Diagnosis

The next day we drove back to Spokane for the scan and a chat with Tanya. I felt the emotions of the day brimming at my eyelids as we drove and talked.

When a good friend had called me a couple years ago to tell me he had ‘just the guy’ for me, he described Russ by saying, “He’s a Jesus guy, just like you.” He was right. I’d prayed that if I were to be married, it would be to a man who would lead our family in faith. I dreamed that together, we could share God’s love and life as the strongest bond between us. God fulfilled that desire by bringing Russ into my life.

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As we drove that day, his spirit lifted mine from the trench of pity and pain that was sucking me in. His voice did not quiver as he said with conviction, “We aren’t just going to be average parents to this little precious one, we are going to be the very best we can be.” A few miles closer to the clinic, after a conversation about God being in control us desiring more than to be ‘fair-weather Christians’, we agreed that our faith in God was our lifeline for every corner of our lives, not merely a religion we associate with. And in the midst of our conversation about our babies likely diagnosis, Russ said these words, “This is where faith lives.”

When those words travelled from my ears to my heart, I could sense the Holy Spirit in the car with us. It was as if we were embarking on a journey that would not only require faith but would create in us as a couple, a deeper, vivid and living faith from which to be parents and continue to experience God’s lavish love for us. And the Holy Spirit was present, affirming that He was near, empowering and comforting us as we stepped forward.

We arrived at the Maternal Fetal Medicine clinic. I felt like every staff member knew our news. We initially met with Tanya again and she walked us through the results of the tests. She wrote in pen over the printed results, 82%. This was our currently known risk that our baby would have Down syndrome. I won’t lie, I’ve never thought 18% held such good odds.

To determine the further likelihood of Down syndrome, they wanted to do another ultrasound to look for ‘soft markers’ of Down syndrome. Tanya explained that babies in the womb can present with particular features associated with the syndrome…which would add to our 82% if found. Flatter facial features, white spots on the heart, shorter than average femur bones and a slightly turned in top joint of the pinky finger were some that she mentioned.

I laid in the dark room, with my belly exposed and the ultrasound wand swishing the goopy gel around in search of our little swimmer. All of the sudden, as I fixated my view on the grainy black and white screen, a little hand came into clear view and waved at me. There it was! The little pinky was turned in slightly- but noticeably. At that moment, 82% disappeared. I knew our baby truly did have three copies of the 21st chromosome.

Following the ultrasound, the doctor met with Russ and I to review the scan. He began to re-explain the purpose of the scan in detecting soft markers and then told us that many of those markers had been found. The white spots on the heart, the shorter arm and leg bones, a glossy look on the stomach and that slight curve of the pinky finger. Each of these markers added certainty to the diagnosis- although none of these could allow him to give us a 100% diagnosis. Only an amniocentesis could provide the genetic verification of that- a procedure where a long needle is inserted into the womb and a sample of amniotic fluid is used to verify the diagnosis. I had sat through this very same procedure with a dear friend and was not keen to undergo it myself!

Russ, being an analytical kind of guy, asked if our % of risk had gone up. The doctor sympathetically nodded yes. Russ, not yet satisfied, asked if it was up to 90%. The doctor shook his head and said, “Oh no, more than that…I’d say 98 – 99% really.” I looked at Russ, as I watched his heart letting go of the last hope that this was all a dream. I offered, “Honey, he can’t legally say it’s 100% because we haven’t done the amnio’….but essentially, he is saying it’s for sure.” I looked at the Doc to be sure I wasn’t mistaken, but he nodded his head in agreement and then offered some comforting words to us.

He suggested that we think about and then decide what we would do with the results. I’ve read many statistics about prenatal testing and the subsequently frequent termination of babies with Down syndrome. Statistically, 90-95% of babies diagnosed in utero are terminated. He had laid out a long list of complications which our baby may face, because of the diagnosis. However, our hearts knew that this special and unique life was not ours to end. It was ours to steward and was entrusted to us by the Creator, who breathes purpose into each life. We told the Doctor we would not consider termination.

I was thankful that at that moment, he said, “That’s good, we always advocate for life.” Life is what we have. A tiny, intricate, sacred life growing steadily inside of me. And we have the redemptive, abundant, powerful life of Christ, coursing through our family. We left the clinic knowing we would never be the same again. Our lives had changed forever. As the weight of the day began to settle in, and the silence between us became vulnerable, I heard Russ’s words. “This is where faith lives.”

Results

As promised, Tanya called me back on Tuesday. Her call came late in the afternoon and Russ was home. I handed Madeleine to him as I glanced at the familiar number on my phone and I perched on the couch, looking out the window. I half wished I’d grabbed our calendar to remove the guesswork from my expectation of a re-scheduling of the blood test.

In the very short time I’d had with Tanya, I already appreciated her clear and informative approach to genetic counselling. It’s so rewarding to see someone so well suited for their role. Her voice was friendly and we went through the standard niceties of how are you, etc. Her tone shifted ever so slightly and she asked, “Is this a good time, do you have a few minutes to talk?” The answer to her question came out of my mouth, as my heart suddenly raised a red flag and began to wave it in the pit of my stomach. “Yes, now’s a great time….Russ is home.”

I tried to compensate for my gut reaction by focusing the conversation on the reschedule. “Are we going to have to reschedule?” I asked, suddenly hopeful the answer was yes.

“Actually, the lab has sent the results, and the reason they are late is that they wanted to verify and be sure of their findings.” Again, my voice carried a tone of confidence as I heard myself respond, “Oh, okay…..they have actual results?” Inside, my truest self knew and the red flag no longer waived, it just stood, certain of the news that was about to be heard.

The bliss of not knowing suddenly shattered as Tanya gently, yet clearly explained, “The results are showing a high risk of Down Syndrome.”

There it was. The bliss was gone and the words Down Syndrome took it’s place, causing my mind to grasp for some level of certainty. I suddenly became conscious that Russ was holding Madeleine and listening to my side of the conversation. I don’t know why that silly voice of mine continued to carry on the conversation as though there was nothing noteworthy happening…..or perhaps it conveyed a fore-knowledge of the news. Almost cheerfully, I said, “Oh, alright. So now what?”

I could hear Tanya’s slight surprise at my tone and acceptance of the news. She didn’t miss a beat though, “We would like to have you come back if that’s possible because we will do another scan to determine a more accurate level of risk for Down Syndrome. Could you come in tomorrow?”

When I hung up the phone, I could feel a numbing sensation washing over me. Russ looked at me inquisitively and all I knew to say was, “It’s not good hun. It’s Down syndrome.” There was a nonsensical thought that circled my mind as I looked at Russ absorbing the news. Am I the cause of this? It’s my fault he now has to face this. What is he thinking of me right now?

Of course, those thoughts were straight from the destroyer of all good things. They were planted to bring shame and drive a wedge between me and Russ. But Russ’s gentle and tender love immediately removed those fears and silenced the enemies voice. We sat together, I cried and we just let the likely possibility sink in. Our baby has Down syndrome.

Tests

 

We told our families soon after we knew we were expecting and got the usual jokes and prods like, “Wow….not wasting any time eh!?” We laughed with them in agreement, because the truth is- we don’t have time to waste. I’ve never had a sense of my ‘biological clock’ ticking…although we both knew if we wanted a little crew of kiddos, we couldn’t put too many months between pregnancies.

At my 12 week ultrasound, I asked the technician if the scan included a nuchal translucency (NT) test. This testing is an early way to detect chromosomal abnormalities in the baby (by measuring the fluid at the neck of the baby) and it had been a standard part of my prenatal testing during my first pregnancy in Canada. She informed me that the scan didn’t include the test.

Shortly after, we sat with the OB who reported that everything in the scan was looking healthy and normal. Her eyes were very kind and communicated the shared sense of thrill that a perfect new life brings. I held my ultrasound photos in one hand- proof that there was, in fact, a little human growing within me! It was all great news and I allowed it to put my unspoken, nearly unconscious concerns to rest. I questioned the absence of the NT testing and the OB suggested that we consider NIPT testing- a relatively new and far more accurate blood test which could be done at any time during my pregnancy. The costs for the test would not likely be covered by our health insurance and I would have to go to Spokane to have it done. I didn’t expect we would opt in, but when I looked up at Russ, who was shifting back and forth with Madeleine in his arms, I saw a look on his face that I’ve come to recognize as a decisive, Spirit-led, decision-making look. He returned his eyes to the Doctor and said, “We would like that test, I think it would be good to know.” Although I was surprised, I agreed wholeheartedly and the test was arranged.

I arrived at Sacred Heart’s Maternal Fetal Medicine clinic on January 4th for a Non-invasive Prenatal Test (NIPT). I was 14 weeks pregnant and only just starting to show evidence of a bump. A friend had come to help me with Madeleine. As we sat in the waiting room, I looked at the other pregnant women and wondered what circumstance had brought them there. My mind wandered into that query and I could only imagine their worse case scenarios. I, on the other hand, expected a one-time visit and confirmation that our little one was developing perfectly- just as Madeleine had.
My first appointment was with a Genetic Counselor named Tanya. She graciously explained the testing, it’s accuracy and then proceeded to educate me about possible chromosomal abnormalities that could be detected. I had sat through this very same spiel with a dear friend, only a couple years prior, and it was like a strange flashback. The graphs and tables of age-related risk for Trisomy 13, 18 and 21(Down Syndrome) were initially intimidating. The fluky possibility that a particular chromosome could triplicate itself, instead of duplicate, seemed so random. When Tanya explained that my risk was less than 1%, I lent into my optimistic nature and saw only the 99.5% chance that my baby would be typical.

Trisomy 21 Karyotype Female - Copy
The blood draw and ultrasound were uneventful- although I love every chance to see my baby swimming and bopping around in my tummy in real time! The Doctor then reviewed the ultrasound with me, assuring me (just as I had expected) that everything looked very normal. I asked him if the back of the neck had been measured and he explained that although I was a few days outside of the ideal range of pregnancy for that test (10-14 weeks), the neck was measuring normally. If there were any reason for doubt on my way into the clinic, it had all evaporated by the time I left. The staff had each been so personable and caring, and yet, I never intended to see them again. I would get the blood test results over the phone in 7-10 days as a final confirmation.
The next week I called Tanya to ask if my results had arrived. She had asked me to prompt her on day 7, so I did. The results weren’t in and she told me to call back the next day, Friday, when the tests would most definitely be back. I wasn’t feeling nervous about the results, so I waited until the latter part of the day to call and ended up leaving voice messages requesting the results. My call was not returned and the day was nearly done, so I knew I wasn’t going to have the results until Monday. Sure enough, on Monday I received a call from Tanya, apologizing for the wait. She said the results still had not arrived and that the delay was usually a precursor for a “non-result”. This would mean I’d have to return to Spokane and have a second blood draw, as not enough genetic material was collected the first time. She was going to follow up with the lab to confirm this was the case, but she told me not to worry…and apologized that I would likely have to drive back to Spokane.

Taking Madeleine and driving back to Spokane in the middle of winter was not on my bucket list for 2018. I didn’t know then, that the following 24 hours would change the rest of my life altogether.

Rachel