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[molli_sols]

Unoriginal, Praying for you and your little one.  Hoping you find some good ways to take your mind off it this weekend. 

Icicles, I am right there with you on the summer class.  I'm due a week after mine ends, but it's all online so I don't have to adjust much.  My campus semester starts two weeks after that though so I am hoping for the day or so after summer grades are due to have a little recovery with no official duties. 

[titania]

Sorry unoriginal!  That sucks to have to wait so long.  Hoping for the best results from the amnio.

[icicles]

I am sorry, unoriginal, and hope for more comforting results at the amnio.

At times like these, I try to tell myself "it is what it is, and I can't do much to change this baby now except take good care of myself and take my prenatals. it will be what it wants to be." I rarely feel that I can't control something, but during pregnancy, I force myself to stand back and acknowledge that a lot of what this baby is (and will be) happened the second it was conceived when the chromosomes paired off.

[menotti]

Good luck, unoriginal.  As someone who studies screening, I am always stunned by how completely blase the doctors are about Downs screening - lots of violations of basic principles of screening there.

Well, my morning sickness came roaring back and no bleeding, so I assume I'm still going.  I've actually been just astoundingly sick over the last few days.  I'm supposedly headed into the peak weeks here.  Can't hardly wait.

[icicles]

Icicles, I am right there with you on the summer class.  I'm due a week after mine ends, but it's all online so I don't have to adjust much.  My campus semester starts two weeks after that though so I am hoping for the day or so after summer grades are due to have a little recovery with no official duties. 

Ooof! Yes, it looks like we are both dealing with pregnancies that hinge on some precarious timing. Let's hope for the best! I am really hoping I don't have a c-section and can recover relatively quickly.

[unoriginal]

Good luck, unoriginal.  As someone who studies screening, I am always stunned by how completely blase the doctors are about Downs screening - lots of violations of basic principles of screening there.

Well, my morning sickness came roaring back and no bleeding, so I assume I'm still going.  I've actually been just astoundingly sick over the last few days.  I'm supposedly headed into the peak weeks here.  Can't hardly wait.

Menotti, I'm glad you're currently feeling like sh!t!  :)

I'm interested (from a scientific viewpoint) what you mean about the violations of basic principles of screening.  I found my own experience to be professional, and I think they were basically accurate, although I was confused as to why the doctor said on the day of the ultrasound that the measurements looked good, and then a week later, when the results came back, I was told that I had elevated risk precisely because of the ultrasound measurements.  But I think the genetic counselor cleared that up pretty well for me.

I've been having wildly swinging emotions.  It's going to be a long, long 4 weeks. 

[senay]

Unoriginal, I'm so sorry that you'll have to wait for four weeks to learn more news.  But try to remember the 92+% odds that all is well with your little one.  In the mean time, do what you need to do to take care of yourself physically and mentally.  Treat yourself to something nice...if you like pedicures, get one; if you like cupcakes, go for it.

The big news from my sequential screening is that we know the sex of the baby at only three months!  Another boy.  So now we can begin discussing (debating?) boy names with real certainty.  And now I am showing enough to have folks start asking the "are you...?" questions.  I'm breaking out the real maternity clothes this week, instead of the loose regular clothes I have been wearing, so my students will probably start giving me the eyeball as well.

Hope everyone has a very good week!

Senay

[titania]

Good luck, unoriginal.  As someone who studies screening, I am always stunned by how completely blase the doctors are about Downs screening - lots of violations of basic principles of screening there.

Well, my morning sickness came roaring back and no bleeding, so I assume I'm still going.  I've actually been just astoundingly sick over the last few days.  I'm supposedly headed into the peak weeks here.  Can't hardly wait.

Menotti, I'm glad you're currently feeling like sh!t!  :)

I'm interested (from a scientific viewpoint) what you mean about the violations of basic principles of screening.  I found my own experience to be professional, and I think they were basically accurate, although I was confused as to why the doctor said on the day of the ultrasound that the measurements looked good, and then a week later, when the results came back, I was told that I had elevated risk precisely because of the ultrasound measurements.  But I think the genetic counselor cleared that up pretty well for me.

I've been having wildly swinging emotions.  It's going to be a long, long 4 weeks. 

Menotti I am also glad you are feeling sick again!

I am not an expert, but one of the complaints I heard when reading about the screening process is that it is just not explained sufficiently well.  A "positive" means just elevated risk which suggests further testing, rather than a positive result.  But when not explained, a lot of people come away saying "I tested positive and then the doctors were wrong because the baby was fine," not really understanding that screening is not the same as diagnostic testing.  Anyhow, Menotti may be referring to something completely different, but I remember reading about that at the time I was doing the testing.

Senay, congratulations on the boy!

[molli_sols]

I am in my office bawling because I just felt the baby move for the first time.  I thought I was getting tickles last week but then my ultrasound showed an anterior placenta I thought it was in my head.  No way.  This was the real deal.  I want to lay down on my yoga mat to soak up the flutters for a while instead of grading exams  :-)

[menotti]

Good luck, unoriginal.  As someone who studies screening, I am always stunned by how completely blase the doctors are about Downs screening - lots of violations of basic principles of screening there.

Well, my morning sickness came roaring back and no bleeding, so I assume I'm still going.  I've actually been just astoundingly sick over the last few days.  I'm supposedly headed into the peak weeks here.  Can't hardly wait.

Menotti, I'm glad you're currently feeling like sh!t!  :)

I'm interested (from a scientific viewpoint) what you mean about the violations of basic principles of screening.  I found my own experience to be professional, and I think they were basically accurate, although I was confused as to why the doctor said on the day of the ultrasound that the measurements looked good, and then a week later, when the results came back, I was told that I had elevated risk precisely because of the ultrasound measurements.  But I think the genetic counselor cleared that up pretty well for me.

Well, there's a set of criteria a good screening program should meet:
    constitute a significant public health problem, meaning that it is a common condition with significant morbidity and mortality. (Maybe, these conditions are pretty rare, but very serious)
    have a readily available treatment with a potential for cure that increases with early detection. (This is the crux of it - how do you feel about a treatment that is a late abortion?  It's a "cure" in only a narrow sense.)

The test for the disease must
    be capable of detecting a high proportion of disease in its preclinical state (Quad screen doesn't do a great job, though quad screen + amnio is good)
    be safe to administer (quad screen very safe - amnio much safer than it used to be, though still may carry a slight risk of miscarriage)
    be reasonable in cost (prob ok)
    lead to demonstrated improved health outcomes (again, depends on your feelings about abortion)
    be widely available, as must the interventions that follow a positive result

I guess my main concern is that doctors don't make the process very clear.  I was told this was a routine test.  I was not told, well, if this comes in high, you'll need an amnio, and if that's positive, you have the choice of a disabled child or late-term abortion.  Not to mention an incredibly stressful few weeks, even if everything is good.

I'm pretty strongly pro-choice, and I don't know what decision I would make.  But it certainly would be a difficult one, and not one I'd make lightly.  So the doctors more or less blowing the test off did not sit well with me.

[unoriginal]

Well, there's a set of criteria a good screening program should meet:
    constitute a significant public health problem, meaning that it is a common condition with significant morbidity and mortality. (Maybe, these conditions are pretty rare, but very serious)
    have a readily available treatment with a potential for cure that increases with early detection. (This is the crux of it - how do you feel about a treatment that is a late abortion?  It's a "cure" in only a narrow sense.)

The test for the disease must
    be capable of detecting a high proportion of disease in its preclinical state (Quad screen doesn't do a great job, though quad screen + amnio is good)
    be safe to administer (quad screen very safe - amnio much safer than it used to be, though still may carry a slight risk of miscarriage)
    be reasonable in cost (prob ok)
    lead to demonstrated improved health outcomes (again, depends on your feelings about abortion)
    be widely available, as must the interventions that follow a positive result

I guess my main concern is that doctors don't make the process very clear.  I was told this was a routine test.  I was not told, well, if this comes in high, you'll need an amnio, and if that's positive, you have the choice of a disabled child or late-term abortion.  Not to mention an incredibly stressful few weeks, even if everything is good.

I'm pretty strongly pro-choice, and I don't know what decision I would make.  But it certainly would be a difficult one, and not one I'd make lightly.  So the doctors more or less blowing the test off did not sit well with me.

Well...

They routinely test infants for metabolic disorders like PKU with that heel prick at day 1 or 2, but those are certainly not common conditions.  That does fit the morbidity, mortality and treatment criteria though.

About the interventions that follow a positive result.  Yes, I spent some time last week researching late-term abortion.  It's decidedly not widely available where I live - I'd be looking at a 2-3 hour drive each way, which probably means an overnight stay since the procedure will take 2 days, which means I'd have to concoct some story for my children, who do not know about the pregnancy...

I don't know what decision I would make if the results are positive.  I am having a very difficult time even weighing my options.  My doctors haven't really talked to me about the options, especially the implications of the disability - which is obviously an enormous factor in the decision-making.  My doctor is affiliated with a catholic hospital - I had to cite menstrual problems (which was the truth) to get an IUD (which ended up not working for me) - so I don't even know if they are going to mention late-term abortion.  And you're right - if they don't, there doesn't seem to be much of a point in doing the screening. 

[amlithist]

I am sorry, unoriginal, and hope for more comforting results at the amnio.

At times like these, I try to tell myself "it is what it is, and I can't do much to change this baby now except take good care of myself and take my prenatals. it will be what it wants to be." I rarely feel that I can't control something, but during pregnancy, I force myself to stand back and acknowledge that a lot of what this baby is (and will be) happened the second it was conceived when the chromosomes paired off.

I never really thought of this until now, but it occurs to me that this is true beginning with the pregnancy, and then for the next ____ years (ours are in their 20s now, and there's no end in sight for this situation!).

ETA:  we're both as pro-choice as they come, too, Menotti, but it was an issue that tore us up while we waited for results, further complicated by the experience of my husband's sister's little boy having had hydrocephalus at 18 months and, even now at age 35 functioning as about a 7-year-old. 

In any event, I'll share what my wise mother told me at the time:  if you're going to have to decide, it'll come soon enough--don't worry yourself sick until you have to.  Easier said than done, I know, but it really is true.

Good thoughts and hugs to all here--and Menotti, hooray for the sickness!  :-)

[macaroon]

About the interventions that follow a positive result.  Yes, I spent some time last week researching late-term abortion. 

Ah - this isn't the only "intervention". 

I'm a pushy jerk about any type of medical testing, and I was even moreso while I was pregnant, some of which had to do with the fact that I participated in a prenatal screening study with child #1 which required a higher than usual degree of informed consent.

So I asked my OB - "If I'm not going to abort anyway, why do this screen?"  And he told me....

The "other" interventions occur shortly after delivery.  Many babies with down syndrome have heart defects, and some have intestinal defects, and sometimes they require surgery.  If you decide to continue the pregnancy, you'll want to deliver somewhere with a pediatric cardiologist on staff, and ensure that he or she is alerted when your baby is born.  Similar issues with spina bifida, and if quad screens and nuchal translucency are coming up positive, and other things aren't quite right (like the baby's size), it might be a good idea to deliver at the "best" hospital just as a precaution. 

[tinyzombie]

I am in my office bawling because I just felt the baby move for the first time.  I thought I was getting tickles last week but then my ultrasound showed an anterior placenta I thought it was in my head.  No way.  This was the real deal.  I want to lay down on my yoga mat to soak up the flutters for a while instead of grading exams  :-)

Delurking to say congratulations! That's so exciting.

I teared up over a baby in footie PJs yesterday.

Tick.

Tock.

[dr_alcott]

About the interventions that follow a positive result.  Yes, I spent some time last week researching late-term abortion. 

Ah - this isn't the only "intervention". 

I'm a pushy jerk about any type of medical testing, and I was even moreso while I was pregnant, some of which had to do with the fact that I participated in a prenatal screening study with child #1 which required a higher than usual degree of informed consent.

So I asked my OB - "If I'm not going to abort anyway, why do this screen?"  And he told me....

The "other" interventions occur shortly after delivery.  Many babies with down syndrome have heart defects, and some have intestinal defects, and sometimes they require surgery.  If you decide to continue the pregnancy, you'll want to deliver somewhere with a pediatric cardiologist on staff, and ensure that he or she is alerted when your baby is born.  Similar issues with spina bifida, and if quad screens and nuchal translucency are coming up positive, and other things aren't quite right (like the baby's size), it might be a good idea to deliver at the "best" hospital just as a precaution. 

+1. x100.