Panorama Test during Pregnancy

After my 10th week of pregnancy, I had the Panorama Test done. It was recommended at my doctor's office. It was optional, but they are more keen about it when you are in your 30's. Some insurance covers it, including mine. 

The test basically screens for chromosome abnormalities, like Trisomy 21, 18, 13, Monosomy X, etc. Aside from that, they can also determine the gender of your baby (no need to wait for 2 to 3 more months, during ultrasound). 

For more detailed info, you can check their site:

http://www.panoramatest.com/en

(photo credit: Natera website)

My doctor gave me a Natera kit (box), which I brought with me to their partner laboratory. They took around 4 vials of blood from my arm. 

I got the results in about 2 weeks. Thankfully, we have low risk for the the abnormalities. 

Next comes the billing. Even though my Insurance covers it, we still have co-pays and deductibles, so I was monitoring the claim. I was surprised the test cost $7,999.00. And my insurance approved only of $4900+, thus a $3000+ co-pay?! But, I checked right away with Natera. Called their office and they explained to me that I am only to settle less than $100. The $3000 I think was a negotiated rate, that will not be covered by the insurance, and will not be paid by the client. Thank God! So, if you're going to have the test, make sure your insurance covers most of it. You wouldn't  want to be worrying about medical bills before you even give birth.

If you are not going to have the test, don't worry much. There is a Pre-Natal blood screening on your 2nd Trimester which will also cover some of the chromosome adnormalities. I even found it redundant that I had the Panorama test. Although, it helps you detect the abnormalities earlier, by 5 weeks+, and also predicts gender of your baby sooner and at 99.99% accuracy. 

Pregnancy Weight Gain

I'm 19 weeks pregnant and I already gained 10lbs! 

During the first 12 weeks, even though my baby bump ballooned early, I only gained the first 4 lbs, mainly because of my morning sickness, selective cravings, and heightened sense of smell, which made me avoid foods with strong aroma. But after the first trimester, my energy and suppressed appetite came back and thus, have been eating more often and much more, the whole day.

So, what is the weight gain guideline for pregnant women?

a. If you are healthy, with a Body Mass Index (BMI) of 18.5 - 24.9, it is between 25-35 lbs.

b. If you are underweight, with a BMI of less than 18.5, it is between 28-40 lbs.

c. If you are overweight, with a BMI of 24 - 29.9, it is 15-25 lbs.

d. If you have a BMI of 30 and up, the suggested weight gain is only between 11-20 lbs.


My BMI before I got pregnant was 24 already, so I'm close to being overweight.
With my first pregnancy, I gained a total of 30 lbs. I was only able to lose 20 lbs+ after. This time I will set my weight gain limit to 25 lbs, just to make sure it will be easier to lose them, postpartum. 

If you want to check your BMI:
Click the link: BMI Calculator.
or go to: 
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html


Also, during my first pregnancy I avoided sweet and salty food for the first and second trimester. However, in my third trimester, the sweet cravings kicked in --- doughnuts, milk teas, chocolates, and ice cream and within that last few months I've noticed how bloated I look compared to the previous months. 

This time, I decided to submit to my sweet cravings during the second trimester. True enough, the weight gain jumped up immediately within a month. But, come third trimester, I will stay away from sweets and carbs (hopefully). 

They say, you can gain 1 to 5 lbs during the first trimester, and 1 to 2 lbs per week during your second and third trimester. 


During my first trimester (12 weeks), I gained  4 lbs, and from 13 to 18 weeks, 6 lbs. So I guess, I'm on the right track. But wait, if I continue to gain 1 lb per week in my remaining 21 weeks, then, my total weight gain will be 32 lbs... (uh-oh!) Maybe somewhere around my last 2 months I will find a way to resist the sweets and carbs. Wish me luck! 

References: 
American Pregnancy Association
www.babycenter.com  

Travelling to South Lake Tahoe In Winter, While Pregnant

Heavenly Mountain Resort - Observation Deck

I was 17 weeks pregnant when we went to South Lake Tahoe, first weekend of February, together with my husband and 3-year old toddler. It was a 4 hour drive from our place at the bay area. A day before we left, I just had my visit to my OB/doctor, and she gave me a go signal to travel. I was at the earlier part of my Second Trimester, no longer having morning sickness, and was a bit more energetic. Fetal heartbeat was fine. The only advise that my doctor gave was not to stay at more than 8,000 feet altitude. I'll tell you why, later.

Here are the things we need to consider and prepare for:

1) WEATHER. We avoided the bad weather as it increases risks for longer travel time and other travel considerations. A week before our travel, there was a winter storm and the 4 hour travel time was increased to 6 hours due to speed limit, heavy traffic, and chain controls. We were already booked that time, together with my husband's office colleagues, but we decided to cancel a day before our scheduled departure. We are glad we did, otherwise, we would have endured the hassle. We booked a week later, with clear skies forecast, and as high as 50 deg F on daytime. 

2) TRAVEL STOPS. We planned just for one stop, halfway to our destination, at Sacramento (2 hours from home). We left around 9AM, and by 11AM, we were already there, in time for early lunch. Within less than an hour, we finished lunch, had our pee break, and were back on the road. Being pregnant, I  needed to keep myself hydrated and as such pee break is a must. If you want to plan more pee break stops, it would be better, maybe one stop per 1.5 hours of travel. 

3) TRAVEL TIME & TIME OF TRAVEL. I think it is best to avoid traveling late night. Food and other stops are more accessible in broad daylight, especially if you're not familiar with the place where you are going. On our way there, we have no problem with the travel time, we got there in 4 hours driving time. But on the way back, the traffic was slow (Sunday afternoon) at Highway 50, with only one lane, and some passing lanes every few miles. Actually, I feel that the passing lanes caused the bottleneck. An extra hour was added to our travel time. When we stopped at our original planned stop, I was having a bit of leg cramps already.   

4) TRAVEL KIT. Bring snacks and some heavy food, in case of emergency (bread, canned food). Bring plenty of water, too. Bring medicines, blankets, extra clothes. Bring car tools and tire chains, too. 

5) LODGING. You have to have a reliable hotel, inn, or lodging house. I read reviews before booking our hotel. Cleanliness is a big factor for me, especially that I'm carrying a baby in my womb. I don't want bed bug bites and smelly rooms. We had to balance cost vs comfort. We also considered accessibility of our hotel to other tourist spots and restaurants to save time and effort. 

Lake Tahoe Resort Hotel

We were able to book at Lake Tahoe Resort Hotel. We had to shoulder the higher booking rate because we booked a day before, just to be sure that I'm feeling well. It was a nice, non-smoking hotel. I have seen a lot of families booked there. They also have a breakfast buffet which serves a variety of food choices. They have their own vallet parking (with charge). But there is also a nearby open free parking (walking distance). They also have  option for late check-out, with extra charge ($25 for 2PM and $50 for 8PM). Being situated along Lake Tahoe Boulevard, it is also walking distance to Heavenly Gondola, some shops, and food establishments. However, at nights, if your room is facing the street, you can hear the music from nearby bars. It was not that loud, we were still able to sleep well (maybe that's just me). Better if you choose the room at the other side of the hotel, just to be safe.    

6) FOOD. We ate from familiar restaurant chains. There are a lot of restaurants at South Lake Tahoe main area. Being pregnant, I wanted to make sure I can eat something familiar from their menu. Trying out new food may not be that advisable to avoid tummy discomfort especially while traveling. Being pregnant, taking medicines for any form of discomfort is not easy, readily available, or advisable. But if you really want to experience other food, just make sure they are fully cooked and better if you bring your medicine, approved by your OB/doctor. 

7) ACTIVITIES. 

- Snow Tubing for family (not me) :)

Hansen Tube & Saucer Resort

Being pregnant, skiing and ice skating is already out of the picture. I just watched my husband and toddler go for ice tubing at Hansen Resort. 

They charge $20 per age 5 and up for 1 hour and $15 for succeeding hours. It already includes the tube. 



You need to bring your own gears, but because the slope is not that narrow, most tubers are not wearing any. 

As for me, I was wearing my snow boots while watching them at the sides. The ice can be a bit slippery and balancing maybe a bit of a challenge while walking on sloped areas. Just make sure you have a pair of good traction snow boots. 
   

- Sightseeing 

Gondola Ride up to the mountain

We also went to the Observation Deck of Heavenly Ski Resort. We took a ride at the gondola for $50 per person up (age 13 and up). Children 4 and below are free. Child rate is $22 (5 - 12 years old). It's a 2.4 mile ride.  

The Observation Deck is at 9,123 feet. Up there, you can see the Carson Valley, Desolation Wilderness and a wide view of Lake Tahoe. 

Observation Deck, Heavenly Mountain Resort

About the altitude recommendation from my doctor, the reason was the oxygen level is thinner as we go up. Some people may experience difficulty in breathing, and also reduces the oxygen for your baby. We only stayed there for less than an hour. I felt fine, no nausea or anything, other than feeling chilly up there. I never had any shortness of breath. 

If you are fit, in good shape, and have no pregnancy complications, I think it is okay. But best if you have a go signal from your doctor. 


We also went for a quick drive to Emerald Bay, just a 15-minute drive from our hotel. We went to the spot with a central view of the bay, about a mile from the vista point. 

Emerald Bay, Lake Tahoe

It was not that hard to travel at 4 months pregnant, but it was not as easy as when you're not. The size of my belly is still manageable; I can still walk with only a little discomfort; And am no longer having morning sickness. 

I just made sure I was well rested in between activities and I do not tire myself much. I take extra caution in walking on ice or climbing slopes. There a lot of limits with the activities you can do, but you can still find enjoyment in other simple activities, especially when you spend them with your family.      

Choosing Pregnancy Kits

It has been more than 3 years since my last pregnancy with my first child. We were not planning on a second one, although it cross our minds every once in a while. Then, I woke up one morning experiencing something vaguely familiar --- tenderness on my chest as if I was lactating. I started counting the days from my last period and with a hint of possibility, I decided to buy some pregnancy kits just to be certain.

I found a number of Dip Strips available at the store. 
Let me to classify them based on how they read the results:

1. Plus Signs. When it is positive, you get two perpendicular lines, forming a 'plus' or cross lines. If it is a negative, you only have one horizontal line. 
2. Parallel Signs. When it is a positive, you get two parallel lines. When it is a negative, just one line.
3. Digital. This one is straight forward, either "pregnant" or "not pregnant" or "yes" or "no" depending on the brand of the kit that you will use.

In my case, I was able to try a total of 5 tests kits and all 3 types.

I remember during my first pregnancy, I only tried 2 kits, both of them with the parallel sign indicator. But since this might be my last pregnancy (planning on having only 2 children), we decided to try other kits for experience-sake.  

Among all kits, my first choice is still the parallel line test kit. It is the simplest and easiest for me to use. Plus the readings stay longest and the price is cheaper, too. My second choice is the digital test kit. Very straightforward, it answers your question directly YES or NO or PREGNANT or NOT PREGNANT. The only downside is that it has batteries, which has disposal requirements; also it is prone to error if accidentally used incorrectly; and it is the most costly among the three kits.  


So my advice, is that you get one parallel line test kit and one digital test kit for further confirmation. With the 2 test kits, I think you'll be pretty sure with the results. You can also use 1 test kit per day to spread it closer or even after your date of expected period, when the test kit gets higher accuracy. 

But then again, you can go crazy like me, and try almost everything on the market. ;)


Here are some details per test kit, for further information:


First, I got the Clearblue PLUS Pregnancy Test.

• It has 2 test sticks. 
• Promises results "5 days sooner" or 4 days before your expected period (as explained in their insert instruction). The accuracy increases as the test date is closer to your expected period. Also, if you are testing before your expected period, they recommend the first urine in the morning.
• You have to read the test within 10 minutes of doing the test, otherwise they say you can disregard any changes on the result. 
• Price Range: $7.99 - $14.29 (Target offers one of the lowest price based on comparison on online prices)

Findings: I did the test one day before my expected period. The perpendicular line is barely visible. Although it says on the instruction, any visible form of vertical line perpendicular to the horizontal line indicates a positive. But still, you keep doubting your eyesight, so it is difficult to say. And by the way, I tested at the middle of the day. =) (Sorry, was too excited)

These are the 2 test sticks that I used, and this photo was taken the day after the test. I forgot to snap a shot of it while the barely vertical line was still there. Thus, their instruction is true, you should read the result within in 10 minutes, and if you want to capture the moment (especially for first time moms), better do it right after you read the result). :D 

Next, I tried Signature Care Digital Pregnancy Test.

• It has 2 Test sticks.
• You can use the test 5 days before missed period. Accuracy of test increases as test date is closer to expected period. Promises 99% accuracy from the day of your expected period.
• Results will be displayed on the display screen for approximately 24 hours (based on their instruction insert).
• Price: $15.39 in Safeway.

Findings: I did the test on the day of my expected period and it says "pregnant". Straight forward answer. No second guessing the lines.  I love it! A little pricey than a regular dip stick, but less complicated to interpret. Although based on some reviews, they do get errors. But so far, I got clear readings on the 2 test sticks that I used. You just have to follow the instructions. Do not over wet the strip, just follow the 5 second instruction & Do not tilt down the test stick towards the side of the screen, to avoid malfunction, and I guess you'll get good readings, too. 

Next, I tried the parallel lines test kit, Answer Pregnancy Test. 

• It has 2 test sticks.
• Test 5 days sooner, too. Also promises 99% accuracy from the date of expected period, but lesser accuracy prior. 
• A positive test result will last 48 hours and a negative test result should not be read after 10 minutes (as per instruction insert).
• $7.99 - $14.29 ($7.99 at Walgreens)

Findings: This is the easiest to read. Also, one of the cheapest test kit. Also, the display result last longer. I got a positive and I checked 2 months later, the 2 parallel lines are still visible (Yes, I still have them, just in case I proceed on writing a blog about them, which I am now... :>)

Next, I used another Plus sign test kit, e.p.t. (early pregnancy test)

• Includes 2 test kits.
• 5 days sooner. Accuracy increases to date of expected period.
• Result must be read within 10 minutes. It does not matter if one line is fainter or darker than the other.
• Price: $14.99 + 

Findings: Even at 2 days after expected period, the lines can be a bit faint. I am starting not to be a fan of Plus sign test kits. :<

Lastly, I tried First Response Gold Digital Pregnancy Test

• Includes 2 digital test sticks
• Test 6 days sooner than your missed period or 5 days before expected period. 99% accurate from the date of your expected period.  
• Results will be displayed within 30 minutes. 
• Price: $13.99 - $17.59 ($13.99 at Target)

Findings: This is accurate and easy to read. Am I pregnant? YES means you are and NO means you are not. I'm pretty sure the display lasts longer, but not more than 24 hours, too. Just to be sure, you can follow the direction. It is one of the soonest pregnancy kit that you can use. I should have used this one the first time.  

Disclaimer: 

I am writing this blog based on my personal experience only. 

I am not a health or medical professional. 

But I do hope, this will help most people who will read this. :)