Wednesday, August 14, 2013

Looking Back: A Reflection on the First Ultrasound

This post was written on 8/3/13.

I'm going to cheat a little for this entry and do some reflection on the week following that first ultrasound.  I simply could not bring myself to sit down and write during that matter how much I knew I needed to, the words just would not come.  And although we are now past this part of our journey, I want to put all those feelings into words before they begin to fade.

I barely slept at all the night before our first ultrasound.  Even though I knew there was nothing I could do to change the outcome of whatever was going to happen, I was nervous.  We had already made the decision that the girls would be staying with my parents that night instead of coming with us to the ultrasound (to be fair, we had not yet told anyone other than a few close friends about the pregnancy).  I could not stomach the thought of them being in the room if we were to once again receive devastating news.

I did reasonably well on the way to the doctor's office, but as we stepped off of the elevator and prepared to walk in, I just lost it.  We were a few minutes late because I stopped at the restroom in an attempt to get it together but quickly realized that with each passing moment, I could literally feel the hysteria working it's way up my throat and it wasn't going to get better with a few minutes of crying in a restroom.  We went inside and I struggled through a brief check-in.  Our favorite nurse came out to speak with us the waiting room (somehow, the receptionist had gotten the idea that I wanted to reschedule?) and I let her know that today was the day - I would be a mess whether we did it now, an hour from now or three weeks from now.

It was the same room where we received Aaron's diagnosis and I can not even begin to describe the intense panic of walking back into that room, sitting on the table and waiting to see the images that would appear.  Even as I sit here typing, my body is nearly vibrating with the emotions that I can do nothing to quell.

She was able to point out almost immediately the baby's full, round head with two neatly defined lobes - no anencephaly.  What an amazing blessing as we got to hear that tiny heartbeat for the first time and see little arms and legs flailing around.  I struggled not to jerk around too much as I worked through the tears of joy.

Then, as she was finishing up the ultrasound, she asked if we had done any genetic testing after Aaron was born.  We had not.  She asked if we had done any yet this pregnancy.  No. Then asked if we were planning to do any. No...but what do you see that is making you ask so many questions?? She informed us that she was seeing an increased nuchal translucency, one that was nearly twice what would be considered "within normal limits." (Simple explanation is this: nuchal translucency is a measurement of the fluid present behind the neck of the baby; it is an indicator of risk for several genetic conditions including Trisomies 13,18, 21 and Turner Syndrome.  It warrants follow-up testing.)  She went to speak with the doctor and since we had an appointment with her that day anyway, she led us to the exam room and we waited to talk with her.

The information was basically what I already knew - what was seen on the ultrasound was not a definitive diagnosis but was a risk factor for a number of things.  They would be calling for a consultation within a week with the same Maternal-Fetal Medicine specialist that we saw to confirm Aaron's diagnosis.  His office called a few hours later to set up an appointment in seven days for a Level 3 ultrasound and a consultation with the specialist.

For those seven days, we lived in a kind of limbo that would be hard to describe.  Our options ranged anywhere from "Your child has another, totally-unrelated fatal birth defect" to "Your baby might be perfectly healthy without a thing in the world wrong" and everything in-between.  With Aaron, the diagnosis was definitive from that first ultrasound...there was little room for doubt.  We began grieving for him almost immediately - those were pretty clear feelings of loss.  This time, we weren't really allowed to feel anything other than terrified at the prospect of burying another child.

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