Thursday, September 14, 2006

It's Still Not Real

I can't explain it but I think Meg said it best, really. It's so very hard to relax and enjoy this pregnancy when I know that so many of my friends are still suffering. Additionally, I realize every moment that it can be my last moment... That this can end at any time. That's never far from my mind.

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Having said all that, I'll move on to the NT scan and OB appointment. It was actually last week, not yesterday but even though it went well, I didn't feel so great about it afterward so I haven't posted. The truth is that I feel very disconnected right now. Disconnected from both the pregnancy and from other pregnant friends -- online and IRL friends. Ok let me just get it out. After all, confession is good for the soul, right?

First I went for the NT scan. I was 11w1d and it was a milestone. My first transabdominal ultrasound! The tech asked how I was doing and I told her that I was a little nervous because I'd had some brown spotting that morning. Thank goodness she didn't tell me that brown spotting was fine. I'd have killed her. My miscarriage last year made itself known with some brown spotting and that was the same ultrasound office that did the verification after the Dr. couldn't find the heartbeat anymore. But like I said, she didn't say anything and just started the ultrasound. The first thing I noticed was that the baby wasn't moving. I was literally laying there holding my breath. She showed me the heartbeat and said it was fine. I felt better after that and just watched her do the measurements while I tried to remember them all. The CRL (crown to rump length) was 52mm which translates to 11.9 weeks so it's consistently a week ahead. The heartrate was 161. The NT measurement was 1.3mm and I'm told that anything under 3mm is great. She showed me the blood pumping thru the umbilical cord and the regions of the brain with the color doppler. It was really cool. So that was all good. She gave me a couple of pictures and offered the rest room to me before I left. Just as I was about to pee I remembered that I have to give a urine sample at each OB visit so I zipped up and just headed for the lab for my blood draw. As soon as that was over, I went up to the Dr's office.

Here's the background that you need to have before the doctor's appointment: The Thursday prior to the appointment, I called for the 8w bloodwork results. The Dr. called me back with them later that afternoon. Mind you, I haven't met her yet but she was highly recommended by many people. She called and said that by and large the bloodwork was great. No STDs, thyroid is fine, blood sugar was great, etc. The only issue was my hemotcrit which was 29 (normal range for an adult female is 37-45). She advised that I begin taking iron. Now, without going into any sordid details, I have a blood disorder called Beta Thalassemia Minor that masks itself as anemia with the little exception that any extra iron in my blood causes overload, a very dangerous and often fatal condition. Since I was a kid, I've been told not to take any extra iron and if I am, NEVER more than 9mg a day. She was recommending 60mg of elemental iron daily. Several times during the phone conversation I expressed my concern about taking iron based on hematocrit levels alone. The truth is that hematocrit levels and iron levels aren't necessarily correlated. Most often in the general population they are, which is why it's done so often but for Thals, it's not a correlation at all necessarily. So when all was said and done, I bought the iron pills but decided not to take them until after I had a chance to talk to her at the appointment on Tuesday. I wanted to 1. get her to draw blood for a serum ferritin test that would tell the actual levels of iron in the blood and 2. get a referral to a hematologist that's familiar with Thal for additional analysis and recommendations.

The appointment was less exciting and more stressful than the ultrasound. I gave the urine sample, got weighed, had my blood pressure taken and waited for the doctor. The good news is that I didn't have to mention the Thal. or Iron at all. She'd quite obviously done a good deal of homework between the time we spoke on the phone and the appointment. She immediately offered to order the serum ferritin test and let me know that if it indicated an iron deficiency, she'd recommend the lowest dose of iron and would continue to check hematocrit, and ferritin levels at each visit. She also said that she'd be doing an ultrasound at every visit to monitor fetal growth as Thals have a slightly elevated risk for IUGR (inter uterine growth retardation) babies than the general population.

Here's the stressful/less exciting part: *sigh* naturally she brought up my weight. First she told me she didn't want me to gain any more than 15 pounds. Which is fine except she never told me how to actually do that. She told me to eat right and C. confirmed that I already am. She told me she wants me to walk at least 30 minutes every day. I asked her if that's in addition to the gym. She looked at me in a surprised way and asked "what do you do at the gym?" Fighting the urge to give her the answer she was looking for, I told her the truth -- that I take a circuit training class 3 days a week and the other days I usually jump on the elliptical trainer for 30 minutes of cardio. She said to keep doing that and she wants me to do that every day until at least 30 weeks. She never did answer my question.

So I never heard back about the iron levels and have spent every day worrying that I'm gaining weight even though I'm eating the exact same or less than I was eating before. Not to mention that fertility drugs really make you pack on the pounds and I've been on them for almost 4 years straight. I'm not sure what kind of miracle she's expecting. I'm trying hard to keep in mind that I don't have to love this woman -- just have to be confident that she's got my best interest at heart and is working toward a healthy baby for me. That's not an issue. The only issue I have is the way she handled it. How difficult would it have been for her to find out about my exercise, nutrition and lifestyle before she started pounding on the weight thing. Also, she clearly came into the conversation with some preconceived notions. I guess that's the crux. But I'm trying to let it go. It's pretty challenging though. The gym used to be fun. These days it's a huge chore. *sigh* Hopefully it'll start being fun again really soon.

I go back October 11. November 8 is the Level II fetal survey ultrasound. We should be able to find out the gender at that one.

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Wednesday I'm starting an ASL (American Sign Language) class at a local community college. My major at college was Deaf Studies, but I've forgotten just about everything. Especially the grammar and syntax of the language. I do remember some of the signs, but couldn't use them in a sentence if you put a gun at my head. It's an 8 week class.

On the heals of that, C. and I are taking a "Sign with baby" class. That starts in early November. I love the idea that babies can sign long before their verbal skills catch up. Bonus points because the class uses ASL signs and not made-up baby signs.

2 Comments:

At 12:27 PM, Anonymous Anonymous said...

Okay sweetie...here's my 2 cents for what it's worth. PLEASE don't fret about your weight. Like in the real world, they try to judge your health based on your weight. She looks at you and a number on the scale and assumes something. You are healthy dispite what the scale says. Don't starve yourself or worry about a weight gain just because she is telling you shouldn't gain more than 15 pounds. You cannot predict how much weight you will gain. Everyone is different. I know sticks who gained 75 pounds even though they exercised. Me - I figured since my weight yo's yo's and I'm generally about 10 pounds overweight - that I'd blow up. Nope, only 25 pounds and 10 of that showed up during month 6! So...I would continue to eat right, walk and keep stress low. Even the best of conditions could have you gaining more. In some cases, it's beyond your control (except if you eat massive quantities of Ben & Jerry's. That could probably catch up with you).

 
At 4:16 PM, Anonymous Anonymous said...

I'm glad that all went well with your scan and it sounds like everything is going good. I always forget your pregnant until I read your blog. You little sneaky girl!
As for your DR., I think like anonyomous said, you are being way healthy and that's what is important. I think only gaining 15 pounds during a pregnancy would just be a little too hard.

 

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