Feeling Pregnant

The nausea and exhaustion has really kicked in full force in the last week. I have been feeling a little queasy the last few weeks, but it was mild enough that I could ignore it. This last week, though, I have gotten to the point where it can be difficult to eat anything other than fruit and cornflakes -- not exactly a balanced diet. Sometimes, I can manage a normal lunch, but almost never anything significant for dinner. I can't really eat any red meat and often even chicken can be problematic. Y has been making me these protein shakes, so I will have some protein in my diet. I hate those things even when not pregnant, but I have still been managing to get them down.

I get pretty tired around mid afternoon. I work at home a lot of the time, so it is tempting to go lie down, which I really need to not do from an employment perspective. Before T goes to bed, we usually let him watch Sesame Street for a half hour, so I have been having him watch on the TV in mine and Y's bedroom. I keep failing asleep during the show, so Y tends to find the 2 of us together passed out in the bed. Now, when I tell T it is time to go to bed, he walks to our bed instead of his crib -- not good.

My sense of smell has also really increased. Walking around the streets of NYC or even just walking through the Mall can be a real sensory assault. I have also noticed the T's poopy diapers, which never smelled good to begin with, seem really awful to me, so that is not helping in the nausea department either.

I'm also feeling the reality of the pregnancy setting in because I have gone ahead and scheduled my various 1st trimester appointments and testing. My first OB appointment is a week from Monday, which is great, because it is MLK day and I'm off already, so I won't need to schedule extra time off.

I am going to do the Ultra-Screen diagnostic test for 2 reasons. The Ultra-Screen is primarily a diagnostic test used to assess if the baby is at elevated risk for Down's Syndrome, Trisomy 18, and other genetic disorders. One of the components of the Ultra-Screen is a blood test for PAPP-A and this was the blood test that I had when pregnant with T that came back abnormally low, which, in addition to increasing risk for Down's Syndrome, correlates with placenta problems later in pregnancy. If my PAPP-A comes back low, this would be the first indication that I may be likely to have placenta issues again this pregnancy. If the Ultra-Screen shows elevated risk for a genetic disorder, I will go ahead and have CVS done. If there is not an elevated risk, then I will likely wait and do amniocentesis instead. I had a very good experience doing CVS my last pregnancy. The procedure was not very painful and it was great to know I was having a genetically normal boy at only 13 weeks. However, CVS does involve removing tissue from the placenta and, given my history, I don't want to needlessly disturb the placenta.

Scheduling the CVS after the nuchal scan that is part of the Ultra-Screen was a bit of a challenge. The Ultra-Screen needs to be done no earlier than 11W1D and it is best if I can get the CVS performed before 12W0D. To further complicate issues, if you will recall, my RE and I don't really agree on the dating of my pregnancy, so there is a potential difference of 2 days. Risk of miscarriage from CVS depends very heavily on the experience of the doctor doing the procedure. There is a practice in NYC where women come from around the world to have CVS done -- that is where I had my CVS done last pregnancy and really the only place where I would consider repeating the procedure.

What I worked out was that on January 30th, I will have my nuchal scan and, at the same time, my 1st appointment with my perinatologist. Unfortunately, they are also forcing me to have an appointment with a genetic counselor even though I had multiple genetic counseling appointments during my first pregnancy and I know all the potential issues associated with diagnostic and more invasive genetic testing. I'll be 11W3D by my dating and 11W1D by my RE's dating of the pregnancy.

Then, on February 3rd, I have a tentative appointment setup for CVS. This is at another hospital, so, unfortunately, I am being forced to have yet another genetic counseling appointment before the procedure. CVS can be done either vaginally or abdominally, but these doctors will only do CVS vaginally if the fetus measures less than 12W0D by ultrasound. I'll be 12W0D by my dating of the pregnancy and 11W5D according to my RE. The timing is a little tighter than I would like, but it was the best I could do.