“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)