Friday, October 19, 2007

Precarious

So if any of you can think of positive things to say, or happy thoughts, or inspiring stories, I need them.

I saw Dr.J. today and she told me that the report that had been faxed over by the radiologist did not show heartrate numbers, but they phoned for me this morning. Basically, the crown rump length, (CRL) is 4 mm, and the fetal heartrate is 98 bpm. (The gestational sac was in proportion, but not the size I mentioned in the previous post. I have to go fix that typo....) Most people have conventionally been told that any heart rate under 100 is not viable, but hearts don't just turn on like lightswitches at 6 weeks precisely. So some studies say that 98 is within the median range for 6 weeks gestation exactly and a CRL of 4 mm, and other studies say I'm borderline or just plain screwed. There are some on this site. And a bunch more, but I can't look up all the numbers. I'm crying so much I fogged my contacts.

The radiologist didn't write anything negative on the report and Dr.J. assures me that she would've, or that she would've phoned Dr.J. directly right there and then if she had any concerns. And I keep trying to hold onto that, the hard-earned knowledge that they don't let you leave if anything is wrong. Because they don't. They keep you there and phone your Doc. And this U/S clinic is really really busy and has a lot of experience dating pregnancies and determining viability. So they would know.

But right now, all I can think about is that this may be my last chance at pregnancy, and I just want to crawl into a ball and cry, because if it all goes wrong, I'm not sure what I'll do.

Help?

29 comments:

  1. While I believe PollyAnna and all her thoughts can kiss my white, wide ass, last night in a discussion with my counselor she said something that though hard to hear was important: I spend a lot of time of focusing on what if this fails or I have another loss. She said why not focus on what would happen if it DOESN'T fail? Why should one hold more importance to me than the other? Each chance can be independant of the others.

    This pregnancy came to you completely unexectedly. It is independant from whatever it is that makes you sad right now. Hold onto that thought that if your doctors would have had something to be concerned about, they would have told you. That's what I will prefer to think about until you find out something more.

    Maybe this wasn't the "help" you wanted, but I hope it helps, even if it's just by a wee, little bit.

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  2. Nothing can ever be easy can it?

    I'm so sorry you have to go through this. Since there are some studies that show the 98 hb is in the median range, that suggests to me that 100 can't possibly be a hard and fast line for viability. Also, I think you're absolutely right about the u/s clinic. When can you schedule another u/s?

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  3. I wanted to ask the same thing as Niobe-- when are they seeing you again?
    I am so sorry this is hard, and I do hope the most important indicator-- the clinic's behavior-- will be the one that is most reliable.

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  4. Tuesday, If I go back earlier they won't have as accurate a comparison. Week to week is better.

    I'm trying to think hopeful, but shit.....

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  5. The 98bpm is so close to that 100. It is within the median range. When's your next u/s?

    Like DD said, try to give equal time to the positive side of the what if's.

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  6. I know how hard this is because I've been through it. The statistics make you crazy and the waiting is horrible. Be good to yourself. That's all I know how to say...

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  7. Oh, I don't know what to say. It's early and it's hard to get accurate readings early. Next week will be a better indication. That, old, "we need more information."

    But it is true that they don't let you walk out if they know/feel something is wrong. You should go with that. But I understand that dead baby thoughts are more seductive. I don't know why, they just are. It just sucks.

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  8. I don't know if this will make any difference to you, but at 5w5d my embryo's hb was 96 bpm at 3ish mm CRL. One week later it went up to 130-something. Try to hang in there until next week. I'll be holding onto hope for you here and sending out some good vibes.

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  9. I wish this was easier for you. Try to hold on to the fact that you ARE currently pregnant -- you really have not been given any bad news regarding this pregnancy. I know a history of problems and miscarriage is terrifying, truly I do -- but right now, there isn't any evidence to support that your current pregnancy will go down any of those roads.... It's extremely difficult, but try and focus on that. And, *IF* something happens to this pregnancy, there is no reason to think this will be your last chance ever at pregnancy -- it's fantastic and amazing you got pregnant, your body did this all by itself, and there is no reason to think that it couldn't do it again.

    I don't know if anything I've said is helpful or not, but just know that I'm thinking about you.

    Please keep me posted.

    hugs
    xx
    Nilla

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  10. My RE doesn't even measure the heatbeat this early on. They just eyeball it and as long as they think it looks good, that's good enough for them. Plus, they do the standard measuring to make sure dates are close enough. So much can happen in just a day with your developing embryo, that there's no reason to think that today, that little heart is beating at over a hundred. I don't mean to give false hope - but I've just seen lots of women who have somewhat seemingly slower heartbeats that in the end, were just fine and they worried for nothing. I sincerely hope the same happens for you and your little bean.

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  11. All the stats and the studies and the tests make this whole baby business seem like an exact science... When it just ain't.

    We don't all end up the same, I don't believe we all start out the same either. A little bigger, a little smaller, a little brisker, a little slower.

    I'll be thinking of you and the wee one.

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  12. That they got any heartrate at 6 weeks is impressive to me. At 5w2d, we say nothing. Two weeks later we saw a teeny tiny heartbeat. So I say to hold onto hope. It's early.

    And if it all goes to shit...well...we'll deal with that if it happens.

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  13. Jen in VancouverOctober 19, 2007 5:15 pm

    Aurelia, I've been lurking for awhile but I thought you might like to know the following: when I had a u/s at 6w2d, the heartrate was 96bpm. I was concerned for reasons you outlined in your post. Anyway, said baby is currently running around my kitchen babbling to his steadily beating heart's content. I know n=1 is not much of a sample size, but in our case everything was just fine.

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  14. Thinking of you. I've been down this road so many times ... for me, 98 is so close to 100 it sounds great! But that's **me** and may be annoying to hear! So I'm sending you good thoughts. Take care of yourself, and be gentle with your fears. Having gone through the sorts of losses women like us have gone through, it is so very hard to trust.

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  15. Aurelia, the knowledge we gain as IFers can be a blessing in allowing us to be advocates for our healthcare. But often it just sucks and toys with our hearts.

    Stats are stats, but never a guarantee. So hang in there. In my book, 98 is pretty much 100 (and I'm a scientist). Medicine is beautifully imprecise -- I mean look at you ... you're pregnant!

    Hope that Tues comes quickly for you.

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  16. In the UK they don't record heartrate at this stage - they reckon presence = good sign, absence = bad, other than that we actually don't know enough about how these things indicate anything.

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  17. I've been lurking on your blog for quite awhile and am finally delurking.

    I have to agree with the others who say that 98 and 100 are essentially the same and I have been working at the lab bench for almost 15 years now. Of course it would all be easier if you got a heartrate of 100+, but like DD said, the possibility that everything is going to be ok is probably just as good as it not being ok. So, for the time being, just keep holding on to whatever positives you can hold onto.

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  18. You KNOW they won't let you go if it's bad.
    I've watched the u/s tech get all quiet and quickly snap some measurements before backing away to call the midwife. They can't hide that something is wrong. And they can't look you in the eye.
    So hang onto that hard-earned knowledge. It's true.

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  19. Nothing to be done but a "hang in there". The others have given you some very logical points above, but I suspect even if the heart rate had been 263 you wouldn't be feeling comfortable just at the mo. (Actually, 263 would make anyone freak out, but you know what I mean.)

    I imagine you're already lining up your next scan for reassurance?

    Bea

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  20. At six weeks the hb is just getting started. Indeed, my docs often said to me at that stage before they did the u/s that they may not see a hb at all, and that would be ok. A week later you want to see it but six weeks you may nor may not see it.

    Also, I have learned over the course of my paranoia and hysteria in pregnancies after my Trisomy 18 pregnancy that measuring a little small is ok too. The time to worry is when you are measuring a week small when you should be measuring at 16 weeks.

    James was measuring a little small to start with, and his beta numbers were lower than our T18 pregnancy. But he is totally healthy and was 8 lbs 11 oz at birth, bigger than his higher beta and measuring ahead at six weeks brother.

    Hang in there. It is too early to freak out over any of this. When it's time to freak out the u/s people will call the doc. That hasn't happened yet.

    Holding your hand across the internet.

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  21. DD makes a great point. Although it's hard as hell to think of things that way, when you're so used to things going south and killing off another little piece of your heart.

    FWIW, I was in your exact shoes two months ago: 6w2d and a heart rate between 90-100. And freaking out when I consulted Dr. Google and saw all the studies. Four days later we were at 150bpm.

    Think positive, or think of something else while you wait - and good luck with your u/s next week.

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  22. I've never checked into this stuff, as my clinic didn't check the heartbeat rate, just that there was one. And they told us that simply hving a heartbeat at 6w was indicative of a good outcome. I really hope that that's the case and that all will be fine for you.

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  23. Aw, Aurelia... I love you, and I agree that they would have kept you or written something negative on the report if there was cause for concern. Of course, for us there's always cause for concern (i.e. we're concerned) but I'm gonna put my money on a good outcome here.

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  24. I hope so much that on Tuesday this turns into a story you can tell about scares you had that turned out to be nothing.

    As Catherine said, if it all goes wrong, we'll deal with that too.

    (((many hugs)))

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  25. The one thing that nobody pointed out is that you said the tech seemed a little uneasy..honestly the tech has alot to do with the images/recordings that the doc reads. I have known great techs and so-so techs and it can make a difference. Two techs can do scans back to back and give the docs variable information. I think seeing a HB is more important at this stage than the actual rate, imho.

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  26. At 6w??days (too painful to go back and look it up on my blog -- you can read it if you like) the HR was 74 and THAT was deemed a non-viable pregnancy. We waited and it only went down to the 50s later, so the embryonic heart was dying.

    The good news is that the 90-100 range usually improves in the next week or so. It is the under 85 range that usually means something in the heart is malformed. Having been there myself, waiting is the worst part. Schedule an appointment ASAP so they can recheck the heart-rate. Even by next week they will be able to tell you what direction it is moving in.

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  27. Ugh - waiting is such torture. I will say the difference between 98 and 100 could be made simply by the technician.

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  28. I think you're absolutely right - they're not about giving you false hope and placating you. If they were worried, you'd have known. I've never had anything sugar coated. When I miscarried in the summer it was me, of all people, who was clinging to hope and trying to make the numbers fit. The doctors and techs were all very, very sure nothing good would come of it. And they never, ever lied. It was us that kept asking for more ultrasounds and going back "just one more time".

    I think it's a very good sign that no one suggested impending doom.

    I know that doesn't necessarily make these next few days and weeks easier, but I just wanted you to know what I've experienced in the hopes that it'll give you a little bit of hope yourself.

    ((((HUGS))))

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  29. I am so sorry I missed this post last week... I am thinking of you and your bean...and praying all turns out well for you and your dream of another child.

    I do think it is still a wee early to determine whether the heart rate given is a danger sign or now...at 6 weeks, there are a lot of variabilities. They let you out of the u/s...no questions made. I hope you can rely on that good sign that everything will be okay.

    **Hugs**

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