NT Screening, Take 2

Week 13

The only good thing about my first appointment was that the specialist wasn't very concerned.  John and I decided if she wasn't worried, we weren't going to worry.  At least not obsessively.  I had told my bosses at work so they were aware of why I was missing work on a weekly basis and we got the neighborhood under control.  Now it was a waiting game.

The other good thing was John was around to come with me to the second appointment.  We went back and were in to the sonographer almost immediately.  Will Peanut cooperate this week?



13 weeks, just chillin'

High five, dude!

That would be a no.  Not only would Peanut not cooperate, this child doesn't sit still.  It's pretty amazing to watch a tiny human doing somersaults.

Again, the specialist came in and tried to get my little fetus to cooperate.  No such luck.  But we did learn a few very reassuring things. 

1. The specialist said she has done enough nuchal translucency screenings that she can usually tell if there is an issue even without the measurement.  In that case, even before the bloodwork comes back she recommends the parents to schedule chorionic villus testing (an invasive diagnostic test that can be done before an amniocentesis).  She thought Baby K looked normal and did NOT recommend any invasive testing. (Whew!)
2. She explained the reason that an enlarge/abnormal yolk sac indicates chromosomal defect when noticed between weeks 8-10 is that at that stage, the yolk sac is larger than the embryo and it's the chromosomal defect that causes the yolk sac to grow and not the embryo, eventually leading to miscarriage or serious defect.  My abnormality was noticed at week 11, at which time the embryo was already larger than the yolk sac, and in all of the sonograms the fetal development was tracking perfectly with my due date, so she didn't see any reason for concern.  For reference, the yolk sac is the embryo's primary source of nourishment until around week 12 when the placenta becomes attached.  Once the placenta attaches, the yolk sac dissipates completely.  This is also about the same time the embryo is officially considered a fetus.  That is also why week 12 is when it's considered "safe" to tell the whole world you're pregnant.

I almost started to cry again, this time with tears of relief.  The nurse advised us of our last option, the blood test after 15 weeks, and we agreed.  We didn't go through all of this for no results, so I gave a sample of blood before we left with a card to come back in 2-3 weeks for blood draw number 2.

We were both relieved.  And we both decided after this roller coaster that we were not going to worry about it.  There are no guarantees, but we both agreed there is no reason for us to stress out about something we have no control over.  If the specialist wasn't worried, then we wouldn't worry either.

Still No Answers

Week 12

Monday I was worthless.  I spent a few hours again on the phone, still trying to get the insurance coding from my first ultrasound straightened.  I will give Blue Cross Blue Shield of Kansas City recognition for their fantastic customer service.  You don't hear that very often about an insurance company.

John had to travel for work, so he was out of town for my appointment Tuesday morning.  It was hard to sit in the waiting room with all of the other hugely-pregnant women.  I spent most of the wait examining my fingernails.

When I was finally called back, I was taken to the genetic counselor first.  She is the contact person for all patients, which makes sense but I really didn't care about a single thing she was saying.  If you listen to genetic counselors, everyone should be tested for everything under the sun.  I must have been giving her a pretty good "What the fuck?" look because she stopped partway into her spiel.

"Did you have a question on something?"

Me: "The only reason I'm here is because of the abnormal results on my ultrasound from last week."

GC: "Oh, I don't think we have your sonogram on file."

Me (already agitated and getting more so by the minute): "No, you have them.  My doctor's office sent them over twice and I double checked to make sure they went with my file."

GC:  "Let me see."

She went to her computer and pulled up my file where, lo and behold, there were my sonograms.  She muttered to herself and wrote something down.

GC: "Well, it shows you have an enlarged and abnormally shaped yolk sac.  I've never seen that before and this is outside my area of expertise so I'm uncomfortable commenting on your risks other than it increases your risk for defect."

Now, I know I was slightly irrational and completely stressed out, but it seriously took every ounce of my self control not to cry and not to jump across the table and punch this women.  At that point, she was just wasting my time when all I wanted was to do the stupid nuchal transluceny screening.  She blathered on, pretty much oblivious to me.

For the NT screening, they take a blood sample from mom and using ultrasound images from between 10-12 weeks, they can compare measurements of skin and fluid on the fetus and relate that to hormones and proteins in mom's blood and that is how they determine likelihood of chromosomal defect.  At least that is my understanding. 

I finally was called in for the ultrasound, the specialist would be in later.  The sonographer started taking images and while I was thrilled to be able to see the Peanut again, I was nervous as hell.  For the screening image, they need the fetus in a very specific position to get the correct measurements.  Peanut was not cooperating.

The sonographer had me cough, got to the bathroom, and jump up and down to try to get the Peanut into the right position.  No such luck.  I shouldn't be surprised - no child of mine will do anything that he/she doesn't want to do. 

I was almost in tears.  No image meant no answers.  The specialist came in and started looking herself.  The good news: she thought everything looked good.  The bad news: no results today.  But I had 2 options.  Option 1) Try the sonogram again next week.  Option 2) Take a blood sample today and then again after 15 weeks 2 days.  They accuracy was about the same for each option but the blood test only obviously takes a lot longer to get results.

I went with Option 1.  Another week until we could try again. 

12 weeks and completely stubborn.