When your Pregnancy isn't Boring
When I was about 8 months pregnant with Lyla, I (along with a few colleagues) attended a nutrition consortium forum, hosted at our local public library. The focus of the forum was epigenetics-- something I am very familiar with now but, at that time in my career, was a relatively new and popular topic of discussion. Our seats were assigned for us, and my very pregnant belly and I were seated at a table with the main speaker and the head of obstetrics at OHSU (for non-local folks, that's the really large research hospital in Portland). Anyhow, given the circumstances, he and I did a whole lot of talking at the table that day. And I will never forget his parting words to me at the end of the meeting. He shook my hand and said, "I wish you a very boring remainder of your pregnancy."
I had never given it much thought before, but he was right. My pregnancy with Lyla to that point, and beyond, all the way through her delivery, was very typical and very boring. In the best possible way.
Naturally, I assumed my second pregnancy would follow suit.
I was wrong.
I went through the first half of my pregnancy in boring, uncomplicated bliss (after recovering from the shock of the surprise pregnancy, of course). And then came my ultrasounds at 20 weeks. Ultrasounds, plural, because in addition to the baby's anatomy scan, they were also going to take a look at my enlarged thyroid. I saw one of the midwives for my usual 20-week appointment the morning of the ultrasounds and she let me know that if anything unusual came up on the scans that they would call me a couple of days later; otherwise, no news was good news and we would chat at my 24 week appointment.
Two days later, we had just loaded up the car to head south to my parents' house for a long weekend, when I checked my phone and saw that I had a voicemail from the OB's office. And I knew. I knew the call meant something was wrong. So I called right back and, of course, had to wait an agonizing 30 minutes to get a call back. The waiting is the worst, am I right?? It gives you all this time to stew and worry and FREAK OUT. Which I really tried not to do. I just kept praying silently to myself over and over and over, "let it be me. Let it be me. Let it be me." It's terrifying to love our kids (even the ones we haven't met yet) SO much, isn't it??
Anyway, I finally got the call back from one of the midwives, who was so kind and gracious and explained everything really well and answered all of my questions. The bottom line was this: both the ultrasounds showed potential issues--for me and for baby. The baby's ultrasound showed a large nuchal fold (potentially; measurements were inconsistent), which can be a soft marker for Down's Syndrome (the other markers being nose and heart--both of which looked great, healthy, and just as they should). To delve into that further, we had the choice of getting a better ultrasound at a hospital in Springfield or doing a genetic blood test. If either of those tests showed more evidence of Down's Syndrome, we would be referred to specialists up at Doernbecher (at OHSU) to prepare us for what was to come. On another note, baby was also measuring big, so she said they would like to do another ultrasound at 32 weeks and, depending on that, maybe another one at 36 weeks. Lastly, my thyroid ultrasound did not show signs of cancer (she made sure to get that out of the way right out of the gate, bless her), but it did show possible signs of inflammation, so they wanted me to see an endocrinologist to investigate thyroid-related autoimmune issues.
So. Nothing too scary or daunting or earth shattering, but unsettling nonetheless. And it meant more appointments. More ultrasounds. More blood work. Did I mention that I have also been seeing a chiropractor and a physical therapist regularly to try to get my pelvis stabilized, in good alignment, and manage my debilitating pelvic pain?? It has all just been WAY more than my last pregnancy, when I don't think I scheduled a single extra appointment, ultrasound, or required an additional blood test. Ever.
We had planned to not find out the gender this time around (and we did not find out at the initial 20 week anatomy scan), but when we learned how many more ultrasounds and tests we were in for, we dropped that idea like a hot potato. Which is a good thing, because when we went down to our ultrasound the following week in Springfield, we got a realllyyy clear between the legs shot the moment she put the monitor on my belly. Hello, baby boy! Sadly, that ultrasound did not clear up any of the confusion from the initial ultrasound (apparently they stop measuring the nuchal fold at 20 weeks and I was already 21+ weeks) and they could still see some possible thickness around the neckline. Again, the nose and the heart, ventricles, blood flow, etc. all looked really good. With that being the case, I had blood work done immediately following. It was supposed to take two weeks to come back, but I just got the call today from the genetic counselor and everything looks great (huge praise!). We were also asked to come back in three weeks for an echo-cardiogram--the reason being that if baby boy has a chromosomal abnormality, the health and function of his heart could change over time, so they would like to keep monitoring it. While the genetic test looks good, they still want to check for any heart defects--so we are keeping that appointment on the books. Lastly, they also, like my usual OBs/midwives in Corvallis, wanted to see me for a 32-week ultrasound.
In the meantime, I met with the endocrinologist (who, like everyone else was just so great and understanding and clear in her explanations). She spelled out exactly what they thought might be going on and what they would be looking for on blood tests, but that the waters were muddied a bit by my pregnancy. My TSH and T4 Free numbers have been totally normal (I had blood work done at 8 and 16 weeks), so I was asked to get more labs done to test for thyroid antibodies. If the test results came back showing hyperthyroidism (and possibly Graves disease) then I was going to require another fetal ultrasound at 26-27 weeks.
All of that to say, here is what we know (and don't know):
I had never given it much thought before, but he was right. My pregnancy with Lyla to that point, and beyond, all the way through her delivery, was very typical and very boring. In the best possible way.
Naturally, I assumed my second pregnancy would follow suit.
I was wrong.
I went through the first half of my pregnancy in boring, uncomplicated bliss (after recovering from the shock of the surprise pregnancy, of course). And then came my ultrasounds at 20 weeks. Ultrasounds, plural, because in addition to the baby's anatomy scan, they were also going to take a look at my enlarged thyroid. I saw one of the midwives for my usual 20-week appointment the morning of the ultrasounds and she let me know that if anything unusual came up on the scans that they would call me a couple of days later; otherwise, no news was good news and we would chat at my 24 week appointment.
Two days later, we had just loaded up the car to head south to my parents' house for a long weekend, when I checked my phone and saw that I had a voicemail from the OB's office. And I knew. I knew the call meant something was wrong. So I called right back and, of course, had to wait an agonizing 30 minutes to get a call back. The waiting is the worst, am I right?? It gives you all this time to stew and worry and FREAK OUT. Which I really tried not to do. I just kept praying silently to myself over and over and over, "let it be me. Let it be me. Let it be me." It's terrifying to love our kids (even the ones we haven't met yet) SO much, isn't it??
Anyway, I finally got the call back from one of the midwives, who was so kind and gracious and explained everything really well and answered all of my questions. The bottom line was this: both the ultrasounds showed potential issues--for me and for baby. The baby's ultrasound showed a large nuchal fold (potentially; measurements were inconsistent), which can be a soft marker for Down's Syndrome (the other markers being nose and heart--both of which looked great, healthy, and just as they should). To delve into that further, we had the choice of getting a better ultrasound at a hospital in Springfield or doing a genetic blood test. If either of those tests showed more evidence of Down's Syndrome, we would be referred to specialists up at Doernbecher (at OHSU) to prepare us for what was to come. On another note, baby was also measuring big, so she said they would like to do another ultrasound at 32 weeks and, depending on that, maybe another one at 36 weeks. Lastly, my thyroid ultrasound did not show signs of cancer (she made sure to get that out of the way right out of the gate, bless her), but it did show possible signs of inflammation, so they wanted me to see an endocrinologist to investigate thyroid-related autoimmune issues.
So. Nothing too scary or daunting or earth shattering, but unsettling nonetheless. And it meant more appointments. More ultrasounds. More blood work. Did I mention that I have also been seeing a chiropractor and a physical therapist regularly to try to get my pelvis stabilized, in good alignment, and manage my debilitating pelvic pain?? It has all just been WAY more than my last pregnancy, when I don't think I scheduled a single extra appointment, ultrasound, or required an additional blood test. Ever.
We had planned to not find out the gender this time around (and we did not find out at the initial 20 week anatomy scan), but when we learned how many more ultrasounds and tests we were in for, we dropped that idea like a hot potato. Which is a good thing, because when we went down to our ultrasound the following week in Springfield, we got a realllyyy clear between the legs shot the moment she put the monitor on my belly. Hello, baby boy! Sadly, that ultrasound did not clear up any of the confusion from the initial ultrasound (apparently they stop measuring the nuchal fold at 20 weeks and I was already 21+ weeks) and they could still see some possible thickness around the neckline. Again, the nose and the heart, ventricles, blood flow, etc. all looked really good. With that being the case, I had blood work done immediately following. It was supposed to take two weeks to come back, but I just got the call today from the genetic counselor and everything looks great (huge praise!). We were also asked to come back in three weeks for an echo-cardiogram--the reason being that if baby boy has a chromosomal abnormality, the health and function of his heart could change over time, so they would like to keep monitoring it. While the genetic test looks good, they still want to check for any heart defects--so we are keeping that appointment on the books. Lastly, they also, like my usual OBs/midwives in Corvallis, wanted to see me for a 32-week ultrasound.
In the meantime, I met with the endocrinologist (who, like everyone else was just so great and understanding and clear in her explanations). She spelled out exactly what they thought might be going on and what they would be looking for on blood tests, but that the waters were muddied a bit by my pregnancy. My TSH and T4 Free numbers have been totally normal (I had blood work done at 8 and 16 weeks), so I was asked to get more labs done to test for thyroid antibodies. If the test results came back showing hyperthyroidism (and possibly Graves disease) then I was going to require another fetal ultrasound at 26-27 weeks.
All of that to say, here is what we know (and don't know):
- Aside from the uncertain nuchal fold issue on that first scan, baby boy looks strong and healthy
- We just got our genetic test results back and they look great!
- We have an echocardiogram scheduled for mid-September
- Baby boy is big (I don't know if they are going to re-evaluate my due date, but he's definitely measuring a week or more ahead of schedule)
- We will have another ultrasound at 32 weeks (not sure if we'll do that locally or in Springfield) to check on both his size and any other possible issues
- My thyroid blood work did show that I am producing antibodies, but not the types related to Graves, so we do not need another ultrasound at 26ish weeks (yay!). I have a follow-up endocrinology appointment (with more blood work) scheduled for around 35 weeks of my pregnancy to check everything again. And I will very likely require a visit postpartum, too, as that might be when issues actually arise.
I know many of you have been concerned after our somewhat cryptic post last week, so I hope that fills in some of the gaps for you. (I apologize for the length; it was hard to avoid). People keep asking how we are doing, and the truth is, we have really been ok. Thank the Lord for my sweet, calm husband who did not seem ruffled in the least when I recounted my conversation with the midwife. I am also deeply thankful for fabulous health insurance and healthcare providers who have been so responsive to our needs and our questions. We got the initial call Thursday afternoon, spent that evening going over our options, called the midwife back on Friday, and I was able to get into the endocrinologist the following Monday and got in for a follow-up ultrasound on Tuesday. One lab was supposed to take a week to come back and we got it back in three days; the genetic test was supposed to take 10 business days, but came back in four. We have gotten personal phone calls and quick responses. No one we worked with seemed panic or overly concerned, just precautionary, which set my mind at ease. With the news of the genetic blood test coming back today, we are deeply relieved.
All of that being said, had the call today given us challenging news, we still would have been ok. There would have been a lot of questions and uncertainty and fear, for sure. Life would look a whole lot different than we expected, and admittedly, that would probably be a hard thing for me to process. But this is OUR baby. And he will be welcomed with great joy and fiercely loved, no matter the circumstances.
On the plus side of all of these extra ultrasounds, we did get some pretty great shots of our sweet boy, Fisher Michael Bennett.
Also, we are having a BOY, you guys! We (Lyla included) are SO excited!
Oh Casey, CONGRATULATIONS on baby boy Fisher! What a delightful name! I have been praying for you since your mom let me know a little bit about what was happening with you and Fisher. God is so faithful! I look forward to meeting him someday and hearing the final chapter of this story. Blessings and hope to you sweetie!
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