A Geriatric, Cystinosis Pregnancy Part 2: When the Doctor is Stumped

If you didn’t read Part 1, be sure and take a look at how this crazy story began.

Outside the imaging center where my second-opinion ultrasound took place, I sent a quick email to my reproductive endocrinologist. “Heartbeat found,” the subject read.

I think it took less than a minute for the phone to ring.


There was some silence. “Jessica?”

“Yes?” It was Dr. R.

“That’s impossible.” More silence.

I divulged it all: My quest for a second opinion. My bottle of beer after the blighted ovum diagnosis. My concern over stopping my pregnancy-sustaining medications at Dr. R’s orders. My relief that I didn’t schedule a D&C for earlier in the week like he wanted.

The heartbeat measuring strong.

The “empty sac” that now, four days later, contained a yolk sac, a fetal pole, a heartbeat, and a crown-to-rump measurement consistent with six weeks, three days.

He started by reassuring me not to worry about the missed medications, that they stay in your system for a few days and that the most important thing was that I restart them immediately. (I didn’t tell him that I already had.) He then insisted on seeing for himself.

Despite my reluctance to ever return, I was back at his office one week later. I was nervous. Had it all been in my head? Would the sac be empty? Has the embryo disappeared?

This time, Wayne was with me. He had never seen a fetal heartbeat. Although I had seen one with a previous pregnancy, when he excitedly came to the next appointment that go round, it was gone. Would the same happen here? Would the heart even be there?

Dr. R came in and I could have sworn he was a bit nervous. There was no small talk. He set up the ultrasound. He turned the screen so I could see it.

And it, I did see. I breathed. “Thank God,” I said. “It’s still there.” For me, that was the end of the appointment. I was ready to get up and leave. But Dr. R wasn’t.

“I’ve never seen anything like…” he started. Silence. “But it was empty when we….” Silence. He turned to the physician assistant in the room. “Get [JP] in here.” He turned to me. “[JP] was here. You remember, she was here. She saw the empty sac too. A tiny empty sac at six weeks, one day. When we should have at least seen a yolk sac. A tiny, empty gestational sac measuring four weeks at best.”

JP came in and stared at the screen. Dr. R briefly used the doppler. The chugga-chugga-chugga of the heart of my baby filled the room. JP covered her mouth. I heard the nurses out in the hallway, just outside the door, cheer. 160 beats-per-minute strong.

Deep down, I hope I’ve made him hesitate to ever diagnose a blighted ovum so early again. Even if the dates are without-a-shadow-of-a-doubt exact, as is the case with my pregnancy, miracles happen.