A long overdue post / Anomoly Scan in three parts

Wow, it's been a while. Things have been really hectic, but that's no excuse for failing to post for weeks on end.

I had my twenty week anomoly scan and associated medical appointments at the hospital on 9 December (with a return visit on 14 December). Mum and Dad came with me since S was staying up in London for a couple of days for meetings. It was lovely for Mum to be able to come into the scan with me as my one accompanying adult, although I did feel a bit mean leaving Dad in the waiting room. The anomoly scan can take a while, and I was in for about half an hour whilst the two ultrasound midwives (who both share my name!) measured and checked every part of baby... except for the bits that baby refused to show off, despite all our best efforts. I announced at the beginning of the scan that we didn't want to find out the baby's gender, and asked that we be told to close our eyes when we got to that bit of the scan. However, it turned out that there was no risk whatsoever of finding out since baby was tucked down low in my womb, in a breech position, curled up like a little hedgehog. This meant that we couldn't see the very lowest part of the spine (important to see in order to check for spina bifida). Baby also had a hand over his/her face, which meant that we couldn't see the lip in order to check for a cleft lip/palate. We decided that I should go off for my other appointments and then come back for another go to see if my little passenger had moved into a better position.

First I saw Dr I, who went through my numbers and discussed tweaking doses a bit here and there - especially background insulin. We agreed that my requirements seem to be taking off, and he told me that I can be a little more aggressive with my doses. Recently I seem to have been in a pattern of testing and correcting more than I'd like, and of course, with Christmas coming up I'm going to have to be at the top of my game anyway, given all the naughty food temptations which will be coming my way!! Dr I also dialated my pupils in order to check my eyes for retinopathy. At this point he ducked out for a few minutes whilst one of the Obstetricians popped in to see how things were going. She was surprised at how upbeat I sounded, saying that most ladies tend to complain of feeling tired and run down at this point in pregnancy. Although I have been tired things have gone pretty smoothly for me so far, so I actually feel pretty lucky, all things considered. We then talked a little about what comes next for me in terms of my care - she walked me through the typical care plan for pregnant ladies with pre-existing diabetes and then explained that based on the results of my ultrasound I'd be having growth scans every four weeks starting from 24 weeks. This is good news, since if there was anything to worry about in the scan I'd be down for fortnightly scans instead. At this point she swapped again with Dr I, who checked the back of my eyes. He could see evidence of one or two tiny microhaemmorhages in my right eye, but said they were nothing to worry about - especially given where they were located. We agreed that I'd come back for my next diabetes and obstetrics checks along with my 24 week scan, in early January (Thursday 6th), and in the meantime he ordered a bunch of blood tests (not quite the full works, but most of them!) S, the diabetes midwife took my bloods for me, and then it was off to see the ultrasound ladies for a second time to see if baby was co-operating. The second scan was much shorter, and we managed to tick off the upper lip, but still no luck with the lower spine. At this point I was free to go, although feeling a little tender along my bikini line from all the prodding and poking. I booked to come back to the hospital on Tuesday 14 December, and then headed out to lunch with my parents.

Here are the results of the (first two) scans (which all fell within the normal ranges):

Biparetal Diameter: 47.2mm
Head Circumference: 183.7mm
Posterier Ventricle: Transcerebellar Diameter: 20.1 mm
Nuchal fold thickness: 4.4mm
Abdominal Circumference: 152.8mm
Femur length: 33.2mm

Heart action present, Fetal movements visible, Presentation Breech.
Amniotic fluid: normal.
Cord: 3 vessels.
Placenta: Anterior clear of os.
Heart: 4 chamber view normal.

The following were visualised and appear normal: head, brain, face, neck and skin, abdominal wall, gastro-intestinal tract, kidneys and bladder, extremities, skeleton.

All in all it was pretty amazing. We even saw 10 little fingers!

Here are a couple of pics:


When I went back for the third bit of the scan on Tuesday 14th baby was still curled up in a little ball, and still in a somewhat awkward position, but the good news is that we were able to see the lower spine and the skin covering it. All is fine - the little heart was beating, the baby was moving, and baby's mum is just delighted!

I finally rang up for the results of my blood tests this afternoon. I'm amazed to say that my HbA1C was 6.6% - hurrah! It sounds like my thyroid function might be drifting a little though - so that's one to discuss at the next appointment. I was told early on that I'm borderline for an underactive thyroid, so it's not a total surprise. Everything else was apparently fine, so I'm looking forwards to a more detailed discussion of my bloods when I go back in January.

Things get even busier for us tomorrow, with S's parents arriving for a few days visit. They're staying with us until Christmas morning, when we head off for a few days to see my parents. The way things have worked out this year we'll be having three Christmas dinners in a row - Christmas Eve with the in-laws at our place, Christmas Day with my aunt, and then on Boxing Day we'll all descend on Mum and Dad's. That's a lot of turkey! We've had a few inches of snow in Bristol, so everything's looking very Christmassy indeed. Mum and Dad have also had snow in Berkshire, and S's parents have apparently had a foot or more in South Wales. Fingers crossed that they can travel to Bristol safely.

Merry Christmas to all!

I'll sign off with the obligatory fruit and veg update...

Visiting the Midwife

I saw J, the community midwife, again on Tuesday. This was a pretty short visit - just a chance to get back the results of the various blood tests I had last time, have a BP check, and hear a bit more about what to expect at this stage of the pregnancy.

I've always wondered what my blood group is, and now I know. It's A+, which is the second most common for people in the UK. My husband is O+, for the record (which is the most common). I also found out that I don't have HIV or syphilis (didn't think I did, but nice to have the proof!) I'm also not a carrier of sickle cell or thalassaemia (due to my ethnicity I'm very low risk anyway, but again, nice to have the confirmation). Being a researcher, as soon as I got home I did a little googling to help me understand the results of my full blood count, which just looked like alphabet soup on the page. Here's what I found out about what all of those acronyms mean:

WBC - total white blood cells
RBC - total red blood cells
Hb - Haemoglobin (low Hb= anemia)
Hct - Haematocrit (the fraction of the whole blood volume that consists of red blood cells)
MCV - Mean Corpuscular Volume (the average volume of the red blood cells)
MCH - Mean Corpuscular Haemoglobin (the average amount of Hb per red blood cell)
MCHC - Mean Corpuscular Haemoglobin Concentration (the average concentration of Hb in the red blood cells)
Platelets
Neutrophils - may indicate bacterial or viral infection
Lymphocytes - higher with some viral infections/leukemia, lower in HIV
Monocytes - raised in bacterial infection, TB, Malaria, leukemia and ulcerative colitis
Eosinophils - increased in parasitic infections, asthma and allergies
Basophils - increased in bone marrow disorders like leukemia and lymphoma.

Good news for me - everything was in range, except for the Eosinophils, which were at the very top end of normal. Since I've had asthma since I was four, and also have masses of allergies, this was to be expected.

I also had my blood pressure taken. It was 120/64, which is brilliant for me. I asked whether BP tends to go down in pregnancy, and was told that it can do, although it usually finds its way back up to the levels seen at the booking appointment by the time women reach the third trimester.

We also talked a little about what I can expect to happen over the next few weeks. I'm 17 and a bit weeks now, so I may start to feel baby's movements any time (this usually happens between 16 and 22 weeks, and can be on the later side in first pregnancies and bigger women). The advice from the NHS is that you should expect to feel movements every single day after 24 weeks, although they won't be consistent throughout the day since baby has a cycle of sleeping and waking. If you don't feel a movement, or if you are having noticeably fewer movements, then you should call the maternity unit by 9pm, and they will bring you in for tests. We also talked through the symptoms of pre-eclampsia. This is more common if you have close relatives who've had it (my mum did), if you have diabetes (tick), a BMI of 35+ (tick), and if it's your first pregnancy (tick!) Signs to watch out for include raised blood pressure, protein in the urine, bad headaches that don't go away, blurred vision (or flashing lights/spots in front of your eyes), bad pain below your ribs (especially on the right hand side) and vomiting. Again, any problems, and you call for help immediately!

I'm not seeing the midwife again until I'm 25 weeks, so that will be around mid January. In the meantime, if I want my Mat B1 form before then (which in the UK allows you to arrange maternity leave, amongst other things), I'll need to contact J at 20 weeks, and she'll leave it behind the counter for me at our GP's practice. Next stop in the pregnancy wagon train is my 20 week scan on 9 December.

I also finally had my flu jab today, so I'm typing this with a very sore left arm! :(

I'll finish off with the obligatory fruit/veg pic (although I'm a little suspicious of this one, since I think onions are usually smaller - at least they are when they come out of our veg box or from our allotment!)

A very quick post for World Diabetes Day

I didn't want today to go unmarked on my blog. It's World Diabetes Day.



Last 14 November I had no idea that there was a World Diabetes Day. Since then, in preparation for this pregnancy I've taken my diabetes in hand, and got my HbA1C down to 6.4% (a number I haven't seen for ten years or more!) I've worked hard, and proved to myself that I can do it... but I haven't done it alone, because this year I discovered the DOC - the Diabetes Online Community. Diabetes, especially Type 1, can be incredibly isolating - but thanks to the DOC I don't feel so alone any more. So, this is my big thank you to all the wonderful D-bloggers out there who've become my support network. YOU ROCK!

Happy World Diabetes Day.

The big reveal, an intense working week, and a huge surprise

1) The big reveal

Once again I've been absent from my blog for longer than I intended to be, so I have lots of catching up to do. After my lovely week off I went back to work on 1 November and finally told them the news that I'm pregnant. Everyone was really lovely about it, and more surprisingly no-one had guessed. I was sure that I'd been busted a few times - especially by my closest friends - but apparently I'm better at this cloak and dagger stuff than I thought. (That's actually a slightly disturbing thought!) I was sure that the number of medical appointments I'd been having would have raised some eyebrows somewhere, but although one or two people expressed a slight concern about my health, it seems that having diabetes can be the perfect camoflague! It's good to know that there are some advantages, huh?

The really good news for me is that work have agreed to fill my post on a fixed term basis when I go on maternity leave in March (for a year), so I'll be able to come back into the same job when I return to work. Since I really like the particular role I'm in this is fabulous news. There's not another job within my organisation that I'd want to do, and I would have been really sad to have to take another role. All my organisation are committed to is to keeping a post open at my grade, not to keep my specific job open, so I'm actually feeling pretty lucky at the moment. There are also some childcare options to start to consider (which seems a bit mad when baby isn't even here yet). My parents, who live about 65 miles away, have offered to come down and look after the baby a couple of days a week. There's also an on-site nursery at work (although it's a 40 mile commute every day, and I'm not sure how fair it would be to drag baby to work with me). Lots to think about. In the new year I'm going to visit the nursery and talk to a couple of mums who do the same length commute as me, to see what I can learn from them.

It's really nice to finally be out in the open, and not to have to censor every word that comes out of my mouth!

2) An intense working week (or fortnight, in fact!)

Since I got back to work things have been manic. I've had to be in London for six out of the last ten working days, with one more trip to go on Monday. As a result I'm exhausted, not least because some of these days have involved either very early starts (5.30am) or late finishes (like the day I got home at 1 am following a lovely night out with American and European colleagues following a big meeting, and a missed train home meaning a two hour wait at Paddington railway station). I was hoping that the tiredness would abate in the second trimester, but given my working schedule I haven't been able to tell if it has! I have been told to take it easy by my boss, and by our director, so I'm trying to dial things back a little now. (Let's see how that goes, shall we?) I am planning a good long break at Christmas, as well, which is not so far off now. I go on leave on 13 December, so only about a month to go. Whooo-hooo! I love Christmas more than any other season of the year, and it's nearly here. I'm busy knitting presents at the moment, and have started to feel the pressure of the clock ticking for the first time in the last few days.

Things on the pregnancy front have been pretty quiet since my appointment at 13 weeks. I've had a couple of one-off episodes of spotting, but very very minor and nothing to write home about. I'm starting to thicken a little around the middle but as I'm quite a large lass I'm still not really 'showing'. I'm really looking forwards to having a proper bump to show off (rather than having people think I just over-indulged at dinner last night). I can feel a tightness in my abdomen that wasn't there before though, so something's definitely starting to happen. In general things are going smoothly, although whenever I spot I panic a little (or sometimes a lot, according to my lovely hubbie). How would I know if something had gone wrong? I have to wait another four weeks for my 20 week scan, and I can't tell you all how much I'm looking forwards to the reassurance of seeing a little heartbeat on the screen. How do pregnant ladies deal with the whole paranoia thing anyway? Or it it just me?!

3) The huge surprise

I had a hospital appointment yesterday morning to see the diabetes team (no obstetricians this time). I'm still getting over this nasty chesty cold thing that I've had for about a month and a half, and to be honest I'm having to work incredibly hard to keep on top of my blood sugars. I've seen some numbers that I really don't like (hitting 13 mmol/l a couple of times a week), and in general I've felt that my control has been slipping compared to where I was when we conceived. Dr Inspiring gave me a real pep talk last time I was at the clinic, telling me that I was still doing brilliantly, and that I shouldn't beat myself up over the odd high number, but although I knew this was totally rational I still felt a bit disappointed that I wasn't doing better. As I was having my bloods drawn at the end of the appointment all I could think was that my HbA1C was bound to be much higher than the previous time, when it was 6.3%.

When I arrived at my appointment this time Dr I asked me how it was going, and I explained that I felt I could be doing better. He had a quick peek at his computer screen and then told me the result of my last blood test (the one I was expecting to be so rotten)... My HbA1C three weeks ago was apparently 6.4%. WTF? You could have knocked me down with a feather. I even asked him to check again, since it didn't seem possible. The only thing I can think of is that it must be a combination of more highs and more lows, whilst the 6.3% was a result of a flatter less bumpy set of readings. I am sooooooo happy. I'd been steeling myself for a number beginning with a 7 at best. Dr I repeated his pep talk from last time, and we agreed that since I was doing so well there was no need to come back before my 20 week scan appointment, when I'll also have an eye examination (pupils dialated, therefore my parents will have to drive me), as well as a diabetes check, an appointment with the obstetrics team, and the all important anomoly scan. So, between now and 9 December I only have one appointment, which is with the community midwife next Tuesday. I'm intending to try and enjoy this little break, since I know once I reach 24 weeks it'll be serial growth scans every fortnight right until the end of the pregnancy. I'll try to blog again next week once I've seen the midwife.

Until then, here's the obligatory fruit update - I'm 16 weeks and 2 days pregnant today, which means since I last blogged I've passed through another two fruity landmarks...

Crazy Busy

I can't believe how long it's been since I last posted. Things have been super busy at work for the last couple of weeks and I've also had a nasty chesty cold for more than a month, but thankfully S and I are now at home for a week on annual leave, which is lovely. I've been incredibly tired, but hopefully I'm now making a dent in my sleep deficit, and with any luck I'll be feeling a bit more human when I return to work next Monday.

When I last wrote I was still battling my thrush, and feeling slightly miserable about the whole thing. I managed to take 6 pessaries before the spotting (this time caused by irritation from the pessaries) became too much. At that point I seemed to be getting better, although I still had the pinky-yellow discharge that was proving so worrisome. In the end I decided to go back to the doctors, and saw the same female locum for a second time. She did an internal examination and told me that she thought the thrush had probably gone now, but that I have a cervical ectropian or erosion. This can also cause yellowish discharge and spotting, and is (thankfully) harmless to the baby. Just to be on the safe side I had a series of swabs for everything else that could possibly be causing the problem (thrush, BV, etc etc) and got the results back today (all clear!) So, no more pessaries for yours truly (much relief) and I can stop worrying.

I had another hospital appointment on 21 October to see the whole team (diabetes, obstetrics) and to have my nuchal translucency scan, which gives an indication of the risk of Downs Syndrome and a couple of the other trisomies. It was a pretty nerve wracking wait, and I'm glad to be on the other side of it now. S and I had decided that we'd have CVS if we came up as high risk, but I'm pleased to say that the results were great and we therefore don't need any diagnostic testing. The results of the scan were as follows:

Crown Rump Length: 68 mm
Nuchal Translucency: 1.8 mm

Estimated risk of Downs (Trisomy 21) -
Background risk: 1:203, revised risk following the scan: 1:897

Estimated risk of Trisomy 13/18 -
Background risk: 1:387, revised risk following the scan: 1:1,231

We also got to get a good look at the littl'un, who was practically turning back flips - lots of jerky movements to be seen. In the end, since the baby wasn't in a good position to do the NT scan transabdominally, I ended up having another transvaginal scan. The midwife had a colleague with her who was learning how to operate the ultrasound equipment, so for her benefit (and ours) she spent quite a lot of time showing different views of my little passenger. We saw all the arms and legs, the umbilical cord, the baby's heart beating, both lobes of the brain, and the bones of the skull.

Here's a picture:



This was also the official dating scan, after the ultrasound midwife refused to date me last time for (allegedly) being less than 10 weeks' pregnant. At that time we were quibbling over three days - I know I was 10 weeks and a day (thanks to the ovulation sticks), whilst the midwife was sure I was 9 weeks and 5 days based on the date of my last period. This time our dates were much closer together - I was maintaining that I was 13 weeks and 1 day pregnant, whilst the scan dated me at 13 weeks. What's a day here or there?

After the scan I saw the obstetrician and diabetes specialists, both of whom thought I was doing really well. My blood pressure was 130/60 at this appointment, so nothing to worry about on that front at present. We talked a little with the obstetrician about travelling, since I have a work trip planned early next year, and S and I had been discussing the possibility of going away for a few days before Christmas. The advice was as follows:

• it's okay to fly until around 34 weeks, with the second trimester being the best time;
• wear flight socks, walk around a lot, keep hydrated, and try to keep flights as short as possible - a couple of hours is the best, long haul not so good;
• any radiation risk is most serious in the first trimester - after that the risk of thrombosis (blood clots) is the greatest worry.

Dr I came in next, and we discussed the fact that I've been struggling a little more with my sugars than I would like, courtesy of my cold/chest infection. However, after a look at my monitoring diary he told me that I'm beating myself up too much, and in fact I look to be doing pretty well. My adjustments have been about right, and I should keep on going in the same vein. Hopefully my insulin requirements will tail off a little once I'm clear of the infection, and then they'll go up slowly in the second trimester, and should only rocket in the third. It's good to have the reassurance that I'm not dropping the ball, even though I wish I was doing better. It's worth noting that in the last few days my meter average has dropped back down to 6.9 mmol/l, which does make me much happier.

I rounded off my appointment by having bloods taken for an HbA1C and Thyroid function, which gave me an opportunity for a gossip with D, the nurse who has diabetes, whilst she tried in vain to find a vein in my arm, before eventually taking the blood from the back of my hand.

I got into work a couple of hours late, but this should be the last appointment where no-one knows my situation. I intend to let my boss and colleagues know our news once I get back from leave on Monday, and that should help with future appointments. I'm next at the hospital on 11 November, just to see the diabetes team, and after than I'll have an appointment when I'm 20 weeks, for a detailed anomoly scan and to see the obstetricians.

After my busy week at work we had a lovely weekend down in Devon visiting friends who live on the edge of Dartmoor. It was the first time we'd seen them since our wedding last year, and we also got to meet their 8 month old daughter for the first time. She's a total sweetie, and we really hit it off. It was lovely to spend some time in 'baby-world' and to pick up some parenting tips. It's also great to be able to inspect some of the paraphernalia that our various friends have bought for their babies too - peeking at prams, high chairs, cots and suchlike. After all, everything's so expensive, so it's nice to be able to learn from people's successes and mistakes.

I'll finish up with the latest size/fruit update. It's fabulous to be into the second trimester, and tomorrow baby will graduate from peach to lemon.

Quick update

I spent most of last week in Edinburgh on a work-related trip attending an academic workshop. I decided not to fly, since the hassle involved isn't worth the time saved. Instead I took the train up on Sunday, and back on Wednesday. It was good to see the fruition of something I've been working on for the last three years, but all in all the trip was pretty draining and I didn't have a moment's time to myself what with workshop sessions, side meetings and meals out with colleagues. Travel's usually tiring, but with an (as yet unannounced) pregnancy in the mix it was even more so. It didn't help that at 1.30 am on the night I arrived the hotel fire alarm went off, which meant we all had to spill into the street. Nothing like meeting all the workshop participants in your PJs and overcoat! I also found it challenging not to be in charge of my diet and eating times. The food was too rich for my taste, and being out of my usual routine I put on a couple of pounds and my average sugars slipped a little higher than they've been (7.5 mmol/l for the week). Grrrr. (Still, all in all I've only put on three pounds since I found out I'm pregnant, so that's not too bad). I also had my first (and let's hope last) taste of morning sickness on Tuesday morning, when someone walked past my breakfast table with a full fry-up including slab of black pudding. Eeeek, did my stomach lurch. I'd have forgone breakfast altogether, if I hadn't already had my insulin.

Whilst I was away the dreaded thrush returned. I took the three pessaries prescribed by the obstetrician on Thursday, Friday and Saturday nights, and on Sunday all the symptoms had gone. Hurrah, I thought, until they came back with the associated spotting on Tuesday afternoon. Grrrrr again. I toughed it out until Friday, when I had an appointment with a locum at my GP practice. She was very supportive, and we decided to try a totally non-evidence based approach (based on gut instinct). So, I came away with a prescription for 14 (yes you read it right) pessaries, and instructions to take 7, and repeat if that didn't work. At least it will see me through to my next hospital appointment when we can regroup if necessary. The problem is that the symptoms disappear when I'm treating it, and come back within a couple of days of completing a course of treatment. Anyway, 4 down, 3 to go, and then we'll see. It might just be worth taking out shares in Bayer, the makers of Canesten, however!! :)

I think my poor system has had enough this week, what with the tiredness, peeing all the time, not sleeping through the night, the thrush and on top of all that a nasty cold. I've had a low grade dose of the lurgy for a couple of weeks now, but on Saturday I began coughing and sneezing like a good'un, and have had a very runny nose. I decided that it would be a bad idea to try to go to London for work on Monday (it would have been a long day, with meetings finishing at 7.45pm), so have been laid up at home for the last couple of days. I've slept practically all the time, so I reckon I must have needed the rest. Am feeling a little less stuffy today, although I'm still needing more than my usual insulin, and I have a horrid taste right at the back of my mouth. Ick. I'll probably go into work tomorrow, and see how I go. I have a fairly quiet week workwise next week, and then S and I have a well deserved and much needed week off - I can't wait. We're planning to visit friends down on Dartmoor over the weekend, and meet their new baby (and flock of sheep) - I'm more excited about the former, S about the latter! Then we're going to slob out at home and enjoy doing nothing. Hooray! I'm planning to tell work about my pregnancy once I go back to work on 1 November.

The only other thing I have to report is that I finally met J, the midwife, yesterday. She works for my GP practice and seems lovely. I spent about two hours with her altogether, filling in the computerised history which makes up the backbone of my maternity notes, discussing how things have been going, and having some routine bloods taken (just pregnancy related stuff, as she won't involve herself at all in my diabetes care). We agreed that it was a slightly strange situation as I've already had lots of contact with the diabetes/obstetrics clinic up at the hospital and therefore wasn't doing things in the usual sequence. Most ladies see J before they ever have a scan or book any screenings, whereas I'm already well and truly within the system. For me she's going to be more of a back up than anything else. I'll see her on and off throughout, but my main care will come through the hospital. I left with a pile of booklets and leaflets to absorb, and I booked another appointment to see J at around the 15 week point (in mid November). I need to go back into the surgery to collect my yellow pregnancy notes tomorrow afternoon. So, next time I go to the hospital I will no longer feel like a defaulter!! I'm back at the hospital next Thursday for appointments with the various specialists (diabetes, obstetrics) and for my nuchal translucency scan and official dating scan (after last time's shenanigans!) Fingers crossed all will go well. I'm looking forwards to seeing my little passenger's progress since the last scan. Hopefully this will be transabdominal rather than transvaginal, and I'm also pleased to say that it should be the last 'bladder full' scan too. I'll leave you with a update on baby's size.


Tomorrow I reach 12 weeks, and baby will graduate to a new fruit (plum). Actually I always thought limes were bigger than plums - one of life's mysteries, huh?!

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!