Odds ‘n Ends and an NT Scan

On Tuesday my hormone levels came back really great.  I’m off Estradiol now and only use one Crinone insert a day.  Hopefully next week we’ll go to every other day, then the next week be done!  Of course, as soon as I finish the Crinone I have to do 5 days of MetroGel inserts for vaginosis.  I’m never going to get away from sticking things up my vagina.

The Zofran pumps helps.  I’m at the max dose, 0.75 cc’s/hr, plus I can request two boluses a day of 1cc.  I still have a really hard time in the morning and evenings, even with the boluses.  It’s super hard to get to work and start the morning.  If I could go in at 10 it would be so much easier.  And leave by 3.  Hah.  Will never happen.

I also take Phenegren at bedtime, and 1 Bonine tablet twice a day.  The pharmacist said the Bonine and Zofran work synergistically together and really help patients that have movement-based nausea.  Whatever it takes, I’m just hoping it helps with the morning and evening times.

Food and drink are strange for me right now.  If I could just stop eating and drinking completely, I would.  I’m supposted to take in 40-something ounces of water a day, but on a really good day I get in between 16 – 32.  Everything tastes bad.  I don’t crave anything.  I have aversions to EVERYTHING.  There’s a weird metallic taste in my mouth at all times.  My favorite drinks, Coke and sweet tea, taste bizarre.  I can sip water, but if I drink too much at once I throw it up.  I’ve found lemonade and this citrus fruit punch my mom makes are going down pretty well.  I freeze the punch and eat it like a slush.  Sometimes I can get a ginger ale down.

I usually eat oyster crackers, Hawaiian rolls, boiled potatoes and occasionally mac ‘n cheese.  Sometimes I can eat French Fries, beans or rice.  The other day I ate mashed potatoes and gravy and it felt like I had eaten a feast, it was so filling and hearty.  No meat, veggies or fruit at all.  Any of that comes straight back up.

Wednesday I had the NT scan.  Fortunately, I had planned in advance to take the whole day off and have someone work for me.  I was able to wash my hair and shave in the morning, but it took all my energy and I was so nauseous after that.  My mom came and picked me up.  We thought the appointment would take about an hour, maybe an hour and a half, then we’d go get something to eat.  The appointment ended up taking FOUR and a HALF HOURS!!!  I had taken a couple of Hawaiian rolls with me and those tided me over, but my poor mom was starving by the time it was over.

We met with the genetic counselor first.  We had already done some genetic screening with Davie, and neither Troy nor I are carriers for fragile X (the most common cause of mental retardation), cystic fibrosis, spina bifida or … crap, I forgot the last one.  So, since we aren’t carriers, there’s no need for us to test again. 

Unfortunately, the Harmony genetic screen and the MaterniT21 are not recommended in twin pregnancies, even if one twin has passed.  If anything came up abnormal, there’s no way to know which fetus the cells came from.  Even amniocentesis is not a viable option, as there is the possibility that there is fluid passing between the two sacs.  The only option would be to do CVS, but Newt has grown too big for it.  I am 13 weeks, 2 days, but Newt is measuring 14 weeks, 3 days.  Also, there’s a 2% risk of miscarriage.  And – even if it was positive for Down’s Syndrome, it wouldn’t change the outcome.  So I opted not to do genetic testing.  If it came back abnormal, we won’t know which fetus it came from, and there’s no way to test just one fetus, and there’s too much risk of miscarriage.  So I would just worry the rest of the pregnancy.

My risk for Down’s is just under 2% for my age group, without factoring in anything else.  That’s a 98% chance for a healthy baby.  There are two soft markers for Down’s Syndrome they look for during the NT scan.  They measure the neural tube, and they look for the presence of a visible nasal bone.  An NT greater than 2.5 is considered a soft marker (most clinics use greater than 3, I don’t know why Tx Perinatal uses 2.5), and the absence of a visible nasal bone is a soft marker.  Our NT measurement was 2.3 and the nasal bone was visible.

I wish the NT measurement was a nice 1.8, but 2.3 is still below their cutoff.  At the end of the appointment, though, the doc really pushed me to have a little bit of bloodwork done.  Not the big genetic screens, but what he called the First Screen.  He said it just measures some hormones in the blood.  Then they take the NT measurement, my age, the blood levels and put them all together to get a percent likelihood of Down’s being present in the fetus.  I told him my concerns about not knowing if the results would come from Newt or the demise fetus, but he brushed me off.

I felt bullied, but I did the bloodwork like he asked.  I would’ve been happy just leaving knowing the odds for my age group, the NT measurement and the presence of the visible nasal bone.  The doc said that because of my age, when the whole calculation was done it would probably push Newt’s NT measurement from the edge of the normal range into abnormal.  But even if it does, we’re not going to do anything else.  I’m not going to risk miscarrying a healthy baby for results that probably won’t be accurate.  So why set me up to worry the rest of the pregnancy about something I can’t change? 

The genetic counselor was a lot more sympathetic.  She kept reassuring me that I didn’t have to do the bloodwork.  She said as soon as it comes back she will call me.  I felt like she supported my decision and would’ve been fine if I hadn’t done the bloodwork.  I wish now I wouldn’t have done it.



6 Comments (+add yours?)

  1. Another Dreamer
    Jun 06, 2013 @ 18:45:20

    I’m glad things looked well at the scan, hopefully everything will look good in the blood work too. I’m sorry you felt bullied though, and that you’re still having trouble keeping anything down. I really hope things get better as they go along.


  2. JustMe
    Jun 06, 2013 @ 18:50:33

    I think it’s fine to have the extra blood work. I had it done, and the combo of my blood work and the scan itself brought my odds WAY down. Hopefully it will just be more positive news.

    Also, don’t feel bad about no fruits or veggies. I totally get it.


    • iamstacey
      Jun 07, 2013 @ 10:50:26

      I hope the whole equation brings our risk down, too. The perinatal doc was so doom and gloom about it. 😦

      But – what are you doing commenting! You’re supposed to be on bedrest! Put the computer down and sleep! No wait, let us know how you are, then put the computer down! Thinking of you all and wishing all three of you a safe trip home.


  3. Amber
    Jun 06, 2013 @ 22:40:35

    I am soooo sorry you are dealing with so much nausea!!! I had a peculiar bout with nausea and vomiting at 30 weeks with graham and had a home IV pump for fluids and zofran. That was miserable. Moving a pump around our house with a two year old is not easy. Glad your scan looked good!!!


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