All I can say is, thank heavens for home dopplers, and thank heavens that I am no miser and bought the top-of-the-range home doppler which shows you the speed of the heartbeat. I decided last night to listen to the heartbeat. I thought it was a little silly, as we had the doctor's appointment this morning, but I wanted to, and so I did. I found it quicker than I ever have before, and it made me very happy.
This was a good thing because the doctor really struggled to find the fetal heartbeat today. He used both of his (rather poxy-looking) dopplers, and only once or twice got a quick burst (1-2 seconds) of what was clearly a fetal heartbeat. He wasn't worried, but I would have been had I not heard it last night. So that's my MO for every appointment going forward, listen the night before so I don't have to worry.
The vast spectrum of blood tests that he carried out last time showed that everything is mostly fine. Annoyingly they didn't run the Protein S assay, which he wanted to give some indication as to whether I would stay on clexane or not. Protein S is part of the blood clotting cascade, and is usually lower (sometimes deficient) in carriers of the MTHFR mutation that I have (C677T). Since pregnancy can lower protein S anyway, he just wanted to see if it would come back within normal ranges, which would indicate I might be able to do without the clexane. They just didn't do the test, despite having kicked up a big fuss when I turned up for all my blood tests about how inconvenient it was, etc. etc.. It was funny to see him talking to the lab trying to chase this. He has a very low-key exterior, but you could see the cartoon steam coming off the top of his head as he struggled to stay cool. The tone of his voice didn't change at all, however. H mentioned afterwards that he'd hate to meet doc in a dark alley when someone has REALLY upset him...
The one interesting thing the blood tests showed was that my haemaglobin is on the high side of normal. Normally this would be a good thing, but given the MTHFR issues, it might indicate that things are not entirely wonderful, risking the kinds of clotting problems that can cause problems later in pregnancy. So given this, he has decided to leave me on clexane at least until 24 weeks, and then reevaluate by doing a blood flow test to see if there are any likely problems. The risks of staying on clexane til then are pretty low. The two risks he mentioned are (i) a situation where you become allergic to the heparin, which sounds pretty nasty, and (ii) severe bone weakening leading to fractures. He says that at the dose I'm on for the length of time I'm on it, these are very very rare complications indeed. He did test my vitamin D, to make sure bone loss isn't imminent, and it came back fine. So my stomach, which is a veritable patchwork of blue, purple and yellow, is just going to continue to look unsightly.
Doc also did a urine test while I was there today, and it showed no protein (good) but a bit of blood which might be ok but might also indicate a UTI, so he's sent it off to be tested. My blood pressure was also a reasonable 130/68, so nothing to worry about there, although as someone who has always had surprisingly low blood pressure til now, it's a bit shocking to hear anything other than: "105/58, are you sure you don't faint often?"
We left with an appointment to come back on 10th May for our 20 week 'anomaly/morphology' scan, and a request that we don't hesitate to come in sooner if I feel nervous. At the moment I'm feeling fine, so I don't know that I'll need to come in any sooner, but we'll see. Thank heavens for home dopplers, again.