dark clouds on the horizon

What was that - 16 hours - of feeling confident and beginning to believe in this pregnancy. I was sitting at work this morning, 9:37am and my cell phone rings. It's my GP's office. The office staff asks if I can come in right now. RIGHT NOW? I'm at work, I said (work is a good hour's drive away from Pleasantville). She offers me the possibility of talking to the doctor on the phone instead. Sure, that would be helpful. Then I get put on hold. The blood drains from my head. My heart pounds. I close my office door and start pacing (thank god my office mate wasn't in).

After an eternity, the office staff comes back on the line. The doctor is busy with a patient and can she call me back. Of course. She tells me the doctor said it's nothing to panic about.

yeah, right.

I go into a meeting (a meeting that's already started) and as I'm being directed to a chair, the phone rings and I have to excuse myself. [Oh the intersection of infertility and work. There's a whole book waiting to be written about that.] Dr. Lovely (that's what I'll call her from now on, my lovely family doctor who has been so good to me) tells me I have 2 subchorionic hematomas: one large one (6.9cm) and one smaller one (2.9cm). Nothing to do now, she says. She put a call in to the OB's she's referred me to, in order to ask what recommendations she should make. She just said not to exercise too intensely. No more stairclimbing at the gym, only flat walking. She said to call in when/if I start bleeding, noting that she'd want to do an ultrasound at that point.

I want to believe that this won't end the pregnancy, but I know it can. I also know that it has happened to many of you, and that you've come through it with babes in arms. I just feel like a ticking time bomb at the moment, knowing that at any moment I could start to bleed profusely.

The one good thing is that usualy, SCH are diagnosed after some bleeding. In my case, it's reversed and so I can be warned about what's coming up. It still doesn't make it fun, but it's a small comfort.

it's never easy, is it. 

the gummy lives

Baby is alive and kicking. And flipping around. And moving his/her arms around. And has a great heartbeat (165bpm). It measured ahead by a few days: today is 12w1d, and he/she measured 12w5d.

Another long wait before my turn, and how grateful was I to have ignored their directives to start drinking water one hour ahead of he appointment. I ended up waiting 45 minutes in the waiting room, so I would have had to do something with all that extra fluid in the mean time. Like cry. Or drool (thanks Pumpkin). No need, I simply started drinking 30 minutes ahead of my appointment and so it was all tolerable. As for the crying, that happened anyway. The technician put the probe on my abdomen and didn't say a bloody word (and I couldn't see the screen). Here's a reenactment:

Augusta: [silence]
u/s tech: [silence]
A: (in her most feeble voice - choking on her words)...is it still alive?
u/s tech: (in a bubbly voice as if to say the sky is still blue) Oh yeah!
A: [tears]
u/s tech: there are some tissues right there...and now I'm going to cry too.

This u/s gave me a lot of confidence. Gummy bear seemed so strong, so much his or her own person. Gummy looked so comfortable in there, just chillin' by (in) the pool, looking for someone to bring him or her a virgin mojito.

It's a glorious day, women. Thank you for celebrating with me.

superstitions and miracles

Miracle: I weaned myself from all my meds on August 15. As you recalled, I acted in defiance of my medical orders and took some progesterone on August 16. Again on August 18. And then no more progesterone. Those first 5-6 days post weaning were inhabited by cold sweats and obsessive inspections of the toilet paper. Nothing remotely pink turned up. What is more, I felt more nauseous and more fatigued. I was forced to conclude that my pregnant state was continuing.

Superstition: I have successfully put away the bottle of estr.ace. However, the bottle of promet.rium, despite being almost empty, is still required to sit on the bathroom shelf. This is purely out of superstition. If I move it to the cabinet, I may start bleeding.

Miracle: I heeded your suggestions and purchased a doppler. Mr. A had some reservations about this. He petitioned against it, stating that it would only make me more anxious in the event that I couldn't find the heartbeat. True, I said, but then I can drive myself to the doctor's office and get that checked out if I'm so worried. I told him all the blog women were doing it. That sealed the deal. Doppler arrived on Friday. Couldn't quite make out the hb on that day, although the machine seemed to be picking something up that was around 125 bpm (certainly not mine, which is really slow). But I tried again on Saturday and used headphones that time and I'm pretty sure I heard it.

Miracle: 12 weeks today and I seem (oh please, please, please) to still have a living fetus inside of me.

Superstition: My nausea is abating. Isn't that a clear sign that my fetus is dead? I guess this is about the time when nausea should decrease, but last time, the decrease in nausea was the one sign that told me (in retrospect) that things were amiss. That being said, I only noticed a little decrease this weekend, right around the 12-week mark. Shit, I sure hope everything's a-ok in there.

Miracle: Hoping for one tomorrow at the NT scan. I will keep you posted.

10w4d update

I'm glad you are all taking the ice water testicle advice seriously. Go and spread the news. I think we are on the brink of eliminating infertility altogether with this breakthrough.

It's been a fairly intense few weeks. I know there was a lot going on in the external world, but I've been focused inward. There's a way in which I feel not very present in my life, but I realize an internal focus is an appropriate point of perspective for pregnancy (did you like the aliteration?).

Women, I don't even know how to thank you for literaly carrying me on your shoulders in the last few weeks. I was SUCH a wreck in the week leading up to the last ultrasound and you let me go on about it and offered the most compassionate comments and emails. Thank you for understanding my level of panic, and letting me get through it without telling me to buck up. There are times when you can't even begin to hold yourself together, you just keep putting one foot in front of the other. I feel like my simple thank you isn't really illustrative of how grateful I am to you all. I guess you'll have to trust me on that one. I owe you all big time.

I'm probably on the verge of another freak out, calculated by the length of time since the last ultrasound and the amount of time until the next one (August 28). But while I am relatively calm (I'll qualify that later), let me give you an update on this pregnancy.

First Prenatal Visit
I met with my family doctor last week for my first prenatal visit. My family doc continues to be a superstar. I think she spent 45 minutes with me that day, the time needed to do the physical and to answer all my questions. My weight was right at pre-transfer level. I did lose about 4-5 pounds in the first few weeks because of the nausea, but seem to have adjusted. I don't know how this whole weight gain business is going to go for me, but I'm keeping an open mind.

I asked my doctor about whether she would refer me to a local OB or to the MFM clinic in the big university hospital center 30 minutes away. She thought about it, and called me later to say that she would refer me, and if they felt the referral inappropriate, they would flip it back to her. That's what happened. So a regular OB it is, which is completely fine with me. It means that if (when, Augusta, when) there is a baby to be delivered, it will be in Pleasantville and not 30 minutes away. She booked me with a new OB in town, about whom she's heard very good things. My appointment is October 5 - which seems like a couple lightyears away.

I had a concern about my iron levels, since I sort of cheated and never took a true prenatal vitamin. Instead, I've been taking a multi without iron every other day, and a multi with low iron on the other days, as well as extra calcium, high powered folic acid, vitamin D and probiotics. I figured I had most of my bases covered with that cocktail, but I was anxious for blood work. My iron came back A-ok. She noted that my B-12 was on the low end of average and asked me to supplement, which I promptly did. Otherwise, all was well on my insides.

She tried the doppler, but at 9w2d, she was really not sure whether she would find it. We had that conversation in my last first prenatal visit, and we never found the heartbeat. She was quick to reassure me that it most often couldn't be found this early, but in reality, owlet didn't have a heartbeat anymore. This time, she couldn't really find it either. Except when we both heard it very briefly and then lost it. I was nauseous on that day and many days since, so I'm trying not to read into it.

I made arrangements for my integrated prenatal screening, which includes an ultrasound at 12w. I'll probably be a wreck again, but I will get through it. August 28 will not come fast enough.

Weaning   
This past Wednesday was the last day to be on all my meds. I was still taking estr.ace, prome.trium, and del.estrogen. As per my instructions from SG, I stoped taking them. Yesterday was my first drug free day. I had some UES throughout the afternoon, and made the mistake of calling it cramping. Bad mistake. By the time I got home after work, I did what any red-blooded infertile would do and shoved some progesterone up my hoo-ha. I feel like a crack addict, except my bliss comes with messy vaginal discharge. Will I get through the day without falling off the wagon - we'll see.

Ok, I guess I am technically at work and should do some work. Have a great weekend.

reporting on life (and death)

My grand-papa died on Friday afternoon.

Gummy bear is alive and wiggling. He measured 9w2d (one day ahead), with a solid heartbeat.

The attending RE walking in a bit late (the lovely fellow who was there last time was performing the u/s), took one look at the screen and proclaimed that it was "disgustingly normal."

I'm in between patients, so this is all I can write for now. I will post again tomorrow or Thursday from the train.

Thank you so much for holding my hand through this. Thank you.

Swimming in uncertainty

Warning - I feel like this might infuriate lovely women who are trying so hard to get pregnant but haven't yet. So, if you are not up for the ramblings of a pregnant infertile, please click away. I won't bat an eyelid.

It feels like forever since the last ultrasound. The next one, scheduled for the near future (Tuesday morning), also seems like it is forever from now. All par for the course, ain't it.

The weather in my head this week has been overcast, with a few thundershowers sprinkled throughout. This even if in reality, there is no cause to think anything is wrong. But there was no suspecting anything was wrong last time either, which is the retort I can't get my mind to shut up about.

Being at the end of week 8 (8w5d today) feels like entering the valley of the shadow of death. My mind is trying to work out the details of when the D&C will happen, trying to anticipate my work schedule and my grandfather's imminent passing (he's now in palliative care - it's the end). I guess what I know of pregnancy, the parts that I know in my body and not just intellectually, have to do with lots of nausea, lots of medication and fear of weaning, lots of uncertainty, and then the end. My mind plays that tape, and each time, I say that it can be different this time. I pull out my list of things to combat anxiety (to which, dear readers, you have made a very significant contribution), and I get back to a state of semi-okayness.

And then I get distracted by the nausea and its management.  

Sigh.

All we can do is wait.

It's hard to imagine sharing this news with anyone outside of our close circle yet. As I was saying to Mr. A, what I'm most uncomfortable about is that people would feel (or look) more happy and excited about this than I do at the moment. Not that I am not happy and excited. You know I am. But those feelings are not predominant in my experience at the moment. I'm still a bit stuck on how crappy that is, and how unfair it is to the gummy bear. I should be jumping up and down instead of thinking every 10 minutes that  he/she is dead.

Can you control your feelings, Augusta? NO, no you can't.

Alright then, let's just ride them out.

So, we'll wait for Tuesday. All we can do is wait.  

From JM Barclay Photography

welcome weaning? not sure

First of all, I know. I know, I know, I know. The placenta takes over. By about 10 weeks, it's all placenta all the time.

Still. I am experiencing weaning worries.

Probably not entirely rational.

On Monday, after the ultrasound, I got a call from the U.S. RE congratulating us on the great u/s and the continuing pregnancy. I tried to ask him questions about weaning and he referred me back to the nursing staff. I decided not to be a door mat and just voice what my concern was. He still was quick to get me off the phone, but tried to answer my question. He seemed very sure in saying that ovaries don't do anything once the placenta takes over.

That's also what my research on the subject has led me to believe, but when one has ovaries that cannot be visualized on an u/s and have never put out any amount of estrogen or progesterone, one has to be 100% sure of this. There's another life at stake now.

The nurse phoned later on in the day. She said that she wanted me to stop my PIO the next day and start prometrium. I balked. At 7w1d? Are you kidding me? When I expressed my discomfort, she showed a willingness to negotiate. While she asks me to trust the treatment team, she also wants me to be comfortable with the steps taken. She mentioned that most women want to get off the injections as soon as is possible, and so that's why the transition to vaginal progesterone happens now in their protocol. I said I had no problem at all with sticking a 1.5" needle in my ass every night (and two on some nights) for as long as it takes. So, I bought myself another week of PIO. Weird on this brings me greater peace of mind.

I am waiting to receive the weaning schedule, but our nurse said that I would be off all medications by August 15. That will be week 10, when it's all placenta all the time.

Dr. RE, our local doctor, wanted to make sure that was well handled, because of what happened last time. We established that the m/c didn' happen because of a lack of progesterone, since I was due to completely wean the day of the u/s of doom. It's hard to have one doc who says we should be cautious and one doc who says you're just like everyone else.

Maybe I am just like everyone else, or other women who go through DE. But the fear is that my complete failure in having a working reproductive system is somehow going to affect the pregnancy. It's not that crazy to think that, really, since we are talking about reproduction. On the other hand, we aren't talking about reproduction anymore (that happened in the lab already), but talking about gestation. And perhaps gestation really is all placenta all the time.

I am thanking my lucky starts that Dr. RE went ahead and booked me for an u/s at 9w. SG did not order another u/s and so I would not have had one until 12w or so through my family physician. That would have meant getting through many weeks of FEAR and ANXIETY without any reassurance (ok, the constant nausea helps to remind me of what's going on).

On a much sadder note, my heart breaks for Jay who just found out yesterday that her little one did not make it. Please go send her some love if you'd like.

beatbeatbeatbeatbeatbeatbeatbeatbeat

Turns out I haven't been nauseous for nothing. There is a little gummy bear* (more like a gummy worm at this point, really) with a beating heart in there. There being my uterus. Still hard to believe, but the evidence cannot be ignored. While I calculated that I was 7w0d, the wee one measured 7w3d. Although the internet tools told me the due date (if there is one) will be on March 11, Dr. RE said it would be March 6. The day Mr. A and I got married. Oat's birthday. A very wonderful day indeed.

There was a lovely young doc who was set up to do the u/s, but they couldn't find my chart. Turns out Dr. RE had snatched it up, since you know, he wanted to do the u/s himself. And then our nurse walked into the room for another reason, and ended up tagging out the nurse on duty. She too wanted to be there. The young doc ended up performing the u/s and, although young, not too green to keep silent. She voiced in the first 20 seconds that she found the heartbeat. Dr. RE said he couldn't see any collection of blood (no SCH - thank the lord), and he commented that the lining looked good. I checked in at the end with the young doc just to make sure there was nothing concerning that she saw, and she said there was absolutely nothing concerning. At this stage it all looks like it should.

Dr. RE, not surprisingly, was incredibly thoughtful in planning for the next steps. He wasn't sure whether SG would order a repeat u/s, but he remembered well the timing of the fetal demise last time (9w). He said we would be booked for another u/s on August 7. I love this man so much.

It's early days, women. There are still many, many mileposts to cross. But you can't get to those mileposts without crossing this one. So today, I'm just going to be happy we've gotten this far. Thank you for keeping us in your thoughts. It feels so steadying to be supported by our great medical teams and you, amazing friends.




*I'm trying to think of something else to call this growing bean in my belly, but so far, that's all I've got.

the wilderness or 6w2d

I decided it was prudent to pee on a stick again yesterday morning. Why? I'm not sure. I just had some leftover from the July 5th stash and wanted to just see that plus sign appear. Well, I'm apparently very pregnant because there was no waiting for a line to appear. It seemed that as a response to my tomfoolery, the cosmic giggle came down on me and I barfed out most of my breakfast (the uneaten portion still in the bowl on my kitchen table). Dude, the universe said, YOU'RE PREGNANT!

Ok, I get it, says the girl currently nibbling on dry rice cake bits (I recommend the lunberg plain salted).

I feel like pregnancy is a sort of deep wilderness. One is certainly a visitor in a strange land. Getting through the day is a goal that repeats each morning, necessitating the right combination and timing of hydration, carb intake, and walking. The nausea is serious, and I am managing it. Although I am a little apprehensive when I read that it is most intense from weeks 7 to 12. Ladies, I think I'm in for a ride.

I had some spotting last Thursday. Nothing of any significance, either in colour or in volume. It did sweep me up and drop me into the land of tears for a few minutes, and then I grabbed hold of myself. I've known all along that spotting/bleeding was likely, and that it doesn't necessarily mean anything.

The ultrasound is booked for next Monday, July 23rd. We'll get to see if this gummy bear has a heartbeat.

I really enjoyed reading all your comments from my last post, and felt like all of a sudden, I had an arsenal to defend against the attack of FEAR and ANXIETY. I've actually started to write down all the strategies you've suggested on a list. I plan on carrying it around for the moments when I need immediate assistance.

I still don't know how this story ends, but it helps me to hold on to the words "we're having this baby." I've even started to integrate the fact of being pregnant into my dreams, which is much different than last time. I met with my beloved supervisor this week, and she said that I was making space for this baby and that it was my work right now. I think she's right.