Baby is (still) fine

[mmcirvin]

Well, we went for our third ultrasound today, and as far as they can tell, our daughter-under-assembly is in good shape. It seems as if the process is specially designed to worry people, though...


To recap, the first ultrasound around 19 weeks at Melrose-Wakefield, the one Sam described here, found an echogenic focus in the baby's heart. This is a bright spot of calcification that's harmless in itself, but is sometimes claimed to be weakly correlated with Down syndrome; however, iayork mentioned in a comment on Sam's second ultrasound post that he'd discovered that even this weak link was not corroborated by later studies with better statistics. So an echogenic focus essentially means absolutely nothing, especially given Sam's normal quad screen. Nevertheless, they scheduled a second ultrasound at New England Medical Center a few weeks later, maybe for liability butt-covering reasons.

That time, as Sam recounted in her second post, the tech saw the echogenic focus again, but the doctors opined that, given the unlikelihood of anything being wrong, it hadn't really been worth doing the second ultrasound in the first place. Nevertheless, they went ahead and scheduled a third ultrasound, this time because the aspect ratio of the baby's head was a hair below tenth percentile; circumference was normal but it was a little bit long and narrow. This usually just results from the baby being in breech orientation, as she was at the time, but it is apparently sometimes a marker of craniostenosis and they wanted to be sure her head was developing all right.

Well, rationally, "below tenth percentile" isn't a lot to worry about, since on any given measurement, a tenth of all fetuses are below tenth percentile (and another tenth above the ninetieth), most of whom are going to be healthy. And I looked it up—the kinds of craniostenosis that look that way seem mostly associated with genetic syndromes that have all kinds of other markers, and we certainly weren't seeing any of those, nor was there any family history. But this gave me all kinds of horrific visions and worries anyway.

It's astonishing how powerful this effect can be, even if you've imbibed mathematics for decades and got a degree in something vaguely to do with probability. I'm a worrier. (I'm pretty sure I do have a family history of worrying! I hope baby doesn't get it!)

I wish I were as cool a cucumber as Stephen Jay Gould, who got a disease with a median survival time of 8 months, soon figured out by carefully studying the shape and nature of the distribution that, despite the grim median, he actually had a good shot at living a lot longer than that, and was able to convince himself of that prognosis on a deep emotional level (as the postscript says, he died 20 years later of something else, after finishing his masterwork).

Anyway, this time her head shape fell within the range considered normal, as did everything else (the echogenic focus is still there, but still means nothing). This might have been because she's turned head down. And she sure is bigger, though it sounds as if the really impressive growth spurt is still to come. Unfortunately, the pictures from the second and third sessions aren't as photogenically perfect as that profile shot from the first one; to the untrained eye they basically look similar, only bigger and blurrier.

Comments

[adw3345.livejournal.com]

Hey Matt-

I found out about the scan you admired of Zhanna's baby, here is the machine at the hospital they have:

http://www.gehealthcare.com/usen/ultrasound/4d/virtual_4d_mini.html

I had thought it was an ordinary ultrasound machine used in a special way, but at the time I hadn't really been following along with what the doctor was doing.

Anyway, ask if they have one in the hospital, or if not, can recommend another place which has one. I read in the newspaper that there are boutiques opening that just do this like a portrait studio and not for medical purposes, about $200 a session or so. Really cool to see and you can already see family resemblance even when baby is in Mommy's tummy.

Good luck with babykins!

-Derrick

[mmcirvin.livejournal.com]

I think she'll be photographed quite enough after she comes out!

Thanks for the info, though. That's pretty cool.

[muffyjo]

You are a good worrier, and even better at finding ways to not worry. I do hope THAT talent gets passed along. :) Let me explain, imagine if you had only to rely on what the technicians said instead of going ahead and doing the thinking for yourself and getting help to research the realities. You would be worrying a great deal more and for no good reason. No, I think your penchance for collecting data is one you NEED to pass along to the next generation. Remember the 60's? Remember "Question Authority". Had more blue states done that...well, I digress.

I'm pleased to hear you are doing healthy things and that all three of you seem to be in good standing!

[mmcirvin.livejournal.com]

I caught the tail end of the '60s but was too wasted on Gerber pureed beets to remember much of it.

The thing about my worrying is, you people on the Internet only see the very tiniest tip of the iceberg. samantha2074 gets it full force.

[muffyjo]

I, too, am a worrier. Sometimes I think I do it because I can't find something better to occupy my mind, sometimes I think it's because when I'm not worrying, I feel like...heh...something must be wrong. :)

The most important thing is to realize that not only can you spot the problems, but that you have competent and fairly healthy coping mechanisms to counter it. You find out about a problem...great, you know how to find solutions to it, research.

What's also smart is to include people in your life with the insight, that you can trust, to tell you when you are over-worrying. I'm guessing samantha2074 is one of those people. For me it's kerri9494 andlillibet, primarily. Then you need to find a way to either distract yourself with something else, or find some other mechanism to shut the brain down on that particular tangent. It's a very useful skill to have learned.

[mmcirvin.livejournal.com]

There's a sort of moral element that comes into it: the idea that if I'm distracting myself with fun things to forget all the horrors and dangers of the world, that's an irresponsible or callous thing to do. But despair and panic are just as paralyzing as complacency.

(I'm pretty sure I do have a family history of worrying! I hope baby doesn't get it!)

[asienieizi.livejournal.com]

Let's hope now you both can go onto worry about other things now such as baby furniture, diapers and names. She's going to be just fine. Yes I know, you're going to worry anyway but think of it as preparation for when she becomes a teen!

Re: (I'm pretty sure I do have a family history of worrying! I hope baby doesn't get it!)

[mmcirvin.livejournal.com]

Trust me, I am already worrying about her getting a driver's license.

[mmcirvin.livejournal.com]

Incidentally, it looks as if "craniosynostosis" is the more correct word, but it's more of a tongue-twister...

Also, I looked at some more stuff on the web, and even when her head was narrower than normal, it wasn't really shaped like the head of a kid with that kind of craniosynostosis, where the sagittal suture closes up prematurely. Their skulls tend to become sort of triangular with a wide forehead in front and a long tapering rear portion.

Darwinian worrying?

[vardissakheli.livejournal.com]

Parental worrying must be a survival characteristic. If we dumped our eggs in nests on the beach and never saw them again, it would never have been selected in our evolution. But we need years of parental care before reaching sexual maturity, so whatever hardware and/or process it is that makes parents worry about us must be tied up in continuation of the species.

Re: Darwinian worrying?

[mmcirvin.livejournal.com]

Yeah, we're definitely K-strategy creatures rather than r-strategy. Though that can be obscured when a society has lots of food and a need for cannon fodder.

not necessarily K vs. r

[vardissakheli.livejournal.com]

Parasitic nestlings like cuckoos and cowbirds aren't produced in extra-large numbers, for instance. They just take advantage of nurturing resources other than the parents. Because the parents range so far for food, worrying about their eggs and chicks would be disadvantageous to their survival.

I don't want to think too hard about analogies to class distinctions in human societies.