Trisomymommy

Birth plans...

I’m now on the weekly ultrasound-and-non-stress-test plan.  Last week’s appointment showed that the amniotic fluid had dropped back down a bit, so I spent Thanksgiving weekend lying on the couch and drinking as much as possible while my mother in law cooked.  Hopefully today’s scan will show that it has gone back up.  If the levels continue to hover below normal, they are proposing to induce me at 38 weeks or so (three weeks from today, yikes).  I guess the logic is that once you reach full term, there is no point in keeping the kid in a suboptimal uterine environment.

I am ambivalent about the degree of monitoring I’m getting and the proposed induction.  On the one hand, if anything starts going screwy with my body or with this baby, I want to find out as soon as possible and I want the best possible care.  If it’s better on the outside than on the inside, then I’m all for getting this girl out, stat.  I understand all of the criticisms of the medical establishment for practicing defensive medicine and doing excessive intervention, but I believe that for the most part, our interests align: we all want a healthy baby.  I want it for personal reasons, they want to avoid a lawsuit, but in the end we want the same thing.  It is, after all, a high risk pregnancy, what with the low fluid levels, my sticky blood, the Lovenox I shoot up every day to thin out the sticky blood, and my (gulp) advanced maternal age.  So maybe they are right to watch me so closely and try to wrap things up as quickly as possible. 

In addition, I kind of like the medical care.  Nothing makes me more emotionally vulnerable than pregnancy, and I think my reproductive history exacerbates the problem.  It is very hard to relax and have faith that everything will be fine.  Everyday I imagine something going terribly wrong.  It doesn’t help that of the last four friends who have given birth, three have struggled with serious birth defects or life threatening birth complications.  And it doesn’t help that the last time I gave birth I was glowing with elation only to have my world fall apart as some pediatrician started talking about extra space between toes and a single crease on a palm and did you have an amnio?  Although I feel more or less at peace with B’s diagnosis now, nothing can ever undo the trauma of that moment, and I find myself reliving it now.  This time around I do know that the baby has the usual number of chromosomes, but it’s all too easy to imagine having some variation on that same conversation.  (I will be absolutely terrified to hand this baby over to a pediatrician to examine.)  So given this emotional state, the weekly tests are mildly reassuring and the idea of a medically induced and closely monitored birth doesn’t seem so bad.

 

And yet, I can’t help but wonder if this is all rather excessive.  My fluid levels are not that low, just lower than normal. The girl is growing perfectly, she kicks a lot, and shows no signs of being stressed.  The blood clotting issue is being treated and so is unlikely to pose any problems.  I don’t want anyone trying to force this girl out before she’s ready, and I don’t want to end up having a c-section because of a failed induction that wasn’t even medically necessary.  I would like to do this naturally, despite the irony of having conceived this embryo in a Petri dish and then storing it in a freezer for two years before having it transferred to my medicinally prepared womb.

And besides, if I go for the induction, I’ll have to choose the date, and I just don’t want to deal with the astrological implications.

Drinking 2

This drinking thing works.  My amniotic fluid is now at normal levels.  Excuse me, I have to go pee.

Okay, I'm back.  Sometimes as I reach for yet another glass of gatorade, I hear Elliott Smith's voice in my head singing Between the Bars ("Drink up baby, stay up all night...")  Like most of his songs, this one is dark and depressing and has nothing to do with trying to stay properly hydrated for the sake of your amniotic fluid, so it really isn't appropriate for my situation.  Come to think of it, he has another song with a great melody and a chorus that starts, "High on amphetamines..."  and sometimes I find myself singing that one out loud, despite it's personal irrelevance.  I'm no addict, I just like the music.

 

Update: 21 Months

This has been a fabulous month in the world of Miss B.  For one thing, she is healthier.  We gave her two back-to-back courses of antibiotics last time and when we finished them, her symptoms did not return immediately as they had been doing for the past several months.  She still has some congestion and wakes up with a wet cough, but it's much better than it was.

B has always been a night owl and she had been going to bed at around 9pm, sometimes later.  In some ways this worked for us, as it meant that we got to spend time with her in the evenings, but in some ways it didn't, because we had no time to ourselves in the evenings. I decided that we needed to get her on an earlier schedule, but it was not easy to do.  Until... lo and behold... the end of daylight savings time.   Miss B doesn't know that twice each year, most of our country (even the good people of Indiana) just declares that it's now a different time.  We could keep time constant and decide, hey, let’s all get up a little earlier or later, or let’s change our work and school schedules so as to take advantage of changes in daylight, but instead we make time itself change.  It has never made sense to me, but I follow along because everyone else does and I have to be able to schedule things with them.  Taking advantage of B’s ignorance about such things, when it came time to call what was 9:00pm 8:00pm, we just started putting her to bed at 8:00pm, and it worked.  Now sometimes T and I have actual conversations in the evenings.

Of course the huge development for B, which I have already blogged about, is the talking.  She continues to say “Mmmmmmmmmuh” whenever we discuss cows.  She says, “All done” (or rather, “awduh”) appropriately in a variety of contexts.  Recently I was trying to put her hair in a little samurai ponytail, which is acutely annoying to her but better than the chronic annoyance of having hair in her eyes all day, and as she tried to squirm away she said, “All done!”  Another time she was climbing up the stairs and slipped a little, lightly bonking her head.  She turned around, sat on a step and declared, “All done!”  This used to only apply to meals, and I’m impressed at how well the concept has generalized.

In other language news, last week, our infant educator was here and played some music on a little cassette player, which B loves.  The IE started to put the tape player away, saying, “Okay, we’re all done with the music” and out of nowhere, B yelled, “No!”  We had never heard this from her before, and shocked at her impertinence, we scolded her for talking back.  No, that was a joke.  Of course we cheered and had some more music.  I guess there will be a time when, rather than celebrate any talking at all, we’ll have to teach her what not to say.  But right now she could tell me to go f- myself and I’d be charmed.

People often say that when kids are making big strides in some area, such as motor skills, they plateau in other areas, such as speech, as if they can only handle one developmental track at a time.  I was discussing this with a friend who is a developmental psychologist and we concluded that we have no idea why this would be the case or if there is any research showing that it is true.  At least for my kid, I’m starting to suspect that it is true.  As we’ve finally started to see speech kick in, we haven’t seen any major advances in walking.  She doesn’t really like to practice walking and lately has been giving us what we call “noodle legs” when we try.  Maybe we haven’t been trying enough because we know she doesn’t like it, and besides, we’re so thrilled with her moo that we’re happy to forget the walking and let her crawl to the cow book.  So, maybe the reason development seems to happen in one area at a time is that parents are satisfied when there is at least development in one area and they stop pushing in others.

Drinking

I failed to post everyday in October.  To my credit, I knew that I would not manage to post everyday and set for myself the much more manageable goal of posting more often than before.  (Yet more evidence that I am very wise -- I know that the secret to happiness is low expectations.)  I did achieve that, so yay for me.

Although I did manage a whopping seven posts last month, I did not write anything especially thoughtful about Down syndrome.  The truth is, I haven't been thinking about it all that much.  Of course I think about Miss B all the time, but her diagnosis is more in the background for me these days.  It's the specifics of this one little girl that hold my attention, and to follow up on some of last month's posts, here are some of those specifics:  She is sleeping perfectly again.  Immunoglobulin test results came back normal, although she continues to struggle with sinus and respiratory issues and our ENT now wants to remove her adenoids.  (Your opinions on this surgery are welcome.  I'm not sure what to think.) For about 15 minutes on Halloween she wore a cow costume and we all delighted in sitting around saying "moo" until she became too irritated by the ill fitting hood. 

I turned 37, further advancing into the obstetrical "advanced maternal age" category.  The pregnancy just hit 32 weeks and has been going along well, although we had a bit of a scare last Friday.  At about 2:15 pm, I started having mild contractions.  I realized that I'd had some coffee in the morning but no water all day, so I figured I might just be dehydrated.  I started drinking water as fast as I could. Two hours later, I was peeing every 20 minutes but the contractions were still coming, so I called my OB, who told me to go home, lie down, drink more water and call back in an hour if it didn't get better.  So I did all of that, and it didn't get better. The contractions were not strong enough to be labor contractions, but they came exactly six minutes apart for four hours and I could feel pressure on my cervix with each one.  The doctor told me to come in to labor and delivery, which required us to scramble to find a friend who could take Miss B for the evening (we have no family nearby).  The contractions eased up as soon as I got there, but the doctor there kept me for about many hours and did lots of monitoring and the fetal fibronectin test, which came back negative, and then sent me home telling me to remember to drink enough water.  Duh.  I am a fool.  I was absorbed in work stuff and I forgot to drink. 

Of course I was careful to drink more water this week, but yesterday when I went in for my regular appointment they decided to do an ultrasound to check amniotic fluid and the level turned out to be lower than normal.  I've been instructed to take it very easy and drink a ton of water and get checked again in a few days. 

There's this thing that seems to happen to me during pregnancy -- I just lose all creative motivation.  I've had a hard time blogging, commenting, or even responding to emails.  It's not that I'm depressed, I'm just kind of turning inward and less engaged with the outside world.  Obviously this is an emotionally complex time and there is much to write about, but I don't seem to have the words for it right now.