Tuesday, February 23, 2010

Normal

First, can I tell you how much I HATE dealing with a "regular" ob? I miss the kindness and compassion--and, yes, the handholding--of both Smirky and my perinatologist. I feel like the nurses at the ob's office see so many "normal" fertiles and normal pregnancies that they just get nervous when an uptight infertile with a history of miscarriages calls the office.

But, I'm getting ahead of myself.

After last week's nuchal scan I called my ob's office to ask some follow-up questions about my normal-but-still-higher-than-we'd-really-like translucency measurements. I got transferred to a nurse and explained my situation:

"Hi, I had my nuchal scan yesterday and the translucency measurement was technically in the 'normal' range, but was higher than we'd like, so I'm naturally very nervous. I know that we don't get the full results until my bloodwork comes back, so I'm hoping you can tell me when I could expect the full results."

"What? Well...er...you don't get the full results until your next blood draw at 16 weeks."

"Well, yes, but I know that we get a risk assessment from these tests and I'd like to know what they are. You see, I'm 12 weeks pregnant and understand I can only get a CVS until I'm 13 weeks pregnant, so I really have less than a week to decide whether I want to go that route. And, I don't want to make that decision without the results of this test."

"Let me look for your chart."

Long Pause...

"We don't have any results yet."

"Yes, I didn't expect you would, but my measurement was higher than normal so I'd like to know when you will."

"Higher than normal? Well, I wouldn't worry unless it was lower than normal."

!!!!!!!!!!!!!!!!

"Yeah. I'm pretty sure that's wrong. Can you direct me to a genetics counselor?"

And that's how I ended up back on the phone with my fabulous perinatologist who both understood my concern and explained lots of helpful options, including the fact that I could call them Tuesday (today) to get the full results and discuss next steps. I heart them.

So, call today I did. Unfortunately, I got a woman on the phone who basically said, well yes, I have your results right here, but I can't GIVE them to you.

????!!!

She couldn't read me the results but instead had to fax them to my useless Ob. I'm sure there's some horrible privacy law about why they couldn't, but it was bullshit. I'm a person. Who's scared. And on the phone RIGHT NOW. Please just tell me whether I need to worry!!

So, I had to hang up and call my ob. I got another nurse...let's call her nurse snippy.

Me: (I open with the whole backstory above, but I'll spare you.) "So I'm calling to get the results."

Snippy: **SIGH** Hang on...

Snippy: The first part is normal, you'll get the results of the second part and your paperwork later.

Me: "Um...I don't understand what you're saying. Can you please explain it to me? I'm really scared about all of this and really want to understand all of it."

Snippy: *sigh* "The results are normal."

Me: Now on the verge of tears..."Well, can you at least tell me the numbers that go along with it?

She did. And then got off the phone quickly.

I hated her. I mean, I hate to bother your busy important schedule, but I'm scared sh*tless that something is wrong with my baby. A little bit of fucking compassion wouldn't kill you. Bitch.

The bottom line is that it seems like everything is "fine." The risk of the baby having Down's went to 1:710. (My age-related risk is something like 1:365 or 400.) And the risk of the other trisomies was 1:10,000.

So, good news. I will now not be totally assured until...well, until delivery, really, but short of that until my 16 week blooddraw and 18-week anatomy scan. But, I'm glad that my risk didn't trip a "quick get this girl an amnio STAT" radar.

Exhale.

Let's hope no more excitement lies in store for me down the road. I would like to hear "normal" over and over again between now and September. Here's hoping!

Thursday, February 18, 2010

In the high range of normal

When you've been through what any of us has--pregnancy, miscarriage, infertility, treatments, etc.--you want to go into every doctor's appointment and hear only one thing: "everything looks perfect!" Anything short of that--even if it's merely a less-than-effusive, "sure, everything's fine" will send most of us into a panic.

So, you can understand how I felt when the ultrasound tech was nearly silent for 40 minutes of today's nuchal screen and as she kept trying to jolt the baby into a different position by jostling my belly over and over again.

This was NOT the reassuring 12-week ultrasound I was hoping for.

The problem, apparently, was that the baby was lying in such a way that made it difficult to accurately measure it's nuchal translucency. She took a bunch of different measurments, each time getting something in the range of 2.8-3.1mm. (Apparently anything above 3.0mm is considered abnormal.)

Thankfully, she finally gave up and brought in another tech, who was able to take the measurements in about two and half minutes. He took three measurements in a row that put the thickness at 2.6mm. Better, but not altogether reassuring.

The good news is that everything else looks fine: the heartbeat was a strong 153bpm, you could see a four-chamber heart, a stomach, the bladder, the lungs, arms, legs, etc. And, you could see a clearly defined nasal bone, which is apparently a reassuring sign.

The second tech tried his hardest to be reassuring, but the damage from the first tech was done, and now I'm freaked. And, Dr. Google is even more useless than ever when researching this topic. I can find some info that suggests that any reading over 2.5mm at this point is high, some that say anything over 3.0mm is. Either way, this isn't the super-thin result that I think everyone wants to see.

I now have to wait at least a week until we get the results of my bloodwork back to assess the actual chances of this baby having a genetic abnormality.

Of course, I hope that everything comes back just fine and we can put this behind us. But, I actually suspect that the results will be inconclusive. Apparently the point of this screening is to get your risk down to something less than 1:1,000. The risk for my age (35 at delivery) is something like 1:350. I'm willing to bet I get something right around that number, which will tell me only that I should have skipped the damn test entirely. (Of course, there is also a chance that my risk will go up and that I'll see a number higher than that. Let's just hope that isn't the case.)

I'm still trying to process all of this--and to talk myself down. I just have to hope everything is fine. I'm sure I'll post something more coherent eventually. For now, just keep your fingers crossed that this little bean is just fine.