Yes, it is 2:38am in my time zone.

And yes, I have to be at the hospital close to 5:30am.  And I will be giving a presentation on secondary syphilis in an HIV +ve patient at 11:00am.

I have yet to finish the presentation to my liking.

I am not sure I will even be awake enough to give this presentation.

On the plus side, thank God things are going well with dear Surrogate.  We are just over 24 weeks.  Continuing to hope and pray.

More to come...if I ever get a break from this rotation!

Happy and healthy and sweet 5774 שנה טובה ומתוקה לכולם! And it's a...but you'll have to read to find out.

Welcome to the year 5774.  Or, תשע"ד.  I'm still terrified, but I am a little excited that it might be a really wonderful new year.

Yes, thank God, things are going well.  We are about halfway there, and our Little One is doing well, as is her dear Surrogate Mama.  And yes, that was a "her" -- it is a GIRL!  Husband and I would of course been thrilled either way, but I have to admit I would have no clue how to raise a boy.  (And then of course there would have to be the conversion asap before the brit milah, meaning within eight days.  So a girl sounds like sugar and spice and everything nice.

Which brings us to the Name Game.  Welcome and prepare to play as often as you like, free of charge. We're looking for L names that sound good in both Hebrew and English, and preferably Biblical.  Husband doesn't like Leah, although I do.  And while the Internet has provided numerous options, none of them appeal.

And one other note -- while I wish I could grow this baby myself, it IS definitely amusing to tell people we are this far along and have them stare confusedly at my lack of bump.

When life gives you a fragile aorta, you gotta get a few laughs for it!

Question for all the Intended Parents out there

What have you done to make a surrogate pregnancy feel more real?  Our dear Surrogate lives on the other side of the country so physical contact isn't much of an option.

Thoughts?

Sort of...

We are, God-willing, fifteen weeks today.  Or rather, I am nothing, but our dear Surrogate is fifteen weeks and feeling well, thank God.

I am more grateful than I can possibly express that things have been going well.  This is a precious tiny hope.

But I am not excited.  I am terrified.  I am tense.  I wonder when the ticking time bomb will explode.  I wonder if I could withstand it.  I have friends and cousins who are pregnant, with similar due dates.  Where they are excited I am scared what the next day will bring.  Two years since losing Peanut I miss him just the same, and feel the same numb disbelief and longing and hurt I did on 19 August 2011 when they told me I had to terminate a pregnancy with a beating heart.

And then there is that feeling of being a fake mommy-to-be.  I know pregnancy doesn't make the mother, and I am grateful not to be part of the conversation about nausea and constipation and bloating and heartburn...But at the same time I feel like an outsider, or perhaps a junior member of the club who will never have a full-fledged card, or maybe someone peering in a window to somebody else's party.

But please don't think I am complaining when science is working a wonder.  I mean it when I say I am so very grateful.  I am however confused, and worried, and trying to sort out the feelings of being "sort of" pregnant.

Other people will announce their pregnancies.  There will be Facebook posts, and discussion at work.  But I am telling only my closest friends, and I weigh each one carefully.  I am telling about twenty people outside of my immediate family (and Mim's "immediate" family includes grandparents and aunts/uncles) and that's it.  And those twenty include my program coordinator and the scheduling coordinator, and the program director of my future fellowship, who obviously need to know.

Of course, keeping a big secret is easier without a big bump :o)

On an entertaining note, I ended up visiting the emergency dept. Saturday night after a needlestick injury where the patient on whom I drew the arterial blood gas was hepatitis C positive (but with a virla load of only 14,000, thankfully!).  Of course one of the nurses asked if I could be pregnant.  (She obviously didn't know about Turner's Syndrome.)  I told her I am pretty sure that requires functional ovarian tissue!

Of course, the fact that one of the ED docs who I know assessed me for the needlestick injury makes me feel all sorts of weird about her knowing I have TS.  I am not ashamed of it.  But it is sort of private health information and a bit of a bigger deal than the HTN and hypothyroidism which I readily disclose to anyone.

TS sisters, what's your disclosure policy?  Whom do you tell?  Or if you don't have TS, who would you tell if you did?

...and we have a decision. And some really cool cases at the hospital.

Thank you, Kim, for your encouragement.  Means a ton.  I told my father no again; we want to stay here and be close to family.  I think I'm happy with this decision.  Sure, the ego boost if I were accepted at a Big Name University would be fun.  But the fellowship match is a binding contract; you don't get to choose between multiple acceptances.  The computer algorithm matches your preferences and your program's preferences and that's where you go.

Today is beautiful.  It's about eighty degrees, and sunny, and I'm sitting in my backyard preparing a presentation on a patient with acute GI bleeding.  (Don't worry- I'll spare you all the details!)  The sky is clear blue and it is so peaceful.

I really wish I didn't have to work tomorrow.

Oh, well.  Surrogate is doing well, thank goodness.  She had a course of nitrofurantoin for UTI (or was is asymptomatic?  Either way, she's pregnant, and the guidelines suggest treating.  We are waiting on the AFP triple screen and the nuchal scan.  I'm so incredibly nervous that something will go horribly wrong.  One of my friends who's pregnant the usual way was so excited for me when I just told her (without intending to disclose, but ended up stuck).  I think people who haven't experienced infertility or loss don't understand what a ticking time bomb this seems.

In other news, I may have some fabulous cases at the hospital about which I can't disclose much due to HIPAA.  What I can say is one might involve pneumococcal endocarditis presenting with subdeltoid septic bursitis, and another might involve Klebsiella endocarditis.  (Endocarditis is a heart valve infection.)  it's a future Infectious Disease doc's dream!

Little Miracles

Also, I heard my little one's heartbeat courtesy of a recording from yesterday's ultrasound.  It brought tears to my eyes.

Dear Readers: your advice, please! Or, whether or not to unleash the not-so-secret weapon

With kind thanks in advance.

Dear readers, I have a quandary.

I am applying for a fellowship in Infectious Diseases; that is, two years of additional training beyond my residency.

I have been called reasonably intelligent, occasionally even bright, and have decent evaluations.  I have (I think?) good letters of recommendation.  I have strong board scores.

I stand a decent chance of being accepted to stay on at my current institution, and life is wonderful here.  Husband and I live within a brief walk of my parents, grandparents, aunts, uncles, etc.  Our neighborhood is charming and we own our home.  And I was always taught that family is the most important thing.  Plus, we may perhaps? have a little one on the way, though I still hesitate to believe it.

Here, then, is the debate: I have a not-so-secret weapon at my disposal.  His name is _____, Division Chief of Infectious Diseases and internationally-renowned expert in the field.  If ____ makes a call, I could go Elsewhere and train and Big Name Universities.  At least, I am told so.  If he tells you to take a candidate, you take the candidate.

Thing is, if you unleash The Division Chief, it is binding.  You rank the Big Name Universities first on your match list.  You can't have someone make a call and then change your mind.

Now, training at a Big Name University might be a life-changing opportunity.  It has been known to Open Doors.  But what if the doors I wish to open are those of a home down the street from my loved ones?  And how would I effect child care if we do have a baby and we live far away from my family?  My family is what is dearest to me in life.

Thoughts?