Tuesday, September 19, 2006

More Questions (updated)

Today I was hoping for some answers.

I'd been recommended to a pre-natal medicine clinic for what I believed was going to be a level II ultrasound which I hoped would adjust my maternal serum odds and make the decision about whether to have an amnio easier.

I was disappointed.

The midwife that saw me prior to the scan was odd and intense. She stared at me after every statement she made for just a few seconds too long, as if to say, "You DO understand what I'm saying, don't you?" The long and short of it was, she shattered my confidence that 1:161 was nothing to worry about.

There was a clinic held by a doctor that morning doing amnios and it was strongly recommended that I consent to one. For the first time in the history of this pregnancy, I didn't fold immediately and give in.

"Um, I was under the impression that I was just coming in today for a high level scan, not an amnio."

"We recommend amniocentesis for everyone who's had a positive test. That's anyone who's 1:250 or higher risk. We just follow a set of guidelines."

By the time the consultation was over (made worse, I might add, by a student doctor staring at us intently from about 3 feet away.) I was literally about to totally lose my shit. The waiting room was full of pregnant women now, so we stood in the corridor and I whispered to Mr. DD in hushed, hysterical tones while he tried desperately to reassure me that we didn't know anything more now than before we walked in, so I should try to be calm. There was only one other woman in the room who looked more miserable than me. She had come alone, had an IV peg in the back of her hand and was walking with a great deal of pain. I suspected she might have had a termination that she didn't feel particularly happy about and had to resist the urge to go and hug her.

The scan (which wasn't level II) was conducted by a rather brusque, but not totally unfriendly Northern Irish doctor who couldn't find any definite "Downs markers". I would have enjoyed it had I not been so rattled by my consultation with Nurse Rachet moments earlier; fingers and toes were clearly discernible and the Prawn wriggled around to avoid being Big Brother-ed.

We were forced to re-visit Nurse Rachet after the scan to discuss options. Her attitude softened remarkably when the whole lot of crazy that I thought I could keep under control till we got to the car burst out in a huge flood of tears and snot right there in her office.

"I'm so sorry," she said, "you seemed so bouncy when you came in here. I hate to send you home like this."

So now I'm left wondering what the fuck to do next. Since the beginning of this pregnancy, I've had an awful time getting two doctors to agree on anything having to do with my treatment. My GP was dead set against the progesterone, my specialist was all for it. My GP didn't think an 8 week scan was necessary. My specialist did. My specialist told me that 1:161 was really nothing to worry about. Nurse Ratchet said, "Oo, he was a bit brave saying that, I think."

My gut feeling is that there is nothing wrong with the Prawn. But this morning shattered any illusion of calm that I had about this pregnancy.

I don't know what to do.


I was determined that I wasn't going to sit around on my ass today without answers, so I phoned up Dr. Bow Tie Guy. Technically, he's not really my doctor anymore, but he told me early on if there was ever anything I wanted to chat about that I should make an appointment.

Since Mr. DD couldn't come with me due to the fact he was buried under work and trying to figure out what in the holy hell is going on with our estate agent. So, to make sure I didn't end up completely turning into a puddle of unreasonable goo in front of Dr. BTG, I wrote the entire story down as honestly as I could remember it and showed it to Mr. DD before I left. He thought it was good.

Dr. BTG was running behind, but when he finally DID see me, I handed him the letter and explained that it was probably going to be more concise than I could.

The eyebrow went up not too far into my missive.

"You didn't even SEE the consultant?" he queried.

"No, just the midwife."

As the reading continued, he truly began to get a face on like a piece of knitting. He immediately got on the phone to his secretary and asked her to get a hold of the clinic consultant's home and mobile phone numbers. In the 7 months or so that I've known him, it's the first time I've seen him get irritated.

"I'm going to have a chat with him this afternoon and I'll call you at home this evening and we'll see whether we can't come up with a better plan. Oh, and there's no charge for the consultation today."

He patted my hand as I left the office. "Fear not," he said, "I have good vibes."

Can I just say again.....LOVE HIM.


SaraS-P said...

Trust your gut, I say. Don't let a bad experience with the medical community shatter your hopes. It sounds like Ratchet wanted to be on the safe side, and didn't consider that she would sound like she was delivering bad news. It sounds like the scan (level II or not) produced some good signs.

Piece of mind is probably fleeting right now, but I wish you the best.

Meri-ann said...

I wish I had some sage advice to give you- but do what will give you peace of mind. Trust your instinct all the way, but if an amnio would make you relax a tiny bit then go for it..... Like I said I don't have any decent advice for you, just wish you weren't going thru this.

Meg said...

Sounds like your day was highly traumatic... I know exactly what you mean when you describe your whole outlook chinging as a result of a comment, even though the circumstances haven't changed.

But really, no downs markers in the scan is a great thing. I think you can breathe a lot more easily now. Are they still going to give you a high res?

I don't know about amnio... I've heard some pretty nasty stories.

lisalou said...

Trust your gut.

rockmama-in-waiting said...

I think my hope is to somehow manipulate numbers so that it makes the decision easier. The nurse said the test I had was very accurate, but it was only a double screen AND, for some reason, my weight factored into it somewhere. Surely the quadruple screen, which is MOST effective between 16-18 weeks would be more accurate? At any rate, I'm going back to my specialist for some advice.

katty said...

This sounds like a horrible experience. This is the address of the place I was reccomended. The professor is the bloke who invented the nuchal fold scan, and he does the scans (and CVS, I don't know about amnios) on a wednesday. Three pregnant women told me to go there (both reccomended by their NHS hospitals) and all told me they found it excellent. The website address is http://www.fetalmedicine.com/f-fmc.htm.
Sorry again for your horrid and confusing experience.

rockmama-in-waiting said...

katty, thanks for the address. If I do decide to go through with the amnio, I'll definitely try to get a referral. London is only 40 minutes away for me, so not a terribly long journey.

katty said...

It's more that they have a very high resolution scanning machine - I didn't even need a full bladder for the scan! A friend was given 1:28 chance of downs based on a nuchal fold scan and her age at her NHS hospital, but was advised by the hospital to go to this place as a private patient because it had more sophisticated methods and was given something like 1:500 odds when her blood test was combined with the far more detailed scan. Though I think you are now too far along for a nuchal fold translucency (I think that's up to 13 weeks isn't it)?
You don't need a referral. It's private. You just book yourself in.
I am not going to mention this again and sorry to harp on about it, but its all been on my mind at the moment. I don't know what their miscarriage rates are for an amnio; I believe it is pretty low for a CVS but I intend to check.
I wish you a great deal of luck.

katty said...

No wonder you love him. What a great guy!

Emily said...

OK, I just found your blog through Flotsam and read through your entire archives. I'm dying to know how things are going... wishing you the best. Love your writing.

Alexa said...

I heart Dr. BTG. I will be thinking of you and the prawn, and hoping you get some answers.

Chardy May Cosmo said...

1 in 161 is a .06 percent chance. Less than 1 percent. That's what you need to take from this. Less than 1 percent. You have a greater chance of winning the lottery.