Happy and relieved post - Eighth Appointment / First Ultrasound

First things first. There was a time this week (a few days ago to be precise), when I didn't think that my next post would be a happy one. It's been an incredibly worrying few days, in which I have swung wildly between optimism and pessimism, rational and irrational, positive and scared. Last Thursday evening I went to the loo, wiped and saw two or three tiny pinpricks of blood. Almost so small that you wouldn't notice, except that the pregnant woman notices everything! A few days before I'd had a little whitish/yellowish discharge that I know can be the herald of thrush, and having done some checking about on the internet about what can/can't be done in pregnancy I treated it with a Canesten pessary. Symptoms got better... then came back, along with the spotting. The first day I didn't worry so much, but then it happened again on Friday. Saturday morning saw me at the pharmacy trying another tack - the internal 5x strength cream. When I applied it I saw a couple of bigger (but still miniscule) clots, and freaked out. Sunday - no spots. Monday - a few tiny spots. Tuesday - some pink staining but no spots. Wednesday - no spots (but by this time a good dose of panic). I'd checked and there were no appointments available at my GP (although I could have called in as an emergency). So, I decided to wait for today's hospital appointment. If I had been in the process of miscarrying, I would have only been sent to the hospital for an ultrasound, and with one booked anyway, I might not have been seen any quicker. Anyway, all the reading I did suggested that I wasn't bleeding that much anyway. Some of the sites I found on the web were super reassuring, others, less so. I found some information about thrush and cervicitis (an infection of the cervix) that sounded like it was what I'd been experiencing, and it said that thrush doesn't cause miscarriages, although it's the commonest reason for spotting in early pregnancy. My head was awash with worries and hopes, and I had the lamest title for a blog post floating around in the background - 'Fear and spotting in Northeast Bristol'. I decided to keep quiet and not to post anything until I knew one way or the other.

S was a rock in all of this - he knew just what to say, and allowed me to run away at the mouth when I needed to get it all out of my system. 'You just have to be brave'.

Around rolled this morning, and I set about following the pre-scan instructions to come to the hospital with a nice full bladder. Ladies, I have some advice for you. Two and a half pints of liquid is overkill. TOO MUCH. By the time we arrived at the hospital I was already struggling a little - wow it hurt! And then we waited... and waited... and waited... and waited. The time for my scan rolled past. Then it was 20 minutes later, and my bladder and I were starting to be a little grrrrrr. I asked S if he thought I'd end up like Tycho Brahe (famous C16th astronomer who was so polite that he refused to leave a banquet when he needed the loo, and wound up dying of a ruptured bladder - ouch) but S thought that I'd have to wait a little longer for this to be my fate! Finally I was called. I said to the nurse that I couldn't have waited much longer, and she told me it was fine to go to the loo as I'd already had my scan! 'No, I haven't' said I! Oh. She went to see the sonographer, and then came back and said, 'actually, since not ten weeks pregnant yet, we won't be scanning you today'. I explained that although the date of my last period put me at 9 weeks and 5 days, in fact the ovulation tests and the fact that I knew when we'd done the deed, meant that the obstetrician and I had agreed I was in fact 10 weeks and 1 day, and that was why the scan had been scheduled for today. She relayed this fact to the sonographer whilst S, my distended bladder and I returned to the waiting room. Fortunately a couple of minutes later I was called for the scan! It turned out that although they could just make out the baby and it's heartbeat by scanning me the traditional way (transabdominal), that it would be better to go for an trans-vaginal scan. This meant that I could (finally, oh blessed relief) empty my bladder!

Here's the (very short) summary of the report they gave me, along with one of the wonderful pictures we had printed (at a cost of £4 each - worth every last penny!):

• Normal intrauterine pregnancy (hurrah!)
  
• One baby (relief!)
• Fetal heart action present (even bigger relief!)
• Crown-rump length - 30.9mm (which is around consistent with the dates we were debating - 9w5d and 10w1d).
  

They said that they wouldn't confirm my estimated due date (EDD) until they'd done a rescan, but I'm happy enough with the outcome. We talked about the options for screening for Downs. The usual blood tests aren't deemed reliable in diabetic women, hence the offer of a nuchal translucency scan between 12 and 14 weeks (80% accurate in identifying problems). The alternative is to go privately for an OSCAR test (which combines the nuchal translucency scan with some blood tests - it stands for 'one stop clinical assessment of risk' - about 90% accurate). We discussed what the risk level is for my age group (still in the low risk category at 1/165) and the midwife left the room to dig out a leaflet for us. S and I grabbed a couple of minutes to confirm our earlier discussions about this issue, and by the time the midwife came back we'd agreed what we want. We're going to have the nuchal scan on the NHS, since we both like and trust the clinic where I go, and don't want the hassle of going elsewhere for a private scan (the expense isn't an issue, but the different team is). If we come back as high risk we'll opt for CVS (Chorionic Villus Sampling, if possible) and amniocentesis (if not). The CVS can be done sooner and the risk of miscarriage is about the same (1%) with both. We agreed I'd come back for the nuchal translucency scan in three weeks, when I will be, by my reckoning 13w1d.

Enough already. Here's the best bit of all - the picture (and for a size comparison the last couple of fruit/veggie offerings from The Bump!)


Once I'd finished with the scan, S and I went into one of the consulting rooms, where we were joined first by L, the dietician, who checked my monitoring diary, suggested upping my Levemir slightly (to counteract the effects of my horrible thrush and a nasty cold), and discussed the three very crashing hypos I've had. L reckons that Lucozade might be the answer - apparently it's the quickest fix out there - with the formula being 1/3 of a bottle if you're in the 3's, 2/3 if you're in the 2's, and all of the bottle if you're less than 1.9 mmol/l. Hate the taste of Lucozade (although I haven't tried it since I was under the age of ten), but might have to give it a go. L thinks it's particularly good for beside the bed or in the car. Dr Inspiring also stuck his head round the door to say Hi, and it was nice to introduce him to my lovely hubby S. L and I agreed to cancel the next appointment I had booked (on 14 October) so I could see the diabetes doctors alongside the obstetricians on the same day as my next scan. Seems sensible to me (and has the advantage of doubling up on appointments and being less likely to get rumbled at work before I'm ready to make my big announcement.)

Once I'd seen the diabetes crew, I had my blood pressure taken by one of the healthcare assistants (140/70) and saw one of the obstetricians. She wasn't concerned by the spotting, and agreed that it was probably the result of my thrush. She reminded me that both diabetics and pregnant ladies are more likely to suffer with yeast infections, and given that I'm a diabetic pregnant lady it's not really that much of a surprise that I'm suffering. Given that I've tried (and failed) to self treat twice, she agreed that it was time for the big guns, and wrote me a prescription for three pessaries (one a night for three nights). Let's hope that works. If it doesn't we're out of options, since the oral treatment is contra-indicated in pregnancy. One option would be to put me on a longer term regime of pessaries - one a week - to keep the thrush in check, at least. So, keep your fingers crossed for me. I'm also intending to eat a truckload of live yoghurt (which is supposed to help) - although how I'll manage that between Sunday and Wednesday when I'll be away from home (in Edinburgh on a work trip) I don't quite know! Hopefully the hotel might do yoghurts at breakfast?? The other thing we discussed was the flu vaccination. Having already checked it was okay to have, I'd booked an appointment for this Saturday, but I wanted to check it was okay to have in the first trimester. The obstetrician suggested waiting until after 13 weeks, so when I came away from the hospital I swung by my GP surgery to reschedule. Unfortunately all of the first block of appointments are now taken, so I'll have to try again in a week or so, but it's worth the wait to be careful.

That's all from me for now. It's been a long post, but I've had lots I wanted to say. Hopefully the next few weeks will be a somewhat easier ride. S and I have been grinning at each other all evening in a combination of relief and excitement!