Cytomegalomania

Today's post continutes my effort to catch up to the present moment.

The upshot of attaching ourselves to IVF specialists (without, as it turned out, needing to) is that their standard practice is to see new pregnant people through the first trimester. Since they deal exclusively with "high risk" pregnancy, Marci and I enjoyed the benefits of hypervigilant prenatal care. Ultrasounds every three weeks, regular lab work that checked hormone levels--it was like having our own pit crew.

While this was mostly positive and reasuring, their extreme close-reading of data tapped into my paranoid side periodically. One of the more notable of such moments was at the 4 week mark, when an ultrasound didn't reveal the presence of an embryo, only a yolk sack (I didn't know humans even produced these, but the yolk feeds the embryo for a while until the placenta takes over the job). For more on this development, and the whole 40 weeks, check out the new National Geographic special here.

The attendant cautioned that we may have been experiencing a false or "chemical pregnancy," in which all the hormones start throwing a big party without a guest of honor. Or, it's like a surprise party where you walk in the door and everyone shouts, "Surprise! You're not pregnant! Again!"

She gave us two choices: wait another week for the embryo to grow and become more detectable (if, in fact it was even there), or immediately drive 30 miles to one of their other offices that had even more sophisticated ultrasound equipment, before it closed for the weekend in 20 minutes. Not wanting to wait a whole week with such a major question mark over our heads, we sped over and had this image taken. So here you can see the tiny yolk, which dwarfs the invisable embryo. What they saw on the "live" version was ultimately enough to convince them that all was well (I have images that show The Peanut *much* further along now at 16 weeks, which I'll also post).

While I appreciate thoroughness, this was definitely an "erring on the side of caution" moment.

The title of this post suggests another such moment. After a weird fever and inexplicable rash (on her arms and legs) last week, Marci's blood was screened by our new OB, Dr. W. He was checking her immunity status on 3 viruses that can spell trouble for a fetus: Rubella, Parvovirus B19, and Cytomegalovirus. A few days later, he called to tell us that she has long-held immunity to the first 2, but not the third.

So, in three weeks, they screen Marci's blood again for antibodies. If they show up this time, it means her fever was evidence of Cytomegalovirus, and that she caught the virus exactly when you don't want to, i.e. while pregnant. I did some (alright, obsessive, dedicated) checking on this virus and, believe me, you don't want this while you're pregnant. There's around a 40% chance the infant could be born with severe mental retardation, vision and hearing problems, liver issues, the list goes on. CMV is the leading viral cause of retardation in the country, with about 6,000 kids a year born with it.

So how do you pick up this virus in the first place? That's the kicker. About 80% of adults already carry it! If you're not a fetus, it really has no effect on you. Prime vehicles for transmission are day care environments, where it can be passed by snotty, oozy kids who don't wash their hands well (what kid does?).

Anyway, Dr. W. said he has no special reason to think this is what Marci picked up, but since it's one of the dangerous (incurable, untreatable) ones, he's investigating further. He actually said her fever was more likely one of the thousand other things you can catch with no ill effects for the fetus.

If she comes up clean in three weeks, then the issue (for me, that is--she seems marvelously relaxed about all of this) is how to avoid this germ for the rest of the pregnancy (since, of course, she's still not immune). Do we avoid the few toddlers in our lives (the niece and nephew)? After all, this thing can be passed without the carrier feeling sick. Do we wear holsters with Purell dispensers like some toll booth workers? Not a bad idea! Evidence shows handwashing stops this sucker.

There is another possibility I considered after seeing a recent Peter Gabriel concert on Pay-Per View.

Obviously, that hole in the front would defeat the purpose, so hers would be sealed up most of the time. We have wide hallways where we teach, so no problem there, and stairs, come to think of it, would be even easier to negotiate in the final trimester!

I've found that this current "Cytomegalo" issue perfectly illustrates the distinction between Marci's and my approach to uncertainty: she's absolutely sure she's fine, and I'm pretty sure (despite professional reassurances to the contrary) that she has it, or will have it.

You can get here from there, after all

Until my wife, let's call her Marci, became pregnant, I never thought much about the process. In fact, I never thought about pregnancy as a "process" at all. I assumed one simply gets pregnant, waits nine months, and then a new kid emerges amid tears of joy and all of that.

I hate to use the tired analogy of the "roller coaster," particularly because roller coasters are pretty much entertaining from beginning to end. I've never seen someone at an amusement park gleeful as they ascend a hill, and depressed as they rapidly descend. If anything, it's the opposite. Anyway, you get the idea.

Marci and I have had some really exciting moments so far: ultrasounds that reveal The Peanut's arms flailing around, the Doppler gizmo that broadcast Peanut's heartbeat, and the initial $8.99 Walgreen's home test that signaled the beginning of this whole thing. However, sticking with my honesty policy, I have to admit that we approached these moments more with an attitude of "cautious optimism" than with "unbridled joy."

Among the pregnant, I've noticed, there is certainly an "unbridled joy" faction. These folks seem a bit naive, or somehow in denial about the gravity of the whole undertaking. Perhaps I'm just misreading "pregnancy banter" codes and all of these people are totally aware of the multiple risks to mother and baby out there, but banter policy forbids their mention.

I guess I should back up. Five months ago, Marci and I wouldn't have thought we could even get pregnant. We had tried for about 15 months and had just reached the point of discussing options with a fertility specialist.

I was encouraged and amazed by all the 21st century options out there for couples trying to conceive (our doctor had even pioneered one of these cutting-edge procedures himself). Our doctor's office was 5 minutes from home, and was a satellite to his main office in a Major Urban Center. Shortly after contacting this group, a FedEx package appeared at our door containing glossy fertility education material. All of the photos displayed black and white photos of couples. The couples were each late 30s or early 40s, dignified, slightly academic-looking (maybe that's a projection), and were each holding (or otherwise regarding) a new infant with an aire of easy self-confidence and relaxed but obvious satisfaction.

I began to think this was the perfect solution. Ovarian stimulation, artificial insemination, IVF, testicular sperm extraction, ovulation induction, egg harvesting, intracytoplasmic sperm injection, laparoscopy, endometriosis treatment, and embryo cryopreservation--let's go! I started to pity people who got pregnant the old-fashioned way, like animals, really. The superior option was to have a big team of well-paid specialists take care of the whole thing for us. Yes, this would be much more civilized, and much more like living in the future, which is automatically cool.

Dr. B. discussed all the options with us, gave us a great gift bag that included my now-favorite purple coffee mug with an IVF logo emblazoned on the side. "Just come back when your next cycle starts, Marci, and we'll run some tests, " said Dr. B. with a firm handshake, "I think we can get you guys pregnant."

As it turned out, he was right, and all we had to do, apparently, was walk into his office. Marci's next cycle never came.

New to Blogging, New to Potential Dad-dom

On many occasions over the past four months, I've said, either to my wife or to myself, "I ought to start my own blog." The concept is not unfamiliar to me, since I work in education and technology. While I have the longstanding belief that there is a special place in Hell for people who ramble on endlessly about themselves, I feel compelled, nevertheless, for a few reasons. The overarching motivation to start a blog is that my life seems to be undergoing a significant number of irreversible transitions, rites of passage, and journeys into the unknown. There's probably a great German phrase (or, more likely, single word) for this, but I don't know what it is. For brevity's sake, I'll just make a list.

1) I just made tenure at my university.

2) My wife was just admitted to a Ph.D. program.

3) This same wife is 16 weeks pregnant.

4) She also plans to continue working full-time (incidentally, at the same institution where I work).

5) In addition to our current home, we are in the midst of purchasing a condo closer to her grad program.

Actually, looking back over the list, these all seem like pretty good news for '06. The first two have been long-term goals for both of us, #3 looked like it couldn't happen, and then did (more on that), and #5 is designed to make numbers 2 through 4 easier to manage.

We'll see. Grad school starts at the end of August, the condo (they say) will be built by September, and The Peanut will be here in mid-November.

The coming observations, musings, rants, links, and photos will all likely be inspired by one of the 5 items on the list above.

If you happen to be reading this, thanks! My intent with this blog is to work against my tendency to self-censor, with the obvious goal of keeping this journal as fresh, straight-forward, and honest as possible. I'm looking forward to seeing where this will go.