Wednesday, January 13, 2010

Preparedness

I’m not sure you fully appreciate the miracle of life until you try to start one. With all of the complications, precise timing and conditions required, the room for error, it’s a damn miracle that anyone is born at all. From there, it’s a series of tests, could be conditions, and other complications that make you wonder how anyone can be born totally healthy.

If you are here, thank your mom. If you are healthy, thank your lucky stars.

Doesn’t it seem like you only hear about perfect pregnancies? And you only see pictures of women who look zealously overjoyed to be 20 pounds heavier and peeing every 30 minutes. But what about the rest of us? The ones who are finding the oh so joyous journey of pregnancy to be cobblestoned, full of detours and other obstacles?

You get tested for a lot of things when pregnant. Like I said, don’t ever expect to leave a doctor’s office without giving blood or pissing in a cup when you are pregnant. Last Monday I went in for my first visit to the real OB/GYN. Until then I had just seen a specialist. It was time for them to test me for many things at the ‘regular’ doctor.

The first visit is quick. I didn't even see the doctor. I had an ultrasound to be sure the baby is still in there. Then got blood drawn. As in, 10 different vials of blood drawn. The nurse comes in to tell me I am due on such and such a date – like I didn’t know – and where my placenta is (ok, this I didn't know). She told me that right now my placenta is covering the cervix which is totally normal in early pregnancy. But it has to move up. If not, it leads to placenta previa which leads to all sorts of not so fun things like possible best rest and a fairly certain C-section. I thought about it for a moment and got aggravated. Come on, if I am doing the training for this race I am doing the real thing! Do not cancel the swim! I say that now. I am naïve at best.

Was that a roadblock? Not really. The roadblock actually came a few days later. The nurse called with my lab results. In pregnancy you get tested for everything – STDs, blood type, possibility that you are part canine, other diseases. They were probably testing my caffeine level. Which right now is totally decaffeinated.

You could say hell just froze over but it’s 14 degrees here. I can see that it’s frozen, thank you.

Now, I already know that my blood type is A positive which, if you recall, means I’m perfect. Turns out that medically this is not the case. You see, less than 2 percent of women test positive for antibodies in pregnancy. I am among the 2 percent.

I know – what the hell are antibodies? I didn’t know either. Which meant I didn’t know the questions to ask on the phone. All I could think of was is this serious? To which the nurse replied, well it could be serious. Thank you. Thank you for that well-educated gem of reassuring information….*%(#$*)#($#!!!

The seriousness of it quickly became apparent when she said I would have to see the perinatologist. I don’t even know what that is, I thought to myself. I soon learned that it was a doctor specializing in the care of the baby in the womb.

Of course I spent all weekend researching information about antibodies. And with the limited information I had, ‘you tested positive’, I was all over the place. There are hundreds of antibodies that can be in your blood. The most serious when pregnant are those resulting from a negative Rhesus factor. But that is not the case for me, remember, I am A+ (or Rhesus positive). So, other antibodies could be from anything. And there are so many of them; C, D, M and some have names associated with them – Duffy, Kell, Lewis, Kidd. By the end of the week I felt certified in hematology. Pathologically speaking of course.

Since I knew it wasn’t from being Rhesus negative, that left me with all the other blood antibodies. And everything I was reading either did not make sense nor look good. You develop an antibody in response to exposure to an antigen. Usually by way a blood transfusion or come into contact with someone else’s blood. For the record, I have not done intravenous drugs nor drank blood. Nor had a transfusion. Sometimes, though, you are exposed from the mixing of your blood with fetal blood in miscarriage.

Monday couldn’t come soon enough. I had my first appointment with the OB/GYN – this time actually seeing the doctor. And did I have questions for her too. Of course I peed in a cup. They took my weight, which for the record has gone up about 6 pounds in the past 12 weeks. I pretty much look the same – except for about 5 pounds of extra boobage. I met the doctor. She is nice. She talks fast but I married a fast talker so I was totally prepared. She asked me a million questions. Mostly which I answered no to. What can I say about my family history, we are small healthy Italian people.

She then told me what was in my blood. I knew what to expect – a series of letters or names. I had read something online that caught my attention about antibodies; Duffy dies, Kell kills, Lewis lives. Those were the big ones.

I was positive for anti-Kell antibodies.

My stomach dropped. Do you need a stool sample?

She explained a dozen things I already knew after spending 3 days straight researching all about antibodies. I know that the most serious is being Rhesus negative with anit-Kell being second in line. Only .2 percent of pregnant women test positive for this. It can cause severe fetal anemia, organ failure, even death. I know it complicates pregnancy by 100 times including frequent ultrasounds, blood tests and monitoring. I also know it can be treated, if needed, with in-womb blood transfusions for the baby (amazing, isn’t it?). And those transfusions might have to be repeated multiple times before birth occurs. Birth may then be induced early because the later the pregnancy progresses the more risk occurs and…..

And honestly the doctor didn’t know that much more than me. Anti-Kell is rare so who can blame her. They can’t know everything. She also didn’t know how I got it. Maybe because I am special. Combined with being perfect this makes absolute sense. I am trying to retain my sense of humor here. But it almost quickly left when the doctor reminded me that being in my 35th year I am also of advanced maternal age. Super. Between being decaffeinated, elderly, constipated and now blood poisoned with a low-lying placenta keeping humor is not easy.

The good news is that as of today I no longer need to have progesterone shots!

The doctor then left the room so I could get undressed for all of the physical exams. Undressing distracted me. But finally sitting on the table, wrapped loosely in those damn gowns that NEVER CLOSE CORRECTLY, a million worries, thoughts, outcomes and emotions buzzed through my head until finally, they all cleared, my head was quiet and this came to me:

We’re just going to have to take this one day at a time, Liz. One mile at a time, one foot in front of the other.

The doctor returned. She pulled out the Doppler and immediately upon sticking it to my stomach I heard the amazingly fast yet steady whooshwhooshwhoosh of a baby’s heartbeat. That sound, that simple yet powerful sound reminded me that no matter what was in my blood, there was also a baby in me. It is alive. It is, thus far, healthy. The show must go on, Liz. One step at a time.

The appointment wrapped up quickly. I am healthy, things look good. Relatively speaking. I will go to the perinatologist on Wednesday. More waiting. Tick tock, tick tock, tick tock. In addition to whooshwhoosh, that is also the sound of pregnancy.

Driving home, I let it out – the emotion, the fear, even the anger inside of me. Thousands of other women have perfect pregnancies. Why not me? Did I do something to deserve this? Maybe I tortured puppies when I was younger. Maybe I was really mean to my friends. Wait a minute, I didn’t even have that many friends! Maybe I should stop running. Maybe I should eat ice cream. Maybe I should…pray?

Hormonally you are at the limit of all emotions when pregnant. The slightest thing can send you hurtling over the edge of backlash, tears or fury. This time it was tears. Here I was, approaching my 13th week, the week where things should be feeling better, you made it through the most anxious months of pregnancy. Here I am in the outgoing lane of the first trimester, exiting right into pregnancy complications and variations thereof. Why. Why me? I just want to experience the fucking joy of pregnancy that every other woman seems to be beaming with out there. I want to relax. I WANT TO BREATHE. I want to not worry and be free.

And you know what? For 40 weeks of my life, I don’t want to have to worry about numbers. I don’t want to have to worry about paces, send offs and interval recoveries. NO NUMBERS PLEASE. But instead here I am faced with the risk of having to worry about numbers – will my titers rise? If so, how quickly? During which week? Will they go up from 1:32? If so, what does that mean? Should I get amniocentisis? Is it worth the 1 in 500 risk?

Breathe.

I am fortunate to know a high risk OB. Soon after returning home, I told her what they found. She wrote back:

Anti-Kell is one of the more dangerous ones.

It’s different when you hear it from someone who deals with it all of the time.

That night I laid in bed. Night has a way of leaving you exposed to bring forward any unquiet demons in your head. Appearing in my head over and over again were the words, I am so scared. Yes, I am physically strong, yes, I am mentally tenacious, yes, I am emotionally resilient. But I can’t help thinking that in this case, will that be enough. Am I prepared for this.

I have no way of knowing. But I will find out more on Wednesday. So until then I shall keep on keeping on. That’s all I’ve done so far. And so far, it has worked.

Whooshwhoosh.

19 comments:

ADC said...

Everything will be fine. You are armed with so much knowledge that many people did not have in the past. Just keep going - one foot in front of the other.

Pedergraham said...

Oh ELF, hang in there. I am not a praying person, but I will keep you and Chris and this little one in my thoughts. You ARE perfect and special.

Kim said...

You have done everything, you are well informed, fit, wonderful person who has done everything she could. Now, let it be and keep putting one foot in front of the other. If it's supposed to be, it will be ELF. You've done many things people thought were impossible. This is just one more. I believe in you guys..pull together and be as positive as you can. Thinking of you and Chris..

Angela and David Kidd said...

I hope you get some news today. I honestly can't imagine what you are going through to offer you any good advice. You are keeping it together much better than I would have been able to in your shoes. But I do want to tell you that the whole "Pregnancy is wonderful" thing is a bunch of crap. This is a myth that I'm pretty sure is spread by men. The only women I know who have loved being pregnant have been the barefoot and pregnant type (and no disrespect to any of you reading who felt this way and aren't barefoot and pregnant but I clearly don't know you).

Like you said, keep taking it one day at a time. Nothing else you can do.

Mary IronMatron said...

God, I'm sorry Liz. I hope it all turns out okay. Pregnancy is so stressful, even when perfect, so I can only imagine how you must feel.

Thoughts with you.

Bob Mitera said...

It's out of your control.

Eat right. Stay hydrated. Workout as directed.

You will not be given anything you cannot deal with. The strong get the toughest tests and this is a mental test.

Head up ELF. Lots of people with you in their thoughts.

Molly said...

Tons of positive vibes for you today. I'm sure you are getting the best care possible and I hope the specialist can put you at ease with an appropriate course of action. Little IronWaterstraat is tuff, just like his/her parents!

Stef said...

Yup what Bob said. Do everything that is within your control (which you are) and trust with the rest.

Seems easy for me to say not ever being pregnant but from this vantage point just know I'm holding and sending supportive, positive vibes for you.

Hugs, Stef

Wes said...

so far, your pregnancy too is perfect. Plan for the worst, expect the best...

jennifer said...

I suspect a lot of people's reports of "perfect" pregnancies are just instances of selective amnesia. There are always speedbumps. And the more medical professionals poke and prod and examine you and the little ELF, the more speedbumps they will find to worry everyone over. It will almost certainly be JUST FINE. But of course you have to worry - you're pregnant with your first child!

FWIW, I'm Rh-negative. Just had to get a shot with both pregnancies, and it was all OK. (They were both Rh-positive, and so would've been in serious trouble if I hadn't gotten that shot.) I also was warned about placenta previa at my 5-month ultrasound with #1. You're only at 12 weeks - my goodness! Plenty of time for that placenta to move.

Just keep doing your stuff, with your awesome sense of humor, and it will be fine.

Beth said...

You can do this! You and Chris will make it through - one step at a time like you and everyone else said. I know you have the best doctors and medical care and they will do their thing while you do yours. Praying for you guys. And thanks for sharing. Because for those of us that haven't already been through this, it's amazing to get a feel for the emotions, the potential issues, and everything else...before we do it oursevles!

Meredith said...

For Dave and I, we get really pissed off at the people who seem to get pregnant so easily (you included) when we've tried and tried and have come to the realization it may never happen for us. So we feel you there.

We're praying for you.

Melissa said...

Liz, thanks for sharing with us, I hope your apt today goes well. I'll be thinking of you, Chris, and the little ELF.

Alili said...

The good Catholic in me wants to say a novena, the bad Catholic in me realizes I don't own a dang rosary.

Thinking of you.

TriEVIElon said...

Let yourself just be scared, there is no other way. Put all of your energy into what you want to have happen. It may not, but as much energy as you have it can't hurt!

I will be holding positive thoughts/prayers for you in my heart. I think we all will.

Reading this really puts life into perspective. Growing a human being really is a MIRACLE. My thoughts are with you... keep us posted.

Connect with that little baby and tell him/her to hang in there - this is IRONMAN....

vsberg said...

I'd be scared out of my mind. Definitely have you in my thoughts. Keep on doing what your doing and have faith.

Vanessa

Mer! said...

I needed a deep breath just reading this..wow....I can't imagine how frightening news like this can be---I guess if I were you, all I would want from people is for them to listen and have them keep me in their thoughts....so---know that everyone is thinking of you. Like you said, you're prepared and you're ready and the best thing you can do is wrap yourself around someone super smart (like the high risk OB) and try to educate yourself as much as possible and you're doing that.

Pregnancy *is* so emotional, as you wrote---the last thing you need is one more "number" to worry about----agreed.

Hugs and hoping that you get some more clearer answers as time goes on. --thinking of you!

Shevaun said...

Hope you got some good news yesterday and a good plan on how to proceed. Good luck. Stay strong.

TRIHARDCHIK said...

Liz, you and the little one will be in my prayers.

I agree with Jenn, most women have issues of some sort when they are pregnant. There are probably more complications that are not shared.

Do what you can that is in your control, listen to your doctors, and have faith. One day at a time is the only way to finish.

Take care and God bless!