Thursday, January 12, 2012

One Bourbon, One Scotch, and One Beer

Here is the story of how the ultrasound played out with extraneous details removed, though I could tell you how our local radio station plays Two for Tuesday and it was George Thorogood or how we got to watch all of Access Hollywood (or whatever show it was) about Beyonce’s baby’s escape from the paparazzi while we waited over a half hour for our appointment.

We had the chatty tech. She’s also pregnant. I would guess it’s her first and a girl based on how she is carrying. She measured the cervix. All is good. It’s tipped or curved or something so a curved line measurement gives >5 cm. No imminent labor here. So that is really, super good news. I’ve been feeling better on the contraction front (though not on the energy front) and have been itching to do exotic things like go to the grocery store and climb stairs. I don’t think I am up for either of those activities yet, but it’s nice to know that if I do them and overdo it, I am probably not going in to labor. I finally did have enough energy to stand at the bathroom mirror and pluck my eyebrows. Three weeks. I can’t believe I went three weeks. It looked like caterpillars were inching their way toward each other.

After the cervix, she moved on to the placenta. It’s receiving good blood flow. The smaller lobe is anterior and the larger lobe is posterior. I don’t think that’s important; I’m just letting you know what I know.

Then she measured structures in the brain. Everything there is fine. She measured the head circumference and it’s fine. Then she did abdominal circumference. That is all fine too.

She went to the face. And the cutest thing happened, I nearly died. The baby yawned while the tech was in 3-D view of the face. And then? Muse fell asleep. He yawned and fell asleep. He’s a genius. He’s a genius who appears to resemble Bobo with Mr. Long-Suffering’s nose.

She moved on to the bowel. She turned the contrast down. She moved a little and turned the contrast down again. Then she did that again. The bowel was not as bright as bone in any of the views and would not be called echogenic. I knew what she was doing, but I couldn’t tell whether it was as bright as bone, so we asked. And she said she is not calling it bright. Whew. Moving on.

She took a photo of tiny baby feet for us. Then, I noticed that yes, indeed, this baby is a boy. I can’t believe I never noticed those parts in ultrasounds with my other children. It was so obvious. I guess once you know what you’re looking for, you can find it. Chuckles, by the way, giggles and gets all shy when he sees ultrasound photos with an arrow saying “Boy”. Very embarrassing.

Finally, on to the heart. She took echos and let us listen to the heart beat, measured the rate, and took several views of the heart. I could see the valves opening and closing. The valves! How tiny they must be (I saw the valves with Bobo too…but way back when I was pregnant with Chuckles, the technology wasn’t good enough for that in a standard ultrasound). She could not find an echogenic focus in the heart either. So that is good.

She mentioned that the baby is breech (no big deal with the planned c-section and not a surprise given placental location and the fact that I know where the head is all the time). She finished up with the weight estimate of 3 pounds and baby is measuring about 10 days ahead (which is normal because I have always had babies measure ahead and be large at birth).

We went in to see the perinatalogist who said that the computers were taking a break because of the unseasonably warm weather (54 degrees in Chicago in January). Only the first half of the photos made their way from the ultrasound room to the computer on his desk (and I think they go through the server located in Bahrain on their way). He popped out of the room to go look at the photos on the machine. He came back and said the tech was already scanning the next patient, so we should go home, he said the tech said everything looked ok, and he would call us that night.

So, we left feeling pretty good about ourselves. We even stopped and got dinner to bring home to the kids. Hamburgers, fries, and shakes! Woo hoo.

True to his word (and I think I love him), the perinatalogist called shortly after I finished eating. He said the echogenic focus in the heart is gone and the bowel is no longer echogenic as well, but that the heart appears enlarged. He said he is not worried about it because we are big people and maybe if it was his baby since he is only 5’ tall that it might be something to note, but since we are big people it’s probably nothing, come back in 4-6 weeks and be scanned again. We really are big people. I am 5’8” and Mr. Long-Suffering is 6’4”. However, I would assume that the heart is large for the baby’s size so even though the baby is large, the heart is large even for that. But I know that without volumetric calculations, large is a subjective thing based on the specific angle of the scanning and so on. I am trying to be quite zen about it. Google is not terribly helpful on this point. Enlarged fetal heart on ultrasound doesn’t yield the kind of useful hits one might like to find. Nothing reassuring, though nothing terribly alarming either. There are three things it could be, and they aren’t that bad: absolutely nothing (I always love it when the most likely scenario is that the scary thing is just something that is totally normal and sometimes seen), a relic of gestational diabetes that will revert to normal within 6 months of birth, and Down Syndrome.

That was Tuesday. Wednesday morning, I had my regularly scheduled ob appointment. I asked about my gestational diabetes screening which I had done right before Christmas. I made a strategic error. I had it done in the morning of December 22nd on my way to work so I had eaten a large-ish bowl of oatmeal and munched on two Christmas cookies right before going. So, I guess we could call that the worst-case scenario. And even with all of that, I still got a 126, which passes (since you need to be <130). I’d never had GD before so I wasn’t terribly worried I would all of a sudden have it. The regular ob was happy to hear that the foci were gone in the ultrasound and glad to hear I am having a follow-up on the enlarged heart, and told me to come back in 3 weeks. I’ll be about 33 weeks then. He said then I would go to every two weeks and we would start additional testing at 35 weeks. I have no idea what additional testing he is referring to and I didn’t think to ask. I can’t remember what it was last time. I figure they’ll check for anemia or something to make sure I am good for a c-section. They won’t be checking for group strep B since I will be having the c-section (and antibiotics) regardless.

So, that is what I know. The baby is a giant genius with a big heart.  Who doesn’t want a kid with a big heart?

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