2012

The first cut is the deepest

Baggie

I have been regaling the world with tales of my enclave of the Bagnall family for nigh on four years.  Many of these updates are planned; some are written out of necessity and are difficult because there were no major stories to base them around but there have also been a number of them that have been thrust upon me.  This is one of those.

Most of these updates have photos to illustrate the stories behind them.  A few have no photos.  This is one of those.

So what has happened to necessitate an emergency update prior to Éowyn’s birthday?

Our story begins in the early hours of Wednesday morning.  Lucinda had gone to bed feeling a little discomfort in her abdomen which we had put down to pregnancy grumbles, but at 0100 she woke me up saying that the pain was a little stronger and it felt like she needed to go to the loo.  We put it down to a virus that is going round and although she had a disturbed night thought it was nothing more.  I went to work the next day but kept in touch with her through the day to find out how she was feeling.  She didn’t seem to be getting better and she couldn’t get an appointment at our local doctor’s surgery so I left work early so that she could go to the walk-in clinic at our local hospital (Ashford) – it no longer has an Accident and Emergency department like many hospitals around the country, it used to but now it just has this walk-in clinic.

She was at the clinic for around 90 minutes before she was seen and they worried her: her symptoms seemed to indicate appendicitis and that she needed to go to the ‘local’ Accident and Emergency department at St Peter’s Hospital in Chertsey (the hospital where both of our children were born).  This is where living in the same village as your parents and brother comes in handy.  With Éowyn and Amélie in safe hands we headed around the M25 (in rush hour) to St Peter’s.

We reported in to reception and were quickly seen by the triage nurse.  Bloods were then taken and a cannula inserted in her hand and we were led to a bay to await a visit from the on duty doctor.  Appendicitis in pregnancy is not uncommon, and in fact appendectomies are the most common need for surgery in pregnant women, however appendicitis in pregnancy can be notoriously difficult to diagnose as, due the growing foetus, the appendix will have been pushed up and back from its usual position.  In addition not all of the usual symptoms (especially a fever) will be present.

The doctor we saw was excellent, she had a great bedside manner and quickly concluded that Lucinda did indeed have appendicitis and that she needed to be seen by the surgical team as soon as possible.  As you are probably aware appendicitis is the clinical term for inflammation of the appendix which, if left untreated, leads to appendiceal rupture (a burst or perforated appendix) which can lead to peritonitis, septicaemia and even death.  Obviously being pregnant complicates this somewhat.  A conservative estimate for the mortality rate of a healthy adult with a perforated appendix receiving treatment is about 0.5%, for a pregnant woman it is 8 times higher with 1 in 25 of patients dying and the prognosis for the unborn baby is worse with 1.5% dying in women with appendicitis and over 1 in 3 dying should the appendix burst.  Thankfully we were unaware of those odds at the time.

It is with those odds in mind that medical teams will err on the side of caution and always opt for the appendectomy.  It is far better to remove a healthy appendix than run the risks of the above, especially since the risks of the procedure are far lower than hoping that it can be tamed with antibiotics (which is only in the case of a ‘grumbling’ appendix).  Hence the removal rate of healthy appendices in pregnant women is higher than that in the population at large.

We were taken from the Accident and Emergency area to the Surgical Assessment Unit to await for the surgeons.  Unfortunately we had just missed the surgeon’s rounds and they were not expecting him to come back for several hours.  After waiting for several hours Lucinda and I decided that it was probably best for me to head home at relieve Lucinda’s dad of childcare duties and allow him to get some sleep.  Lucinda had her phone and strict instructions to call me when the surgeon came.  At 0200 the surgeon assessed Lucinda and basically told her to get ready for theatre.  She called me and was obviously very scared especially as there seemed to be a debate between the surgical team and the obstetrician team over who was in charge and what pain relief and medication she was allowed.  As many of you know when you are pregnant the only pain relief you can be given is paracetamol, nothing stronger and any medication given needs to be proven not to cause any issues to the unborn baby.  Not necessarily what you want to hear when you are pregnant, in pain and scared.

Needless to say I didn’t sleep very well and I am sure that the girls knew that something was up and they had a disturbed night too.  I got out of bed early and phoned the Surgical Assessment Unit.  They told me that Lucinda was now under Midwifery care and so to call the Joan Booker ward.  It took three attempts to get through to the Joan Booker ward to be told that they had no record of Lucinda and were just about to hang up on me when I became a little more assertive and before I really did get angry with their dismissive attitude they suggested that perhaps she might be on the Labour Ward.  I called the Labour Ward (thank Tim Berners-Lee for the internet!) and got through to a very helpful Midwife.  She went to check on Lucinda while I was on the phone and said that both Lucinda and our unborn son were in good health even if Lucinda was a little groggy.

Plan A then went into action.  Amélie was dropped off at Nanny and Granddad’s after which I took Éowyn to pre-school before taking supplies to the hospital.  Lucinda was a little groggy and in some discomfort but in good health and not in the pain that she was in the night before.  Obviously the Labour Ward has a high demand for immediate bed space and so we were temporarily moved into a delivery room to allow more immediate needs to take Lucinda’s space on the ward before she was to be moved to the Joan Booker ward.  In a quirk of fate the delivery room that we were moved to was the same delivery room that Amélie was born.

Before we were moved to the Joan Booker Ward the surgeon came to see Lucinda.  He seemed very pleased with her progress and was quite happy to discharge her from his care into that of the midwifery team.  He did confirm however that her appendix was extremely inflamed and close to rupture and because of its inflamed nature and the fact that in pregnant women the appendix will have moved he was unable to perform keyhole surgery and hence why she now has a 2 inch (5cm) scar.  Again in a quirk of fate she received her first operation scar thirty years to the day that I received mine (although mine is slightly more impressive: a 10 inch sternotomy scar from open heart surgery).

Before moving down to the Joan Booker ward we requested to listen to the bubba’s heart beat.  We knew that the midwife team were happy that all was OK in there, but we wanted physical reassurance of our own.  We were both relieved when a really strong heartbeat resonated through the room.

Lucinda got stronger throughout Thursday but was starting to feel the two nights of lost sleep, so I left her in the late afternoon and headed for Nanny and Granddad’s for a home-cooked meal and to see my little girls.  Again both the girls seemed to pick up on the fact that something was amiss and it took quite a while to settle Amélie before I could actually sit down and relax and eventually try and get some sleep of my own.

Friday morning started as Thursday: drop Amélie off at Nanny and Granddad’s, Éowyn at pre-school and then to St Peter’s.  Lucinda looked much better but was still feeling sore.  As anyone that has been in hospital would know it is not possible to get a good night’s sleep, especially when you are being woken every four hours to have your blood pressure and temperature taken and so it was for Lucinda.  It wasn’t long before we were given the news that we wanted, Lucinda had been discharged from the surgical team and the midwife team were happy to do the same and so it would not be too long before she could go home.  She also let us listen the bubba’s heartbeat once again and it was loud and proud.  By all accounts if a pregnant woman is to have appendicitis the best time to have it is in the second trimester.  In the first the foetus may not survive and in the third it can bring on contractions (indeed, one of the drugs Lucinda was given was an anti-contraction drug so that the surgery did not bring on labour).  Therefore Lucinda chose well to suffer appendicitis in her 17th week.

Just after lunch the duty midwife came with Lucinda’s notes and medication – Paracetamol for pain relief and Enoxaparin, a anticoagulant to thin the blood to prevent thrombosis.  The paracetamol was in the usual tablet form but the Enoxaparin is in a pre-filled disposable syringe and Lucinda has to give herself an subcutaneous injection once a day for the next five days, a small price to pay.

I have to praise the staff at St Peter’s and especially the midwifery team, they looked after Lucinda extremely well and the head midwife especially took an active role in Lucinda’s care.

So you will forgive the lack of photos and our elusiveness over the last couple of days but I think that the above is fair excuse and I thank my lucky stars that I still have my wife and unborn son even if Lucinda is making me honour the wedding vow ‘In sickness and in health‘.

Peace and Love

Baggie

Amélie’s Second Birthday

Baggie

So a couple of weeks after we announced to the world that we are expecting our third child, our second child celebrated her second birthday.  Yes can you believe that Amélie is 2 years old.  This time in 2010 we were on the way to St. Peter’s hospital and thankfully the road conditions were not the same as they were this year as there were road closures and heavy traffic around the area and I can’t imagine trying to battle your way through heavy traffic with a wife in the latter stages of labour!

As a modern father I have (so far) managed to be off work on all of my children’s birthdays and Amélie’s second one was no exception, in fact I managed to organise myself the entire weekend off.  Amélie’s birthday was last Friday and on Fridays Éowyn goes to pre-school and this Friday was no exception.  However before we took Éowyn to pre-school she helped Amélie to open her birthday presents.  Amélie obvious wasn’t entirely sure why she had presents but didn’t care too much as her big sister opened a Peppa Pig treehouse and nothing else then mattered.  We did manage to wrestle it from her grasp so that we could take Éowyn to school before heading out for the day’s adventure.

With the impending third baguette due in March we have come to realise that Lucinda’s Nissan Micra is not going to cope with three car seats.  In fact, most cars have difficulty fitting three car seats in, hence the proliferation of MPVs on the market.  Unfortunately most MPVs simply replace the boot (trunk for my American readers) with two seats.  This obviously is handy and does allow extra car seat space, unfortunately it usually means that there is no boot (or trunk) space, which when you have pushchairs and the general accoutrements that goes with children is a real disadvantage.  Not all MPVs are made equal though and the balance is to find one large enough to accommodate the three car seats and the progeniture paraphernalia without feeling that you are driving a van (especially when you have been used to driving a Micra) and, possibly more importantly, without breaking the bank.

The model that seems to tick the majority of the boxes is the Ford S-Max (not only does it have seven seats and boot space but it is wide enough to get three car seats across the middle row meaning that as a family of five we could keep the back two seats down turning it into a very large estate car). So it was with this in mind that we took a trip to Car Giant in Shepherd’s Bush to look at their current crop. Unfortunately none of the ones that they had in seemed to be right and when you are spending that kind of money it needs to be right.  There was one that had caught our eye when we looked at their internet site but unfortunately in real life this particular individual did not inspire love and affection from either of us so we decided that we would walk away and keep looking there are plenty more S-Maxes in the sea.

Returning back home, we picked Éowyn up from pre-school and then Amélie completed her birthday day at home playing with her new toys with her big sister.  It is probably the first time that Amélie has things that Éowyn really wanted and I think that Amélie realised this and suddenly became very possessive of her presents.  Time for a lesson in sharing, for both of our children.

A relaxed Friday afternoon melted into an equally relaxed Saturday morning.  However there was a big family outing planned for the evening.  Hollycombe Working Steam museum, near Liphook in Hampshire is, as the name suggests, a working steam museum with an Edwardian steam-driven fairground alongside the obligatory steam train and traction engines.  It is open all summer long and although it closes for the winter in September and October it opens for evening admission which, with the autumnal dark nights, adds a magical element to the fairground.  It is somewhere that Lucinda’s family try and visit each year but unfortunately we have not been able to make it for the last three years for one reason or another, in fact the last time we visited Éowyn was a baby.

We arrived at Hollycombe about an hour or so before it opened and Lucinda’s dad fired up the camping stove and cooked us all sausage and bacon sandwiches.  We provided desert with Amélie’s birthday cake (a cake that she was unable to eat because it contained milk – so she had her own chocolate brownies that Lucinda made especially for her) before buying our tickets and heading into the museum.  As we entered the museum we noticed that the steam train was running.  This was the first time it had been running on an evening that the family had visited and therefore it was too good an opportunity to miss, so we paid our £2 and climbed onboard.  This really whetted the girls’ appetites for the fair and so after disembarking we headed to the full size carousel.  Again both girls thoroughly enjoyed it and Amélie didn’t want to get off.  Fortunately there were plenty of children’s rides for them, a junior roundabout, juvenile dobbies, austin cars and the children’s chair-o-planes and they enjoyed all four.  We were unsure how they would react to the chair-o-planes but we need not of feared, they loved it!  In fact it was a bit of a struggle to get them off each ride and more than once they were the only children on the ride and made the operator send them round twice.  I would thoroughly recommend a night trip to Hollycombe for kids, young and old and imagine what it must have been like for your great-grandparents visiting one of these at the turn of the 20th Century.

We ended the weekend in style at the Village Centre in Englefield Green at a joint 4th birthday party for Éowyn and the other children from our N.C.T. group.  It was just coincidence that is was 2 days after Amélie’s birthday, it was planned to be somewhere in the middle of the span of the N.C.T.’s group’s birthdays.  The Village Centre was a great venue for the party and was just the right size for the group that we had invited, it felt cozy without feeling too crowded and had plenty of room for games.  Sharing a children’s party certainly takes the pressure (and the expense) off one family.  We all had responsibilities for different aspects of the catering and we all organised one mass participant game each.  As a consequence of sharing these responsibilities it meant that the stress was reduced (or at least shared across six sets of parents) and thus as a parent you could actually enjoy your child’s party.  There were tears (it wouldn’t be a children’s party without them) but on the whole the children were very well behaved and we keep them entertained long enough to prevent any serious altercations.  It was good to meet up with our N.C.T. group even though it was difficult to sit down and chat for any length of time,as a parent that is something that is now second nature.

Now work beckons and my mini break is over, the wide world of sport stops for no man, but before I leave you just an update on Éowyn’s quasi corporeal companions (imaginary friends to you and I).  Dizzy, it seems, it a naughty boy but no bad deed goes unpunished.  The other day Éowyn calmly informed us that Dizzy was in hospital.  He had tiptoed out of the house and got squished by a car.  Do not fear he is alright but it seems that his place in Éowyn’s affections has been relegated slightly and now there is a new brother called Connor.  Connor it seems looks like an old man in a paper hat.  When I suggested that Connor was an old man I was rebuked, ‘No Daddy, he just looks like an old man.‘  So now you know.  He also will only wake up if you speak to him in Russian.  Éowyn’s quasi corporeal companions are not limited to people, Russian or otherwise, she currently has a cat called Stephanie and a dog called Giggly.  Either she has a fantastic imagination or she can see things that are hidden to us cynical adults.

Peace and Love

Baggie

 

What’s going on ‘ere then?
Birthday girl
Cheeky!
Hollycombe
All aboard the Steam Train
Love you Mommy
Wheeee!
Lucinda and her Daddy
Racing Car number nine
Zoom around the track
I am enjoying this, honest!
Shine on Harvest Moon
Can I help?
It’s working!
No one is watching
Be there in 5!
Birthday cake
And blow
Is that you Jack?
Look what I have got
Some bubbles for you
I win!
Young artists!
Smile for daddy
I’m just staying by the food
Chocolate Goatee
Fantastic party, hic!

And then there were three

Baggie

Not the 1978 album by Genesis but the news that Lucinda and I have been keeping to ourselves over the wettest summer in a century:

Lucinda is Pregnant

Yes, we are expecting our third child on 10th March 2013, just over a week before my 40th birthday.  I will therefore keep this update short and to the point and leave a detailed update of our general news for another day.  You will notice that Baguette no.3 already has its own page under Amélie’s in the sidebar, they are already part of the family and to prove that they are part of the family its first photos are below (two photos but only one baby).

Peace and love

Baggie, Lucinda, Éowyn and Amélie

Baguette Number Three
Baguette Number Three

 

OK, this was meant to be a short write up and some of you that all ready knew about the above may wonder why there has been a little delay in posting this good news.  We were due to post this at the beginning of last week when we had told parents, siblings and our respective colleagues and managers, however just before all those people had been told we received the phone call that everyone dreads to receive: that our results indicate a higher the normal risk that our little one could suffer from Down’s Syndrome.

When you go for your 12 week scan (in the UK) there are three tests that are conducted to check for chromosomal abnormalities, most commonly Down’s Syndrome.  They are the fetal nuchal translucency test (which checks for the fluid beneath the fetal skin in the region of the neck) and this is done during the ultrasound scan.  The other two tests are biochemical tests of the mother’s blood and are to measure two ‘pregnancy’ hormones: free beta-hCG (human chorionic gonadotropin hormone) and PAPP-A (Pregnancy Associated Plasma Protein-A).

In a baby with Down’s syndrome the fetal nuchal translucency will be larger than normal (i.e. >2.9mm), the free beta-hCG levels will be higher than normal while the PAPP-A will be lower than normal.  These results are then added to the mother’s age and they give you a probability of chromosomal abnormalities.  These tests are indicative but not definitive however are there to help to give you an informed choice.  Any mother with a risk of less that 1 in 150 is contacted by the medical team to offer further invasive testing.  We were given a 1 in 70 chance.

Obviously this was a bit of a kick in the guts but both were of an opinion that we needed to know and so opted for a more invasive test.  There were two tests offered to us: Chorionic Villus Sampling (CVS) and Amniocentesis.  Both have a similar miscarriage risk and both are in the region of 99.9% accurate.  CVS involves taking a sample of the placenta while amniocentesis involves taking a sample of the amniotic fluid.  The main difference between the two (for us) was that the CVS test could be done within the week and we could get the results 4-5 days later.  The Amniocentesis can only be done between 16-20 weeks gestation (i.e in 3 weeks time) and there is a 1-2 week waiting time.

We travelled to St George’s Hospital in Tooting (South West London) for the procedure, which involves a detailed ultrasound scan followed by the procedure itself.  The procedure involves using the ultrasound scanner to guide a long slender needle through the abdomen into the placenta.  It probably looks worst that it was and in fact Lucinda said that the procedure wasn’t painful but uncomfortable.  However, afterwards she felt a little woozy and had to lie down and compose herself before we made the journey back.  The detailed ultrasound didn’t show any obvious problems but the placenta sample was the important test.  

Each human cell nucleus (not quite each but this isn’t a biology lesson) usually contains 23 pairs of chromosomes, which are thread-like structures that contain the DNA molecules.  The common chromosomal abnormalities are that are tested for are caused by extra copies of chromosomes.  Our sample would be tested for Patau Syndrome (trisomy 13, i.e. 3 copies of chromosome 13); Edwards Syndrome (trisomy 18) as well as the more common Down’s Syndrome (trisomy 21). 

While we were at St George’s we were asked (and we consented) if they could also take a sample of Lucinda’s blood to compare with the placenta sample as part of a research project that is hoping to be able to detect fetal cells in the blood samples taken from the mother.  If these tests can be developed then there would be no need for such invasive procedures that put the baby at risk for they will be able to test the fetus’ cells rather than relying on hormonal levels in the mother’s bloodstream.

As you can imagine the wait for the results was horrendous, even when you were trying to block it out it would come back with vengeance, it was always there lurking in the background.  We were told that if there was a chromosomal abnormality we would be told more quickly that if there were no issues as the abnormality would show up quickly in the first set of tests.  If these first tests were clear then they would conduct a second and then third round of tests just to be certain.  So we hoped that we would not hear for the full 4 to 5 days (by our reckoning late Thursday or Friday).

So imagine how we felt when St George’s called before that Thursday afternoon deadline (a deadline that only really existed in our heads); I think we both went as white as sheets and our hearts pounded when the rang to give us the results.  Then imagine how relieved and happy we were when then said that they were pleased to inform us that the placental tests showed no chromosomal abnormalities, our little bubba was going to be fine and we should continue the remainder of the pregnancy as any normal third pregnancy.

One pleasant side effect of chromosomal testing is that they can determine the sex of the child.  We were given the option of finding out and we decided that we would like to know and therefore share we you dear readers.  Our third child will be a boy.  Both of us feel that with two daughters and now a son this will make our family complete.

Peace and Love

Baggie