20 Week Appointment

Yesterday, I had my 20 week appointment. This was almost as non-eventful as my 16 week appointment. Weight check, up 4 pounds, blood pressure 100/58. The doctor measured my fundal height, but did not tell me what it was and I did not ask. I think I am way bigger than I am supposed to be at 20 weeks, but hey, I am 39 and this is my 5th baby. I am cutting myself some slack. She informed me that the AFP blood draw was normal. This is the blood test that screens for spina bifida. In addition, the baby looked great on the ultrasound. She said the baby  had absolutely no markers and looks perfect.

She did not ask me any questions about how I was doing and I did not ask her any questions about some things that had been giving me trouble. It was then that I realized that I had more in common with Bill Clinton than I thought: I had also adopted a "Don't ask, don't tell" policy with my doctor.

Because I will be on vacation for my 24 week appointment, she insisted I come back at 23 weeks and not wait until 26 weeks to come back for a check-up.

Nothwithstanding, she insisted that I have a fetal echocardiogram at 22 weeks. I asked her if it had to be 22 weeks and she said it could be 23 weeks. I explained that with 4 children I am very busy and this really isn't a good time. Additionally, we will be out of town for two weeks and then getting ready for back to school and enjoying the last bit of summer, so couldn't I just wait until 26-28 weeks when the kids are back in school. I got a big old "no" on that one. Her only reason was that if something was wrong with the baby's heart, and we wanted to terminate, we would have to do so before 26 weeks. I explained to her again that I have no intention of killing my baby regardless of any test results. She then explained that if something were wrong, we would need time to consult with specialists and come up with a game plan. I explained that I already know which specialists I would consult and I would do whatever they recommend, should there be a problem, so lining up specialists is not an issue. Still her answer remained "no" and she insisted I have the fetal echo at 22 or 23 weeks, no later.

The good news is that Gabriel's cardiologist from Hopkins comes to my OB's hospital to do fetal echos twice a weeks. Actually she and another lady from the practice split the duty. Unfortunately, the only times I can schedule it is Tuesday  morning or Thursday afternoon. And I was not permitted to call myself and make the appointment, someone from the OB's office had to do it. So, I gave her my availability, which was quite limited, and told her that because I live an hour away and have four busy children, I need to schedule my 24 week OB appointment at 23 weeks and have that appointment either immediately before or after the fetal echo. Somehow she got all confused and she had to keep calling me back and the imaging place back and finally on the 7th go-round, we got a time and date that would work for me. On August 2, I will go for my OB appointment in the morning, the last morning appointment at 12, and then head over to imaging for the first afternoon appointment at 1. All of this on the day after Isabelle gets her braces and two days before leaving with a family of 6 for vacation. I really didn't understand this urgency at all.

As I write all of this and think about what a hassle all of this could be, I realized two things: (1) I am very lucky to live where I do and have access to the best doctors around who want to take  care of me and my baby girl; and (2) you know it's the fifth baby when major tests are more stressful due to the hassle of juggling schedules than the stress of the tests themselves.