Wednesday, November 28, 2012

Update from Monday

Let me start by saying everything is okay.

Now, let's backtrack. 

On Monday, P and I arrived to the Diagnostic Center a half hour before our scheduled appts. and I felt so out of place.  It was like being at the infertility clinic for the first time.  You didn't want to have to be there, but you also hated feeling like such an outsider.  It was a very professional environment.  No big smiles to welcome you.  No feelings of warmth from the secretaries.  I guess if you are there, it isn't for a good reason, so it is just best to keep things as formal as possible. 

We waited for about 20 minutes before being called back to meet with the genetic counselor.  She was great.  Very informative, commented that she could tell I did my research, and there was really nothing she said that I hadn't already prepared myself for.  My AFP came back at 2.7.  They like to see it between 1.0 and 2.0.  The way they determined mine was elevated was they compare me to others just like me: a white, 29 year old, in good health, who concieved via IVF.  Taking into consideration all those things, my AFP came back 2.7 times what would be considered "perfect."  She then went onto explain the other 4 things that were measured in my blood.  The others looked good, particularly the 2 connected to the placenta, which means the placenta is most likely functioning properly.  After we had our meeting, we went to sit in another waiting room for about another 15 minutes.  We both were sweating, surrounded by other couples, no one knowing where to look or what to say.  I had no idea what to expect.

When we got into the ultrasound room, the technician told me to lie on the table and that was all we heard from him.  He did point out a few things he was looking at.  But, it was basically, my husband and I sitting in silence while the tech. jabbed at my stomach for 45 minutes taking over 50 pictures and all sorts of crazy measurements.  Every once in a while I looked at the small television screen, but I mostly stared at the ceiling fighting back tears having no idea what was going on.  At the conclusion of it, he told us he needed to consult with the doctor and then would be back.

Ten agonizing minutes later, he walked in with the doctor and they looked over the spine a bit more closely.  Then he finally told us that from everything they could see, there were no problems.  The spine, kidneys, brain, liver, arms, legs, nose, mouth (sometimes an elevated AFP can be due to a cleft palate) everything looked good.  I couldn't believe it.  I was afraid I was going to pass out. 

The wave of relief that rushed over my husband and I is almost impossible to put into words.

The doctor then went on to explain that in their report they will recommend that I have serial growth ultrasounds every 3-4 weeks to make sure the baby is continuing to thrive.  Many times the unexplained elevated levels can indicate complications that may arrive in the third trimester.  Many times, it can mean nothing, and it could just be a level that is normal for my body.

The last few weeks have been stressful and terrifying for the two of us and we are so grateful that our little one seems to be doing well and from everything they could see is a very healthy, bouncy baby.  We have fallen even more in love with this little one and cannot put into words how relieved we are. 

Thank you so much for your comments.  This blog continues to be a great source of support for me, especially when the outside world just doesn't seem to be able to provide it.  I am so thankful to be a part of this community.  Thinking of all of you...

Sunday, November 25, 2012

Big Day (maybe the biggest)

Tomorrow is a big day for us, driving to the appts will probably be one of the most difficult things we have had to do so far in our short 3.5 year marriage.  The genetic counseling appt. is first and then we have the Level II ultrasound which could take anywhere from 45 minutes to 3 hours.  This past week has been a struggle.  I am surprisingly calm tonight but don't know how I am going to get myself up on that table tomorrow.

Thanks so much for all your kind words of encouragement and support!!

Sunday, November 18, 2012

16 & 17 Weeks

Multiple times throughout this pregnancy I have heard the word "perfect" used to describe our little one. It always made me uncomfortable. I don't like that word. Maybe I knew something was going to go wrong, or maybe I just always plan for the worst.

About three weeks ago I went for some bloodwork and my NT scan. Both occurred between 11 and 13 weeks. Since the NT scan went well, I assumed there would be no issues. I felt like I had finally entered the "safe zone" if there even is such a thing.

Along with the first set of tests, there is a second set of bloodwork that has to be done at a very specific time in the second trimester, usually between 15 and 18 weeks if you want it to be most accurate. I was planning on going the Wednesday before Thanksgiving because I had it off. But, for some reason I decided to go this past Monday, thinking nothing of it.

This past Wednesday night on the way to pick my husband up at the train station, I noticed a missed call and voicemail from my OB. At first I thought it may be a call to confirm our anatomy scan, but after quickly calculating in my head that it was still weeks away, I immediately knew it was something bad about the bloodwork I had done just days before.

When I called her back, the first words out of my mouth were, "Oh my god, what is wrong?" She tried to calm me down, but also needed to tell me the reason why she was calling. The bloodwork came back abnormal. They generally like to see your AFP (fetoprotein) levels at 1.0, although 1.0-2.0 is an acceptable range. Mine came back at 2.7, which means it is 2.7 times the median. I now fall under the category "high risk" pregnancy. Our baby is at a higher risk then most of having a neural tube defect, it can be an indicator of placenta issues, or many times a sign of complications to come in the third trimester of my pregnancy.

A few hours after the phone call I decided to reach out to the only person I knew who could provide me some type of support: my RE, DR P. I emailed her and within seconds recieved an automated response that she was out of the country until November 28th and if it was an emergency there were other numbers to contact. The tears continued. The next morning I awoke surprised to an email response from her (that is why I love her so much.) She had reached out to a friend of hers who worked at a High Risk Center at Columbia and these were her thoughts on my situation:

"AFP is totally non-specific; 2.7 is slightly high but different labs use different cutoffs (and there are different cut offs based on race, etc) That said, 2 is generally the threshold I remember. Many people will repeat it to confirm it's high before pursuing a workup but the other option is to go right to Level II ultrasound. It can be caused by many things...bleeding earlier in pregnancy, placenta issues, or can be a marker of uteroplacental insufficiency. If her scan is normal, I would not go as far as RECOMMENDing an amnio, although I would certainly offer it and then also do serial growth scans at 28 weeks and 34 weeks."

The reason for my elevated number is not bleeding, because aside from a little episode of it after a pap smear, I have had zero bleeding. The number doesn't seem to be high enough for a neural tube defect. So, my OB is leaning toward it is most likely an issue with the placenta. She said this will mean more monitoring for me come 24 weeks. Sometimes this can lead to low birth weight, premature labor, preeclampsia, and growth problems with the baby. Sometimes, it can mean nothing and we will deliver a happy, healthy baby.

Hysterical crying and the worst anxiety I have ever felt came over me for the first 48 hours after getting the phone call. I did go to work on Thursday and Friday, but avoided everyone and everything. I went in to talk to my principal and explain what was going on, only to break into huge sobs. She couldn't believe I even was at work and tried to get me to go home, but I knew it was best if I kept busy. She told me whenever I needed to leave I could. Everytime one of my students referenced my baby I had to hold back tears. It was so hard. I am showing now, there is no hiding it. And all I want to do is protect myself and this little baby.

On Friday I called my OB's office again and asked to speak to her. She called me back within a half hour and after breaking down yet again, she agreed it would be best if I came in for a quick check of the heartbeat to calm my nerves. I couldn't fight this feeling that this baby inside of me had died. Luckily, she was able to find the heartbeat right away which put my mind at ease, even if for a few minutes.

Upon pulling myself together over these last 48 hours I have done some of my own research. It seems out of 1,000 women, 50 will get the same phone call I got on Wednesday night. That is only 5%, but it doesn't matter how small, I am part of that 5%. Of those 50 women, 1 or 2 will go on to have children with a severe neural tube defect.

We have an appt. with a genetic counselor on the 26th followed by a Level II ultrasound. If everything looks good, close monitoring will be the next step. If abnormalities are picked up, we will need to decide about an amniocentesis, which would be performed that same day.

I don't know how we are are going to get through this next week...

I need to keep reminding myself, I have wonderful doctors and they are doing everything they can to assure everything is okay with both me and the baby, and they will continue to do so for the remainder of this pregnancy...but I am so scared. I hope everything is okay.

Tuesday, November 6, 2012

15 weeks

P painted the nursery this weekend.  We went with Benjamin Moore's Stonington Gray and I love it! Beadboard will go up in the next few weeks and then I will be sure to post pictures.  We have picked out both the crib and dresser from The Land of Nod, hope to order both some time in early January.  I think if I wasn't a teacher I might have gone into some type of party/event planning.  I had so much fun planning my wedding and am loving every second of planning this nursery for our little baby.

I had a tough night Friday night.  Whenever I think I am doing great, reality slaps me in the face and I realize maybe I am not doing so great.  We went out with good friends who announced they were 8 weeks pregnant after 3 months of trying.  So, I came home and sobbed.  P couldn't understand why and I could only express my feelings through anger.  It's not that I am not happy for them I am sometimes just struck at the unfairness.   Even talking about our pregnancies its as though we are living in two different worlds...our thoughts, fears, concerns, couldn't be more different.  Then I called my mom. She always makes me feel better.  My mom reminded me that my baby will never be taken for granted, my baby will be filled with more love than sometimes thought possible because this baby has been wanted and desired more than humanly thought possible.  Because of our struggle, this baby is going to have a wonderful life and P and I are going to be wonderful parents because we know how much of a miracle the chance to have a baby really is.   My mom reminded me that all that matters now is the little life I have growing inside of me so I am choosing to focus on that.  And when I start to feel sad, I need to put my hand over my belly and remind myself of this wonderful little gift that deserves nothing but the absolute best of me.  She also reminded me of the pain so many of you are still dealing with on a daily basis in your struggles to beat infertility.  My mom is a very smart woman.

With all that, I am so excited to be 15 weeks pregnant!

How far along: 15 weeks
Total weight gain: 6-7 pounds...could I really gain one pound a week from here on out?  Scary thought...
Maternity clothes: all of my pants are maternity, still need to find some leggings, and have a few comfy tops from Gap
Stretch marks: No
Sleep: Not terrible, but not great....I am able to stay up way later than just a few weeks ago, love having more energy!!
Miss Anything?  Being able to go to the bathroom without any issues i.e. constipation, weird pains, constant peeing
Movement: No, but anxiously waiting!! Must be getting close!
Food cravings: Nothing new...still love my snacks and can't get enough orange juice
Anything make you queasy or sick: Lettuce (of course it can't be Doritos or chocolate!)
Have you started to show yet: without a doubt, I teased my kids today telling them to stop laughing at my chubby belly and they laughed and laughed!  Already had a few people at work touch my stomach, I thought I would be uncomfortable by the gesture but I love it, I love the excitement. 
Boy or Girl: Not sure, but really anxious to find out.  The old wives tales are doing nothing for me.
Looking forward to: Our anatomy scan which is November 30th!  We will be asking the tech to write down whether it is a boy or girl on a piece of paper and then wrapping it to put under the tree and open it Christmas morning!! Ahhh...definitely husband's idea....I hate a very impatient person...don't know if I can do it!  But, it is important to P, so I will try.