The Unbearable Lightness of Babying

I know. Not my best work.

Anyway - we left off at the 9 week ultrasound, where there was still a heartbeat! Hurrah! For those of you who have never had an ultrasound in the first trimester, what you see is a peanut floating silently, still, with a rapidly vibrating bit located somewhere on it, and that is the heart. We'd had LOTS of ultrasounds by 9 weeks, so I was used to seeing the slowly growing peanut with its one moving part.

And time passed, and I did my best not to worry too much about what was going on in my midsection, and I took my freaking Prometrium and felt miserable and sick, (although around 11 weeks I started to feel better for no reason that I could think of. I mean, I was still taking the pill every night at bedtime. It was weird. But very, very welcome). Basically, I spent three weeks incubating.

Then came the 12th week, when I was due to appear at the local hospital's Prenatal Care Center, (a high-risk OB practice), for my Nuchal Fold Translucency screening, and the first of two blood tests, 4 weeks apart, that would test for Down Syndrome, Trisonomy 18, and Open Spina Bifida.

No pressure.

For the sake of providing full disclosure, when you are pregnant there are LOTS of tests you can have done. They fall into two categories: Screenings, and Diagnostics. Screenings are not 100% accurate. They give you a risk assessment percentage or ratio that provides you with a *fair* idea if your baby is at risk for certain issues. Diagnostic tests are usually more invasive, (ie they sample the amniotic fluid in your uterus by using an ENORMOUS needle), but also more accurate. And they are completely your choice. You do not HAVE to have any of them done. I know a few people that chose not to have the first trimester screenings done - they said it wouldn't change their plans in terms of carrying the pregnancy full term, and they thought it would just make them more nervous.

I think you guys have probably figured out by now that I am an anxious little bird, but there was no way I WASN'T having the test done. Even though it would take a month to get the results from the second blood test, which would bring the accuracy of the Nuchal Fold Screening and first blood test up from somewhere in the 60%s to the mid 90%s, I considered 1 month of anxiety to be highly preferable to 6 months of having no idea what was going on down there. But I also didn't want to do the amniocentesis and risk miscarriage, so we opted for a screening. If the screening came back positive for anything, then we'd discuss risking an amnio.

The first trimester Integrated Screen includes an ultrasound that measures the fluid at the back of the baby's neck, and two blood tests, done 1 month apart, that measures god knows what but presumably the doctors have an idea what they're looking at. We arrived at the prenatal center on time for our appointment, despite getting a little lost, and then we proceeded to sit in the waiting room for an uncomfortably long time. Finally, a nurse called us back to the examination room. I hauled up my shirt and pushed down the waistband of my pants and she tucked a GIANT paper napkin into the waistband of my pants to protect my pants from goo, and then she began the ultrasound. At first the screen was black, then it went to a static-ky gray, and then suddenly the baby's image emerged from the static.

Sandy and I both stared. This was a MUCH more high tech ultrasound machine than the one at Dr. G's office, and this was NO peanut. This was a miniature human being. A BIG miniature human being. A big miniature human being that immediately raised both arms and waved them wildly above his or her head, and then grabbed at his or her ears. We'd never seen the baby more before. It was a revelation.

I blurted out, "holy shit, is it waving its arms?"

Then I said, "excuse my language."

Then I burst into tears. Completely hysterical tears.

I'm told that's a perfectly normal response. The crying, not the swearing and apologizing for it. Whatever. Sandy was looking pretty sniffly too, so don't go blaming the hormones. It's insane to go from this...to this, in three months. Insane.

Anyway, the nice tech let me calm down before starting to point things out. Hands, legs, behind, (the baby totally has Sandy's tush, which will be profoundly unfortunate if it turns out it's a girl), the nose, the eyes, the mouth, the skull, which was super creepy looking...you get the picture. So far, the baby has all the important bits. She showed us the umbilical cord, and changed the screen somehow so we could see blood moving through it, (which was wild). I asked if the baby was moving around so much because she was prodding my uterus with the paddle thingy on my stomach, and she said no, not really, they move around a lot regardless of what anyone does. Then she poked me with a finger in the stomach, and I could SEE my uterus indent where she was poking me. That was completely insane. The baby didn't really react. "See?" she said.

She had to nudge the baby a few times to get it to roll over so she could take the pictures she needed of the back of its neck, from the side. She took some measurements. Then she let us watch the baby for a little bit, took the paddle off, printed out some measurements for herself, printed out some pictures for us, and left the room, saying as she went, "I'm going to go put these measurements into the computer - it'll collate the results and the doctor will be in to let you know in a bit." She paused in the doorway and added, in a way that let us know she was reluctant to say anything but wanted us to be prepared, "it might be a little while - the patient he's with now is getting bad news, and he's going to need to stay and talk with her, and make sure she's okay." We nodded, and she left, closing the door behind herself.

For 15 minutes I lay prone on that table with my tummy covered in horrible goo and my shirt tucked up, uncertain of whether or not the doctor was going to be doing any more ultrasounding on me. When they finished an ultrasound, my previous nurses or doctor had always handed me the giant paper napkin to wipe my stomach clean at the end of the session. She hadn't. So maybe I was supposed to keep it on? But I didn't want to keep lying there like a very greasy log...

I wondered aloud what I was supposed to be doing. Sandy was of the opinion that I shouldn't wipe it off. He said he was pretty sure the nurse had indicated that the doctor was going to have a second look at the baby. I thought she had just said the doc was going to discuss the results with us, no ultrasounding required. We argued about it in a friendly way for a while, then finally I said, "I'm not going to keep sitting here like this. If he has to take another look, he can just cover me in goo again." I sat up and wiped myself off, and pulled my shirt back down.

The nurse had left the screen on, stuck on a frozen picture of our baby's face in profile. We stared at it. My left eyeball started to twitch, and I yelled all of a sudden, "it's so weird that it's for you I've been sleeping only on my left side and eating hideous fiber twig cardboard cereal every morning...YOU BETTER APPRECIATE EVERYTHING I'VE DONE FOR YOU!"

Sandy coughed behind me, and said, very politely, "Sweetheart. Are you sure you want to start yelling at our child already?"

Time passed. More time passed. We cracked jokes until we started laughing and then I hissed at Sandy to stop making me laugh because I didn't know how close the other room was where the patient was getting bad news. We reduced our laughter to choked giggling. Around the 25 minute mark Sandy suggested that we were part of some kind of psychological experiment that tested how long two people would sit in an examination room with a closed door, waiting for a doctor to show up.

We waited some more.

Finally, the door opened and the doctor rushed in. He immediately began apologizing for the wait, saying he hated to make people wait but the previous patient...we indicated that we understood. I said, "the nurse said she was getting bad news, and that it might take a bit. It's okay - she needed you more than we did."

He said, "yes! Back to back! Back to back! And every time I have to make like, three phone calls - one to her doctor, one to her pharmacy, one to...but you don't have the same doctor she does. You use Dr. G, right?"

My mind was suddenly a very small, very quick hamster wheel, repeating the words "back to back" over and over again and thinking, "WHAT THE HELL DOES HE MEAN, BACK TO BACK??? IS HE TALKING ABOUT ME???" Before I could say anything apart from "yes" to the Dr. G question, the phone rang, and a woman's voice said into the room, "Dr. N - you have a phone call on line three. Dr. N - a phone call on line three." He looked apologetically at us and said, "I'm sorry - that's her doctor. I'll be right back." He left the room.

I burst into tears again. All I could think was, "why did he say I use a different doctor than she does? Is he going to have to call MY doctor? Oh god. Oh god. Oh god...back to back. Oh god."

Sandy patted my back, with panic naked on his face, and told me to "stroke the furry wall" - a line from the movie "Get Him to the Greek;" one of the characters was having a really bad reaction to recreational drug use, and the other character was making him pet a furry wall in the nightclub to calm him down. He handed me my little fur neck warmer. I sobbed, and petted it, for all the world looking like Lennie from "Of Mice and Men."

I sobbed, and hiccuped, and choked, and then suddenly I noticed that the doctor had left my chart on the counter by the door. I immediately stopped crying, and started to look crafty. Sandy saw it on my face and said, "don't you dare touch that char..." but I was already bouncing off the table and trotting across the intervening distance to snag it. I stood there by the door, furtively flipping pages. I found a page that listed probabilities, and started reading. High school math, don't fail me now!

I read: Probability Down Syndrome: 1 in 500

I thought, "Oh shit." I know the cut off for Down is 1 in 270, but still - that's an awfully low number for that test. Then I read immediately below it: Adjusted Probability Down Syndrome: 1 in 2,500

I looked at the bottom of the page - where it said something about the first #s having to do with the probabilities based SOLELY on my age, and the adjusted #s being the probability based on the combination of my age and the measurements from the test. 1 in 2,500 was totally acceptable to me. I calmed down.

I read the other probabilities, for the trisonomies - they were even better. I calmed down. I replaced the chart on the counter. I went and sat back down on the table. I smiled seraphically at Sandy. The doctor returned, apologized again, and then proceeded to tell us everything that I had just read. He said the numbers looked great. He also said that the test was only 65% accurate, or thereabouts, until he had the results of the second blood test, but thus far, I was considered "Screen Negative" for everything.

This was a significant relief to me. One of the weirder aspects of pregnancy is how vivid and memorable your dreams are. For a month prior to the 12 week mark I'd been having dreams of giving birth at home, to twins. One a boy, who came out a toddler and started marching around the place a la "Lasher" by Anne Rice, and the other a girl, who came out like a normal baby apart from having Down, a hare lip, and NO THUMBS.

Dreams like that are totally normal when your eggo is preggo, (just like dreaming that you've lost your shoes, makeup, hair stylist, dress etc are normal before your wedding), but still. Horror! So to see "Screen Negative" was a good thing for the sake of my sanity.

The doctor escorted us to a different exam room, where a nurse stole my blood for the first blood screening. The doctor asked me if I was able to wait for the results of that blood test until the second blood test had been done, and I said "sure" because even though I desperately wanted to know, I was still pushing myself to get over my fear. I told myself it was just a month. I could do it. I just had to get through Christmas, and wait until the first week in January to get the second blood test done, and then we'd be up to 95% accuracy. I could do it.

And I did.