Rotating Doctors, Rotating Perspectives

The maternity clinic I attend actually houses four different clinics in one building. The one I am in has nine physicians, and you see whomever is working when you come in for your appointment. Three of the clinics share on-call (delivery) duties, so any one of about 14 physicians could be the one who delivers your baby. Meaning, there is a chance you will have never met the person who delivers your baby. This is okay with me…I feel like it won’t really matter who is there that day because they’re all equally qualified and that experience is pretty much going to suck anyways (until it’s over, of course).

What is interesting about this set-up is that you meet a variety of physicians in your prenatal visits. In three visits I’ve seen three different doctors, plus a couple of residents as well. I have to admit, I am a bit of a creature of habit, so I’m surprised this doesn’t unsettle/annoy me more than it does. So far the first one was my favourite, so I’m going to kindly request that the universe sends her to the hospital on the Big Day.

Anyways, they have all been fine/good, but they have also all been quite different in personality and style of care. Some are more laid-back, some are more directive, some more communicative or information-heavy, some more blunt etc., etc. For that reason, I’m actually kind of glad that I’m exposed to different perspectives instead of being stuck with one personality, and having to take just one doctor’s word as gospel truth. If I had been thinking about this more at the outset, I would have made an effort to ask each doctor the exact same question on some random topic so I could have compared their responses. I don’t necessarily think I would have gotten different answers per se, but I know the question would have been addressed in significantly different ways, if that makes sense.

On Monday, I had the pleasure of waiting for 40 minutes (alone in the exam room, of course) for the doctor-on-duty to see me (for 10 minutes, of course). With no entertainment, I was practically forced to eavesdrop  overhear the doctor’s visit with the patient in the room beside me. The 40-year-old woman was in for her first appointment, and they set her due date for July 2 (seriously, this is how clearly I could hear every single word spoken behind full walls and two closed doors – the need for whisper-mode was duly noted for the next time I have a sensitive/embarrassing topic to discuss in there).

Anyways, this doctor was really hammering home the point of eating lots of protein, lots of veggies, limiting starches, increasing your calcium/dairy “but without increasing your fat intake!!!” and that “sugar is enemy number one in pregnancy!!”. She then asked the patient what she does for exercise (“uhhhh…..yoga?” was the tentative reply) and told her she had to work up to 150 minutes of “dedicated exercise” per week and that yoga was “okay for stretching” but you also need cardio and strength training, yada yada yada. Then she went on to talk very matter-of-factly about the heightened miscarriage and genetic risks of pregnancy at 40. Her tone the whole time was very friendly and even-toned, but the messaging was unmistakably all-business.

Sure, it was all perfectly good advice and accurate information, but I couldn’t help but feel a little bad for the patient. A patient I don’t know a thing about, mind you, for all I know she is diabetic or has weight or other issues that necessitated this hard-line stance on prenatal fitness…but if I had been dealt that kind of doctor at my first prenatal appointment I would have been overwhelmed and feeling pretty bad about myself. At 11 or so weeks pregnant, it’s quite likely you’re still feeling like a bag of shit and having a hard time keeping any food down or dragging your ass home at the end of the work day, let alone whipping up a salad and blasting out a few sets of squats when you get home.

The upshot was that by the time the doctor made it to my room, I had 40 minutes of warning on how opinionated and direct she was apt to be. Small wonder baby’s heart rate was a record 158? Luckily, I was spared the scary warnings and exercise lecture. In reviewing the results of my last ultrasound though, she asked if I had found out the sex of the baby. When I said that we had, and it was a girl, she told me, “I don’t recommend that. They are occasionally wrong and it has been shown that it’s very hard on you psychologically when that happens.”

Well okay then. I mean, valid food for thought and all, but too late for that now, no? Why voice that opinion (and it is just an opinion) after the fact? I gave her a confused cocker-spaniel head-tilt and glanced at the resident in the room who was also giving her the side-eye and glancing back at me.

After being shocked a week or so before by a friend who told me gender ultrasounds are wrong about 30% of the time (!!!) I had already scoured for statistics and found that they are generally considered at least 90-95% accurate – with the experience of the technician and timing of the ultrasound (i.e. not too early in your pregnancy) being the major factors, and that in many cases (right view, right tech, right timing) they can tell with near 100% accuracy. As far as my own experience went, I asked how confident technicians are in their predictions and mine said, “we don’t make guesses: I either know or I don’t know.” I believed her.

So while I am sure that finding out she is actually a boy after expecting a girl would be quite the shock, this physician seemed to be making a strong recommendation for my “psychological health” based on something that maybe – at worst – happens once or twice out of 20 times.

As I laughed the comment off with a, “well, I guess it’s too late for me now!” she went on to urge me not to imagine scenarios or “create a persona” for a girl, and to try really hard to keep thinking of it as an “it” — exact words! Okay lady, now you’re just talking crazy. Good fucking luck with that one.

Isn’t it at least possible that there could be psychological benefits to finding out early? Benefits that could apply 90-95% of the time? Bonding maybe? I’m no expert, but it feels like encouraging me to objectify and distance myself from the baby isn’t the most psychologically sound recommendation either.

Whatever. I left the clinic that day, took my shetus directly to the mall and bought her the most adorable pair of size 1 baby Chuck T’s. She’s a good girl, she deserves it 😉

The first name ain’t baby. It’s Perry. MISS Perry if you’re nasty.

It’s a girl!

I have no explanation for the fact that I’ve had Janet Jackson’s “Nasty” stuck on a loop in my head for 3 days, but so it has been. Perhaps little baby girl fetus (or the “shetus” – credit to Nicole G.) was trying to tell me that boys drool and girls rule, as the ancient wisdom holds.

The ultrasound was a ton of fun this time around. Baby is much more interesting at this stage (19 weeks), to be sure, but our ultrasound technician made a big difference as well. This one was really friendly and excited about stuff, which made me excited too. She was pointing out body parts and explaining things and providing colour commentary that just made it way more fun and interesting.

The shetus was moving around like crazy – kicking, punching, opening and closing her hands, giving two thumbs-up, pointing with her index finger and somersaulting around. When she took a break to “rest”, she would raise one arm straight up in the air (which is also a really bizarre thing I often do in my sleep, incidentally).

It was cool to make the connection between the physical sensations (which could have been gas bubbles for all I know) and her movements on-screen. Today, the movements have been much more noticeable and I’m not sure if she’s just getting stronger by the day or if it’s that I now know what I’m feeling for that’s made such a big difference overnight. Maybe both. It feels less like flutters/vibrations and more like I’ve swallowed a live (and rather large) goldfish that is vigorously flipping around in a rather small bowl. She seems to like food and is really active after I eat something, and the cats on my belly make her go crazy too. I can’t wait until the kitties can feel her kick/punch them back!

It turns out that I have an anterior (front) positioned placenta, which sort of acts as a buffer between me and the shetus. This can cushion her movements somewhat and explain why the sensations had been so subtle. The way she was going at it in there, I think this could be a good thing for me.

We do have our favourite name picked out (I think?!) but I have been forbidden from discussing it with anyone. Andrew is pretty much the meanest.

With that said, I now present the first baby butt photo. She was mid somersault here – and as a former gymnast, I’d like to see a little more toe-point happening, but we can work on that.

BabyButt.jpg

Other random stats I can remember…heart rate was 144. Foot is 3cm long. She weighs 0.7 lb.

Twelfth Week Terror

Between 11 and 13ish weeks you can do the First Trimester Combined Screening – a combination of blood work and a detailed ultrasound that shows the chances of your baby having a birth defect. Besides the obvious checking for a heartbeat, organs and counting of the appropriate number of arms and legs, it also gives you a view of your risks for Trisomy 21 (Down Syndrome) Trisomy 13 (awful), and Trisomy 18 (fucking horrifying) – and I say this with the utmost compassion and respect for those families that have gracefully dealt with these issues. They are better people than I.

While they can’t tell you conclusively whether your baby has such a problem, they give you a good indication and can help you decide if further testing (like CVS or Amnio) may be called for.

That is, if you want to know. This testing is optional—a fact I may have forgotten to mention to Andrew. Not intentionally – honestly – I just made the assumption that he would feel the same way about testing  (knowledge is power) that I do. He does, but I probably shouldn’t have assumed. He realized in speaking to some guys at work that not everybody opts for this testing and was surprised. Whoops. Personally, I can’t imagine why you’d want to remain in the dark – but, I get that some people feel like they wouldn’t do anything differently anyways and would rather not find out something that is beyond their control. I guess. No, I still don’t get it…I’m trying.

If there were a manageable problem with Perry, I’d be spending the next 6 months researching the shit out of it, getting supports in place, lining up experts and programs and therapies…and probably going to therapy myself to get my head right.

Anyhow, it’s fairly accurate. For example, first-trimester screening correctly finds Down syndrome in 82 to 87 out of 100 fetuses (feti?) who have it. Of course, this also means that it is missed in 13 to 18 out of 100 fetuses (seriously, shouldn’t it be feti??). If you combine your first trimester test results with additional screening from the second trimester, the accuracy jumps to 95%.

It was scary for me because I am (shamefully) afraid of coping with Down Syndrome, and had it been positive for Trisomy 13 or 18, I would have given serious thought to terminating the pregnancy. Not fun thoughts. Age was also a factor in my fear.  Basically, the way this testing works is, you have a background risk based on your age alone and then your test results give you a new, “adjusted” risk. Because I am 35, my background risk of Down Syndrome was already 1 in 255. I don’t know about you, but this wasn’t a comforting stat…tennis underdog Roberta Vinci was given 1 in 300 odds of knocking #1-ranked Serena Williams out of the US Open. That shit happened, yo. To Serena fucking Williams.

Luckily, my adjusted risk for DS is 1 in 5105 and I basically kicked Trisomy 13 & 18 in their wussy little asses on Monday. Everything else looked good as well, and besides being hard to rouse (in spite of vigorous pushing, poking, prodding, rolling and bouncing) Perry is alive and well. As Andrew said, he* sleeps like his mother. Here’s hoping he* carries on with that!

*No, I/we don’t think it’s a boy. I/we don’t think anything…I don’t know how you would guess on your first pregnancy with nothing to compare to?!

P.S – You guys! I just found out that my talented friend Christina can photoshop my ultrasound pic so that Perry is giving the finger (the ultrasound tech may have kinda deserved it) or devil horns…just like I had hoped for! God, I love working with art directors!

Worst flight ever

We went to a wedding in Florida, leaving when I was 6 weeks + 3 days and coming home at 7 weeks + 2 days. I hadn’t been experiencing any majorly annoying symptoms, other than hating most food, so I managed to enjoy the pool and beach time as much as possible without my beloved Miller Lites. I did have a glass of wine at the wedding though and it was undoubtedly one of the best things I’ve ever tasted. Anyways, all was well until the day we were leaving. The pain started in the morning and ultimately lasted until around 11 pm. In the morning it wasn’t too bad and I just keep moving around to try to get relief. It was in my lower left abdomen (thank god I googled “gallbladder rupture” before we left and learned it was on the other side so I couldn’t panic about that). And it was intense. I thought maybe it was just gas pain because in early pregnancy your digestive system slows to a crawl and you can’t take a decent shit to save your life. But it was so localized and so intense that I wondered if something else was going on.

You are always looking out for one-sided pain in particular because of the risk of ectopic pregnancy, where the baby is growing somewhere other than the uterus – usually in a Fallopian tube. This not only means you’ll lose the baby, but it’s also life threatening for the mom, as when it eventually ruptures you bleed internally.

The trek home consisted of an hour and a half drive to the airport in Tampa, and a connection through Houston to Calgary. It all sucked, but the flight from Houston was really where I began to consider geography and wonder if I would have to make them make an emergency landing in Denver. I actually thought something was exploding near my left ovary. I was also throwing up on this leg of the trip, when I wasn’t curled up in a fetal position. My husband was worried and frozen, especially when I started crying. I’m an emotional cryer but not a physical pain one, preferring to curse my way through pain like a motherfucking sailor on shore leave. I didn’t cry when I broke bones, severely burned my hand or stabbed a knife through my palm trying to pit an avocado. Although of all these, I especially advise against breaking a rib. Sacrifice an arm if you must.

The pain was shy of excruciating, but by hour 7 or so I still just couldn’t take it anymore. I had resigned myself to going straight to the hospital when we got home, but then we landed and it started to ebb away. Exhausted, and knowing I had a doctors appointment already conveniently scheduled first thing the next morning, I went straight to bed and passed out.

After confirming that I was in fact pregnant (thanks doc) she made a call and got me in for a rush ultrasound, also fearing the possibility of an ectopic. Although the fact that my pain had disappeared was a good sign. Perry was snug in the uterus, flickering away (flickering is the magic word you want to hear at this point, since that is the heartbeat of the shapeless blob). So in a way, I was actually kind of lucky to have the chance to see Perry at just 7 weeks. All 12mm of him, which was bang on for dating the pregnancy at 7 weeks + 3 days.

Heartbeat was 143 bpm, “yup, that’s about what mine is right now too,” said Andrew.

What the pain was, we’ll never know. Could have been a rupturing cyst of some type, a gastrointestinal issue (your colon is in that quadrant of your abdomen) or just horrible gas. Google tells me that some women liken bad episodes of gas pains to labour pains, so I guess they can be pretty intense. Here’s hoping labour only has me in tears after 7 hours.