gestations and has seen about 8 momo twins already (he was a younger guy about our age).
Over all we were very pleased. We also met with one of the higher up Doctors. She was very blunt and to the point. We felt she dodged one of out question about "How many have made it to 32 weeks?". They never answered that. They simply marked that as their goal. This is a different target date than UNC had in mind. Joy and I are fine with that because the stats are pretty good at 32 weeks and Dukes NICU has some amazing stats. In fact, Joy and I had already discussed that if we were at UNC we would be really antsy about waiting for 34 weeks. At 30-32 we are far enough out of the woods with major hemorrhages etc that we would be more comfortable to have them born than to risk spontaneous death.
The stats for Duke NICU are crazy. Out of about a dozen or more university hospitals that were on the charts, duke had the best mortality rates. Roughly 50% of 23 week old live and about 70% of 24 week olds live. The other places are around 16% and one article I had just read on NPR about a hospital in the UK was at 9%!. Duke is at about 50%, this is crazy. However, just because they keep them alive, doesn't mean it isn't without cost.
The chance that the child will lead a normal life is very small. Around 10-20% for a 23 week if I remember right and about 20%-30% for a 24 week. The list of complications and life long problems is to great to list here. He made it very clear that just because they might "survive" it is not with out great physical impairments. However, these statistics are a testament to how great their doctors and methods are. In addition, our doctor is going to get us an appointment with a neonatalogist to discuss what they can do, what to expect etc. This will help in sorting out when to go in for the intensive monitoring.
We decided after speaking with them that we wanted to use Duke instead of UNC. Once we made that decision we had to move our 18 week ultra-sound from UNC to Duke. When we went up front we apparently opened a can of worms. Duke wanted to do a fairly detailed Ultra Sound to check for TTTS. We were asked if we could do that right then so we figured sure. Later the head doctor, Ultra Sound Tech. and student came out to the lobby to clarify that yes we want to go with Duke. Then they had us in the U/S room about 20 minutes later.
Man talk about quick. Plus, their equipment was incredible (sorry I'm a geek). They were getting very clear images, dopplers (which I had only read about) for watching blood flow in the cords, and even a few 3d snaps. It was a bit of a relief to see that they were using tools I had been reading about, but that the other places weren't using. This made me a little more comfy.
It now looks like our level of care is jumping a lot. We will go every other week from now on. We need a few more records moved to Duke before we are official with them. However, they will now take over everything. No more Wilkerson and UNC to bounce between. Duke will now do all of the OB visits and perinatal visits in one place. In addition, the first Dr. we spoke with was happy to make himself as available as possible to use him for our visits.
Our scan today checked out fine. We saw detailed shots of their hearts which was so cool. We don't have any measurements to share and like I said we forgot to get a CD with the 3D snaps. We have our 18 week anatomy scan on April 4th. This will take about 2 hours or so. Once 24 weeks rolls around we will either be admitted or go 2-3 times a week until either 26 or 28 weeks.
The in hospital monitoring at Duke is a little different. UNC Does a 24/7 monitor, while Duke does a 30 minute check up about 3-4 times a day. Duke believes there is no need to 24/7 based on their research and that it can increase the stress on the mother to be wired up all day and have issues with bathrooms and moving around.
ok....well I have lots to do....I'll see if I can get Joy to post something
GO PACK!!!!
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