Wednesday, May 4, 2011

Even more Puzzling...

Today, Athong came in for a prenatal. (For those unfamiliar with her case, please read here first.)

Thrilled to see her in my prenatal line, I asked her quickly if her baby was doing well. She nodded excitedly and handed me her book.         --Hallelujah!

Since she hadn’t come the month before, I thought perhaps she had miscarried. I can’t tell you how relieved I was to see her. I kept thinking, “May this be the baby that lives, Lord!”

She positively glowed when I called her in to be checked. We exchanged pleasantries as she lay down and lifted up her shirt, exposing a perfectly round belly bump.             --Adorable.

Before I left on R&R, Athong had faithfully come for several weekly check-ups in order to get the full arsenal of our STD-fighting meds! She was eager to do whatever it took to keep this child.

Each visit, I expectantly searched for fetal heart tones but found none. I did find a growing belly, however, and so assumed either she was off on her dates or ... she’d miscarry very soon. We prayed it would be the former. but steeled ourselves for the latter, just in case.

So when she reported ‘no bleeding’ at all this morning, I was hopeful.

Already measuring 11 cms, her belly was firm but tender to the touch. She winced a bit while cautioning me to be careful; she didn’t want to lose the child.

Laughing lightheartedly, I continued to check her in.

My doppler picked up a number of blood vessels and whooshing sounds, but nothing resembling a heartbeat could be found.                         -- Not good.

Searching for much longer than I normally do, I sent for Dennis to consult. This was looking oddly familiar. As we waited for him to arrive, I reviewed all the basics with her again.

-- So, Athong. Tell me again when you think you got pregnant.
-- Well, it actually stopped bleeding in June of last year, but then it continued each month until February of this year. Then it stopped for good.
-- Oh, I see. So, you think you are only 3 months pregnant now. Right?
-- Yes.
-- But last time you told me that you got pregnant in December of last year.
-- No. I got pregnant in March.
-- Huh? So your last menses was in February and you got pregnant in March?
-- Yes.

Here’s the trouble: If she is only 3 months pregnant, why then this colossal belly-bump? What’s more.... why is it so hard? If she is 5 months pregnant, why can’t I hear the sweet toc-toc-toc of her child inside. Even at 3 months, there should be something... anything. But all I can hear is the soft wooshing of nothingness.

Palpating once again, I made mental notes: “It’s definitely a pelvic mass. Her ovaries are tender but not enlarged. Although no reported bleeding, her menses have been irregular. Plus there are no fetal heart tones. The fundus is growing (it grew 2 cms since last month), but it’s woody and hard. Could it be...?”

My brain trailed off as Dennis came in. Catching him up to speed, he nodded and palpated it all for himself.

Conclusion: She needed an ultrasound.

I can only think of three reasons for this state of being. One: she has a baby that is astute at hiding its heartbeat (unlikely); Two: she is only 2.5 months pregnant with large fibroids or some kind of uterine mass; Or three: she has a hydatidiform mole.

Personally, I suspect the hydatidiform mole. Horrified as I am to admit it, it just fits the symptoms best.

Unusual bleeding. HCG in her urine. Lots of nausea. Woody hard fundus. No fetal heartbeat.

Would someone please tell me I’m wrong? I would LOVE to be wrong.

I don’t want another hydatidiform mole. You all remember what happened with the last one. (If not, please read these stories. Story one. Story two.) Plus, she DESPERATELY wants a child.

Taking the news in stride, she nodded with possible INcomprehension as I explained the details over and over again.
-- “What you need is an ultrasound. We need to know what we are dealing with,” I said.
-- “No. I will go to the witch-doctor. I’m sure I have been cursed. The witch-doctor will fix it.”
-- “Actually... the witch-doctor will not be able to help. What you need is a picture on the inside which will tell us what is in there. Please don’t waste your money on a witch-doctor. Please get an ultrasound instead.” I almost begged. 
-- “Okay. I will go.”

Was she just telling me what I wanted to hear? I couldn’t tell. Please pray for her. If she has a hydatidiform mole and doesn’t seek help, she will start bleeding soon.

I’m very concerned for her.

Also... please pray that God would bless our clinic with an ultrasound machine. We need one desperately. It would be so great to not have to guess all the time.

Does anyone have one they want to donate to us? Does anyone have connections for a cheap retailer? I’m semi-desperate! ha ha.

Please pray for an ultrasound machine.... and a place for me to train how to use it. Thanks.