Wednesday, May 6, 2009

A "Fascinating" Study.

"Tater Tot - May 5, 2009"

A quick lesson in science.

Science and math were never my strong areas. English and writing floated my boat way more, which makes sense since I love to talk. Scratch that. I don’t love just to talk, I love to run my mouth. I don’t really need a willing partner. I talk to myself all the time. It’s getting worse as I get older, I find myself not only talking to myself, but complain and bitching about other people, to myself. Out loud. I am not sure how many times my poor husband has walked into the room to find me muttering, “Did he take the trash out? No, of course not, that would be way too easy, and way too much to ask, now wouldn’t it?” Smart guy that he is, he usually just turns around and walks back out. But anyway, I am getting off subject.

The current alarming issue with this “blessing” of a pregnancy is that my blood test for the Alpha Feta protein test came back “elevated”. What is Alpha Feta-Protein you ask? I don’t know. But yesterday I found out that it is in the baby, all babies have it, and they secrete it thru the urine (which is amniotic fluid) and then drink it again. A little icky, but sterile all the same. My problem is that my blood levels are showing a higher then normal amount. To give you an idea, an average level is 1, at 2.5 the doctors become concerned, and mine is 3.38.

There are two reasons that it can be higher then normal. One is that somewhere on the baby there is an opening, or a lesion, that is allowing more of it to “leak” out and enter my blood stream. Typically if a baby has a lesion, it will be on the spine, due to Spina Bifida, or at the base of the skull or brain, which could also be Spina Bifida, or a variety of other defects. Another typical cause of a lesion is if there are additional openings near the umbilical cord, which could mean the intestines are outside of the body, or other issues. But the most common thing the physicians see when there are defects of this sort is Spina Bifida. The effects of this defect can range from mild; incontinence, club feet, possibly being wheel chair bound, to lethal. The higher on the spinal cord the lesion is found, the more severe the defect.

The other issue that could cause my blood levels to be elevated is that the placenta is not doing its job properly, not filtering out the protein before it enters my blood stream. Unfortunately there isn’t any way to test for this. The doctors just “monitor” everything carefully, because while it could be that there isn’t anything wrong, it often causes 3rd trimester issues such as preeclampsia, preterm labor, slow growth and so on. Thrilling!

The point of the ultra sound yesterday was to examine the baby, mainly the spinal cord and brain, to see if there were any signs of lesions or abnormal skull development. We met with the genetic counselor first, which is always required, and always helpful. One of the more enjoyable things for me is that the gal mentioned that my case is “fascinating” because of my switched chromosomes, and since the baby has the same translocation. Apparently even though I am healthy, and the baby appears to have the exact same make up as me, anytime there is a chromosomal “switch” there is some cause for concern, because everything didn’t go as perfectly as they would like to see. Greg thought this was hilarious. I just want to make it thru my day, and he thinks I am going to end up on the Discovery Channel, as Case Study A.

As we walked into our appointment for the counseling and ultrasound, I mentioned to the Counselor that this would be my 11th ultrasound, and today I am 18 weeks along. That fact alone made me realize that it wasn’t all in my head; this has been a stressful few months. As I thought about it more, I realized that I had walked into every single one of those appointments prepared to see that the baby’s heart was no longer beating. Every time I see that little flutter in the middle, I have been breathing a sigh of relief, and mentally prepare myself to be disappointed next time. I hope that that feeling goes away soon, but I am not sure that it will.

Once again, I was relieved to see the heart beat, little miss tater tot was swimming around quite a bit, and so far is a busy little girl. Maybe mommy should lighten up on the caffeine a little bit? I was excited to see more of the baby at this ultrasound, in the past she has been pretty small and alien like, but unfortunately I think we missed that window. She is now big enough that you only get to see portions of her at once, a leg bone, a face profile, etc. The whole exam took about half an hour. The tech was not able to see everything she needed, the tater tot started to relax and curled up. The tech asked me to lie on my left side for a moment, while she went to see if the doctor was available. Apparently she went to lunch, because about 40 minutes later the doctor came in. Good news and bad news, depending on your perspective. From everything he could see, baby looks fine. But they can’t really see everything. They try to look as early as possible, but sometimes it’s too early. So I go back in 4 weeks for another ultrasound. It’s frustrating to have a conversation with a doctor about it, because it seems like they talk in circles. They will say things like “it looks good for now, but you can never be 100% sure, so let’s check again in a little bit.” It seems like they are so concerned about being sued or liable for something that they will never commit to anything. So they will continue to “monitor”. He made a joking comment that “with your chromosomal issues and current issues, I am confident that we will be seeing you at least once a month.” This is from the doctor at maternal-fetal medicine. Delightful! I cannot imagine anything better then being a fascinating case for you guys, and writing a check for your time. The other side of this being the twice weekly monitoring my ob-gyn mentioned, in addition to your regular check ups. Are you shitting me? I am all for erring on the side of caution, but if I am comprehending this correctly, you are telling me that for my entire 3rd trimester I am going to be at Legacy’s maternal-fetal medicine dept monthly, at my ob-gyn monthly for my regular checkups, and also at the ob-gyn twice a week for monitoring? Oh the strides modern medicine has made, and how grateful I am for it. Just kidding. I am grateful, and maybe after the ultrasound (#12) we will have in 4 weeks, if everything looks fine, I will be able to relax. I would love to be able to feel the baby move. I don’t look pregnant, my boobs are just humungous (thank you Chris G for pointing that out, you try toting these babies around) and I just look fatter. But by then I will be 22 weeks along, and hopefully the tater tot will be letting me know she is there, and not to count her out just yet.

As I think about it more and more, and trust me, I think about it a lot, I haven’t slept in days, it really is quite ironic, and it makes sense. Of course this tater tot is going to kick my ass with this pregnancy. And of course she isn’t going to let me breathe easy for quite some time, if ever. She is going to be demanding, exhausting, somewhat high maintenance, and of course worth dealing with all the above. Just like her mama, right?