Thursday, December 18, 2008

Three Strikes At The Super Mega Extreme ULTRAsound

Strike One

When I first found out I was knocked up, the infertility doctor's office wanted me to come in right away to give me an ultrasound. I guess to be sure I wasn't faking it, even though they'd already made me do the blood test thing. So I did go in, and the doctor stuck that microphone-looking ultrasoundery thing up there (yes, "up" not "over") and searched around while Ish and I stared quizzically at the screen and I tried to pretend I was having a normal morning.

"I'm not seeing anything," The doctor said, looking at the black-and-white blur.

And I immediately thought what any possibly-probably-maybe pregnant woman in stirrups with a giant camera up her hoo-ha would think: Don't tell me I'm doing this for nothing.

Mind you, this is the same doctor who also couldn't see my ovaries with the vag-mic. At that time, he'd said my ovaries weren't showing up either because they were "hiding," or because they were too small to see or produce eggs. Potato, potahto.

(That's sarcasm, folks. I wanted to scream at him. WHAT DO YOU MEAN, YOU DON'T KNOW? WHAT DO YOU MEAN, I'M EITHER FINE OR INFERTILE?)

Anyway, back to the recent past. The doctor eventually angled the vag-mic into a wildly uncomfortable position, like he was trying to poke at my belly-button from the inside. Suddenly a spot appeared on the screen.

"Oh, there it is." Nothing in his demeanor or facial expression changed when he said this. Perhaps he was wondering what to order for lunch. I wanted to kick him in the face. (Wouldn't have been too hard, seeing as his head was about level with my stirrup-ed heels...)

He then went on to explain, while continuously prodding at my uterus all Alien-through-the-stomach-like, that he couldn't get a good reading but it seemed as though Spot was exactly six weeks, 5 days old. Which would put Spot's due date at June 25. Which is exactly what BabyCenter had already told me and it didn't have to come anywhere near me with a giant, lubed-up vag-mic.

He concluded our meeting by saying I should schedule an ultrasound with the Ultrasound People who were apparently located "downstairs." Because they have better equipment and will be able to confirm that Spot is fine and has a heartbeat and everything. Um, okay.

I didn't leave that appointment feeling reassured in any way.


Strike Two


I returned a week or two later to get the Better ultrasound done. While still early, I was hoping that I would see Spot moving or doing something cool. Like be demonstrably alive.

This time, I had to show up with a full bladder. They tell you to drink 12 oz of liquid an hour before your appointment and to hold it.

Ladies and gentlemen, I say to you OH MY GOD. I pee every four seconds as it is. Trying to hold 12 ounces of water for an hour+ is absolutely torturous. But I did it.

I showed up, signed in and sat in the waiting room crossing my legs and trying to think about very dry things. Eventually my name was called (15 painful minutes late, mind you) and Ish and I were escorted into a room with the high-tech ultrasound person called a "sonographer."

You want to know how I know she was called a "sonographer"?

Because. I went in, took off my clothes from the waist down, got up on the table, laid back. She took out her OVER THE BELLY wand (yay! no vag-mic!) and proceeded to see if she could find my bladder so she could press down really hard on it. At least, that's what it felt like. It was painful and weird. AND HERE'S THE BEST PART. The screen was not visible to me. Ish could see it and the "sonographer" could see it, but I could not. I had NO idea what the screen looked like. I just watched her face.

Finally, she spoke: "Do you know why you're here?"

Was this a trick question?

"Because they want to confirm that I'm pregnant, and the age of Spot, and to make sure there's a heartbeat."

She continued to make faces at the screen while testing to see how much longer I could handle not leaking all over the table. She did not, however, reply.

"Uh...so...do you see a heartbeat? Does everything look okay?" I finally asked her in desperation.

And do you know what she said?

She said, "Oh, I can't tell you."

!!!!!!!!!!!!!!

She pointed to the sign on the back of the door. It read something like, "Sonographers are not permitted to make medical assessments. If you have any questions, please contact your doctor directly."

I thought I would cry, but luckily I had all the pain and uncomfortability of a near-to-bursting bladder keeping me distracted.

And just when I thought things couldn't get any more fun, she put the "over" wand away and busted out with the "up" one.

"I just want to see if I can get a better reading with this one."

Sigh.

When it was all over, and I had gone to the bathroom, and we were heading out of the office, the "sonographer" said that the doctor should call with my results by the end of the day. She added, perhaps taking pity on us and my bladder, "There is a heartbeat. It's just -- there's more than that, so be sure to talk to your doctor."

It then took TWO DAYS for me to hear from the doctor's office. Wondering what "more than that" meant. Maybe Spot had a heartbeat but no feet? Maybe there were three Spots? Who knew. So when I finally heard from the office, all the person on the phone said was "Oh, everything looks fine." Which is certainly better than any alternative, but COME ON.

I then had to schedule my first "normal" appointment with the "normal" OB department, I guess because the infertility people consulted with the "sonographer" and decided I should be scooted on over to the "regular pregnant people" office. Or something.


Strike Three

My appointment with the normal OB nurse wasn't until about two weeks ago. And while my appointment was mostly to tell me all the normal stuff -- don't eat sushi, don't use hot tubs, take pre-natal vitamins, sex is fine -- it started off with an ultrasound.

This time, I was pretty excited. I figured I was at about 11 weeks and should be able to see something. Dooce had seen a little thing flapping around by this time. Surely I would, too! Surely there would be an improvement over Spot and "reflection on sonographer's face"!

So out came the vag-mic.

Again, it took some prodding and poking before the nurse could see anything. At least she offered, "It's because of how your uterus is tilted." Good to know, I guess. Hi, my name is Kristy and I have a tilted uterus.

But then again, there it was. I could definitely see Spot on the screen. I couldn't see movement or make out limbs or anything like that, but there was a thing, and it had a head and a not-head, and I was very happy.

Again, however, the nurse just squinted at the screen.

"It's not a very clear image." Sigh. No, of course not.

"I've heard that being overweight can affect the clarity of ultrasound images. Do you think that's what's happening here?" I offered. No one had mentioned anything about my weight ever, so I was curious.

"That can happen, but I don't think that's the problem here. I think it's just the angle of your uterus."

She tried again to use the super-mega-extreme-ultra-sound to figure out when my due date was, exactly, but said the image wasn't good enough to say for sure. It was looking like July 1, but that might not be accurate.

She finally stopped with the wand, gave me the rest of an exam (your left nipple might be flatter than your right nipple, are you planning to breast feed?), and told me to meet her in her office. There, we discussed all the fun, DON'T DO THIS WHILE YOU'RE PREGNANT stuff.

Decided it was probably best to stick with my original due date of June 25, but it could be later (this sucks only because I am very VERY anxious to be out of this first effing trimester of terror), and scheduled my CVS test.

For today.

But I'll get to that.

My point, really, is that I feel pretty good and am trying to be positive and confident. But I already feel like I'm at a disadvantage. I've had THREE ultrasounds, and none of them were especially conclusive. No swimming or flapping around. Nothing but medical professionals squinting at the screen.

I left that last appointment and went home and cried. Maybe next time will be better.


* * * * * *
I go in for my CVS test this afternoon. CVS is, essentially, an early amnio. They stick a large needle into you and take cells from the fetus and then watch those cells develop for a couple weeks. At the end of that time, they can tell you most conclusively about any genetic disorders Spot may have.

Unless there are complications, we will find out if Spot has Fragile-X, among many other very scary-bad chromosomal disorders.

I don't know what we would do under the various possible circumstances. Probably nothing, probably in every case. But we want to know, and we want to know sooner than later. That is what we decided.

The chance of miscarriage is supposedly increased, though they aren't sure by how much. Current figures say anywhere from 1 in 200 to 1 in 360. I'm trying not to think about that.

Instead, I'm trying to think about getting to see -- hopefully, finally, for real -- a good, solid image of Spot. One that doesn't make the medical professional holding the vag-mic squint and go mute.

I'll let you know how it goes.

28 comments:

  1. Shiree in Salt Lake City10:06 AM, December 18, 2008

    First - a very warm hug. I know what you're going through. I did it 16 years ago.

    I am happy to report that Spot 1 is now a very beautiful, very talented 15 year old girl, and Spot 2 is a moody, quiet and handsome-like-his-wonderful-dad 12 year old boy.

    The anxiety and disomfort will be a dim memory whe you are holding the perfect baby that the medical professionas told you that you would never have.

    I'm sending you warm, healing white energy...all will be well, believe in yourself and Ish amd use your guardian angels!

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  2. I hope everything turns out okay. I was "high risk" with both my pregnancies (overweight, diabetic, and - with the second - AMA, which is their kind abbreviation for Advanced Maternal Age). I had CVS and amnios and lots and lots of ultrasounds. I understand what you are going through and wish you only the best. The odds are in your favor for a positive outcome. Hugs!!

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  3. The sonographer can't tell you if there's a heartbeat? That's bullshit. So sorry you had to go through all of that. They should know better than to keep you hanging like that.

    Good luck with the CVS today. All of these tests are very nerve-wracking, but I agree that it's better to know all of these things sooner rather than later. Sending good thoughts your way.

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  4. Good luck! And for the record, the "overweightness" does NOT affect their ability to see during an internal ultrasound, but could definitely affect the external one. I also think that requiring pregnant women to hold in urine should be a crime. The first few ultrasounds look like a hamster anyway...
    We had the amnio this time around (because like someone above mentioned, I'm AMA - hey, at least they don't call us "elderlies" anymore!), and it was all good. Hope the CVS goes as well as our amnio did!

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  5. Doctors are all bastards.

    You are in my thoughts during this tough time! I am crossing my fingers for you that all is clear and wonderful in the CVS test results!

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  6. Good luck today!

    my cousin had a very hard time with pregnancies, but she has two fine healthy boys now, so I believe everything will work out well for you too.

    *warm thoughts*

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  7. I'm sending tons of good thoughts and vibes your way today.
    They've really left you hanging, and to put it eloquently, that really really sucks.
    My fingers are crossed over here in Maine.

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  8. I'm so sorry. This part is hard, the waiting. At 10 weeks I had a LOT of bleeding, was convinced I was having a miscarriage, and the "sonographer" wouldn't tell me if there was a heartbeat when I went to the emergency room. She could have saved me a lot of heartache while I waited, crying, to see the doctor. Fortunately, the baby was fine and is now 14 months old and trying to tell me he's done with his nap. I disagree. Let's see who wins.

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  9. I remember the bladder thing SO WELL! It is so painful and makes you want to pee everywhere!

    I had twins and somebody was down there every week. It blew.

    I just know that Spot is fine, I have a feeling about it.

    You are a great writer!

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  10. Oh this is all SO STRESSFUL! I'm sorry that these experiences you mentioned have been less romantic and more frustrating ...

    I think Spot is going to be ok!! I really do ...

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  11. How stressful! I'll be thinkin all sorts of postive thought for you! (love the nickname too btw)

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  12. Ah, yes. The full bladder. My personal favourite? "Please go empty some of it, one cup full" as they hand over a little styrofoam cup. Have you ANY idea how difficult it is to empty some of a very, very full bladder? Well, I'll tell you - it's VERY freaking difficult. Also, it's an excellent reminder to keep up with one's kegels.

    I hope all go goes well with your testing today.

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  13. Yeah, a full-bladder ultra sound is the worst! Good luck!

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  14. Oh, I remember the full bladder ultrasound. My favorite part was when they called us back (45 minutes late!) and I made a half-joking comment about how desperately I needed to pee and the sonographer said, "Oh, the full bladder thing? It doesn't really matter." I managed to resist the nearly overpowering temptation to pee all over her hand.

    BTW, I don't read Dooce, but I have had 3 kids and I DO NOT remember anything visibly moving on an ultrasound (except a flickering heart beating) on any ultrasound before about 15-16 weeks.

    Good pregancy vibes coming your way!

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  15. Ugh, here's hoping for a perfect amnio. And if you haven't considered it, and you can take my assvice with a grain of salt, but I have heard it said that pregnant ladies are generally sensitive. Adding any complications or possibility of complications will make it worst. You might want to get a new doctor or see if any of your friends/coworkers has a good recommendation for a good practice. Yeesh.

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  16. Good luck Kristy! I'm sure your CVS will come back fine.

    All the "if's" aren't so bad either, really.

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  17. how very frustrating! The sonographer can't make MEDICAL assumptions but she SHOULD have told you "everything looks good" or "I don't see any problems" or SOMETHING.

    And you are entitled to KNOW what's going on. It's your body and your pregnancy. Call your OB's office and DEMAND to know what they know. Legally, they can't keep that information from you.

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  18. Do you get the feeling that they go out of the way to hire the least sensitive to people to deal with the most sensitive patients?

    Do they have no idea how a pregnant woman interprets every glance, every squint, every verbal hesitation by a medical professional as a reason to worry?

    I think they do it on purpose.

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  19. I have to wonder, with all the things that science has achieved, why does the interior space of the female reproductive system continue to be such a source of mystery? Although I have never been pregnant, I spent a good part of the last few years having mine examined, prodded, scraped, biopsied-- one procedure after another, only to have them say "we don't know". The full bladder ultrasound-- I had that too, the "inside wand" kind. The results? "Can't tell from the picture."

    Uterus: the final frontier.

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  20. oh my goodness how frustrating! I am sorry you are faced with so many strike outs! ugh.
    oh and doesn't cvs sound like a grocery store?

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  21. I had the worst sonograms ever. I had a sonographer call in 2 doctors and we found out our daughter had severe heart defects. I remember they just shuffled us to a hallway and said, "Call your doctor after tomorrow." It was the worst experience in the world, feeling so uninformed with what was going on in MY OWN BODY.

    In hindsight, I'd demand answers. Lots of answers, and to be treated with more respect. You deserve that, too. This is one lesson I've learned as a mom: You're sometimes the only one sticking up for you and your kid.

    Good luck! Sending some healthy baby vibes from Austin...

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  22. This is the first time I've been to your site in ages. I din't know you were "in that way"! Congrats to you and Pete both and I look forward to what imagine to be years of hilarious and moving posts. Nimmi

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  23. Hang in there.

    I've had many, many ultrasound and a lot of them were scary.

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  24. OMG are these people completely heartless? Seriously, they need to go to class about how to be human.

    I get to do one of those "fill your bladder to bursting and then wait around while the do their test" things in a couple of weeks. Possible fibroid we're investigating.

    Your story made me laugh but I think I'm gonna be bummed the day of.

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  25. Keep sugar around for your friends, and for your own use in minute amounts. Flour and cornmeal get used from time to time, but in very small measurements. A handful of rice or beans can be good in soups. Crossovers from me old diet world - and there are precious few - are cottage cheese, celery, some other vegetables (but not carrots), and some fruits (but not bananas).

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  26. That is just crazy! I'm overweight too and high risk because of other complications and my "check to see if you're preggers for sure" ultrasound with the vag-mic at 7 weeks took 15 minutes, I got to see live action heart beat on a monster flat screen, AND took home a picture that looked like a lima bean. Plus she told me everything looked perfect and to keep up the good human growing work!

    I'm so sorry this process has not been reassuring to you. I just want to go kiss my ob/gyn full on her skinny-girl lips I feel so lucky now...

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  27. hi :) i sporadically drop by your site because i have no life and i try to live vicariously through others who DO have lives that i wish i had (did that, in any way, make sense?).

    on the side of the doctors and sonographers and... basically, on the medical side, in their defense, and just to explain some things in the hopes that you'll understand them (and i hope it'll lessen your ire some :))...

    1. ultrasound people can't say anything because they're not 'medically trained' and if they say something and the doctor says otherwise, the patients can sue (especially if it's a major thing) or quote the sonographer back to the doctor and... let's just say it can just get confusing for all parties concerned.

    2. full bladders are usually needed for ultrasounds to be able to see the uterus better because the uterus is located behind the bladder. and if the bladder is not full, it can give a wrong reading.

    um... hope that helps. or at least, makes it bearable :)

    btw, congrats to you and your man on getting pregnant! :)

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