19w6d: An Anatomy Scan in Pictures

Meet Squishy!

Just lounging. Hard to tell in the picture, but in this shot baby's right arm is hanging down by my cervix, knocking on the exit.

We have the same shot with Smudge, with the exasperated hand on the forehead, saying,"Really, mom? Are we done yet?"

We got shots of Smudge's hands. Seems only poetic that this time we got feet.

Hand on the forehead

Hi Squishy

Profile

We saw baby yawn and then shove fingers into his or her mouth.
S/he looks just like Smudge. 

Everything looks perfect with Squishy. The perinatologist once again said he doesn't understand why I needed the c/s with Smudge and that he thinks I have a reasonable chance at a VBAC. Baby measures perfect - exactly 19w6d - and in the 40-50% for weight and length. 

I've also met a handful of people who have used the doctor that I have a consult with next week, and say he's fabulous. My midwife appointment is the following week. By the end of the month, I will know who my provider will be. 

Meanwhile, Squishy is bouncing around like a wild person and we're still firmly on Team Green.

I'm a Bad Blogger. 18w Update

Stephen King always talks about his "faithful readers". Well, if I have any, i owe them an apology. I've been very lax at blog upkeep. It's been over a month, but it's been a VERY sleepless month, in my defense. Do you want to know the main difference between being pregnant with #1 and #2?

The toddler.

And I love that toddler more than I ever knew possible. But man, if having one doesn't make being pregnant a LOT more difficult. Gone are the days where when I was tired, I could just put up my feet and try to rest. Enter The Toddler. She needs attention and mommy time and honestly, who could blame her? She's going to have to share me pretty soon, and although I'm so happy to be giving her a sibling, I know it's going to be an adjustment for all of us. But man, am I tired. I'll be really happy when this latest round of teeth are in.

But here we are at 18w. And just because nothing can be easy, i spent this morning at the perinatologist. Over the weekend I had a lot of intense cramping and a little bit of spotting. Finally monday morning, I called the midwives just to get their opinion. Fast forward to today.

A picture of an 18w Squishy picture

Baby looks great. So, no worries there, and I'm perfectly happy with no documentable reason for what I experienced. It's certainly better than some of the alternatives, like pre-term labor, placenta previa, etc. But when the perinatologist du jour came in to check on me, he saw that I was worried and told me we could chat in his office before i left.

We reviewed my c/s (again) and Smudge's birth history, which led to a shocking statement from him that still has me reeling.

He doesn't think I had a complete abruption. 

No, that's not what he said. He said I DIDN'T have a complete abruption. And what he says makes sense, because he just highlighted every doubt I've had over the last 22 months. A complete abruption would be the equivalent of severing the adults aorta. Completely cutting off blood supply and oxygen to the baby. Babies who have complete abruptions die and those that don't, have resuscitations. They don't have 1 minute apgars of 9.  Maybe they don't have normal placental pathology either (my placenta was completely normal - i saw the report).

My OB lied about so many things. For example: when I had my 35 week scan, and Smudge weighed in at 5-12,  we laughed about it, because I had "requested" a 6 1/2 pound baby. Then when she was born, my OB said, "well, we always knew she was going to be small". You f-ing liar, do you not think I remembered that 35 week conversation? You may have dozens of patients. I only have 1 OB. I know what we talked about. Truth is, you missed an IUGR situation, and you just didn't want to get called on it.

My doula told me months after Smudge was born that my OB had been pushing for a c/s for hours. Did i just become an inconvenience who was taking up a hospital bed for 2 shifts? Did she just pull out the ONE reason she knew I wouldn't refuse?

Did I really have a c/s that I didn't need?

I'm so upset. I'm heartbroken and hurt and all of these adjectives I can't even name. And I'll never know the truth. My chart is a mess. It's handwritten, not even computerized and my doctor can write whatever she wants. No one has to corroborate anything. 

My c/s was a huge step in my feeling like a complete failure. 1st having to do IVF, then the c/s and then not being able to breastfeed. I feel like my body has completely failed me. And I know that the c/s is partly responsible for the breastfeeding issues, because the IV fluid lead to increased swelling that my 5lb baby couldn't maneuver around and the IV narcotics I was forced to have (i refused them, and the anesthesiologist gave them anyway. He said I "had" to have them, but he would give me a smaller dose) then impacted my ability to breastfeed in recovery. 

I'm still dealing with the emotional impact of all of it. I really hate my body, I feel like I can't do anything right. 

And this may have not been my fault. This could be just a freaking OB on her own schedule who didn't want to just let me take more time when my contractions spaced. So convenient that my contractions spaced and then I had the decel that sent me to the OR. 

I'll never know.

18w midwife appointment tomorrow. Smudge's appointment at CHOP is Monday. Anatomy scan the following week and Fetal Echo with Smudge's cardiologist the week after. 

October is going to be busy. So much to think about right now. Really didn't want to add to the pile. 

Please send hugs and vegan cupcakes. 

NT Scan and Perinatologist Update

I swear that was the longest appointment ever.  It was good news. Squishy looks great. But because of some of the issues with my last pregnancy and with Smudge, there was a lot to talk about .

First, the NT Scan. It looked great. Squishy is CRAZY active. More than Smudge ever was. Just as stubborn too. Goodie. But the NT measurement looked awesome. 1.4mm. The perinatologist said that's a great measurement at any point in the pregnancy. They also saw the nasal bone, which is good news. There were no other soft markers present that would indicate a chromosomal abnormality. They saw all of the major organs they were looking for, 2 arms and 2 legs. The umbilical cord has 3 vessels and Squishy is measuring a couple of days ahead, at 12w2d. 

See... Squishy.

It's a picture of a monitor, so please forgive the quality.
Our actual pictures won't be scanned until tomorrow.

We talked a lot about my Smudge pregnancy. He's concerned that I won't be able to VBAC, but that's not his expertise, so I'm not really considering his opinion. If Dr Z and the midwives think I can do it, that's all that matters. Dr C (from the perinatology institute) can make sure Squishy grows and thrives while s/he's inside, my midwives will take care of things from there. He had some concerns about placenta placement, but it's nice and posterior for now, so there are no concerns with my incision. Two fibroids have made an appearance (background: I had three at the beginning of my Smudge IVF cycle and at my c-section they found nine. At the beginning of my Squishy cycle there were none, so we fully expected them to make an appearance at some point, since they're likely hormonally driven) but they're on the exterior of my uterus, like the other ones were, so not concerned about them at this point. Also, the cyst that was on my right ovary (and at one point the size of my head) has completely resolved. So yay that. 

I brought up my concerns about Smudge not having grown in my last month of the pregnancy. (At 35 weeks, she was measuring approximately 5lbs 12oz, and then was born 5 weeks later at 5lbs 8oz - just this side of low weight for gestational age.) He reviewed all of my records from my pregnancy, and said that at every scan I had, she was measuring 40-50%.  He agreed that it was concerning that it appears she didn't gain any weight from 35-40 weeks. He plans on monitoring me a little bit closer at the end of this pregnancy. I'm okay with that. A few extra ultrasounds aren't going to hurt - but it they indicate that the baby is in trouble, then we will be able to do something about it. We were fortunate that Smudge was healthy, despite her lack of growth. It might not be the same next time. 

We also discussed the two congenital issues that Smudge had. Her severe hip dysplasia and her cardiac defect. The latter automatically got me signed up for a fetal echo. I'm okay with that. Dr C said I could go back to Smudge's cardiologist for the echo, which is great. I just love her (another Dr C). Her hip dysplasia was another story. As of right now, Smudge's orthopedic surgeon at Children's Hospital of Philadelphia (CHOP) is calling it Developmental Dysplasia of the Hips. If Squishy is born with hip dysplasia as well, both babies will be given the diagnosis of Congenital Dysplasia of the Hips. Unfortunately, this is something they can't look for in utero. Dr S (the ortho) has already agreed to see us soon after birth for an ultrasound, rather than waiting the standard 4 weeks. I just can't wait that long. Smudge was in treatment at 6 days old. I'd feel negligent if Squishy needed something that we weren't providing in that time. 

I know this has already been so long - but wait - there's more. 

My MTHFR comes back into play, as being homozygous for the mutation makes me a higher risk for having a child with a spinal/neural tube defect (which we were initially concerned about with Smudge). However, since my homocysteine level has been normal, he's less concerned. Even though, he's recommending that combined with my age, I have the 2nd trimester AFP blood test done. He said at their clinic, they're 95% accurate with picking up spinal defects via ultrasound, but it's better to be safe than sorry. 

After all of that, I had my blood drawn for my 1st trimester risk of chromosomal abnormalities. 

He also told us that the clinic has been involved in some groundbreaking research, and that they're now offering a blood test (not covered by insurance now, but hopefully one day will be) which can indicate the trisomies and certain other genetic disorders like Turners Syndrome with 99% accuracy. That's just amazing. Hopefully we won't have to be concerned about the risk enough to pay for this test, but it's nice to know there's a more accurate blood test available prior to having to submit to an amniocentesis, should it come to that. 

That's enough, right?

It was a lot of information in one day. I practically fell asleep on my way home and I'm still really dragging. Smudge's Dad is working hard on trying to get her to bed, because I'm pretty sure if I were doing it, I'd be asleep before she would. 

Now we wait for the results. But based on the ultrasound, we hopefully have little (other than my age and egg quality) to worry about. 

Stay tuned....