To Screen or Not To Screen, That is the Question

So there are a handful of screening tests that one can do throughout the different trimesters of pregnancy, some in the first, some in the second. Which one you get, or if you even elect to have them done, depends on your personal choice and risk factors which are a culmination of all the risk factors you, your baby daddy and the rest of your inbred family have. They are purely SCREENING tests which means they are manufactured so that they will catch more people then they will miss, i.e. more false positives, less false negatives. If they come back positive, you then get the joy of deciding if you want to proceed with confimatory tests, like amniocentesis, which have their own risks and benefits. FYI, amniocentesis is a big 'ole needle into the belly to suck out a little fluid from inside baby's water balloon house and has baby's genetic material floating in it, so that it can be analyzed for diagnosis.

Some people say, "I won't have any screening for genetic disease done, because I wouldn't do anything differently with the pregnancy." I respect this and, in fact, tell my patients the same thing when trying to help them decide if they should do the testing or not. Some people, however, are Type A crazy planners who have to know this, just like they have to know the sex of the baby, so that way they can prepare themselves for what is to come. You can guess which category we fall in to. That's why we did decide to get the first trimester screening done. No, it won't change anything about our plans for our baby, but, yes, we would like to not be blindsided on what is sure to be one of the happiest days of our lives.

You would think this decision would be a non-issue, but for some nosey posey's, it has been anything but. Let's just say that some people were appalled (actually pissed) that I would decide to do such a thing. They were like, 'What if your patients find out? What will they think of you? What will they think when you convinced them not to do it?"

This was annoying.

FYI--It's not a big fricking secret since I told EVERYONE who happened to be around me that day and saw the evidence of the vampire attack on my arm and asked what was up. If my patients find out (which isn't likely unless they are seriously awesome hackers who somehow manage to breach the wicked security on our electronic medical record...or you loud mouths put a post in the local newspapers because you're so worked up about it) and to actually have the sack to ask me about it, I'd tell them the same thing I told you (Please see above 3 paragraphs b/c I'm sick of the redundant typing...and the parentheses).

What will they think of me? Probably that I have some genetic disease either in my or my husband's family and then they'll proceed to feel very, very bad about even asking me once they realize this...even though this isn't true. Then they'll realize that the reason they come to me and love me and trust me with their lives is that I'm very thorough and detail oriented and, at times, an anal spaz, and so they wouldn't be the least bit surprised if I had every test allowed by the FDA and ACOG done.

What will they think when you convinced them not to do it? Well, I'm not in the business of convincing anyone to do anything (unless it's to quit smoking.) That's called 'paternalistic' and something they beat out of you from day one in medical school. I'm in the habit of giving them informed consent, i.e. risk and benefit profiles for each and every option, including doing or not doing prenatal screening. It's a very individualized process as each patient has their own background, risk profile, and general personality traits that can pretty much tell you what they want to do before you even tell them all the gory details. Not to mention, that the majority of these diseases, while they do cluster in families and with older parents, are random mutations that can happen to any parent, at any time in life, with any risk profile.

So, there.

Yeah, it's a little whiney, but it's a little annoying when people word vomit their opinion all over you without you asking, too. (I don't count my word vomiting, obviously, not because I'm trying to be hypocritical, but you all chose to read my random goings-on). It's like when I told someone the names we had picked out for a boy or a girl and said that we had actually chosen them before we found out we were pregnant and just really liked them. This comment was followed up by this person saying, 'huh, really? Well, I hope it's a girl/boy then (depending on which name they hated the least).' Okay, assmunch. I didn't say these were CONTENDERS, I said these are the names that our child, boy or girl, will be blessed with for the entirety of their priviledged life. End of discussion. Thanks for your input. Your baby shower invite, announcement, and any and all communication about my perfect little angel has all been lost in the mail.

Enough of the negative biz. Everything else on the knocked up front has been getting better by the minute. I quit feeling like I was going to yak at any second and have gotten back to a less dairy-centered diet (only a little less). I am, however, super wasted tired ALL THE TIME. I'm a sleeper anyway, but this is getting ridickerous. I could go 12 hours a night, every night, easy. Needless to say, this cuts down on other bedroom activities...well, any other activities really. Also, while eating like a cow for the first 5 weeks, I didn't manage to gain any weight, but things are a little...oh...mushier then they used to be. So, the new goal is to A) sleep like a 6 year old (bed by 8, up by 7), and B) get a little exercise in a couple times a week (as long as that doesn't get in the way of my eating...or sleeping...or eating,) and C) eat for one. I'm making a slight effort to trade in my Little Debbie stockpile and other 'for the baby' treats for some healthier grub. I'm pretending that the mushy is 'baby weight,' but it's more like my husband silently musing, 'baby, wait...before you eat that third cupcake.'