Thursday, January 31, 2008

I Feel Fine

On Tuesday, 1/29/08, I had another follow-up appointment with my OB. I saw the third OB in the practice, since they like you to see each doctor at least once when you're pregnant. This was a male doctor, which was strange, because I'm so used to only seeing females. And there's a good reason why I do. He (and I've found, other male health practitioners) blew off a lot of the things we were discussing. Like it was no big deal that they found the Choroid Plexus cyst, because, as he put it, eh, they always go away anyway. Maybe so, but until we know for sure that this particular cyst will 'go away anyway', I'd like my concerns to be validated. Back to my more sensitive female doctor next visit.

So I had my blood pressure checked (normal at 120/80), my weight taken (I only gained one pound since last my visit 4 weeks ago, which makes me even with my pre-pregnancy weight), and protein and glucose levels in my urine checked (both normal). The nurse listened to the heartbeat; really, the nurse did all the work. The doctor just came in, reviewed my chart, felt my belly, and that was all.

The best part about the visit was that this was the first doctor's appointment that I've had since August that didn't require any blood to be drawn! I can't remember leaving that office without a sore vein in my arm or hand. It felt great.

I return for another follow-up in 4 weeks.

I don't know if I've mentioned this, but my one major problem that I've had this entire pregnancy has been chronic sinus congestion and excessive mucus and post-nasal drip. It's pretty gross to talk about, but it's sometimes been so bad that it's made me vomit and dry heave. In fact, I've thrown up more from the mucus than I did my entire first trimester from morning sickness. It has made it very difficult to work because speaking on the phone seems to make it worse and I have to put my phone on mute while I gag and dry heave at my desk. Fun, huh?

So I went to a regular GP doctor about 3 weeks ago. She prescribed Rhinocort nasal spray and told me to buy over the counter Robitussin. I used those for a few days, but honestly did not see any improvement. And I didn't want to be taking any medication just for the hell of it. Then I came down with a bad cold. Actually, it probably wasn't any worse than any cold I've had, but not being able to drug myself full of Nyquil really made me miserable. I was out of work for 3 days because I wasn't sleeping and I couldn't breathe or function during the day. Any medication that I could take wasn't helping at all, so why take it?

When I returned from work, one of my coworkers showed me an article she had read about natural and/or holistic remedies for common ailments. Under 'sinus congestion' there was mention of a Neti pot. I remember that my acupuncturist had mentioned it to me a couple of months ago when I told her about my sinus problems. But then she went on to describe its use as 'pouring water up your nose' and that broke the deal for me. However, I was now becoming desperate to give myself some relief of the constant mucusy post-nasal drip that was making me so miserable, and decided to give it a try.

Best decision I've ever made. I started using it twice a day- once in the morning after my shower, and once at night before bed. I could breathe again, and my mucus was significantly lessened or gone completely. I've been using my Neti pot for over a week now and my life has changed! I am feeling great and can spend more time focusing on all the wonderful things my body is doing.

Like growing! My belly is at a point where people who already know I'm pregnant are commenting on it. I think I'm not quite where strangers would assume I'm pregnant as opposed to just fat, but I'm definitely looking more pregnant each day that passes.

Blobby is starting to kick and punch me too. It's not painful at all; just very weird. I wish DH could feel it from the outside, but it's still a little too early for that. We tried a few days ago. I told him to put his hand where I was feeling the kicks and he didn't feel anything. So what does he say to me? 'Blobby kicks like a girl'. What did he expect- Mia Hamm? Oh god I hope not. At least while said kicking is occuring in my body.

More than halfway now.... 18 & 1/2 weeks to go. :)

Monday, January 28, 2008

Magical Mystery Tour

On Friday, January 25, we had our level 2 ultrasound. I was so nervous about it because of the Choroid Plexus cyst and enlarged kidney that was seen on the 16-week ultrasound 4 weeks ago. Not to mention that what they saw on the level 2 would determine whether we were going to go ahead with the amnio that day.

The weirdest part about the entire visit was what I learned in the first five minutes. The tech had just started to look for the baby on the screen and she confirmed with us that we did not want to find out the baby's gender. I was worried that she would be looking at sex organs that day so I wanted to know ahead of time so I could look away. I asked her if she would be and she replied, 'oh, I already know.' I asked her, just from looking at the baby right now? And she replied, 'no, I knew from the last time.' OMG. The u/s technician and my doctor have both known whether our baby is a boy or a girl for four weeks! It was a very strange feeling to learn this. I mean, we definitely don't want to find out until the baby is born in order to maintain some element of surprise, but it's still a very weird feeling to know that somebody knows!

So we started measuring body parts. Based on the way the baby was laying, the tech was able to see some structures more clearly than others. One by one, each anatomical feature was measured and labeled. Everything seemed to be measuring on target or just a few days behind. We counted fingers and toes, looked at the face and up the nostrils, and watched in amazement as Blobby moved around like crazy. She jiggled my belly a bit to get Blobby in various positions so we could get better views of various structures. My baby is weighing 12 ounces. Wow.

It was a fantastic visit. Until the tech finished measuring everything and called the Maternal-fetal specialist in to do her own measuring. That was when my worrying started. The last time we were there, it was she who confirmed the presence of the Choroid Plexus cyst and enlarged kidneys. The way she studies the screen with an ambiguous facial expression makes me worry because you can't tell if what she's seeing is good or bad.

The bottom line was that everything was measuring within tolerance. Some structures were measuring a few days behind, which can be due to technician variability. I watched the doctor as she clicked on the word "Normal" next to all but three structures. The diaphragm and lips were not coming in clearly enough to see definitively, but the doctor noted that she didn't see anything that would lead her to suspect any abnormalities. Plus, both kidneys were measuring normally and symmetrically, and the best news ever was that the Choroid Plexus cyst appears to be resolving. What a relief!

I will be returning in two weeks to get a better picture of the lips and diaphragm. I am eager to rule out cleft lip, which can be associated with many genetic disorders. Again, the doc did not see anything that would cause concern. And although the heart looked beautiful- four chambers and a normal heartrate, she suggested that we see the Fetal Echocardiologist just for peace of mind.

So, with all the good news we received on Friday, there was no reason to stay for an amnio. We left with smiles on our faces and beautiful photos of our baby.

With no amnio and no finding out the gender, some things about this pregnancy will remain a mystery. :-) We can't wait to find out for sure on the big day!

Edited to add on February 4, 2008:
I returned to the Maternal-Fetal specialist today so they could get a better view of those features that they couldn't see well the last time, the lips and the diaphragm. Blobby was in a completely different position today (head down, feet up by my belly button), and was being a little more cooperative, although the nose was angled right up into the placenta so it was initially difficult to get that view of the nose and lips. But we finally got them and everything looked perfectly normal! We even got a much better picture of the heart, which looked great. The u/s tech and doctor both commented on what a difference a week and a half made with respect to how those particular body parts were showing up.

They also commented on how Blobby has my facial profile. :-)

Next week, I will be seeing the Fetal Echocardiologist. I confirmed with the doctor that it's not because of anything she saw on the ultrasound; only that considering my age and high-risk status, she figured she'd have me cover all bases. My next ultrasound will be at 28 weeks. Normally, I wouldn't go until 32 weeks but again, being high-risk she wants me to come in earlier so they can monitor Blobby's growth. Fine with me. I love seeing that little munchkin on the screen. It is just so amazingly surreal that that 8-celled blastocyst we transfered back in September turned into our little Blobby with moving parts. I am completely in awe.

Monday, January 14, 2008

The Word

So I've been trying not to think/worry/fixate on the soft markers that were found on the ultrasound 2 weeks ago. Later on that week, I had blood drawn for a second trimester quad screen, which screens for spina bifida, Down's, and Trisomy 18. I guess my 'don't worry' approach really worked, because I completely forgot to call for the results of the quad screen last week.

Thankfully, everything came out great. My risk for open spina bifida is 1 in 1500; the lab report states that the serum AFP value is considered NEGATIVE for a pregnancy at this gestational age. My risk for Down's Syndrome was lowered from 1 in 157 (based on my age only) to 1 in 3300, based on my age and biochemical markers; the lab report states that this screening profile does NOT indicate that the patient is at increased risk for a Down's Syndrome pregnancy. My calculated risk for Trisomy 18 was lowered to less than 1 in 10,000; the lab report states that this screening profile indicates that the patient is NOT at increased risk for a Trisomy 18 pregnancy.

So the question remains, should we even allow those 'very soft markers' found on my 16 week scan to affect our decision about amnio. I'd say that the blood tests would be more accurate than a subjective identification and measurement of a couple of structures on an ultrasound. Our level 2 ultrasound will be the true test. The kidneys should be more easily identified by then, and we should have a better picture of the Choroid Plexus cyst.

It should go without saying that I really am praying (to the extent that I pray) for a completely healthy baby. The most common question that I have been asked is if we're going to find out if our baby is a boy or girl (the answer is no, by the way). The gender of our baby has been the last thing on my mind; my concern first and foremost has been the health of my child, and honestly, while admittedly I am leaning more towards one gender than another, I couldn't care less if it's a boy or a girl. I want to give this child the best possible odds of a happy, healthy, and fulfilling life.

I have to admit, however, that I have another reason for hoping that this child is chromosomally and genetically normal. You see, there have been many online conversations on the subject of ARTs and their ethics. My viewpoint is that infertile couples have as much right to a biological child of their own and should be able to achieve one by whatever means are necessary. However, there are some who do not share this opinion. These people are typically of the 'holier than thou' mindset, and believe that they speak the word of God. They lecture and preach that if God had wanted us to have biological children, we wouldn't have been made infertile. Of course, these are people who can have as many children as they want quite naturally, and usually do. They think that people like me are going against God's wishes and deserve whatever punishment we get. We are going to go to hell because we are not leading the righteous path that God has paved for us. And we deserve to never have children because that's 'God's will' and we should never go against God's will. And if God forbid my child was born with something medically wrong, that would be more ammunition for these crazies to preach and lecture that we shouldn't have deviated from the path of righteousness.

So you see why I need to tell all of these 'more righteous than thou' assholes to stay out of my body, mind their own business, and SUCK IT. Beautiful children, conceived via ARTs, are born every day, and their parents love them and care for them as much as God would expect them to.

Monday, January 7, 2008

I've Got a Feeling

'...a feeling deep inside, oh yeah...'

I'm sure this isn't exactly what Paul McCartney was singing about, but I have been feeling Blobby moving for the past 3 days. I didn't realize what it was when I first felt it so subtly this past Friday. It doesn't really feel like those typical descriptions that you hear when women talk about feeling their babies moving. It certainly doesn't resemble any kicks or pokes; and I couldn't exactly describe it as the sensation of 'butterflies fluttering', although I can understand where that description comes from.

To me (and this will probably sound very strange to many of you), it feels like there is a vibration which lasts for approximately one second and resonates somewhere in the lower right section of my Nether-regions. Yes, that's right- I feel it in my hoo-hoo, my va-jay-jay, my 'down there'. Weird, I know, but that's where I'm feeling it. Could be that Blobby is hitting on a nerve which is shooting down to that area, or it could be that because my uterus consists mostly of scar tissue which probably has little or no feeling, I'm not actually feeling it in the right place, but in the surrounding areas.

On Friday, these sensations were very few and far between- maybe once every 20 minutes or so. Saturday I barely felt them because I was running around doing shopping all day. Sunday I felt them a little more frequently, and today I feel them every few seconds. It's crazy!

Now, I realize that pregnant women can often confuse other, um, bodily functions with their moving babies. I can tell you with the utmost certainty, that this is definitely not gas (a feeling with which I am quite familiar with, thank you very much), or a growling stomach, or nerves, or a rumbling tummy after something that I've eaten isn't agreeing with me. I know what each of those feel like, and this isn't that!

I consulted a friend of mine who had her second child this past summer. She confirmed that during her more recent pregnancy that she felt a similar sensation and felt it very low, so she believes that I am indeed feeling Blobby.

What an amazing feeling. It's my baby!

Friday, January 4, 2008

Tomorrow Never Knows

Well, we've returned from our trip and we had a great time spending time with the family. I'm very relieved that I had no complications along the way and Blobby is still doing great. Yes, of course I used the doppler 3 or 4 times over the course of the trip so I could hear that beautiful heartbeat and feel reassured.

On Monday the 31st, I was squeezed in for another ultrasound. It was suggested by my maternal-fetal specialist, and who am I to refuse an offer for a scan? I really just wanted to get updated pictures, since the last scan was at 11 weeks and that was 5 weeks ago! Way too long for me to wait.

The u/s technician did her thing and I have to say it took a long time. Blobby wasn't in the most easily accessible position so it took some work to get a good angle. Lots of measurements were taken. Lots of body parts which I recognized. Also, little dark circles inside white areas, which apparently were worth taking the time to measure, but to me, had no more significance than little dark circles inside white areas. After her measurements were taken, she called in the maternal-fetal specialist, who spent a while taking her own measurements. She seemed to be focused on the same two areas, taking measurement after measurement. Now I was starting to become a little concerned.

After she was done, she told us that she saw a couple of things she wanted to talk to us about. Holy shit. My heart sank. This was the first time I had received any kind of possible bad news about Blobby. Let me tell you, it is not a good feeling. So after I cleaned myself up, we met with her in her office. This is what she found: a Choroid Plexus cyst in the brain, and an enlarged kidney. She called these 'very soft markers' for some genetic disorders, but explained that only about 1% of cases of the CPC have a genetic origin; the others are a normal part of fetal development and usually resolve by the third trimester. The part that bothers me so much is that we really don't know anything. If she was to tell us that seeing these abnormalities on the u/s means that our baby has a chromosomal disorder, we'd know and we'd deal with it. But nobody can tell us anything. It just sucks not knowing.

She went on to talk about the enlarged kidney. Because the fetus is only at 16 weeks gestation, it is still very early to accurately measure certain anatomical features, including the kidneys. She said it was very difficult to get a clear picture of the kidneys, but that compared to the other kidney, this one appeared enlarged. Again, this is something that may or may not have any genetic origin.

We further discussed the risks of having an amniocentesis. We are scheduled to have one following a Level 2 ultrasound on January 25th. We figured we'd reserve the appointment time, but have the u/s first. If we didn't see anything that caused any concern, we'd cancel the amnio. Because there are risks involved in amnio, including fetal trauma, loss of amniotic fluid, and even miscarriage, we would only take that risk if there was a large chance that our child could be born with a fatal disorder. Problem is, we may not really know for sure before having to make that decision. We may be basing our decision on all of these 'soft markers' which may not be significant at all. The good news is that the nuchal fold, which had been measured at my 11-week Nuchal Translucency screening, was still measuring well within the normal range.

In addition to that appointment, I had an OB appointment on 1/3. I saw a different doctor in the practice, who I loved. She really took a lot of time addressing my questions. We discussed in detail the issue of having or not having the amnio and she made a lot of good points. One of her arguments for having amnio is that it's not only about making a decision about whether to terminate a pregnancy. Another reason is, if there is a disorder that will require immediate medical attention, the doctors will know in advance what they will be dealing with. This is a really good point, but with such a low risk of having any chromosomal disorder, I'm not sure if it's worth having the amnio.

She also discussed with me reasons not to have the amnio. She could sense that we were leaning toward declining it, and confirmed that it ultimately is about what we are comfortable with. Would it be worse to give birth to a child with a disorder and be surprised, or would it be worse to potentially lose a chromosomally normal baby? After looking through the results of my 11 week NT scan and the repeat nuchal fold measurement taken at 16 weeks, she agrees that our risks are very low of having a baby with a genetic disorder. In addition, she reminded me that when you're dealing with a chromosomal disorder, the markers seen on u/s tend to be bilateral. In our case, both the cyst and the enlarged kidney were unilateral, which gives me a sense of relief that maybe the cyst is just a normal part of development and will resolve like it should, and maybe the enlarged kidney is not related to any syndrome or disorder. As the doctor added, worst case scenario, our baby will have one non-functioning kidney, but in those cases the other kidney takes over. It is not a fatal condition.

At my doctor's appointment I was also weighed. I only gained 2 pounds since my last visit. Considering that my last visit was before the holidays, that's pretty damn good. A non-pregnant person would be lucky if he or she only gained 2 pounds over the holidays, let alone someone who is expected to gain weight! I also had my glucose and protein levels checked, both fine; my blood pressure was normal. Blood was drawn for a progesterone level (I am now completely off the Prometrium) and for the quad screening which includes AFP. We should have more info about the results of the AFP next week, which will also help to come to a decision about the amnio.

So the level 2 ultrasound will be in 3 weeks. DH & I are trying not to be concerned until we have more information. Hopefully the picture will become more clear and we'll be able to arrive at a decision that we are comfortable with. A friend of mine gave me the advice that my instincts as a mother are already very strong, and that I should just go with my instincts. Because if even if there is no way to know what will come in the future, I know myself and I know how much we want this baby. I think I will heed that advice.