Leave of Absence

I didn't want this to turn into a Mommy-blog but other than the Tiny Human, there's not a whole lot going on.  I promise after the Tiny Human is born that this will return to a training blog as I try to make a return to athletic endeavors.  But between now and Nov. 12, I just don't have a whole lot of training-related things to talk about.

Instead, I'll catch you up on the Peanut.  But I need to go back a few weeks first.

Week 11

I had my first appointment with my OB's office that Wednesday.  It wasn't with my doc, it was with their OB coordinator, so a pretty generic appointment.  Step on the scale, pee in a cup, give some blood, talk to the nurse, and since I was past 9 weeks, we were going to listen to the heartbeat.  Cool.

At the end of the appt, the nurse pulls out the doppler and tries to find the heartbeat.  No luck.  Ok, let's not panic, they're pretty little at this stage.  The nurse ordered an ultrasound since she couldn't find any heart sounds and they wanted to make sure everything was OK.  I was able to get in later in the day and called John.  We went in and thankfully, everything was OK.  We got to see the little bugger, hear the heartbeat, see some in-utero gymnastics, get some pictures and go home.

11 weeks, 2 days heart rate of 172 and about 2 inches long.

This whole pregnancy thing was feeling a little more real now that we had photographic evidence that I was, in fact, pregnant.  John was so excited he may have had a few too many beers that night and told one of the neighbors.  Up until this point, Kelly was the only one we had told.  The next day I told my boss at work the good news.

Later that Thursday afternoon, I got a phone call from my OB.

OB:  "I saw your sonogram and we found an abnormality in the yolk sac."

Me:  "I'm sure that's not a big deal, right?"  I was still on the saw-my-baby-for-the-first-time high.

OB:  "Well, it could be nothing.  But there is some research that shows this is an indication for increased risk of miscarriage or other defects.  I wanted to talk to you about first trimester screening."

That was like a blow to the head.  I wasn't quite absorbing all of the information as we talked but it slowly sunk in that suddenly there might be cause for concern.

Me:  "We talked about it but I'm not sure if it's covered by my insurance so we weren't going to have any screening done.  Aren't the second trimester testing options just as accurate?"

OB:  "They are about the same accuracy but you will know much sooner with the first trimester screening.  Even if it's not covered but is applied toward your deductible, I think it would be worthwhile for you to see the specialist.  She might just say it's nothing, but it would be good information for you to have."

Now things had sunken in.  I was expecting, "it's nothing for you to worry about" and instead I was highly recommended to see a high-risk maternity specialist.  What the hell just happened?  I asked a few questions about being referred and other logistics.  I wanted to talk to John.  Maybe I was reading too much into this.  Genetic screening can be expensive and the best answer I got from my insurance company was it would be covered if it was "medically necessary."  But no one could tell me what was considered medically necessary and what was voluntary and it was up to the specialist to decide. 

I called John immediately.  He didn't even hesitate.  Do the screening.  Who cares if it's $1000, just do the screening.  I called my doctor's office back the next day and told them I wanted to do the nuchal translucency screening.  They take it from there.  It's all very overwhelming - my doc's office calls and schedules with the specialist group.  You don't have a say in which doctor you see, which location they see you at, or when the appt is. 

They called back in about an hour - next Tuesday, 9am, ShawneesMission Hospital, Dr. Wickstrom.  Drink lots of water before you come in.  That's it.

At the same time, through dealing with my insurance company on the phone, I realized there was an error in the billing of my first sonogram.  The nurse coded it as routine, instead of medically necessary (I have now learned the importance of the distinction) and so I was also on the phone repeatedly with my insurance company, my doctor's office billing dept, and the diagnostic imaging company who did the sonogram trying to get it straightened out, besides the issue with my abnormally shaped and sized yolk sac.  I'm glad I told my boss what was going on because I was turning into a stress-crazed woman, locked in the conference room glued to the phone.  By the end of the day on Friday, it was all I could do to keep my composure.  After the final call scheduling with the specialist, I had to sit in the conference room to keep myself from crying.  Since the conference room is all glass, I was sure my co-workers thought I was crazy.

At the end of the day, I did the stupidest thing I could possibly have done.  I went online and searched "abnormal yolk sac".  I knew I shouldn't be doing it while I was typing it into the search engine.  But there was surprisingly little information.  No wikipedia page, nothing on the Mayo Clinic web page, just several mommy-blogs and a few research articles.  I opened some of the journal articles and was met with words like "miscarriage" "chromosomal defect" "abnormal outcome" and "embryonic demise".  The current research is on two different abnormalities - enlarged yolk sacs and abnormally shaped yolk sacs.  Mine was both.  My stomach turned into a sinking pit that threatened to swallow me whole.

I was the only person left in the office at this point and I think my bosses would forgive me for doing personal research on company time.  I started to cry.  Depending on the study, the chance of miscarriage or chromosomal abnormality for an abnormal yolk sac at 6-8 weeks was between 80-100%.  After reading the abstract and conclusions for 3 different research papers, I closed my computer and headed home, crying most of the way.  That was the start to the worst weekend of my life.