We had our 16-week checkup yesterday! As an added value bonus, I also got my H1N1 vaccine. After having the 'flu with Savannah, I am not taking that risk again - and this one seems to be really nasty for people with immunocompromised systems... like say, pregnant women. And possibly women who get sick easily even without being pregnant. And former smokers. And... I digress. A poke in the arm for a 'flu vaccine never killed me before, and going without it one year potentially could have killed Savannah... so I'm taking no chances.
And as you can surmise, I'm still alive.
But on to Scary Baby!
I decided not to know what my weight gain is but the really good news is that my blood pressure seems to have come back to "normal" - I was 118/70 which makes me much happier. After about 20 minutes (longest we've ever had to wait here), we met our first lady doc, Dr. Gould. Really nice and very helpful. Since she didn't ask me about gestational diabetes or talk to me about weight gain I assume I'm progressing nicely. We talked about why my heart and head are pounding and why I have constant headaches, and the reason is... "You're pregnant!" She told me how to get around nosy pharmacists who don't want to give pregnant women decongestants (yes, this happened to me)... send Ivan to get them for me! I now have a game plan.
She then skipped straight to the fact that we have not set up an amniocentesis date. At first I was kinda annoyed about this. Two out of three appointments have seemed to focus on why Ivan and I aren't scheduling an as-yet unneeded amniocentesis. The philosophy behind doing so seems to be, "Well, what if you need to make a Decision?"
We already have! We have decided to await the results of our integrated screening. A quick explanation....
There are a couple different ways a couple can pursue genetic screening. There's the fast but least accurate way, which would have given us early results (we'd have known by now what our odds are of having a baby with a genetic defect) but with an extremely high rate of false positives. There's the not-as-fast quad screening, which also has a (slightly lower) unacceptable rate of false positives. Both these tests consist of the nuchal fold ultrasound measurement and a single blood test in the first trimester. They're done mostly so that parents can decide whether to go ahead and schedule an amnio right away.
We opted for the slowest but surest method, which involves the nuchal fold measurement, two blood tests, and a high-resolution (level II) ultrasound. We won't find out til all of the work is done and the results are processed and combined to give us our odds of having a child with genetic defects, but we will have 90-95% accuracy.
The big reason for getting an amniocentesis done is so we could make another decision if need be - whether or not to have a therapeutic abortion. Couples make this choice based on chromosomal anomalies routinely, and the earlier in pregnancy it's done, the better. We have some pretty definite ideas of what we would need to see on the high-res ultrasound to convince us that we need this. We would need to see a baby that is clearly incompatible with life and for whom dragging it down the birth canal only to put it through excruciating pain for the three or four hours it lives would be intolerable agony. We couldn't do that to our child.
An amniocentesis would reveal anomalies that might require medical intervention at birth - but so will a high resolution ultrasound. Since there still is a small risk that amniocentesis can cause a miscarriage, we want to avoid it if at all possible. If the high resolution ultrasound reveals minor issues that are still compatible with life, we'll have the amniocentesis done to see what we're facing down the road. Otherwise, we prefer not to take the risk.
The concern our doctors (who really do seem concerned) have is that most states will not perform therapeutic abortions beyond the 22-24 week mark. Well, we're wrapping up the bloodwork and ultrasounds at the 19 week mark, and I've been assured we should have results back within the following week. So if, and obviously we want this to be a big IF, we need to make that decision, we'll have the time to do it.
I always hate talking and typing about this stuff. Makes me teary and what not. But we were able to convey this to Dr. Gould and she was right on board.
So, after this big long discussion about why we are not all fired up to get amniocentesis scheduled before the results of our integrated screening, we moved on to the heartbeat time, yay! I hopped up on the table and bared my belly.
No yay. No heartbeat. Dr. Gould was chatting to us while she looked and I was chatting back gamely, and it still wasn't there. She reassured me that it was still pretty challenging to find the heartbeat with the Doppler instrument this early, and decided to go find out if the room with the ultrasound machine was available.
She left. I hopped off the table and dived at Ivan. I didn't cry. I felt like I was holding together pretty well and I know, know, KNOW that babies can be difficult this early. Ivan and I made small talk about nothing I can remember and I compulsively rubbed his fuzzy head.
Four years, three months, and two days later she came back and took us to the ultrasound room.
And there was Scary Baby! In all his lazy, non-moving glory. For a moment I panicked because I didn't see the heart flicker that we saw the last three times, but he IS getting skin and fat deposits and stuff, so it stands to reason. After moving the instrument around a little bit, Dr. Gould was able to find the heart beat at 144 bpm. Scary Baby is sitting up pretty high, which makes it understandable that he was hard to find on the Doppler.
Dr. Gould told us about a time she was using a Doppler and couldn't hear anything on it... no placental noise, nothing. She looked at the battery indicator and said, "Oh, it died..." and you can imagine the mother's reaction... she said she had to backpedal reeeeally fast and explain that she was talking about the machine... not the baby...
I think I still would prefer that to Scary Baby, who is sleeping comfortably and has drained me with all the excitement he caused. Nap time, and then I have a gorgeous grapefruit awaiting my afternoon graze. He seems to like those. I'm hoping enough vitamin C will help my sinuses get ungermy and thus, the headache I've had for two weeks will go away.
Here's to hope!
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