FUCK.
And did I mention FUCKITY FUCK FUCK?
And OH! I keep forgetting to tell you: FUCK.
I left my level II ultrasound appointment yesterday with a handy little flier entitled, Patient Information: Intracardiac Echogenic Focus.
FUCK.
Twin B has an echogenic focus in her heart, which confusingly enough doesn’t appear to have anything to do with the structure (or functioning) of the heart itself. Rather, it is another ‘soft marker’ for Down’s.
First of all, I fucking hate how the doctors use fucking air quotes when referring to these <bunny ears> soft markers. And secondly, Twin A had the slightly higher risk based on the NT scan. So now this twin’s odds went from 1:500 to about 1:250, same as her brother.
The handy dandy reading material they gave me says, "You have recently learned your unborn baby has an ICEF. We expect that you may have questions about what this could mean for your developing baby [you fucking THINK!?] and hopefully this information will answer some of your questions."
It should also say, "And we hope that you don’t crap your pants in the waiting room after reading this pamphlet, which would make for a less than pleasant experience for your fellow patients." (I don’t know why it doesn’t say that.)
Basically, the ICEF is a bright spot within the fetal heart picked up by the ultrasound. In most cases, the presence of one is nothing more than a ‘normal variation’ of anatomy, but in some cases it could mean there are other problems such as Down’s.
The appointment yesterday was just pure comedy. Except of course, the part about the ICEF and me leaving in tears.
But before that part, the first technician was yelling at the technician-in-training to "turn on the machine like zis and put a tape in and viola! you can get started!" He was Persian but had what sounded to me like a very strong French accent. He was heaving the ultrasound machine around and banging it into the table and plugging cords into the wall and flinging the wires and cables around and I was trying to stay relaxed, but BeBop, who hasn’t been to too many appointments with me, was clearly out of his element and unnerved by the whole thing.
The technician finally got things going and once the babies could be seen on the screen, he kept yelling strange letters and numbers at the poor trainee who was furiously scribbling notes in my file. It sounded like this: "Put 4.5 on E3, and CIRCLE IT! YES!!! NO!! Put 4.5 on E3 over to zee RIGHT – ZEE RIGHT – and CIRCLE IT. YES! GOOD!"
"Do you feel zee babies moving yet?" he asked. "Um, I’m actually not sure," I said. "Well with za first baby you might not feel it for awhile. It is called zee quickening."
"Will I know it when I feel it?" "Oh yes," he answered.
Finally, he asked the doctor to come in and take a look. Immediately warning bells went off in my head, "does he always ask for a consult?" I asked the trainee. She said yes, but honestly I was starting to freak out a bit.
The doctor turned out be like 100 years old, with a shock of white hair and the strongest Irish or Scottish accent you have EVER heard. (Thus the comedy, had it not been happening to us.)
So the technician was showing him the bright spot (ironically named, no?) while he was babbling almost incoherently. I kept interrupting them to ask questions and eventually I got the hang of their accents. But poor BeBop was in a chair, and their backs were turned to him, so he literally could not understand one word of what they were saying.
After the doctor was done confirming the presence of the ICEF, we were in the waiting room waiting for the genetics specialist. The first tech came out and said, "Did you understand Dr. Irish/Scottish Brogue? He speaks so fast and has zee strong accent and many peeeple cannot-uh understand him…"
Every time I would repeat a statement back to him to ensure I understood what he was saying, he would respond with an enthusiastic, "VIOLA!! YES!! You understand zee situation!!"
He went on to explain that about 4% of Caucasian couples have a baby with an ICEF picked up by the ultrasound. In the vast majority of cases, it’s nothing. It either resolves itself and goes away or remains but the baby is perfectly healthy.
But.
In some cases, they have found that Down’s babies have an echogenic focus. This is the same issue with the NT measurements, a higher number doesn’t mean you have a baby with Down’s, but some babies with Down’s were found to have the higher measurements. Thus the annoying term ‘soft marker’ I guess.
In the end, they were not too alarmed because we had done PGD. They didn’t come out and say we should do an amnio, but of course they offered it to us. They did recommend we get a heart scan, but they said this was routine for all twin pregnancies. This was news to me.
I have an appointment next Tuesday for a heart scan and I guess we’ll see what they say. We still don’t want to do the amnio. BeBop would support me if I decided I did want to do it, but I don’t.
Plus, at this point both babies are in the same risk category. Which twin would we test? Pick one? Flip a coin? Test BOTH? Can you see the comedy in this whole scenario?? Yeah. Me neither. But I’m trying here.
Anyhoosers, after we walked out I was stunned, to say the least. "Can’t we just get some GOOD news?" I wailed. "Can’t we just catch a break and get a clean bill of health, so I could worry a little less instead of a lot more?" BeBop was parked in the other direction, so after he tried to console and reassure me, he headed off towards his car. As I approached my own car, any semblance of focus, grace, balance and decorum went down the toilet as I managed to somehow turn my ankle stepping off the curb and FALL INTO ON-COMING TRAFFIC.
Thankfully, the light at the end of the block was red, no cars were screaming by ready to smoosh my head into the pavement. My keys went flying so after it dawned on me that, fucking hell, I had fallen again, I sort of lurched forward and grabbed my keys and stumbled into my car.
And dissolved into heaving, gasping-for-breath sobs.
Then I turned on the car and the song Little Wonders was playing on the radio. I first heard this song just after I found out I was pregnant with twins, and it’s been a huge source of comfort to me every time I hear it.
let it go
let it rub out of your shoulder
don’t you know
the hardest part is over
let it in
let your clarity define you
in the end
we will only just remember
how it feels
chorus
our lives are made
in this small hours
these little wonders
these twisted turns of faith
time falls away
but these small hours
these small hours
still remain
let it slide
let your troubles fall behind you
let it shine
till you feel it all around you
and I don’t mind
if it’s me you need to turn to
we’ll get by
it’s the heart that really matters
in the end
chorus
all of my regrets
we’re washing it somehow
but I cannot forget the way I feel about now
in these small hours
these little wonders
these twisted turns of faith
these twisted turns of faith
time falls away
in these small hours
in these small hours
still remain
they still remain
these little wonders
these twisted turns of faith
time falls away
but the small hours
these little wonders
still remain.
BeBop is still convinced everything is just fine. And that if it’s not, we’ll still be okay. I continue to wonder how on earth women go through this.
I am waiting for the heart scan to see if they pick up anything else and recommend doing amnio, or perhaps don’t see the ICEF at all.
In the meantime I am trying to not think about it or cry too much at work or in the car, but rather just limp around on my sprained ankle and wonder when I’m going to need a full body suit of padding and a helmet because of my worsening clumsiness.
And I’m trying to stay calm, and have faith. Faith that all of this will be okay, that my little wonders are just fine.
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