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.