6w-2d: Referral to a specialist

I got another call today from the OB/GYNs office about a referral to an internal medicine specialist. Evidently the OB/GYN is freaking out and is calling in the “big guns”. When I spoke to the specialist (let’s call him Doctor Big Gun) she said he wanted to “consult” with me and order more tests.

I’m getting a little tired of this. I’ve had every coagulation disorder test known to man – and there hasn’t been anything found. I’m really regretting asking for the referral to this newish OB/GYN (who I think I’ll refer to as Dr. Nervous Nelly from now on). My “old” OB/GYN – when confronted with my history with my first child’s birth - literally shrugged, said “Eh, these things happen” and proceeded to supervise my blithely uncoagulated, healthy and successful pregnancy with my second child. I liked Dr. Eh.

I’m considering going back to him. Seriously considering it.

 I still haven’t even seen Dr. Nervous in person, but she’s been very busy. I already have the test requisitions, a prescription for Heparin injections, two ultrasound scan referrals and a note to carry internationally (for the needles).

I haven’t purchased the Heparin yet, I’m waiting to see if the verdict on Friday is “viable”. Why inject myself if there isn’t any point?

Dr. Nervous has me thinking if I don’t hyper-medicate (without any indication of a need – just taking heavy-duty IV meds as a precaution) then I’m taking a huge risk. Terrible mother risking her baby’s life like that. Tsk.

 It just doesn’t seem that way. I understand she has to cover her tush and liability issues and all… but does that mean I have to agree to unnecessary medications that can actually cause problems?I just don’t know what to do. Damned if I do switch (you’re putting your baby in danger!) and damned if I don’t (over medication, panic!)

2 more days until we find out if this pregnancy is viable… I hope we get some sort of answer, although I’m starting to understand there’s no concrete nailed-down money-back guarantee of a live, take-home baby.

I am getting used to the idea, though.

It Takes a Man to be a Dad

A great pro-father video from Youtube.com:

The idea of my significant other being a Dad fills me with glee. His loves this stuff…

6w-0d… again

I’m re-visiting the 6 week pregnancy information, after having reached this milestone a few days ago. I’m adjusting my tickers and pregnancy newsletters to my new estimated stage – 6 weeks today, according to the ultrasound scan.

I’m trying not to be too attached to the idea of being pregnant. I still have a hard time saying “I’m pregnant” or talking about a theoretical baby. Making plans for the next 8 months or so makes me very uncomfortable… I don’t want to say anything about the pregnancy… because it could also never happen. Why mention something that may never happen? 

That makes me feel like I’m betraying this pregnancy, somehow.

I guess I’m trying to protect myself from a potential loss. The outcome for significant bleeds for my age group isn’t great – essentially a 50/50 chance of actually having a “take home” baby (or an “adverse outcome” in doctor speak). I have “Advanced Maternal age” and the AMA communities are just… bleak. There’s so many losses and so much negativity from the medical profession and society that it just seems like a disaster.

The perception is that AMA mothers are doomed to have children with DS – yet it’s actually a less than 1% chance. The reality is that the incidence of congenital issues of any sort in the general population is 3%. There’s a higher chance of hip dysplasia, hypospadius or asthma – and those I’ve already dealt with.

On the really positive side, my GP – who has known me forever – told me “Yeah, you’re 40, but you’re a young 40″. Not concrete science, but I’ll take what I can get. Another comforting thought – both my grandmothers gave birth in or around their 40s – and that was 50 or 60 years ago – and they came out of the experiences unscathed back when medicine was far less advanced than it is now. Genetically it seems women in my family are good at birthin’ babies when we’re practically senile.

Well, you know what I mean.

Currently… my symptoms are continuing – my chest is very sensitive and has dramatically increased in volume and firmness (bonus! pregnancy breasts are better than plastic surgery! must tell all the other senile moms… although I suspect this solution to a sagging bustline may not be that popular). I am starting to experience morning sickness, mostly just moments of queasiness and food sensitivities… I’m viewing this as a positive thing – symptoms of any sort means the pregnancy isn’t completely doomed.

I’m doing everything I can to help this pregnancy along – no more coffee or caffeine or chocolate (sigh), I’m taking prenatal vitamins and extra folic acid, exercising and trying to rest, but… I do have two small children, I am a single mom and I work full-time… so rest is a relative term.

The spotting has mostly ended – there’s a tiny bit once in a while, but nothing like it was. I hope it stays that way.

Mostly… just waiting, and seeing.

6w-2d: Ultrasound results

I think I’ll call today “around the hospital in 80 minutes”.

I let my mother in on what was going on – with all the tests, I knew she would figure it out. We headed out for our appointments (she had one earlier in the day) together.

We arrived very early at the mega-hospital center where the OB/GYN sent the ultrasound scan order.  After much circling and waving and gesturing (polite gesturing) of parking attendants we finally found a spot at the end of the lot (this hospital has been having notorious issues with parking lately, so we were thankful for any spot).

We were also in the wrong place.

We were expecting to be directed to the Radiology department in the main hospital, or perhaps Maternal Fetal Medicine, but it was actually neither of those. The lovely lady at the info desk directed us to get back in the car and drive around the hospital to a completely different outlying building on the other side of the hospital complex.  So, after following her directions we found another rare parking spot at the second building. After negotiating through the building (it’s still under construction) and two different sets of elevators we found the radiology center.

Turns out that was wrong, too.

The nurse at the counter looked up my appointment on the computer and it turns out that it was at a radiology center outside of the hospital complex (across the street on the other side of the hospital). So, we got back in the car again, drove around to the third building and luckily found yet another parking spot.

Finally, we were in the right place. Thankfully we had started out really early, so we arrived on time.

They did the ultrasound scan and explained the results respectfully and clearly:

• I am definitely pregnant
• the pregnancy is located in the uterus (phew!)
• it measures 5w 4d, not 6w 2days. A discrepancy of 5 days.
• there is a significant placental bleed
• it’s too early to see anything
• my good parking karma has been exhausted. Let’s hope the baby’s parking karma hasn’t been, and it stays put for a good, long time

They’ve asked me to come back in a week for another scan to check the baby’s growth and to check on the bleed. They also asked if I could be wrong about my dates. Anything’s possible – I am 40 and my periods have been more irregular than they’ve been previously. It could be that my dates are 5 days off.

It could also be that the baby is in trouble. The bleed is pretty concerning. My mom’s reaction was “why” and I had to admit – I know nothing about bleeds. I have no idea what it means. The results aren’t a complete disaster… but it isn’t the best news. I guess I’ll just have to wait and see what happens – hope for the best, but prepare for the worst.

6w-1d: Call from the OB/GYN

Well. In spite of my expectation of not even hearing from my new OB/GYN’s office for another couple weeks… the OB/GYN called me today.

She sounded more than a little freaked out.

“You had PIH and a clot before? Both your children were premature? You’re 40?!?”

Yes, I did have both children early – by C-section for medical reasons. Yes, I did have PIH with one, we’re not sure about the other… but it was atypical and we still don’t know what was really going on - it could be because of my first child’s massive issues in utero. Yes, I did have a PE (pulmonary embolism – the clot moved to my lungs) after my first delivery – but I’ve had every single test for a clotting disorder done by a specialist and the verdict was that 3 major surgeries in less than six weeks (one of which was the C-section) and a transfusion postpartum was just too much trauma and that’s why I had a clot.

“But you could have died, a lot of women die!”

I said I knew that, better than most.

“Well, I hope you have prescription coverage because I’m putting you on Heparin shots”.

What? Oh, fabulous, I thought.

I explained to her I didn’t have a single clotting issue they could find and that my second pregnancy was perfectly healthy with no anticoagulation (afterthe clot with the first pregnancy). She’s just too freaked out that I’ll have another DVT (deep vein thrombosis) and didn’t listen.

“Your first baby had birth defects?”

Yes. It was proven to be inherited from his biological father – we went through extensive genetic testing. My second child is perfectly healthy. This baby has a completely different biological father. It’s a non-issue.

She still didn’t like that.

“Why did you get pregnant?”

That question made me angry. I told her that we were using birth control and it still happened, so we’re dealing with it… but the implication that my being pregnant was such a horrible, risky, unworthy situation made me angry. And a little frightened.

Until now I didn’t think I was in imminent danger. My second pregnancy was wonderful with only a little problem at the very end when my liver tests were only slightly abnormal.

“You’re having an amnio…?”

No, I said. No amnio, no invasive tests. We weren’t comfortable with the miscarriage risk. If I somehow manage to carry this baby I’m not going to risk the baby’s safety with a test that would give me results I wouldn’t use. If this baby has a problem I still wouldn’t terminate. I already have a special needs child, so it isn’t the unknown, horrifying possibility it is for many pregnant women.

I did ask to have an NT scan and a quad screen… and a biophysical profile or fetal echo if necessary.

“We don’t do quads – it’s too expensive. Taxpayers don’t want to pay for that.”

So, the new OB/GYN ordered an ultrasound scan – for tomorrow, to be sure of my dates (I am sure, but she isn’t) so the NT scan later will be accurate. I was also told to come to the doctor’s office to pick up a “package” including my prescription for Heparin and requisitions for a whole bunch of tests.

Why do OB/GYNs never seem to realize that the vast majority of mothers work? I had to do a bit of professional gymnastics to get the day off for all this. Thank goodness there were no major meeting on my calendar for tomorrow.

I asked her what do I do when I travel for business with injectible drugs? She said she’d put a note in the “package” for me to use when I travel.

So, my plan is to have the ultrasound first and see if this pregnancy is healthy and likely to continue. Then I’ll pick up the package and deal with the prescriptions and tests – but only if the pregnancy looks viable. I was instructed to tell the ultrasound technician that I needed to know the date so I could phone later tomorrow to book my NT scan.

I also have to schedule a Pap with my GP sometime in the next couple weeks.

The new OB/GYN will then see me for the first time at 12-16 weeks.

At least I’m getting an early scan out of this.

I am not looking forward to injecting myself every day.

5w-6d: Just call me spot

The spotting has continued but there’s no true bleeding, and it has been tapering off. I feel like I’m tempting fate by saying that, but I’m trying to reassure myself.

I’ve been reading articles about spotting at all the popular websites, and all the reading has left me with one recommendation: “call your doctor and get an ultrasound”.

That would be lovely… in an ideal world. The problem is, I’m not only waiting on a referral to a new OB/GYN… OB/GYNs in this area typically don’t even see pregnant women until after 8 or 10 weeks. It really is a pragmatic and necessary standard – we have a shortage of OB/GYNs so they want to maximize their time with only viable pregnancies, and unfortunately there’s not much to be done for most women who are miscarrying – so why waste their time.

It seems insensitive, almost cruel, but the logical side of me does understand.

That doesn’t help me feel better.

I’m trying to stay calm – if I have a miscarriage, there isn’t much I could do anyway. If I don’t, then the bleeding most likely doesn’t mean much. I don’t have pain or other symptoms that would indicate an ectopic pregnancy (or any of the risk factors).

I’m betting my cervix is just plain irritated.

I know how it feels.

5w-4d: Seeing red

Had a true bit of bleeding this evening, probably only about half a tablespoon’s worth.

 Still, it was enough to make me panic a little, a bit of a shock.

It has stopped now, and I’m resting as much as possible for the remainder of the evening.

I’m sure my partner is also anxious, but he’s hiding it remarkably well.

5w-4d: Spotting

I’ve been spotting for the last 3 days. At first it was a mild discolouration and then it was some pink with streaks of red. Not enough to amount to anything, but still very alarming. I know that spotting can happen in pregnancies that continue on normally… it happened with both my kids.

Still, it does make your heart skip a beat.

I’ve been feeling mildly crampy for a week, dizzy and very tired. I took it all as a sign that I should slow down, so I’m trying to take it easy.

5w-2d; No morning sickness… yet.

Today I’m 5w 2d. The Pregnancy Calendar says I’m 37 days into my pregnancy.

I’m re-reading Vicki Iovine’s book “The Girlfriends’ Guide to Pregnancy”. I love this book; despite her sometimes wandering and image-focused musings, it’s hilarious, comforting and real. It’s also about an “older” mom.

She survived, I should, too.

No morning sickness as of yet. I know I’m completely jinxing myself and I’ll wake up tomorrow absolutely wretched. My biggest fear – because I commute to work – is being struck with an unstoppable wave of nausea while I’m in mid-commute – in the middle of a packed, standing room only bus.

 Hopefully it will never happen.

I have been having dizzy spells for the past week or so, lots of mild-ish cramps and pulling sensations. A massively swelling chest – I’m wearing bras to bed now because my chest is larger and sensitive to any shift in position. My sense of smell has changed, things don’t quite smell the same. I’m exhausted – Dawn of the Living Dead exhausted. I can sleep on the bus or at the computer, anywhere I stop moving for a minute.

 I’ve been cutting down caffeine and I’m down to 1 cup of caffeinated coffee a day now – soon to be just decaf. It hasn’t been as difficult as I feared, then again… I’m not caffeine free yet.

In a way I’m looking forward to morning sickness – maybe then this will seem real. I still can’t believe I’m pregnant, it doesn’t seem real. My partner has said he’s very happy. I’m mostly stunned, worried about how I can possibly manage this… and wondering when I’ll feel pregnant.

I know it’ll come back to haunt me.

4w-6d: Update

Today I’m 4 weeks, 6 days. The Pregnancy Calendar says I’m 34 days into my pregnancy, 20 days post ovulation. I’ve passed the magic 18 days post ovulation – the first of many “I’ll take what I can get” milestones that I’m reassuring myself with.

My pregnancy related accomplishments to date:

• my significant other had to employ some serious Mission Impossible skills in order to sneak pregnancy tests to the grocery check-out while I distracted the kids (look kids, sliced turkey is on sale!) because they can read and just casually tossing some pregnancy tests into the shopping cart with the groceries would have caused a major uproar once they sounded out “puh-reg-nan-see-tuh-est“
• no spotting of any sort beyond a few pinpricks that were probably the little person burrowing nicely into their new home
• I’ve peed on three rather expensive sticks in a series of mostly incredulous Murphy Brown-like moments where I just couldn’t believe I wasn’t going through very early menopause. I think pregnancy tests are the only time in my life where I’ve been tempted to consider something I peed on to be a keepsake.
• visited the Pregnant After 40 board at iVillage and was instantly depressed at how bleak it all seemed
• listened as both my dear friends whooped in disbelief and glee when I told them why we weren’t going to enjoy a three-martini play-date anytime soon
• watched my poor significant other try to grapple with this whole concept… or rather this whole conception. It’s his first.
• watched my sort-of B chest expand on it’s way to previous D heights. Perhaps this will distract my significant other a little.
• I’m cutting down on coffee, which is painful and the worst withdrawal is ahead of me
• I’d like to think the cramps (ow) are the lack of coffee, but it’s probably somebody making their little self quite comfortable. They’re the “stretchy” type cramps, and there’s no bleeding, so I’m trying to stay calm
• early pregnancy exhaustion and dizzy spells have arrived… I could sleep standing up, or in a meeting. That’s not a great career move, by the way.
• fretted that I wasn’t feeling any morning sickness. Until 3pm today. Suddenly it’s here… and I’m wondering why I missed it. They say it’s a positive sign… I keep telling myself that
• took my lunch today (veggies, yogurt, whole wheat crunchy things) in a desperate attempt to start off healthy
• started on prenatal vitamins. I remember these, why do they have to smell so revolting?
• noticed my sense of smell has gone overboard when I kept sniffing my vitamins and gagging
• realized I’ll have to buy maternity clothes for the office
• realized I gave away every single baby-related thing I had