Wednesday, April 25, 2007

Graduation day

Yesterday was a big day for me. I reached 11 weeks gestation, and officially "graduated" from my RE. I had mixed feelings about this, as on the one hand, I love my RE, and on the other hand, it's nice to all of a sudden be a "normal" patient. I still don't feel normal, but maybe that'll come one day.

To mark the occasion, I had an ultrasound, which was AMAZING. I saw little arms and legs flailing, a big head, and the spine. Those little legs were kicking so fast, I couldn't believe that I can't feel it from the outside. All of a sudden, the blob has turned into an actual baby! I couln't stop grinning.

The only fly in the ointment was getting the results from some lab work that I had done two weeks ago. Apparently all is well with my urine (good thing, since I pee every 30 seconds these days), and most of my blood results were good. However, they ran my rubella titers to check my immunity, and the results were on the low end of "indeterminate", just one point above "negative". So, I'm potentially at risk for rubella, and it's now too late to get revaccinated. The RE was quick to reassure me that all will be well if only I avoid children. But how on earth am I supposed to do that? If a kid is sitting next to me on the subway, shall I pull out a gas mask? I was screened for immunity to rubella last year by my old RE, and the results were fine, so if I've lost the immunity, it's just happened in the last year. How typical.

Today, I had my first appointment with my new OB/GYN. I've transferred to a big hospital that is only about a 10-minute walk from my apartment, so it's really convenient. They also have a big international clientele, so they have a whole clinic set up for non-Korean speakers. My new doctor was really nice, and spoke perfect English. She did look like she was about 12 years old, but I'm trying to convince myself that's a good thing. If she's just finished her residency, then she should be chock full of information about the latest greatest advances in the field, right? The most amazing thing was that I got to keep all of my clothing on for the whole appointment. I didn't know that was possible! I'll have to get back into the stirrups next week for a pap smear and the nuchal fold translucency screening, but still, it was nice to meet the doctor fully clothed.

Two things came up that made the appointment a little stressful. First, she really encouraged me to have amniocentesis. I'm really struggling with that issue. On the one hand, I really do want to know if there's something wrong. On the other hand, I really don't want to risk my baby's life for some information. I guess I'll decide after the nuchal scan next week. It's hard to know what to do.

The other worrisome issue came up when I asked her about my plans to travel to Indonesia for work in June/July (have I posted about that?) She said that flying is fine in the second trimester, but that I'm at risk for cervical incompetence because I had a LEEP procedure (removal of abnormal cervical cells) about 15 years ago. So, she discourages me from having any real exertion after 16 weeks! I was planning to try to exercise regularly throughout this pregnancy, but I guess that's out. Well, at least now I have a doctor's permission to be a fat lazy slug.

And speaking of fat, I've already gained almost 3 kilos! Aargh!


Thalia said...


First, you don't have to get your kit off for the nuchal, it's an abdominal scan, at least it is here. Second, are they doing blood tests along with the nuchal? because nuchal results alone won't really tell you if you should have future testing or not. See if they can add in a free-beta-hcg, and the afp test, to give you a more accurate view of risks.

It's wonderful when it suddenly looks like a baby, isn't it? So magical. I'm very happy for you.

Lut C. said...

My nuchal fold scan was a transvaginal one, though the doc tried an abdominal one first.

My doctor and a midwife told me the triple test (this is the afp test, I believe) is less significant for women over 32. The reason being that it is a calculation of risk, not a diagnostic test. Once over 32, the influence of age on the risk overshadows the other factors.

To be honest, I'm confused about all this.

I've had the triple test done and am waiting for the results. I'm leaning against doing an amnio, but won't make my final decision until I get the results.

Sarah said...

i think you have a good approach, taking it one test at a time. after the NT they come back to you with odds, right? so once you have that info you'll feel a lot more prepared to make the amnio decision.

i've been trying to decide whether to do the NT. after hearing about the blob-to-baby transitition i'm inclined to do it just for the extra u/s!

hmm, how common is rubella in korea? i would think maybe it was a bum test if you passed just fine so recently?

Marie-Baguette said...

So glad the baby is doing well! Well my advice would be to get the amnio or the CVS. Risks are much lower than previously thought -- it is not 1% but 1 in 1,600.

One of my friends had all her tests pointing to a normal baby but the amnio showed the baby had trisomy 18.

Judi said...

After my NT ultrasound I felt no pressing need to get an Amnio done. I was 37 at delivery. My friend who is my exact same age, after the NT ultrasound she felt compelled to get it, because her risk for a Down's baby was quite high. The Amnio proved the baby was perfectly normal and she could relax the rest of her pregnancy. I think as things progress you'll know what is right for you. I'm so happy to hear of your ultrasound and seeing your baby for the first time, sounds wonderful!

Tinker said...

I have this feeling like you're catching up to me. Every time you post you seem closer to the same gestation I'm at. Weird. It must be that proportionately the gap gets smaller -- a good thing. Did you realize that you're already a quarter of the way through your pregnancy?

I did the same -- using the info from the nuchal scan to make a decision about amnio. The Canadian OB/GYN society is really discouraging amnio without other markers to indicate that it is warranted. I guess this speaks in part to how good the nuchal is.

Hopeful Mother said...

Bummer on the rubella results.

It is AMAZING to see a BABY on the screen, isn't it? Wonderful!

I think you're wise to wait on an amnio decision until after the nuchal - but it is definitely your decision, and each of us probably has different logic for our choices. For me, the real question was - what choice would we make if an amnio/CVS showed a defect? That was our deciding factor to not do an amnio or CVS - at which point, it was nice to see the babies again on ultrasound and get a look at the NT measurement along with looking for "soft markers" for defects, for peace of mind.

But again, everyone is different, and you should make the choice that you are most comfortable with. Good luck!

Sara said...

Thalia-I don't know yet if they'll do bloodwork with the nuchal. The doctor didn't say anything about it, but doctors here are often less than fully informative. I'll ask for the other tests at the appointment next week.

Thanks everybody for your thoughts. It's really helpful to see what factors other people considered when making this difficult decision.