Sunday, March 28, 2010

appointment with the high-risk OB in the U.S. and the big announcement!

When I booked my trip to the U.S., I decided to make an appointment with a high-risk OB, for a few reasons.
One: if anything were to happen while I’m here, I wanted someone to have my records and be familiar with my history.
Two: I haven’t decided where I’m going to deliver, might be in Ireland, might be here, might be somewhere else.
Three: while I adore my high-risk OB in Dublin, there are a few things that just aren’t “done” in Ireland and I wanted a U.S. trained physician to give me a thorough exam and advise as to whether I needed to have any additional tests, etc…

The appointment was fine and I had a chance to meet with the hospital birthing center staff, the prenatal assessment nurse, and the high-risk OB. She went over my records and we discussed the heparin. I was kind of hoping to be switched to Lovenox (only one injection per day and much less stingy, or so I’m told). The OB here said that she agreed with the fertility clinic in Dublin; I can’t be on low dose heparin (Lovenox, Clexane, or Innohep). There are just too many auto-immune issues and they are too severe, so I’m stuck with heparin and the two, stingy injections per day, oh well. She said that she would like to induce or schedule a c-section at 39 weeks, which is two weeks later than what I’ve otherwise been told, so that was good news. She also said that I’m “at much higher risk for fetal death” because of the autoimmune issues, so she will be scheduling BioPhysical Profiles every week, should I come back to the U.S. She did a very thorough exam, ultrasound, blood work, etc and everything looks great. Next week I’m scheduled to see her again, more tests and another ultrasound.

And now the big news….

When I was 16 weeks pregnant, I asked my maternal fetal medicine doctor if he could make a “guess” as to the baby’s gender. He said that it was still very early, but if he were a guessing man, he’d guess that “it’s a girl” and that he “didn’t see a penis.” LOL. Since it was so early, we didn’t want to tell very many people, just in case. When I was 21 weeks 1 day pregnant, I had the “anatomy scan”. Not knowing my doctor’s guess, the doctor doing the scan also said that it was a girl. At that point, we started telling more people. I’ve now had yet another doctor tell me that it’s definitely a girl. So there you go…

IT’S A GIRL!!!!!!!

Saturday, March 27, 2010

flying at 21 weeks 6 days pregnant

March 17, the day that most people are trying to get to Dublin, I was getting out. That’s right, I flew to the U.S. I wasn’t terribly concerned about flying while pregnant; I was more concerned about the number of times I would need to get up. The flight wasn’t full, so the lovely woman at check in blocked the row so I would be able to get up as needed, and stretch out. That lasted until we were in the air and the guy across the aisle noticed the two empty seats next to me. He hopped over, despite me telling him that I would be getting up every 45 minutes (8 hour flight). It actually turned out fine as I wasn’t comfortable enough to sleep anyway, and he was great about getting up when I gave him “the look.” Due to the timing of the flight, I didn’t have to do my heparin injection on the plane, but instead in the women’s restroom at Newark airport. Not the ideal location, but it was okay and I rewarded myself with Starbucks. I am VERY happy to announce that they made my drink correctly, which in 18 months, hasn’t happened at the Starbucks in my neighborhood in Dublin.

The flight from Newark to Minneapolis was even less full, and on a much smaller plane. I had two seats to myself, but again, was horribly uncomfortable and much too excited by that point to rest. There was only one lavatory, which had a fairly consistent line. Eep. I kept looking back, waiting for my opportunity to pounce. I finally heard the woman across the aisle ask the flight attendant about the lavatory, which she said was once again occupied. A minute later I looked back, saw that it was empty, and sprang into action. I felt really bad about “cutting” in line, but by that time I was desperate. Upon landing, the woman across the aisle offered to get my laptop bag down from the overhead bin. Ugh, I felt horrible; I had cut ahead of a nice person. It became even worse at baggage claim when she not only approached me and asked if I needed help with my bags, I didn’t, but also wished me a pleasant evening.

Anyway, I landed in the great USA without incident and to the very kind woman sitting in 10A, my apologies for charging ahead of you to get to the lavatory.

a tough pill to swallow

A few weeks ago, Guinness’ fabulous, private vet, S, called. She had heard back from the feline guru in New Zealand. Her suggestion was to try Guinness on a heavy dose of antibiotics, treating him for toxoplasmosis. She was aware that he’s tested negative twice, but she’s had great success treating another toxo-negative cat in New Zealand. She also mentioned that neuro signs related to toxoplasmosis usually appear in cats Guinness’ age, so we decided to try the antibiotics.

S told me that the dose was very high and that he would likely have diarrhea, nausea, and vomiting. He was getting four pills a day (for 7 days) and took them like a champ. All was well until late that Sunday night; he started to cry around midnight. He wasn’t feeling well, which was apparent in the litter box. I got him settled down and he slept the rest of the night. Monday morning he ate, had his pills, and promptly vomited, repeat Monday night and Tuesday morning. I spoke to S and she said that we likely would have seen an improvement in the first few days, we didn’t, and that it was fine to discontinue the pills. It was definitely worth a shot, but we should have known, too easy of a fix.

He’s now having a few weeks of relaxation (no pills or injections), some time to rest his system. Hopefully in that time we will hear back from the university in the U.S. Depending on the results of that test, we have a few other meds to try. It’s so tough to wait on answers for this little guy.

anatomy scan at 21 weeks 1 day

Apologies for not updating in a long, long time. The anatomy scan was rescheduled for March 12 and as usual, I was 30 minutes early for the appointment. Not that I’m still bitter about not being told of the previously scheduled appointment.

The baby looks great, everything is measuring on target, and the doctor made a gender guess, consistent with what my maternal fetal medicine doctor had previously told me. More to come….

Thursday, March 11, 2010

surprise, surprise, surprise…

Guess who doesn’t have a thiamine deficiency?

Yep. We were told on Tuesday night that just as we suspected, Guinness does not have a thiamine deficiency. This is both good and bad news. Good because it means that I’m not completely crazy, and because Guinness can stop his daily thiamine injections. Bad because it means that we STILL don’t have a diagnosis and because as we have always suspected, it’s likely something very serious.

Next step: Our fabulous vet at UCD is sending Guinness’ urine sample to a university in the U.S. for an organic acid, urine test. It’s very expensive to do, but we are running out of tests and therefore don’t know how or even if, we should treat him.

This next test is for metabolic storage diseases. If the test is positive, we will be devastated (there is no treatment), but at least we will have a diagnosis. It will then come down to quality of life. While he’s not episode free, baby boy is doing remarkably well and is not in any pain. Both his private vet and his vet at UCD agree that there is absolutely no reason to put him to sleep right now. He’s eating, drinking, using the litter box, seeking out affection, cuddling, purring, running up and down the stairs, and has most recently started playing and wrestling with Bella again.

The episodes are brought on by stress and excitement, both good and bad. He has episodes when it’s time for treats or wet food and he has episodes when he’s frightened or at the hospital. Too bad there aren’t spa services for stressed out cats and pregnant women ;)

For now we wait for the test results from the university in the U.S. (it could take up to a month). Depending on how baby boy does in the next few weeks, we will probably try a few medications because well, why not.

Wednesday, March 10, 2010

Me, forget an appointment? Riggghhhhhhhtttttt

Today I had another appointment with the MFM/OB/ Perinatologist dude. He asked how my anatomy scan went to which I replied, “I’m having it today.” To which he asked "when?", and I said, “uh now”.

It turns out that my “anatomy scan” was scheduled for last week and in a different department with a different doctor, but nobody bothered to tell me. I thought that my doctor was doing the scan, today, at the appointment that was written down in my appointment book and on my calendar at home. After a little game of back and forth regarding whether or not I was told (I wasn’t), they are going to try to get the appointment rescheduled for next week, likely at a different hospital. That will be a fun hassle to deal with.

I walked out of today’s appointment feeling sad, disappointed, and angry. Supposedly I was told of the appointment for the anatomy scan back at my first appointment in January. Now, considering that my husband was with me at the first appointment, and that we are both super organized, observant, only children who write EVERYTHING down, wouldn’t it make sense that at least one of us would have written down AND remembered the appointment? Plus, I’ve gone through two IVFs and a FET to get to this point. The anatomy scan is a major milestone; no way would I have forgotten that. Not to mention, I have NEVER in my entire life, been late to or missed a doctor’s appointment, and I’ve had a lot of them. Additionally, I was told today that there is an extra fee for this scan. I would have remembered to bring an extra bank check had I known that. RAGE

Today’s appointment was great in that the baby still has a heartbeat and looks good. The regular ultrasound machine was missing and had been replaced by what looked like an old, small laptop (no paper for pictures :( ) sitting on a rollaway cart. The image quality was um, well, ur, there really isn’t a nice way to describe it. Hopefully one of the local hospitals will be able to fit me in for a scan sometime in the next week.

To top off this lovely day, when I arrived at the pharmacy to pick up more heparin, I was told that the price had increased. Fine. Then I was told the cost. On what planet does generic heparin nearly double in price in 21 days? €66 ($90) for 10 tiny vials of heparin? Fabulous, knowing our insurance company, we’ll probably get $5 of this back.
Tomorrow has to be better, right?

tell me lies, tell me sweet little lies

Actually no, please don’t. The amount of times I’ve been lied to this week (it’s only Wednesday) is baffling, absolutely baffling. And it’s bad enough to lie (HUGE pet peeve), but if you lie, and you get caught in your lie, do NOT make up more lies in an attempt to cover your original lie. Or worse, lie about something that somebody else did or said, particularly if they were also lying and you weren’t aware of it. Lastly, if you are going to lie to both a husband and wife, make sure you tell them the same lie, because they likely talk and compare notes.

I wish I could tell you that the lies don’t affect me, but they do, in a big way. Calling people on their lies or providing proof to others that these people are lying would unfortunately be detrimental, so I sit here with my mouth closed, writing a cryptic post on my blog.

Someday I will write a book, oh yes I will. Someday long after we have retired and are sitting back on the golf course, sipping fruity drinks in the warm, Arizona sun.

Saturday, March 6, 2010

Hmmm, what to title this post…

When you can’t say something nice...

No, no, those won’t work, because I am going to say something.

Rarely have I read an article that invokes the level of anger I experienced yesterday that continues on today. I was checking one of my favorite FS (Foreign Service) blogs and was both horrified and saddened to read the author’s latest post. It appears that a man, Matthew Nasuti, who had a brief, but very troublesome relationship with the State Department has decided to write an article about FS life. Having been fired after only two weeks as a contractor and losing numerous frivolous lawsuits against the State Department, he must have felt that this was his only recourse. Fortunately several Foreign Service Officers and spouses have left comments, but that certainly doesn’t prevent the general public from believing this completely fictitious piece.

Other bloggers, particularly Digger at Life After Jerusalem, have addressed this nonsense much more eloquently than I can, but before giving you the link to the article, I will leave you with this.

The author’s comment about American diplomats living in “Embassy bubble complexes” and that the “hardships that diplomats face are therefore zero” leaves me raging. They live in embassy complexes because it’s too dangerous to live elsewhere. When my husband was in Yemen, he had to vary his routine (route and time) daily to get to work safely, not to mention the craziness of Third World traffic. In addition, he had his car searched for bombs when both arriving at work and arriving back at home. Matthew, that doesn’t sound like a hardship to you? Do you not watch the news? Have you not seen what has occurred at the embassy in Sanaa?

Then there’s the all important food (picture me rolling my eyes). “This reporter believes that most Third World countries have better tasting food than one would find in Germany or Great Britain, but to pampered diplomats, who refuse to learn the local languages and are hostile to non-European cultures, Third World countries seem confusing and inhospitable.” Err, seriously? He doesn’t see the difference between eating food in a Third World country versus Germany or Great Britain? Matthew, do we need to spell out the diseases and parasites often found in food and water in Third World countries for you? My husband had to bleach each and every fruit and vegetable he put in his mouth when he lived in Yemen, and even then he was sick for the first few months he was there, and occasionally throughout the next two years. Not to mention having to brush his teeth with bottled water.

I urge you to read the nonsense written by Matthew Nasuti , though remember his history while doing so. PLEASE take the time to read the comments below the article, left by the dedicated men and women of the Foreign Service. Also check out Digger’s post and comments. Right on!

the infamous, arrogant piece of garbage, I mean the article titled, "American Diplomats Shun Hardship Posts in Third World Countries."

Friday, March 5, 2010

Happy 101 Award!

Thank you very much to TeeJay at Inconceivable for my newest award.

When you receive the Happy 101 Award, you have to list 10 things that make your day and then list 10 blogs worthy of this award as well. Post a link to the blogs you nominate, and make sure you let them know that they have been nominated!

It’s been a long day, so I’m going to break the rules and do five and five.

In no particular order:

1. The cats.

2. An iced grande, nonfat latte with extra ice from Starbucks. What a perfect way to begin the day.

3. My husband.

4. Shopping in the U.S.
Nordstrom, Costco, Williams-Sonoma, Trader Joes, even Safeway. What more does a girl need? Hopefully these things will be “making my day” in the very near future. Details to come!

5. Fresh, crisp salads.

The award goes to:
Ambivalent Womb
Circus Children
Everyone Else But Me

Wednesday, March 3, 2010

house calls are great, unless you're a cat

After realizing last Friday that there was no way that I could traumatize Guinness with his daily thiamine injection, and his fabulous vet offering to come to the house to do it, we now have daily house calls.

When she arrived on Saturday, Guinness was shocked and looked at us as if to say, “you told her where we live?” Poor baby. He took his shot like a champ and just let out a small whimper. Nothing like the previous day’s biting, scratching, and screaming fit. His vet said that it was very helpful to see him at home, as he was walking around and acting “normal”, something they’ve never seen at the university.

Sunday, Monday, and Tuesday’s house calls were a little bit more complicated than Saturday’s. Now Guinness knows what it means when the doorbell rings at night and he runs up the stairs as fast as his little legs will carry him. One of us has to carry his wiggly little body downstairs, fluffed out tail and all. Our brave boy is doing so well with his injection that he doesn’t make a peep anymore. My husband distracts and helps to hold him, the vet holds him and injects, and I talk to him and tell him what a big, brave boy he is. Hey, it works. As soon as he’s released, he runs back up the stairs and hides under the covers on our bed. For his bravery, he’s rewarded with small bits of baked chicken, which he loves.

Unfortunately a diagnosis is still up in the air. His blood was sent to a lab in the U.K. last Monday for the thiamine test, though they claim to have just received it on Friday. His MR images have been sent to more specialists to see if they agree with the thiamine deficiency diagnosis, or possibly have a more plausible diagnosis.

Guinness’ wonderful vet from our private clinic called yesterday to check on him. I felt terrible that nobody had kept her updated (it’s been over 3 weeks since our referral to UCD). We talked for almost an hour and I emailed her Guinness’ MRI report, summary from UCD, and video of an episode. She has a colleague in New Zealand (where she’s from) that sees the most difficult cases there, so she’s going to forward all of the information and get her opinion. Thank you S!!!

For now we wait, but I’m happy to report that there has been a bit of improvement. He still has episodes with his legs and the shaking is a bit more pronounced. However he is eating fairly well, going up and down the stairs, and has used the litter box. He seeks out affection and likes to snuggle. He runs to the kitchen when he knows that it’s snack time and has been sleeping in bed with me at night, often snuggling on my chest while I read.

I know he hates his thiamine injection, but I’m so very grateful to his vet, B, for coming to the house every day to give it to him. This saves me from being the one that hurts him, she gets to see him interact and get around at home, and it saves us the trip to UCD every afternoon, which always stressed him out and brought on an episode.

I’ll keep you updated as test results come back. I can’t say enough about the excellent care he’s receiving.

A very good sign. He came upstairs to help me make the bed on Sunday night. One of his favorite things to do.

The fur on the back of his head is growing back!

A picture from five minutes ago. Bella is no longer hissing and growling at him.