Paul & Sarah

Great appointment today. Confirmed something important about our baby: it’s a little punk. Misty (Dr. Schwartz’s nurse) spent a good 15 minutes trying to coerce the little critter to show us the goods. We were looking up at it’s bum, like we were under the invisible little chair it was sitting on. But the baby just wasn’t about to open it’s legs and confirm what we thought we saw. The baby was flip flopping and bouncing around (maybe because of the two sips of OJ I had right before the ultrasound) but not about to show us what we wanted to see. DANGIT. Next time… (Misty and I both thought we saw something, but she wasn’t confident enough to call it.) It continues to seem odd to me to see the baby doing crazy acrobatics and I still can’t feel ANYTHING. Hopefully soon.

Dr. Schwartz was great about answering questions today, having been prepped by my e-mail last week. We covered a lot of things today:

• I only gained half a pound!! Holy cats! I was totally shocked. I was honestly expecting a gain of 4-6 pounds because my clothes are totally fitting different (way tighter) and well…. I’ve been eating more than I ever have cuz I’m starving all the time!! Dr. Schwartz was happy to see the small gain, but cautioned me that I need to make sure that I actually am eating enough since the baby does need a fair amount of nutrition for all the growth it’s doing these days. He totally gets that my brainmeats are making it hard for me to eat as much as I apparently need to. At my next appointment he’ll be checking to make sure that the baby is growing and gaining weight as expected. But he was supportive (as always) that I must be doing things pretty well as far as nutrition and calories because my blood sugars are consistently improving, and my a1c results (like a 3-month diabetes report card) were down to 6.0 (from 6.5 and 6.3 the last two times it was checked.)
• Speaking of proper nutrition, my Muscle Milks are TOTALLY FINE. Contrary to what the morons at GNC and Vitamin World yelled at me last week, there’s NOTHING of concern whatsoever for pregnant women to have protein shakes. The L-Arginine in the shakes (as a form of protein) is also found in most nuts. L-Arginine has been found to help with placental growth retardation, as well as preeclampsia: both of which I’m at risk for! (The lady at GNC was yelling at me that I was going to have a GIGANTIC, over-grown baby because of drinking protein shakes, and that my doctor was stupid for allowing them. Dr. Schwartz asked which GNC it was cuz he wants to have a word with them.) So I can happily keep drinking my yummy High-protein, Low-carb, vitamin-rich shakes. Hooray!!
• The swelling in my ankles/feet is nothing to worry about yet. Dr. Schwartz thinks I’m just prone to swelling. (I’m getting a fair amount of swelling in my wrists too.) He encouraged me to continue to keep my feet up as often as possible. He agreed that striving for good hydration is a good idea, but that it won’t help this kind of swelling as much as it does for regular hot-weather swelling. He cautioned that it’s not gonna be fun towards the end of my pregnancy when it’s hot, cuz then I’ll have both types of swelling working together. Oy. (Oh, and apparently a restless legs / ants under the skin feeling in the evenings is normal too. Wheeeee.)
• He also commented that towards the end of my pregnancy, he expects to see me twice a week for nonstress tests and whatnot. So I’m gonna have to work something out with him for scheduling, and work something out at work so that I burn as little of my paid leave as possible. (Maybe I can just not take a lunch EVER AGAIN.) I’m really concerned about my maternity leave. I’m taking as little leave as possible for my appointments, but any leave I take comes directly out of what I’ll be able to take when the baby is born. I have to take 8 weeks off because the daycare won’t take infants under 8 weeks – but there’s no way I’ll have that much paid leave saved up – especially if my appointments move to once a week or more. Unfortunately, we need both our salaries – so I’m not sure what we’re gonna do for several weeks that I’m gonna have to take off unpaid. I guess that’s what credit cards are for, right?
• So, because I’m doing so well (blood pressure was lowest it’s ever been, blood sugars are consistently lower, weight gain is very small) I’m cleared for another 3 week appointment. No changes to my insulin or blood pressure meds for the 2nd appointment in a row! So I’m set for Wednesday March 24th at 3:00pm. (Dr. Schwartz is taking me as his last appt from now on so I can burn as little paid leave as possible – he just has to leave by 4:00 to catch his flight home.) Edit: I changed my appointment to the first of the day at 8:00am, because I actually lose less work time by going in the morning. Those first-thing appointments go fast tho, so I can’t always get them. There will be a full ultrasound at the next appointment to check growth and (hopefully) confirm sex for us.
4 Comments | Tags: changes in me, clothes, development, Doctor Appts, testing, Ultrasounds

• The raging psoriasis on my arms is gone. Apparently it’s a common occurrence during pregnancy because of the elevated estrogen levels. (I was surprised that it wasn’t from the progesterone, since that stuff seems to be responsible for everything else!) The stuff on my head is not nearly as bad, but I have been using a medicated shampoo for the first time ever – so I’m not sure what’s fixing that. (For those who don’t know, I have really horrible psoriasis on my arms: unsightly and extremely painful.)
• I’m still not feeling anything from the baby. Really beginning to bug me. I think I’ve felt a flutter or three, but nothing more than that and not for over a week. Dangit, I’m more than halfway done with this process…. I wanna feel something! Plus, it’s just disconcerting to not feel anything. I want some sort of confirmation that everything is OK in there. I poke and poke at my belly, and I can feel the honeydew melon in there… but no response from it’s tenant. Wah.
• Speaking of that honeydew melon… bending over is a thing now. Like, I avoid doing it now. It doesn’t hurt, but it’s not comfortable. And I figure if it’s not comfortable for me, it can’t be enjoyable for the baby. I’m noticing it more when I get into bed too these days. We have a fairly high-up bed, so it’s a bit of a climb to get in. Lifting my leg up that high kinda shoves everything up. Maybe it’s time for a little step-stool.
• I have an appointment to see Dr. Schwartz on Wednesday afternoon. Dr. Schwartz said we could take another look and see if we can find out the sex at this upcoming appointment. I really hope the baby cooperates this time. I’m gonna drink orange juice on the way over to the appointment to wake the kid up. I REALLY wanna find out the sex. I’m pretty sure it’s a boy, but confirmation would be great.
• I’m gonna talk to Dr. Schwartz about a bit of swelling I’m having in my ankles. Most days my ankles are a little swollen by the time I get home from work. If I put my feet up for a little while it goes back down, but it’s a little worrisome. I’m really concerned about pre-eclampsia, so I’m on watch for any symptoms.
• Lastly, I’m STARVING. Like all the dang time. Doesn’t seem to matter what I eat, I’m ravenous again within 2 hours. I’m trying to make healthy choices, but it’s still worrisome. I’ve never been this hungry, this often in my whole life. It’s hard to deal with, cuz I know I’ve gained weight. Granted, I know that some weight gain is expected – cuz ya know, the baby is growing… but when you live your entire life trying to avoid any sort of weight gain, it’s hard to get right with this gain. (Plus the books and websites say I should gain somewhere between 0-14lb for the whole pregnancy, which short of living like I’m training for a marathon doesn’t seem possible or realistic.) I wake up a couple times a night to pee and most nights I’m starving for at least one of those trips to the bathroom. Usually I just ignore it and go back to bed, but then come 7:00am’s alarm I’m so hungry I’m nauseous. But eating in the middle of the night just seems so wrong. So yeah, there’s that.
3 Comments | Tags: changes in me, development, Doctor Appts, emotional hoo-ha, movement, Ultrasounds

For those waiting with bated breath: WE DON’T REALLY KNOW. Sorry.

Our kid is a little stinker. The baby spent basically the entire time sitting on it’s butt, directly on top of my cervix. The tech tried and tried to jiggle it outta position, but nothing doing. (a couple of Andes mints didn’t help either.) She had a hard time even getting the measurements she needed for the anatomical ultrasound (femur, abdomen, head) because the little critter wouldn’t cooperate. And the couple of times it did move where we could get a look: it put it’s hand(s) between it’s legs.

But the good news is that Dr. Schwartz says everything looks fine. Some of the measurements are measuring “ahead” by nearly two weeks, but Dr. Schwartz says that’s because Paul and I are both tall, so we’re having a tall baby. It’s weight clocked in right at 8oz.

For those interested or who know what on earth this relates to:

• Head Circumference: 16.25cm (6.4″)
• Abdominal Circumference: 12.42cm (4.8″)
• Femur Length: 2.5cm (1″)

The heartrate came in at 161, so according to old wives – it’s a girl. Dr Schwartz and the tech gave us a guess, but they both strongly cautioned us not to paint anything yet. I tried to explain to Dr. Schwartz that I’m a planner and I really need to know… he chuckled, told me to deal, and then listed his favorite neutral nursery colors.

Paul’s mom Jeanne came along today and seemed to really enjoy herself, especially when the tech turned up the sound and the WHOOSH-WHOOSH-WHOOSH of the baby’s little galloping heart stopped our chatter for a moment. I wish the kid would have cooperated a bit more so she could have seen it wave and face us like Paul and I have seen before. I invited her to come to the next appointment if she wanted to, since we’ll try again then to get/confirm the sex.

In the meantime, there’s new pictures that I screen grabbed from the DVD we got today. (I’ll get a DVD of the next appointment too.) They’re mostly body parts, but there’s a couple cool profiles – and an awesome 3/4 full face image from the heartrate image. It’s small, but if you’re good at all for looking at ultrasounds, I think you’ll see it. It’s kinda like the face on the moon… the baby is looking to the left. You can see the chin, lips, nose, cheeks, forehead and a dark hollow where the left eye is.

The rest of the appointment was pretty ordinary. Insulin and one BP med were upped a tad. Weight is up .5lb for a total of 4.5lb in 18 weeks – just fine. My next appointment is in 3 weeks, which is great. The fewer appointments I have for a bit, the less paid leave I have to burn. (Last week’s illness cost me 3 days of maternity leave…) They drew blood for TSH, a1c, and the 2nd part of the quad screening. (Dr. Schwartz took a copy of a bill I got from the lab for $700 worth of “genetic” tests that my insurance is denying from my first visit in November… I LOVE that he’s willing to take on that kind of stuff for his patients.)

So for now I guess we’re looking at more gender neutral stuff, since we might not find out the sex of our little stinker until July!

Today’s appointment would have been very short were it not for the uncharacteristically long waits in the waiting room and in the exam room.

My weight is down a pound, my blood pressure is in a happier range, and my blood sugars are making Dr. Schwartz smile. (For once he didn’t change my insulin dosage!) Dr. Schwartz walked in the exam room, looked at me sideways and asked “How’s your boobs?” (I emailed him last week about a sudden re-occurance of tear-inducing breast pain. Turns out it’s just another Joy of Pregnancy^TM. But he did offer some advice on bras and whatnot that he assured me he had to research, as opposed to knowing off the top of his head. I’ve linked the worst of the pain to a ridiculous sensitivity to cold, so I’m making sure to stay well covered up, especially at night. Because crying during one’s morning shower sucks.)

We chatted a bit and he reassured me that I’m doing fine, baby is doing fine and if I wanted, I could space my appointments out to three weeks for a while since he’s confident that I don’t need to be ‘checked on’ as often now that we’re out of the scary 1st trimester when so many things can go wrong. (Holy run-on sentence, Batman!) I’ve even been given leave to stop e-mailing him my blood sugars if I don’t want to. (I think I still will though, cuz I feel like I’ve barely got a handle on them.) I think I’ll start spacing out the appointments though, so that I don’t burn any more sick leave than I have to. The more I can horde, the longer I can stay out on maternity leave.

The next appointment is February 10th which will be lots of bloodwork (including the quad-screen to follow up the 1st trimester’s triple-screen) and the BIG anatomical ultrasound – so it should take nearly an hour. We’ll find out the sex, assuming the little critter cooperates.

Speaking of the little brat… We tried to see the sex today, but the critter was having none of it. It turned it’s back to us three times. The tech actually had trouble isolating the heart because the baby wouldn’t stop flopping and flailing around. I was disappointed that I didn’t get much of a look, but I’m OK with not knowing for two more weeks. I’d really like Paul to be there when we do. We’ll be sure to get a DVD of the next ultrasound, and hopefully it will include some good pictures.

Quickest appointment yet today. But I guess I’ll be having more like this for the next couple of months.

Took a quick look at the baby, mostly to check the heart rate (160, just like it has been.) Didn’t get a measurement, but the critter obviously bigger than it was two weeks ago! (According to the intertubes, it’s 3-3.5″ or roughly lemon-sized.) It was just kicking back, with it’s arms up, like laying in a hammock. The tech got two pictures, but they’re pretty fuzzy. It was bobbing it’s little head, but not dancing like last time. (This appointment was at 3:00pm, whereas my others have all been before 10:00am… so maybe afternoon is siesta time?)

Dr. Schwartz went over my 1st trimester screening results with me and things are looking great.
Downs Syndrome result is 1:4800 (chances of the baby having DS are one in 4800 similar births.) The baseline chances for someone of my age with my health profile was 1:320, so the actual test results tell a MUCH better story.
Trisomy 18 result is 1:2350, which I guess is very good. Dr. Schwartz says anything over 1:100 is fabulous.
Based on these numbers and the great results on the nuchal fold screening, there’s no need to seek further testing (like a CVS or amnio) at this time.

My a1c is down to 6.3 from 6.5 when I first got pregnant. (The a1c is like a 3 month report card on my blood sugar control. Anything below 6 is non-diabetic territory, so I’m doing fabulous in this regard which basically negates any diabetes-related risks to the baby.) Thyroid is creeping up a little, which is expected. My thyroid meds will prolly get adjusted at my next visit, if for nothing else than to negate the fact that I’ve got 30% more blood volume now. My blood pressure was lower than it has ever been – which means the new med (Methyldopa) that was added to my regimen last time is working. Still on the high side, but Dr. Schwartz was happy to see some movement on that, finally.

I e-mailed Dr. Schwartz yesterday with a couple of questions, so he’d be ready to be interrogated. Got some surprising answers, not what I was expecting from the reading I’d been doing in books and online.

Delivery: Currently Dr. Schwartz is planning on letting me go to 39 weeks – so delivering around 7/10/10. (If I went to 7/11, this would be the 3rd kid in my family with that birthday, which includes my brother!) He wants to avoid a C-section if at all possible. Vaginal delivery has a lot of benefits to the baby, but mostly he doesn’t want me to have to deal with recovery from abdominal surgery. He feels that at my current weight and as a diabetic, recovery would be less than optimal and that I would be in a lot more pain & have a longer recovery than average. He’s totally open to a C-section if it becomes necessary, but has every intention of inducing me first and letting me at least attempt to labor. He said that actually he expects me to do well with a vaginal birth. So YAY for that. I’m not all crunchy granola and ‘needing’ to try to push the kid out – but I’m totally open to the experience. I am also totally open to the epidural as soon as they’ll let me have it. :)

OMG pains: Apparently mostly what I’ve been experiencing in the last two weeks has been “low pelvic pain” as opposed to “round ligament pain” My pelvis is splitting apart and it’s totally normal. Hurts like hell and scares the crap outta me when it takes my breath away or wakes me up in the middle of the night, but it’s normal. So whee and hooray for being pregnant.

Bedrest: Currently not a big concern. Dr. Schwartz says I’m doing fine and that he avoids complete bed rest if at all possible. Apparently high risk pregnant women are at higher risk for DVT (blood clots) when on complete bed rest. He didn’t rule out modified bed rest for the last month or two though – which would mean that if I’m not at work, I’m home with my feet up. (Honestly other than the fact that modified bed rest would mean baby/house prep has to be done sooner, being ordered to go home and put my feet up sounds pretty good actually.)

Next appointment is first thing in the morning on Wednesday the 27th. Dr. Schwartz says we’ll try to figure out the sex at that appointment, but if we don’t get an answer then we will for sure at the next appointment which will be the “big” anatomical ultrasound. So hopefully we’ll know soon!

We have quite a little dancer on our hands. It was flipping and wiggling and kicking and WAVING at us. But it behaved just beautifully for the ultrasound tech – even flipping to the other side to give the tech a better angle for the Nuchal Fold screening.

Paul was just slack-jawed the whole time. I was pointing out what we were seeing on the screen and he was just amazed when he finally started to see the little critter on his own. It was pretty awesome! I was laughing and giggling like a loon every time it waved at us! I couldn’t believe how active the little shrimpy thing is!

There’s new pictures in the gallery, and we’re working on putting up the little movies they gave us. (The tech made us a DVD instead of printing out pictures this morning; how cool is that?) Just click the above picture to get to the gallery (or click the “Gallery” link at the top of the page.)

Nuchal Fold screening went just great. The tech & Dr. Schwartz discussed which picture/measurement to submit for review and the “official” measurement. They decided on the largest measurement she could get, which was 1.21mm. Anything under 3mm is just great, so we were very pleased with these results.

They took a bunch of blood for the 1st trimester screening panel, and gave me supplies to (ick) capture all my urine for 24 hours. So Sunday will be fun. But they gotta check for protein and something else, and this gives them a baseline.

Insulin got bumped up a little more (2 units) and Dr. Schwartz is adding another BP med since I don’t think the Labetelol is really doing anything. But he’s OK with my BP where it is, and is happy to see my blood sugars where they are. Nobody had mentioned my weight to me at any appointments so far, so I asked. Turns out I lost 2lb this time, which seems odd to me, cuz I feel puffier than ever and can’t fit into some of my jeans already.

All in all, great appointment. Paul and I are so stoked!!

Today’s doctor appointment was pretty quick, but still satisfying. (That sounds weird, doesn’t it?)

Paul couldn’t come with me, but that was OK – nothing major to discuss today. Next time I’ll want him there if possible. But today was just a check on me and my meds, and a check on the critter. It’s like there’s two exams happening at once. While the tech is doing the internal ultrasound, Dr. Schwartz is quizzing me on my blood sugars and how I’m feeling and whatnot.

I forgot to ask for the heartrate, but I heard it loud and clear when they started the ultrasound. Sounds like a tiny herd of horses in there! The tech was either really gentle, or the critter is getting big enough that they don’t have to go all Cirque Du Soleil to get a good angle anymore. I think it’s more of the latter.

The little critter is now 3.5cm (nearly 1.5″) and has a face! The tech was able to get a couple of profile shots – so finally it looks like there’s a baby in there instead of some weird cyst. :) It’s still pretty alien-looking with the huge forehead and all, but at least there’s identifiable parts! Well, they’re fairly identifiable on the original printout – if you know what you’re looking for.

I’m doing well too. Dr. Schwartz loves my blood sugar webpage, and wants me to add a column for taking my blood pressure too. We talked about my concerns about my sugars still being too high (especially fasting in the mornings) but he kinda got on me to relax about it. He reminded me that the “diabetic rules for eating” don’t exactly apply to pregnant ladies. He’s not nearly as concerned about my ‘high’ sugars as I am, and is more impressed with my attitude and willingness to do whatever he tells me. He said that he spends entire pregnancies trying to get a patient to make slight changes in diet or whatever and that he rarely has ever seen a patient as motivated as me to make necessary changes. So that was nice to hear. I don’t think I’ve ever had a doctor who has validated the fact that I do try to follow the rules and be a good patient. It’s nice to have someone telling me that I’m doing just fine and to relax. :)

My blood pressure is still too high though – it seems that the labetelol that I’ve been on forever isn’t working as well as it used to. (Personally, I don’t think it was really working before.) He upped my dose again and wants to see what effect that has before changing things again. He’s concerned that I’m gonna be passing out whenever I stand up. :)

Also, Dr. Schwartz volunteered to call my pharmacy and straighten them out about my insulin. They gave him the same explanation they tried on me: it’s my insurance that won’t let me have two vials at once. So after he called me and told me that, I called my insurance again. I talked to a wonderful girl who double and triple checked with her supervisors that I CAN indeed have two vials at once and that Walgreen’s Pharmacy is full of crap. She’s having the plan administrator double check why the Walgreen’s system might be kicking it back though. Once they re-confirm everything, someone will call me back and then they’ll call Walgreen’s for me and explain to them how to do their job. (sigh) Having insurance is supposed to make health care easier, isn’t it?

Next appointment is on December 30th at 9:30am. Really hoping Paul can come to that one. They’ll be doing the nuchal fold test then. But in the meantime, things are progressing just as they should. I’m still pretty dang tired, but that’s to be expected right now.

So um yeah. It's bigger now. 1.5cm to be precise. The fluttering heart was easy to see in the murky orange image. The heartrate was a solid 160 – just as it should be. The new little picture (that still doesn't show anything that anyone can tell) says 7w6d on it, so maybe I'm a little further along. Next appointment is December 16th at 8:30am so Paul can join me again. Hopefully by then we'll be able to actually see something worth showing off.

So we're both feeling pretty good about stuff.

Dr. Schwartz wasn't concerned at all with my blood sugar readings. I was afraid they were too high, but he said they were just fine all things considered. He upped my insulin a bit, and doubled my blood pressure meds. But he stressed that I was doing just fine and not to worry. Also, my a1c came back at 6.5 which he was really happy with. He said he was hoping for under 7, so 6.5 is really great. I'm thrilled, because this means I had good blood sugar control when I conceived – which greatly lowers the risk of heart and neural tube defects.

I'm cleared for two cans of chunk light tuna a week, I can use psoriasis shampoo, I can have all my teas, and can have sex. Life is good. I've bought stuff to make (healthier) Egg McMuffins at home, cottage cheese and no-sugar-added canned fruit, and fixings for tuna salad. Lunchtime will be easier and healthier starting tomorrow. (Cheaper too.)

Now we just need to get a hold of Paul's sister, Cassie. We can't really tell anyone else in the general public until we tell her – and for a week now we haven't been able to get in touch with her. Random 6-hour-delayed chats are all we can get, and Paul is insistent that he wants both of us to tell her, face-to-face on the Skype. I'm hoping that maybe she'll respond when she wakes up tomorrow morning and we can talk to her tonight around midnight. Cuz I really wanna tell a couple of people, but we gotta tell Cassie first.

That’s our baby’s due date, for now.

Desert Perinatalogists are my new favorite people. They’re going to be my all-the-time OB, so I don’t have to go back to that horrid Dr. Foster. I am so stoked about this!

After racing there this afternoon I was taken back to speak with a genetic counselor. I commented as we were sitting down that I found it humorous that we were going to talk about genetic testing and such when no one had even confirmed the pregnancy yet. She was flummoxed. Honestly, at that point I was feeling so beaten down about this whole situation that I didn’t really care anymore. I just wanted to *know*. We chatted a bit about my medical history and then she went to go find my doctor and an ultrasound tech.

20 minutes later I’ve got warm goo all over me and the tech is trying really hard to get a good image from the outside. She found the “sac” but couldn’t get a good view at all. So she went and got the doctor and after another 10 minutes or so, they did the internal/vaginal ultrasound. She was as gentle as possible with the probe thing, but she was having to work to get a good angle and find things.

But find things she did. The amniotic sac is there, with a tiny little ‘yolk’ thing, and inside that was an even tinier little blub. The top of the blub had a flutter that we saw a few times when the probe was angled just right. At one point she caught a heartbeat. She looked at Dr. Schwartz who said “yeah, grab it and count it!” The machine said the heart rate (which sounded like a faint whooshing over my heartbeat) was 107. Dr. Schwartz came over, took my wrist and a moment later said “Your heartrate isn’t 107. That’s not you.”

They did some calculations after taking out the probe and handed me a printed out picture of the sac & blub (you can’t really see anything…) with a post-it on it that says 5w4d, 7/17/2010. I started crying. Not sobbing like I have in anger several times in the last few days, just tears of happiness overflowing my eyes. Dr. Schwartz put his hand on my shoulder, squeezed and congratulated me. The nurse/tech handed me a box of kleenex.

After I got dressed again, Dr. Schwartz came back in the ultrasound room and we talked about a lot of things. My drugs were changed again, to a different kind of insulin. Dr. Schwartz explained his theory on why I’m on two completely different insulins now and it seems to make sense. But everything we’re doing is on a “try it an see” basis and he wants me to be open with him about how I feel on all of it. He’s not opposed to trying different things, but he’s glad to hear that I’m willing to do whatever he tells me to do for the sake of the baby.

He explained about the practice, and how he’s only there Monday-Wednesday because he lives in Denver. He still ends up delivering about 85% of his patients though. And the practice doesn’t believe in ERs unless someone is bleeding. They always want me to call them, day or night, for anything. (Exactly the opposite of what the other OB said.) The staff really seems very nice and they all reiterated that I’m to call them with ANY questions at ANY time.

I’m logging my blood sugars now, and will be logging blood pressures too once they get me a blood pressure cuff. I’ll be faxing them info at least once a week. They’re not freaking out about my issues and they don’t want me to either. Dr. Schwartz said “This is what we do. We take care of this stuff. Don’t worry.” They took a TON of blood (I love their lab tech – she got me in the elbow in one stab! Took 9 viles of blood!) and gave me an H1N1 vaccine. Just like that! I met again with the genetic counselor lady and she took a detailed family history. Nothing really of note, except the strong history of diabetes on my side and my VSD. (They’ll do a fetal echocardiogram ~19 weeks because of my personal heart history and the fact that I was on an ACE inhibitor when I got pregnant. But she said it really wasn’t anything to worry about.)

My next appointment is on Wednesday December 2 at 2:00. Paul will be with me. We’ll have another ultrasound and they’ll confirm gestation at that time and change the EDD if necessary.

I called Paul as I walked out the door to go home. I asked him how he’d like a baby for his birthday next year. (Dr. Schwartz explained that even though my EDD is 7/17/10, there’s very very little chance that he’ll let me go that far.) Paul sounded pretty happy when I told him.

Tonight I went to Borders and bought books. The Mayo Clinic Guide to a Healthy Pregnancy and The Pregnancy Instruction Manual. I’ve waited so long to be able to buy pregnancy books and not feel like a total fraud. I was grinning like a loon at the checkout girl.

So today's appointment at the OB (Dr. Foster) was a train wreck. Three stabs and they couldn't get blood outta me. The doctor was a rude, arrogant jerk. He did a rather painful Pap on me while explaining that I was TOO LARGE for them to attempt to use their ultrasound equipment (which is apparently barely useful for anything but making sure a full-term baby is in there…) From the sound of what they told me today, they never do ultrasounds in-office other than to attempt to see the position of a full-term baby. Which seems asinine to me.

I was reduced to tears twice trying to get someone to understand that we just desperately want to know for sure that I am pregnant, and some indication of how far along I am, so we can come to terms with how long the fetus (embryo? dunno, depends on how far gone I am) was exposed to the Schedule C meds.

He did *directly* contradict what Dr. Wellborn told me about all my meds though. He said they keep women on all the drugs I was on throughout their pregnancies. So who knows, maybe I won't be on insulin after all.

He referred me to a Perinatalogist practice, but they're not going to be my regular OB? I don't quite understand, but they're gonna keep track of the diabetes + HBP pregnancy stuff, and Dr. Foster's office will keep track of the baby? I don't know. It took involving 4 nurse chicks and another doctor to figure out where I was being referred to and why.

So I have an appointment with Dr. Foster in 4 weeks, on December 16th. I have an appointment with the High-Risk group tomorrow at 1:30. I know that's not gonna go over well at work, but hopefully after this week I won't have a million appointments for a while.

I/we just want to know for sure. No one at these doctor's offices seems to understand that. How can they be so curt and blase about stuff like this, especially when they know it's our first time?

I hate medicine in Nevada.