A Little Reassurance. 7-24-11

It's been yucky morning sickness today. I went to the grocery and gulped Gatorade at the check-out hoping I could make it home without having to visit the ladies' room again at Kroger. Pringles and veggie sushi for lunch. Maybe it was too much, but I couldn't get the taste that I wanted. I spent the majority of the day on the couch; although I really needed to return a few things to the store. The unisom wasn't helping too much. I did manage to drink a little hot tea, which I hadn't had in 3 months. I got a call from the nurse from the university clinic--on a Sunday, which kind of shocked me. She was explaining my results, as I was getting a call from my great aunt D.

So, she reminded me that at my age, my risk of having a child with Down syndrome was 1 in 75. She told me that my screening results were positive for Down syndrome. However, my risk of having a child with Down syndrome had actually gone down to 1 in 210, which is a huge improvement. She said the cut off for a "positive" was 1 in 230, and I was pretty close to that. My test results have reduced my risk and are very close to the risk of having a miscarriage with amnio. That is great news. My risk of having a child with Trisomy 18 went down from 1 in about 700 to 1 in 10,000. Excellent news. Very reassuring.

I was then able to call my great aunt D back and share the good news with her. Of course, she was so happy for me. And I made a quick call to my mom who is visiting my great aunt R in CA. She wasn't as happy as I thought she would be, but I think she was shocked that my a priori risk of Down syndrome was so high (1 in 75) and a “positive” result was a little frightening. Overall, though, it was great news, and when I went over the numbers again, maybe I was able to convince her that it was.

12 Weeks 4 Days. 7-16-11

I'm breaking protocol and jumping ahead and planning to post this soon. I was so nervous about my first trimester screening, I could hardly sleep. I hadn't seen Boop for a couple of weeks and not under the best circumstances, a very perturbed little critter. It couldn't have been more different today. Boop was laying on his/her back, taking life in. Yes, Boop was still busy. Little arms and legs were moving around. One minute Boop with legs crossed, the next minute about to suck the thumb (photo), the next minute stretching (photo). Normal heart rythm, normal nuchal translucency, nasal bone present, normal well-attached placenta in the right location. Good, good, good, and WHEW good! All very good signs. Poor sonographer, she was trying to get some good photos of me. She almost caught Boop's legs crossed Indian style, like a little frog.

Speaking of legs crossed, the high risk OB caught me. "Don't cross your legs." Oh no, please no. I gave up caffeine, lunch meat, raw sushi, wash my raw fruit in soap and water, have suffered through morning sickness, taking crappy meds, bad spotting, all the various body changes, but you want me to give up CROSSING MY LEGS!! Miserable. How do you stop crossing your legs? That's the only way I know I how to sit. I tried crossing my legs at the ankles, but it's so uncomfortable. Anyone have any ideas?

Thank goodness, all seems to be well with my little Boop. And I'm beginning to be able to manage my morning sickness with only Unisom, B6, and lots of fruit juice/sports drinks now and haven't had a Zofran in about 4 days! So, this is what morning sickness feels like. I learned today that taco meat is out for a few more weeks; I was a little too ambitious yesterday... I'm still waiting on the results of my PappA, and I'll have my AFP in a few weeks. The high risk OB said for me to stay on the progesterone. And the resident convinced me to go to a midwife instead of an OB. Actually, I had been hearing quite a bit about this on the SMC listserve; many folks had great things to say about midwives. I'm hesitant, but it seems better than some of the other options. We'll see. Might as well try it.

High Risk OB 6-29-11

I just got an automated call to confirm my 1st high risk OB appointment. Boy, I'm a problem waiting to happen, and this OB has no idea what he's getting himself into! At least, he'll be more familiar with dealing with tough cases! I'm trying to remember how many chronic conditions I have. It's the combination of AMA, as it's known to genetic counselors (advance maternal age), and psoriatic arthritis (PsA) that is landing me on his doorstep. I'm actually quite relieved to have the added care. I was hoping my RE would suggest it, but my rheumatologist wound up being the source of referral.

I wonder what will happen during this first visit. I'll be a few days early for first trimester screening, I think. I am really anxious to see the results, anxious in the eager sense, and anxious in the nervous sense. Being my age, I know that my risk just keeps increasing everyday for a chromosome abnormality. There are very few that can survive--Trisomy 21 (Down syndrome) and sex chromosome problems. Sometimes 13 and 18 can survive, but they really aren't able to interact socially. The screening test primarily looks for Trisomy 21 and 18. When I was in genetic counseling school, they were just starting to do ultrasound screening to measure nuchal translucency as a screening for Down. Basically, they are measuring the accumulation of fluid behind the baby's neck. It's done before week 13 because that is when the lymph system develops and takes that fluid away. It apparently has good predictive value. When I was training, I believe it was accompanied by biochemical blood tests for beta-HCG and PappA, and now I think they only do one (beta-HCG?) as the predictive quality is so good.

I've already prepared myself for a baby with Down syndrome. When I was in the genetic counseling program, I used to volunteer to help with the Buddy Walk. Children with Down syndrome are just as sweet as can be, for the most part ;) I've met some amazing little ones in clinic, including a precious little girl--I hope I'm not saying too much. I walked in to see this beautiful little toddler all dressed in pink. Before the MD (I've worked with some amazing dysmorphologists...) came in, I told the mother that she would need to undress the toddler down to her diaper. As she undressed her, she was telling me about how the baby nearly died because she had not been diagnosed with Down syndrome <WOW, how did the pediatrician/PCP miss it?!?>. They air-lifted the baby to an <unnamed> hospital who immediately knew she had Down and fixed her right up. Anyway. I looked over at the little girl, and she had a wonderful smile on her face. She pooched her belly out and was rubbing it frantically. I turned and gave a strange look to her mother. She smiled and said, "She's rubbin' her punkin'. She gets that from her daddy." I laughed and said, "Oh, okay." <My dad's fave nickname for me was punkin', not sure if I told her that.> She continued, "We're proud of that belly. We worked awful hard to get that pumpkin' to grow." I left the exam room and saw her father sitting outside, who had an um, er, rather large punkin'. He looked up at me. And I said, "She was rubbin' her punkin' for us," and he just grinned from ear to ear. What a lovely family. They understood. What we really want are happy, healthy babies. Oh, and now the pregnancy hormones are kicking in, and I'm fighting tears. <Well to be honest, I can’t blame the pregnancy hormones. This story usually makes me misty-eyed.>