Monday, April 21, 2014

Abnormal Pregnancy Blood Tests and Nagging Fears...

            “The blood test results were not in the normal range,” Dr. Landry said. I stared out our expansive kitchen windows and let my eyes wander across the valley and rolling hillside to the towering, snow-covered peaks in the background. Then I closed my eyes to bring my dazed mind back into focus.
            “They were just outside of normal, in the direction indicating an increased risk for Down Syndrome,” he continued. “Keep in mind that this test is not highly accurate. But there is a more accurate test I can order, performed through the University of California at San Diego. I will have to obtain approval through your insurance company first, but I think you should have it done. I do not believe there is any problem, but it is an option for you. The obstetricians in California have been pushing the state to utilize this test for some time, and it will be available to all pregnant women in January. Since you can’t wait until then, we have to get authorization.”
            “Okay,” I agreed as I began raking my fingers through my hair and pacing the kitchen and thinking out loud to him. “I know there’s no neural tube problem. The ultrasound pictures ruled that out. And even if the tests indicate a likelihood of Down’s Syndrome, you know I won’t agree to an amniocentesis. If I did have an amnio, and the genetic tests indicate my baby has Down Syndrome, you still wouldn’t be able to tell me the severity of the condition, would you?”
            “No,” Dr. Landry sighed. “This is true. I wouldn’t be able to give you that information. But I think it would be best if we knew what the possibilities were. However, the blood test is entirely voluntary."
           I didn't think twice. “I’ll have it done.” The phone call ended after Dr. Landry promised to call the insurance company.
            We quickly received authorization, and I drove thirty miles to the lab. Upon checking in, I learned I’d be part of a test accuracy experiment, which required me to sign forms giving my permission for the test information to be compiled into research data, and the outcome of my pregnancy forwarded to the testing and research facility. They drew the necessary amounts of blood then rushed the specimen to the University of California at San Diego.

            Dr. Landry assured me he’d call when the results arrived.
            His phone call came on a Friday night, around 7:00, while I was lying on my bed, relaxing and chatting with Chris, who was puttering around the bedroom. Chris answered the phone, uttered a “Hi!” and an “Uh huh,” and then handed me the receiver.
            “It’s Dr. Landry,” he mouthed.
            I sucked in my breath as a short oath abruptly escaped my lips. “He’s calling me himself?” I squeaked. Chris nodded, and I sighed in resignation. If Dr. Landry were making a personal call to me on a Friday evening, at this hour, it couldn’t be good news.
            “Hi!” he greeted me from the other end of the line. “It’s Mike Landry.”
            I dispensed with the usual “Hello. How are you?” then waited, eyes pinched shut, fingers raking my hair.
            “I am very happy to let you know that the results are back and everything is just fine! They indicated you have only a 1 in 600 chance of having a baby with a genetic abnormality. I thought everything would be fine.” I could envision his satisfied smile, as he sat hunched over my file at his office desk.           
            “Oh, thank you so much for calling me personally, Dr. Landry! When Chris told me it was you on the phone, and not your nurse, I thought for sure you’d be giving me bad news!”
            “No, with this kind of thing I do the calling myself.” (Shock.) Not too many doctors like that around.
            “Well, I appreciate it very much, “ I countered, eyes widening as I locked them with Chris's. “I am very impressed. Not many doctors I’ve had experience with do the calling themselves. Thank you!” A smile broadened across Chris’s face as he interpreted the conversation for himself.
            “You are welcome. Now you can relax. I will see you at your next appointment!”

            My next appointment. I absent-mindedly nibbled my lip. If I could just get beyond that critical twenty-week period, I knew I’d be able to relax. Until then, concern would plague me about something going wrong, something we missed. I mentally admonished myself for reading too many books about pregnancy problems, too many books about prenatal and neonatal loss.
            I needed to enjoy the good news I’d just received: the chances of my baby having a genetic abnormality were slim, and I did not have a placenta previa. The baby was strong and active. What more could I worry about? Why not settle back and enjoy this last pregnancy?
            With all of this wonderful news, why do I harbor some elusive dread that something was just not right?



            My twentieth week appointment arrived, and Dr. Landry triumphantly announced that everything looked normal. My weight gain was still rapid, but he’d allow me further extension of culinary indulgence for another couple of weeks before insisting I watch my diet more carefully. Everything was proceeding so well that I could discontinue my disability status.
            Before leaving his office, I nagged him again about the cervical pressure I’d felt, and the unusually high amount of discharge.
            His response remained the same: Both of those complaints were normal. Since I had delivered my first son at full term without any problems, he said there was no reason to expect I had an incompetent cervix. He reiterated, with emphasis, “I am not concerned about your symptoms.”
            “I’m reading too many books about pregnancy problems,” I muttered to myself while dressing.
            Happily, I left the office after making an appointment to return in another month, and my focus turned to the following week when my parents would join us for Thanksgiving. We planned to converge on my cousin’s house in Escondido for a family gathering and feast.
            As long as I can get some rest, everything should be okay. Didn’t Dr. Landry say I was doing fine? He would know, wouldn't he...?

NEXT WEEK: A not-so-stress-free Thanksgiving sends me over the edge, and my women’s intuition bears fruit…

Until next week,

Thanks for joining me!