Wednesday, May 28, 2008

The Big U/S: And it's a...

...healthy baby!

I'm 18 weeks and 1 day today and so far the baby looks perfect. The u/s tech was a sweet heart. She started off by asking that if she got a good shot did we want to know the sex of the baby. We laughed and looked at each other. It's been an on going debate. Do we want to know? Would a complete surprise be better? Or would knowing so we can buy gender specific clothing and nursery items be better? If we find out, are we going to keep it a secret from friends and family? We told her that we did want to find out. We decided to try to keep it a secret from family and friends. I'm not sure if we can do that or not! Chris isn't very good with secrets. :)

So then the u/s tech asked Chris what he thought the baby was. Chris has been saying girl all along. I went with that at first but the past month or so I've really thought it was a boy. So one of us was bound to be correct! The tech asked if we had any bets riding on the sex of the baby. Chris is a little gun shy on bets right now after losing two in a row. (Ask him about the words to Hang on Sloopy and what color Charlie Brown's shirt is. One of those got me a vacation in the Keys and one a dinner and I movie!) The tech tried to goad him into taking a bet but he wouldn't budge. She said that she would save that and tell us at the end of the scan.

The baby was sitting on it's bottom in a breach position. We didn't see the baby moving around so I didn't relax until she dopplered the heart. That's aways a sweet sound no matter how many times you've heard it. 143 bpm. That's about what I get at home, usually around 149 or so.

She started first by measuring the baby's brain, upper lip, and heart. The heart took some work to get a view of all four chambers because one of the baby's arm was creating a shadow. According to the tech, the baby had it's hands together like it was praying. I had trouble seeing that but I'll take her word for it. She tried all kinds of different angles and finally jiggled my tummy. She said, "Come on, baby, this is war!" We all started laughing. But I felt bad for the baby! If it was sleeping, who were we to disturb it?

She then checked both arms and legs, measuring the bones. She also checked to make sure the feet were straight. I'm glad she told us what she was looking at because most of the time I didn't have a clue. But I did catch a peak at what looked to be between the baby's legs. It pays to look at other people's ultrasound pictures online! I didn't say anything though because Chris was enjoying the show.

She checked the baby's stomach, kidneys, and bladder. Blood flow looked good. The baby measured normally at 8 ounces.

She then said that she'd get us some profile shots and the gender. She put it on 3d a few times but wasn't happy with the views. The baby isn't really filled out yet so she said it would look better in a few weeks. Chris was happy with one of the
3d pics but she questioned him and then didn't print it for us.

She gave us what she called the baby's first porno shot. I wasn't thrilled with her calling it that. But actually when people say money shot, it's also a porn reference. Yech.

Here's the pics! Can you tell what the baby is?


So then the doctor came in and reviewed the ultrasound pictures and we got another mini scan. This time the baby had flipped head down. How come the baby will never move on the screen? I had even drank some orange juice on the way down to the doctor's office. The doctor said the baby looked perfect! He didn't see any soft markers for genetic problems. Since I'm 37, he spoke to us about having the amnio.

According to the NT scan and bloodwork my risk for the baby having downs syndrome is 1 in 890. So that's good considering for my age the risk is 1 in 140.

According to my age the risk for having a baby with other genetic problems is 1 in 89. That's scary but it's still not that high, 1.1% chance. For 89 babies, 88 will be healthy.

The risk of miscarriage for the amnio is 1 in 200. If we had seen something that was a soft marker for a genetic defect, then we might have proceeded with an amnio. At this time, I don't see any reason to risk a potentially healthy baby to a miscarriage from the amnio. We wouldn't terminate the pregnancy any way. So the doctor had me sign my refusal to the amnio. He wasn't intimidating about it, just matter of fact. He did stress that at this time the baby showed no signs of any problems. So we're going with that!

I do have another Level II ultrasound scheduled with this same specialist in 4 weeks. The baby will of course be bigger then so a more thorough scan can be done. At 18 weeks today, it was still on the early side for the anatomy scan. So I get another treat at 22 weeks.

Friday, May 16, 2008

Crying and Laughing...

Tuesday I went in for the second blood draw for the integrated screening. Basically this combines the results of a first trimester blood draw, the NT scan, and another blood draw in the second trimester to provide the risks of several genetic defects. It's a screening, not a diagnostic test. It has a much lower false positive rate than just the blood draws separately. I felt this was a good initial step for us to take because at my "advanced maternal age" many go straight for the amnio. The amnio carries a risk of miscarriage (perhaps 1 in 200) which was something I would rather avoid after having lost two babies due to miscarriage.

After the blood draw, the nurse said she would be calling me with the results in 3-5 days. That made me nervous and excited all at once. Originally I was led to believe that I wouldn't get the final results until my big ultrasound and genetic counseling on 5/28. I worried that if I got the results early and they were bad, I would have to another 12 days of torture for my actual appointment and ultrasound. On the other hand, if the results were good I would have a little more peace of mind the next two weeks.

This morning was the third day after the blood draw. I was downstairs listening to the baby's heartbeat on the doppler.

I thought I heard my phone ringing upstairs over the whooshing of the baby's heartbeat. I RAN upstairs. I missed the call but it was just from my dermatologist. As I was listening to the voicemail, the phone rang again. This time it was from the perinatal center. Thank God I got the first call so the phone was in my hot little hands already. That was one phone call I wanted to take live and in person.

I'm crying and laughing and thanking God all at the same time!

The perinatal center had the integrated screening results. The baby is screening negative!

The risk for down's syndrome is 1 in 890.
For my age (37) the standard risk is 1 in 140 so we beat those odds!

For trisomy 18, the risk is 1 in 10,000.

For neural tube defect, the risk is 1 in 3,000.

I know it's not a guarantee but those are all good numbers for my age!!
They consider 1 in 300 a "positive" screen.

Woohoo! Thank God.

Now we'll see how the baby looks at the big anatomy scan on 5/28. I'm praying that there are no soft markers or other problems and we can be reassured that the baby is healthy.

Thursday, May 15, 2008

I will soon be unemployed

And I guess it's a good thing. I'd rather keep working but my employer is unable to accommodate our need to work locally.

My husband and I drive a tractor trailer for a living. We have a scheduled run from south Florida to Atlanta five days a week. It's 7,000 miles of driving every week with no time off or at home. We're constantly moving.

My OB has been okay with me driving as long as I promised to get up and walk every two hours. Pregnancy is a state of hypercoagulation which means blood clots are more of a risk. Add that to me sitting 11 hours a day and you have a risky situation. My OB stressed this to me, reminding me of the NBC news correspondant, David Bloom, who died while riding along with an infantry division heading to Baghdad. I had just watched a television documentary on the initial days of the Iraq war and I remembered his story.

It's been a struggle to stop and walk every two hours because of the tight schedule we're required to keep. It's been more of a strain on Chris because he's had to do more of the physical work than before. He's also been driving a larger share of the miles because I'm so tired. Obviously we couldn't continue doing this job forever. Eventually we need to be home for the baby! We've been trying to ask for different jobs for over 8 months. For one reason or the other (all legitimate) our manager has asked us to continue to do the run until the timing is better. Well with the economy, the timing isn't going to get better for a long while.

After my 15th week OB appointment, we decided to speak with our terminal manager again. This time I needed a firm date to stop driving. I had hoped to get an office position. I had done that part time four years ago when I drove locally so I definitely had the experience. But did they have an opening?

So we had the sit down with our manager. He congratulated me when I told him I was pregnant and would need to stop driving that run soon. He of course figured something was up with all the doctor appointments that I had. I actually told him that I had two miscarriages over the last year for some reason. My voice broke! That's the first time I've told anyone out loud other than very close family. I just didn't want him to think I'm a sickly person and normally needs a lot of time off. That last year has been the exception for my normal attendance.

There's a hiring freeze right now that actually may last until the end of the year. He can't create an office job for me, said he was sorry to lose a good driver but with the economy as it is there's just nothing he could do. I understand that and expected it. May 31st is expected to be my last day.

As for Christopher, the manager has been trying to create a new nightly run for a while. He's going to work on that and try to get two city drivers to take over our run. So hopefully Chris will either have a night job driving about 430 miles or he'll work in the day making city deliveries. If they can't find someone to take the job from the city, then Chris may be out of the job too. The night job would pay better plus it's less physical work.

Chris told me that he didn't want me to work any where else so that's a relief in part. If he doesn't get to keep his job then that may change. Now we wait and see.

We're prepared financially. The plan is for me to be a Stay At Home Mom. I guess now I'll be a Stay At Home Baby Grower. It's still intimidating though to think that I won't have a job for much longer. I've been working since I was 15. I've never depended on anyone else. A baby brings big changes!

Monday, May 5, 2008

15 Week Appointment

TMI time.

At my initial OB intake appointment it was discovered that I had a bacterial infection. They didn't inform me of it until I made an appointment at 12 weeks. Normally they wait to treat this infection until the second trimester just to be safe. I got a one dose treatment but was advised to stop the progesterone suppositories cold turkey. That was my security blanket! I had planned to wean off the suppositories because I didn't want to see any spotting.

One in four pregnant women will get bacterial vaginosis so it's pretty common. It's actually more common than a yeast infection. BV carries an increased risk of miscarriage so I of course freaked out. I'm not really familiar with "normal" pregnancy discharge because I was on progesterone suppositories for the first 12 weeks. I started seeing more white discharge and worried that the infection was back. With the infection the first time, I had no red neon flashing sign symptoms which can also be common.

My OB thinks that I just have a yeast infection. I swear that man loves stats. "15-20% of women treated for bacterial vaginosis get a yeast infection afterwards" I told him I was concerned since BV is associated with a higher risk of miscarriage. He told me that didn't cause my other miscarriages. Sigh. I *know* that but I'm worried about THIS pregnancy. He reassured me that I can call him any time I have a question.

I asked him if they would measure my cervical length at the level II ultrasound at the genetic counselor's. He said they would, but how did I know about that. I told him too much time on the internet. :) I was a little concerned after having all the infertilty/Recurrent Pregnancy Loss testing procedures (SHG, HSG, EMB, IUI) in such a short time plus I've had cervical biopsies in the past for HPV. Then he tells me that cervical length didn't cause my other miscarriage either. Right, but about THIS pregnancy? He told me D&C are used for birth control in Russia and they don't have a higher rate of miscarriage so he doesn't feel that those procedures which dilate the cervix affect cervical length very much. Threw some more stats in. Mentioned that I can call him with questions again.

He used the doppler to hear the baby's heartbeat. He didn't tell me the heart beat rate today and for some reason I didn't ask. Chris and I just looked at each other like smiling fools while we listened. Then he measured the fundal height for the first time ever. I was nervous about how that would go down with me being overweight. He said it was *perfect.*

So far I've gained 4 lbs. I wish I'd kept it lower but I had a pig out week or two in between appointments that included McDonalds and donuts. I know I'm not eating for two but it's still nice to indulge in a craving as long as the weight is okay. My breasts could easily be those 4 pounds that I gained. Seriously, porn stars would be jealous that I got these big boobs for free. ;)

My OB was so nice and talked to us for a long time. Including about me still driving the truck. Mentioned I could call him any time at least twice more. LOL So it was a good appointment but I would have rather left with another RX for the bacterial infection just to be safe. My OB was really nice about it all but as soon as he left to look for samples of YI cream, I asked Chris if I really sounded like a paranoid freak.

I mean, I must sound like a paranoid freak or my OB has ESP because I THINK like a paranoid freak most of the time. FYI: Two miscarriages in a row will definitely put you on the paranoid side of the fence.