Sneaking Through the Danger Zone

I feel like I'm tiptoeing through this pregnancy, sneaking up on the dreaded 17 weeks (I'm at 15w2d today) and hoping that nothing terrible happens again. And there is such a temptation to think that if I get through the next two weeks I can breathe a giant sigh of relief and start ordering crib sheets. I hope I can get in that groove instead of starting to worry about the other 97 things that can possibly go wrong.

I had a quickie appointment today just for a flu shot, a doppler check (mine hasn't come yet) and the blood draw for the second trimester screening. This is the test that came back all wonky last time, the way we first knew something was terribly wrong. It takes a few weeks to get the results, so I'll just have to be glad that I have an u/s in the interim. It helps to know that the baby is actually alive - problems can be big or little or catastrophic, but being dead doesn't leave a lot of options.

I still haven't decided about the amnio. We talked about it today and figured we would wait until these results come back and go from there. It's not so much that I'm worried about the risks involved, but I know that there are so many other things that can affect the outcome that I'm not sure it would give me much peace of mind. Then again, my husband and I have always said that we don't want to raise a child with severe problems. But some problems can be mild, and that's where it gets confusing.

I have a friend with an adult daughter with Down Syndrome. She is very social, independent and happy. She has had a lot of therapies throughout her life. Her mother is particularly involved in the DS community, traveling with her daughter to DC to speak to congress and throwing yearly fundraisers at her fabulous home. My friend has found a lot of fulfillment in that process, and I think she feels truly that the circumstances turned out to be the best fit for her, in the long run. But it's hard for me to imagine myself in that kind of life, even though I have the best possible role model for what that life could be like. In some ways, I feel like just knowing she's there is such a safety net for me, but in my heart I really dread ever having to use it.

I'm thinking about a leopard print, by the way. For the crib sheets. Or a funky marimekko-ish geometric. Something absolutely not pastel or dainty. No fairies or dragons or tractors or ballerinas, either. If I can find the right fabric I'll sew it myself - a dust ruffle and a sheet being basically squares. I still have my daughter's old crib - it's been lent out a few times but has always come back in good condition. There is also a matching changing table, so at least I won't be out shopping for furniture. The closet in that room/office has some built-in drawers and cubbies, and a dresser probably wouldn't fit in there anyway. But, maybe a leopard-spotted glider chair?

More Relief

They really had me on tenterhooks yesterday - after I checked in for my appointment I could hear the nurses talking about me in the hall. They were trying to decide if I should go to ultrasound first or in the regular exam room to see the doctor. Should the doc see me first and be there with me while she found the doppler heartbeat, or was it better to be definitive and go straight to ultrasound?

I was hoping for the ultrasound first. The thought of not being able to find a doppler heartbeat and then having to wait for a confirming ultrasound in a room full of giant bellies just seemed too awful. But, they sent me to the exam room first, since they wanted the doctor to be with me in case things didn't look good.

It did take a few seconds for her to find the heartbeat. I could feel my own heart pounding, and could hear it through the doppler, but then it changed - a much faster, smaller rhythm. It was such a relief - I hadn't even known how tense I had been until that moment. I know that just hearing a heartbeat now is no guarantee of a happy ending, but it's the most I could hope for at this point so of course I'm happy about it. Happy while it lasts, can't really do much better than that.

The ultrasound was uneventful, with normal everything. Growth was right on target, the two halves of the brain have the right amount of space around and between them, the femur length is good. I'll have another u/s in two weeks, which is nearing the time that gender might possibly maybe be identifiable if everything is in the right position and etc., etc. Which basically means there's a chance, but don't count on it.

Which of course is fine with me - as long as everything else is okay the gender isn't important. I keep imaging a girl, but that's probably just because I have already have a daughter. I'm so much more invested in having a baby that's actually alive that something like gender seems completely incidental.

So, good. I have an appt. next week just for a doppler check and some bloodwork. Plus, the big decision - amnio or not? Thoughts all over the place on that one, so any advice is appreciated!

Pain Relief

I had a frightening headache for about 48 hours. It lounged across my forehead like a bad toupee, sort of sliding over my eyes. I went to sleep with it and woke up with it two nights in a row. I took tylenol and sequestered myself in a darkened room with a cold washcloth and I started to think that it might not be possible for me to live anymore.

By the time it finally occurred to me to call my doctor I was sure that something was terribly, terribly wrong with me. Aneurysm, tumor, temporal arteritis... you know, the standard google-induced paranoia. But also, the last time I was 13ish weeks pregnant, I had terrible headaches. And that didn't end well, so of course I was thinking the worst. Luckily, my doctor had a magic solution ready that didn't even require a trip to the pharmacy. She told me to take a motrin.

Yes, it turns out that you can actually take motrin during pregnancy. All of that tylenol-only is simply a precaution against something that isn't a problem in early pregnancy. Although that changes in the third trimester - then you really shouldn't take it at all. There is some risk of premature closure of a duct in the heart during a critical time after about 20 weeks. Actually, in some cases if a baby has to be delivered prematurely they give ibuprofen to specifically speed up the closure.

So, who knew? The funny thing is, my progesterone suppositories and the dexamethasone also had long warnings about not taking during pregnancy, but I was so determined to do whatever my doctor said might work that I never worried about it at all. By the time you have jabbed yourself full of nun pee, it's funny that a little motrin can be such a source of anxiety.

Now that my headache is finally gone, I can go back to the anxiety that probably caused it in the first place - worrying about my upcoming ultrasound. I know that I should "be positive" and all that, but it's hard to think about these next scans, the next round of screening, the next few weeks, without remembering that feeling of utter helplessness and loss. Sometimes I feel like my whole sense of this pregnancy is a murky black-and white feeling, a ultra-sound representation of the kind of feelings a pregnant person is supposed to have. The happiness is in there somewhere, you just can't see it from the outside yet.

Officially Whatever

So, I don't know. According to the calendar, I am officially into my second trimester - past the 13w3d mark. Since I'm not sure if the baby is still alive that doesn't really mean anything to me, but I hate to be morbid...

Last time, I rented a fetal doppler and took it to an OB appt. to be sure I was using it properly. The doctor showed me how to use it (seemed simple, really) and that was that. She cautioned me not to get it out every five minutes and said it was best to think of it as occasional reassurance. Which was fine, right?

Except obviously I got it all wrong. I didn't use it very often and I ended up picking up my own abnormally fast heartbeat (side effect of anemia) and was so determined not to be a panicky pregno-chondriac that I just kept naively reassuring myself that all was well.

I wasn't sure if I would rent one at all this time, but as the days go by I know I need something during the wait between appointments. If there is still a heartbeat at my next appointment I'm going to rush straight home and send in my order. I've picked out a fancy hospital-grade model with a digital display, so it won't be as easy to confuse the heart rates. It's cheaper than paying for extra appointments, plus I think my sanity will be well worth it.

It's funny how my original ideas about pregnancy being a natural process and trying to avoid a lot of medical intervention have been eroded to the point that I have set up an account with a hospital supply company. I used to think that having a baby meant signing up for prenatal yoga classes and buying a body pillow. Now, I'd order an u/s machine if I could afford it!

Hmm? What?

This has been one crazy month so far, and since it's only halfway over who knows what will happen before October...

I can only assume that there is still a live baby inside of me, although this is mostly based on not thinking about it too much. At my last appointment, my OB cheerfully told me to come back in three weeks and I absolutely freaked out about waiting that long. Here I am, coming up on the weeks that led to the demise of my last pregnancy, and I couldn't imagine why she wouldn't want to monitor me more closely than before. My last ultrasound had been a week before this appointment, and I know that there are a lot of insurance regulations, blah blah blah, but I absolutely cannot wait a month between ultrasounds at this point.

She did agree to see me in two weeks instead of three, but I was hoping for week by week appointments, at least for a while. Maybe that's just not realistic, but I have begun to think about calling in with "pains" of some sort and see if I can get in earlier. The stress alone is bad enough that my insurance will have to pay for more acupuncture and chiropractic appointments if it won't approve extra ultrasounds. Grrr!

In other news, my daughter has started her new fancy private school. This is not the "school for geniuses" here in Los Angeles - that idea just seemed worse and worse the more we found out about it. Neither is it the "hyphenated exclusive prep" school here that was salivating over her test scores. The school we chose is more focused on developing the whole person than creating an academic superstar. Plus, it is close to our house as well as our philosophy. Which is part of our philosophy, actually, in that we didn't want our child on a bus for two hours a day. Part of me is just desperately hoping that I haven't made a giant mistake about this, but my gut feeling was that those other schools would have made us all miserable.

The work itself is just so different from what she's used to that the level of challenge is more about figuring out what the expectations are than just doing the assignments. The homework is posted online, along with the schedules for all of the extracurricular activities and any special events. She has to check rubrics for each assignment to make sure she isn't missing a crucial component. There are honors levels for most classes, and study halls with teachers who take smaller groups of kids and work past the assignments at advanced levels, so I do think she'll be fine as far as being challenged. Far better than last year. Plus, she has to figure out how to change for PE and still make it to science afterwards on the other side of the campus. I think that will be the real challenge, actually.

We're both still trying to figure out how to get to school an hour earlier than we used to. The good news for me is that I don't have to worry about making it to the office on time - now I can even stop at the farmer's market on my way to work. And I'm fine once I'm up and about - but getting out of bed so early is almost impossible. I miss coffee...

Nose News is Good News

So, today I had the nuchal translucency screening. It can't be done until 11.5 weeks, so of course I scheduled it for the first possible date, at 11 weeks 4 days.

The nuchal fold is a translucent space in the tissues behind the neck, and if the area is expanded (larger) it can mean that fluid is accumulating in that space - not a good sign, since genetic anomalies can create that excess fluid. Checking for the presence of a nasal bone is also part of the screening. So, a thin neck fold and any kind of nose bone are the hoped-for findings. Which, luckily, is what we found today. And even though I know that it's not a definitive test, it is nice to see that things aren't suspect already.

Still, with my last pregnancy, the nuchal translucency scan was also fine. The first trimester blood screening was normal, growth was always right on target. It does weigh me down to think of how much can go wrong between now and birth, and as much as I want to be able to believe that these things are rare, that the odds are always in favor of "fine", it's hard to forget that I've been here before, not so long ago.

It's not that I'm all doom and gloom - I loved seeing the little somebody wiggle around, floating and bobbing like one of those giant balloons in a parade. It's amazing how human-ish the fuzzy combination of blobs and splotches can look. I'm so grateful for each reassurance: the placenta looks good, the organs look fine, we counted two arms with hands and two legs with feet. So, I am happy, but it's mixed with caution. I am relieved, but it's not complete. I suppose maybe I am pleased - a word that always seems more neutral than it ought to be, but I guess that helps it work here.

I think I am going to have to start "telling" - I'm too bellyish to be anything but pregnant, so it's mostly just obvious. Even a solid diet of pastries couldn't make anybody this particular shape, so the idea that I just got fat over the summer might not go over as well as I had planned. The traditional notion of waiting until the first trimester is over coincides with my girth fairly well - and if that means 13.3 weeks, then I will just have to carry strategically placed tote bags for another twelve days. I'll be like an inconveniently pregnant sitcom actress, always holding potted plants and shopping bags and giant manila folders over her midsection. Too bad it's about a million degrees here and I can't just wear an enormous poncho all the time!

Lag Time

So, maybe it wasn't the best idea to schedule my ultrasound - on the other side of LA - while I'm still eight hours ahead of local time. It might have been okay in the morning (we've all been up since about 4:00), but by this afternoon my eyelids were drooping and I couldn't finish my sentences. I probably should have rescheduled, but my sanity had been pinned to this ultrasound for so long that it didn't occur to me that I might not go.

I had to stop for a 7Up in hopes that the sugar rush would perk me up, and I cranked the oldies station and tried to channel some of that boppy energy. And it worked, to the extent that I did make it to the clinic without actually falling asleep at the wheel. But I had the bizarre wish that there was such a thing as eyelid-propper-uppers, which can't be a good sign.

The nervousness was crazy. There were all sorts of billing issues and it took forever to get into the little room. Then I sat there with the giant napkin over my lap, waiting and waiting for the doctor to finally come in and read the verdict. When he did get the probe in I couldn't even look at the screen. After so many scans I can say that when there is a lot of wand movement and the doctor/tech doesn't say anything for a while it's not a good sign. That was all I could concentrate on - how long would it take him to say something. I think I actually closed my eyes until I heard him start talking.

The first thing he said was that the baby was really moving around a lot. Suddenly, everything else seemed less crucial - the exact beats per minute, the specific crown-rump length - it all just became "everything looks normal". Such a relief! At 11w1d the baby measured 11w3d, but was moving around so much that it can't be particularly accurate. I guess the 7Up did perk things up, after all...

So, alive and well. So far, so good. I even drove home without even thinking about my eyelids. I have another scan on Friday (nuchal translucency) so at least I know I can make it through this week without worrying myself into a frenzy. I'm so relieved that I don't even know what would have happened if it had been bad news. And I know that this isn't the end of worrying, I know that there are no guarantees, but for now, I'll take it. It finally feels good to be home.