#32 - A DIFFERENT EXPLANATION

It has been a mad crazy week at work – it always is in the weeks between Thanksgiving and Christmas.  The good news is that I have managed to keep my focus over the last week or so and I have been successful in banging out a chunk of backlogged paperwork.  

Today was an interesting day.  I feel like there was a sign hiding behind every corner that I turned, but I can’t figure out what any of those signs were pointing to.  I ran into the grocery store for milk between clients today.  Near the entrance of the store, a sales associate was setting up a display of Styrofoam coolers - generally not something that one would take special note of, but there were two points of interest for me.  First, who sets up a display of Styrofoam coolers in Pennsylvania during December?  Second, since our visit to the funeral home to make Gracie’s arrangements, every Styrofoam cooler I see reminds me of her.  An odd correlation, I suppose, but one that I think will always remain.  The funeral home we used provides free services for any child less than one year of age.  Those arrangements include a ‘Polystyrene casket,’ which is really nothing more than a Styrofoam cooler.  The thought of burying my little girl in a Styrofoam cooler still makes me cringe – we opted to upgrade her to the fancy plastic model, but I will forever make the connection between my poor little Gracie and Styrofoam coolers.

After passing by the beautiful display of Christmas coolers, I was mowed down in the produce section by a runaway toddler.  Mom was in hot pursuit, and apologized profoundly in between shouting for the little girl to stop.  Her name was Gracie.  I walked about 20 feet further past two men who engaged in conversation.  I heard just a snippet of what they were saying - what I heard was ‘After Grace died, we….’   Seriously, what gives?  I’m not more than 50’ inside the store, and I feel like I have been bombarded with reminders of Gracie. 

There were other signs throughout the day.  I saw 3 old Subaru station wagons like the one we sent to Subaru Heaven a year ago – same color and everything.  A weird sign, but usually a meaningful one that at least one other person will appreciate.  I heard an ambulance call dispatched for a cardiac arrest of a 3  y/o boy – it was one of the only emergency calls that I heard dispatched all day, and he did not live.  I can’t help but wonder why that is one of the only calls I heard dispatched all day. 

Moving on from all of the signs.......   After much thought and debate, Jeff and I decided to schedule an appointment for a Maternal Fetal Medicine specialist, just to see what they had to say.  I was really just looking for a little more peace of mind for when we start TTC.  That consultation was today, and surprisingly, it left me feeling just a little better about things.  The doc did a very thorough review of my chart and asked me quite a few questions.  I learned that my placenta was very, very small.  I had been previously unaware of this, and I am a little disappointed that this information was not passed along during our previous follow up appointment with the regular OB staff.  By itself it is not an answer, and it not likely something that could have been identified during prenatal exams or testing, but I still wish that we had know about this before today.  This doc also officially confirmed that Gracie was growth restricted.  Prior to today, everyone has danced around the phrase ‘Intrauterine Growth Restriction.’ 

When it was all said and done, this doc told me that he believes Gracie’s demise can be attributed to either Trisomy 18 or Trisomy 21.  We have no genetic or chromosomal testing to go on, but he felt very strongly that all of the existing information points to one or the other.  He said that he was inclined to lean toward Trisomy 18 because of the higher mortality rate that Trisomy 18 carries compared to Trisomy 21.  Statistically speaking, stillbirth should not have happened to us, so I don’t put a whole lot of faith in statistics.  That said, it is a pretty safe bet that we will not have another baby with a Triomy defect.  I tend to regularly jinx myself, so we won’t talk about what the statistics say about the ‘other lightning’ striking twice. 

I am wishing that had known 18 weeks ago that insurances almost ALWAYS pay for genetic/chromosomal testing after a stillbirth (our midwife was told by someone that my insurance would not pay, and that out of pocket cost was roughly $1700), and I wish that I hadn’t been too emotional to give consent for an autopsy.  But, I do feel a little better after this appointment.  I have felt from day 1 that Gracie had mild Down Syndrome-like  facial features, but since we have no testing to prove or disprove my theory, we have been going back and forth between the possibility of placental clots and chronic (but well controlled) hypertension – with both theories coming up relatively empty.  I am very comfortable with the theory put on the table today – it fits a little better with all of the history (I had a Trisomy probability score of 1:47, but we opted to not have an amniocentesis), and it means that I don’t have to always wonder if there is a clot forming somewhere in my placenta…  We are going to proceed with daily baby aspirin during our next pregnancies just in case, but I am pretty comfortable in feeling like I may have a better explanation…