Thursday, June 5, 2008

7w2d: Introducing.... Blueberry!

I'm sorry if my comments have been sparse lately. I'm trying to catch up with everything, mostly real-life stuff.

I haven't told you guys our nickname for the embaby: he or she is called Blueberry. I think the name came up on the day of the ET; I was looking at pictures of 5 day blastocysts online and we were trying to think of a name, and that's what stuck! Maybe we were influenced by pictures of the day 4 morulas (aka raspberries); I don't know. Anyway, I've really liked how so many of you have had nicknames (Scrappy and Doozer come to mind), and it feels really good to be able to call him/her by name without assigning a gender and still staying a tiny bit detached (see below).

My two readers with a medical background may recall that there is a scary syndrome known as a "Blueberry Muffin Baby." Which is not a good think, as it signifies congenital rubella, CMV infection, etc. I refuse to give up our cute nickname because of that!

Chicago was fun but exhausting. There were about 33,000 (or more) people attending this conference, so it was crazy. I was listening to lectures about breast cancer pretty much 8AM to 4 or 5PM every day, and I learned a lot. It is always inspiring to hear about all of the new therapies and hopefully tests that will help predict which patients will benefit from these therapies. I also realized that unless I start focusing more time on work, I'm unlikely to ever get my name on even a tiny abstract.

The fun part of the trip was that I had the chance to stay in a hotel room with my friends K (wonderful friend since 7th grade, high school, college, and residency; also a Heme/Onc fellow and the mother of an adorable 9 month old boy) and A (friend from residency, also a Heme/Onc fellow at the same institution as K, and 17 weeks pg). We enjoyed talking about everything: pregnancy stuff, career issues, and reliving the laughs, odd personalities, and horrors of our stressful Inter.nal Medicine residency program. It definitely helped the days pass quickly up until today's ultrasound:

The great news is that Dr W is thrilled about Blueberry's progress. His/her crown-rump length is 9.9 mm, right on target. The heart rate was a perfect 148 bpm, and this time we not only saw the flicker of the heartbeat, but we were actually able to hear it (via transvaginal Doppler). Absolutely amazing!

I would be lying if I didn't admit to you all that I am still incredibly nervous, though. Blueberry's gestational sac is only 17 mm in its longest dimension. The mean gestational sac diameter would certainly be even smaller. 17 mm corresponds to about 6w3d or so, ie about 6 days behind. I've spent hours googling this topic, and this pretty much summarizes my current angst:

1) I asked specifically, and Dr W is NOT concerned about the sac size. She says it is completely fine, and she assures me that if she did have any concerns, she would let me know. I don't know why this isn't enough for me.

2) most websites, scientific articles, and textbooks do not really talk much about sac size or the variation thereof, and it is most frequently mentioned referring to badness such as having a certain-sized sac without a visible yolk sac or embryo

3) there was one (and only one) study in 1992 which found that if the difference between the gestational sac size and crown-rump length was less than 5 mm, the chance of miscarriage was 90%. If it was 5-7.9 mm, it was 26%, and above 8 mm, it was 10%. In my case, the difference was 7.1 mm (17-9.9 mm).

4) The sac should increase in size by about 1 mm/day, and the average is 1.1 mm/day, I believe. An increase of under 0.6 mm/day is a poor sign. Mine did increase by 1mm/day since 6w0d, so I guess I'm on-track there.

5) I read a blog in which the author had a normal sized embaby and a small sac, raising her OB/GYN's concern. Unfortunately, the blogger's embaby stopped growing soon thereafter (at about 8.5 weeks). Other blogs described twins in which the smaller sac embaby did not make it. A few other blogs had cases in which everything seemed to turn out fine, but somehow these did not completely reassure me.

Oh please, please don't let Blueberry run out of space to grow!!

My mood varies from elation to dread, depending on if I am thinking
about the beautiful heartbeat or the petite sac. I will probably see Blueberry next on Tuesday, June 17, at 9w0d. Our other option was 8w3d, but that is Friday the 13th, and I guess I'm feeling a little superstitious. The main consideration, however, is that S will be coming to the next ultrasound, and I figure that we might as well see as developed of an embryo as possible at that visit. So, 9 weeks it is! Today's ultrasound was great, but I couldn't make out what was head/yolk sac/body/limbs, and I'm looking forward to being able to see a bit more detail.

I am truly sorry if all of my whining and worry seems frivolous to anyone out there who is still TTC. I don't know, I think I am kinda scarred from the entire IF experience, and I can't believe that this will really work for us.

Please keep growing, Blueberry!


Blue said...

First off, huge congrats on your pregnancy; I've been reading your blog for a while now and have found it helpful and inspiring to follow your story. I'm thrilled for you that you got your bfp! (sorry I didn't comment earlier, I'm just starting to de-lurk from the shadows and comment more). Blueberry is such a cute name too!
As for your worries - its totally understandable and I don't think those of us still on the ttc side of the fence would ever think they were frivolous or whiney. It takes so much effort and emotion to get to where you are now; I can't imagine that the worries would just evaporate. The best news is just how positive your docs are - hold on to that even in your most worried moments!
I'm glad you got through ASCO without being totally exhausted! I've been before and it just seems to get bigger by the year. It was exhausting just trawling through abstracts from my desk this week :-) !! Sending you lots of positive vibes for Blueberry!

Morrisa said...

I think Blueberry is just beautiful! I know it's hard to not worry, even when the doctor tells you she's not worried. I do it all the time! It's not that I don't trust my RE, it's just that when it takes so long to get here you can't help but worry. I think that as long as your sac is growing along with your baby you should be fine. Grow Blueberry grow (and make sure your house grows too!)

Jen said...

At this stage of the game, you're going to be nervous. I know that I sure was. And as a doctor, you have an even more heightened awareness of what can go wrong coupled with better research skills. Very dangerous. My only advice is to do everything possible to keep busy for the next couple of weeks.

By the way it is absolutely amazing how much growth takes place between 7 and 9 weeks. I remember my Spot going from a blog to a gummy bear in that short amount of time. I can't wait to see how your Blueberry changes too!

Hilary (The Trying Game) said...

Blueberry is a great name! I know it's waaaay easier said than done - and I am the last person that should be touting this advice - but really, try to relax. Your little one will undergo so many changes, trust me, you'll be worried about the next thing in no time.

Hang in there. And keep breathing.

Anonymous said...

Love the name. Sorry for the concern, and I hope it turns out that you worried for nothing.

Yipppeeeee!!!!! I'm so happy for you.

DC said...

Last time I made it to ET, I named my embies "Cr@ppy" and "Gimpy." (They had arrested at two and four cells, respectively.)

Glad the u/s went well! :)

Lorrie said...

Blueberry is such a cute nickname! Congrats on the ultrasound, and on actually hearing the heartbeat.

I think it would be weird if you WEREN'T a bit worried about Blueberry, considering what you've gone through. But try to stay optimistic.

Glad your trip went well.

sashacub said...

Congratulations on your pregnancy!
This is the first time I have ever written on a blog. I can't believe how similar your story is to mine. We are the same age (and star sign), both internal medicine (I'm though I have a year of fellowship to go). We have been trying since Jan 2007 (both drs, he is male factor infertility, I have PCOS). We are just starting IVF(straight to ICSI) this month - I am currently on puregon injections and probably going for a harvest (not up on the lingo yet) this Friday. I am terrified about OHSS. I have been lucky enough to not have any SES yet. I am encouraged by your blog. I have been dying to ask about things like coping with work, getting through being a registar (what we call it in Australia). I know work isn't important in the scheme of things, but looking at how you cope with balancing everything. I think I will have to go to your blog from the beginning and catch up with it..glad I've found this site!