Magpie's 20w6d anatomy scan

We had a second anatomy scan this morning, just shy of the 21 week mark. First off, baby is still alive! Phew.

This time, we saw the corpus callosum, good amniotic fluid level, well functioning four-chambered heart, femurs, arm bones, hand bones, feet, vertebrae, cute nose and lips, intact palate, properly positioned cord insertion, and a three vessel cord.

They also checked down below and Magpie is definitely still Ms. Magpie, not a mister.

Cervix remains long and closed, measuring over 4mm (phew!)

The only potential issue they saw is that the placenta is somewhat close to my cervix. (1.9 cm and they said it should be over 2.0 for safety). So they want me back again in a month to check on this. I am not super worried about it at this time. It is close to 2.0cm, and the fallout if I have marginal placental previa is that I will have a cesarean. I would strongly prefer a vaginal birth, but mostly what I want is a healthy, live baby. However we get her here is secondary.

So I have to go back in four weeks to check the placenta again.

It was a long, long appointment, because the little miss wouldn't get in the right position to finish checking the heart and pulmonary artery. She finally did (after me drinking juice, coughing, doing jumping jacks, rolling around on the table, and lots of poking... but it took her over an hour!). Apparently, this is one stubborn little girl.

The coolest part is that my mom is here this week visiting from across the country. She hasn't seen me pregnant until now, so this in itself is super wonderful, and she came with Will and me to the anatomy scan and saw the baby up close and personal, which was very special. I took her out to Sarabeth's for breakfast afterward. All in all a great start to a Friday.

Here she is...one day shy of 21 weeks...I still can't believe it.

Mo

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The 20 week milestone

Reaching 20 weeks is a big pregnancy milestone. I am thrilled we are here. That the little one is still alive.

I had been doing ok with my fear levels until about a week or so ago...and then as we approached the 20 week mark, all hell broke loose internally. I became terrified that the baby would die before we reached 20 weeks. In my nerve-wracked mind (and in medical terminology), her death before 20 weeks would be miscarriage #7. Should she make it past 20 weeks, and then die, she would be stillborn. She would be counted differently, as my child, as having been here. Of course this is all semantics. Nothing magical happened between last Friday and Saturday. Same little one. Same emotional impact of her death, if that had occurred. But I felt so afraid that she might just get lumped in with all the other losses, and be, well, "lost" amidst my history of recurrent miscarriage.

Perhaps needless to say, but while I was in this terrified state of mind, imagining this little one making it full-term, and being born alive, and joining our family...well that was a tall, somewhat impossible, order.

In this strange, dark way, 20 weeks became this critical milestone to get to.

I saw the OB last week and immediately she could tell I was much more anxious than I have been. She wanted to know why, and I tried to explain. I ended up crying on the exam table about wanting this baby's life "to count." I could tell that I shocked her. I haven't been so emotional this whole pregnancy. I haven't let myself get emotionally invested.

But as usual, she was great. Reassuring, normalizing. Saying I've been holding myself back this whole time, and now it's hitting me. I am pregnant. There is a real baby inside of me. A baby I could lose, just like all the others, and have my heart shattered. She listened, she reassured me. She checked everything checkable. Cervix is long and closed. Blood pressure good. Urine fine. Weight gain fine. She had me list my fears again and we went over them one by one:

preterm labor
preeclampsia
PPROM
cervical incompetence

She said preterm labor doesn't happen this early unless I'm dilating. And I'm not. I look fine so far for preeclampsia. PPROM also almost impossible unless I start dilating. And cervical incompetence (which could lead to many of my other fears) we are checking for weekly and see no evidence of.

I have another anatomy scan this Friday. We will check on everything checkable. Again. I will get a cervical measurement done. My mom will be here visiting and will come with Will and me. I think it will thrill her beyond imagining to see the scan. This is her first time to see me this pregnancy. Her first time to see me visably pregnant ever. Another milestone.

I've been checking on little Magpie almost daily with the doppler. She's in there cooking. She's the size of a cantaloupe. She's doing fine as far as we know.

Her mama is a bundle of nerves but is hanging in there too. I just need Ms. Magpie to stay in there for another 8 weeks minimum.

Stay in there. Stay alive. Stay in there. Stay alive.

I repeat this to her in an urgent whisper several times a day.

So far, she seems to be listening.

Mo


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90% good, 10% fear

Sorry for the lack of updates recently. I've been traveling a lot for talks and otherwise swamped with work on top of being fairly exhausted. Sleep is getting tough. I hope it is not a harbinger of what the remainder of this pregnancy will be like. I am uncomfortable. My legs are restless and achy. My back has started to hurt sometimes at night. Which all translates to me getting through my busy days and travel as best I can and then trying to take it easy when I can.

Today marks 18 weeks, 5 days. Wowza. I can't believe we are still pregnant. That time is still passing. I show my stomach to Will almost every night, with the question/comment - "Can you believe this?!" He just smiles at me and says it's amazing.

It is feeling more real. I am able to hold the idea that we might actually have a baby on one hand, and simultaneously hold the possibility that we could lose her at any time. I was worried I wouldn't be able to imagine a good outcome at all, so being able to hold both outcomes seems like a step in the right direction.

Ninety percent of the time, I'd say I'm able to hold the good and imagine we will have a living child. We talk like this, that this child will have a name, and have a room, a future in our family, etc. Which is good, but also strange-feeling.

And then 10% of the time, I'm afraid. Sometimes deeply afraid. I've had lots of uterine sensations this week. I usually feel something once or twice a week, but this week it's been pretty much every day at some point. Sometimes just an odd feeling, sometimes a uterine tightening. Sometimes a stabbing vaginal pain, although that's been momentary. It's been hard not to get scared that something is wrong. That my cervix is giving way, that something is wrong with the baby. So I went in this week to get checked. Baby looked much the same as last week, slumped over with the weight of her ginormous, heavy head. The OB checked my cervix also, and she said it was fine. So that was reassuring, although I am still a little nervous.

This is the way things are right now. Trying to take an acceptance stance. Not judge myself. Just get reassurance when I need it. Take things one day at a time. Let myself a little more and a little more, imagine a positive outcome.

As far as we know, all continues to go well. Edging closer and closer every day. Hoping for the best.

Mo

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17 week anatomy scan results and picture

Sorry for the delayed post. I know I made at least a few of you nervous. I was totally wiped out yesterday and had to also prepare a talk for today. This morning, I spoke to 400 military service members for three hours. Yowza. Ex-haus-ting. It went well, but I am glad to have the talk behind me.

So...on to the anatomy scan. Yesterday, at 16 weeks, 6 days, I had my first anatomy scan. I thought I would need to drink a bunch of water, but turns out, that was not needed. Will and I were nervous. Me especially. I worried that the baby had died (I hadn't used the doppler in the past several days to reduce the baby's exposure time, since I knew this scan would be long, but of course that left me extra antsy). I was also nervous specifically about heart defects. They seem relatively common, so just at baseline I was worried about it, and then I came across information in the past week that high vitamin E intake in pregnancy is associated with congenital heart defects. I haven't been trying to supplement with vitamin E, but I've been taking high doses of fish oil (10 capsules a day per one of my doctor's instructions)...and it turned out when I checked the bottle that it contained vitamin E also...so inadvertently, I was supplementing this. Once I did the math, I started to seriously panic. I was way above the dosages associated with heart defects in this study. I've been trying without much success to calm myself since then.

So needless to say, a nervous-at-baseline Mo was especially nervous about this anatomy scan. 

Luckily, everything looks good so far. The center I went to has you meet with a high risk OB right when you do the scan, so we were able to get our results and have all of our questions answered. He said that all looked good. There were a few things we couldn't see yet, re: the heart (can't yet rule out a ventricular septal defect), at least one thing we couldn't see yet re: the brain (the corpus collosum), and the OB also said that later on the kidneys could turn out to be polycystic. But we saw what we should see at this stage. A four-chambered heart, a closed abdominal wall, a cute button nose, lips! (with no cleft), two kidneys with good blood flow, the stomach, all the bones where they should be. The OB said we could see 90-95% of what we need to see and that I should come back at 20 weeks, when they will be able to see the rest. 

They also checked my cervix, and although they didn't give me the measurement, it looked nice and closed, even to nervous me. 

The baby, they said, weighs about 6 ounces now (my little petite filet!).

And, they said that they are 99% sure that it is a girl.

Wow. A baby girl! That is just amazing. This whole experience continues to be so completely mindblowing. We haven't been hoping too strongly one way or the other - we just want a healthy, living baby. But a girl is extra special. In Will's family, there are 9 sons between all of his siblings. There are 0 daughters. In my family, 2 stepsons among my siblings, 0 daughters. So this little girl is going to get doted on, I do think.

So without further ado, here she is!

Mo

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I'm in trimester WHAT?

Today marks 13 weeks, 2 days.

I can't believe we've gotten this far after so many false starts over the past five years. It is so strange to have pregnancy things magically seem to be working. Knock wood, not taking anything for granted, one moment at a time. Hard not to wonder what is different now? So many fresh IVFs, and transfers, and three natural pregnancies on top of three IVF pregnancies. But all that didn't work. And now? Now it seems like this baby is practically growing itself (knock wood, not taking anything for granted, one moment at a time).

Will's mom says that the difference this time is that when Will's father passed away this summer, he began overseeing our trying to conceive journey and has helped this last transfer actually (finally) be the one to work.

Sounds as likely as anything.

Whatever it is, it feels so miraculous. So hard to fathom.

I'm thrilled right now, even if I am a bit confused about where I am trimester-wise in pregnancy land. I think I'm maybe in the second trimester? According to some sources, apparently. Other references make it sound like I need to get to the end of 14 weeks first.

How do you count the trimesters? Is one method more popular and accepted than the others? I'd be most curious.

But count the days and weeks however you want. We are decidedly, amazingly (knock me over with a feather) pregnant. Pregnant enough that I have purchased one pair of maternity pants and some drapey shirts (hoping to hide this another month or so from the prying masses at work). Not so pregnant as to really be showing, but pregnant enough to feel like I'm looking rather fat. Pregnant enough to be off all hormone support now for over a week (and yes, we snuck in an extra blood draw at the end of last week and estrogen and progesterone looked just fine...rising some even off of the meds).

It is absolutely crazy to behold,

but I am pregnant.

At least for today.

And I still can't believe it.

Mo

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Telling (parts 2 and 3)

On Easter Sunday, we told Will's sister that we are pregnant (a little over 11 weeks pregnant). She was hosting the whole family, but we went over briefly several hours early to be able to break the news before her preparations were in full gear. She was very happy for us - and gave Will a huge hug, which was nice. When Will went outside to play with our dog Moxie and her sons, she said she knew I must be very nervous, but that I would start to feel better as time passed, in particular once we got to 23 weeks. I nodded, but inside, I was thinking - 23 weeks! I won't feel better at 23 weeks! It would be very dangerous - maybe fatal - if the baby came then!! I'll feel better maybe around 28 weeks, when if the baby comes it stands a high chance of being ok!! But this didn't seem constructive, or even really her point. So I kept it to myself. She also started comparing me to other women who in her mind have struggled. I'm not sure why she did this. We weren't even talking about the pain or difficulty of anything. This was a happy news moment. And then unfortunately her examples of women who struggled didn't go over so well with me. One example was one of Will's cousins. Poor woman has four kids but hasn't been able to conceive another despite her desire to do so. I do feel bad for her...some...but it's not really the same thing. Her other example was someone else who conceived her first child accidentally, but now had had a miscarriage and had already spent six months trying to conceive her second. I felt myself wanting to say something. Wanting to say how these women aren't like me at all - how it's different when you have spent five years doing many IVFs, have six miscarriages under your belt, and zero children, and are at the stage you are thinking you aren't ever going to have any. But what would have been the point of that? She was trying to...trying to...well, I'm not sure, really. But saying something wouldn't have helped. I know she only meant good things.

We also told my mom on Easter morning. I had sent her a framed picture of one of my ultrasounds. I knew from package tracking that it had arrived on Saturday AM. I'd wrapped the frame and put a note on it that said to call me before opening... but no call came... so come Easter morning, I called her. We chatted for a bit and then I asked her about the package. Package? She didn't know what I was talking about. Hmmm...she said, maybe she should check the front porch. And lo and behold, it was there. She opened it, and then started making strange noises. She wasn't able to speak really. Finally she said my name, and Oh! several times. She said this was such a surprise. She said she'd been hoping for us and wondering, but didn't want to pressure us by asking anything. She started to ask me if we'd gone to Denver for this...and then halfway through stopped herself, saying aloud, "It doesn't matter how you did this. This is just wonderful!" Good answer, Mom! She was just over the moon. It was wonderful to get to hear her excitement and enthusiasm. She is still that excited now...many days later. It makes me happy to hear her elation about this.

Mo

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Nuchal translucency screen results

Today was the nuchal scan. I was really nervous going in to it. Afraid the baby wouldn't be alive or that it would somehow look terribly deformed.

Before the scan started, we had the usual awkward and painful interchange where the tech was filling out paperwork and asked how many times we've been pregnant. When we said 7, I saw her do a little double-take. She asked how many births - 0. She asked if they'd all been miscarriages - yes. Awful. Awkward. And then we moved on.

We saw right away that the baby was alive, heart beating away. Baby was doing flips in there. At first they couldn't get a good neck measurement, so the tech looked at a bunch of other things instead. We saw the two hemispheres of the brain and she said the skull is intact. We saw the arms and hands. The legs and feet. That the abdominal wall was completely closed. Nasal bone was present and noted. Placenta was posterior, with baby lying transverse, its head on my left hand side. 

All good things.

All amazing things to see.

The tech lowered the head of the table I was lying on to see if she could get the baby to change position. No dice. She had me cough a little to try to move him/her. Finally, we got the baby in a good position. 

Nuchal fold was measured at 1 mm. So under 3mm, which I think is the cutoff that indicates a potential problem at this time marker. Here's an image of the nuchal fold, with a normal nuchal fold versus an abnormally thick one that might indicate a chromosomal problem:

photo credit: fetalecho.com

And below is an image of our little munchkin. Despite all the movement, its hand is STILL up by its face. My goodness this baby likes to keep its hands by its face!!

This is the best picture we could get. Looking more and more baby-like every day!

We had the screen at 1pm...and I've been on tenderhooks since then waiting for the doctor to call with the official results. He just finally called.

Our baseline risk of trisomy 21, considering my age + the fact that we have had a prior trisomy 21 pregnancy, is 1 in 74 (gulp).

Using the nuchal fold measurement + the bloodwork, our risk has dropped to 1 in 990 (!).

Our baseline risk of trisomy 13 and 18 is 1 in 227. 

Using the nuchal fold measurement + the bloodwork, our risk has dropped to 1 in 4,521 (!).

I also asked about triploidy, since that is the one thing we weren't able to test for ahead of time. He said that by this gestational age, a triploid pregnancy would look abnormal and have a smaller amount of amniotic fluid than expected. He said it would also likely screen positive on the nuchal screen. He said he had never seen a pregnancy look this good and turn out to be triploid.

I think it is sinking in.

We are pregnant.

We are really pregnant!

And things are looking good so far!!

Mo

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Weaning...ever so slowly

I am continuing to gradually wean off of my medications.

I got my blood drawn again yesterday and my hormone levels are continuing to rise.

I've dropped to two estrogen patches for the past week or so and my estrogen levels are up -1,116 as of yesterday.

Progesterone has been dropped to 1/2 cc daily for the past several days, with no suppositories, and is a stable 35.44.

photo credit:  Goodbye City Life

I've now been asked to drop to one estrogen patch and to do the 1/2 cc PIO every other day (gulp).

I'll get the levels tested again on Thursday or Friday.

I asked at my local clinic when people tend to go off of their meds and they said at 8 weeks (!), so I guess Denver is taking their sweet time with me.

That's just fine. I want to be sure my body can handle these hormone things all on its own. This pregnancy was way too hard-fought to be careless with in any way.

I'm curious though, when did you wean off your medications if you had a successful FET?

Mo

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Telling (part 1)

On Tuesday, I told my boss that I am pregnant.

I didn't really want to tell her so early, at 10.5 weeks. It feels weird...and dangerous (this is my 7th pregnancy after all....and I have no children). But we are in the process at work of hiring a post-doc, and my boss was vaguely considering trying to hire two, but leaning towards only one. She really should hire two, in general, I think. And especially if I am going to be out for a few months next fall/winter.

I also am strongly suspecting I will not go to California for my two talks. I needed to let her know that as well. The Rochester talk must go on - there is a contract, and there is no one else to give it.

I had previously told one person on my team, who is in a senior position to me, and who knows my boss very well, that I am pregnant. She is a good friend and knows that we have had a long road with many losses. She has been advising me to tell my boss for some time. Has said that my boss will be very supportive and protective. That my boss is smart enough to know that I have been married five years, am on the older side, probably want a family, and obviously don't have kids. That she probably knows we've had some troubles, and that she would be a big advocate, but only if I tell her. I was scared, though. One, I think it is weird, and too personal, to tell too early unless someone is a good friend. Two, I wasn't sure she would be super supportive. She's a tough woman, and a single mom, and I honestly thought she might go either way. She's not the most sympathetic in general. She's internationally known, a big player in a male-dominated academic medicine clinical research area, and has the savvy and the thick body armor to prove it. Also, although we work on a larger team of clinician-researchers, the three of us (my boss, my friend, and me) make up the core of the team. I didn't think my boss would be very excited about me maybe not being at my best and then taking a bunch of time off.

So, yeah.

But because of the hiring and presentation issues, I felt I had to take the risk and speak up.

So I met her in her office alone after another meeting, told her a few other things of importance, and then slid this in at the end. Saying I knew it was early, but for planning purposes, and because I trusted and respected her, I thought she had to know. That anything could happen and I very well may not have a baby, but that just in case, I needed to tell her.

And damn if she wasn't just wonderful.

Her response was so genuine that I almost teared up (the pregnancy hormones make this easier, but still...). She was thrilled for me, for my husband Will. She said she wanted to do anything possible to make things easier on me. When I told her I might not want to go to the California conference, she said no problem. I told her I started to miscarry in 2010 at another work-related conference and that I associated the travel with miscarriage, even though it was likely not causal. She said that I shouldn't go to California. That I "don't have to do exposure therapy during my pregnancy" by traveling to a conference if that makes me nervous. That she would try to travel in my place (!) and that if not, we'd have someone else give my talks. That if I didn't want to fly to Rochester, I could drive or take the train and take more time off. That if I still felt that was too stressful, I could just cancel it, contract be damned.

She did ask me pointedly if I would be returning to work after I have the baby ("after I have the baby" - ha! ha! egads!). I looked her in the eye and said yes.

She asked if I was 100% sure.

I said I've never done this before, so I can't be 100% sure (she started looking upset at this), but that I spent many years training to enter this field (8, including my post-doctoral fellowship), and that I loved my work. That seemed to mollify her a bit.

She said I'm entitled to three months off, and that she assumed I would take all of it. Then she said that given how long we have struggled for this baby, I might want to take additional time off, another month or two, and that she would strongly support that. This shocked me, and moved me. I told her that was wonderful, but that right now I really can't imagine that I'm even going to have a baby, so I can't really envision the time off aspect yet. That much further along, should I be so lucky to get that far, I would look into that, if that was ok. She seemed to understand. But WOW. That she would suggest I could take extra time off...that's pretty amazing.

She also asked when I planned to tell our larger team. I said I hadn't really thought too much about it yet, but I thought it wouldn't be for a long while. Maybe 20 weeks? 25 weeks? She said she would keep things to herself no problem and she understood that emotionally that would feel a lot safer for me to wait a long time, but she cautioned me I might not be able to wait that long. She said people started asking her when she was about 12 weeks pregnant (the audacity!) and she ended up telling sooner than she planned because of that. So hmmm....may need to get clothes that are roomier to try to buy myself more time...some of my regular clothes are a bit snug already.

It was really scary to take the risk and tell my boss. I hope I didn't tempt fate by telling.

Symptomwise, things are a bit strange. I  was feeling a little better, but then I actually threw up on Tuesday night and was feeling very nauseated last night as well. Fatigue had seemed to be lifting too but then yesterday I felt like I was hit by a truck. And headaches! I'm not a headache person, but blinding headaches almost every day for at least part of the day. That was a bit of a surprise. Not sure what's causing it. So, symptoms are still coming and going. All of which is fine. More than fine. Bring them on! I am just so, so grateful to be this far along. I still really can't believe this is happening, one day at a time, pregnant as far as I know. I had really given up on the idea that this could happen for me.

Mo


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