Yes Mr. High Risk OB, I am now 30.

Brynn has been into mimicking everything we do lately. When I pull out my new cordless vac she runs to grab her toy vacuum and follows along behind me. Since we no longer have a cleaning lady and since she is so gangbuster about cleaning...perhaps I should invest in an actual working vacuum for Brynn to "play with" aka be my child cleaning slave? Just kidding :-) Do you think people would frown on that? Is 20 months too young to clean? I guess so..maybe in a few years :-)

Today I woke up, packed Brynn in the car and headed south to my parents house. I dropped Brynn off so that they could watch her while I went to my 9:30 appointment with my perinatologist. This was the same peri that co-managed my pregnancy with Brynn, and he is quite the joking type. Before we discussed how future pregnancies would be managed he asked a few questions about our recent miscarriage, how many embryos we were planning on transferring on our upcoming FET, and my current age. Before I could answer, he blurted out "Well, it shows here you're 30." Yup Mr High Risk OB...as of this past Tuesday I am now officially 30. I asked him, "Does that change anything?" His response was well...not really...just that I was a little closer to "advanced maternal age." At 30? What the heck? He then of course smiled and said that was his way of saying a belated happy birthday - and that he was just kidding. I smiled back and told him that saying phrases like that is not exactly a way to get along with the ladies. He just has an odd quirky sense of old man humor so I know he truly thought he was funny :-)

But for the record....30 is not that close to advanced maternal age or AMA as they put it on the charts up in L & D. (labor and delivery). At least I say so. And while I'm on the topic I think whoever came up with that label "advanced maternal age" ought to be shot. What do you think?

My meeting with the peri went well, about what I expected it to be. He asked to see pictures of Brynn aka the "vasa previa miracle" as he refers to her. I proudly whipped out a few to show him. He discussed the following:

- progesterone taken through the first trimester
- scans to monitor for IUGR
- a cerclage to be placed around week 13 (McDonald vs Shirodkar)
- weekly cervical checks starting around week 10 via internal exam and serial ultrasounds.
- progesterone IM shots around week 16
- steroid shots around week 24 (viability)
- Zofran, Reglan and other options for nausea - vomiting if or when it occurs
- being followed by a GI doctor for hyperemisis and gastritis if those two ugly sisters rear their head again.
- the addition of possibly adding Protonix (especially IV) if IV nutrition is needed
- the possibility of a PICC line so I could spend more time at home with Brynn if IV nutrition is needed
- screening for placental problems such as a vasa previa which we had last time

We actually scheduled another appointment for next week to discuss what type of cerclage should be placed. The appointment is in conjunction with a peri from another large hospital nearby. Although the hospital that I work at and my peri that I met with is a large hospital facility, my peri wants us to get the second opinion on my care from the other large hospital facility in the area. Our hospital (the one I work at and will be treated at) does over 7000 deliveries a year and the peri group pulls in patients referred from over 17 local hospitals. I feel confident in the care I receive. But if my peri feels that a second opinion is warranted, I will certainly go to the appointment with the two peris next week. My peri said that even for a unicornuate uterus, our case is certainly not "textbook" and so they want to cover all their bases. (or asses?) Just kidding :-)

Risks discussed for both me or the potential baby with a future pregnancy...well.... I want to remain upbeat and I will not bullet point those here or now. It was nothing that I hadn't heard before or wasn't aware of. Regardless, I left the meeting excited and anxious. I want to get our transfer underway...I want to get the ball rolling.

Yesterday I started my provera in addition to the premarin I'm taking. I'll hopefully get a period in a couple of weeks and that will be the start of our transfer cycle. Next Thursday my RE wants to do a sonohystogram to take a peek inside my old uterus just to make sure things are squeeky clean. So keep your fingers crossed for me.

Tomorrow the hubby and I leave for New York City for a long weekend. It's the first time I've been away from Brynn for the night and I'm both looking forward to it and am worried of course about it. My parents are watching both her and Neela at our house so they'll be in the comfort of their own beds and familiar surroundings. Keep your fingers crossed that everyone survives the first time separation! Especially my parents :-)