Today was our appointment with the Maternal Fetal Medicine doctors. I'm not exactly clear on all the aspects of Maternal Fetal Medicine (actually, I don't know a lick about it) but I know it's the place I had to go to have our risk level established for things such as Down Syndrome. The office is above the Outpatient Center at Women's and Babies hospital, so I knew the general area. Doug came with me since an ultrasound would be part of the exam. We were the first appointment of the day, so we didn't have to wait long. An ultrasound technician brought us back to the room. She never introduced herself but told me she'd be doing the first ultrasound, taking measurements and getting several views of the baby. She told me she would take her measurements and show them to the doctor who would then come in and do another ultrasound doing the same thing. I thought this was strange. "What, the doctor doesn't trust you?" I asked, laughing so she'd know I was kidding. No, she explained, it's not that at all, it's just that with both the doctor and her doing the measurements, there's less chance for error, so that’s how they do it. Well, I couldn't argue with that.
This room was set-up entirely different from the ultrasound rooms downstairs. Here, the equipment looked newer, shinier, and there was even a second monitor above the bed where I could watch everything she was scanning. I didn't have to crane my head to look at her screen. Doug had a big, comfy chair and a good view of both screens. This ultrasound was much longer than any of the others. I'm told this is because the other ones were only to detect a heartbeat while this one was to actually check all the baby's limbs and skull and take measurements of the spine (head to rump), the neck, the nose, etc. It was fascinating to be able to see the baby for so long, and to see all the motions it was making.
The technician commented at how active the baby was, and it really was, it was dancing all over the place, the head was bopping and the legs were moving, too. It was crazy. She took images of the baby's legs (two) and arms (two) and showed us that the skull is developing nicely (whew!). She took her measurements, which was really interesting. The whole time she was working the baby was tossing and turning and swimming all over the place. It was really wild to watch. It's unreal to think that this baby is inside of me and moving all over the place, yet it's too small for me to even feel yet. It's completely surreal. The technician finished and covered me up with a towel, saying the doctor would be in soon. Doug and I marveled at how cool it was to see the baby for so long and to see all the detail.
In a moment or two, the doctor came in and started the whole process over again. Once he took his measurements and images, he printed out an image for us. Then he proceeded to tell me to wipe myself off and get dressed. I hate doing this when the doctor is standing there. I think this is one of those insensitive things that causes me to dislike male doctors. There's something humiliating about wiping ultrasound gel off your belly with an already partially oozy towel that's been used to wipe off the instruments first. It's also somewhat degrading trying to fish up your underwear and pants that are unzipped and rolled down to your neither regions. It's not something you can do while lying on the bed, which causes you to stand and turn away from the doctor while attempting to reach for your zipper and buttons. Of course, turning away from the doctor meant facing Doug. It's not like he hasn't seen me zip up my pants a million times, but it's just downright uncomfortable when there are two perfectly dressed adult males in the room, both looking at me. Ugh.
The next step, the doctor informs me, while I realize I didn't do a good enough job wiping the ultrasound gel off my belly and now my pants feel cold and gooey, is to draw some blood to be sent away and tested. The blood work, combined with the ultrasound measurements, will determine my risk. I cheerfully explain that I thought it would only be a finger prick, not an actual blood draw. He says that finger pricks are unpredictable and don't always work, so his practice draws the blood instead. I laugh uncomfortably at how difficult it's going to be to get blood from me. Doug explains my problem with hidden veins while I chatter quietly about how I didn't realize there would be a blood draw, had I realized it I would have eaten a bigger breakfast, I would have drank more water, I would have worn a heavy sweater to keep my arms warm. The doctor acts unconcerned and takes my arm. I show him where Cindy has been successful getting blood from me in the past. He checks it out but keeps looking. He reviews both my arms, hands and wrists and finally settles on the spot I originally suggested. He misses. He tries again, he misses. He tells me he's going to have to get a phlebotomist from downstairs at outpatient services. I tell him to request Cindy, as she can get me on the first try. He makes a comment about how he will get whomever is available, he won't make any special requests. While he's gone I dread their arrival. I know it's going to hurt and I'm going to get light-headed.
Much to my surprise, Cindy walks in with the doctor about 5 minutes later. She immediately smiles at me and says she remembers me. I remind her where to go (my left arm, at the elbow crease, toward the left), she tells me she remembers and gets started. She misses the vein on the first attempt but keeps the needle in. She moves the needle around a bit and apologizes for the pain. I tell her to just get the blood, I don't care about the pain (which isn't really true, but it's all I can think about). She strikes blood and a moment later it's over. The doctor takes the vial and dumps the blood onto a little card with special circles on it. It reminds me of how you have to fill in your answers on a test paper with your number 2 pencil, and you have to fill out the entire circle. The sight of the blood on the paper made my stomach turn, so I stopped watching. Cindy packed up her kit and headed out, wishing me well. Thank God for Cindy and other people like her.
The doctor stays with us and talks for a while about my blood clot history, he asks me questions which I answer honestly to the best of my recollection (it was over 10 years ago). He says he wants to pull my paperwork from Lancaster General, where I was hospitalized, and review it. He leaves for a long time and returns with a couple print-outs. He says that he wants to pay attention to it, but he does not think it's necessary to keep me on blood thinning medications while pregnant. He suggests additional blood work (yippee) for me to have done another time. He said he'll send a report to my OB who will in turn order the blood work for "thrombosis" and some other items. He explains that a counselor from his office will be calling me in a few days once the blood has been reviewed and they can make an analysis of my risk level. He requests my return around 18 weeks for another scan and sends me on my way. I have my hang-ups about male doctors, but overall I think he was a very nice doctor. He did make a joke about how he hopes my veins will double in size by the time I give birth, since I'll need an IV when I'm in the hospital. That wasn't very nice, but I'm sure he was kidding. :)
