Tuesday, December 3, 2013

Week 19....

First, I had NO idea that Disqus was such a pain, and I'm sorry I subjected you guys to it for so long. It is gone now, never to be reinstated. On comparing blogger commenting and WordPress commenting, there does not seem to be too much of a difference. WP IS nicer in other ways, but when I think of how much else I have to do when I move, I sort of whimper and think it is not worth it. So I'll *probably* stay here. So commenting is easier, and as a favor to you all (I hate it when I have to do it on other sites), I've turned off the word verification thing. Hope I am not immediately bombarded by spambots or whatever else that mysterious feature protects against.

Pregnancy news: J will be 19 weeks along tomorrow. She apparently went for an hospital visit last Thursday and everything was fine. She is not having an easy time of it though: while her hemoglobin levels are just below the the lower edge of normal, which is apparently good for a pregnant person, she tells me that this pregnancy has been much rougher on her than her last pregnancies, with constant dizziness as well as nausea.  One reason could be the crazy high beta HCG levels...the levels in almost all my pregnancies has been really high: one clue about how high came in the dual marker scan at 12 weeks; they express the levels as "multiples of the population mean" or MoM. So if you have a beta-HCG MoM value of 1, your levels are at the population mean. In this pregnancy, the beta-HCG MoM was 2.15, which may be the reason she is feeling so crummy. I hope it is nothing more sinister than very high pregnancy hormone levels.

The one thing that I've been freaking out slightly about is the placental grade. Classically, you are supposed to start with a grade of 0 in the first trimester, move to 1 in the second trimester, stay as 2 in the second trimester and most of the third trimester, and hit 3 only just before you deliver. The placenta was grade 1 in the first trimester, and grade 2 already by 17 weeks. I expressed my concerns to the fetal medicine specialist, and she told me not to worry, that the grading system is obsolete; now what counts is the placental blood flow as measured by the doppler. And that, apparently, was normal. We go in for another scan this week, as recommended by the fetal medicine specialist.

I now have to start thinking about feeding this baby, and how to come up with breastmilk from a safe, tested source. I'm also starting to weigh the pros and cons of induced lactation. Every time I start to think about planning for when the baby comes, I'm paralyzed with fear: what if I start doing stuff and something goes wrong? But as the weeks pass, I do have to put that behind me.

In other news, I found this excellent Fertility Authority article on multiple embryo transfer that I thought was worth sharing. What they said about the shortsightedness of American insurance companies in refusing to cover IVF and thus pushing people to transfer multiple embryos and then having to pay for the staggering medical costs arising from complications in twin/triplet pregnancies was spot on...talk about penny wise and pound foolish! I wish they at least covered transfers as a compromise.

15 comments:

  1. The big difference between blogger commenting and Wp commenting is the ability to follow replies to your individual comment without following all replies to the post. MUCH more conversation friendly. I freely admit that I never follow replies on blogger blogs b/c I don't want to get notifications every time anyone comments anything on the post - so if you replied to my comment on this post (for example), I'd never see it, whereas with WP I'd get a notification anytime someone replied specifically to my comment.

    Also, the CATCHPA is HORRID hard on blogger commenting (especially from phones) -- though that is something you can take off. FWIW, when I changed my settings to NOT allow anonymous comments and to NOT require Catchpa back when I used blogger, I never had issues with spam comments.

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    1. Thanks Josey, yes, this lack of being able to follow conversations is why I turned to Disqus, and it is a really nice feature to add in.

      I've gone all bold and decided to get rid of Catchpa (word verification) and allow anonymous commenting...we will see how that goes :)

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  2. This comment has been removed by a blog administrator.

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  3. Thank you for turning off Disqus. Hope things go well for you with the choice to stay on this site. Sounds like the measurements that matter most (placental flow) are good and that's what matters most. Exciting that you're/she's close to 20 weeks! Sending lots of good thoughts and care. I hope they gave her some guidance on how to help the pregnancy symptoms and dizziness (though maybe there's only so much to be done).

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  4. Congratulations on 19 weeks!

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    1. PS if you decide to induce lactation, I'd love to hear about it!

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  5. 19 weeks! Wow!! I'm so glad to hear it. Yeah, I don't allow anonymous comments either. "Anonymous" is usually someone who isn't brave enough to put their name on whatever crap they are spewing. :-(

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  6. Yeah for 19 weeks...it's totally understandable for you to feel so much fear. It does sound in your posts that the excitement & expectation is becoming more prominent than the fear...so you're either hiding it well or tipping the scales.

    I found that once I removed the captcha, I had to turn off anonymous comments as I got way too much spam.

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  7. A joy at 19 weeks. This is great news and I look forward to each update from you.

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  8. Ah finally I can comment!!

    Congratulations on the pregnancy - I have been reading but unable to comment. Very happy for you and looks like everything is proceeding well. I understand that you have some fear and concerns but try and enjoy this time too since it goes by quickly. Take care.

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  9. Congrats on making it to 19 weeks, and thanks for making commenting possible!
    I haven't read the article yet, but certainly agree with the notion that it's not clever to deny IVF coverage. The preterm stillbirth of my twins cost as much as my IVF cycle. If they had covered that, perhaps with the requirement to transfer a single embryo given my age and lack of history... perhaps things would look different now.

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    1. Thanks! I visited your blog and found the description (that you expected that only getting pregnant would be the difficult bit) so sad and so true. As a scientist who looks at the statistics, I was always blathering on about doing a single embryo transfer. When push came to shove, I put the desire to see a BFP as quickly as possible way before caution, which makes me angry at myself. I'm now trying to raise awareness about all of this so I don't have to read about another 20-week tragedy again, but it seems like I am mostly wasting my time. The regulation has to come from above the patient level, and god knows what that would take.

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    2. I think it's difficult to reach hopeful parents-to-be before they actually do IVF. An insurance-based approach as Augusta outlined below would work, I think.

      A friend of ours pointed out that "you only see the success cases", which I think is very true. You see many parents with twins, but you don't easily see those who have lost their babies in mid-pregnancy. I think presenting patients with actual statistics on how many twin pregnancies encounter which problems might help - though it is hard to protect against the wishful "This won't happen to me" thinking.

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    3. I am going to try to put that together. Almost 50% of twins are preterm (before 36 weeks), I think. Even in the best case scenario of birth at 34-35 weeks, there can be effects on the health of the babies, and that is something worth talking about.

      The stats on prom and incompetent cervix would be harder to get, but I will look for it.

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  10. Oh! It's so great to read good news on your blog, SciChick. I'm so, SO happy that the pregnancy is continuing well, although I feel for J who is struggling. And I'm darn happy that you have to contend with big questions such as how to feed your baby. It's all about to get VERY REAL!

    A thought about multiple embryo transfer: the Quebec government (Quebec is a province in Canada, but I think you know that already) decided to cover the costs of up to 3 IVF and go for eSETs unless otherwise indicated. The initial data shows that the rate of multiple pregnancies has dropped in the province and the cost to the health care system has also been much reduced. It makes so much sense to create the conditions for couples/women to chose eSET instead of transferring multiple embryos in order to get pregnant.

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