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How do I get connected with Evergreen Fetal Therapy?
 
Most patients are referred to us by their high-risk OB provider.  After discussing your case, we have determined that it would be beneficial for you to come for evaluation and consultation with our physicians.  Other patients refer themselves by contacting Melissa or Donna to arrange an appointment.
 

What can I expect during the Ultrasound and Consultation Appointment?

 
You will have a detailed ultrasound examination performed by oen of our advance-trained sonographers.  We have a team of sonographers that have gone through special training to be able to better care for our fetal therapy patients.  Depending on your particular situation, the ultrasound will likely take at least an hous, and possibly up to two and a half hours.  Likely this exam will include a transvaginal ultrasound to measure the length of your cervix.  Once the ultrasound is complete, the sonographer will review her images with Dr. Walker and/or Dr. Paek.
 
Dr. Walker and/or Dr. Paek will then come into the ultrasound room and get to know your baby/babies a bit, and then begin to discuss the findings and treatment options.   We schedule plenty of time to allow you and your family to ask questions and feel like you understand your diagnosis and the plan for care.  Melissa, the fetal therapy coordinator, is also present to be able to help you with any questions you may have later or just general processing of this information.  Additionally, Melissa will communicate with your referring physician about the care you received here.
 
If surgery is recommended, the physician will then perform a history and physical exam, start the consent process and get your paperwork ready for the hospital.  If you are a candidate for Laser Photocoagulation, we have two consent forms-- one for the hospital care and the second that specifically desribes laser surgery.  We will also draw some blood, so that we can be sure that surgery is a safe option for you.
 
After completion of the appointment, we will walk you to where you can get any prescriptions filled (as applicable) and if you are scheduled for a procedure, show you where to come the next day.
 
How long will I be in Kirkland?
 
You should plan on spending a few days in the Kirkland area-- one day for the detailed ultrasound exam and consultation and another for the procedure.  In most situations, you will spend the night of the procedure in the hospital and will be discharged the next morning.  When scheduling flights, please schedule your returning flight after 1pm to allow time for discharge and travel to the airport.  There are a few hotels convenient to the hospital in the Totem Lake area of Kirkland, Washington.
 
Preparation for Surgery  

Before surgery, you should not eat or drink anything for at least 8 hours.  This is to reduce this risk of vomiting during the surgery.  You might hear the phrase "NPO" in the hospital-- this simply means, nothing by mouth.  We will give you a card with specific instructions of when you need to start this process.  This includes gum, candy and mints.

Once in the pre-operative area, the nurses will start an intravenous line (IV) to give fluids and medication necessary during the procedure.  You may have a support person (a spouse, partner, family member or close friend) during this time.  We recognize that this is an emotional time and in most cases have made exceptions with our operating room to allow one support person to accompany you to the procedure.  Dr. Walker and/or Dr. Paek will come see you prior to the procedure to answer any last questions you may have and ensure we are ready to proceed to surgery.   

During the procedure
 
You will  be taken to the operating room by the nurse and helped onto the operating table. The anesthisologist will give you pain medication-- most often, a spinal.  Following your anesthesia, the operating room nurse will place a catheter into your bladder to keep you comfortable during the procedure.  Dr. Walker and/or Dr. Paek will position you for the procedure, and then using ultrasound guidance, draw a "map" on your belly with a sterile marker.  This helps them quickly identify some key elements, such as umbilical cord insertions and safe entry points.  The operating nurse will "prep" your belly by cleaning in carefully with a betadine solution and then once dry, sterile drapes will be placed on you and we're ready to go!
 
The skin incisions made for the intruments are extremely small and usually require only steri-strips and band-aids to cover them.  The procedure will talke between 40 minutes and an hour and a half, but may take longer. 
 
After the Surgery  
 
Following the procedure you will be taken to a room on in the Family Maternity Center at Evergreen Hospital.  The nurses there will be monitoring your temperature, pulse, breathing and blood pressure as well as monitoring your uterus for contractions. Although pain should be minimal, medicine will be available if needed.  Antibiotics (as needed) and medication to help relax the uterus and stop any contractions will be given.  
 
The morning after the procedure, an ultrasound will be done to see if both babies survived the procedure, as well as any changes in fluid volumes and blood flow in each baby.   Also, to ensure safe travels home, a transvaginal ultrasound will be done.

 

Follow-up Care  
 
Your physician can resume your care for the remainder of the pregnancy.  Both you and your provider can contact us if there are any questions or concerns. We recommend  weekly ultrasounds for the month following the procedure.  If everything looks normal, ultrasounds can then be done every two weeks, or as suggested by your doctor. 
 
We will continue to be interested in your progress and would like to receive copies of your ultrasound examinations and any other relevant information.  Information regarding delivery will also been requested from your doctor.  We ask that your placenta be sent back to us for evaluation.  This is extremely important to evaluate our care and techniques. We will give you the appropriate container and instructions.
 
We will contact you annually by telephone to see how your babies are doing for at least 2 years.
 
How can I get more information?
 
Because this is an uncommon procedure, we have tried to keep this information sheet simple and straightforward. If you would like more detailed information, please contact Melissa Dorn, Fetal Therapy Coordinator, at 1-866-FET-SURG.
 
 

 

How do I get connected with Evergreen Fetal Therapy?
 
Most patients are referred to us by their high-risk OB provider.  After discussing your case, we have determined that it would be beneficial for you to come for evaluation and consultation with our physicians.  Other patients refer themselves by contacting Melissa or Donna to arrange an appointment.
 

What can I expect during the Ultrasound and Consultation Appointment?

 
You will have a detailed ultrasound examination performed by oen of our advance-trained sonographers.  We have a team of sonographers that have gone through special training to be able to better care for our fetal therapy patients.  Depending on your particular situation, the ultrasound will likely take at least an hous, and possibly up to two and a half hours.  Likely this exam will include a transvaginal ultrasound to measure the length of your cervix.  Once the ultrasound is complete, the sonographer will review her images with Dr. Walker and/or Dr. Paek.
 
Dr. Walker and/or Dr. Paek will then come into the ultrasound room and get to know your baby/babies a bit, and then begin to discuss the findings and treatment options.   We schedule plenty of time to allow you and your family to ask questions and feel like you understand your diagnosis and the plan for care.  Melissa, the fetal therapy coordinator, is also present to be able to help you with any questions you may have later or just general processing of this information.  Additionally, Melissa will communicate with your referring physician about the care you received here.
 
If surgery is recommended, the physician will then perform a history and physical exam, start the consent process and get your paperwork ready for the hospital.  If you are a candidate for Laser Photocoagulation, we have two consent forms-- one for the hospital care and the second that specifically desribes laser surgery.  We will also draw some blood, so that we can be sure that surgery is a safe option for you.
 
After completion of the appointment, we will walk you to where you can get any prescriptions filled (as applicable) and if you are scheduled for a procedure, show you where to come the next day.
 
How long will I be in Kirkland?
 
You should plan on spending a few days in the Kirkland area-- one day for the detailed ultrasound exam and consultation and another for the procedure.  In most situations, you will spend the night of the procedure in the hospital and will be discharged the next morning.  When scheduling flights, please schedule your returning flight after 1pm to allow time for discharge and travel to the airport.  There are a few hotels convenient to the hospital in the Totem Lake area of Kirkland, Washington.
 
Preparation for Surgery  

Before surgery, you should not eat or drink anything for at least 8 hours.  This is to reduce this risk of vomiting during the surgery.  You might hear the phrase "NPO" in the hospital-- this simply means, nothing by mouth.  We will give you a card with specific instructions of when you need to start this process.  This includes gum, candy and mints.

Once in the pre-operative area, the nurses will start an intravenous line (IV) to give fluids and medication necessary during the procedure.  You may have a support person (a spouse, partner, family member or close friend) during this time.  We recognize that this is an emotional time and in most cases have made exceptions with our operating room to allow one support person to accompany you to the procedure.  Dr. Walker and/or Dr. Paek will come see you prior to the procedure to answer any last questions you may have and ensure we are ready to proceed to surgery.   

During the procedure
 
You will  be taken to the operating room by the nurse and helped onto the operating table. The anesthisologist will give you pain medication-- most often, a spinal.  Following your anesthesia, the operating room nurse will place a catheter into your bladder to keep you comfortable during the procedure.  Dr. Walker and/or Dr. Paek will position you for the procedure, and then using ultrasound guidance, draw a "map" on your belly with a sterile marker.  This helps them quickly identify some key elements, such as umbilical cord insertions and safe entry points.  The operating nurse will "prep" your belly by cleaning in carefully with a betadine solution and then once dry, sterile drapes will be placed on you and we're ready to go!
 
The skin incisions made for the intruments are extremely small and usually require only steri-strips and band-aids to cover them.  The procedure will talke between 40 minutes and an hour and a half, but may take longer. 
 
After the Surgery  
 
Following the procedure you will be taken to a room on in the Family Maternity Center at Evergreen Hospital.  The nurses there will be monitoring your temperature, pulse, breathing and blood pressure as well as monitoring your uterus for contractions. Although pain should be minimal, medicine will be available if needed.  Antibiotics (as needed) and medication to help relax the uterus and stop any contractions will be given.  
 
The morning after the procedure, an ultrasound will be done to see if both babies survived the procedure, as well as any changes in fluid volumes and blood flow in each baby.   Also, to ensure safe travels home, a transvaginal ultrasound will be done.

 

Follow-up Care  
 
Your physician can resume your care for the remainder of the pregnancy.  Both you and your provider can contact us if there are any questions or concerns. We recommend  weekly ultrasounds for the month following the procedure.  If everything looks normal, ultrasounds can then be done every two weeks, or as suggested by your doctor. 
 
We will continue to be interested in your progress and would like to receive copies of your ultrasound examinations and any other relevant information.  Information regarding delivery will also been requested from your doctor.  We ask that your placenta be sent back to us for evaluation.  This is extremely important to evaluate our care and techniques. We will give you the appropriate container and instructions.
 
We will contact you annually by telephone to see how your babies are doing for at least 2 years.
 
How can I get more information?
 
Because this is an uncommon procedure, we have tried to keep this information sheet simple and straightforward. If you would like more detailed information, please contact Melissa Dorn, Fetal Therapy Coordinator, at 1-866-FET-SURG.
 
 
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