Third Ult.Snd./Fetal Echo-Cardiogram, Gives Good News

On Monday afternoon, completing 29 weeks and beginning my 30th, I went to a follow-up ultrasound at Northwestern in the city with Dr. Sabbagha, "The Guy" for fancy ultrasounds and head of the Ob/Gyn UltraSound department. I invited my dad, both to help out with Tyler in tow, and also to share the ultrasound experience. Mom got to come to the last one, and I didn't want him to miss out.

Anyway, this one was a follow-up to the last one, where they couldn't get a good-enough look at the heart, and where they saw choroid plexus cysts in the forming brain. (I mispelled that in the last update. Now I've got my paperwork handy!) The reason why these two factors freaked out the doctors is that, in addition to my having a mildly elivated risk of downs from the earlier blood work, the presence of choroid plexus cysts can be indicative of downs when also combined with abnormalities of the heart. You see, the plexus are related to blood flow to the brain, it was explained to me Monday. However, choroid plexus cysts are not uncommon, and resolve themselves naturally. It is only when they see both the cysts and the heart abnormalities that they will push the downs panic button. Hence the fetal echo-cardiogram.

The good news is that not only have the cysts resolved themselves completely, but the heart, all four chambers, and the flow in and out, is completely normal! To summerize, what this means is that, while my "advanced" age (ha ha) and some otherwise not uncommon protein levels (proteins "free-beta hCG" and "PAPP-A") in my blood are sometimes associated with a risk of downs syndrome, all of the ultrasounds, including a measurement of the nuchal translucency (pocket of fluid along the back of the spine at the neck), a check for skeletal dysplasia, and a fetal echo-cardiogram come up completely normal. The upper lip is also normal, and there is no sign of spina bifida. Ben and I have chosen to forego amniocentesis, which would give us a definitive answer to all this but we feel is too invasive for our taste, and besides which we have passed the Illinois limit of 22 weeks for termination--should we have chosen to do so. So, it's full steam ahead from here on out!

Whew! Okay, you can put away your medical dictionaries!

It feels good to just be done with this scary stage of testing. We'll get what we get, and we'll love what we get, and I look forward to having that baby in my arms finally!

Tyler was an absolute pleasure all day. We took him to an early morning appointment with a doc we are considering switching to at Prentice, then he had an early nap with worked well as he was in the best of moods for the afternoon ultrasound. My dad, goddess bless him (tee hee), picked us up and was a fantastic support throughout! Ben was at work waiting for word, which came pretty late because it took something like 45 minutes in the waiting room to start!

Tyler was playful and had cheerios and juice, climbed all over the furniture and his stroller, danced to the waiting room music and sang for us. He also admired the "big pumpkin" which was full of candy and which I put out of reach. He showed off for a mother-daughter pair who shared the cosy waiting room, and made up a game where he would run toward their couch, stop suddenly and freeze (looking for a reaction), then walk backwards toward his Gampa who would "catch" him in a bear hug and tickle his neck with his mustache to delightful toddler giggles until Tyler would "break free" and run toward the women's couch again. He danced for them and sang snippets of his latest song, "The Sun Is a Mass of Incandescent Gas" by They Might Be Giants (which of course no-one recognized so I sang some of it with him).

This was I think my second most uncomfortable ultrasound, the first being my first ultrasound when I was pregnant with Tyler. This technician was the only one to insist on my taking my pants down to an embarrassing degree, and ruined my clothes with repeated and generous applications of the goop they squeeze over your belly. She pushed hard on my stomach and it still hurt the next day, and she asked me to lay on both sides and my hip got out of joint and didn't recover until the next day. She also was snippy about my bringing my son and his big fancy stroller into the room with me, but I didn't budge on that point!!! (I DID ask permission when I made the appointment, mind you!) Tyler tried hard to get up to the equipment which was a big no-no, and wanted me to hold him the whole time, which of course I couldn't do. They had a big wide screen on the wall where we all could watch the ultrasound, which was really cool. Dad says it was worth taking off of work and that it was very meaningful to him to see the baby in utero wiggling around, his next grandchild. Tyler had only one meltdown when he was convinced that I was being hurt. Usually at the Doc's Ben lifts him up and I smile and say hi and he is reassured. Didn't work this time. Gampa had to take him out when he really began to scream "Mom Mom!" over and over. I hear tho that as soon as they got out to the big hallway beyond the waiting room, he took off running up and down happily and gave my dad quite the workout. After they left the technician seemed to warm up to me a bit and described everything I was seeing and even helped me clean up and sit up too. But I was sort of down at the time and had trouble mustering up the oohs and ahhs. I had read the report from the last ultrasound that they gave me to bring to this place, and they had blamed the inability to see the heart on "fetal positioning and maternal BMI." Yeah, my fat. Which wasn't a problem for any of Tyler's ultrasounds and I'm no heavier than I was. Anyway, I took it personally, and every painful dig she gave my belly I took a little personally, so that I nearly teared up. And of course I was so worried about those cysts and the baby's heart.

I was so glad Dr. Sabbagha came in himself to review the new report with me that very day. It was such a relief! (I won't be surpised by an extra bill, however. Our talk with Dr. Pergament, the fancy-fancy downs-screening ultrasound head guy from the 13-week ulstrasound, cost us $300 in a separate bill!) I asked him lots of questions about the cysts and the heart and other organs, and also about the baby's size and growth progress. He estimates that the baby will be under 8 pounds if it progresses as it has been. The funniest part was how sweetly flustered the older man was, because by this time Gampa and Tyler were back and full of energy (or at least Tyler was). I introduced them and he said "oh, that's the little boy causing all the ruckus!" He stuck his hand out in a vague way, as if he wasn't sure whether to shake my hand or Gampa's, so I took it of course. In the end he seemed to think my dad was the baby's father, asking him his height as he marvelled about how tall Tyler is at only 2 years old. He was sharp at reading the report and talking about the ultrasound, but was distracted by Tyler and seemed glad to leave, and I just thought that was hilarious. If he'd had us come into an office and sit down, I'd have had Tyler in his stroller alongside, and would have been much more quiet as we had been with Dr. Pergament. But that's okay. I was glad to get out of there, too.

Dad topped the afternoon off with a cookie for Tyler and a scone and tea for me for the ride back through the city, cozy in the car against a cold wind coming off the green, choppy water of Lake Michigan--which we could see from the medical building right on the shore, and then down Michigan Avenue with all the sites to see, past Water Tower and Millenium Park and the art museum lions.