“When” it works

I had my “20 week” (really, 19w4d… and I think this baby is actually more like 19w1d….) appointment with the high-risk OB today.  I was a total MESS.  I kept reminding myself that at the 15 1/2w apt, the doc said she would be really surprised if we found something at the 20w appointment.  But that did not stop me from feeling absolutely ill in the hours leading up to the appointment.  (It’s amazing how much impact my mental state can have on my physical state!)

I saw a new ultrasound tech today, so of course I gave her the “do you know my history?” / “I want you to tell me if you have any concerns” speech.  She was familiar with my history, and suggested she would tell me if she was worried (but I didn’t believe her).  Baby is growing, had a heartbeat, etc.  But the ultrasound took FOREVER.  I kept asking, “is that normal” “does that look right” “do you have any concerns” “what are you looking for now” etc.  She spent a super duper long time looking at the heart, and that was freaking me out.  After about 45 mins (of her reassuring me repeatedly she did not have any concerns “yet”) she said she was done and was going to get the doctor.  For all of my “good” ultrasounds, the ultrasound techs have been like, “you can get cleaned up, I don’t think the doctor will want to see anything.”  And for all of my “bad” ones, they have asked me to stay as I am (stomach exposed) so the doctor can “take a look.”  So, of course when she said she wanted me to stay as I was so that the doctor could take a look I totally freaked.  She said, “oh it’s normal, he always likes to do a check.”  I’m like, yea right lady.  Then I pressed her, what’s he going to be looking for, do you have any concerns, etc.  She said, no concerns (not very convincingly), he’ll just want to confirm my findings and check a few things on his own.  And then she was gone for like 20 mins.  (Another bad sign.)  And when the doctor finally came in—the same one that diagnosed our omphalocele almost 2 yrs ago!—the genetic counselor was with him.  I nearly had a heart attack!  I literally said, “you guys are freaking me out!”  And the doctor said, “we’re both just so excited to give you the good news that everything looks great!”  Sweet relief!

Then the doctor did another mini ultrasound (it really is part of his practice to take a second quick look).  He said nothing looks structurally wrong at all and he would be really surprised if we had any major structural issues.  Then we talked about the potential non-structural issues that might not be diagnosable.  Both he and the geneticist said something along the lines of, you know you have had a number of pregnancies marked with structural abnormalities (the anencephaly and omphalocele ones, and likely many of your prior miscarriages).  But you have no reason to think they were also afflicted with neurological issues, although they could have been.  On a separate path you have had a completely structurally sound child who is neurologically normal.  (Actually, quite above average!)  At this point, this pregnancy appears to be on the same path as your son—structurally sound—and there is no reason to think that it would not be neurologically sound as well.   The doctor suggested that he doesn’t need to see me again, but he understands how hard this kind of pregnancy is, so if I want to come back in for another ultrasound at 28 weeks I should feel free.  I told him I would think about it.  Obviously the purpose of the 20 week ultrasound is to give you time to “make decisions” (ie terminate) if you find something really wrong.  By 28 weeks there’s nothing they can do…. Except give a freaking out mom a little more comfort… for a bit.

So that’s that.  I promised myself (and my husband) that I would stop freaking out / saying “if” this works after this appointment.  I mean, from this point on there’s nothing more I can do anyway.  And I also promised myself that I would cut some tags off of some maternity clothes!  So I’m going to do just that.  AND, we decided that this was the appointment that would be required before telling the OTHER tiny man in my life what’s going on.  Yes, you read that right, we’re telling the little man he’s getting a sibling sometime later this week.  Stand by for the report!

I am going to try to embrace the pregnancy.  After 15 weeks of “if,” it’s going to be hard to start saying (and thinking!) “when.”  I look forward to working on it.

P.S. Depending on the measurement baby looked to be measuring around 19 weeks plus a couple days or so.  So he’s continuing to measure a little behind.  (He’s been “behind” since the beginning.  I’m pretty certain I ovulated late in my cycle.)  She guessed he was weighing in at 10oz.  (Which is basically what a 19 ½ wk old should weigh.)

P.P.S. I got my final test results back—I am not a carrier for Fragile X, and my risk of being a carrier for spinal muscle atrophy is 1/834, so there is a risk that I’m a carrier, but it’s pretty small.  (The untested carrier rate for white people is 1/47, so the blood test dropped that risk because I had at least 2 SMN1 Copies.  If they had detected 2 SMN1 Copies, the chance would be 1/5600 that I’m a carrier.  https://clevelandcliniclabs.com/wp-content/uploads/2017/10/Spinal-Muscular-Atrophy-SMA-testing.pdf)

My lovely lady hump

All is generally good here at 18w6d.  Baby continues to have a normal heartbeat, and is rumbling around so much I haven’t been scared that there won’t be a heartbeat at my weekly appointment.  I actually felt him kick (or punch??) from the outside the other day!  All of my labs have been coming back normal.  (Although we’re still waiting on the genetic carrier results from the fragile X and spinal muscular atrophy blood tests.) 

My massive online orders of maternity clothes were finally delivered this week, and with great trepidation I started cutting off tags of a few things so I have something to wear.  (I’m planning on leaving the tags on most of the things I want to keep until after my “20 week” (really 19 ½) appointment next Monday.)  My belly is getting harder and harder to hide, and I’m running out of energy to try.  I saw a good friend the other day and told her I was pregnant, only to have her say “I was wondering….”  This is the first time the tummy has given me away!!  I think it’s going to look less like too much cheese and more like too little baby in another couple of weeks.  For now, I just look like a person with skinny arms and legs and a beer gut.  Hawt!

I’m not super stressed out about the 20 week appointment next week—the high risk OB told us after our 15 ½ week appointment that everything look great and she would be really surprised if they caught something new on the 20 week.  That being said, I am still a little nervous.  It’s particularly unfortunate that hubby can’t make this one—he has an out of town meeting.  Boo.

What’s really keeping me up at night, though, is worrying about all of the things that could be wrong that they can’t or won’t find until baby is born.  Did you know that there are more than 4,000 different kinds of birth defects, and that around 3% of babies are born with some kind of birth defect, and that up to 70% of birth defects are undiagnosed??  AND, let’s not forget that the risk of birth defects rises with recurrent miscarriages (it doubles: https://www.ncbi.nlm.nih.gov/m/pubmed/8290380/), and it increases with a history of birth defects, and it increases with age of parents (although I read that while that is definitely true for chromosomal defects, it may not be true for all defects: https://www.webmd.com/baby/news/20140203/babies-born-to-moms-over-35-may-have-lower-risk-for-certain-birth-defects#1).  So I feel like our risks are pretty much sky high.  That’s not a great feeling.

Of course, we’re under a microscope and going to an awesome clinic, so we would expect a much higher detection rate than average.  And a lot of the super common and devastating ones (anencephaly, spina bifida, trisomy 13/18/21, structural brain defects, structural heart defects, structural kidney defects, limb defects, clubfoot, etc.) either have been ruled out or should for the most part be ruled out at the appointment next week.  AND some birth defects are relatively harmless.  (In fact, I was born with an abdominal hernia—a birth defect.  After a nail-biting [for my parents] surgery when I was a month old, I’ve had no issues.)  I mean, do I want my baby to have a hernia or cleft pallet or even tracheoesophageal fistula/esophageal atresia (what my niece was born with)?  No, of course not.  But those are generally fixable and have no super long-term issues.  I continue to worry that baby will be born with something profoundly wrong.  For now, all I can do is… oh, wait, I can’t do anything.

The other night I dreamed that someone told me that if I walked on broken glass it would help my baby.  So of course I chose to walk on broken glass.  (And it wasn’t like the thick broken glass of a dish.  It was super sharp like a broken light bulb or holiday ornament.)  When I woke up, I was at the part of my dream where I was pulling out bloody two-inch shards of glass from my feet.  And then I made the mistake of googling the meaning of walking on broken glass while pregnant.  Apparently it’s a bad sign.  Whatever.  I didn’t need to search out the meaning of my dream online to know what it means—I would do just about anything for this ~6in ~8oz little fella I’ve never even met yet.  (And it might be a throwback to all of the shit I was willing to do when we were trying to have kids with fertility treatments.)

My husband has started to get on my case about continuing to say “if” this works.  WHEN he says, WHEN.  When will I feel the same way?  I’m not sure, but not now.  And probably not for a while.

P.S I wasn’t super worried about it, but it doesn’t appear that either my new low-dose aspirin habit or my long-standing swimming habit poses any risk to the little man.  (http://pubmedcentralcanada.ca/pmcc/articles/PMC4805457/; https://www.ncbi.nlm.nih.gov/pubmed/23628264)

Doing it all wrong

I feel like my posts have been a little too optimistic lately, so time to bring things back down to earth….

Had my weekly appointment with the nurse today.  First things first, there’s still a heartbeat.  Just wanted to get that out of the way.  So that’s good.  BUT there are some things to be concerned about.  Nothing major… yet. 

(1) My platelet count is low.  Not dangerously low, but outside the bounds of normal measurements.  (It’s 140,000 now.  I’ve had my blood taken many times, and it’s always at the bottom range of normal.)  This is not entirely uncommon in pregnancy—approximately 1/10 women will have low platelet counts during pregnancy—usually closer to the end.  It’s called gestational thrombocytopenia.  And as long as my measurements are above around 80,000, they won’t do anything.  Once it goes below that, there could be some issues.  Among other things, if it gets too low, you can have bruising / uncontrolled bleeding.  And they won’t give you an epidural because of risk of complications.  Here’s some general info on it:

https://emedicine.medscape.com/article/272867-overview

So bummer, but hopefully not something to be extremely concerned about.

(2) I’m at risk for preeclampsia.  There are many risk factors that I do not have, but the two big ones I do have are advanced maternal age and recurrent pregnancy loss.  Also, it’s been a while since my last pregnancy, which is also a risk factor.  (?)  For now the treatment is just to take a baby aspirin and hope I don’t get it.  Obviously I’m being monitored and I’m aware of the symptoms. 

Here are some articles about preeclampsia and risk factors:

http://www.bmj.com/content/353/bmj.i1753

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC554027/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4354613/

(3) This is the one that gave me the most grief today.  I was not thinking the past couple of months and I’ve been eating sandwich meat.  (!!)  Once a friend reminded me that you’re not supposed to do that during pregnancy, I stopped.  Instead, at a meeting today, I had a veggie sandwich.  Only I realized after the meeting that I’m not supposed to eat sprouts, either, and that damn thing was full of them.  I spent 10 minutes googling and then completely freaked out and called my OB’s office and asked if I should make myself throw up.  They said no, and just don’t do it again. 

I swear to G, if I lose this miracle pregnancy due to food poisoning I’m never going to forgive myself.  And, in reading about the food risks, I realized I’ve been eating soft cheeses too, which are also no-nos.  ARGHHHHHHH.

(4) As if I didn’t have enough to fret about today, I realized that I need to get my fat ass into maternity pants.  I’ve been wearing dresses and tights, which have been quite forgiving.  But today I wore pants.  I tried to make due with normal pants and the old rubber band around the button.  (I don’t have any maternity pants, and was trying to put off buying them as long as possible.)  That worked first thing in the AM, but by mid-day I was not feeling it.  I was so uncomfortable that I spent a small fortune online shopping for pants.  (It was actually a pretty emotionally draining experience—this is the first time I’ve bought anything relating to baby/pregnancy since my son was born.)  I bought multiple sizes in multiple styles from Gap, Macy’s, Pea in a Pod, and H&M.  (I’ll return most of them.)  Hopefully something gets delivered this week and fits.  By the end of the day I was so stressed and ornery (and I’m pretty certain one of my male co-workers saw my unzipped fly and underwear when we were talking), I left work early and went to the mall and bought a pair of tights to wear tomorrow. 

Deep breath.  Tomorrow is another day.