Adventures in Can-Am Relations

All looked good with the babe yesterday! He/she is growing well and scored an 8/8 on the biophysical profile (measures muscle tone, body movements, breathing movements, amniotic fluid levels and heart rate).
They didn’t remeasure the nuchal fold, but said that there wasn’t excess fluid there, so any measurement would just have shown excess skin. They still have no idea what caused the huge nuchal translucency measurements at weeks 11, 13 and 20. They did recommend that the baby come into the genetic lab after birth for evaluation, in case there was something that was missed. But, they released me from their care, back to my regular OB. No longer high risk!

The babe is measuring quite large (97%) so they wondered about gestational diabetes. I actually did the test on Friday, so I imagine that I will get results shortly if they’re not good, or at my next OB appointment on Tuesday. I’m not sure what the large size means in terms of my attempt at a VBAC, but if that’s my biggest concern, I have a lot to be thankful for. This has certainly been a roller coaster and I’d like the next 12 weeks to be uneventful.

Now that it’s becoming more real that we’ll have two children in 2.5 months or so, we had to get going on another bedroom. Currently, our third bedroom is a spare room with queen sized bed and a whole lot of junk. So when we were down in Hamilton for the tests yesterday, we stopped at IKEA and picked up some new furniture for Elijah since we’ll be moving him to a new room (can’t move the crib without dismantling it, and Elijah’s been sleeping like crap so we figured, what the heck, might as well transition him to a big boy bed now). We bought a full sized bed (even though I wanted a toddler bed, I agreed with John’s reasoning that a toddler bed would only be useful for a short period of time), a dresser and a little chair for E’s desk (he currently has to sit on a giant box of wipes- we’re a little ghetto). We still need to buy a mattress and bedding, and then we can set the room up and let Elijah try out his new bed (with bedrails!). Hopefully it’s a smooth transition.

Tomorrow I go for my next ultrasound at the MFM. It’s been 8 weeks since my last one, and I’ve been sleeping terribly. Having awful awful (although very weird) dreams. Like this weekend, where I dreamed that Elijah was 1″ tall and I put him in my mouth for safe keeping while out and about. He got hungry so I tossed him a cheese cube, but forgot that he was in my mouth, and I swallowed the cheese cube and Elijah along with it. I know, it’s so preposterous that it’s humerous now, but I was frantic that I killed my baby in my stomach. I woke up in a cold sweat. I’ve run down all the possibilities in my head for tomorrow and I can only now just hope and pray that all is well with this munchkin. I do need to stop browsing the internet since it does me not an ounce of good to read stories, even the good ones. My mind already goes to the bad ones.

In another note, I found a lump in my breast. I went to see my doctor last week and she sent me for an ultrasound. So I’m waiting for those results too. My mother is a breast cancer survivor, and I know that the hormones of pregnancy can speed up the growth of cancerous cells. I know the odds are good that it’s a milk duct or lymph node, but I can’t help panicking a bit. I’ll be good once my doctor gets back to me. I hope to hell I don’t have to go for more testing.

After our enlarged nuchal fold (back of the neck) measurement at my 20 week appointment, they sent off the remaining CVS (placental) sample for in-depth chromosomal testing (the original testing just counts the number of chromostomes to test for trisomies; this microarray testing checked for microdeletions or microduplications within chromosomes). They told me it would take 3-5 weeks for results. It’s been 5.5 weeks. I’ve been on pins and needles.

All is normal! They also checked for Noonan’s syndrome, and the baby doesn’t have the most common chromosomal abnormality for that. That doesn’t completely rule it out, though. That is associated with increased nuchal fold, and heart problems but the heart looked good at the last two ultrasounds.

I have my next ultrasound at the high-risk clinic in 3 weeks (at 28 weeks). They’ll be looking more in-depth at the heart, esp for things that wouldn’t have been developed at 20w. If necessary, they’ll do a fetal echo u/s. Otherwise, I can be released fully back to my OB.

So another hurdle passed. I won’t breathe easy, though, until this babe is in my arms, staring up at me. 15 more weeks until my due date. I hate to wish away the time as this will be my last pregnancy, but I just want to be out of the woods.

I’ve really been grappling with having made the decision to have the microarray analysis done. Tuesday I had to go to the high-risk clinic to give a blood sample to send off with my remaining placental sample for the advanced genetic screening. It sucks that we’re even having to consider all this, but I want answers. However, what if I get answers to questions I wasn’t even asking?

Microarrays test about 200 genes for microdeletions and microduplications. Most are poorly understood and/or have no known implications on health. Some do have influences, and I do want to know if the baby has a gene that can cause some problems, that we should be watching for. But….what if we find out that the baby (and/or I) have a microdeletion or duplication that isn’t understood? Will we be always looking over our shoulders and overanalyzing things in case they *might* be related? We will forever know the genetic makeup of this child of ours- will this harm him or her in the future, even if there are no current health implications? Will jobs/insurance/life depend on genetic makeup? I feel like I may be trying to get answers to uncertainty by creating more uncertainty.

But there’s no going back now. The tests have been ordered and now we wait. I hate that I’m a researcher and have access to thousands of medical journals and scholarly search engines. I need to stop looking things up and focus on what is in the now- the 21 week old fetus in my belly, growing and kicking.

Just when I think we’re in the clear, another hurdle pops up. Last week I had my 20 week ultrasound at the high-risk clinic. After everything being perfect at 16 weeks, we were quite optimistic and John didn’t come with me (since he doesn’t have any paid time off left, we figured it was no big deal). But, of course, it’s never easy.

This ultrasound was much shorter than the last one (the 16w one was about 1.5 hours long!). I got in with the genetic counsellor and got the good and bad news. Good news is the baby is measuring right on schedule- good strong heartbeat, normal heart, brain, spine, organs, limbs. Bad news is the nuchal fold is once again enlarged– 7.2 mm when normal is < 6 mm. They have no idea what could be causing this. It's quite abnormal for it to decrease in size (from 13w to 16w) and then increase again. And quite abnormal for it not to be accompanied by structural defects. So while I thought I was finally going to be released from being 'high risk', I'll be going through more testing. They're sending part of the placental tissue taken from my CVS off for more genetic testing- microarray analsyis for chromosomal microdeletions, and to test for Noonan's syndrome. I'm trying to hold on to the fact that the heart and other structures were perfect on two separate ultrasounds, so even if it is a genetic problem, it should be a more milder case. However, I'm still a basket case. I won't know the genetic results for another month, and I go back for another ultrasound at 28 weeks.

At least the little one is moving around a lot now, so I can rest assured that he/she is still with me. More than half-way there and I'm trying to hold on to the happy things to feel a bit more connected with this pregnancy, which should be my last.

After a month of travelling (I’ve been in 6 countries in 32 days- Austria, Slovenia, Croatia, Bosnia, Canada and USA) and conferencing, I’m getting back to some normalcy.

While we were in Croatia, we received the call that our CVS was completely and utterly NORMAL. So no chromosomal problems for this timbit. Such a huge huge relief, but I knew that we weren’t out of the woods until the level II u/s could confirm that the heart, spine, brain and limbs were good. 12 hrs after we arrived back in Canada from Europe, we were at the high risk clinic for that u/s and I’m so incredibly happy to report that, after a 70 minute ultrasound, everything is absolutely perfect. The little one was measuring right on track, and even the nuchal fold was within normal limits. I have another level II ultrasound at 20w, and if all continues well, I can be released back to my regular OB and no longer classified as high risk.

I’m now starting to enjoy pregnancy, even with the heartburn, nausea and backpains! My stomach really popped out last week (17w) and it’s starting to sink in that we are going to have a second baby in less than 5 months. So much to do in that time…

just got the call and I had to answer it. I was shaking and practically crying before she gave me the results that the baby doesn’t have one of the major Trisomy disorders (T13, T18, T21 (Down syndrome), Turner’s or other X/Y disorders. Not out of the woods by any stretch of the imagination, but this is a big hurdle. The full CVS results will come while we’re away but I asked them to call me on my cell. We get back the evening of the 26th and we go back to the high-risk clinic the morning of the 27th for another level II ultrasound (to see if there are major heart or other anatomical defects) and to discuss the full results.

I am so very cautiously optimistic right now. Not enough to actually tell people that I’m pregnant, but enough to maybe get some sleep tonight.

I’ve decided that I’m going to answer the phone and get the results, even with J not being with me. I won’t be able to handle having the message on my voicemail. 4.75 hours until the end of the workday. I hope the call comes today.

Not sure how I’m going to do it. It’s only 9am, and results could come anytime before 5pm I guess. So that’s 8 more hours. I thought I wouldn’t answer the phone and let it go to voicemail, but I’m not sure I could sit here knowing that the results were available. I just hope I have the strength to hear them. I’m trying to stay positive by reading stories of good outcomes with super high NT results, but it’s so hard. I have also been reading stories of poor prognoses to prepare myself. But I’m not sure if anything can really prepare me. I just hope to hell that the call comes today and not Monday. I have slept like shit the last 10 days and I don’t know how I’ll get through the weekend without some answers

Yesterday I went to the high-risk clinic and had another ultrasound. Got to see the little one jumping around and looking, well, normal. All except for a big bulge on the back of his/her neck. The NT grew to 9.2 mm which, when I was told, made me bawl like I’ve never cried before. The genetic counsellor insisted that just b/c the number is a lot bigger than last week doesn’t mean anything. It was tested by two different techs in two different labs. She said that even if it had gone down, it wouldn’t mean anything. Maybe not to them, but to me it means that this is real. That the finding last week wasn’t just some mistake by the u/s tech.

Good news is that they didn’t find any hydrops, which are fluid pockets in other parts of the body. Hydrops are 100% fatal, so there’s that. At the meeting with the genetic counsellor, J and I told them that we want a definitive diagnosis (none of this 50/50 chance crap), but that we’re leaving for Europe on Monday. Thankfully, they were able to get us in for a CVS (chorionic villus sampling) later in the morning. Met with the OB, Dr M, who was very reassuring about the procedure (even if he couldn’t be reassuring about our diagnosis).

B/c my placenta is anterior, the CVS was fairly straight-forward and easy for them to do. The needle was only in my stomach for about a minute, so the pain/discomfort was short-lived. The anxiety, on the other hand, is long-lasting. We should get preliminary results (telling us if the baby has Trisomy 13, 18 or 21, and if there are X/Y disorders) by tomorrow afternoon. Full results aren’t ready for 2-3 weeks. So even if we get the ‘all clear’ tomorrow, something bad could show up in the next couple of weeks. So I pray that we get good news tomorrow, and I hope that Europe is distracting enough to get me through the next couple of weeks.