Down's Syndrome Scare

AMA: American Motorcycle Association? Academy of Model Aeronautics? American Medical Association? No, no, and no. My most recent encounter with this acronym was last Thursday when I went in for my Level-2 ultrasound.

To be admitted to the Maternal and Fetal Medicine Clinic, women must be referred by their primary care obstetrician. The clinic, located within a hospital, "offer[s] a comprehensive range of personalized high-risk obstetrical care and fetal diagnosis and treatment services." As I filled out the paper, I was interested to notice that in the space for diagnosis, it listed Advanced Maternal Age: AMA. Even though my previous two pregnancies have gone smoothly with not a single complication, I am now classified as "high-risk" and am in need of a more detailed ultrasound simply by virtue of my age.

Of course, being of advanced maternal age, and having that reminder each time I visit the doctor's office, I have worried about Down's. Of all the possible fetal complications for older mothers, Down's is probably the most well known and the increasing risks by age are well documented. I have worried on and off about Down's since we found out I was pregnant.

That fear was almost completely eliminated when I received the results of the maternal serum screen that is given at 16 weeks to evaluate risks of neural tube defects and chromosomal abnormalities. I passed with flying colors, with my odds of Downs coming back as 1 in 3500. This is compared to a rate of 1 in 225 for my age group. The doctor said that I had a similar risk to a 20 year old, but looking at the chart I cited earlier, the screen gave me a much lower risk than the average 20 year old.

I scheduled my ultrasound for 21-weeks, since we were out of town and this was the soonest we could do it. After it was over, a doctor came in and talked to us about the results. Everything looked fine, save for one thing. The baby's nuchal fold was extra thick. The technician's three measurements were 5.5 mm, 5.5 mm, and 6.2 mm. The average for a baby of our gestation is closer to 3. An increased nuchal fold is a primary physical characteristic of Down's babies. We talked with the doctor for quite a while, asking a lot of questions, trying to understand the evidence and what our options were. With what they saw on the ultrasound, the doctor put our risk for Down's at 1 in 175.

After talking for a few minutes by ourselves, we decided to go ahead with an amniocentesis so that we could find out for sure one way or another about our baby. I know myself. I am terrible in transitions, and if we did have a baby with Down's, I knew that I would be much better able to handle it if I had time before he was born to do research, talk to specialists, and find support groups. I also knew that I would worry incessantly for the entire second half of my pregnancy if I didn't know, even if the risk was less than 1%.

The amnio wasn't as bad as I had always imagined that it would be. It only felt a little worse than getting a shot. Happily, the needle was a lot shorter than I expected and I just held AJ's hand and looked away. It was over quickly, and I didn't even need a band-aid. I felt fine the rest of the day.

They told us to expect the inital results by Monday. The full chromosomal panel would be completed by 10-14 days, but with certain labratory techniques, abnormalities in several chromosomes could be detected much more quickly than that.

I held it together pretty well on Thursday. I was processing everything the doctor told us and after we returned home, I tried to find more detailed information online about risks and what the doctor told us. I went to bed pretty early (continuing jet lag) and then got up at 4 am on Friday when T climbed into bed with us and I couldn't go back to sleep. That's a long time to be alone and quiet in the dark and by 7 am I was worried and in a state. My emotional reaction was: "I cannot handle the kids I have now. There is no way I could handle a special needs child."

The whole day Friday, I felt really tired and down. I was worried about what would happen and couldn't set aside my anxieties. I was hunkering down for a long weekend with my worries, wondering if I should skip out of church. But, then I got a call from a genetic counselor associated with the clinic at about 4:30 that afternoon. We were clear--everything looked good. I asked a lot more questions, but was just relieved to get the word and get it so much sooner that I had anticipated.

Oh, and although we saw really clearly on the ultrasound (I love this shot AJ described as baby porn) , the chromosomal tests confirmed that our baby is XY all the way. T has decided that we should name the baby Sportacus. I think it sounds great with out last name, and so we will be calling him that for the duration of the pregnancy.

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Market Day

Tuesdays and Thursdays are market day in Vicenza. Starting around 8 in the morning, the entire piazza and up the side streets are filled with vendors hawking their wares under tents. Just the sheer logistics of getting their goods in and out of selling areas is remarkable. I love walking around, looking at all the clothes and the people who are are out shopping. There is always a good lively crowd--older women in heels and suits with perfectly coiffed hair, mothers with their babies in strollers, young people. It feels like the whole of Vicenza comes out for the market. Forget about Target or the grocery store. So much of what you need is right there. Clothes of all types, ties and scarfs, knick-knacks, kitchen pots and pans, tablecloths and blankets, plus produce, fish, cheese and flowers are all available within feet of each other. In a short time, you can gather everything you need.

I found a great bag that I have been using ever since, including our trip to Tuscany. I can sling over my chest, making it so much easier to carry that my other bag which constantly slips off my shoulder. And I got a poncho which I thought would work well for a winter pregnancy. I have been wearing it since then--it has been chilly in the mornings.

I think the picture that T took of Nana at the market is pretty good, by the way.

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Nove and Marostica

On Monday in the late morning, we made a trip over to Nove to look at the ceramics. TF took T to the zoo and playground in the area, and C and I went over to the ceramics stores. The warehouse type store is piled high with ceramics of all varieties, and I kept envisioning T running through the aisles. Happily, he was otherwise engaged. I picked up a couple of platters for gifts that I needed to give, plus a huge mosaic platter of Florence that I will put in our front room. Unfortunately, they did not have all of the colors of the chicken plates I wanted to get my mom for Christmas. I think we will go back on Monday so I can pick those up before we leave.

Then, we went over to Marostica for some lunch. T was very cranky, very contrary, but after eating, he seemed to be doing better. Marostica also has a city wall, but is unique because the wall was built up a steep hill with a castle at the top. You can see the wall in this photo. Not the best shot of the main piazza--there seemed to be cranes all over Italy. T had a great time swinging his sword around in front of the castle at the base of the hill too.

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Two more Italian Books

I have been working on a couple more books about Italy on this trip.

First, Brunelleschi's Dome: How a Renaissance Genius Reinvented Architecture by Ross King is about the completion of the dome of the Duomo in Florence. It is interesting, although it was a little technical for my taste, with a few too many details about the engineering feats Brunelleschi accomplished. I was suprised to learned that the dome is one the largest ever built--massive in its entirity. Brunelleschi not only had to design a dome that would not collapse under its own weight (using innovative techniques such as a double dome with empty between the two layers, a herringbone pattern to lay the bricks in order to provide strength, and a chain of stone built within the brick to provide support) , he also invented a machine to lift the heavy beams and slabs of marble to several hundred feet above the ground and figured out a way to erect the dome without the use of centering--wooden frames used to hold up the arch. There is also some information about Brunelleschi's personality.

Second, Sprezzatura: 50 Ways That Italian Genius Shaped the World is 50 essays that can be read individually about 50 mostly individuals (but a few other Italian phenomena--Venice, Roman building advances, Medicis and banking, and Italian fashion for example). Starting from the Roman period, the authors move to contemporary times. I read probably 75% of it, focusing on the earlier periods of Roman and Renaissance contributors. Each essay felt a little too packed with details, but overall it was interesting. After reading it, I decided that I had missed out on some classical literature, including Ovid, Dante, Petrach, and Boccacio among others. I almost persuaded myself to read thier major works. But, when I saw The Divine Comedy and Decameron in a Florence bookstore, I rethought my noble idea and decided to put this on my back burner book list. Maybe I could read a little bit at a time some other time??? Among the more interesting essays, I enjoyed learing the development of the modern calendar and Julius Ceasar's involvement with it (perhaps because it was the first one in the book). I also enjoyed reading about the figures of the Renaissance like Michelangelo, Galileo, Machiavelli, da Vinci, the Medicis, and Palladio.

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Thiene

I enjoyed a quasi-feeling of having the day off on Sunday. On a General Conference weekend, a broadcast of the first session occurs at the church, but it doesn't take place until 6 pm. The men went over to the church at 11 to watch a taped copy of the priesthood session. But, C, T, and I went out for a walk. It was a beautiful morning and we walked over to a statue garden where a remnant of Vicenza's city wall stands. T had fun looking at the fountains, ducks, statues, and trees, and then we strolled over to a park-like area. It was very casual, very relaxing.

After lunch, we headed out to Thiene to catch the Renaissance festival we had bypassed the day before. It was exciting to see the Renaissance characters against an actual Renaissance backdrop. We saw jugglers on stilts (one of T's favorite--especially when they juggled with knives and threw them "way up high!"), men twirling flags, a whole piazza of children's games, and knights marching up and down the street. T also was excited by the knight's helmets with the plumes. But, what we mostly saw? Throngs of people. The streets were packed. I guess Sunday is family day anyway, and I'm sure the rain pushed everyone to Sunday as well. It was so so crowded. So, we didn't stay for too long. But, the highlight of the day was the procural of a knight helmet and sword (complete with sheath) for T. He was thrilled and has been thwacking at things non-stop since then. We decided to make a Renaissance dress for MJ too so they can go as lady and knight for Halloween.

We came home and again listened to conference, with a slight break from 7-7:30 for dinner. After conference was over, AJ and MJ called and it was good to talk to them. AJ asked, "So, the question of the day: did you hear Sister Beck's talk?" I guess it was during the dinner break for us, and as it turns out, I think I'm quite fortunate that I didn't have that one take me by surprise. Even AJ said there were some thing that "made my blood boil." Unusual for him. It turns out that the talk has a lot of good material, but there are a few things that I'm sure I would have been very upset by. I spent some time on Sunday night and Monday around the bloggernacle reading what (so many) people were saying about it, and I was glad not to be in the middle of it emotionally. I also discovered that the talk I had walked out of in April 2004 when I was pregnant with T was a talk by her. Hmm. I'm sure I will post my thoughts on her talk somewhat later, but for now, I'm content to enjoy the Italian fall and not let any ire ruin my mental state.

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Rainy Day

After an excellent first day, both T and I were exhausted on Saturday. For some reason, I was awake early that morning from 2 am-5 am. I'm not sure if it was the jetlag or the pregnancy induced insomnia I have occasionally experienced, but I didn't get out of bed until 10. With T, it was more like 11:30. After we finally got out of the house around 1:30, we drove over to the post so that T could get a soccer ball to play with at the park at the piazza. By the time we were done there, it was pouring rain. A heavy downpour. We waited a while to see if it would let up and then finally TF ran out for the car and we jumped in. We had planned to go to the Renaissance Festival in Thiene, but decided to postpone the trip. Good choice, because the rain didn't let up all afternoon. We ended up driving back into Vicenza the long way because of multiple detours due to the soccer game there. I guess there is no calling off an Italian soccer match. But, I got to see the outskirts of the town, and one of Andrea Palladio's (famous Renaissance architect son of Vicenza) most well known villas, which has been copied many times over.

We relaxed the rest of the day. I took a small nap in the late afternoon, and then we booted up the computer to listen to the first session of General Conference, at 6 pm.

Oh, and one thing I did in the middle of the night, as well as the previous and next day? About 10 NYT crossword puzzles from TF's "Solvable" collection.
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Citta Della

On the first morning, T slept until 12 pm, 13 hours straight. After two failed attempts to arouse me, I finally opened the shades in his room and he eventually got out of bed. That first afternoon, we took a drive with TF and C around nearby areas. Our main stop was Citta Della, whose predominant feature is a still standing medieval wall that surrounds the city. Citta Della was originally used as a garrison for solidiers whose job was to protect nearby Padova. We were able to walk around the top of the city wall, check out the guard towers, look at the niches where archers could lob arrows down upon enemies, and look at the city and moat that still has water in it. T was very interested in the replicas of knight gear--chain mail, the helmets with the nose protection, shields, spears and swords, and bows and arrows. He was anxious to show Papa the room with the knight gear (after he had relieved himself on the nearby lawn, completely independently).

I especially liked the the CAUTION sign. Doesn't the outline of a person falling disastrously encourage careful footing? For me, it did.

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Italy Adventures

T and I made it to Italy last week. The weather has been absolutely beautiful and Italy is enchanting. We are looking forward to AJ and MJ's arrival tomorrow afternoon, and I have been working on the details of our trip to Pisa, Lucca, and Florence next week.

We got into Venice about 4:30 in the afternoon. Our flight from MSP was overnight, and T slept a good amount, but I didn't--there was a lot going on for most of the flight. The women in front of me, who were missionaries travelling to Africa, were so chatty. And when the loudest one in particular wasn't talking, she was digging through her enormous bag which sounded like it was full of aluminum foil covered treats. So annoying when you're trying to sleep. Anyway, we did pretty well getting through Amsterdam. T was a trooper and in good spirits. I was happy to see C after we got our bags in Venice. She helped us to the car and then we headed home. T and I both went to bed around 11 that night--pretty good when it was only 4 pm CST.

I fell asleep instanteously, and jumped out of bed at 7 am when I heard the church bells ringing the hour. I was anxious to get out exploring Vicenza, but decided to wait for a while to either find a guide or a map. TF took me for a walk around Vicenza, and in just that little time walking very near their home, I was awed and charmed--the aromas, views, and atmosphere was breath-taking. I can't believe that this is really where they live. I'm sure that the charm wears off with time here, with their everyday stresses of dealing with parking etc, but I am in love with their city. And it's such a great way to visit Europe with kids. We use AJ's parents place as a base, where we can have quiet days. And when we want to hit the museums or places further afield, they get to stay and enjoy time with nana and papa.

This is a view through the gate of the Teatro Olympico, dating from the mid-1500's, from the first morning's walk with TF.

This is a Palladian palazzo a few minutes walk from AJ's parents house.

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Frankenstein

For book group this month, we did Frankenstein. I was a bit behind in my reading, so read through it in a couple of days. Kinda crazy book. I didn't like the monotone voice--the ever present Mary Shelley--of all the characters. Ever the monster spoke in the most educated and vocab filled voice in his 6-8 chapter monologue (after learning to speak by watching cottagers teach an Arabian woman to speak French--he also learned all about geography, politics, etc. In fact, after these experiences, he devoured John Milton's Paradise Lost.) I could not lose myself in her fantasy world. It just didn't work for me. The women portrayed in the book drove me crazy--very one-dimensional and the very idea of a Victorian woman. Who is that perfect???

But, it was a decent read. And I guess there were a few of those timeless themes that supposedly help to make a book a classic. I thought Victor was crazy and irresponsible. I couldn't believe that he just left monster-man (a much more sympathetic creature to me) and for two years didn't do anything about his creation. It was only after the death of his brother that he was forced to deal with the situation. It reminded me a bit of the movie AI. What is our responsibility to those things that we create?
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