Julia

48 Hours And 400000 Years Later

Thank you very very much for the sympathy and helpful suggestions. I have a big ol' post up at REDBOOK that explains (I think - I am actually not sure what I wrote, I just kept typing) this in greater detail but the short version is that I have an appointment with a perinatologist at Mayo Clinic on Monday. The plan is to have him take a look and then do CVS, if warranted. My only remaining worry with all this is that my appointment starts at 7:30 am, we couldn't find a babysitter for Patrick overnight (that I approved, which means my mom or brother could not come) so unless I can arrange some sort of temporary drop-in care for him in Rochester Steve and Patrick will be at the hotel pool while I see the doctor. It seems a little sad to go alone, though. Sort of weird and a little pathetic. Hey, maybe I'll bring a sock puppet!   

I keep looking at these ultrasound pictures of B, trying to put them at an angle where it doesn't look so very BULGY back there. Steve and I brought out the two other images we have from abnormal pregnancies 11 and 12 to do a comparison and our conclusion is that the nuchal on 13b over here is less than half the size of 11 (which was absolutely massive, the fetus looked like it was reclining on a beanbag chair) and somewhat smaller than 12. Due to the wild variations in the size and scope of the pictures this is about as scientific an approach to interpreting this as taking the fact that yellow jackets have just built a nest in the lintel of our front door as a sign about the pregnancy from the bee gods. I don't know. Maybe it will be ok. I honestly tried to believe a few impossible things before breakfast this morning but first I threw up and then I had to take Patrick to Montessori camp and by the time I got home my willingness to see a genetic soft marker as anything other than a goddamned genetic billboard of doom had evaporated.

But let's talk about mosaicism. Mosaicism is when there are both normal and abnormal cells present in an embryo and it is, I guarantee, what the nice PGD guy will say happened if it turns out that we have another unbalanced translocation in the works. You can see how it occurs, of course. Say you start with a normal egg and a normal sperm and they create a normal cell together. That normal cell divides to create new normal cells. But somewhere early on in the process one of the normal cells becomes abnormal, losing part of a chromosome or picking up an extra one. That abnormal cell might divide as well, such that you now have normal and abnormal cells both adding their little all to the embryo. When PGD is done they take a cell or two and test that. If the one they take is normal but the majority of the remaining cells is abnormal the PGD results will be misleading. OK? OK.

This becomes a little harder to imagine when you are talking about reproduction involving carriers of a specific genetic condition. In order for that genetic condition to get passed on you need to have the original sperm carry it, yes? Well, this is where the nice email from the nice woman came in so very useful.

She wrote:

"But it is also possible that (for example) the translocation quadrivalent segregated 3:1 in meiosis and that the fertilizing sperm carried two normal chromosomes and one translocated one. The translocated chromosome could have then nondisjoined again during one of the earliest embryonic mitotic divisions, so that the embryo was a mosaic, and the cell that was selected for PGD happened to be one that had two normal chromosomes and had lost the abnormal one. but the abnormal one was still there in other cells."      

Which I found as satisfying as a chocolate chip cookie because it offered a logical explanation for something I had previously found completely illogical. Also, the situation she describes would be rare, so the odds of our getting another unbalanced but mosaic embryo would be rare. So when the lab said "these two are not unbalanced" this time I could believe them.

There are so many different possibilities over here that a less dedicated person than I would probably not even bother to worry about them all and would just breathe deeply and steadily until Monday, possibly taking up painting or the flute in the interval. But I am nothing if not devoted to my ability to catastrophize so this is what I have come up with:

1. the nuchal is not actually abnormally large. we saw a bad/twisted/distorted view for some reason

2. although it is increased it does not mean anything. 90% of fetuses with nuchal translucencies between 2-3mm (to take a random guess at what we saw) are fine.

3. the fetus has Down's

4. the fetus has trisomy 18

5. the fetus has trisomy 13

6. the fetus has some other random genetic disorder

7. the fetus has a normal karyotype but suffers from a congenital heart defect 

8. the fetus carries an unbalanced version of Steve's translocation

Any other possibilities that you can think of? Well, eight is probably enough to keep me busy until Monday.

I realize that I seem to be ignoring the other twin in this. And actually I am, a bit. Some part of my mind is aware that we have a very good chance of bringing that baby home and I am thrilled about it. But it is too schizophrenic to feel unreserved happiness when I am worried that the other bobbing and weaving lump is about to die. Does that make sense? I cannot seem to compartmentalize my anxiety about 13b and what is going to happen just yet. I will, I know. I have been at this too long to dwell on disappointment at the expense of wallowing in happiness. But I'm just not there yet.

Remind me to talk about Patrick's birthday and Montessori camp. Both went/are going well.

Brief and Ugly

FUCK.

Ultrasound today showed one nice looking fetbryo and one fetbryo with an alarmingly distended nuchal translucency. Details on this are up at REDBOOK (link to the right there) and I don't feel like typing it all over again. So if you want to go check there I will wait.

With me?

FUCK.

I... sometimes I don't even know what to do with myself. Am I a COMPLETE FOOL? I read this definition of insanity once and I bristled (positively bristled): insanity is repeating the same action but expecting a different outcome. You know when you read some glib definition of mental illnes and it touches a nerve you probably have issues. Here I was, pregnant again, IVF again, PGD again, but hopeful as hell.

Actually my real issue is hoping that I will still get two children from this. 

Latitudes

When I drive I point the car in the general direction I want to go and then I just... drive there. When Steve is behind the wheel it is somehow much more complicated and involves near constant calculations concerning not only his own speed but the velocity of every car around him, possible lane changes for the next three miles, law enforcement probabilities and minute mirror adjustments with topographic shifts. I don't know if any of this makes him a better driver than I am, but it certainly makes him a lot less chatty. The drive to Chicago was pretty boring, what with Steve silently playing Le Mans and Patrick noting each and every mile marker. Finally I said, "This is boring" and Steve obliged me by offering what can only be described as a gambit, an honest-to-goodness conversational gambit: if we had to live anywhere other than Minnesota where would I want to live?

I have probably told you this story before but what the hell, we are growing old together aren't we? No reason we can't start repeating ourselves. Steve and I originally moved here because I wanted to leave Chicago. Nothing against Chicago, you understand, I was just at that stage of life when I was convinced that true and ever-lasting happiness was waiting for me. Somewhere else. So we went to a bar one night (this was back when I used to drink white wine. go figure) and we made two lists on two cocktail napkins of places to which we would be willing to move. Since Steve and I have nothing in common beyond this fierce, almost mystical, love we share; it took about seven or eight cities on both our lists before we had a match: Mpls-St. Paul. So here we are and there is no real reason why we couldn't move somewhere else tomorrow, apart from the fact that it will take us at least six months just to pack the garage.

As I considered Steve's question I was surprised to discover that my original seven cities were no longer very appealing to me. San Francisco is beautiful and I still love it muchly, but yesterday I watched a gray fox chase a squirrel up a tree while a turkey and fawn arranged themselves artistically in the foreground. That tree right there, actually, but it is just one of the many you can find here in the Northwoods. And when we want to drive from the Minnesotan equivalent of Union Square to Marin (work with me) at four o'clock on a Friday we just hop into our car and go, secure in the fact that any traffic will be comparatively light and we will probably know all of the other drivers anyway. Nice chance to wave to old friends when the interstate slows to 50. It is very pleasant here.

However, when pressed, I decided I could be happy in Baltimore (home of my alma mater, forever dear to my heart), Seattle (rainy and close-ish to my brother and an ocean) or possibly Denver. I waffled on Denver and I am waffling still. I like the city and the mountains but it is so damned sunny all the time. Steve pointed out it would be good for my hair, though, so it's still on the list.

And would you like to know where Steve would be willing to move?

Jackson, Wyoming.

I don't know why I found this so amusing but I really did. I'm over there in Baltimore and Steve is finding himself in a town in Wyoming.

However, this was not where I was going with this. Steve's mention of Wyoming elicited the fact that I have never been to Wyoming. Or Idaho. Or Montana for that matter. So I suggested that we might want to pack up the car later this summer and do a little back-of-the-car camping trip. Steve doubted my sincerity (just because I have never gone camping with him it does not mean I have never gone camping) but I managed to assure him that I think it sounds delightful. We broke out the atlas when we got home and I started looking at possible routes West. I was only able to look for about two seconds before Patrick commandeered it (Patrick. he likes maps. a lot) and began to plan his own route: "So what we'll need to do is drop down 35 here to 14 and then cut over to Pierre... ."

Detailed trip logistics aside (Patrick's route would take us through every small town in the West and would last about four months) we had decided that we would do this.

So I mentioned it to my mother. And she laughed. "You're going to be pregnant with twins and go camping?" she asked.

I said, "Certainly! Why not? It will be fine. I might be pregnant, not incapacitated by two broken legs" in that peevish tone women reserve from adolescence for just such conversations with their mothers. And actually it would be fine and we don't hold with all that cotton-wool molly-coddling over here. Sure I threw up in Target yesterday but did I quail? Did I falter? No! I finished shopping for the blasted birthday party goodie bags, weak and trembling though I might have been.   

Where the hell was I?

Oh right. The POINT (at last) is that prior to my mother mentioning it, I had completely forgotten that I was, in fact, pregnant. At no moment during the days Steve and I talked about this little jaunt did it ever cross my mind that I may be X weeks pregnant at the time and anxious for middle-of-the-night bathroom access, if nothing else. Not once. As many times as I have gotten annoyed with Steve over the years for forgetting that I was pregnant (which is many) I am suitably chastened to discover that I am capable of forgetting, too. Apparently I am perfectly aware of the morning sickness, the number of hours since my last ultrasound (250) and the number of hours remaining until my next one (108) but I have not synthesized this information into any real concept of the future. Who knew?

New REDBOOK post up.

Oh, and where would you live if you had to move?

Not For The Scallops

I felt pretty gross last week and then we drove to Chicago for a wedding and now here we are, a week later.

How are you?

Gross is actually a relative thing and I was really worried that a, uh, twin pregnancy was going to be twice as bad as usual in the morning sickness department. Which meant that I would die. And it saddened me because I have always been rather fond of me. But in truth the vomiting has been a little better than in past pregnancies. Rosy-fingered dawn drags me out of bed each day, so nauseous I cannot sleep, and I crawl off to the bathroom lugging my water bottle with me. If you are squeamish avert your gaze here but I feel the need to pass this tip on to anyone in need: I find that when vomiting is inevitable it is nice to just chug cold water and succumb. Throwing up water isn't so bad and it helps to settle my stomach. Anyway, I do so in the morning and then go about my day; repeating the whole water/vomit thing another three or four or five times. And so, to bed. I have taken an anti-nausea Reglan a couple of times, like this weekend for the actual wedding or before taking Patrick to the planetarium for the black hole movie he wanted to see (note: there are not enough drugs in the world to assist in watching a movie that is shown on a dome and involves swirling - swirling and flashing lights). The rest of the time I just muddle along and if I have not gained any weight I have not lost any either.

We thought about telling Steve's family about the pregnancy this weekend. We even decided we would and then... it just didn't seem right somehow. We didn't tell them about the last couple of pregnancies and we did not mention that we were doing another IVF cycle. It's not like it is a secret or anything, or that we were worried that they would be anything other than kind and supportive. I guess we are a little embarrassed to still be trying? I don't know. I was sitting there with the immediate family and Patrick nowhere in sight (we have no intention of telling Patrick anything until I can tell him he is going to have a brother or a sister and actually believe it myself; also, should we ever be so lucky as to actually get to the first point, I want to give him some notice but not so much that it is like driving to Chicago with him counting down each mile of the way for us) and I opened my mouth to start a sentence like, "We have news" or "We hope to be in expectation of an interesting event" or something equally precious but nothing came out. We have another wedding next week, different major players but same supporting cast. Maybe we will mention it then.

I am, all implicit pessimism to the contrary aside, extremely happy and very excited about all this. Not only did I not scream when given a due date this time; I have contemplated it with affection. I have adjusted it for twins. I have given thought to how I am going to concurrently have house guests at Christmas and be due with two babies. I am indulging in fantasies and I am enjoying them tremendously. I have even... thought about possible names. It is like Mardi Gras over here, ya'll, and I am unapologetically letting les bon temps rouler.

Next ultrasound is a week from today, when Doreen the ultrasound tech and I (along with Steve) plan to play amateur perinatologists and see what can be seen of those nuchal translucencies. A real NT scan can only be performed by a trained expert, of course, but Doreen caught the last one at ten weeks so we thought we might as well take a look before the big perinatology appointment in early July.         

I want this SO MUCH. This is it for us. If we lose these we are most emphatically done. But I am trying not to think about that too much. Like I said, I'm happy.         

++

Patrick has been absolutely delightful lately. When we got back from Chicago last night he announced that he was pretending it was Christmas and he wrapped his toys in blankets or put them into boxes and gave them to Steve and me with a great deal of pomp and ceremony. I scored some Legos and a few Matchbox cars.

He painted a picture today and then came to get me for a viewing, saying and I quote exactly, "I am quite the little artist, aren't I?"

Thank you, Jasper Johns.

He turns five next Monday and is as excited as one is when one is about to turn five next Monday. He and a friend from school are having a joint birthday party (did I tell you this already?) and it took me a while to convince him that they could each have their own cake. There is a streak of asceticism in Patrick and I have no idea where it comes from; Steve and I being as acquisitive as the next greedy bastards. Many's the conversation I have had with Patrick concerning the purchase of a new DVD, for example. I see the opportunity to acquire a new children's film as a solid hour and a half of free time in my pocket and have frequently tried to suggest to Patrick that we buy movie X or Y and take it home. He, dour forty-one inch Puritan that he is, always frowns repressively and says, "We have DVDs at home, Mommy" and returns it to the shelf. You think I am kidding, of course, but I am sorry to say I am not. I don't think it is so much that he is displaying a maturity beyond his years as the fact that he is out to get me. I say "black"; he says "white". I say "Ooh, Little Mermaid!"; he says "Put it back."

Where was I?

Oh right. It took me about a month to convince him that he and Liv can have two different cakes and now I am bitterly regretting it because he has decided that in that case he would like a universe cake. You know, your standard issue sheet cake covered with black frosting and decorated with the Earth, the Sun, Saturn and the Andromeda Galaxy. And even if I could make such a thing (which I most emphatically cannot) I cannot bring it to the place where we are having the party because Minnesota state law prohibits the consumption of homemade food products in inflatable party palaces. Or something like that. I didn't read the statute. So now I need to find a bakery that can improvise. Any thoughts?

Two present suggestions for this age range, by the way, and if you are interested.

The first is a Dig-a-Dinosaur kit that Steve's birthmother gave Patrick when we saw her last week. It is basically a lump of sand in which is embedded a model dinosaur fossil. First the kids get to excavate the bones, then they get to snap the pieces together, and finally they get to paint it. Those bits took most of an afternoon and now Patrick has been running around the house for days with his black, orange and purple T-Rex menacing things. Two big and two little thumbs up. Available here and wherever else google might direct you.

The second is A Pirate's Life treasure hunter. As best I can tell it is like a remote key finder but the two parts look like the two halves of a treasure chest. So you hide the bottom part and then the top part lights up from red to yellow to green as you get closer to the treasure. I have yet to see this in action but, honestly, what is not to like? Check it out here.

Over at REDBOOK I just urged everyone with pets who have bladders to stock up on Anti-Icky Poo (my cats are losing their goddamned minds. first they peed on the bed and then as I was stripping the bed and grumbling, one of them snuck over and peed in a pile of stuff I was about to take to the dry cleaners. I will take the two possible culprits to the vet, of course, but if neither of them have any issues they are definitely grounded) and now here I am hawking toys. My days of public service never end.      

The Whole Weekend Post

I got an email from an exceedingly kind woman/PhD in genetics/expert in chromosome biology this week that managed in a few succinct paragraphs to utterly turn me sideways on the necessity of having CVS done this time around. Considering the fact that moments prior to receiving this message I would have put my personal need for early prenatal testing second only to the zeroth law of thermodynamics in terms of that which is inviolate, it was really quite an impressive feat. I guess I am just a sucker for an impressive curricula vitae, a few pretty compliments and the use of the phrase "the translocation quadrivalent segregated 3:1 in meiosis" followed by a Lemony Snicket reference.

I would only embarrass myself if I attempted to recreate her elegant prose, but the gist was that PGD is much more reliable than I think it is. So, to paraphrase, if the embryos look like ducks and quack like ducks and PGD'd like ducks it is not entirely unreasonable to consider NOT defenestrating them just to prove they might be ducks.

More so than the remarks of a friend of mine (*) I found many of your concerns and suggestions quite helpful.

Let me back up a bit first and explain where I am coming from, in general. Although I know that choosing between a second trimester termination and a third trimester stillbirth is not the worst thing that has ever happened to anybody it is, quite definitely, the worst thing that has ever happened to me. Yes, the majority of our abnormal fetuses died before twelve weeks but one did not. One survived despite really significant problems and it was unclear how long he would continue to do so. Days, weeks, another month or two? There was zero expectation that he would survive to be born, but how long the pregnancy might continue was anybody's guess. So as much as I kept repeating no no no I don't want to do either no no no, please, no we had to make a decision. To this day that experience reigns for me as the most traumatic of my life. It was... it was HORRIBLE. I was in physical agony and sad beyond belief and I felt alone and helpless and ashamed. And I am absolutely certain that I never want to go through that again. Short of giving up on children altogether (which at the time would have meant that Patrick would never have been born), I vowed to do just about anything to avoid a repeat of that misery.

So early prenatal testing is important to me, perhaps in ways that those who have not been in my place cannot quite understand. Of course I do not want to endanger a healthy pregnancy any more than anyone would (even less, if that were possible, because they are so hard for me to come by) but the ramifications of not getting early information are still very real and raw to me.

Under normal circumstances (that is to say, a non-PGD'd pregnancy) I would never consider not doing CVS if it was at all possible. I opted for amnio rather than CVS one time and... well, we just talked about that. It is not a gamble that I am ever willing to take again. Not only is the worst-case scenario so freaking terrible, the risk of it happening again are quite real. We are not talking about the more familiar odds of an over-35 year old woman who is the typical candidate for prenatal screening and testing. We are not talking about what I would or would not do to avoid a 1-in-200 chance of raising a child with survivable defects. That is not our problem and frankly I am glad it is not because I think that must be very hard in its own right. When Steve and I approach CVS it is with the understanding that statistically we have a 50% chance of detecting a lethal genetic arrangement and anecdotally our experience has been that such a defect has existed in excess of 90% of the time.               

However

We did do PGD. Unlike an unassisted pregnancy we do have some reason to believe that the embryos are just fine. The question in my mind, though, was how much reason was it, really? Having been burned by PGD results in the past I was seriously hesitant to put too much faith in them. Which is where the nice email came in so handy. Although both REs and my PGD guy have assured me that PGD testing is actually pretty damned good I felt that they had reason to mislead me. Like the blasted commissioned saleswoman who assured me I was FABULOUS in that red dress (hint: redhead. possible but not bloody likely and in this particular dress most assuredly not), I felt that they might have ulterior, possibly mercenary, motives. But a random reader who just happens to be chockful of useful information on the care and feeding of chromosomes? Her I can believe.

So once I ratcheted back the risk scales a bit the dilemma changed. If the embryos are, in fact, less likely rather than more likely to carry unbalanced translocations, the need for CVS becomes a little harder for me to assess. Which is where the rest of your comments proved helpful.

Originally your suggestions for scans and NT screens were greeted over here with a sigh of regret. Because the proven relationship between increased nuchal translucencies in the existence of the more common trisomies does not exist with our translocation. There are so many billions of possible weird little genetic combinations out there asserting themselves in all kinds of random phenotypical ways that it would take thousands of lifetimes to track even a tiny portion. In other words, there is no research that says that the absence of an increased NT means anything at all with our translocation. However, as a few of you noted, we DID see an increased NT (and cysts in the brain) at least once around eleven weeks and possibly twice. Soooooo... what the hell. Why not err on the side of optimism this time? (huh. I realize it sounds ludicrous to describe recognizing the possibility of identifiable defects as optimism but work with me).

I cancelled CVS and scheduled an NT screen instead with the understanding that if there are any obvious anomalies we will do CVS immediately. And whether one fetus or both looks odd at that point will determine who performs the CVS, so much so that I am not even going to worry about it yet. The compassionate doctor will do the NT screen and we'll go from there. I could explain the logic of using the more ethical practice but I am afraid it will sound rather clinical and I do not want to offend anyone, so I will not.

All of which is to say: change of plan and thank you very very much for your comments. They really helped me to make what I think is the best decision for us and I quite literally would never have reached it without you.

++

Patrick spends about seven hours out of every day making up riddles and then sharing them with me. If you just winced, thank you. If you think this sounds cute send along your phone number and I will have him call you instead.

It all started with a box of popsicles that had riddles on the sticks. Patrick thought he could do better. Some of them are actually pretty good:

Where does a bear park his car? In the Grrrrrr-age.

How does a cat cut the grass? With a lawn meow-er.

What was the kitten's favorite TV show? Deadliest Cats (thank you Steve! now I know what you guys do down there when I am cleaning the kitchen after dinner)

A few are rather esoteric:

What did the cat say to the dog? Bark!

Some make no sense whatsoever:

Why did the tree grow? Because he thought he was in Afghanistan!

And finally there is the new genre introduced by his three-months-older and slightly more sophisticated West Coast cousin, the bathroom joke. I will spare you the details but the punchline is always a variation on: because he wanted to pee on him! Ho ho ho.

++

Ah, Patrick. Now that I have the three/four years almost behind me I feel qualified to say, man, that is a freaky little stage, isn't it? I was looking at some pictures from the past two years recently and each one was... oh, there's Patrick with his beloved American Heritage dictionary! aw, there he is with a pencil in one hand, a calculator in the other and an insane gleam in his eyes! I have often wondered why I shared so much of my angst with you about Patrick's oddness when it was more often than not met with loud sniffs and muttered rumblings about obnoxious bragging, but as I was looking at these pictures I can understand my weak need to confide. It WAS unnerving. He was weird.

I have spoken to a lot of preschoolers by now, though, and I have concluded that they are all weird. Patrick has a friend at school, a very nice bright kid named Odin. Over the past year Patrick was bringing home increasing amounts of information about dinosaurs, a subject in which he had previously shown zero interest.

"Where are you getting all this stuff about dinosaurs?" I finally asked, curious.

"Odin."

"Oh, so Odin knows a lot about dinosaurs does he?"

"Mommy," said Patrick with an emphatic hand gesture, "Odin knows TOO much about dinosaurs."

Every time I think about that I laugh. I remember writing a post two years ago about Patrick's alphabet obsession and people wrote in to talk about their similarly aged children's single-minded pursuits. The two that stick out for me are the little boy who was fascinated by the skeletal system and the little girl who would go around the house with crayons trying to match the specific colors; not blue, you understand, but peacock vs prussian.         

I kept wondering when Patrick was going to start reading less for the pleasure of stringing sounds into words and more for content. He has had picture books he likes to read (Bad Kitty springs to mind. we recommend it) but it took him a while to connect an interest in a subject (say black holes) with a desire to read about it. A few months ago he developed a passion for poetry, mainly the works of Shel Silverstein but anything remotely funny and directed at children will do. From there he has spread into other things, science and nature books for the most part. There is a series of books on animals (Why Do Snakes Hiss? Why Do Birds Sing?) that he is enjoying right now (provided I can keep finding more at the library and provided he stops wanting to then acquire said animal as a pet. a snake in my house? not. going. to. happen.) For thirty glorious minutes on the flight home from South Carolina Steve, Patrick and I all sat in a row silently reading our respective books. It was a consummation devoutly to be wished.

Other than that he is all about Legos and racing Matchbox cars and finding bugs outside. He lucked into a very obliging catepillar he named Celea that we set up in a jelly jar and who promptly spun a coccoon right before his eyes. I felt a sit-com mother, what with all the childlike awe and wonder.

He is starting the Montessori camp this week and I hope he likes it. I still don't know what to do about the Y camp, though. I talked to a friend of mine this week whose daughter has taken a few Y classes with Patrick at our branch (which also staffs the camp) and when I mentioned that I was thinking of sending him for a couple week-long sessions she asked, "ARE YOU CRAZY?" She then proceeded to remind me of all the half-assed supervision we have witnessed: her daughter repeatedly running across the balance beam and falling each time while the teacher sat in the corner until the girl eventually split her lip; the art class in which the instructor was on her cell phone and the kid poured an entire bottle of tempura paint over his head; the sports class where the more agressive kids would take turn after turn while the younger/more timid children waited for a ball that they never got; the scary swimming class in which twins lost their grip on the edge and dragged each other underwater for one terrifying minute while their mother raced for the pool area and all the other parents pounded and kicked on the glass wall trying to get the attention of the instructor or a lifeguard or SOMEBODY (I just got choked up writing that. it was terrible.)

It was sort of nice to have somebody from my very specific reference point confirm that my fears concerning this camp are not entirely irrational. And caveat caveat I am not saying that ALL Y programs or camps are dangerous open mine shafts etc, just that SOME of the people running A FEW of the programs at THIS SPECIFIC facility have indicated a laissez-faire attitude toward their charges that does not settle well with me as I contemplate extending the times involved from 40 minutes to 6 hours and I will no longer be sitting right there.

You know what? I think I will cancel it. Whether he has the time of his little life or not I am clearly going to be a basket-case. I'll throw in a few extra weeks of Montessori (if he likes it) and we can do the Y camp next year after he has kindergarten (this school starts all kindergartners at half-day and then transitions them individually to full-day as the year progresses, which I think is awesome) under his small belt. Good. I feel better.

++

I am writing this over the course of two days, can you tell?

Ultrasound tomorrow at 10:30. I am not sure what I am expecting. I admit that I was not surprised to see everything looking ok so far, since good initial levels have usually given us expected growth in the beginning. I will be 8w2d tomorrow, though, and I guess I am prepared for anything. I have been spotting (brown) off and on for the entire week and while I still don't feel like it means anything I guess it might.

I'll post after the ultrasound at REDBOOK.                        

Smidge

Under the heading of "Coincidence", in light of our recent discussion re. the halcyon days of summers past, comes the fact that Steve is now on antibiotics for Lyme's disease. I removed a deer tick from the back of his knee two days ago that was nestled into the center of the most obvious bull's-eye rash one could ever hope to see. I think we got it quite early, though, so I am optimistic that he will not be succumbing to anything beastly any time soon. It is much easier to find ticks on Patrick (I removed another deer tick from the child the same day. no rash) since Patrick is not covered with thick black hair and dotted with small black moles (hmmm, doesn't Steve sound appetizing). As for me I don't go outside when it gets all buggy so I have only had one burrow in this summer. 

Nature is one big death-trap, I'm telling you.

However, as you rightly noted, the Patrick Y camp dilemma is not really about disease-carrying insects or even sunburn. Wait. Let me get cranky about sunscreen for a minute. It is my only cranky thing (well one of the few) but we do not fuck around with sunburn here. We held the wake for Steve's cousin's husband when died at thirty from melanoma developed after childhood burns on the lakes of Minnesota. I have had squamous cells removed twice from a spot on my abdomen that got terribly burned the first (and last) time I ever wore a bikini. Patrick got a sunburned scalp (through a tent no less) at three months and has subsequently developed an irregular, rough, mole-like, skin patch there upon which we keep a very close eye. My grandmother was missing most of her nose by the time she died, due to skin damage acquired during an Alabama adolescence spent on the tennis court. For every few kids that produce a healthy golden glow you will get one with sun sensitivity and then... trouble.  Skin cancer can develop from ONE bad childhood sunburn, so you must always be vigilant. VIGILANT! Ahem. Thank you.

Where was I? Oh right, I was acknowledging that that was not the point. The point is my fear of letting Patrick grow up and your gentle (mostly) prodding that I need to do so. You are right of course, and it is always nice to hear it thoughtfully and sympathetically expressed.

AM I certain that Patrick cannot put on his own sunscreen? Not in the slightest. It has never once occurred to me to ask him to try. He (although I know this will shock your lights out based upon how I describe him) actually has excellent small motor skills, so there is no reason, really, to believe that he is not perfectly competent in this area. Just yesterday he sat in his booster seat with a pen and a Mad*Libs and neatly completed several pages in perfect tiny legible print (although he used "plastic" as an adjective about 12 times for some reason). While the car was moving. So he could probably smear himself with cream, given the cream and the inclination.

I do question the inclination, although (good lord, could I be any more wishy-washy in this post) his teacher assured me he was very good about getting himself dressed to play in the snow at school despite the fact that neither Steve nor I have ever seen this reputed talent. Patrick is the kid who would a million times over rather go sit in his room than put on his boots because we told him to do it in order to go sledding. Cute kid, that. As I think I have mentioned in the past Patrick has never once in life said, "I want to do it!" OK, once, but we were talking about driving the car so it was not bloody likely. The rest of the time he is perfectly content to wander around forever, wet and naked, until someone appears to dry him off and help him into some pants.

One of the things that appealed to me so much about the Montessori camp is that they are such bad-asses when it comes to fostering independence. I was hoping that they would be able to help Patrick build on many of the skills he has developed through preschool over the past two years. For whatever reason I expect that the Montessori instructors are better equipped at gently but firmly nurturing self-reliance in a recalcitrant four year old than I can expect the college counselors to be at the Y. Still, as long as he isn't actually injured, your insistence that he will probably have a great time was well taken.

In conclusion: I recognize that I have hindered Patrick's necessary development either through well-intentioned smothering or deeply-rooted subconscious resentment that my role as a stay-at-home mother is predicated upon essential planned obsolescence. I further recognize it is a big world out there and Patrick is eager to paint it. So my only remaining concern is how to best make up for letting my beloved child develop his valet addiction and whether dropping him head-first into a potentially chaotic camp situation is the way to begin to remedy this. Most of you said yes. Some said no. I think the best thing to do is start with one day and work from there. All in favor?

Motion carried.

Meanwhile, hey! I am pregnant with twins! 7 weeks 3 days today. Go figure. I cannot decide if I am now immune to the realities of pregnancy unpleasantness so this doesn't seem so bad, or if it really isn't that bad this time. I throw up about three or four times a day, but... I don't know, who doesn't? I go to bed early and my lower back has this THING going on that makes it agonizing to sneeze. Apart from that, not too bad so far.

But enough of that. I am facing a massive dilemma and I need your thoughts, please.

Despite the PGD we are still going to do CVS. At least one of my two previous PGD'd pregnancies carried the unbalanced arrangement so we are not confident enough in the embryo screening process to avoid secondary genetic testing altogether. It is possible that CVS cannot be done with this pregnancy (google assures me it is harder with twins) in which case we will do amnio later but either way we will do something.

Now this is what is keeping me up at night. There are two perinatology practices here. The first one is the place I had such problems with last spring. Was it last spring? Remember the perinatologist who did not tell us that the fetus had obvious abnormalities and the genetics counselor who wrote a bogus letter when I sought a hospital termination and the week of pointless run-around followed by the ultimately inevitable in-uterine fetal death that could have been predicted if just one person had had the integrity to be honest with us just once in the process? Yeah. I hate them. But that doctor was really, really good at CVS. The best, I think. Extremely careful and methodical.

The other place continues to provide care whether the genetic results are good or bad, no matter what the patient chooses to do. That perinatologist told us immediately when she saw that the fetus had defects and candidly gave her opinion that she did not believe it would live. They were kind and forthright and I loved dealing with them. But I thought she rushed the procedure itself and I had a massive bleed afterwards for the first time following CVS. I do not trust her skills as much as I do those of the other doctor. However, I am terrified that something will be wrong with one or both of the embryos and I will be left alone to figure out what to do.

See my problem? Do I assume everything is fine and go with the place where I feel there is the least risk or do I assume we might have problems again and go with the place that has a much more compassionate approach?

It's a hard one.                   

PS New post up at REDBOOK.          

Lazy

Hello! Sorry for the delayed silence over here, I was busy getting my ass kicked by the beautiful state of South Carolina.

Patrick was sick in the beginning (high fever and sore), I had a bleeding episode, the toenail on my big toe is ripped diagonally but is still hanging on, there was a sunburn, morning sickness, a consistent inability to stay awake past 9:30... blah blah.   

anyway, that is where I was and what I was doing. You didn't miss anything.

The bleeding went away, although as recently as this morning there was, well, I guess I would call spotting. So faint as to be almost imperceptible but it is there. I am not worried about it, though; I guess because I have never miscarried that way and I am too limited in my imagination to whip into a froth about something without a personal tragic point of reference. 

Ultrasound in one hour with my RE. I am more excited than nervous, so I think I am expecting things to be plodding along as they should (famous last words, right there). I need to get a REDBOOK post up later so I will update there this afternoon, either way.

A couple of questions for you:

1. Do you know of any good, open-ended car track sets? Like for Matchbox cars and that ilk? Patrick loves his Geotrax train tracks and I want to find something similar but car related for his birthday. All the ones I can find can only be assembled in one way (like an oval track, for example). If you can think of anything I would be grateful.

2. I signed Patrick up for two different camps this summer. One is the summer extension of a local Montessori school. I signed Patrick up half days for three random weeks. I think he will like it as it sounds like a version of his preschool: art, waterplay, snack, nature walks, etc. Pretty low-key and Patrick will really like having new kids to play with. I feel good about this one.

The other thing I signed him up for his a YMCA camp. It said it was for ages 4-5 and it lists a slew of cool activities like archery and canoing. Much more camp-like, in my mind, than the Montessori and I thought Patrick would enjoy doing some bigger kid stuff for a change. But I just got the handbook and I am worried, hence the question (which is coming. bear with me). For starters this camp goes from 9 until 3. Patrick has never done a full day before and while he has never had problems separating I am not sure if it will be too much for him. They have a list of things he will need to bring, including his own insect repellent, water bottle, lunch, rain gear and sunscreen. They note that they will remind kids to reapply sunscreen throughout the day. I laughed.

Patrick is a wonderful person and a joy everlasting but he could not reliably apply his own sunscreen under any circumstances. I can only assume he would spray the insect repellent directly in his eyes. And don't they know that small children need to have their clothing lightly sprayed with repellent rather than have it saturate their soft, absorbent skin?      

Some of the Y classes Patrick has done have been run by well-meaning but completely lackadaisical college kids, such that one sports class resembled nothing so much as visiting day at Bedlam. I am trying to picture one such instructor as the only thing standing between Patrick and mosquito-bitten, sunburned dehydration and the image makes me feel faint. So I am thinking about canceling the Y and maybe adding a couple weeks of Montessori if he likes it.

But here is my question: picking up on any of the things I have said (be it your own Y experiences, or camp, or a child suddenly going all day to anything at just-turned-5) please tell me what I should do. Maybe I am over-protective? I worry that I baby Patrick (hence his refusal to zip himself into or out of anything) but I also worry that he still needs some babying.

He just seems a little... LITTLE to suddenly be in charge of his own water bottle. But I am willing to be advised to the contrary.