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.          

Comments

[Another BT Wife]

You may not consider this a real answer...but can you start out with an evaluation ultrasound at the place where they are kind and caring and you can get a good, honest opinion about how the fetuses look? And then move on to the other place and start all over, getting no information but allowing that guy to do the actual CVS testing? I'm littlea from redbook - we're finally pregnant after donor and a peri who did an u/s for me was horrible as far as his bedside manor and arguing with me about whether or not my donor was REALLY karyotyped...but if he were the best at CVS, I'd go to him in a heartbeat if / when I ever get to be pregnant with my DH's bio child. So maybe my answer isn't really helpful, but I no longer believe in either / or choices with healthcare.

[Ersza]

My son was not ready for all-day anything at age 4 or 5. There is no way I would have trusted him to put sunblock or insect repellant on, and he would have probably panicked at the thought of being packed off to camp all day. He also was not ready for all day kindergarten at the age of five. We sent him half days. And when he was six, in the first grade, it was still a really tough, long exhausting day for him. Some kids, especially girls, are very independent at an early age, but it is normal for a four-year-old to need quite a bit of help and to not really be ready to be away from Mom for more than a couple of hours. Have you asked Patrick what he thinks about going to all-day camp and putting on his own sun screen, etc? I think he should have a say in this.

[Celeste]

You will make the right decision.

My 2 cents... I know this is hard given your history, but I would give the little embryo's the benefit of the doubt and go with the less invasive doctor. If something is indeed wrong, you can always deal with that when the time comes. I know your situation sucked ass last time, but this pregnancy has been by the book so far. God knows you deserve to have a perfect pregnancy! I say have the fresh perspective that everything is golden with this one and forget the past if only for the next eight and a half months!

Congrats on two wonderfully thriving embryos!

[LetterB]

Good god that is a dilemma. Although I feel totally unqualified to give this advice having only considered the procedure and never actually had it I would go with the doctor that you feel is more skilled at the cvs. You can (and I have no doubt you will) be very clear with them about your expectations in light of your previous experience. But even just having doubts about the other doctor's ability will probably make the experience more harrowing than it has to be, let alone if the procedure ends with bleeding again. Good, good luck with this.

[Cat, Galloping]

go for the one with the skillz. no question in my mind. they might not be jerks, but their jerkery did not affect the outcome of the embryo and i believe you have (unfortunately) have the experience and ability to be your own advisor on results. Niceness does not make up for shitty skills risking these fetbryos.

[robin j.]

You mentioned that the abnormalities are obvious to you now when looking at the ultrasound. It makes sense to me to go to the more competent doctor, insist upon him telling you what he sees, and whether or not he complies, looking at the little ultrasound pictures yourself and from there making a decision about which provider to see for further treatment.

[Karen]

I agree with Galloping Cat and the LetterB. You can always travel to some far away Big City to see someone completely new, but that sucks too.

I haven't congratulated you yet on your condition! Well done! Keeping fingers crossed for a smooth sail from here on out, vomitting aside.

Karen

[Audrey]

Yay for the twins! *keeping fingers crossed*

[Sarah]

I have no advice on anything, but just wanted to stop in and say WOW! and NBHHY!

[Beth]

Are you constrained by your health insurance to choose a place/practice/doctor and stick with it for absolutely everything? Or can you switch around? If the latter, start out with the compassionate/good previous experience folks. And then see where you need to be from there.

I tend to be fairly counter-culture in general (homeschooling, homebirth etc) so where Patrick is concerned .... I think 4/5 is tiny. A microdot in the universe of human existence. I absolutely would stick with Montessori. And the sunscreen? We don't mess around with that here either: no way, no how, never. Go with where you can be most certain he will both thrive and be safe.

[Kristin]

Throwing up three to four times a day? That sounds pretty bad to me. You really have been through the war when you think that's nothing. Regardless, congratulations and happy vomiting!

[cursingmama]

Flip a coin?

Helpful - no?

Hoping that Patrick takes to the sunscreening of himself with a vigor you never expected, but is not so vigorous as to bring undue attention. If you are successful with the teaching of the sunscreening I would like to send my children to you for lessons; they always miss something and that something is usually bigger than the piece they managed to get.

[e]

I would imagine that any place would have more experience and skill at amnio than at CVS, no? So it may actually be immaterial which place you choose. I think you should go with your gut feeling.

[jennifer]

I guess personally I would go to the skilled doc for the cvs and have the records transferred to the other doc. They can't refuse to transfer your records and you certainly don't have to tell them what you are planning to do. Whatever you decide good luck!

[Leggy]

First, I'm very excited that its twins and I hope they both are 100% healthy and that everything is uneventful from here on out.
That's a tough dilemma re: where to go. I like the idea of u/s at the first office and CVS at the second- is that an option? Or could you travel to another clinic in another city? I guess if it were me, I'd lean toward the jerks who are more technically proficient.

[Michele]

Speaking from personal experience .... I had a very knowledgeable peri (Farb) who I felt safe in the hands of over 4 amnios in 1 month. He messed up when he didn't bother to tell us of the risk of death from my condition and when he called my son's death an "event" (while looking at him).

Next time around I went with another peri (Saul) who was much more compassionate but not educated at all when it came to my situation. She talked to us a lot more and was very reassuring when things were going good - even if we were still scared.

If I were to do it again, I'd go for the more compassionate doctor.

I understand your reservations when it comes to the other peri because of the bleeding after the CVS. I guess you just have to weigh the pros and cons. If you go with the first be prepared with a list of direct questions ahead of time - hopefully you'll get answers that way.

Congrats on the twins! Good luck with everything. Sorry for the babbling! ;)

[shannon]

The place with the compassionate approach will presumeably listen to you if/when you have concerns about how the procedure is done (ie: "rushed", the bleeding last time, etc.).

I pick compassion.

[katie]

I say go to the place that does the best job, ask for the results and have them sent over to the kinds and caring office. When it comes to those little buns in your oven, you need to feel safe and confident that they are safe during the procedure.

I am so happy for you, and have a good feeling about these two little bundles of joy!

[Jessica]

Dear Julia, that is a no-brainer. The only choice when it comes to sharp instruments next to fetbryos is the one with the steadiest hand, regardless of sucky personality. You don't chose a surgeon for his or her people skills either, do you? You can always ditch them afterwards. :-)

[Aurelia]

First, can I say that the phrase "subconscious resentment that my role as a stay-at-home mother is predicated upon essential planned obsolescence" has just blown me away.

Because of course, it's true. They still need us as they grow up, but in a very different way, more for emotional and mental support than the hard physical work of baby and toddler hood. But that is so much harder to see, and is such a huge change.

It's killing me that my older son is gone to sleepaway camp this week at 10 almost 11, and wants to go again, because of course, he's finally become fun to hang out with. And now someone else will get to enjoy his company, and I'm really resenting that, even though I know he's going to have a great time while he's away.

Sigh...

As for the Doctor? I'm going against the tide here, and I'm going to say don't go with the cold jerk, go with the people who respect your choices. Specifically because the bleeding might not have been due to her skill level but instead to the condition of your placenta, and it would've happened no matter what. Baby with birth defect=placenta with birth defect, and you can't know for sure it was her fault.

But I do know for sure that any Doctor who lies about your health and restricts your access to your own records and ultrasound pictures is unethical and at least here, would lose his license if a complaint was made. Really, how can you trust him or that genetics person now? What if a bad result comes up and they lie about it again? What if a good result comes up and you have trouble believing it because they have lied in the past?

If you can't decide between the two, the other alternative is to find someone else, even out of town, who won't turn this into a zero sum game. I know someone here in T.O. Maybe your readers can suggest someone in their cities closer?

[Jenn]

Well, as much as the first place sucked, I'd probably go to them for the actual CVS, then promptly transfer to the nice people. Even if everything is good with the CVS, it's not a bad idea to have a perinatologist follow a twin pregnancy.

[SarahD]

Having read your blog a long time, it really does sound like you're doing and feeling better with this pregnancy than many of the others. Yes, you're still nauseated, but it doesn't seem to be nearly the misery you were experiencing before. That, at least, is better for you, and I'm happy for you!

Good question about the doctors. As you said, it may be irrelevant if they cannot do a CVS on twins, in which case you can stay with the compassionate doctor without worry. Otherwise, I'd either, a) get tested at Dr Jerks and transfer records under the guise of "second opinion", b) discuss at length with Dr Compassion the need for extra time and care considering the twin pregnancy and hope for a better procedure.

Either way, I wouldn't stay with Dr Jerks--that whole episode was beyond ridiculous and I was completely incensed for you.

[reenie]

My opinion is...I would go with the most technically experienced person because this is not something to mess around with...your health and the health of your unborn children. I'm assuming they will be fine and live long and happy lives so you would want them to have a "safer" procedure. I don't think that is coming out right. Barring another terrible outcome, you would want the best people for the job, technically speaking. Going to someone because they are nicer will be nice, but bleeding profusely is not nice. And (not to be mean) but it didn't stop the news from being bad, right?

I am so so so so so happy for you right now...eeeeeeeeeeeeeeeeeeeee!!!!!!!!

[Joy]

Patrick sounds all ready for college! "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." I knew a few too many guys like that in my coed dorm...

[Molly Chase]

Wow, I really wish I had good advice, but I'm finding myself also in a bit of a pickle as far as pregnancy/babies/crazy risk factors go. I had a high-risk but completely by-the-book pregnancy and delivery the last go around, but I loathed my OB practice. They were so impersonal and cold. My next pregnancy will be high-risk as well (I'm a type I diabetic) but I'm going back and forth about whether to try to find a more touchy-feely OB, so to speak, or cowboy up and stick with the one that came through for me last time. My instinct is to look elsewhere--it is not in my nature to allow people who can't seem to remember my name to so closely examine my girly-parts.

My advice would be to go with the second doc, but I'm not a reliable source of advice on the subject, obviously.

Long time lurker, by the way--congrats on the twins. Incredibly exciting.

[tgsdmom]

Go for the heartless pro.

[Nancy]

I have to admit to excitedly counting out the weeks on my fingers yesterday when I saw the Redbook post -- hazzah! Twins. Holy moses, lady, that would be something else. Cheering and hoping for you.

As for the delimna. Yes, that's a toughie. I hate hate to reward shitty behavior -- and I thought that genetics counselor was so over the line with her cowardly actions it made me want to spit -- but you want the best doctor for that task. If it were me, I think I'd go with the steadiest hand. Is there anyway to then transfer the case to the other place? I don't particularly like that answer, but I'd feel more anxiety over the procedure. Part of the problem last time was the shock of their appalling lack of communication; at least now you would know precisely who you were dealing with and could ask targeted questions accordingly.

Anyway, two cents; a tuppence, really. A haypenny. Kopeck?

[Anne]

Planned obsolescence, yes, but only in a sense; know and remember that you will always be essential, no matter how old your child--your approval, your ability to be a sounding board, your enthusiasm, your positive, supportive, stories of what your child was too young to remember about him/herself, your cheers for current accomplishments, your ability to come through with time/advice/effort/whatever in a teen or even adult emergency, your unwavering support and unqualified love--these will be valued so long as you both live. You will never be anything but essential.

[teki]

My daughter attended a summer daycamp with the Y when she was around the 4/5 mark. They told me the same thing about sunscreen and like you I had my doubts about her application. I could be wrong, but I *think* they tell you about the sunscreen as a kind of test as to if they should go to camp. She didn't come home one time with so much as a tinge of red and my people are whiter than Wonder Bread. Someone at the camp kept her slathered in sunscreen. She had an amazing time despite my fears. I was mostly fearful of the older children but it went super great. As for Montessori, she attended a Montessori school from the age of 2 (No, NOT a daycare!) until she was 8. The things she learned was amazing. When she was transitioned to public school, she skipped a grade and if I hadn't had a problem with my 9 year old being in a class with 11 year olds, she could have skipped another grade. You are completely correct about fostering of independence. She learned how to pour, cut with scissors and even cut with a knife (!). Things I clearly wouldn't have had her do at home with me at her age! It sounds like Patrick will do great in the Montessori environment. He will be able to progress at his own pace without having to wait for the rest of the class to "catch up". Good luck and I hope he has a great summer!

[Chickenpig]

Weelllll...My doctors were strongly against both CVS and amnio with twins, unless there were markers that it may be necessary for further testing. Considering they had trouble just getting their heartbeats strait, I was very nervous about it. I waited for my level II ultrasound, there were no markers present for genetic abnormalities, so we passed. (my husband has wonky sperm, but not the same problem as yours). When I looked at the stats on giving these tests to twins and how many times a needle missed and took one out, I didn't think it was worth the risk. I would never have been able to forgive myself.

As for the sunscreen thing. I worked at a summer camp as a junior counselor a loooong time ago, and one of my never ending jobs was putting sunscreen on the young ones and/or badgering the older ones until the re-applied, as well as insisting that they drink water. I assume that given the age of these kids the counselors will expect to have to put sunscreen on the four and five year olds and keep them hydrated properly. I wouldn't worry about it, especially since Patrick is smart enough to ask for help, and on the ball enough to tell you exactly what goes on at camp.

[throwingutah]

Go with the first practice and request that they not be assholes this time. That covers all your bases.

[Lydia]

I think I'd book a supersaver airfare and fly to New York. There's 2 or 3 guys who are supposedly the best in the world.

There's also a guy in Philly... Wepner? Wapner? Somebody.

OK I looked it up. Ronald Wapner.

http://www.nyp.org/news/hospital/875.html

[laughing mommy]

Could you go to the methodical doctor at the bad place and then grab your records and run over to the new place?

If not, I would go to the methodical doctor... even if I hated him.

[Katie]

I wanted to comment on your redbook post but couldn't be a**ed to sign up so am commenting here - Mr. Spouse has developed an attitude to pregnancies that is more similar to mine as we have gone along our weary way - during no 1 he was in denial, no ?2 came after a long wait but never really got going, we decided to investigate adoption, but then no ?3 caught us off balance and he seems to have decided he really wants this just as I was thinking I might want not to do it any more.

When we saw the heartbeat, and even more, heard it at 8w with no ?4 he started getting excited and making plans. This past week, while I've been zonked out on anaeshetic and painkillers, he has if anything been more emotional than me, though I think I'm coming back to (very sad) life just as he gets busy with work again and therefore distracts himself.

As nos 1 and ?4 were both at nearly 10 weeks, and the others at 5, those are the only ones with memorable due dates, and I think he will be remembering this one too.

[margalit]

I think if I were in your situation, I would find out who the best doctor is ANYWHERE that does CVS (which is very hard with twins and I believe most doctors want you to wait for amnio if the twins placement is tough to see clearly) and amnio, and travel there. I would want the best and if you can afford it, you should get it. There is a wonderful doctor here in Boston that everyone loves. She was great during my twin pregnancy, but I opted not to test.

[victoria]

Oh man, Julia, that's a toughie. That genetics counselor deserves a special ring of hell just for her. I hate her so much for the sh*t she pulled with you. Oh, my god.

But you want the best possible care in the CVS.

What about this: go to the clinic with the good CVS technique BUT (1) write a letter to the perinatologist explaining that you want to be notified kindly, but clearly and PROMPTLY if abnormalities are observable and (2) write another letter to the g.c. explaining that what she did was foolish, unethical, unprofessional, dishonest, and extremely cruel.

I hate that spineless, heartless, cowardly, dishonest, unprofessional cow so much I'd write the damn letter myself if I could.

[Jennifer]

Ummm, well then. Tough choice. The actions of the last practice were unconsciable, and to agree with another commenter, traipsing on the unethical. I guess that based on your experience with your RE this time (If I didn't know better, I would swear that we went to the same practice), and everything else, I would start with the doc that actually provided advice and counsel. Talk about what happened with the last CVS and see what you get. She may have performed more procedures, etc. in the interim. I also like the option of getting the initial ultrasound from this practice, and going to the second (AKA assholes), getting the CVS or amnio done, and going right back to the other doc with the results. Getting a CVS done with a singleton is scary, and I can't imagine the complexities when you are looking at twins.

BTW, it's so great to read 7w3d on a blog from you....here's to more "smooth" sailing! (Anyone who can say that 3-4 vomiting episodes is easy is my hero!)

[nate]

I think I would be tempted to go w/ the more skilled perinatologist, but b/f you go w/ her, sit down w/ her and go over your, umm, dissatisfaction w/ last spring's experience.

re: sunscreen--my daughter's preschool won't let the kids near sunscreen. Safety issue, among other things--if a kid got sunscreen in his/her mouth, that would be a big problem. Also, kids that small can't effectively brush their own teeth--why do we think they should be able to apply their own sunscreen? So each C's tube is in a big bin of them, w/ her initials on it, and we put it on her in the morning, then they reapply after lunch.

Lydia: Judge Wapner?

[susan]

Long time lurker here...

I know you're in the Twin Cities, as am I. I don't know which perinatologist practice you went to for either, but I can let you know my experience here if it helps at all. I went to the one attached to United Hospital in St. Paul (don't remember the name- MN perinatologists, perhaps?) for an amnio (not CVS) and had an awesome genetics counselor- so kind, caring, and open to what we wanted. And then an asshole Dr.- didn't give a shit that I was freaking out during the whole thing. But man was he good. I'm curious which experience you had there, and perhaps you could simply get a new genetics counselor at the same practice as the asshole doc?

Don't know if this helps, but there you have it.

[Jody]

Um, well, I would either talk with the compassionate doctor about your concerns post: last bleed, or do the CVS with the doctor whose skills with the needles are strongest. Because, well, the worst that happens with the good-CVS doctor is not as bad as the worst that happens with the so-so CVS doctor, assuming losing an otherwise healthy pregnancy due to a (absolutely minimally likely to happen, almost but not quite not worth thinking about) post-CVS complication.

For myself, I bled enough during my pregnancy not to want to invite more of it, although I do see the problem with returning to the medically skilled but ethically challenged doctor.

Hmmm.

Sorry, that's maybe not so helpful.

[Jody]

Oh, also, the big peri practices in NY and DC both reduce about 2/3rds of their HOM pregnancies, and the standard of care there is to do CVS on at least one or two of the embryos first, so if you're looking for top-notch CVS/mutliples care with S/R options in the event of disaster, it might be worth traveling.

Because you don't have enough to think about.

[Spacemom]

Re: sunscreen...my almost 3 year old insisted she could do it herself. We let her try and then follow up. My almost 5 year old does a pretty good job of it.

Re: Twins Mazol Tov!

Re: CVS, I would screw the compassion and go to the one who can do the job. I guess I would be so jaded at this. Sorry about the bleeding. I had lots of bleeding with my first child and fun it was not!

[nate]

Blah, hit post b/f I totally reviewed it and left in an extra "each", so that may not make so much sense.

Anyway, if you basically like the Y camp, but are concerned (and rightfully so) about sensitive skin, etc., you're well w/in your rights to tell them that Patrick needs extra help, and b/c of genetic susceptibility to skin cancer you'd prefer they put it on him. B/c really, in loco parentis means they'd better take care of him BETTER than you do.

[May]

Personally, I'd go for skill over personality. Get the info you need and then run like the wind over to the compassionate practice.

[MichelleL]

I second going to Dr. Wapner in Philadelphia. You've invested so much time, effort, $$$, and heartache. Go to the best.

[Anna]

Oh, I wish I could help. I'm just as indeciseive. I'm so happy to hear that things are looking so good so far. Everything is crossed for you, Julia! Best wishes!

[MichelleL]

OK -- he's now at Columbia-Presbyterian -- my old stomping grounds. The campus is in Spanish Harlem, not the best neighborhood but right on the A subway line. Stay someplace downtown, take the A train up to the hospital. There's my vote.

[Lori]

I would go for the one for skills AND explain to her your situation and tell her that given your history you want to know if the fetus (what's the plural? fetii??) appear abnormal. Tell her exactly what disturbed you last time about going to her office. of course, there's still the problem with the sucky genetics counselor.

[Aussiechick]

Go to the one who's best at CVS, then the nice one if there's a problem.

Sucks to support asswipes, but you don't want to risk a healthy foetus, even if it means you have a really bad week, y'know?