Friday, March 13, 2015

First MFM Appointment

Two days ago at 12w1d we saw the doctor of Maternal Fetal Medicine (MFM)/aka high-risk OB/perinatologist for the first time. The first segment was with the genetic counselor. She was warm, thorough, and knowledgeable. She asked us several questions about our family like how many siblings we have, are they genetically ok, do they have children, how are they, same for parents and their siblings etc. Also our health and pregnancy history. 

On my father's side (Jewish) there is a cousin with Prader-Willi Syndrome which can occur through deletion of chromosome 15. Therefore the counselor mentioned we may want to test for micro deletions of chromosomes. 

On C's father's side (French-Canadian) there is an incidence of cerebral palsy. The counselor did not feel this merited further testing.

Based on Jewish ancestry and French-Canadian ancestry she said we are at a higher risk of Tay-Sachs disease.

Other than that, the standard testing at this point would be for extra chromosomes on chromosomes 21 (indicator of Downs Syndrome) and 13 and 18 (indicator of "non-compatibility" with life.) Also a test for a Y chromosome, which would indicate gender - though for twins less conclusive of course. A test for spina bifida would be done four weeks later at week 16.

She did not recommend or dissuade us from anything, merely presented facts. At first I was on board. Then I started to get saddened and overwhelmed. We did not commit to anything until after the ultrasound to allow time to digest this information. Ultimately, we elected the afore-mentioned tests and also got a thyroid and thyroid antibody test per the doctor's recommendations.

The ultrasound followed this segment. It was a high-tech room, very large and comfortable with a large monitor from the ceiling so we could easily view everything. She explained everything as she moved the wand. She was starting at the ovaries. I could not even look at the screen nor could I wait. "Are they alive?" I interrupted. I probably seemed a bit crazy, but I am still traumatized by my loss and expect to find out bad news at every ultrasound. 

They were ok! They were moving! One was sucking its thumb, the other with arms up and legs crossed sunbathing style. They really look more and more like people. No Downs Syndrome markers - NT fluid was great and nasal bone present.

They are still measuring identically in size. Slightly ahead at 12w4d. Heartbeats have started to diverge, though. One was 163, the other 153. So, I could see indications of gender sameness or difference from this information. I can find out soon, though! Less than three weeks!

The doctor then came in. He went over the risks of twin pregnancy like pre-eclampsia, preterm labor, gestational diabetes. Of course I am focused on an incompetent cervix as a potential issue and he said it is at 3.8 cm and they like it above 3 cm so right now things are good. He said the very best thing I can do is to drink a shitload of water. Enough to have to pee every 30-60 minutes. That will keep the uterus from contracting. 

He said he disagreed with my OB, at this time he did not see a need to restrict exercise or sex at 16 weeks. But, things with twins can change so who knows in the future. Plus, obviously I may not want to! 

So, from there I went to my OB (thankfully next door) and met my OB's partner. It was a brief appointment. He reviewed the notes from the MFM and 
talked to me about twin pregnancy safety. He said my weight gain to date of 6 pounds is on track to the 40 he would like to see. When I told him about my blah experiences with the Doppler he recommended I rent a better one from b.a.b.ybeat like the kind they use in their office. He said with twins it is easier to distinguish heartbeats on the better machine and also with one baby having an anterior placenta it will be harder to use the style I currently have. 

Rented it for three months for $59 since they are having a March special. Score!

In seven to ten days, I should hear the blood test results. In four weeks, I will get blood drawn at MFM for spina bifida and see my OB, who will check vitals and use their Doppler to locate heartbeats. 

In six weeks, I will get an ultrasound at the MFM and amongst other things, they will check spina bifida visually. 

Going shopping this weekend with my pregnant friend with whom I recently reunited after my three month silence. She wants to look at things for her nursery and I think it will be good for me just to go into a store, hopefully get excited a little. 

I also need clothes soon. My jeans get very uncomfortable after a few hours and I have to wear them low to get relief. But it makes the ass sag so they look stupid. I am still able to hide the pregnancy in a lot of work clothes, but they are very uncomfortable in the belly by the end of the day and it almost makes me nauseous at times.  I am actually looking forward to having a pregnant-looking belly. This in-between stuff is annoying. I just look fat even when I try to accentuate the bump. 

Will tell my boss and her boss over the next week. Not sure when coworkers will be informed, but the loose plan is within two weeks since I will probably show soon and our annual conference is mid-April and my daily people need to know before the whole company. But I am so damn afraid of saying it aloud, getting more people excited. So much can go wrong!!!!!! Can I just work from home for the next six months? 

No comments:

Post a Comment