June 16, 2006

ept

No, no, not now. I'm just thinking back to when I bought an ept (early pregnancy test) over 4 years ago. I had just started thinking something might be up because I was about a week late. And then it occurred to me that there could be a reason I was suddenly more buxom than I'd ever been, so I went to the store to get a test. Jeff happened to be out of town, in California for work, so I went alone, to the New Seasons near our house. I was nervous. Believe it or not, I'd made it to 31 years old without ever having bought one of those things - is that unusual? I don't know. It seems to me a lot of women of that age would have had some cause, either because they were late, or paranoid, or just liked peeing on sticks and watching them change color.

So I got an ept, along with a few other things. When I went to check out, the young fellow scanning my items studiously avoided looking at me when he got to that one, and I did the same. Then he got to my produce, and he said, "Is that baby bok choy?" And he blushed, I swear.

Ethan, my baby bok choy.

Posted by ktingey at 09:06 PM | Comments (8)

April 26, 2006

Pregnancy wackiness - part 2

Sorry I never finished this nerve-wracking story... I actually didn't realize people read this blog, but several people mentioned they were still waiting for the conclusion of the post. It seems somewhat anti-climactic now that we all now Linna's A-OK, but I'll continue anyway.

I got an amnio the same day as the follow-up ultrasound, since it seemed so likely the baby would have Down syndrome, and I just wanted to know for sure. The amnio itself was no big deal. They told me that if they got lucky and the cells grew fast enough, they'd push to get results in a week instead of two weeks, since the level of concern was so high.

I actually was OK during that week, just reading the books and waiting for definitive news. The only thing that kept me from being tense was that I figured we already knew the results, so I wasn't really hoping for anything different. However, by the time a week had actually passed, I got increasingly tense... I realized I did still have some hope that maybe, maybe, somehow it wouldn't be true.

Monday was a week, and no word. On Tuesday I called, and spoke to a different genetic counselor (the first one was out on vacation), who said the results should be coming that day, and she'd call me if she could make it before she left at 5. Still no word at 4:45, so I called again, really anxious by now. Finally she called back at about 5:15 with the results.

She said simply, "The chromosomes are normal." I didn't say anything because I hadn't really heard, so she said it again, and I think I said, "WHAT? You're kidding." We chatted for just a few minutes. Jeff was right nearby, obviously able to tell what the results were from my responses. As soon as I hung up I burst into tears in his arms and just cried from relief, I guess.

That was at almost 15 weeks... at 17 weeks I had one more ultrasound, to check out her heart and all anatomy. Absolutely everything was normal, even femur and humerus length. No choroid plexus cysts. It really made me feel that everything would have been better if I had just waited and had only a level II ultrasound, none of these screening tests, and then everything would have come out fine.

And that's the story. I guess I'm a false positive poster girl. Papp-a is a marker for placental function, though they're not sure just what it does. Low papp-a is also associated with miscarriage and stillbirth, which continued to worry me mildly. And indeed, what apparently caused my water to break at 32 weeks was a partial placental abruption, so maybe the papp-a was telling us something. Still, it all turned out OK somehow.

Posted by ktingey at 11:48 PM | Comments (6)

September 05, 2005

Pregnancy wackiness

I don't know why I didn't write down what I was feeling while in the throes of this. It's been a rotten 4 weeks.

Last pregnancy (with Ethan), I took the routine "quad screen" test, which measures AFP, hCG, estriol?, and inhibin-A, if I recall correctly. The idea is that they then take the levels of all these chemicals, your age, and how far along you are, compare that to the average of normal pregnancies and pregnancies with various problems (chiefly spina bifida and chromosomal abnormalities), and come up with a risk of these various things. So, with Ethan, I had a high risk of Down's syndrome (1 in 126, whereas based on my age alone it should have been 1 in 400 or so). We did a follow-up ultrasound which was almost normal, so I was reassured. Jeff wasn't worried at all, and we knew we wouldn't terminate the pregnancy, so we decided not to get an amniocentesis and just made it through the pregnancy. And in the end I was a "false positive," since Ethan didn't have Down's.

But now it's my second pregnancy, and I know what I'm doing. I figured I was pretty well equipped - both to refuse some of the tests that I failed last time (I also failed the glucose screen), and also just to worry less, since worrying was no fun last time and everything was fine. But this time around I'm 35, which is of course quite a bit older than 31 - they call it "advanced maternal age."

So Dr. Ribbink told me that these days they're doing the nuchal translucency test instead. It measures 2 chemicals (hCG and PAPP-A, you'll be excited to know), and also the fold at the back of the neck of the baby, which was one of the things they measured in Ethan's ultrasound too. It tends to be bigger in babies with Down syndrome. Anyway, they do it earlier (10-14 weeks), it's supposed to be more accurate, with a lower false positive rate. I knew I didn't want to do the amnio, so this seemed like a good option.

Seem ominous yet? We went in to do the test, and got to see our very small lima bean on the ultrasound. The neck measurement was on the high end of normal, but they found fluid around the heart and a few other places, which the doctor said he thought meant "about a 60% chance there's SOMETHING going on with the baby." He couldn't say what, but scheduled a follow-up.

A few days later we got the results of that plus the blood test, and I was shocked to hear my odds of Down's: 1 in 9. My hCG was a little high, and my PAPP-A was really low. PAPP-A is one of the strongest single indicators of Down's, so I guess that's what made it 1 in 9. Plus my advanced age, no doubt.

Anyway, over the next few weeks I did lots of research in an attempt to convince myself things were actually OK: my favorite theory was that since low papp-a is also associated with low birth weight, and so is low iron, maybe my perpetually low iron CAUSED the low papp-a. Or maybe because I was only 10 weeks and 6 days, but they use a measurement of the baby to decide the gestational age, they were using the wrong dates. Or maybe because I'm still nursing, my hormones made the chemical levels off. My most plausible theory was simply that since my chemical levels were strange last time, maybe I just have weird levels of things and always will.

That got me through the three weeks we had to wait. But then at the follow-up ultrasound (which involved much more fun kicking and rolling and hand-waving), they found that the nuchal fold was now in the abnormal range, the arm and leg bones were short, and there were multiple choroid plexus cysts on both sides. I was sort of stunned, but took that as pretty definitive news, since that would raise the risk even higher than 1 in 9, which was already darned high. I was depressed, mentally explored and then discarded the idea of termination, and then started preparing. I should mention that although Jeff was worried too, he also had a good line about having a baby with Down syndrome: that all kinds of people make up the human race, and who are we to say that a Down syndrome baby wouldn't bring something wonderful to the world and to our family? When we were worried about it with Ethan, his basic attitude was that our job is just to love our baby, which isn't hard.

So I ordered and read three very good books on Down syndrome. It was helpful and I learned a lot, the most important thing being that in the past decades great strides have been made in terms of helping people with Down syndrome achieve a lot and live pretty close to normal lives.

All right... I meant to finish this story, but I think that's enough for one entry. The thrilling conclusion is coming soon.

Posted by ktingey at 03:55 AM | Comments (3)