Not Smooth Sailing

I'm sorry I didn't update after my appointment on Wednesday; I just didn't have the energy to post it all and since I'm still trying to digest it myself, I didn't know how to put it into words.  The appointment started well and because baby was so scrunched up, the ultrasound took longer than usual to find all the pieces they needed to look at and measure.  Ever the stinker, this one!  But the tech was able to snap several shots of Nugget and the cute little button nose. 

Our little 19 week Nugget, hand coming up to the mouth  :)

Baby did end up cooperating enough for the tech to clearly see the "bits" and tell us she was 99.9% sure of the gender, which she disclosed to us and which we are NOT sharing at this time!  What I can tell you, is that since each of us had a different prediction, one of us is surprised!!  :)  She did also take a couple 4D images, but because the legs and an arm were up near the face, it messes up the focus and the face looks distorted.  It's still really neat to see the actual face and not just the profile.  

Toward the end of the appointment, the tech mentioned that the baby was measuring a little small for the gestational age and that Dr. H would talk to us about that.  So we went into the exam room and had to wait for a good 10 to 15 minutes for Dr.---very unusual, as she's normally prompt.  Turns out she was talking to the tech and getting all the information before coming in by us.  She told us the amniotic fluid is low and that baby is small, both of which are concerning.  She asked if I'd been leaking any fluid; I said no, but sometimes it felt like maybe a little urine, but that I figured it was because it's hard to completely empty your bladder while pregnant---gross, I know, but that's what pantyliners are for!  She said she wanted us to see a perinatologist this week yet so he can check in greater detail if this was any kind of big deal.  And she also wanted me to go up to labor and delivery to have a test done that checks if you're leaking amniotic fluid.  She said we'll be having more ultrasounds through this pregnancy than "normal" so we can check progress more often.  So we left her office feeling a little down and slightly worried; what if I was leaking fluid?  I didn't think there's a whole lot they can do about that and it never really ends well.  Hubby asked me how the fluid would leak exactly and all kinds of questions about how it doesn't just "fall out" to begin with; I don't mind answering his questions because I can imagine it must be scary not knowing how "this all works" and what goes on in there.

We went downstairs so we could get to a different area of the hospital; she had told us to go to East building and check in at registration for the test in L&D.  Got alllll the way over there and nobody's at registration; in fact, it looks like they're closed.  So I pick up the phone to call and get the young guy at West registration.  I tell him we're supposed to register so we can go up to L&D for a test; he sounds confused because, he says, East registration closes at 4pm (it's now well past 5:30) and he'd have to check with Dr. H's office for instructions.  *sigh*  So we wait and then he gets back on the line and tells us we'll need to register back at West entrance...blah blah blah.  Basically, it took about a half hour from the time we left Dr. H's office in West building to get registered for my "outpatient" procedure in L&D on the 4th floor of East building.  Meanwhile, I have several people asking me if I need a wheelchair and if I think I'm going to be delivering today...I say, "I better not be, I'm only 19 weeks!"  Apparently, when they see you're going up to labor and delivery, even though you've told them seriously 6 times it's just for a test, they think you're having your baby.  And when you're worried about that baby's health and safety, it's not something you want to hear or think about.  

Long story short, FINALLY got up to L&D around 6pm and had very nice, competent people helping us from then on.  The test involves a swab up the old "baby chute" and then it gets swirled around in some special liquid and a dip strip is inserted and left in the solution for 10 excruciating minutes.  It's far worse, let me tell you, than waiting for the "pregnant/not pregnant" line!  There is a control line that shows up immediately and then there is a second line that will show up in the 10 minutes if there are any traces of amniotic fluid being leaked.  Test came back negative so we dodged that bullet.  We had been at the doctor's office/hospital for 3 hours for just an ultrasound and a swab.  

Fast forward to today, when I saw the perinatologist (Dr. J) this morning at 8am.  [Between Wednesday and today, I was trying to convince myself that baby is just a shrimp and that genetics on my mom's side where several family members are very petite were playing into it.]  Got called back for yet another ultrasound, this one performed by Dr. J himself.  He did a lot of the same measuring the tech did on Wednesday.  Measuring head circumference, leg and arm bones, belly circumference...he, too, says baby is measuring small---about a week behind.  He said that if I were further along, like around 24 weeks, being a week behind isn't a big deal; but at 19 weeks, it is.  This leads into the conversation that it may be due to a chromosomal abnormality; the only way to check if that's the case is to do an amniocentesis.  Hubby and I are not in favor of any extraneous testing just so we can find out if our baby is going to have Downs Syndrome or something else "wrong" that we can't do anything about once we know and since we wouldn't ever terminate the pregnancy unless my life was at stake, we don't feel it's something we need to have done.  So that's concern #1.  

Concern #2 is that my amniotic fluid is indeed low; I got to see my little peanut (or "Peanugget", as I may decide to refer to him/her) opening and closing the mouth and slurping in the fluid. Dr. J said that there is some fluid there for baby to drink in which helps develop and expand the lungs, which is good, but that it's not as much as they'd like to see there.  On screen, baby looks happy and healthy (at least to me), punching (which baby did on Wednesday) and squirming around.  It's so adorable to watch.  

But then on to concern #3---my previous surgery to remove the large fibroid from my uterus over 8 years ago resulted in a band of scar tissue in the middle of the uterus; this "uterine band" can get caught up in baby's extremities and cause amputation.  He said he's not seeing it happening at this point but it's something we'll need to monitor; I suppose that as baby grows, it will become more challenging to stay away from the band.  Nothing could've been done about the location of the scar tissue; it's just where the fibroid happened to be...in a really crappy place for later.  

So, Dr. J and Dr. H both want to see me again in 4 weeks; another ultrasound will be done and we will see if baby's making any progress in the growth department.  Dr. J did say that it's also possible that baby just needs a good growth spurt and that he thinks baby will be just fine, especially since I made it this far.  I think the reason I didn't get very thorough, concrete answers today was for a couple reasons: 1. He doesn't know for certain and I'd rather he didn't fill my head with doomsday scenarios unless absolutely necessary and that he's sure, and 2. It may still be a little early to be talking "definite" problems.  I think he wants to see what happens by the next appointment.  He said it was our choice if we wanted the test but that we had worked hard to just get here.  There is thought to be a slight risk of miscarriage with amnio's, so right there is my answer: NO.  Dr. J said that honestly, even though it's our choice, we're going to be worried throughout the rest of this pregnancy no matter what the test shows.  If the test shows there is a problem, we'll still be worried; if we don't do a test, we'll be worried but might be able to have some hope that it's going to be okay after all.

He has ordered me to increase my fluids via Gatorade or things with electrolytes rather than just plain water so my system can absorb more (since the water basically just passes through your system) and also increase my caloric intake...didn't know I had a problem with that, but I will do what I must to fatten little Peanugget up!  Hubby didn't go with me for this appointment and now I wish he would've; but you don't know what appointments they "need" to be at and since I had convinced myself (mostly) that baby was just puny and nothing was wrong, I didn't see the need.  Plus, it's really hard for him to take time off and hard for our pocketbook; he already took half a day for Wednesday's appointment.  But I have a feeling that when I ask him to come with me for the next one he won't hesitate.  I got the scheduling people to coordinate the two appointments for the same day back to back so we don't have to drive 2 hours roundtrip twice that same week, just like this week.  And there will be less work missed as a result. 

I am trying to remain positive but this week was a serious blow to my confidence that this pregnancy is going to go smoothly.  I feel like crying every 5 minutes out of frustration that it took us so much to get to this point and now we might have problems (more than one) along the way; and out of fear that my baby isn't going to have an easy life.  Of course I want the best for my baby, but I also want them to have a life free of ridicule and difficulty, staring eyes and judgement.  This positivity isn't going to be easy---but I am going to try.