Twenty-two

On this day last year...

...I spent much of the day in the hospital, concluding the ending of my first (very wanted, but unfortunately very short lived) pregnancy.

In some ways, it doesn't feel like a year ago. In others, it seems so long ago... I often think about what this year would be like if that pregnancy hadn't ended.

I hoped it was something I'd never have to experience again. Little did I know that I'd be in the same situation just a short time later.

I came home from my procedure and spent the rest of the night cuddling with my B-dog. At bed time, I felt well enough to sleep on the futon with her. She, however, did not feel well enough, so I slept in my own bed without her...

Twenty-one

On this day last year...

...I went to my first OB appointment. We had already seen a heartbeat, and I was excited to have been released to my "real" doctor.

What an awful day. I remember having to make that phone call to III from the u/s office to break the news. I think that was almost worse than hearing the news myself.

The memory of that day will never allow me to enjoy the first trimester of a pregnancy (assuming I could anyway...).

It was the beginning of a terrible week. This year, I hope for an uneventful week.

Random thoughts

If I hadn't lost my first pregnancy, I'd have a fourteen week old baby right now. It would make this trip very, very different.

If I hadn't lost my second pregnancy, I'd be sixteen weeks pregnant with twins. Also, a very different trip.

But I'm not pregnant. I don't have a baby. But I have my dogs, and they are my babies. We leave tomorrow to visit my family and leave them with a dog sitter who I don't know. I'm sure things will be fine, but I'm nervous. I'll miss them.

In other news.... my MIL is a very nice woman. She means well. But I just don't like her very much. Isn't that horrible??? One of my fears about moving here was her. Right now, she is confirming that fear. I'm hoping as we're here longer, she will chill. But I don't know. Fingers crossed....

I'm looking forward to Saturday. I planned a surprise party and it's all coming together.

I'm also looking forward to seeing my nephew. He's almost two and a half now, and I just love that age.

I realized this week that my surgery will coincide with when I would have been halfway through my most recent pregnancy. Awesome.

I also realized, with my surgery, it will be fall 2011 before I could even possibly have a baby. Fuck.

That's all I've got today. Probably won't be back until next week.

Irritated

Things that irritated me today:

• I left a note last week asking the cleaners to come today. They didn't. I don't know if he misunderstood the note or what, but now I have to call because I also told them not to come again after that until the end of August, and if they misunderstood that part of the note they are going to set the alarm off.
• The USPS appears to have lost (or delayed) 2-3 important pieces of mail. One was one I sent to get reimbursed by my insurance for the PGD. (This I can resend.) One was the only copy of a photo from my sister's hs graduation that she sent me to be included in a surprise for my parents. (She sent it eleven days ago.) The third is a cd I bought online to be played at my parents' anniversary party. It was sent on June 9. Even if these are just super delayed, if I don't get them by Monday, I can't use them for the party because we leave on Tuesday. I do hope we get the photo, though, either here or sent back to my sister.
• Also a USPS complaint: we can't sign up for a PO box until we get to our location for the summer. So we don't have anywhere for our mail to be forwarded, which means there are several days of delivery until we can give a forwarding address. Plus, and this isn't their fault I GUESS, but we can't have any UPS or FedEx stuff sent to a PO box. But we're not sure they'll deliver to our way out of the way house...
• There are no cable companies who have service in the area where we will be living this summer, so we won't have any cable and can't set up internet. I had to buy a USB modem through my cell company. And then buy a cell signal booster because our cell service isn't awesome there.
• I couldn't connect my usb modem online so I had to talk to a ver.izon salesman on the phone to connect it, and he of course tried to sell me all sorts of shit I don't need.
• My fucking HCG is still >1!!!! It's at 2.5 so I have to go back for ANOTHER beta. Damnit!!!
  

Ok. I feel a little better now...

The suckiness

III and I are headed to see a counselor today. She was recommended by the nurse at my clinic (after I broke down crying on the phone when they told me I was going to lose this last pregnancy... is that so uncommon???). III and I decided we needed to sit down with someone, even if it is for them to tell us "yeah, things just suck right now."

I'm a little nervous, though. I'm nervous about what might come out. I'm nervous about how III will interact with her (he's never been to counseling/therapy). I'm just nervous.

I think I'm at the end of my rope in a sense. I start every day with a headache and I'm exhausted all day. I have so much to do and no energy or motivation to do it. I just want the school year to be over, even though it means we are headed away for at least six weeks. I'm feeling very anxious about the uncertainties in our life right now, and though I dread leaving my home, another part of me just wants it to be over so that I can just deal with the reality of it instead of worrying about how it might be.

I feel like I'm longing for something but I don't know what. There is no one thing- or even several things- that can realistically happen to help settle me.

Yeah. Things just suck right now.

Post op

I met with Dr. Z yesterday for my D&E 'post op'.

Nothing interesting to report. The testing of the "products of conception" came back normal. As expected.

He gave me the name and number of a doctor to do laproscopic surgery to remove my fibroid. The problem is we're scheduled to leave for the summer on June 29, and I'm not sure I can get it in by then. He also had a recommendation for a doctor near where I'll be this summer who could do it, but I'm not sure how that would work with insurance.

While in the appointment with him, he commented on how I always seem to "put on a brave face" at our appointments. What he doesn't know is that I left that appointment and cried all the way home in the car.

I can't believe this is my life. I can't believe it is June 2010 and I'm not pregnant. Next week I would have been twelve weeks with this last pregnancy. My biggest problem should have been when and how we were going to share our news.

While sitting in the waiting room I thought of how sick I am of sitting in the waiting room for ultrasound after appointment after procedure after appointment after blood draw....

At the same time, I'm dreading our impending move and having to change clinics and get to know someplace new and dealing with having a new doctor get to know our situation.

This all sucks. I just want a baby. :(

Lists

• HCG level today was 84.
• I'm freaking out about our eventual move. The way my anxiety works, the anticipation of it is worse than when it (and whatever) happens.
• We don't know when it might happen.
• I withdrew my application for the new job I applied for. I can't deal with thinking about that right now, plus I don't even know if I'm going to be here for it.
• One of the many things I need to do today is to buy a blank book or a journal so I can start keeping lists. A list of the things I'm worried about. A list of things I would want in a new house. A list of things I need to do. A list for each of the categories of things that are keeping me awake at night.

ETA: My Bumpy Journey has a 'challenge' to go back and look at your posts from a year ago. How funny that exactly a year ago I had a Day o' Lists! I do remember how hard last June was. If only I'd known how much harder things would get. :-/

Everything sucks.

Things are rough at our house right now.

III and I aren't really getting along. We had a big throw down last night, which cleared the air, but those are never fun.

At one point, he expressed that there was a time last month where he wondered if maybe we weren't right for each other. I wanted to throw up.

By the end of the evening, things were a little better- lines of communication are open for now. We're going to go see a counselor who specializes in infertility issues.

We are also probably going to move to City B within the next year. :(

On the ttc/ivf/mc front.... my hcg levels are still over 600. Ugh. No wonder I still feel so gross.

And I'm still bleeding...

What isn't said

I wonder what people would think if I answered their polite inquiries honestly.

How are you?
Fine.

Actually, I feel like I'm in a fog. I'm feeling tired and blue and don't really want to talk to anyone.

How's it going?
Good.

Except for my empty uterus because I am, still and once again, not pregnant. I don't have a baby. I don't know if and when I will.

How's your day?
Okay.

Except that I am feeling absolutely unmotivated to do anything. I'm tired of taking care of other peoples' kids and don't really feel all that invested in whether or not I grade their quizzes.

What's up?
Nothing.

Except for the twin pregnancy I just had evacuated from my uterus. And the incredible growing fibroid that killed my embryos. Oh, and my dying father in law who is waiting for a new heart.

Not that I would say any of that. It's not their fault. They're just trying to be nice.

It's interesting the difference between my first miscarriage and this one. It's like, when the first one happens everyone has a story about how they or someone they know experienced miscarriage. But then when it happens again.... Their pity is evident. Their discomfort is palpable.

One of my classroom aides stopped by today. She told me it was good to see me and that she was sorry. I thanked her and told her we just were feeling pretty tired after everything. Then... there was a silence. I could tell she wanted to say something else but literally didn't know what to say. So I told her: "It's okay. There's not really anything to say." She got kind of teary and said "No, I guess there's not." She said she'd pray for us.

I thought it would be good to get back into my routine and come back. But it's not. Nothing bad happened today. The kids have been sweet- they were really worried when I missed several days in a row. But I'm just unhappy. I don't want to be here. I don't want to do any of the work sitting on my desk. I want to be home with III (who is also at work, so it's not like I could be), cocooned in our little house with our dogs and just our life.

But even then, it all permeates. I'm still bleeding, a constant reminder of what we lost on Friday. III's mom calls with updates about transplant potentials, and III hangs up the phone feeling helpless and sad. Even the dogs, who I love unconditionally, feel like a burden right now. Peanut's energy is boundless and M-dog has been a picky eater. They limit our options when trying to go away- whether it be vacation or to support family.

When I try to identify exactly how I feel, it just feels like a cliche. A hole in my heart. An emptiness in my chest. A all-encompassing ache.

We just need a vacation from our life.

Following up...

I've been meaning to update, and I definitely have plenty in my head that I think I want to share, but then when I sit down to type it out... I just don't want to anymore.

Thursday's ultrasound showed that neither embryo had a heartbeat. It also showed that my fibroid had grown from 5cm to 7cm across in just the week. That is basically the length of my entire uterus. Dr. Z actually showed us the ultrasound pictures so we could see exactly how it affected things. Thursday's ultrasound showed the fibroid encroaching upon the embryos.

Despite the bad news, we left feeling okay. Dr. Z is as certain as he can be that the crazy growing fibroid was to blame, and that it is something that can be remedied before we try again. I asked him directly if he thinks we need to stop trying, and he told us that when he has to have that conversation with couples it is very, very difficult, but that was NOT the conversation we needed to be having. That he still, without a doubt, feels we can have a baby.

The D&E was the next day. Again, we got to the appointment and we were both doing well. In good spirits, for what it was. But... you have to answer the same questions five different times for five different people... nurse, anesthesiologist, doctor, another nurse.... and they all just kept telling me how sorry they were. I know for some people that is probably really reassuring, but for me it was too much. By the time they took me into the OR I was crying and couldn't stop. I just wanted them all to stop talking to me, put me to sleep, and do what they needed to do so I could go home.

The procedure went well. I felt fine for the rest of the day.

Yesterday, I spend the evening with KB. She took me out to dinner and a movie- a girls' night date. We had a wonderful time and I just love her to death. It was exactly what I needed.

From here... I have a post-op appt with Dr. Z in three weeks. There we'll discuss what comes next, but if I'm understanding everything I'll have blood work and u/s to make sure I recovered fully and to see what Crazy Fibroid is doing now that all the hormones are gone. Then Dr. Z will refer me to yet another specialist to have my fibroid removed laproscopically. Once that procedure is done, and my recovery from that is complete, I'm sure my insurance will require we try a cycle with my lone frozen embryo. This is not something that III and I feel very optimistic about in terms of it being a "real" chance.... so that probably puts me at the fall before we can do another fresh cycle.

In one sense, it's tough to be "on hold" for that long, but in another it's probably what we need. I'm sweating that I'm turning 35 before I'll have a baby, but in the big scheme of things, what's 3 months? We're still looking into going away for the summer, and while I'll miss "my town", which I love in the summer, as well as KB, getting away from everything might be just what we need.

Over once again.

D&C scheduled for 11am tomorrow.

While we are sad to have another m/c, we are glad to no longer be in limbo.

After our appt today, we went out to lunch and to see I.ron Man 2.

More later....

Can I just be super cranky for a minute?

• I am not feeling optimistic about the outcome of Thursday's u/s. I have been feeling less sick (except for this morning when brushing my teeth almost made me puke in the sink) and any symptoms I am having (hello? Painful boobs?) I am blaming on progesterone.
• Speaking of progesterone. Ick. Uch. I hate you.
• We just got back from a school break 2 weeks ago. Usually the end of the year flies after that break. This year? Not so much. DRAGGING. I can't believe it's only Tuesday.
• My student teacher is done, which I'm actually glad about. But she's not done grading some stuff so I'm still waiting to get it from her. Hard to do progress reports when the gradebook is empty.
• My butt still hurts.
• III's dad is not doing well. They finally got him on the transplant list, but he's a level 2 which means he's low on the list. In spite of that, he is feeling shitty and is basically housebound.
• My cousin is getting married. This should be YAY!, right? FIRST of all... I hate how people who complained about how brides acted when they were in weddings then become those brides. I'm supposed to be in her wedding, and the whole dress thing is already kind of a pain. She originally was going to just pick something that we could all easily get because we're living in different areas, but now she's picked one I have to travel to have fit and buy. I also don't know if I'll be pregnant for her wedding, and she told me they looked at dresses for "all shapes and all conditions". The dress she picked? It does have lovely waist detailing that will make a girl look very hourglassy... but not going to fit a pregnant lady. But hey. The way things are going, I probably won't have to worry about that.
• Also on the wedding thing... I'm kind of jealous. Which is ironic, because I hated planning my own wedding. I was stressed and I cried and I just wanted it to be over. But looking in from the outside- engagement and wedding planning is supposed to be such a romantic and exciting time... There is so much anticipation and hope for the future. So I'm jealous. Lately, I'd love to be back in that naive, romantic, exciting time.
  
• Is it Friday yet???
  

Hanging on by a thread

I vacillate between feeling optimistic and pregnant, and feeling that this pregnancy is doomed. Thursday seems really far away, and I dread finding out that bad news has been dragged out for a week. Before the bad u/s, I ordered 2 pairs of maternity jeans from o.ld na.vy. They came after the u/s... I almost sent them back, but I'm so uncomfortable in my regular clothes right now, I figured what the hell. They aren't the full panel kind- one is the low waist and another the roll down. They are comfy. But, even though I don't truthfully believe in this kind of luck, I feel like I'm tempting fate by wearing them.

I did a little googling yesterday... I wanted to see how high the chance of miscarriage is with a low fetal heartbeat. I was surprised to find that 60% of pregnancies with an early low h/b go on to be successful. I realize that 60% is only a little more than half, but in my mind I felt like it was a much stronger indicator. Many of the pregnancies that don't progress are because of chromosomal issues, which we shouldn't have. BUT I also know that in our situation the heartbeat dropped, so that makes me nervous as well.

Something I thought of this weekend that is also making me nervous.... I believe that Dr. Z mentioned that the fibroid did not seem to increase in size over the 4 days between our last 2 u/s. I realized this weekend that during that time I had stopped taking progesterone... I started up again after Thursday's appointment, so now I'm nervous that that fucker is growing in there and sucking up my uterine blood supply. Dr. Z didn't say anything about progesterone specifically, it's just my own neurotic worrying brain.

Mother's Day has never been a painful day for me. I think it has to do with the fact that I'm not really big on those "hallmark holidays"- not even valentine's day. III got me a mother's day card "from the dogs" telling me that they "woof" me a lot. :) I did call my mom yesterday, and I ended up giving her the basic outline of what had been going on with us. I didn't tell her specifics of this cycle, but did share that we'd peeled back a lot of layers, and that it was frustrating and time consuming.

I also saw KB, Miss M and Baby N this weekend. Sooooo sweet. I love seeing the babies of those I love, though I think going home to a babyless house was tough. Miss M shared the muffins they had baked with me, we played with these weird sticky bendy things, and shared with me her pride about pooping on the toilet. LOL. I got to hold and feed Baby N. He's a cuddly little thing and I held him on my shoulder after burping him. He snuggled in there and got a good nap. Cutie!!!

Wish me luck hanging in there until Thursday. I am not currently feeling good about the outcome at all. It's impossible not to analyze every symptom (or lack of) and even the ones I have I think "Oh, it's just the progesterone" or "Oh, that's just my dumb stomach acting up...."

The details

We have known since I started this process over a year and a half ago that I have a fibroid. None of the doctors I saw were concerned about it. It was not in a place that should have affected a pregnancy.

Putting all of my history together, however, Dr. Z went back to look at that fibroid. When I had my first u/s in 9/08, the fibroid measured 3.0×2.9×2.8. At the beginning of this cycle in March, the fibroid measured 3.6×4.0×2.8 - not a significant change, especially for the amount of time that had passed.

Yesterday, the fibroid measured 5.7×6.9×4.7.

Just looking at the numbers, you can see that it is significant growth. But the math teacher in me wants to clarify just how significant. If you figure out the volume of the fibroid at each step, yesterday the fibroid had almost 5 times greater volume than it did just two months ago. (Over 7 times the volume it had in Sept '08.)

Dr. Z believes that the growth of the fibroid, probably triggered by the amount of hormones coursing through my body, was using more blood in my uterus, thus depriving the embryos of blood. Last week when I had my "bonus u/s", Embryo A had a heartrate of almost 120. Embryo B had a heartrate of 105. On Monday, (which should have been 7w1d) A measured 6w3d but had no heartbeat, and B measured 6w0d with a heartbeat of 84. (Dr. B had told me 66... either that, or I misunderstood.) Yesterday, A still had no heartbeat (and if I'm reading my test results right got smaller) but B measured 6w4d with a heartrate of 84.

Dr. Z was very encouraged by the growth of B. B grew 4 days worth in 4 days. I asked Dr. Z what the heartrate should be at this point, and he said 100. I asked what a lower heartrate meant, and he told me that it doesn't mean anything necessarily, but that statistically a lower heartrate can be an predictor of miscarriage.

If the fibroid doesn't grow any more, and the pregnancy progresses, great. If the pregnancy does not progress, they will remove the fibroid before I do another cycle.

We asked lots of questions, but of course after a meeting like that is when you think of some of the questions you really want answered. Both III and I wonder... if the growth of the fibroid affected how much blood the embryos were getting, and that's what stunted their growth and caused the loss of embryo A, now that there is only one embryo, does it have a better chance because A is not using any of the blood? I thought it was interesting that the embryo that seemed stronger (better h/b, measuring further along) was the one that didn't make it, but maybe because it needed more blood?

So here we are, we don't have bad news, but not completely great news either. Just still in this state of limbo. I have another u/s on Thursday to see if there has been growth and to see where the h/b is at. I don't know what to expect, though I know what we hope for. Thursday will technically be 8w4d, which is when I found out that we had lost the last pregnancy. Hoping that history doesn't repeat itself...

Unexpected...

One of the embryos is still plugging away.

While it is still measuring a week behind, it made the appropriate amount of growth since Monday. (6w0d to 6w4d). The heartbeat is still lower than they would like- 82 vs 100- but my doctor was more encouraged by the growth than discouraged by the heartrate.

I'll update more later- there are some interesting details about why this all is happening. But I go back next Thursday for another ultrasound to see whether this little guy continues to progress, or whether he joins his twin...

Taking charge of MY fertility

Okay, so I never read that book. But I'm a strong supporter of being in charge of your own health, which means having a doctor to whom you can express your concerns and needs.

This is the email I sent yesterday:

Dr. Z,

I am writing to inquire as to whether we can have a short phone conversation. After my ultrasound yesterday I met with Dr. B yesterday. He was very nice and supportive and explained that, due to the findings with the heartrates and measurements of the fetuses, that it appears that this pregnancy will not be viable. However, because he has limited knowledge of my history, he was not really able to tell me much more or to give me further information.

After speaking with (the nurse) D yesterday, I have scheduled an appointment on Thursday for a follow up ultrasound, and will again be meeting with Dr. B. D explained that protocol is usually to have the follow up a week later, and also that you will be out of the office at the end of this week, but between our devastation at the news and the fact that I have been having pregnancy symptoms that are leaving me feeling pretty sick, I was hesitant to wait that long.

I know that much of the information we would like to have may only be available after testing of the embryos are done, and I also understand that at that point we may be left with many unanswered questions.

However, I would really feel better if I could speak to you- who are so familiar with my case and my history- even if only for a few minutes this week.

Please let me know if this is something we can arrange. I can be available by cell phone at almost any time this week.

Thank you.

A

Dr. Z emailed me back and told me he'd give me a call in the evening. Which he did around 10:15pm. During that conversation, he told me that while he was in another office on Thursday, he would arrange it so that I could speak to him by phone after my ultrasound. He sent the following email to his secretary:

A had an ultrasound that wasn't so good on Monday. She's got another on Thursday, when I am in (other office). I'd like to discuss the results with her right after she has the ultrasound. If you call me when the ultrasound is ready, you can have A take my call in an office so I can review the results with her and plan to do whatever is needed. I've CC:d A to this e-mail so she'll be expecting your call.

So I am pleased that I will get to speak to him and that he is accommodating me. It makes a super hard situation a teensy bit easier.

In spite of this, something I am wondering is if I should get a second opinion... a second set of eyes to look at my chart and test results at a different clinic... I'm unsure as to whether I want to. I have generally been very happy with how my doctor and my clinic has handled everything, with the exception being that I'm not yet pregnant. (Well, with a viable pregnancy...)

I hate that I have to go through another ultrasound to be told that my babies are dead, but I guess it is important to be sure and make an action plan from there. At this point, I just want to get it over with so that I can move on. Whatever that means...

There's not really a lot to say.

...and my thoughts are very disjointed.

I'm frustrated that I haven't gotten to speak to my own doctor yet. (My appt yesterday with with someone else from the office.) and according to his nurse, yesterday, I won't be able to talk to him until next week. She wanted me to wait until next week for my follow up ultrasound (to verify what they told me was pretty much certain) and I told her I wasn't willing to do that. She told me my dr would be out at the end of the week. So I sent my doctor an email saying I'd like to speak with him via phone. I got an auto-reply that he's out of the office until thursday.

III and I talked about going away. We may go spend two months or so in his hometown this summer. It means being closer to his family (good for him, not so much for me) and they have a lovely lake house which is quiet and relaxing (good for both of us).

I am feeling like I am never going to have a baby. The doctor I saw yesterday told me not to give up on IVF- he does not feel that we are at the end of the road here. But he hasn't had to go through the shots and the hormones and the procedures and the pregnancies and the failures- with NO ANSWERS to show for it.

I'm defeated. I don't know where to go from here.

I officially hate my life.

There will be no birthday babies for me.

Today's ultrasound- 7w1d- showed 2 embryos. One measuring 6w3d, the other 6w0d. One had no heartbeat. The other had a heartbeat of 66, which was down from 105 on Wednesday.

The doctor I saw was not my own. He said they'd bring me back on Thursday for a follow up and then schedule a D&C.

I had high betas. I had strong heartbeats five days ago.

Nothing makes sense.

I don't know where we're going to go from here.

Due date

Today would have been my due date.

There have been a few things that sting a bit about that. A few friends have recently had babies... including KB. I went to visit her yesterday at the hospital. Baby N is a teeny thing, so sweet and adorable. I got to hold him, and she told me about his birth. It doesn't sting that she had a baby- it stings that we would have had babies who were almost exactly the same age. We would have experienced this together.

Of course, the fact that I am currently pregnant helps ease the sting a bit. It's still so early, I'm not comfortable feeling too excited... but I am just trying to go one step at a time. I am praying that this pregnancy will continue and will result in TWO healthy babies.

This scenario would support my philosophy that good things can come from bad. (It's my variation on "everything happens for a reason" which I just can't personally wrap my brain around.) If my previous pregnancy had progressed, I would not be pregnant with twins right now. I would be a mother to a baby... but it would be a different baby. While, I know I would have loved that baby infinitely, if this pregnancy progresses well and in December we become parents to these twins... I'm sure the joy and the love we will feel will be overwhelming. These will be our babies, and once they are here I'm sure we will be unable to imagine our lives without them.

I apologize in advance for this totally lame post...

One of the things that has bothered me in the past about ICLW is when I try to comment on blogs and people who have signed up don't post all week.

But here I am, not great about posting this ICLW week.

I have a whole story about something that happened with III this week, but I just don't have the energy right now.

So I thought I'd link to some important me stuff from past posts for anyone who is interested.

The story of my best girl.

The worst week of my life- when I lost my hard fought pregnancy and my sweet girl.

How I met my DH.

All about anxiety.

The long explanation of our whole chromosomal thingy.

So there are a couple for now... :)

Oh, and I want to add a shout out for The R House blog and Mrs. R's giveaway. :) If you've ever considered adopting, you must check out her blog- amazing family with an amazing story- and amazing adoption advocates!