Boy or Girl?
R. and I have been debating over whether or not to find out the sex of the baby. “If you don’t want to know, don’t look in your file,” my doctor said. “It’s in there.” Tomorrow we have the anatomy sonogram, where surely the proof will be clear. At the last sonogram, the technician told us to look away while she examined the posterior view if we didn’t want to know. It all feels a little silly — we have to make an effort to avoid the information.
Whenever I tell anyone I’m pregnant (a relief to explain my expanding frame), the first question is “Is it a boy or a girl?” We don’t know, I say, further explaining that this is by choice. The reaction varies. Parents usually say, why not? and I feel as if I have to explain my unpopular decision which is — I just don’t want to know. At first I thought I didn’t want to know because the entire pregnancy (plus six months) has been one of too much information, and not knowing is sort of a relief. Let’s keep something traditional, R. and I told each other.
A couple women have told me that they felt the pregnancy was so much work that they wanted a reward, and finding out the sex was that reward. Right now I feel that being pregnant is enough. I don’t want to rush into any realities. Perhaps finding out the sex would make this more real. Maybe I want the fantasy of it a little bit longer. R. said a lot of people don’t understand what we’ve gone through to get here. For most people, finding out the sex is just another step in a natural, spontaneous process. We are still catching our breath from months of treatments followed by months of nausea.
But lately we are tempted by the information in the file and on the screen. R. says he is 60/40, leaning towards finding out. I’m still holding out. I think my desire to not know also has something to do with possibilities. Is it a boy or a girl? Will it rain tomorrow or will it be sunny? Will we find a larger apartment by December or will we buck up and squeeze one more (little) person (with lots of accessories) in our small one bedroom? For some reason, I like not knowing any of it.
Final Amnio Results
The lab didn’t screw up! Yesterday morning I checked my voice mail at work and received an unceremonious message from my doctor’s office that “your lab results came back okay.” The woman on the machine sounded tired and the news lost some of its punch but still, we are relieved that the waiting period over.
Now R. and I are in the “this is real” mode and acting uncharacteristically giggly and sweet, imagining what it will be like to hold our new baby, to see it’s little mouth make sucking motions, or cuddle up on R.’s chest to sleep. I know it won’t be all sweet and heartbreaking. I know it will be hard and stressful, too. But for now we need to have this happy period that we’ve denied ourselves for so long.
Still, I am only at the end of my fourth month and the remaining five feel endless.
Preliminary Amnio Results
Dr. L. called today with good news. Yippee! The preliminary results mean there is a 99% chance that all is well. Darn. There’s that one percent again. But we are thrilled with the results, even if we have to wait another two weeks for the 100% okay. Dr. L. explained that there is a 1/1000 chance that preliminary test (they stain the cells) produced an incorrect reading. For the past ten years, their labs had a 100% accuracy rate. But three months ago one woman was given a-okay preliminary results and the conclusive testing showed otherwise. Poor woman. But we couldn’t have had better news today so I will stop whining and worrying for now. And try to be happy without being suspicious.
Gene pool crap shoot
Last Friday, R. and I met with a genetic counselor at Columbia-Presbyterian. My doctor suggested the counselor could better explain the NT results and make us feel more comfortable about the CVS. She made us feel less hesitant about the CVS (a marginally higher risk of miscarriage than an amnio), but more nervous about the roulette we are playing with our gene pool. Down Syndrome is our big worry because of my age, but all other chromosomal abnormalities could happen anyway. I’m convinced if anyone spoke to a genetic counselor before trying to get pregnant, they wouldn’t even try.
She took a thorough family history of both R. and I, marking up a pre-made family tree with blank rectangles. With each potential genetic flaw, she’d scribble a different symbol then pull out her genetic counseling book and tell us the chance that the disease or condition was genetic, and our chance of being a carrier. After two hours, we left with a CVS appointment scheduled for the following Friday. Again, we walked most of the way home a bit dazed by the information and feeling very small and powerless to do anything about the inevitable. I guess you could say we had achieved an unsettling peace, a throw up your hands and sigh surrender.
We would have scheduled the CVS for Monday but because of the bleeding last week, we decided to allow for several more days of healing. The spotting had gone away by Monday and all was fine until last night when I started bleeding again at 11pm. Not heavy, but steady throughout the night, ending sometime in the early morning. When it started, both R. and I started pacing around the apartment. We’d been through it before and I knew what the doctor would say. I wasn’t cramping, so no need to panic. What does the book say? R. asked. Why don’t you read it? I responded. He picked up “What to Expect” and I found the more clinical “Your Pregnancy & Birth” given to me by Dr. L. on my first visit.
R. read things like, “It’s definitely scary to see blood down below when you’re pregnant. But what’s not definite is that bleeding is a sign that something’s wrong with your pregnancy. Many women – about 1 in 5, in fact – experience some bleeding during pregnancy, and a very large majority go on to have a perfectly healthy pregnancy and baby.” In my book I found “bleeding” under the “Complications During Pregnancy” chapter: “Miscarriage occurs in about 15-20% of al pregnancies, often during the first three months. Bleeding is the most common sign that a miscarriage might occur.” We decided we liked the more fluffy, illustrated “What to Expect” approach and I decided not to consult the other book anymore.
I just talked to my doctor and she said to go ahead with Friday’s procedure. The ultrasound will show any problems and if there are risks, they won’t do it. We are ready. We want it over with. We want to be able to exhale and poo-poo the numbers.
Prenatal screening
On Monday, I had my NT (nuchal translucency) scan. The test results will indicate the chances of Down Syndrome and a host of other chromosomal abnormalities. Last week my doctor was optimistic: I might have an excellent score and we could forgo further screening. Or it could be in the middle and we might opt to wait for the amnio. Or it could be not great and she’d recommend a CVS, the earlier, slightly riskier procedure.
The test itself is simple and non-invasive. In fact, it was kind of fun. The technician was a friendly, Eastern European woman who obviously enjoyed her job. She needed to get a clear shot of the neck away from the uterine wall (or whatever it was pressed against). The little guy was sleeping. She pointed out the encouraging, strong heartbeat. Good sign. The size of the fetus had doubled since the last screening less than two weeks ago. “I need him to wake up,” she said. “I need him to turn over.” She pressed her paddle into my abdomen and shook it around. I felt a little bad about waking him up from his nap, but we needed to get down to work. “There he goes,” she says, and points out the feet and arms (two of each!) kicking and punching back and forth. I wasn’t prepared for that. Legs? Kicking? In quick paddle like motions. Kick, kick, kick. Pause. Kick, kick, kick. And the little arms and fists scrambling in the air (or fluid). It was a Disney moment. Aw, isn’t that adorable! How wonderful. How amazing!
Then she switched views and showed me the 3D version. This I was not prepared for. This I had not seen in my “What to Expect” book, nor the books Dr. L gave me last week. “What’s that?” I asked, watching this tiny birdlike creature stretch and claw under a sheath of tightly pulled skin. “What the heck is that?” She explained it was a 3D view and more like what the fetus actually looked like. I felt a little sick. I wasn’t prepared to see the un-Disney version. It was real, it was fascinating, but it was a little too much for me. Later, I walked most of the way home, despite the 95-degree heat wave. I stumbled along Broadway in my flip-flops, soaking up the Dominican ambiance, watching all the people who started out as blobs of flesh and bone.
Later, R. said, what did you think? That they start out fully formed? No, of course not. I guess I hadn’t really thought of it. The technician presented me with a handful of snapshots from the session. Two of 3-D view and the rest from the regular ultrasound. One of the latter was particularly clear and showed a shapely little skull with rounded forehead and button nose. I placed that one on the top of the stack and posted it on the refrigerator.
For the next day or two I kept talking about how disturbed I was by the 3-D image. R. scolded me, telling me to stop obsessing about it. I told friends how detached I felt from the pregnancy, how seeing that image had made it more real but more unsettling. I’d lie in bed and think about the creature growing, quickly now, and that half formed face, that alien head without every feature in place. It will grow, R. assured me. And maybe that is what I found most disturbing about the image. That it wasn’t fully formed. That I’d seen it in a state of growth, unfinished, and I fear that that is how it will remain. But I was thrilled to see two arms, two legs. Even fingers and toes.
Yesterday a work, while interviewing a very nice programmer from India, my doctor called me on my cell phone. I knew if I didn’t answer it would be another day or so before we connected. I left the poor guy in the conference room for fifteen minutes while I roamed the halls trying to find a hot spot where my phone worked. Dr. L. assured me that the bleeding I’d experienced the night before was probably nothing to worry about since I’d had a good scan on Monday and she wanted to talk to me about my NT scan. At 3:30am, I’d woken up terrified to see what looked like a heavy menstrual flow. How could she be sure nothing was wrong.? She went on to tell me that my NT results were in line with my age. Basically, we didn’t get the reassurance we wanted. When she told me my range from the test and the range from my age, I quickly calculated that my test, in fact, scored lower. I looked back in the glass enclosed conference room and watched the interviewee click away on his PDA, glad that he had a distraction. Standing in a sea of empty cubicles, I remembered that someone was having a going away party in the larger conference room. I could talk about the risk of Down Syndrome openly, without walls or glass enclosures.
Dr. L. was recommending the CVS and for next week. Rattling off numbers and risks, she assured me the procedure was safe and that their facility was top-notch. I knew I would do it, but said, I have to discuss with my husband. Of course, she said, probably knowing that my decision had been made. I didn’t cry on the phone with her. How could I? I had to get back to my interview. She suggested R. and I meet with a genetic counselor the next day (today) that, she said, would make us feel better about the risks of the procedure. Sure, I said. Of course, more information.
When I went back to the interview, our time was up. I apologized profusely, and wondered if he could read the notes I had scribbled on his resume, the only piece of paper I took with me when I left: CVS, 1/38, 1/ 35, genetic counselor.
I told R. he had to come to the appointment with me on Friday, and that he had to come to the CVS. I’m through doing this alone, I said. I refuse to go to one more appointment by myself and swallow my heart as I watch the ultrasound monitor search for the heartbeat, and hold my breath until I see that fluttering heartbeat pulse on the screen. I realized the last time he’d come to appointment with me was the retrieval, and he had to be there for that. I was feeling very alone.
Talk it one day at a time, he reassures me. And I think, easy for you to say. You aren’t living, breathing, thinking this pregnancy every second of the day. You aren’t the one being prodded and poked, waking up in blood soaked underwear, reading books and searching online for risk factors and what every gurgle and strum of your body means.
Last night I went for a walk in Riverside Park. With the break in heat, the park was busy with dog walkers and joggers and kids coming home from softball games. My irritation with R. for not being there festered. But I realized as I walked along that I wasn’t alone. That I’d been feeling this way, accompanied?, for some weeks now. It’s a strange comfort to know that I’m not alone. And maybe I wouldn’t have felt this way if I hadn’t seen that disturbing image of protoplasm and bones. However unformed, it’s hear with me, every step of my day. Which makes the thought of something being wrong sadder than I can put into words.
Protein 8, what are you?
This week started out promising. On Sunday, I stopped all hormonal treatments (progesterone and estrogen). On Monday, I had bloodwork done to see if my levels were good and if I could stay off the junk. When I woke up on Monday morning, I felt more clear-headed than I had in a while. The opposite of waking up with a hangover, I suppose. The nurse called to tell me my levels were good, so no more shots and patches! It felt great. But she also told me she forgot to give me a requisition for more bloodwork. What? Dr. M. wants me to have additional bloodwork. Can I come back to pick up the form? No, I said. I was pissed that they forgot to give it to me, and with my new queasy way of life making the trip cross and up town is like climbing Everest. The nurse said she would mail me the form, so I didn’t think much of it.
Last night Dr. M. called to give me some OB recommendations.Bboth generalists and high-risk were on the list because she didn’t know if I needed to go high-risk. My latest labs had not come back yet, and they would determine whether I was high risk or not. What? I told her I hadn’t had the tests yet. I was led to believe they weren’t critical. She said I tested inconclusive on the Protein 8 test (I have no idea what this is, but apparently it indicates a clotting issue). I need to retest to see what range I’m in, as a poor result (or deficiency?) will put me at high-risk. High risk for what? I ask. Miscarriage, pre-term, she tells me, and I detect a bit of exasperation in her voice. What the heck do I think “high risk” means?? If the results are low, I may need to be on heparin, a blood thinner, for the duration of my pregnancy. More shots. More worry.
Now, what I love about Dr. M. is that she is so thorough. She leaves no stone unturned. But this just blows. She told me to have the test done immediately because at eight weeks she’d like to treat this condition if I indeed have it. Shit. Just as I was feeling happy and confident about the pregnancy, I suddenly feel fragile again.
Last night, for the first time in weeks, I didn’t drop off to sleep two minutes after picking up a book. I worried, with my new worry of the week, and prayed the test would be conclusive this time, to my benefit.
I’ll go to the lab this morning, but it might be a few days before I get the results. This may be one extra long weekend.
hCG levels are up!
This morning I went in for my second blood test. I would not have been too nervous about it if I hadn’t detected some sort of spotting last night. It wasn’t easily identifiable, and I wasn’t into examining it. Don’t worry about it, I told myself. My sister said it was normal but to tell the doctor anyway. The constant fatigue and crampy pressure in my abdomen does not help me feel equipped to deal with minor worries. But, I’ve learned to like the crampy pressure. I now trust that it is a good sign.
I tell the nurse about the spotting. Was it brown? she asks. No. Was it red? No. It was pink. Furrowed brow. Bright red concerns us, she said. But “pink” is just another fuzzy line in this mysterious business of procreation.
I tell myself not to be nervous, but I am alarmed when the office left a message at 3:30. Usually I call them. But it is fine. The hCG levels had increased to 148 (it was 56 on Monday). This is good. If pregnant, hCG levels double every 72 hours. With the increase in my levels, the doctor isn’t concerned about the spotting, and there is no more pink nor brown nor red. I know this is just the beginning of many foreign bodily ejections and many worrisome, unexplained physical quirks.
Pregnancy Test Results
I wake up this morning at 6am with a full bladder. I lie in bed a full hour, in no small amount of pain, putting off the inevitable, because the First Response is still poised on the magazine caddy. Finally I get up. I piss, I dip, I look. One dark line appears. My hands shake. One dark line where I needed to see two. I brush my teeth and pick up the wand to see the bad news again. But wait. A faint pink line has formed. Shit! A faint pink line! I read the instructions again. Yes, that’s what we want to see.
R. and I stand in the bathroom like a couple of idiots, not trusting anything. “Do you think it is right?” “I don’t know. It says two lines.” I bet most couples would be jumping up and down. But we doubt everything now. We drive to the doctor’s office for my blood test, making small talk, not willing to jinx anything. We will not acknowledge that faint pink line until someone official sanctions it. At 3pm, I’m to call for the results. All day I’m hopped up on nerves, hands shaking, eyes wide, feeling like I drank a quart of coffee. Holy shit. Holy shit. The nurse confirms the test is positive. My hCG and progesterone are at good levels. She sounds cheerful and optimistic. No doom and gloom! I guess I’m pregnant. I guess I learned how to read an early pregnancy test. (Can you tell I don’t have much experience with these?)
We are happy. Relieved. But strangely, I feel a bit shocked. So much hoping and praying and complaining, and now this — the results we wanted. I thought I’d be jumping up and down shouting screaming rejoicing. This is huge. And I am truly happy. But in a quiet, peaceful way. I think I’m on to the next phase, relieved, for sure, that the first step is over. That first horrible step. Another test on Wednesday, then next Monday, then two ultrasounds. After that, we are packed off and sent to an OB/GYN.
After I talked to the nurse, and called my husband, I sat in the small conference room at work (the only place I have privacy) and found I didn’t want to call anyone else just yet. It’s too early. It’s only been two weeks. You don’t announce these things right away. Later, a friend asked if I was going to tell people. I said, well, I have a blog. But people who read it understand. This is a journey. This isn’t your typical road to family planning.
Thanks, everyone. Thanks for the good thoughts and energy and prayers and cheers and for reading and listening. But stay tuned. There’s more. There’s much, much more. I think this is only beginning.
