December 15, 2012

Our Little Santa Girl @ 22 weeks

I am definitely the kind of person who over-thinks things.  I tend to psych myself out in thinking things are going to be much worse, or complicated, than they actually end up being.  But when I went for my ultrasound at Vanderbilt on the 10th I honestly did think it would be just a quick routine thing. I didn't think too much about it, having just had a Level 2 ultrasound the week before at the hospital where I thought I was going to deliver (more on that later).  In fact, I was actually a bit annoyed that I was having to go through yet another one, particularly since we are now out of network with our insurance, and I have been very concerned about the various costs that we are incurring, which our insurance company has denied coverage for.

Yet again, the day was rainy, dreary and cold.  And yet again we were running late thanks to my dear husband who tends to easily lose track of time.  I was annoyed, but not particularly nervous, when he dropped me off at the crosswalk and I made my way into the building and up to the 9th floor where he momentarily joined me.

The wait was short and I was called back so they could get my weight and blood pressure before taking us into the ultrasound room.  Things were moving very quickly here, and for that I was thankful.  We were introduced to Roseanne, who did a wonderful job on my ultrasound - no pain whatsoever, which was a huge relief, and Dr. Bennett - who is the OB/GYN who will oversee my ultrasounds.  She was quick to inform us that the pediatric cardiologist had decided that she wants me to deliver at Vanderbilt.  My heart sank.  Not only did that mean I would lose my precious doctor, but more importantly it meant that they felt Annabel's heart situation warranted her being close to the cardiologist at birth.  By now I have come to accept that nothing with this pregnancy is going to go according to plan, and for the most part I'm okay with that.  Of course I have a lot of fears over the unknown, but I am also well aware that there is nothing I can do to control any aspect of this and I have to roll with the punches, whatever they may be. People tell me I'm brave, and that they are surprised at how positive I am with everything we've been dealt.  I don't consider myself brave because most of the time I'm scared out of my mind, and being positive is all I can be, because what's the alternative?  I have to have faith that everything is going to be okay and that some day soon I will be holding my precious baby girl in my arms and looking back on all of this as a very distant memory.

I won't bore you with the specifics of the remainder of the visit, but it went very well and was much more detailed and information-packed than I ever thought.  We were there for well over two hours.  I can honestly say that I feel 100% okay with being cared for at Vanderbilt. I was treated like I was the only patient in the world.  Since we have been given a diagnosis of Down syndrome and a heart condition we are under the care of the Junior League Fetal Center.  With all of the stress we have going on in our lives, dealing with the details of scheduling and such is already overwhelming. They take that stress away from me and schedule all of my appointments, including doctor visits, testing, hospital tours and anything else I might need.  We met with two of the wonderful ladies from the Fetal Center - Nancy and Patti, and they made me feel so comfortable and well-cared for.  I am so very thankful for them and their care and kindness.

I have been assigned a new OB, who I will see for the first time next week.  Next month I will be touring the hospital's Labor and Delivery, NICU, Down syndrome clinic, and working with the Fetal Center on my birth plan.

Daddy and Grandpa putting the crib together

On 12/12/12 my fabulous husband and dad set up the nursery with the furniture we had just purchased from Craigslist. We got a wonderful deal on high quality furniture. I love going into Annabel's room and feeling the softness of her clothes, organizing her things and dreaming of the day when she is in her crib, waiting for mama to come get her in the morning. I try to imagine what she will look like, what her voice will sound like.  Will she be wailing with impatience, or will she be quietly playing with her toys as she waits?

I have the most wonderful friends and family, and were it not for them I would feel very discouraged and down, but they have kept me in great spirits with their love, prayers and care packages.  I am so thankful for everyone's positive spirit and support through this difficult pregnancy.  Now that I can feel Annabel's kicks and punches on a regular basis I am enjoying the pregnancy so much more. I no longer live in a constant state of fear, worrying that she's not okay in there. Feeling her move gives me such peace and never ceases to make me smile, even though she often jabs me pretty good when I'm eating, which makes me nauseous!  She's a high-spirited girl, and I love that about her.

Until next time I leave you with a few random photos...

Care Package from Angela and Sami

Avocados and Persimmons (not shown) from my Great Uncle in CA - homegrown in his own yard

Almond Cookies and baby socks from Chris and Dick

Adorable doggie magnet toy from Deanette

Doxie Mug from Bonnie 

  

December 4, 2012

Walking across the covered second story walkway from the parking garage I stared straight ahead at the two sets of double doors.  I dreaded walking through them.  Being at a children's hospital was certainly not a place anyone ever wanted to find themselves. 

The day is rainy and overcast.  I comment that we've always gotten bad news on beautiful sunny days, so maybe our luck will change. I have never minded the rain, and in fact had slept very peacefully earlier this morning with the bedroom windows open and the rain beating down on the awning outside.  I absolutely love sleeping in the rain, and hope Annabel finds it as calming as do I. 

Some parents carried babies inside, while others held onto the hands of older children. I tried to guess what was wrong with each child that walked past.  

We made our way to the fifth floor cardiac wing and stepped inside.  It was surprisingly small, sparsely decorated, and quite honestly dreary.  Nowhere in sight were the colorful and cheerful decorations and architectural elements we had seen throughout our journey upstairs.  I was disappointed.  Did cardiac patients not warrant "pretty"?  

A large black woman sat at a desk in the middle of two waiting rooms.  I signed in via computer and we took a seat.  A few minutes later she called me up to the desk, her tone that of someone who was bored and weary of their job.  I filled out a registration form, surprised at the short length of it, then took a seat and waited to be called.  

A little girl of around 1 was waiting with her daddy.  What would have normally been porcelain baby skin was tinted yellow.  Jaundice.  But she was happy and smiling, pushing a tiny chair from the children's play area around like a walker.  It was evident she was very proud of her accomplishment.  Her blonde curls bounced as she walked bow-legged across the room, smiling at everyone who looked her way. 

I pictured Annabel doing the same thing and wondered what she will look like, at what age she will be pushing a chair around as she learns to walk.  I assume it will be later since children with Down syndrome tend to reach milestones later than non-Ds children. This doesn't bother me, as I am well-aware that there will be delays and that all children, Ds or not, do things in their own time.  But nonetheless, I wonder.  

My name is called and we - Russell, my mother and I - make our way back to an exam room.  The first part of my fetal echo cardiogram will be performed by a fellow, as Vanderbilt is a teaching hospital.  Dr J. is a pretty petite blonde with a kind and cheerful smile. I immediately feel at ease with her.  

Annabel is once again active, and once again completely uncooperative.  Dr. J. has a continuous excellent view of her spine, which is not exactly helpful, but she is able to get some images of the heart.  After over an hour of this I am sore and need a bathroom break.  She tells she's going to be my cardiologist, Dr. K., who will try to get better images and will then explain to us what she sees.  

An hour after that we sit in a room across the hall as Dr. K. explains to us her diagnosis: Atrioventricular Septal Defect (AVSD), which basically means, "Antrioventricular septal defects is characterized by a deficiency of the atrioventricular septum of the heart. They account for about 5 percent of all congenital heart disease, and are most common in infants with Down syndrome. (About 15 percent to 20 percent of newborns with Down syndrome have an atrioventricular septal defects). Forty-five percent of children with Down syndrome have congenital heart disease. Of these, 35–40% have AV septal defects."

She went on to draw diagrams and explain what exactly this meant.  In a nutshell:  Annabel's AVSD is "balanced" (no leakage), and should everything continue as is, she will not go into heart failure and should be okay at birth, although she will absolutely require surgery to repair it at 4 or 5 months of age, once her body is large and strong enough to tolerate such a complicated procedure. The thought is terrifying, but at least we have a diagnosis, and the prognosis is usually good.  

She goes on to assure me that there was nothing I did to cause it, nor anything I could have done differently to prevent it.  Annabel will require frequent check-ups for a while, and then a lifetime of yearly checkups should everything go well.  She will be Annabel's cardiologist from here on out, and I feel very secure with that.  I like her very well and she really seems to know her stuff, as well as being kind and patient. 

She tells us that Vanderbilt has an entire program dedicated to children with Down syndrome, and explains that medicine has come a long way in treating the symptoms of Ds, and therefore life expectancy is higher now (almost that of a non-Ds individual) and quality of life is pretty much like anyone else's.  

I have found that my worry about the Down syndrome has been overshadowed by the heart condition, so much so that the Ds no longer bothered me.  For a while I even pretended the Ds didn't really exist. But now, facing both of them at the same time, I feel a bit more sorrow.  I worry about what Annabel's future will be and how we will help her overcome her challenges.  But for now all I can do is be thankful that things aren't worse, because no matter how bad you think things are, there is always someone else going through something much worse.  I decide to count my blessings and hope and pray for the best.  For the present, that's all I can do. 

We leave with an appointment for a follow-up in 6 weeks, and a regained sense of hope.  

My mom brought a few things with her - one, a photo of her when she was pregnant with me, and the other, the invitation to my own baby shower 43 years ago. 

Mommy and me :-)

November 26, 2012

Having been diagnosed with Symphasis Pubis Dysfunction and in extreme pain when I put any pressure whatsoever on my pelvis (so this means, sitting, walking, standing) I spend some of my time on the sofa with my feet up on an ottoman.  Mostly, though, I spend 80-90% of my  life in bed.  One would think this is is great. I mean, who wouldn't want to be forced to lie around in bed all day watching tv, reading or playing around on the laptop or iPad? Let me tell ya, after a week of this (and maybe even less) you get bored.  Utterly and hopelessly bored.  And your butt gets sore.  You hold your bladder as long as humanly possible (which isn't for long when you're pregnant!) because getting in and our of bed is excruciating.  

I spent a few days working on my baby registries, working on the baby shower guest list, and helping my stepmother (who is giving the shower) with choosing the invitations.  I was extremely appreciative of the distraction, and hey, it was FUN!  It gives me something to look forward to.  

I was worried, but not terribly so, about the Level 2 Ultrasound.  Mostly, I was just excited to see Annabel again. 

The ultrasound was going well and Annabel was very active, being her usual uncooperative self, which always strikes me as funny.  I have a feeling she's going to be a stubborn little soul like her Daddy, but it also means she's a fighter, and our little girl needs all the fight in her she can muster.  

We saw her lungs, leg and arm bones, brain, fingers, toes, organs and so on.  The ultrasound tech, Cecilia again, commented on how great she looked and how she appeared to be right on target with her development.  Annabel happily opened her legs several times to verify that she is, in fact, a girl, a fact we already knew, but now had confirmed.  Cecilia looked for the typical markers for Down syndrome and saw none.  My breath hitched with the possibility that maybe the test had been wrong; maybe Annabel was perfectly fine.  

And then she got to her heart, which was the one thing I was most nervous about.  Annabel turned her back and refused to cooperate.  Cecilia kept trying and was able to see something, but she had grown quiet.  Was she worried about something she saw, or was she merely concentrating?  

She said she wanted to call the doctor from upstairs and have him take a look.  I immediately knew something was wrong and my heart sank.  Just a few minutes later he walked into the room with another young woman in tow to observe.  There were now 5 of us in the small dark room.  

Dr. J. gently moved the wand around my abdomen looking at Annabel's heart.  She had grown tired and had fallen asleep, right on her back, which gave the best view.  It seemed like hours passed before he finally spoke, his soft voice heavy with a Belgian accent.  He rested his hand on my belly in a gesture of comfort, and told us that he had seen a "significant" hole in Annabel's heart.  He felt fairly sure this cemented the Down syndrome diagnosis and said he thought she had a Ventricular Septal Defect.  He said some other things, too, but I couldn't concentrate on his words.  All I heard was "heart defect" and that we would have some "decisions to make".  He kept saying how sorry he was, and all I could think about was that my baby, my precious Annabel, was going to die.  He asked if we had any questions, keeping his eyes on me the entire time.  I could only shake my head no.  I couldn't speak.  I could barely even breathe.  Why was this happening to us?  Why did everything have to be so difficult for our baby? For all of use? Why couldn't she be healthy and perfect like most other babies?  

We left the room so I could go down the hall to have my vitals taken before going into an exam room for my prenatal visit.  I saw Dr. J talking to my OB, Dr. D.  They glanced up at us as we left the room.  That was when I lost it.  Russell and I went into the closest bathroom and he held me as I sobbed.  This was just too much; all of it.  We had been given this wonderful surprise gift, only to feel it slipping out of our hands.  

I gathered myself as best as I could and walked down the hall to the room where the vitals are taken.  I could feel the eyes of the office staff on us as we walked by.  I'm not one of those women who looks pretty when she cries. I look horrible, with red puffy eyes and snot running down my face.  Part of me was embarrassed. but another part didn't care what anyone thought.  I remember the girl taking my weight and blood pressure.  I didn't speak as she did either.  My nurse then came and ushered us quickly back to an exam room to wait for Dr. D.  The wait wasn't long, and Dr. D. gave me a hug as she entered the room.  I apologized for crying every time I saw her, and she joked that she wasn't the least bit offended, and said she knew she wasn't the most beautiful woman in the work (she's wrong; she is absolutely beautiful, inside and out).  In a fog, I barely remember the conversation, and there wasn't much anyway.  She told us she might have to transfer me to Vanderbilt to an OB there depending on what the prognosis for the baby ended up being.  She clearly hated to lose her patients and said that the only ones she's ever lost to another OB were for heart issues.  It felt like another blow.  They couldn't take care of Annabel's needs in our in-network hospital, so we would have to go out of network to Vanderbilt.  It would be a struggle dealing with our insurance company, who had already refused to pay for certain things with my pregnancy, even though I am high-risk due to my age and weight.  

Vanderbilt felt big and scary, but I knew that I would do whatever was necessary to accommodate Annabel's needs.  No matter what, she came first.  

We left the office with an appointment for a Fetal Echo Cardiogram for the following week at Vanderbilt, a lot of fear, and a lost sense of hope.  

My first dress, which my mom kept all these (43) years. 

Annabel's new dachshund shoes, handmade in Spain

October 31, 2012

Hugging Kim goodbye I felt a flood of fear.  Her visit had provided me with a wonderful distraction that I desperately needed.  But now that she was leaving for home and I was leaving for my doctor visit, I felt like a prisoner being returned to my cell.

Walking down the hall to the exam room my doctor's nurse said she had been thinking of of us.  I guess people don't get a diagnosis of Down syndrome every day and word had quickly gotten around.  Her kindness immediately brought on the tears and I couldn't respond and I walked numbly back to the exam room.

We sat there waiting for a few minutes, me staring blankly at the wall and then turning to my husband. I noticed he was wearing flipflops with socks.  He had been in such a hurry to leave that he had forgotten to put on his shoes.  I guess he was just as nervous as I was.

My doctor came into the room, took one look at me and immediately embraced me in a hug. That, of course, brought on another onslaught of tears, but this time I couldn't stop them.  They continued to flow for the duration of the visit.  It was brief; she didn't discuss anything other than the diagnosis and gave us words of encouragement.  She kept her hands on my legs the entire time, patting and reassuring.  She told us what we could expect, and talked as if she were a friend, not a doctor.  She gave me her personal cell phone number and told me to call her any time - day or night.  I assured her I would be fine and wouldn't need it, but she just smiled and pressed the card into my hand.  "Any time, day or night," she repeated.

She said my pain was probably round ligament pain and I felt satisfied with that explanation.  At this point my pain seemed like a drop in the bucket compared to the Down syndrome diagnosis.

We heard the baby's strong heartbeat and I of course felt a huge sense of relief.  I had been feeling flutters of movement since 12 weeks, but nothing on a regular basis.  I longed for the day when I felt her move all the time.  I knew I would feel more secure once that happened.  "It won't be long," my doctor assured me.

Russell told her that one of my worse fears was that the baby would die in utero. "Of all the things you could worry about, at this point in the pregnancy that would be the last thing on the list," she assured me.  That made me feel somewhat better.

She wanted me to have my Level 2 ultrasound done at 20 weeks, which was 4 weeks away, so we scheduled it along with my routine prenatal visit for the same day.  I was a little nervous about it, but didn't give it much thought.  The baby had been okay at every ultrasound, her heartbeat strong.  She had 2 arms and 2 legs, 4 fingers and 1 thumb on each hand.  She looked perfect.  Other than her having Down syndrome, what could possibly go wrong? I knew there was a good chance she could have a heart defect, but at the same time I was hopeful that she wouldn't, because honestly, I didn't think I could handle much more heartache.

When we got home I discovered that Kim had cleaned the house before she left.  I was so grateful to her for her thoughtfulness and her gesture touched me immensely.

October 30, 2012

On my best friend Kim's last day in town we went to the Cheesecake factory for lunch.  We had spent the weekend hanging out watching movies and talking, and I even ventured out of the house a few times.  I took her to my eye doctor's office and he and I helped her pick out some awesome new eyeglass frames, which she took back to Michigan to have filled with her prescription.

The distraction of her being her here was good, and I could almost forget about the Down syndrome diagnosis.  Almost.

As Russell, Kim and I walked into the Cheesecake Factory the Geneticist, Dr. B. called Russell's phone and told him that for sure...

We decided to turn the lunch into a celebration, complete with cheesecake (of course!) I ate my entire plate of Pasta Carbonara and half a piece of cheesecake, saving the other half for later (hey, don't judge - I'm pregnant and celebrating!) 

I worried about going to the doctor in the morning for my routine visit.  It was Halloween and Halloween is not exactly one of my favorite "holidays".  As a teenager my family had a very horrifying experience on Halloween night when 3 males broke into our house and very near killed my stepfather.  They came into my bedroom but were unable to find the light switch because it was behind a dresser.   It was a very traumatic experience that has left me with nothing but disdain for Halloween even all these years later.  Through the years I tried to put it behind me, taking my kids trick or treating (and even dressing up in costume with them), passing out candy some years (some years I was better able to put it behind better than others), and basically  move on.  But an experience like that is something you hold onto; it never truly goes away.  

I was also in pain, worse than before.  It felt like someone had kicked me in the crotch, and I had pain all the way around my abdomen. I worried that something was wrong with the baby.  

Red Velvet Cheesecake

October 24, 2012

Russell had left for Phoenix on business the day before.  I dreaded him going, fearing we would get the call from the Geneticist and I would be all alone.  "She said two weeks," he assured me.  It had only been a week, 5 business days since my blood had been sent to San Diego.  She wouldn't call.  But still, I worried.

The day started off like any other. As usual I was not feeling well, so was lying in bed watching television.  I had gotten up to let the dogs outside and when I came back in saw that there was a message on my phone time-stamped 3:26 pm. I didn't recognize the number, but when I listened to the message my heart sank.

"Anne-Marie, this is Dr. B.  I have the results of your test in, but I'm getting ready to leave the office.  Please call me on my cell phone (she read off the number), otherwise I will call you first thing in the morning."

If the news had been good she would have just said that, right?  Giving me her cell phone number definitely wasn't a good sign.  I dialed her number with shaking hands. My entire body was, in fact, shaking as I stood in my kitchen leaning against the counter beside the sink.  She answered on the first ring.

"The baby does have Down syndrome," she said gently.  "Trisomy 21," she added.   And then, "I'm so sorry."

I couldn't breathe.  I couldn't speak.  I began to cry as I braced myself against the counter.  I felt the room shift and my legs go weak. "I understand." I said through sobs.

"Is your husband there with you?" she asked, her voice sounding concerned.

"He's in Arizona on business," I was finally able to say.

"When will he be home?"

"Tomorrow night."

"Is there anyone who can be there with you? I don't think you should be alone."

"I'll be okay," I told her, still sobbing and hiccuping.  "Are you sure? I mean, is the test... accurate?"

"I feel it is," she said softly.  "I'm so sorry," she repeated.

I only nodded.  She went on to tell me she wanted to meet with me, discuss my options.

"We're continuing with the pregnancy if that's what you mean," I told her.

"Okay, good. I just wanted to be sure.  I have to ask... there are time limits on... termination."

"That's not going to happen."

She said some other things which I don't remember. She repeated herself several times as if she simply wanted to keep me on the phone.  Her voice sounded very far away and I could barely hear her over the pounding in my head.  I wanted to get off the phone with her. I wanted to cry and scream and I didn't think I could hold it together much longer. I then remembered that the MaterniT21 test now tested for the Y chromosome.  "Was there a Y chromosome?" I asked her.  I at least wanted to know if the baby I was carrying was a boy or a girl.

"I don't think so, but I'll have to check when I get back to the office in the morning.  I'm fairly certain your baby is a girl."

I thanked her, ended the call and stood in the kitchen and sobbed body-wracking sobs that could probably be heard several houses up.  I called Russell, who thankfully answered on the third ring. I was sobbing and hysterical and I'm sure he thought something really horrible had happened.  It had.  "The baby... she thinks it's a girl... has... Down syndrome..." I finally managed to say.  There was a moment of silence on the other end of the phone and then...

"It's okay; we'll love her no matter what.  This doesn't change anything.  It's going to be okay.  I love you."

I don't remember much about the next two days.  I remember emailing my mother and telling her the news, then texting a few other close family members and my best friend. Russell called my dad and told him.  I couldn't talk to anyone in person.  For two days I cried non-stop for hours at a time.  It truly felt like my heart was being ripped from my chest.  I vacillated between extreme grief and extreme anger.  I hated everyone who so easily had perfect pregnancies and perfect babies. I hate God for allowing this to happen after all we'd been through for the past 22 years.   I then felt like a horrible person for feeling like that and would spend the next few hours feeling the grief, along with guilt, all over again.  Dr. B.'s words repeated over and over in my head, and they still do - "The baby does have Down syndrome."  I can hear it like it just happened 2 seconds ago.  And every time I do I feel the pain all over again.  I'm not sure it's something I will ever forget.

I have always wanted a baby who looked like us and I worried that this baby would not.  She would look different.  Would I even recognize her as my daughter?  What about health problems?  Would her heart be okay? I'd heard that half of all babies born with Down syndrome have heart defects.  And most importantly, I worried about her future.  What will happen to her when we are too old to take care of her?  Will she need lifelong care?  There were too many questions that I didn't have answers to, and I once more felt out of control and terrified.

I also felt like I had failed - I failed myself, I failed my family, and most of all, I failed my baby by conceiving her with my old imperfect eggs.

My parents do not have biological grandchildren and I desperately wanted to give them that experience.  I felt like I had let them down. I felt like I had let my husband down.  It's my fault I told myself over and over.   Will my daughter hate me for bringing her into this world different than everyone else?  Would people accept her and love her despite her differences?

I had no doubt about loving her; I already did.  But I needed time to mourn the loss of the child I thought I was going to have.  I needed time to process everything and at this point I was quite sure I would never recover from this devastating blow.

When I texted my best friend Kim to let her know, she was at work and went into the bathroom and cried with me.  She offered to leave work at that very minute and make the 7 1/2 hour drive then and there to be with me.  We had already planned our yearly girl's weekend and she would be arriving on Saturday.  I assured her I was okay, I just needed time.  I warned her that I would likely be the worst company ever, crying at the drop of a hat.  "It's okay - we'll just hang out in our pajamas all weekend," she assured me.

One of the vague recollections of those two days after hearing the diagnosis was of Googling pictures of babies and children with Down syndrome.  I read blogs and looked at statistics.  Everything made me cry, especially when I learned that 9 out of 10 babies who are diagnosed with Down syndrome prenatally are aborted. It was a shocking statistic.

My family respected my wishes for no phone calls, but they did text and email to make sure I was doing okay. They also assured me that no matter what they would love their grandchild unconditionally. Nothing had changed.

But it had; to me, everything had changed. I wanted to shut myself off from the rest of the world forever.  I didn't want Kim to come. I wanted to be alone to continue wallowing in self pity and grief, but I knew that wasn't healthy because I could feel myself easily sinking into a pit of depression. I needed her to come and bring me out of my funk. I needed a distraction. I needed my best friend.

October 17, 2012

We sit in the Genetic MD's office which overlooks the second story side of the building. There are large trees outside and their leaves are beautiful Fall shades of oranges and reds.  I am nervous, not knowing what exactly to expect.

I  immediately recognize the doctor's heavy accent as Argentinian; my paternal grandfather had the same accent.  She pulls out a blank piece of white paper and writes our names down at the top of the sheet.  She shares with me that her name is Ana Maria, "so basically the same name as yours," she tells me, smiling.  I immediately feel at ease with her.  She then proceeds to take down our family history in a family tree type of flow chart.  Our family history looks good, no red flags.  She then tells us that she recommends a new test, a simple blood test, non-invasive, that will give us a 98-99% accuracy rate for Trisomy 13, 18 and 21.  Handing us a brochure she says she feels comfortable with the test and highly recommends it.  The test is called MaterniT21 and is conducted by a company in San Diego, CA called Sequenom.  We feel this is the route to go.

The test is expensive, about $2500, but because I am of AMA (Advanced Maternal Age) our insurance should cover it.  She assures us the most we will pay out of pocket is $235.

She tells us that it usually takes about 2 weeks to get the results, which she will call us with as soon as she knows.  2 vials of blood later we leave her office feeling nervous about the results, but secure in our decision.  

October 12, 2012

Since Russell had to work I took my mother and mother in-law with me to the ultrasound.  This time we were upstairs in the regular ultrasound clinic.  I had a different technician this time and she was quick to conclude that the baby was still not going to cooperate.  We would have to do a different genetic test.  She briefly mentioned a new test that they had just started performing this year.  It was non-invasive, a simple blood test.  What could be easier? I had heard about the CVS (Chorionic Villus Sampling) and had decided I didn't want to do it as it is invasive and carries a slight risk of miscarriage. This new test seemed perfect.

The technician suggested we make an appointment with the Geneticist for the following week and she would go over our options with us.

When had birthing babies become so complicated?  Numerous ultrasounds, genetic counseling, blood tests to check for Trisomies?  It all seemed so overwhelming, and I once more felt as if I were in high school.  Would I pass the test?  And if I didn't would fingers be pointed at me for doing something wrong and harming my precious baby?  I worried endlessly over every little ache and pain, every possible (bad) scenario playing over and over again in my mind.

I worried about giving birth having heard horror stories of women dying.  Would a C-section be easier?  What if the epidural didn't work on me because of my weight?  I didn't want to be cut open either.  I had visions of storks and cabbage patches and wished the fairy tales were reality.  All of this just seemed so difficult.  I felt guilty for not being stronger; for not being that super mommy who can give birth in a cave with a war raging in the background through 48 hours of labor and no pain meds.  I was scared.

I am a planner. I don't like surprises.  I felt out of control.  I didn't plan any of this - not the pregnancy, and certainly not the extreme amount of medical attention I was receiving.  I wanted this baby more than anything, but this wasn't the pretty picture I had always painted of pregnancy.  I would have preferred to stay peacefully oblivious.

Over and over I have been told to not stress as it's bad for the baby.  Let me just say, pregnancy is one of the most stressful times in your life!  And the stress was just beginning...

October 8, 2012

I lay on the exam table in the ultrasound room.  This room seemed much smaller than the main ultrasound clinic upstairs.  It was filled not only with the very large machine itself, but with a desk, complete with computer, printer and everything else one would need in an office.  The room was, of course, dark but cozy, as Cecilia squirted warm jelly onto my belly and pressed the ultrasound wand to my abdomen.

Having a typical PCOS belly (in other words, lots of abdominal fat) I worried that she wouldn't be able to get a clear picture of the baby, but I was wrong.  She moved the wand around just a little and all of a sudden there she was on the screen, protesting at the intrusion as Cecilia pressed the wand into my belly.  "There's that little cutie pie!" Cecilia exclaimed. Tears of  relief sprang to my eyes, but didn't fall as I watched our baby wiggle and squirm on the screen.  She moved her arms around, kicked out tiny legs, her heart steady and strong, the sound musical and very much like the clomp of a racehorse.

Cecilia moved the wand expertly around scrutinizing various parts of the baby's body, assuring us that everything looked good.  Every so often she would freeze the image and take a measurement. I don't know what she was specifically looking for and I didn't ask. I simply lay there mesmerized by the image of that tiny little person who was growing inside of me.  Every so often she would raise one little arm as if waving or giving a high-five.  Cecilia commented several times that she saw a very strong nasal bone, a good sign that Down syndrome was not present. I felt relief, but had also done enough research to know that the presence of a nasal bone didn't necessarily mean the baby did not have Ds, it simply was a soft marker for it if there was an absence of one.

When the baby decided she'd had enough she turned on her back and went to sleep, ending Cecilia's search for the elusive nuchal fold on the back of her neck, which was the whole reason we were there.  My belly was shaken and prodded and pressed to the point of pain, yet still our stubborn little one refused to cooperate.  The procedure was very long and the pain was very intense at times.  As much as I enjoyed seeing little Cracker Jack on the screen I was relieved when it was over.

We made an appointment for a few days later, a Friday, to see if the baby would cooperate and allow them to get the measurement.

Back home, I spent the remainder of the day sitting on the sofa trying not to move. I was very sore from the ultrasound, and in hindsight the pain was one of the first indicators that I was developing Symphasis Pelvic Dysfunction.  But I was happy. I not only had video of the ultrasound, but I had a cute little picture of our sweetie pie that I looked at over and over.  Life was good.

September 29 - October 6, 2012

The 745 mile trip to the Outer Banks, NC was a difficult one.  I was nauseated, uncomfortable, and had to stop for frequent bathroom breaks.  The never-ending rain didn't help much either.  But I couldn't wait to get there and see my beautiful Outer Banks. It had been a year since we'd been there, having opted for a less expensive vacation in March.

The beach house had gone through some welcome renovations and I walked around excitedly checking them out while Russell carried everything upstairs.  Cookie and Max immediately found their places on the sofa while Rufus and Olivia checked out the new toys in the toybox.  Bailey, our resident Barney Fife, took up residence on the front deck, running back and forth while keeping a watchful eye on his temporary property.

We normally spend the week traveling around the island, doing all of our usual things, visiting our traditional places.  But this week I was feeling so poorly that I ended up parked on the sofa or deck most of the time while my dear husband got takeout or cooked our meals.  The normally simple act of walking on the beach was difficult for me, so sadly, I only did it twice.

But overlooking that ocean we chose the name for our baby if she turned out to be a girl.  We had already decided on the name Leora for her middle name, after my maternal grandmother's middle name.  We heard the name Annabella on television and we both commented on what a beautiful name it was.  It brought up memories of one of my favorite poems, Annabel Lee by Edgar Allen Poe.  Russell and I met in high school and I fondly remember our English teacher, Mrs. Coon, reading the poem to us.  She was an older woman, a romantic although it was often masked by a harder edge.  She pushed her students to be the best they could be.  I didn't appreciate her until years later, and today I appreciate her even more.  I think she would be surprised, but proud, of my chosen profession as a writer, and I wish I could tell her how much of an influence she was on me.

So, at this beautiful cottage by the sea, the name Annabel Leora was chosen.  The poem is a tragic love story, Poe's last published work.  And just as our Annabel already is, Poe's Annabel Lee was loved beyond measure!

On Wednesday my doctor's nurse called to let me know they had gotten the results from my routine tests back and I had a UTI.  No wonder I felt so bad!  She called in a prescription to a local CVS.  I hoped and prayed  the antibiotics would help me feel better.  Of course it didn't take away the nausea, but it did take away most of the back pain, and for that I was so thankful.

On one of our last days there we went to Manteo, ate lunch and sat on the benches overlooking the harbor.  That was one of my favorite days there; just sitting there enjoying the weather and each other's company.  During this trip I had thought a lot about how this would be our last vacation without a little one in tow.  The thought brought tears to my eyes.  I couldn't wait to show our baby the ocean, place her little feet in the warm sand for the first time, and hear her laugh at the seagulls as they laughed back.  Along with the additions of the beach house they owners had even added a brand new Pack and Play, all folded up and waiting for us the next time we visited.  It was as if it was meant to be!

On the way back to the house Russell asked if I wanted to go to the Coach outlet.  It is usually on the top of my list of places I want to go, but this time I just didn't have the desire.  But my husband has always had a mind of his own, and he pulled into the parking lot anyway and parked right in front of the door.  He wanted to look for a diaper bag. So terrified that something would go wrong, I had been very reluctant to buy anything for the baby.  I knew it was ridiculous to be so superstitious, but when you want something so badly and are terrified it's going to be taken away from you at any moment, your mind goes to some really dark places.

Before we adopted our (now adult) children from Russia we had several failed adoptions.  We had bought the crib, the bedding, the stroller and carseat, the clothes and the toys.  We had a diaper service lined up and our dreams were big.  But it was not meant to be.  A few years ago I finally got rid of everything we had stored away for that baby who was not meant to be ours.  It was one of the most difficult things I have ever done.  The crib was not just a crib, nor the stroller simply a stroller.  It represented so much more, and parting with those things signified something I was not ready to give up.  

And now, as I stood there in the Coach store, all those memories came flooding back.  Did we dare buy something for this baby or would I be packing that up as well?  I kept telling myself this time was different.  This was our baby and no one could take her away from us.

We left the store with a beautiful turquoise diaper bag, chosen by my husband.  When we got back to the beach house I looked at the tag to discover the name of the color was "Mermaid" - how perfectly fitting.

To me, that diaper bag represented hope and possibility and a dream that was finally being fulfilled.

Today it sits in the baby's room, still in the big white Coach bag with the red writing, looking just as it did when I carried it out of the store.  In my mind I have decided exactly how I am going to pack each item inside.  I cannot wait to use it.  

September 24, 2012

The next few weeks are a haze of surgeries (my stepdad's) and hospital visits (to visit my stepdad).  I am tired and nauseous all the time, and it feels like I am constantly out of breath (another side effect of the extra progesterone).

I am constantly hungry, but have a difficult time finding foods that don't turn my stomach into a churning mess.  I am craving salads and healthy foods, but apparently my system is not.  I spend a lot of time in the bathroom and chewing Tum's.

My GYN mentioned something about genetic testing since I am of AMA (Advanced Maternal Age).  I know that Down syndrome is a concern at this point, but I try to push that thought very, very far out of my head.  We don't have any health problems in our family to speak of, and certainly no Down syndrome.  And further, after all we've been through with infertility and adoption issues, we wouldn't have been given this gift of a baby to have it turn out to be "flawed".   No, we wouldn't have a baby with Down syndrome.  Of that I was sure.

But in the back of my mind I think I always knew.  We wouldn't be so lucky to beat the odds and get pregnant and have a perfectly healthy child.  There would surely be a trade-off.

The morning of our first prenatal visit finally arrived.  We walked into the huge OB/GYN group office.  I missed the cozy personal feeling of my GYN's waiting room.  Huge portraits of her children hang on the walls in heavy gold frames.  She has 3 children - a biological son and 2 beautiful daughters adopted from China.  I have enjoyed looking at their pictures through the years and I find I miss their smiling faces, assuring me that my doctor is first and foremost a mother.  It makes her "real", not just a doctor, but also a parent.

I don't know this new doctor, this OB.  Will she be be caring?  Will I like her and feel comfortable with her?

I am walked through the process of my monthly checkups - pee in a cup, step on a scale, have blood pressure drawn, go back to waiting room to be called by my doctor's nurse.  I feel lost inside the large office, but everyone seems nice and personable.  The waiting room is busy but not full.  I'm anxious and nauseated from the car ride over.

I am finally called back to the exam room where I wait for my doctor.  She walks into the room, this small beautiful brunette with a smile that lights up the the entire place.  I immediately like her.  She is warm and caring, traits I immediately sense.

I barely remember the questions she asks me.  I'm anxious to see the baby and make sure he or she (since we don't know which at this point) is okay.  I still have the horrible fear that the baby will have died.  I lie back on the table and she brings in a portable ultrasound machine.  I hold my breath and close my eyes as she inserts the probe (I'm still to early along to have an abdominal ultrasound).  And suddenly, there on the screen is our baby.  I see movement, I see the heart beating.  Hallelujah! I let out a sigh of relief and Russell and I look at each other and I can see he's just as relieved as I am.

She moves the probe around and we can see that our baby no longer looks like a blog, but surprisingly like... a baby!  There are arms and legs and tiny little feet and hands.  The heartbeat is strong.  Looking at the baby I find it hard to believe this little being is inside me and not simply an image in black and white on a monitor. We laugh about how the baby looks like a teddy bear in one position.

I get dressed and my doctor asks about genetic testing.  We have already decided that we don't want to do anything invasive.  She schedules me for a First Trimester Screen in a couple of weeks, after we get back from vacation.  They will to a nuchal fold test, which is basically a test to measure the back of the baby's neck.  A thicker nuchal fold will often indicate Down syndrome.

Russell and I leave the office hand in hand with the picture of our little baby safely tucked into his shirt pocket.  All is right in the world.

August 30, 2012

I stared out the passenger seat window the entire ride to the doctor's office.  Tears slid silently down my cheeks as I tried to think positive thoughts.  I think I've cried more in the past week and a half than I have in the past year, maybe more.  It's true what they say about pregnant women being emotional.  We cry over everything!

I am so terrified to walk into the ultrasound office that my legs are shaking.  My worst fear, which is the same fear I will have at every ultrasound, is that the baby will have disappeared and all this will have been some horrible and cruel joke.

They call my name and Russell and I walk down the hall to the ultrasound room.  I have a different technician this time, Cecilia. I will see Cecilia several more times over the next few months. I like her; she is kind and makes me feel comfortable with the procedure.  The room is already dark as she tells me to go into the bathroom and remove my clothes from the waist down.  I can hear her and Russell talking as I take off my pants.  He's telling her how nervous I am.  Tears once more spring to my eyes and I swipe them away, annoyed that I can't seem to stop crying.

I walk out of the room with the big white sheet wrapped about my waist and make my way slowly to the exam table.  It feels like The Green Mile.  I'm so afraid of what she will see.  Or worse, what she won't.

I hold my breath as the image comes onto the screen.  Russell is standing beside me holding my hand, but all I feel is numb.  And terrified.  And then...

There is it, the image of our baby.  She is no longer a yolk sac, but a tiny growing blob of a human being!  Russell and I are both crying.

"You're about 7 or 8 weeks along," Cecilia tells us.  "Everything looks just like it should."

I feel like I'm floating as we cross the hall to the the doctor's office.  My doctor pokes her head out (but I notice she doesn't really look at me) out after a long wait to tell us that she's running behind because she is without a nurse.  L has given birth.  I'm so excited for her, and feel a twinge of hope.  Women do this every day.  They give birth and everything is okay.  I've been so focused on the negative and the worry that something will go wrong, but what if everything actually goes right?

When it's finally my turn to be seen, everyone in the office comes into the exam room and gives me a hug, including my doctor.  She said she couldn't look at me earlier, fearing the worst regarding the ultrasound.  She knew how much I wanted this.

She refers me to a high risk OB, one that she promises I will love. And sends me on my way with well-wishes and more hugs.

Is this really it?  Are we really having a baby?

We decide to celebrate with Indian food.  I think I'm still in shock, but I'm so unbelievably happy I could burst.

And then, just as I'm taking a bit of my masala dosa, my mother calls with the news that my stepfather has fallen off the roof of their second home an hour and a half away.  We don't know what the extent of his injuries are, but the ambulance is on the way.  We will later find out that he had a broken right hip and ankle, and a crushed left tibia, as well as compartmental syndrome.  He will need several surgeries and many months of rehab.  It feels like a crushing blow to our happy news, and we are once more wracked with worry and uncertainty.

August 26, 2012

For the next week and a half I find myself doing a lot of praying, a lot of thinking and a lot of dreaming.  I go to lunch with my friends Brenda and Lynn.  Over a giant tub of queso I blurt out that I'm pregnant.  When we had organized the lunch and shopping date I had been all talk of margaritas.  I feel like they're both looking at me funny (I think I was just being paranoid) when I ask for water versus the two-for-one margaritas the server offers.  I blurt it out - "I'm pregnant."  Lynn gives me a high-five.  Childless by choice, Brenda gives me a half-hearted high-five and looks at me in somewhat of a state of shock (or is that disappointment?).  I want to reassure her that I'll still be the same person - that nothing will change - but I don't, because I know it won't be true.  I don't have any close friends with young children.  Will I lose my friends?  Will they become annoyed with my talk of sleepless nights, spit-up and first steps?  And who will I ask for advice on breastfeeding (do I even want to breastfeed?) or what to really expect when giving birth.  Do people really poop on the delivery table?!  (I decide to Google that one.)

I am feeling so bad, so tired, so very nauseous, and ravenously hungry.  I am still feeling the effects of the panic attacks, which I learn is due to the extra progesterone in my body.  Heck, half the time I don't really feel like I'm actually in my body. This entire thing seems like some weird dream.  It just hasn't registered yet - there's a tiny person growing inside me.

From some research, Russell and I discover that women with PCOS rarely get pregnant on their own.  And women over 40 have less than a 5% chance of getting pregnant on their own.  I'm thinking we should have bought a lottery ticket around the third week of July, my conception date.  We figure our chances were about 2-3%.  My husband feels triumphant; clearly with good reason.

We also discover that in order for the baby to "stick" I should be on progesterone supplements.  My doctor had called with my blood test results and said she wasn't happy with my numbers - everything was borderline low. Russell called her at home and asked her to call in a prescription for Prometrium.  She said she would, but didn't think it would help.  The pregnancy was either viable or it wasn't.  I know she was leaning toward the latter.

The side effects of the progesterone make me feel even worse than I already do.  I feel like I'm burning up from the inside. I feel faint, exhausted, weak, dizzy and nauseous.  And my boobs hurt.  Badly.  I really just want to crawl into bed and sleep for the remainder of the pregnancy.

I spend a lot of time on the sofa with ice chips and ginger tea and candies to ward off the nausea. It doesn't work.  I am nauseous from the time I wake up until the time I fall asleep, but I am assured this is a good thing, for it means my baby is growing and thriving.

I worry a lot.  I spend far too much time Googling things and end up in a near panic much of the time. I decide Google is not my friend and go cold turkey.

I consult the Magic 8 Ball app on my iPhone.  I need answers and I need a miracle.  At this point we don't even know if the pregnancy is viable.  I need hope.

"Will I give birth to this baby?"  I shake my phone, feeling both silly and hopeful.

 

August 21, 2012

"Your dates don't match up," My doctor informed me.  "According to your dates you should be farther along, so don't get your hopes up," she said, her smile sad, her brow creased.  Seeing the tiny dot on the ultrasound earlier had set off a range of emotions, but nothing could have prepared me for the profound love I felt for that tiny little speck of a human, my baby.

"The yolk sac looks good," the ultrasound tech informed us.  I couldn't stop crying.  Could this really be, after all these years?  My husband held tightly to my hand as we both stared at that little dot on the screen and tried to imagine it turning into a baby.

"But I was told I don't ovulate," I told her.

"Well, baby girl, you obviously do!" she said cheerily.  I found the term of endearment both comforting an amusing; amusing since I am at least a decade and a half older than she is, but still, something about it made me feel better.  It made me feel not quite so old, like maybe I wasn't some circus freak who accidentally found herself pregnant.  Maybe everything would be okay.

My doctor shattered that dream in 5 seconds flat.  Another staff member came in and gave me a hug.  She kissed me on the cheek and told me that God gave me this blessing and that everything was going to be okay.  I so desperately wanted to believe her.  Tears slid down my cheeks and I nodded, not trusting my voice. I'm not sure if it was seeing that blip on the ultrasound, but I wanted this baby.  Badly.

My doctor's nurse, who was pregnant herself, sat down in front of me and handed me a stapled stack of papers containing information on what I can and can't eat, what medicines are okay to take, what to expect with the beginning stages of pregnancy, and then told me to buy some pre-natal vitamins, making sure they have DHA and Folic Acid.  Again, I nodded numbly and tried not to think too much.

We silently left the office with a stack of papers, 2 square ultrasound pictures, an appointment to come back in 10 excruciatingly long days to see if the pregnancy was viable, and an explanation of what I could expect if I were to miscarry. I couldn't speak for fear of falling apart.  Why would we be given this gift only to have it taken away? Little did I know I would ask myself that many times over the months.

We decided to tell our parents, who we are very close to. I just couldn't imagine not telling my mom, and if we told my mom then we had to tell the other parents, too.  I was both excited and nervous.  I didn't want to give them this hope for a grandchild and have it taken away, but we felt we needed support.

"Mom, we're not going to Ireland."

August 20, 2012

Since my husband works weekends Mondays are the beginning of our "weekends".  Every other Monday the housekeeper arrives and we are rushing around trying to get the house ready for her and get out the door so we're not in her way.  But this Monday was our "lazy" Monday.  We had errands to run - I was shipping copies of my third novel to the UK to the photographer who had done the cover photo, and we were picking up passport applications for my mom and stepfather for our upcoming trip to Ireland.  It was just an ordinary summer day, humid but not horribly hot.

We had gone camping for several days at the lake at the very beginning of the month and my period had been late, but I didn't think much of it.  Having suffered with PCOS (Polycystic Ovarian Syndrome) for over half my life that was the norm.  However, for the past two years or so my periods had been quite regular, though an odd one here and there would remain in the mix. 

I had started the Paleo diet and was feeling really great. During the camping trip at the beginning of the month I had more energy than I had felt in years!  But for the past two weeks I had started to feel rather run-down. The weekend had left me feeling like I had the flu, but I knew it was more than that.  My breasts were more sore than they had ever been in my life and I had almost constant panic attacks, a condition I thought I had control over.  I spent the entire weekend in bed and by Sunday night, thanks to Dr. Google, I had convinced myself I had some terminal disease.  

My husband Russell, who is an ER nurse, kept telling me I was pregnant.  I laughed it off.  I don't ovulate. I am 43 years old.  We have been married for 13 days shy of 22 years.  We did the fertility treatments early on in our marriage.  We had 7 failed adoptions before finally adopting two older children from Eastern Europe in the mid 90's.  One of those children now has children of his own.  We are grandparents. We are empty-nesters. I am not pregnant.

We went to lunch at our favorite Mexican restaurant.  I felt like I was suffocating. I was hot, claustrophobic. I needed air.  We sat outside and I began to feel somewhat better though still a bit shaky with a sense of derealization, which are always the after-effects of a panic attack for me.  The food tasted "off" and far too spicy.  I didn't enjoy it.  

After lunch we went to Bed Bath and Beyond for a pillow for my mom to give to her on her birthday.  The fluorescent lights very nearly sent me into another state of panic, which again, is the norm for me when recovering from a bad spell of panic attacks.  Dizzy and faint with a racing heart, I practically threw the pillow at Russell and ran out the door while he paid for it.  I could barely breathe as we made our way to the car.  

"Are you ready to get a pregnancy test?" Russell asked.

"I'm not pregnant."

We drove straight to CVS and bought the CVS brand of pregnancy tests.  It was a 2-pack, on sale for half the price of the EPT.  I stared at the box on the shelf.  It seemed so harmless; just a little rectangular box wrapped in clear cellophane nestled side-by-side with other little rectangular boxes.  I grabbed it off the shelf and tossed it into the basket with some other miscellaneous items.  I was sweating, shaking, and was sure everyone in the store was staring at me as if I had a big neon "Old and Pregnant!" sign on my forehead.  

A young twenty-ish male clerk rang up our purchases and tossed the box into the bag.  I watched it disappear into the abyss of white plastic.  Didn't he realize that box contained something that could change the rest of my life?  He didn't give me or Russell so much as a glance as he handed my husband the receipt.  I practically ran to the car, still shaking, and took several deep breaths.  

Twenty minutes later I was sitting on the toilet, unwrapped white plastic stick in hand. "I can't do this," I told my husband, who stood in the doorway watching as our lives were about to change.  Had I known this, I might have paid more attention to his expression.  Was he excited?  Nervous? "I need a cup.  I'm going to drop it."

Russell went to the kitchen and got a coffee mug from the cabinet (I won't tell you which one in case you are ever at my house and are served coffee or tea).  "A coffee mug?" I practically shrieked.  "We drink from those!"

"What else did you want me to get?"

"I don't know; maybe something disposable?" I asked.  My voice sounded odd, like I was hearing it from another room.

"We can wash it."

I peed in the cup, terrified I was going to drop it into the toilet, then carefully uncapped the plastic stick and placed it in the pee.  We were supposed to wait 20 seconds for it to "cure" and show either a plus or minus sign.  1.2 seconds later a blue plus sign glared back at us from the tiny little window.  I practically spilled pee all over the floor as my husband grabbed the cup from my hand, which had gone from a mere tremble to a violent shake.  "Oh my God, Oh my God," I repeated over and over.  And then, "Nooooooooooo," I wailed as I began to cry.  I am ashamed to admit that my first reaction was not one of joy, or even astonishment, but one of pure terror.  Did I want a baby?  Did he?  I'm too old for this! Our lives are good, great, in fact.  We have freedom to do what we want - sleep in late, travel in the off season, curse.  Was this some cruel joke after all these years? Why now???

Russell stood in the doorway grinning; I'm still not sure if it was from amusement at my reaction, happiness over that little blue plus sign, or if it was actually a wayward grimace.  "I guess you'd better call your doctor," he said nonchalantly.   

How can he be so calm?! I was an absolute mess. I paced around the house, my mind racing a mile a minute. He tried to comfort me, tell me everything was going to be okay.  The only thing he convinced me of was that he was completely delusional.  This was going to change our lives forever.  This was not like adopting a puppy.  This was a baby, and babies turn into teenagers and OhMyGod I was going to be 63 years old when this kid was 20! 

Numbly, I went to my purse and got my appointment card for next year out of my wallet.  It contained all of my doctor's contact information. I stared at her number for long moments before finally punching in the numbers on my phone.  I would have to change doctors since my doctor only practices gynecology.  To say I hate going to the doctor would be a vast understatement.  It literally sends me into a tizzy, as my husband would say.  Don't pregnant women have to go to the doctor a lot?  I finally hit send and the phone rang several times as my heart pounded.  When the receptionist answered I blurted out that I had just taken a pregnancy test and that I didn't know what I was supposed to do next.  There was no real reaction, no shock on her part.  She simply told me she'd have my doctor call me back.  

Over an hour later I received a call back from the nurse. She asked when my last menstrual period was and told me she had already made an appointment for me to have an ultrasound the next morning, then I was to come to see my doctor, who happened to be right across the hall.  This was moving all too fast!  Didn't it take months to get an appointment?  And why did  I need an ultrasound so early?  She said something about referring me to a high risk OB due to my age and asked if I had a preference for a male or female.  Definitely female, and I want someone nice, someone who won't judge me for my weight or the fact that I'm too old to be birthing a baby.  She promises she will find the perfect doctor.  

Later that night I try to fall asleep, but sleep is far from my reach.  I am terrified - not because I'm afraid they'll confirm I'm pregnant, but that they'll tell me I'm not.