Julia

From My Boudoir

I am so sorry I did not post yesterday. I don't know why I feel such a sense of obligation to you but I do. The collective you have helped me so much over the years that I feel like an ass-chump when I promise something and fail to deliver on my promise.

That said, I have a note from my doctor.

CVS kicked my ass yesterday. Or rather, it kicked my abdomen so hard that Steve had to physically pick me up when I wanted to change position in bed. The good Dr. Mayo prefers the transabdominal approach and who was I to argue? Actually, it was pretty cool. He came in and we talked and then he checked out the fetii and then we talked some more and then I gave him the ok to do CVS. At which point he sat there staring at the ultrasound screen for, like, ten minutes in total silence. Then he said, "OK. Here's the plan. I am going in over here" pointing to one side of my abdomen "bring the needle over here" pointing to the other side of my abdomen "pick up the sample from B first and then move the needle back to here" two-thirds over again "and get A before withdrawing."

Daaaaaamn.

But, oooooooooooooooooooooooooooooouuuuuch! If the notion was not patently absurd I would say I feel like I did three hundred sit-ups yesterday.

I have a REDBOOK post going up soon which provides greater detail but the short version is:

1. 13a looks great

2. 13b looks pretty good with two small caveats

a. the NT is on the high side of normal but still in the normal range (smallest measurement 1.6mm; largest 2.1mm)

b. it has a two-vessel cord rather than a three-vessel cord which the experts tell me is another soft marker for chromosomal issues

So we did CVS. Steve was in the pool with Patrick at the time but I am pretty sure he would not have been as lovingly solicitous of my pants as the nurses were, tucking towels around my entire body to prevent staining. I am also pretty sure he would not have gently rubbed my elbow and my feet as competently as the nurses did either. And Patrick swam the width of the pool all by himself without floaties for the very first time that we've seen, so really it was all for the best.      

I feel very VERY hopeful. I think everything is ok. I think that they are both fine. I think I am having twins. 

FISH results today. Real results next week some time.

Thank you for checking on me.

PS In answer to a question I keep getting, this is my eighth pregnancy since we have had Patrick. As far as he is concerned I am just one of those people who throw-up a lot. At five you don't have a whole lot of perspective as to how many times a healthy adult should go to the doctor. When he asked why I was in the hospital yesterday I told him I had an appointment and that I am fine. He seemed content with that answer. I don't personally see any problem with letting your young child share the excitement of a pregnancy provided you ARE excited and sincerely expect a baby to show up, whether or not things go unexpectedly wrong down the line. Me, though, I am never THAT excited about a first trimester and I have never felt like I could honestly tell Patrick that we might have another child in X months. Now I do feel like we will have at least one and I will admit that it is KILLING me not to tell him. I think he will be thrilled by the prospect. 

PPS If I really am having twins I seem to be failing already. I have lost a pound and while I dutifully take my Folplex and my Lovenox every day I only just realized that I never switched to prenatals. Imagine! The pregnant woman's talisman and here I am scarfing my One-a-Days.

PPS Oh, since you asked, this is how he got both samples with one insertion: he left the needle in, detached the sample filled syringe, squirted out the tissue into petrie dish A (I thought the stuff would be cell-like and invisible but you can actually see the villi) and then he attached a new syringe for B. I suppose there might be a tiny bit of cross-contamination if some tissue from A remains in the needle but I guess the lab sorts it all out.   

Unexpected Reassurance

Friday I went from sitting upright to leaning forward to hunching over to lying down with a heating pad as I realized that, actually, I was experiencing quite terrible lower abdominal pain. It took me a couple of hours to stop saying "Ohhhhh, ohhhhhh, ohhhhh" and call my OB's office. When I did I left a message that began "I don't know what you are going to do about it but... ."

They brought me in for an ultrasound that afternoon, which was nice; particularly as my most recent morbid visualization has been that I will show up at my appointment on Monday only to discover 13b is no longer with us (if and when there is a reason to do so I promise we will come up with something to call them that is a little less chilly than our current Dewey-based naming system) and 13a now has a nuchal the size of the Cumberland Gap.   

First, let me say that it turns out I have a bladder infection, which is making me feel like my cervix is being pried apart with one of those old church key bottle openers.

Second, the 13s seem to be fine right now; in that they are both alive and doing whatever. Squirming, mainly, and touching their faces and stretching out their incredibly adorable feet (my goodness - THE FEET!) Doreen spent the appointment gently chastising me for being such a Gloomy Griselda, stating that she thinks b's nuchal is within the range of normal. Of course, she also said (when I mentioned my lingering irritation with the perinatologist who failed to tell us about the beanbag-sized NT last year): "Well, you can't just tell someone their baby is going to die!" I thought, "No, Doreen, you are thinking of surprise parties." You can't tell someone they are being given a surprise party. A maternal-fetal specialist, however, when asked point-blank what they think the prognosis for a pregnancy might be, can (and indeed should) mention that they notice some severe malformations in the fetus. It is the difference between ruining a celebration and providing a patient with medical information. But enough about my sworn enemies.

So Doreen thinks everything might be fine, but Doreen is clearly a softie. That said, we did get some different pictures of 13b at a slightly better angle and you know what? That nuchal might just be in the range of normal after all. Presumably there is an art to interpreting these things and equally presumably it is not an art at which I excel. Regardless, I am encouraged by the fact that I now have an ultrasound picture that doesn't make me want to slam my head against my desk. I think there is a possibility that the nice people at Mayo may actually provide universally good news, discounting my concerns about the nuchal as so much ill-informed twaddle. So hooray. You know, this is probably why perinatologists are always urging people not to try diagnosing themselves with home sonography (a flashlight, an empty soup can, some string). Too unreliable.

Can you tell I am giddy? I was emphatically and completely convinced that there was a genetic problem and now... I'm not convinced! Only concerned! Wheeeeeee!

I am very glad that things have transpired the way they have, though. If we hadn't had worries about the nuchal I would have kept my appointment with the local place that was nice but maybe not GREAT when it comes to CVS. If the nuchal was flagged at that point we would have felt compelled to have them do CVS on the spot, as there wouldn't have been time to schedule elsewhere. Instead, I have had time to arrange things such that I am very comfortable that we are covered in the event of every best and worst case scenario. If we do CVS tomorrow I am certain that they will do a good job. And did I mention that Mayo was very clear on the fact that they provide care regardless of the test results? That they are what I euphemistically refer to as compassionate? Well they are. And that is a very good thing because I think perinatology clinics (see above: sworn enemies) that are willing to do prenatal testing but only keep the patients with good results are anti-ethical, hypocritical cess-vermin. Ahem.

Our Rochester childcare dilemma (thank you very much for the suggestions) is largely self-created. When I first scheduled this appointment I immediately called the nanny service we use for babysitters and they arranged for someone to come stay with Patrick overnight on Sunday. This would be the first time we would have left him overnight and the more I thought about it the less I liked the idea. And I am stressed enough as it. So we canceled the sitter and decided to bring Patrick with us, hoping to find some sort of drop-in place that would take him for a couple of hours. But the four big franchisee places were full in their school-aged rooms. And the hotel (which I specifically chose for the pool and club level with evening cookies, neglecting the more important amenities like Mary Poppins in situ) does not have a sitter list. And the list of licensed home daycare providers that accept drop-ins in the area (emailed to me by an extremely helpful woman from Minnesota's office of childcare resources - Minnesota's public services never cease to amaze me) seemed ok but... in point of fact I will worry less if Patrick is with Steve than if Steve is with me and Patrick is with someone I have never met before. So that is what we are doing. And it is fine.

Oh, about that childcare list. It gives information about each daycare provider, like where they are and what ages they accept and what hours they are available, etc. It also allows the provider to offer a personal statement conveying the type of quality care a prospective parent can expect from a given establishment. Things like "I offer lots of fun crafts, walks, activities and love" or "Former elementary school teacher with ten years experience offering baby sign language, structured multi-age curricula and walking distance to the Dairy Queen."

My personal favorite, however, was this terse little gem:

"I have full control of my little clients and they respect me for it."

Ah. Well. The good news is our search for a new warden (damned inmates killed the last three) is over. Unfortunately, we still need someone to take care of the fragile, innocent blossoms of hope and renewal that are our future.

I have been rushing to finish this as I thought we were about to walk out the door (might as well make a day of it) but Steve has just glided past the window on the lawn tractor so I might be mistaken about our ETD. It is amazing to me that we ever manage to convey information to each other at all.

Update tomorrow on how things go either here or at REDBOOK, depending upon when we get back.