Exhale

Thank you all so much for your good wishes and encouragements and sympathies. (May, get your heart our of your mouth, darling, you're liable to chew it or something.)

The short answer is that everything is fine.

ETA: pics to come; I think Sugar took them back to work in her bag.

The bean was very reluctant to get into the necessary position, so we had a nice long spying session while the sonographer punched, jiggled, and generally assaulted my bladder. (I like her anyway.) Heart was visible even to me, amid the sea of static. It was beating away at 155 bpm, she said. Lots of wiggling and so forth.

Measurements are all good and put risk of Downs and Trisomy 18/13 at comfortably remote levels. HCG was also good. PAPP-A, less so. Dr. Southern said that was still fine vis-a-vis Downs and Trisomy 18/13, but did have a slight correlation with increased risk of Pre-eclampsia, IUGR, and Pre-term Labor. Yuck.

The math part, in case you're into that kind of kink:

My measurement for PAPP-A was 5th percentile -- still well below what they like (30th) for its principal use as a indicator of risk for DS and Tri 18/13, but not an issue in my case because all the other data was so good.

The study that found the correlations listed above found them at and below the 1st percentile. It wasn't, apparently, an amazingly significant correlation for all aspects. Risk of pre-e was about double the general population risk for the patient's demographic group, which is still a pretty low risk. (For instance, Dr. Southern said that if I had been 1st percentile, my risk would have gone from about 2.5% to 5%.) IUGR is associated with pre-e (because of blood-flow problems in the placenta), so it's not surprising that it made the list, too.

I'm not at the 1st percentile, though. I'm at the 5th. Which means the correlations in my case are less convincing.

/math

Dr. Southern said he would recommend keeping a closer than usual eye on me for IUGR and pre-term labor, but he didn't seem too worried. As it happens, that's already in the cards. Both are common complications for those of us with bionic anatomies, that is, Müllerian Anomalies. Dr. Baby Factory thought I wasn't at increased risk for incompetent cervix because, unlike most bionics, I have a uterus of normal size and shape. But then Dr. Robot mentioned, in our discussion (ok, her lecture and my attempts to squeeze in a question without being interrupted) of c-sections, that she wouldn't attempt a version on me in the case of a breech presentation, because even if my ute looks normal, it will be different on a microscopic level from a typical ute, and won't stretch as well. The wheels in my head finally got through processing that tidbit this week, so I called to find out whether that also put me back in the incompetent cervix crowd, and it turns out it does. So it looks like I shan't be lonesome for medical attention after all.

Speaking of Dr. Robot, who has the bedside manner of Henry Ford: Dr. Southern asked if I'd seen her and said she'd called recently to ask his opinion on a patient he was pretty sure was me. (They aren't in the same practice; my OB clinic sends all patients to this practice for NT.) Warms the cockles of me heart, that does. I guess she's not so bad. She needs some lessons on talking to people, but she both knows her stuff and isn't too arrogant to seek help with tricky bits. That's not such a bad kind of doctor, really.

Good Morning

Hello, all.

It's 5 in the morning here. I've been awake for at least an hour.

Nuchal this afternoon. I sat down with a calendar yesterday to make notes: I've been spotting and/or bleeding for exactly one month.

Not nervous at all, why do you ask?

Heavy Lifting

Hey there, internets. How are you?

Things are basically fine around here. We've gotten several chances lately to spy on the bean, who seems to have arms and legs and a steady heartbeat. It even *moved* while we were watching last Monday -- a kind of quick sit-up, prompting my mother to observe that it obviously has genes not from our family.

The reason we've been getting so much screen time is more nerve-wracking. I keep bleeding. First was the two weeks of brown spotting leading up to the wedding. Once I'd gotten used to that, it turned pink, starting just before the sit-up look-see. A few days of pink, and I was feeling pretty proud of myself for learning not to panic at every trip to the bathroom, so my body upped the ante: bright red blood, and plenty of it, in the middle of the night.

PANIC.

After the long wait until the OB office opened the next morning -- I didn't see much point in waking up whoever was on call, since there isn't much they could do about it if I was miscarrying and at least one of us ought to get some sleep -- another scan. Less cute time looking at the bean, more v.e.r.y. slow examination of the ute, after which Sweet Sonographer said she didn't think there was any blood flow from in there, so it is probably my sensitive-soul cervices. (Why no one has cranked open a speculum or two and taken a look, I don't know.)

More brown spotting, plus a new, sandpapered sensation in my upper hoo-ha regions; a period of self-imposed, er, pelvic rest. Things seemed to be settling down. And then I cut the cheese.

Sugar and I belong to a hippie food coop (*the* hippie food coop, really) of the sort where all members work. (Well, almost all members -- as the underemployed member of the household, I do both of our shifts.) When we toured the place and entered the food prep area, our guide said, "this is where we cut the cheese. If you join the coop your job might be cutting the cheese." Naturally, I signed up at once.

It's not all fun and games. Besides cutting the cheese, I wrap it, weigh and label it, and carry it upstairs in grocery baskets. Because of summer school and the wedding, I am behind several shifts, which jeopardizes our access to Waldorf-educated kohlrabi, so I made one up yesterday. I was careful not to fill the baskets the way I normally would, but instead to go up when I had ten pounds or so ready. I had them ready at waist-height, and carried them held against my body, for minimal strain, as my back has been unreasonably testy these past few weeks.

After my 3-hour shift, I found a huge streak of red in my underpants. Slightly more controlled panic. Hovered in the public but uncrowded hallway, left a message with the nurse, did some speedy, highly disorganized shopping (extra shallots? Yes. Trash bags? No.), took a cab home. Nice Nurse called back and said that since the bleeding stopped quickly, I should just rest and stop lifting "heavy" things.

Relief, of course. Followed by a nap. Followed by some feelings of pathetic worthlessness.

I like being pregnant. I like how it feels, for the most part. But while I am hardly a tower of physical might, I am used to thinking of myself as strong enough to manage things. I don't like not carrying things, not being able to open the stubborn window. For that matter, I don't like being so easily exhausted that I had to stop gardening after an hour the other day, when I had planned at least two.

I can live with being lazy, but I hate being weak.

Bah.

News

The appointment went well. Jury's a little out on this doctor -- if she'd started the appointment in the mode that she finished it, she would have only seemed a little robotic, but the first part...yuck -- but to be fair, she did send us off for a reassurance scan without argument. And I am madly in love with the sonographer.

I told myself I would do this if we got through today okay:

While You Were BlogHer-ing...

...we went and got married again.

It was a perfect day, preceded by weeks of utter exhaustion and chaos. We have new respect for wedding planners: this was the most low-key party ever to be thrown outside of a parental backyard, and it nearly killed us. But it did not. The food was good (and the caterer's partner, a dentist, fixed our bridesmaid's broken tooth that morning), we didn't run out of wine (even if the champagne was served not at all when we'd intended), and, after an Indian friend bustled me off to a corner to pin me in more appropriately, the sari ended up being the perfect choice for glamorously concealing my lost waist.

Today is our real first OB appointment (not to be confused with the "holy shit, I'm panicking" appointment two weeks ago). Exciting, but terrifying. I'm convinced, now that we've told a few close friends and the parents and the aunts and uncles who were in town for the wedding, that the universe will take it all back. Hubris is a particular fear of mine, you understand.

It's also that the two weeks since the panic appointment are by far the longest I've gone without seeing a doctor in months. It is very difficult to believe that my body could know what to do without constant intervention, and knowing how little useful intervention exists at this stage of the game does not help.

(What also doesn't help is the light brown spotting I've had most days in between these appointments. It has never become any of the things the nurse told me to call back about -- heavy, red, very crampy -- but it is hard to be sanguine about it.)

(My God, what a terrible pun. Apologies.)

Updates of All Sorts

Hi, y'all.

I always wondered why so many bloggers suddenly stop posting as much after successfully getting knocked up. I figured mostly it was an abrupt slowing of narrative -- particularly compared to the flurry of data that was IVF, early pregnancy is pretty low-key, leaving less that needs urgent discussion. What never occurred to me was what I think now must be the real reason, at least for some people besides me: crazy exhaustion.

I can't complain much about my symptoms thus far -- I do spend at least part of every day trying desperately to avoid vomiting, but it's nothing like as bad as some have it; my waist vanished surprisingly early, despite my having lost several pounds in the past few weeks (not just OHSS weight, either), but I'm not sure my waist was ever one of my better features; my boobs hurt a lot, but I also love how they look -- but heavens, I am tired. If I get any more low-energy, I may actually become a houseplant. And at the moment, I am a houseplant trying to teach summer school and plan a wedding.

Which is to say, sorry for posting less. Things will likely pick up in two weeks, after I stop waking up at night to fret about the number of tables in the church hall we've rented or why my mother has decided we need a bubble machine.

Yesterday, however, was not a slow day. Yesterday, I learned that how you get results from the OB practice that has been saying they'd call you back for the better part of a week and won't let you even try to make an appointment (and at least this one takes both your insurance and new patients) is to have a hysterical, weeping tantrum about how upsetting it is that you can't get signed up with them, the RE has dismissed you from the clinic (so your insurance is done with them), and now you're spotting and have no where to go.

Suddenly, I had an appointment an hour later. I may not love the manner of the receptionist, but I must admit she did right by me.

The wee bean is fine, by the way. The sonographer was so sweet. She played the heartbeat for me when I couldn't find it on the screen and asked after it in a terrified voice. She printed out a very fuzzy picture without my asking. We had talked about IVF, and when I half-apologized for freaking out about what really was a very tiny amount of bleeding, she said, "You've been through a lot."

I met with an OB who isn't the one Dr. Baby Factory recommended, but I like her well enough, I think. The practice rotates all OB patients through all doctors, so I don't suppose it matters much who the main one is. She took my history and did a standard gyn exam, since it's been a year since my last pap. Paps, really, since I get to have two -- lucky me! She felt my uterus and said, "You feel pregnant!" That was surprisingly lovely to hear.

The less lovely part was when she said that my double-door womb situation may make a vaginal birth impossible. On one level, that's not surprising: obviously, I don't need a baby trying to come out of both cervices at once. Hearing it out loud was a bit of a gut-punch, though.

...and I have too much to say about *that* subject to possibly wrap this up in time to make it to school. So we'll have to pick that thread up later. The doctor did say "may" not "will," and we agreed to discuss it another time.

heartbeat

Hi everybody. Sorry it's been so long. We have been experiencing serious wedding related stress. But anyway . . . .

We had an exciting Monday! We went for the first ultrasound and saw a tiny pulsating 2 pixels on the screen (apparently a beating heart) and even heard the teeny tiny thing!

Here is our embryo, which, since it looks like a very small blob inside a slightly larger blob, looks like every other embryo, but hey, it's ours: