Perinatologist, Genetecist, Psychiatrist

I called the perinatologist (I think that is the right term in English for spécialiste en médecine foeto-maternelle) and asked him some questions.

- I will get preliminary results, which is what I presume is called FISH results in English, 24h after the amnio. This will tell me about trisomies 13, 18, 21 and X0 (Turner's Syndrome where there is a missing X chromosome). For the last one I would not terminate, but upon consulting Dr. Google, it seems that the vast majority of X0 babies miscarry. These four chromosomal problems cover 75% of all chromosomal problems. No cell culture is necessary which is why it is fast. In fact FISH stands for fluorescence in situ hybridization, I suppose that means they use special wavelengths of light to check chromosome counts. It's just lucky that the ones they can see with this method are the ones which cover 75% of abnormalities.

- I will get a detailed ultrasound at the same time so they can take a look at the heart and kidneys and other organs again. It is too early to do Doppler circulation tracing though, have to wait for 20 weeks for that.

- BPD (biparetal diameter) and FL (femur length) were also normal. I knew this already but had to check again for some reason. The ratio of BPD to FL can also be taken as a marker for trisomy 21.

- My undiagnosed hypothyroidism at the time of conception could NOT have created a chromosomal problem. The very fact that I was able to conceive means that my hypothyroidism was not severe, it was caught very soon and treatment started immediately.

- I had to ask him a stupid question: do amnio samples ever get mixed up in the lab? Answer: no. The samples are divided and there are two different people looking at them.

I need to call my OB on Monday (she was out on Friday) to arrange to see a genetecist. The specialist said that I would be seen quite quickly, on Monday or Tuesday but that it was best to arrange it through my own OB since she could provide all of the necessary background and details to the genetecist beforehand.

The appointment with the psychiatrist was... useful. (Can't really describe it as good, now, can I?) I'm seeing her again next Friday. She did give me some new trains of thought.

When I said that I didn't want to spend the rest of my life regretting a termination decision, she said I could try to accept that whatever decision I make today is the best decision I can make today. Maybe in three years' time I would make a different decision. Maybe if this was my first child and I hadn't already lost one I would make a different decision. But I have to accept that I am who I am today and I make the decision that needs to be made today as that person, not as me in the future. Does it make sense? It did make sense to me.

When I said that this baby should not be impacted by whatever happened to his/her brother, she said that that is probably impossible since I am impacted, DH is impacted and we are the ones making the decision. She reminded me that it is still quite recent (9 months tomorrow) and that all the times are running in parallel, one doesn't supercede the other. By this she meant - there is a start point nine months ago, there is one a week ago, there is one running until May 7th, there is one until the danger of miscarriage from the amnio is past, there is one until the results. Unfortunately I can't stop one to begin another and to try and do so is futile. (OK, she didn't say that last sentence, it's my very own conclusion).

I generally felt much better about this appointment than I ever did with the ones I had with the psychotherapist after Moksha died. I never felt completely comfortable, always felt a bit ripped off and even slightly judged. I felt like the psychiatrist was really absorbing what I was saying, and pausing to think about her answers before giving them to me.

We didn't get to suicidal thoughts but really, I'm not going to do that unless DH dies as well as the baby. We're still not really getting along all that well but slightly better than Friday. We now have names picked out for a girl and a boy. I asked my mother to knit a small baby blanket, which could be used in a coffin. For some reason I picked baby blue as the colour, but I think blue can go for a little girl as well. On Friday I will have to ask my OB to see pictures of what a 15 - 17 week old foetus looks like to prepare myself.

Since Moksha died I have seen:

- a dermatologist (I had a very severe, itchy, all-over-body rash after Moksha died which did not respond to the maximim dose of steroids, and was eventually diagnosed as a stress reaction)
- a haematologist (for the Factor V Leiden)
- an endocrinologist (for the hypothyroidism)
- a new GP
- my OB
- a perinatologist
- a psychotherapist
- a psychiatrist

and hopefully early next week a genetecist. I have NEVER seen so many specialists in my life. It seems that I see on average two doctors per week. I find this in itself quite depressing.