acog who?

my ob care is through the military, allegedly at one of their flagship institutions. i'm being seen at be.thesdanaval.medicalcenter. interesting then that at such a premier institution i'm unable to get a NT screen, my requests for same and ACOG guidelines nonwithstanding. apparently, they do sequential testing and only offer NT scans to those women whose 1st trimester analytes are abnormal. while this seems like a good idea, serum anaysis alone only detects 80% of possible aneuploidy, whereas serum analysis + NT scan has a detection rate of 95%. if i were working with a tiny clinic in a remote area that didn't have appropriate equipment or trained sonographers i would understand. but that is not the case, at "the president's hospital." if acog guidelines suggested that only women of a certain age or risk factor should be offered the combined NT and serum screen i would understand. but acog guidelines are clear: "Women need to be aware of all the different screening options that are available, including their detection rates and limitations, so that they can choose the test that's best for them." if i didn't want the NT scan it wouldn't matter. but i do. it is very odd to me that i'm being denied such a simple screen at, allegedly, one of the nation's top medical institutions. what could possibly be the reason for BN to be so far outside the normal standard of care? cost cutting? abortion politics?

i heard the hb today by doppler; i'm 11w. i have a retroverted uterus so it didn't come up right away and i scared myself half to death. i'm going to wait a week before trying again. part of me thought, that as i'd made my 1st maternity clothes purchases this weekend, that it wouldn't be there as payback for such a wanton display of hubris. like DD said in her post, i guess things will be ok but it's hard to mentally work myself around that. if someone asks if i'm pregnant, the answer that feels most right to me is "technically". i feel bad because i feel like it's keeping me from bonding with the lil bean, but i keep waiting for the second shoe to drop. maybe it'll get better in the 2nd tri?

i honestly couldn't say it better myself

so this post might be cheating, but every now and that i come upon a sublime post that says just exactly what i wish i could say, if i didn't sputter out into an incoherent rage each time i tried. i'd like to refer you now to julie's 3/24 entry at a little pregnant for a spot on discussion about what's so insidious and nasty about this whole j.lo twins THANG.

it's not that fraternal twins at age 38 after years of wanting and trying to become pregnant doesn't scream IVF (umm...but it most surely does)...it's the denigrating way she denies it. no one is asking j.lo to be a mascot for IF (for that i'd like to nominate z.braff if only because he's so damn cute!), but if she could just refrain from being insulting in her she-doth-protest-too-much denials that would be much appreciated? k? kthxbai.

how to quickly lose your mind in one easy step

so early this week i reluctantly stopped lov.enox...no longer being hemoconcentrated following my bout with OHSS/paracentesis/abdominal bloating from hell. even though the shot stings like crazy i quite was sad to give it up, because i got pg and stayed pg (so far) while taking it. so rather like a basketball player and his lucky underwear, i wanted to make it to 12 wks before deviating from my medication regimen in any way. alas, not to be. plus, i figured if i was homozygous for MTHFR (and being ashkenazi, it's a reasonable possibility) i would be treating that simultaneously. i've never been tested for clotting disorders, so it's possible. at my appt this week i asked the resident if i could stay on the lov.enox...she contacted the maternal-fetal specialist who essentially said no can do regarding the lov.enox, because if i do have a clotting disorder it won't cause problems until 20 wks or so, and since i'm no longer hemoconcentrated there's really no need to continue the shot. is that supposed to be comforting? i'm supposed to wait until 20 wks to see if a problem develops? Not Even Remotely Comforting.

even more reluctantly i stopped the PIO. a word about PIO. that shot SUUUUUUUCKS. it is thick, and deep IM, and currently my backside is covered in knots and bruises. i even ended up with sciatica down my left leg from multiple deep IM injections into the same area. so, it's not that i like the shot at all. it's that despite multiple assurances that 'the placenta takes over progesterone production at 6-8 wks' i know there are women for whom that is not the case. i also know that you can have a perfectly healthy fetus, but if you don't have adequate progesterone, you don't have a pregnancy, end of story. i also know, that fertility wise, i happen to fall into a rather small percentage of women who need IVF to get pregnant. further, i happened to fall into an even smaller percentage who get severe OHSS. so, at this particular junction i'm *not* interested in playing odds games. however, i can't write prescriptions for myself (yet) and so the best i could do was secure a pro.metrium script for the next several weeks...and i'm sure earn a few "crazy lady" doodles next to my name on my chart.

so my last PIO was thurs eve and i woke up yesterday (sat) with a small amt of pink spotting. i spotted all day. you can imagine the lovely state i was in. i think i put so much progesterone up my vag that i'm suprised it wasn't stuck shut. by yesterday eve my attempts at remaining calm had failed me and i paged the IVF dr on call (mind you i have been passed off to OB at this point, but at my appt last week i was really unimpressed with the level of knowledge they seemed to have regarding early pregnancy, complications etc.). thankfully they returned my call and i drove an hour to the clinic on sat night at 7pm for a thorough wanding.

science babe looked great. waving it's little arm and leg buds, bobbing it's ginormous, egg-like noggin. it's father has a ginormous head, the ramifications of which are just becoming clear to me now. hb 164. i'm sure the collective IVF team thinks i'm just a big pile of crazy at this point, between the begging for shots, wheedling for pro.metrium, saturday evening scans, etc. etc. etc. however, in my defense, spotting 3 days after discontinuing PIO will cause panic. it just will.

oh well. this gets better, right?

Ok

i begged, borrowed and stole my way into a quick sono this AM and it is still there. Someday, at some point, this will seem less tenuous. i hope sometime sooner rather than later.

crazy doesn't necessarily mean wrong

so, i've decided not to rent or buy a doppler until another U/S confirms a hb. Ditto for any maternity clothes, including bella band. so, i'd better not gain ANY MORE WEIGHT until i have another u/s or i will be utterly without clothings to cover my shocking paleness with.

i guess i'm happy that i haven't had any morning sickness to date (the only thing i had vomiting with was the OHSS) but a little bit of pukiness just to let me know things were OK wouldn't be terrible. famous last words i know, but i thought i'd put it out there.

tomorrow i have OB "orientation" at beth.esda na.val. possibly the most inconvenient place to get to EVER. i can't wait to see what the orientation entails...if it's anything like the IVF orientation was, i'd call it a solid waste of my time. but i'll go if i can get another sono out of it. *crosses fingers*

it has occured to me recently that perhaps t.o.m cr.u.i.s.e was not so much crazy as just more brilliant than our feeble minds could comprehend...seriously. if i had his kind of $$ to throw around i would not hesitate, pass go, or collect $200, but instead simply dash my bruised, knotty PIO heinie down to the nearest sonogram store and plunk down some cash.

sono glow=2.5 minutes

i am utterly exhausted all the time, as well as vaguely nauseous and more than a little backed up. my body, it is a wonderland.

my mind, however, is a deep black pit. it wonders if i should fabricate symptoms to go to an ER where i can spend 5 hrs waiting just to get a sonogram to tell me there's still a hb. it's a good thing i'm too lazy to listen to myself much.

i'm contemplating renting a doppler, but i can't tell if that will lessen the crazy or make it worse :?

ba-thump

we transferred two but there was only one, measuring 7w1d (i'm 7w2d), hr 145, otherwise normal looking for an embryo the size and shape of a bean.

***exhales***

i know it's shortlived, but i'm hoping the sono glow lasts at least 24 hrs. :)

oy

well, the hb scan is weds am and i am brimming with DBT's for the occasion. my head is going to be a particularly unpleasant place to be for the next 36hrs or so.

does being on PIO mean any m/c signs are masked? does anyone know? i'm just wondering...

back from haiti

typical depressed look of a malnourished child. this child is at a refeeding ctr


sad child with severe kwashiorkor at orphanage



giving tetanus vax at a health fair



i am back and hoping to relax. i am exhausted, and everyone keeps telling me how exhausted i look.

to my knowledge i did not m/c while i was there, which just makes me super pissed at my mom for basically telling me nonstop for a month that going = automatic m/c. i want to confront her about it but i'm too tired to tip at windmills right now. so, basically i'm avoiding her.

the hb scan is weds am and i am really really nervous about it. i know it isn't everything...it's just another hurdle in a long line of hurdles, but i'm putting alot of stock in it for some reason. i feel like i might be able to relax if i "pass" that test, if i don't...i don't know what i'll do. get by, i guess.