There is a Reason I am the Way I Am...

...it's called past experience. Whether it is today's scan or getting my blood drawn last week. Experience may not predict future. But it does predict my behavior :)

Blood draw Friday. New place. They said they ship to PPVI all the time, and Omaha confirmed. So when the lady drew it and I started reminding her of instructions and she said she's got it and the people downstairs know what they are doing....I let it go. because they are new to me and deserved the benefit of doubt. Guess who ran my numbers? Yup. Instead of mailing it. Sweet Meriam touched base with me today. She let me know she is working hard on getting the HCG covered by insurance. I let her know I need progesterone meds too. She let me know about the lab mixup and to call right away and see if they still have serum to ship. I did. And the lady apologized for the phone connection being so bad. She promised she would look for the paperwork, was sure they still had some serum, and she would take care of it. Then I got another call. First, they didn't handle it according to instructions so serum left isn't likely usable. Secondly, they said they haven't done this for years and there was a mixup. I need to find somewhere else. Ugh. she called back and said to try "anylabtestnow.com" after talking to Omaha. So frustrating. No progesterone numbers. No HCG.
 God is telling me "let go of it already! I am bigger than numbers. I have this!"

Ultrasound today (transvag-and on the better machine with the tech not the doc). 5 w 5 days when you look at date of last period. 5 w 4 days when you look at ovulation. Said my rosary on the way. Glad it was joyful mysteries! I didn't know how much we would see today, or how to know if we were behind. I found a website beforehand (unsure how reputable) that had the detail I was desiring reported in terms of gestational age. http://www.baby2see.com/development/ultrasound_sonogram/first_trimester_scans.html
From there I wrote down that when the sac is 8-10mm, then you should see a yolk sac. The yolk sac is first visible at 5 weeks and it is always present by 5 weeks and 4 days. I wrote down from fetal pole is usually at 6 weeks or prior and can be see in if baby 2-4mm CRL. With transvaginal ultrasonography, cardiac motion can sometimes be seen in a 2-mm to 3-mm embryo, and is invariably detected in normal pregnancy when the length of the embryo reaches 5 mm. At the end of week 5, the heart rate is about 60 – 90 bpm. In early pregnancies, the actual cardiac rate is less important than its presence or absence. Hmm. That seems a little early. 

Well, my gestational sac was 7.4mm and she could maybe possibly see the yolk sac but not totally sure. She measured the gestational sac, but told me it is the least accurate measurement. It said 5 w so it showed I was behind where I should be, but she didn't put it that way. She said there is variation of burrow time, etc. She could tell that I had a nice corpus luteum on the right ovary and it and the left (though crazy weird high as normal for me) looked healthy. Her thoughts on the whole thing was that it wasn't bad, that baby implanted late (I did see implantation bleeding, but I don't have a date for it! I think going back it was maybe 1/3/15, but I don't know), and that we need to see growth of the sac and a yolk sac next week. Probably a fetal pole, but don't panic if they can't see a heartbeat (on 6w5d). If that is the case, she wants me to come back in the following Monday (I would be 7w 5 d).

Here are my thoughts after looking at this info again, the website, and prior pregnancies. This is not good. Behind at this stage is not good. This looks a lot like Michael. I had a scan the same day with Michael and sac was 8mm and there was no yolk sac. I went back on 6w6d (coincidentally the same time I have another one scheduled) and the sac for Micheal was 1.1 and there was a yolk sac. My doc was worried no heartbeat, thought it was a blighted ovum. I had a heartbeat visible at 7w3d, but too small to measure. At 7 w 5 d it was 93bpm, it went down from there (73, then high 60's, then none).

So I wonder why she is telling me not to panic if I get no hb at 6w6d (when my previous doc's office was ready to call it) and to only worry when I don't get one at the 7w5d scan the following week (again see 93bpm with Michael on that same scan day-and he didn't LIVE!)? For reference, Charlie had a hb at 6w2d and AJ at 6w3d.

I am trying not to be pessimistic. I want to be realistic. I want TCIE's opinion! :) Are we "behind" or is there truly variability even with Napro and the date? Do I hit panic if we don't get a hb we can measure by 6w6d? I realize I hit panic with every pregnancy. I did with Charlie when we switched labs and didn't know that it would affect things this much. I did with Anthony (when the HCG didn't double in three days), which I had forgotten!

Update: TCIE was kind enough to respond quickly (and privately), but gave me permission to share. It looks like I will be able to function for another week :)

Her words: TON of variability in measurement of (gestational sac) GS, I was taught by "the best" sonographer in NJ to not even bother measuring it since its measurement never correlates. (Only to measure if it looks bigger than it should be, since often with anembryonic pregnancies i.e. blighted ovums it is generally much bigger.).
All I'd be concerned about as a sonographer at 5w4d is a) is GS high fundal of uterus, b) are there any subchorionic hemorrhages and if so, where and how big, c) is yolk sac visible (though I have NOT seen some at this stage and it turns up when baby does), and d) general appearance of GS (nice and well-circumscribed, round or oval and not "breaking down" looking.) and e) is cervix closed, and are adnexae clear.

This sounds to me like a perfectly appropriate u/s for right now!
Praying baby keeps growing!!!

I also asked her about next week's scan and what she thought. Shouldn't I be able to expect a heartbeat next Tues? Her response:
Not a DEFINITE m/c if it's not there, but I'd be highly suspicious if it weren't.

I am very grateful for her responses! I continue to have seriously vivid dreams, but it seems those are progesterone related (which we are obviously supplementing to the max) and not a sign of anything else.