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.

Doctor's appointment was as expected. They took me off all oral meds except for the thyroid & HBP. Everything else I was taking was in the “C” Category for pregnancy. I take it that means “Not ideal, but not where we're recommending termination either.” Yes, I'm worried – but I'm trying not to dwell on it. What's done is done.

My hope is that with the ultrasound that (hopefully!) happens tomorrow they'll figure out that I'm not really ~10 weeks, I'm more like ~6 or so. The earlier the better.

But now I'm on insulin. 12 units of long-acting (Lantis) at night, and 1 unit per carb unit of very fast acting with meals. (so 3-4 units of Humalog with meals) There was a lot of stupidity at the pharmacy. The Humalog pens are STUPID expensive. $93 a month. And Dr. Wellborn was pretty candid that by the end of the pregnancy I'll be needing probably triple the dose. (her personal experience.) I'm not willing to pay up to $300 a month for the convenience of having a pen. I'll deal with needles and vials. Plus, the girls at the doctor's office put the wrong kind of needles on the scrip, so they were these huge IM needles instead of tiny sub-q insulin needles. Changes have been requested via fax and hopefully will be ready tomorrow.

I'm trying not to freak out about how much all these meds are costing. It probably works out to about what it was with all the pills – but still. I feel like we're hemorrhaging money in the last week for my medical stuff. I really should look into what the cut off is for declaring medical expenses on taxes.

Tomorrow is the appointment with the OB. Prolly the only time I'll see him. I need a referral to a high-risk OB. I just hope that I can convince them to turn on the ultrasound tomorrow so we can be sure of how far along I am. I've gotta have a firm due date before everyone gets here for Thanksgiving!