One in

Yesterday morning was our "official" ultrasound, the 18-week anatomy scan. We saw the gender two weeks ago at my mom's office (the perks of being the daughter of your RE's nurse!), so we were just expecting to confirm that it really was a boy, and to find out if his legs really were as long as we think they are.

Yes, he's still a boy, and yes, his little baby legs are measuring over a week ahead of the rest of him.

He also has bilateral choroid plexus cysts in his brain.

The cysts aren’t dangerous in themselves, and aren’t associated with any sort of developmental delays. None of them are especially large, although he has more than one in each hemisphere, and chances are good that they’ll spontaneously disappear before he’s born anyway. However, they’re a soft marker for chromosomal disorders, especially trisomy 18, which is vaguely similar to Down’s but is usually fatal before birth or in infancy.

No other soft markers were seen on ultrasound, which is good (although the whole scan took less than 20 minutes, so I’m not sure exactly how closely they looked for some of the subtler signs). Pubmed is all over the place on what exactly the odds are that a baby with isolated CPCs has Trisomy 18, but it seems to be something like 1:275, depending on things like maternal age and abnormal quad screen results.

I had not planned on having a quad screen done, because I didn’t want to wind up having an amnio, with its associated risk of miscarriage. However, since the torment-yourself-with-potential-false-positives part of the program is already taken care of, I signed the form for the quad screen bloodwork yesterday. If it comes back suspicious, we’ll have the amnio ASAP, because it’s very important to me to know *for sure*, regardless of my feelings about termination (which I don’t especially feel like discussing now). I don’t know when the quad screen bloodwork will be back -- I’m supposed to see the doctor again in two weeks, though I will probably call and ask about the results well before that.

My husband keeps insisting that 1:275 is really low odds, and that it’s useless to worry about this now, but I don’t think those are so low at all. Someone has to be in those numbers -- to be exact, about 150 someones this year across the US -- and I’ve been the one-in-a-large-number on more than one occasion. It most likely won’t happen to us, but there is a real and non-zero possibility that it will, and we just have to wait and find out.

Everything else was okay-ish at the doctor’s visit -- cervix looked OK on ultrasound, although they didn’t measure length or anything. We started 17-alphahydroxyprogesterone shots just in case, as a preventative measure for preterm labor, and Dr. Pro wants to follow me more closely from now on, every two weeks. We’ll start talking about nifepidine or terbutaline in a few more weeks, especially if my cervix starts looking iffy.

I hate that I am having to worry about all this -- I just want to be happy and paint the damn nursery.

My baby will not be named...

Amelia
Bella
Cecilia
Diana
Elaine
Frances
Gabrielle
Harriet
Isabella
Julia
Kristin
Laurel
Marjorie
Nina
Ophelia
Penelope
Quinna
Rose
Sophie
Tabitha
Una
Virginia
Willow
Xena
Yvette
Zoe

Nope, we've known what to name this one for six or seven years.

Andrew Leon, our son.

Back to the nethers

Five-minute OB visit for me this morning (not including the hour wait). I told Dr. Pro I'd been having contractions on and off for a week, and she made the frowny face at me, but reminded me there's nothing to be done about uterine irritability at this point. We discussed 17-hydroxyprogesterone shots down the road, but those aren't even an option for another four weeks.

I'm not actually all that panicked about it yet. I'm expecting to experience at least one bout of preterm labor -- I think contracting is just what I do -- and to spend some time on bedrest and perhaps in the hospital. It'll be scary and un-fun when it happens, but I also expect that they'll be able to shut it down, as they did last time. With just one baby, it may not even happen until I'm far enough along that labor wouldn't be stopped. While it would be nice to take home a full-term baby, I've had near-term babies before, so it's maybe not quite as frightening a prospect as last time.

I do worry about not going to L&D until it's too late, because I'm so used to ignoring contractions. If I called my doctor every time I had four contractions in an hour, I'd be in her office every single day of my third trimester. Last time, my personal rule was that we went to L&D when they'd been five minutes apart for two hours, and the first-line remedies like drinking water hadn't worked. Since you dilate quicker in second pregnancies, I'm mildly concerned that I will cross the threshold of "active labor" before going in, and wind up having to have the baby. We'll see what my doctor sets her threshold as later on in the pregnancy.

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In other news, we bought potties for the girls on Saturday. We're doing more potty familiarization than potty training at this point -- we sit them on the potties before baths, and if they should happen to use it, wonderful. They seem to get a big kick out of sitting on the potties, and both girls have peed in them. It's coincidental at this point, but that's how it starts.

I don't expect them to be fully potty-trained any time soon. I think they'll get that potties are for peeing and pooping pretty quickly, but I expect they'll be slower to catch on that we *only* pee and poop in the potty. In my ideal world, I'll have them day-trained by the time the new baby gets here, with pull-ups for naps and bedtime and maybe outings. I don't think that's completely unreasonable, and every diaper I don't have to change will be a win.

In which I talk about things unrelated to my offspring

I don't really consider myself "creative", although I suspect anyone who knows me might disagree with that assessment, given the amount of time I spend doing handwork. I started cross-stitching at six, did various forms of embroidery in high school, picked up crochet a few years ago, and have knitted enthusiastically for two years. I've been sewing a good bit lately, with my beautiful and wondrous new Janome, and started learning to spin a month ago. I do some form of fiber work nearly every night, and almost always have a project within arm's reach.

Yesterday, "fiber creep" took a whole new direction. I signed up for a beginning quilting class, and started cutting and piecing some fabric left over from a tote I made last week. I'm assembling a stacked coin pattern, although I haven't much idea what I will do with it once the piecing is done. I want to make a quilt and bumper set for the Lagniappe's crib, but I can't use this fabric (hot pink floral and stripes, although I'm going to add some brown and either lime or blue) unless it proves to be a girl in a few weeks. Possibly I'll make doll quilts for the girls instead, or pillowcases.

Quilting is an odd thing for me to pick up, in some ways. My personal style, such as it is, trends to the minimalist, not "rustic" in any way. I'm terribly perfectionistic, and I don't like for my finished pieces to look charmingly handmade. Nor am I an art quilter in the making -- I am good at adapting and executing rather than conception, engineering rather than design. Other than the impulse to decorate for the new baby, I'm not sure why I feel like I need to learn to do it. But clearly, I do, so there's nothing for it but to sign up for classes and start fiddling around at home.

If you should be wondering how I'm going to find the time to knit or crochet a blanket and some hats for the Lagniappe, make a quilt and bumper set for it, decorate its nursery, sew myself the maternity skirt I bought fabric for, do a couple A-line dresses for the girls, finish the two pairs of socks and the shawl I'm currently making, and progress on the Christmas knitting (set to include a beaded lace shaw for my MIL), LA LA LA NOT LISTENING.

Latest stunts of my monkey children

• [Claire] Said "bye-bye!" and opened Grandmama's back door
  
• [Claire] Jumped up and down on the foot petal of the baby gate until it popped open
  
• [Claire] Learned to unzip her PJs and take her diaper off
  
• [Claire] Learned to wiggle her arms out of her backwardly-zipped PJs and push her diaper down inside them
  
• [both] Learned to stick their fingers through the baby gate on the gas fireplace and pull out the lava rocks
  
• [Claire] Spat milk all over my laptop keyboard and shorted out the question mark
  
• [Claire] Learned to pull the outlet covers out of the outlets
  
• [Claire] Learned to unplug network cables
  
• [Katherine] Learned to bite when her will is thwarted
  
• [Lagniappe] Moved
  
• [Lagniappe] Caused the onset of uterine irritability by moving
  
• [Lagniappe] Made me leave church in the middle of the Easter sermon to go throw up
  
• [Lagniappe] Made me throw up in a Wal-Mart bathroom -- with twins and a cart full of groceries in tow
  
• [dogs] Pulled two bags of Easter candy out of a bag on the counter, ripped them open, and ate the contents, including the wrappers
  

It's pretty obvious who is the monkey-in-chief...

Tentative improvement

On another note, I think I may be through the worst of the hyperemesis. With my Reglan pump, I've been increasingly well-controlled, and the ratio of good days to bad has been increasing. I have not thrown up very much at all over the last week, except under extreme provocation, such as when Katherine threw up in the hospital. I've felt very nearly normal, and have even gained a couple pounds back.

My pump went haywire on Sunday, just as we were preparing to be discharged, so I just yanked it out and decided to fool with it at home. I left it out for a shower and a nap, and since I was still feeling okay, decided to live dangerously and see if I could get by without it for a bit. I needed a Phenergan by the evening, but I was able to take it and keep it down, and it worked.

I popped a Zofran this morning, got my OB to call in a prescription for oral Reglan, and seem to be doing well enough so far. Late afternoons and evenings are my bad time, and I'm starting to feel a little queasy, but not enough that I think I'm in danger of vomiting. I wouldn't want to go completely unmedicated just yet, but at twelve weeks, it's a good time to try tapering down to oral meds.

I can always go back to the pump if I get in trouble, but I'm hopeful I can go un-tethered!

Heading home

Katherine's platelets were up to 62,000 this morning, so we'll be discharged in the next little while.

Needless to say, we are all thrilled to be going home. It'll be great for her to be at home and free, not stuck in a hospital room and tethered to an IV pole. It'll be great for me to have a shower and a nap -- I didn't get much sleep last night, since she threw up four times. It'll be great for G, who won't have to alternate between taking care of Claire and being with us here. It'll even be great for Claire, who has been rather subdued without her sister (and her parents, and her normal routine).

We will be watching to see, over the weeks and months to come, whether her platelets stay up or continue to drop back down. The IVIG she received raises the platelets in almost all kids with ITP, but when it works out of her system in three to four weeks, her levels may go back down. It's possible we may have to repeat the IVIG treatment again; she will probably recover within the next six months, but she may have relapses during that time which require treatment.

I hope we're done with this, though!