Pink or Blue

I live with all males. I have two male dogs. One male cat. And the husband, as you've likely guessed, is also male. I have believed throughout this entire pregnancy that I am carrying a boy. Why? I do not know - I just have. I have had a VERY difficult time looking at girl names, in fact, I've actually thought, "Why are we looking at girl names anyway? I know it's a boy." A woman at work, who says that she "knows things, has feelings about things" (and hey, maybe she does) has said repeatedly, that although I am "carrying like it's a boy" she sees girl. I shrug my shoulders and tell her that I feel, however, that it's a boy. I've also bought all boy clothing - despite the fact that I had no definitive proof of the baby's gender. It just seemed wrong to buy anything girlie or neutral - because I just felt like, it's a boy, why buy some lame yellow or white outfit (and anyone who tells you that neutral baby clothes are just as cute as gender specific clothes is completely out to lunch, if you ask me, which you didn't)? My mother's side is all girls, everyone, until my sister came along, has had girls. My sister, defied the odds (although yes, it's totally determined by the male, but whatever) by having three boys and then one girl. When the first boy came along, we stared at him and didn't know quite what to do with him. A boy! What does one do with boy?! When the girl finally came along, we stared at HER and weren't quite sure what to do with her - so used to boys we'd become.

In all this, although you might say things have been "planned" (Clomid, IUI, etc.) it didn't feel that way - everything about my reproductive life in the past three plus years has felt completely, utterly, and absolutely unplanned, in so many ways. So, it was an easy decision for us to want to know the gender. And the husband has been anxiously awaiting the 20 week scan in the hopes that we would find out. I, on the other hand, was mainly concerned that the scan would show no anomalies but was, excited (when I let myself) to know as well. So, when it came time for the 20 week scan, the minute I laid down I said, "We would like to know the sex, if you are able to tell." She did a beautiful job of telling us exactly what she was doing and that each and every measurement was normal. However, the little bugger was in a transverse position, with the head near my right side and the rump near my left. The hands were also in front of the face. This made it nearly impossible to see a clear view of the lips or of the heart. And despite the fact that I tried to jump around, poke at my stomach, drink juice, and lay on my left, the bugger wouldn't budge. So, I have to go back next week for those remaining two measurements. At the very end, she said, "Let's find out if the room will be pink or will it be blue?" She moved the scanner around and at last said, "Boy. It's a boy!" And I yelled, "I KNEW IT!" like a complete lunatic. Later, the husband said, "My son" and we both laughed and carried on with the delight of it all. A son. We're going to have a son. And we couldn't be more thrilled.

MOVEMENT!

There is really nothing quite like the first time you realize that someone is moving around in there. The doc told me at the last visit that if I hadn't felt it already, I would soon. I thought at that time that I may have - but I wasn't really sure. This week, however, it's been coming on with much more frequency. Something is really happening in there. I'm not sure what he/she is doing, but I'm sure it involves something like calculus. There's a lot of fluttering and occasional tap, tap, tapping. I keep imagining the little guy in there pointing his index finger and jabbing, rhythmically, at the sides of my stomach, which I thought odd. My sister pointed out that it's more like swimming - so one stroke, two strokes, three strokes feels like a jab, jab, jab. When it happens, when I'm say, sitting around with other people, I just want everything to stand still so I can pay as close attention as possible to the happenings inside the womb. It's such a wild, wild and wonderful thing.

The parentals are in town for my birthday (today) and my father's birthday (Friday). It's been a great visit - although occasionally, they drive me completely bat shit. I can't help but think about how this will play out exactly the same way, thirty-six years from now - the husband and I driving our little one bonkers - all the while we look on in confusion. It's sad, really, but possibly inevitable, no?

I'll write more later, but currently I need to hoist myself into bed - I was falling asleep on the new club chair we just bought (yay). This is the first time we've bought a truly nice piece of furniture, in, oh, say, ever - and just think, it will likely be the last, as now, we have to have things that are kid-proof. Grateful? Absof#$(*!%lutely.

Cheers.

The Cape

We spent the weekend at the Cape. We sat at many restaurants looking through a name book - which was at times daunting and strange. We napped. We ate. We biked (a little). Waiters asked my due date. I talked to a woman in a kitchen store about her jogging stroller. We bought a few baby clothes. And all the while I felt afraid. Afraid to let myself go. I do not know if this is a healthy pregnancy. Still. I do not know. And I am afraid to know. I am afraid of the miscarriage risk, but I am also afraid to know. Once I know, there is no turning back. I have to begin accepting, dealing, moving forward. For now, I can deny.

The rest of the time was spent with the husband reassuring me that, in the end, everything is going to be all right. Sometimes I forget that it's not just me who is going through this - the infertility, the miscarriages, the possibility of our continuing to have problems. This child, whomever this child is, is part of other people's lives too, those who love us. I forget that. I forget that I am not completely alone in this. My sister signed off an e-mail recently with, "I love you and I love the baby." If something is wrong with my child - I will be angry. I will despair. I will blame myself. I already do. But I am not entirely alone. Grief is a lonely business. But supporting and loving this child does not need to be.

To Amnio or Not to Amnio

Although you may have thought I'd closed the chapter on the whole nuchal scan issue and have been kicking around the city gleefully purchasing new maternity clothes because I have accepted my potential fate, whatever that may be, that's not exactly true. The more I thought about the results of the nuchal scan/blood test (high hCG) the more I thought I should talk to a genetics counselor. Conversations with my sister (long time RN and currently studying to be an NP, but no background in obstetrics - besides having four kids) and searching on-line is probably not the best way to handle potentially devastating news. So, we met with one yesterday. For some reason, I thought that it might alleviate some of my concerns. It did not. I wanted to get as many facts as I could about the risk of amnio, so that I would feel like I made an informed decision not to have one. Also, I wanted to get a better analysis of my results. This is what I learned (according to the counselor):
1) There is no known genetic link to Downs - in other words, just because no one in my family has Downs and no one in the husband's family has Downs, does not mean we have a lower risk of having Downs. The risk is completely about the age of the mother. This surprised me. I have read some studies, briefly, about a potential risk between the MTHFR gene and Downs, but let's ignore that, thank you very much.
2) I will be 36 at the due date - the analysis increased my risk to that of a 37 year old. However, from what I've read, it's more like 38.
3) Although the PAPP-A and the nuchal were considered normal, the hCG was decidedly not. They want the numbers to be around 1. A number above 1 for the hCG and below 1 for PAPP-A gives a higher risk for Downs. My hCG was quite a bit above 1, but again, the PAPP-A was normal. The counselor did say that it was the hCG that placed me into that risk category.
4) When I asked what the analysis would be if you changed my age to 25 or 30 she basically said that wouldn't make any sense because the risk at 25 or 30 is so much lower, therefore, the results would be meaningless - because it's all about the age of the mother.
5) The blood tests in the first trimester are actually more accurate than those given in the second.
6) I still have less than 1% chance of carrying a baby with Downs. However, I could be that one person . . .
7) The national average for "complications" from amnio is 1/400. Complications include, but are not limited to, severe cramping, bleeding, leaking amniotic fluid and miscarriage. I've read that the risk of miscarriage from amnio is 1% - but it's hard to quantify. The hospital does not have their own averages for complications from amnio. I found this highly irritating.
8) Upon learning that the husband is a teacher, she basically went on to say what a cake job teaching is, you know, summers off, etc. This did not sit well with the husband.
9) She seemed to be pushing for the amnio because "the birth is supposed to be happy, and what if they take the baby away suddenly and all the doctors are trying to figure out what's wrong, wouldn't that be horrible?" I found this completely bizarre. Right, because even if I had the amnio and the baby was normal, that means that there is absolutely no possibility that there could be complications. Is it possible that she receives kick backs from each amnio performed? One wonders.
10) She doesn't necessarily think blood tests are great tools because you could just have a concentration of one thing in that particular blood draw. In other words, we could have had the test done fifty more times and my hCG would be normal. On the other hand, they could take the blood 100 times and one time it shows a problem, and there really is a problem.
11) I hate genetics counselors and I'm still not having the amnio.

The End.

********
I should have mentioned that we will be having the 20 week scan and we'll know more then, potentially, and the amnio is still available at that time. Again, though, the risk of a miscarriage from the amnio is still higher than my statistical risk for carrying a child with Downs.

Hello, Maternity Mega-Store!

Ah, it's an upside down, crazy world when you start thinking these jeans not only look comfortable, but down right kicky!

But am I grateful for this sudden foray into all things elastic and stretchy-paneled? You better believe it.

Moving On . . .

I'm definitely in a different place than I was a few days ago - I'm more relaxed, less hysterical. I wish I'd never had the test done - I'm not going to do the amnio - although the risk may seem minimal, if I did miscarry - even if it had nothing to do with the amnio, I would never forgive myself.

The test consisted of the nuchal scan, body scan and blood tests. As you know, it's not a diagnostic test, but merely a statistical analysis. The nuchal scan wasn't really the issue - the nuchal scan was normal to high normal. There is a nasal bone. The rest of the scan was completely normal - no abnormalities were detected. The blood work, however, is another story. I was just over normal on one and a little bit just over that for the other (hCG and PAPP-A). What further tipped the scale is my age. Additionally, according to my sister's own analysis, they used to do the nuchal translucency test in the second trimester but found that the nuchal scan was more accurate at 11 - 14 weeks (13 weeks, 6 days). The blood tests, however, are more accurate in the second trimester. She thinks I should have those redone and then also wait for the Level II ultrasound (offered to all my doctor's patients).

I've spent plenty of time on message boards in the last couple of days reading of women who had a higher risk than myself, did the amnio and all is well. Of course, there are those where the amnio confirmed the chromosomal abnormality - but that seems to not be the norm (at least in my reading). However, I'm trying to just accept my fate - and enjoy this pregnancy, enjoy seeing my child grow, whatever lays ahead. I don't have a problem, specifically, with having a child with special needs, it just will take some readjustment. But I am also not so naive as to think that it is an easy life, or the life I dreamed of for my child. Again, you reassess, you readjust, you deal. I also do not have an issue with someone who would choose to terminate their pregnancy - it's just not something at this point in my life I could do. Going through four miscarriages was difficult and I'm not willing to let this one go. I already love this child. Whomever he or she may be.

Thank you for all your comments. They are a comfort.

Nuchal @#()#*)(* Nuchal

And there I was getting all caught up in the likely non-existent lead poisoning debacle when I had so much more to be worried about: the nuchal transulcency test results. According to my doc, at my age (the practically teen aged 35), the risk of Downs is slightly elevated, but still low, considering it is at less than one percent (my google research shows 1/400 or .0025). The results of the nuchal test elevated that to slightly higher but still less than one percent (1/161 or .006). I don't want to have an amnio - I'm fearful of the miscarriage risk (although small). And I also know that at less than 1%, it's still likely (one hopes, one hopes) that things are fine. However, I'm worried that you will read this and think, "Oh, no, that is bad. I've never heard of such a high risk!" I'm worried that maybe I should have an amnio - even though I've been against it since day one. I've been reading a few other blogs who had nuchal scares - and their statics were somewhere in the 1/250 range. Shudder.

The doc seemed mellow about it, however. He indicated that some people probably would have an amnio with my results - but when pressed, said that he himself, if it were him, probably would not (the mental picture of him pregnant, was amusing). He also said I should keep in mind that he's just not the overly anxious type and he's had patients with a 1/5 chance of Downs who, in the end, did not have a Downs baby.

One minute I'm fine and sure all is well, and the next minute, well, I'm crying while trying to puncture myself with a needle filled with heparin.

Ah, onwards and upwards, dear ones. I suppose only time will tell.