Monday, September 23, 2013

Delhi Belly

Many of us have heard of, if not experienced first hand, the infamous gastrointestinal distress cleverly called "Delhi Belly."  This post is nothing about that! 

Instead, I am happy to share with you this surprise update we received today and some pictures of our lovely surrogate, Meera, featuring her baby bump, a.k.a. our precious Delhi belly.

Greetings from SCI Healthcare..!!

We hope this e-mail finds you well.

We would like to inform you that Meera came to the clinic this morning for her regular check up.

As per our recent discussion with our obstetrician she is doing well.

We would also like to inform you that we have also captured some belly images of her.

Her belly is growing day by day and looking very beautiful.

We hope you will like the same.

We will keep you updated with her further progress & new status.

With Best Regards,
SCI Healthcare

Any takers on how how many weeks till she pops?  I'm totally clueless about this, as I think her tummy looks huge already and am just so grateful for all of her care and efforts to keep our baby safe and sound in these final months.

Congrats to all the families with babies born recently!  So exciting to have all our friends announcing their wonderful news lately! 

Sunday, September 15, 2013

Embassy update

We haven't received our visas back from passport processing yet, but in the meantime we followed up with ACS at the US Embassy about the time they quoted us for obtaining the baby's exit visa, and received the following reply:

Dear Bluebird,

The time line is a new policy by the Indian Government.  We had people get their exit visa less than 10 days and others more than that time.  I just wanted to let you know in advance so you can be prepared.  I would think expect up to 10 days although the Government of India told us from 10 – 20 days.  Most people haven’t hired a lawyer, but if you feel more comfortable doing so, then it is your choice.

Thank you.

American Citizen Services New Delhi

This has eased our minds a bit, as staying for possibly over a month would require us to rethink finances, travel & accommodations, pet sitting plans, and work schedules. Unfortunately, neither of our employers offers paternity leave; we must use our earned vacation (which is paltry in the U.S.) and once exhausted, would have to take FMLA unpaid.  So we will tentatively plan for 3 weeks, but hopefully can return home with the baby sooner.

We have talked to a few people who have done the FRRO process by themselves and were fine, but they were very meticulous with their paperwork. We are considering using a lawyer that has been recommended by many, as the service would give us some peace of mind for the FRRO portion, which would cost $200 USD for a singleton ($300 for twins).  If they can facilitate the process to get us through FRRO quicker, the fee would be offset by the expense of staying in India.

We will continue to monitor the situation and other folks' exit process to see if the lawyer and extended stay are warranted.  If you have any relevant information, please share!

On the baby front, we have received no updates.  No news is good news!

Not our baby, just a random funny image from the web!

Wednesday, September 11, 2013

Travel documents and panic attacks

Well, we haven't booked any flights or accommodations yet (which turns out to be a good thing, see below), but when the doctor told us that the baby could arrive as early as November 5th, that got our adrenaline pumping and minds racing.  We would need to get the planning and packing seriously underway.  To divide and conquer, Travis was in charge of making packing lists and I would be in charge of the paperwork.

Naturally, we leveraged the excellent information and advice we got from Mark, Fred, Critty and others about what to pack and how to approach the paperwork.  Thanks everyone!

When I checked our passports, I realized that they will expire February 2014.  Hmm, I had heard about travel being restricted under certain circumstances when your passport expires within 6 months, and we were within that window.  Now this posed several quandaries:

1. Do we send off the passports and risk that the baby comes while the passports are being renewed?
2. Will we encounter more hassle using two passports, the new one and the old one, since the visa remains in the old passport?  Will a bureaucrat claim the visa is invalid since it is in a cancelled passport?
3. Do we risk it by not renewing and trying to travel anyway?

Even though we had found the list of countries that extend passport validity 6 months after expiry and India was included, there were just so many horror stories on the web and variables to deal with: embassies, airlines, pass through countries, screening personnel, etc. that we didn't want to deal with more uncertainties.  But unfortunately that would continue to be a theme in our journey.

We decided to bite the bullet and send off our passports for renewal right away, opting for standard service instead of rush processing due to the extra cost ($60 each) and turnaround time difference of just a week based on the then-current processing time.  We did opt to send priority mail and overnight return mail ($12.85) for the tracking and peace of mind in getting the passports delivered quickly and safely.  We knew the visa should remain valid in an old passport; if we had to explain this each time, that is what we would do.  If anyone has differing information or has experience with this, please let us know!

I'm happy to report that our passports arrived today, quicker than expected, but alarmed us when the old passport that contained our Indian visa was not returned.  We immediately thought the worst: that we would have to apply all over again, that we had been flagged as requiring a medical visa and would be denied, etc. However, a frantic call to the processing center calmed our fears, as we were informed that the old passport would be returned separately within 10 days.


On to the next item on the checklist.  Since it was recommended that we contact the US Embassy in India two months before our due date, we sent an email introduction to the American Citizen Services (ACS) in New Delhi.  They responded with the following:

Dear Mr. Bluebird:

Thank you for your email.  Please make sure to send the DNA kits to our Embassy.  You will have to contact one of the approved DNA kit providers on our website.  For the exit visa, you can only apply while you are here through our Foreigner’s Regional Registration Office in India once you have the passport for your baby.  We can issue your baby an emergency passport in order for you to get the exit visa.  Please note that the exit visa takes around 10 – 20 days to be issued from the Indian Government.

Please advise when your baby is born and documents are complete so we can schedule the appointment and DNA testing at our Embassy.

Thank you.

American Citizen Services New Delhi

I added the bolding.  10-20 days!  Panic again set in, as this is not what we had budgeted or planned for with work or our families, some of whom were going to help us dog-sit.  With the passport and DNA testing taking about a week, this new wrinkle would extend or even double our stay to a month or more.  It's additional expense and time away from home, family, pets and work.

I know we Americans have been spoiled with the historical (relatively) quick exit process of about 10-14 days total.  We can only hope that ACS are overestimating the visa processing time to eliminate unrealistic expectations.  We've also conjectured that it may be due to FRRO giving more scrutiny for those babies that were conceived in 2013.  Whatever the case, this appears to be the new normal.  We will be keeping an eye out for those returning from baby pick up over the next few weeks to see if this time frame holds.  Please contact us if you have any further information on this!

In the meantime, we will continue to pack, prepare, and look into flexible extended-stay accommodations, while we consider baby names.  All suggestions welcome.  :)

Sunday, September 8, 2013

Third Trimester! (and GDM)

I'm happy to announce that we have officially entered the third trimester!

Along with this wonderful news, we received an email from SCI last week informing us of an extra scan per the obstetrician's advice.  When I read this, it did worry me that there was medical concern enough to warrant more scrutiny just a week after our 3D scan.

Greetings from SCI Healthcare..!!!

We hope you are doing well.

We would like to inform you that as per our obstetrician's advise we have done extra USG scan for Meera.

Kindly find attached herewith reports of the same.

We are happy to inform you that our obstetrician has reviewed the reports & noted everything fine.

Your surrogate mother is doing fine.

As per our obstetrician's advise your baby is also doing fine.

Please note that her next scan will be done within one month.

We will keep you updated with her further progress & new status.

With Best Regards,

SCI Healthcare

OK, so everything was fine?  Yeah!  

Not so fast.  

Within the hour, another email was received:

Greetings from SCI Healthcare !!

We hope you are doing fine.

We would like to inform you that as a part of our routine test, we have detected mild diabetes in your surrogate mother Meera.

Please note that she has been reviewed by the Specialist Physician and has been started on units of insulin daily after breakfast.

We are keeping a close eye on her blood sugar level and also on the pregnancy.

We will keep you updated with her progress & new status.

With Best Regards,

SCI Healthcare

OK, gestational diabetes mellitus (GDM), I've heard, is not uncommon.  And SCI said it was "mild."  This is what I read from

Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational is estimated that gestational diabetes affects 18% of pregnancies.

We don't know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin. She may need up to three times as much insulin.

However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

OK, this last part really scared us, so I emailed Dr. Shivani about the treatment and she responded with the following:

She is on 8 units Insulin -- titration of the dose is done as per the daily blood sugar readings which are done two to three times in a day.

The CTG recordings are also done regularly for the baby's heart beat.

With diabetes baby's tend to be large for dates and this could be why baby is measuring a bit big -- also scan is not the most accurate so lets wait and see how things go.

This is called gestational diabetes -- related to pregnancy -- the requirements of insulin could go up and down and generally once pregnancy is over the diabetes will resolve - we will need to monitor her sugars till it does post delivery.

Best wishes

Dr Shivani

At least Meera was being treated, and we can only hope that it prevents any of the serious complications to the baby from gestational diabetes.  We are also hopeful that Meera will be fine after delivery.  I think she must be wondering "what did I get myself into?"  All kidding aside, we will be eternally grateful for her role in creating our little one, despite the challenges.

So for now, the celebrations are postponed and the planning is in full swing for what we have dubbed "Operation Baby Pick-up."