fear

Pregnancy After Loss

I owe you all easily a dozen or so posts. Sorry. I’ll catch up at some point. I just haven’t felt much like sitting in front of my computer lately. Probably because my office is a terrible mess and being in here makes me feel guilty. But I digress. I wanted to talk a bit about my experience with being pregnant after a loss and the seriously amazeballs midwife I saw today. This is going to be a pregnancy-heavy post so skip it if you need.

For some people, namely my husband and my mother-in-law, it has seemed like ever since we were confident that this pregnancy was in the uterus and especially since we saw a heartbeat that they are absolutely certain that this is a pregnancy that will end in a take home baby. I’m not that certain. I have hope. I have a lot of hope and it increases every day. But I’m still scared. Even though I’ve only had the one loss and we are like ten steps further than we ever got with that pregnancy, I’m still scared. Leading up to my appointment today it had been three weeks since I last had an ultrasound and I was scared of a missed miscarriage. I had no logical reason for that fear. I still have all the symptoms (they come and go but some are here daily). The statistics at this point are in my favor. But I’ve known too many people who have lived in those tiny, scary statistics to count on something like that.

So I’ve been anxious, worried, stressed. My husband doesn’t get it. He’s so sure everything is okay this time. And it has been. But my fears are there.

Today I had my first regular OB appointment. The orientation a couple weeks ago was mostly paperwork and and overview of the process. I met with one of the midwives and she was fucking fantastic. I can’t even explain to you how great she was. She totally understood that I was scared without me even having to say anything. Well, I did fill out a form that mentioned that I’d had a lot of anxiety lately. She had clearly reviewed my chart and knew all about the ectopic. She was so comforting with everything she said. She not only acknowledged that I had the fear, but that having it was normal and okay.

I wasn’t due for a formal ultrasound today but one of the first things she said was that I wasn’t leaving without first seeing the baby and/or hearing the heartbeat. So I had my first external ultrasound. Blobby was moving all over the place, which was so amazing to see. The movement meant it took a bit for her to finally get the heartbeat but I eventually got to see and hear it. She didn’t do any measurements but just seeing Blobby moving like that made everything okay. When she was having trouble getting the heartbeat she kept telling me that the baby wouldn’t be moving like that without a heartbeat. Just so comforting.

Other things that were amazing: There are apparently social workers at the hospital who only see pregnant women. She put in a referral for me to see one of them, so now I have a chance to talk to a professional about this all and process all the fears with him/her. I’ll call tomorrow and set up my first appointment. The midwife also said told me not to be a hero, if the depression gets really bad that it’s safe to go back on Zoloft. I feel okay right now but we’ll see what happens when my husband goes back to work and I’m still routine-less. Then she set up the referral for my anatomy scan to be with the Maternal Fetal Medicine (high risk) clinic instead of radiology. She didn’t say why but I’m pretty sure it’s because they have more experience dealing with extremely anxious pregnant woman during those scans. She asked about past physical or sexual abuse and when I briefly told her about my ex she told me not to minimize it, that it was abuse. That was important to hear. I also had to have a pap smear today and she kept reminding me that a little spotting after would be totally normal and okay, but luckily I didn’t even have any spotting. We talked about genetic testing and she told me I won’t hear anything until the second set of blood work is taken and not to focus on and stress about it in the meantime, which I would so do. Just a little nudge that there’s nothing I can do and it’s okay to let it go during that time.

Finally, they have this thing called “Centering” where you meet up for your appointments with a group of women all due during the same month. So you have some private time but it’s also a group conversation and classes about pregnancy and birth and stuff. And they just started having a group meet at the military base that’s closest to my house rather than this main hospital. I’d still be giving birth at the main hospital, but all these appointments (except the anatomy scan) are much closer to my house. I think it will be good for me to have other pregnant women to bond with, even if I’m a bit scared that they will all be young and fertile. And the midwife got me into a slot in the group by my house, so yay. That starts in like 3 weeks.

I can’t explain in words how validating it was to have someone just get how scared I am, without me even really saying so. I never thought that someone outside of the RE’s office would understand like that. She was a little miracle. It’s too bad I can’t request specific people when I go into labor and they are cutting the hours of the midwives in L&D. But that’s okay, just having her today was enough to make a huge difference. I am eternally grateful to the Universe not only for this pregnancy (oh so very grateful for that) but for the little things like this appointment. I feel so incredibly lucky, more than I could ever say.

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Blobby

I’m just going to get this out of the way from the start. I am six weeks pregnant. Actually six weeks + three days going by my last period.

I haven’t written about it here for a few reasons. The biggest being that we were waiting until we told our families. A couple family members know about the blog and it would be irresponsible and frankly cruel for them to find out here. I’ve also been stupid busy. I graduated this past weekend. My mother-in-law was in town staying with us and one of my aunts is in town staying with my parents. I have had very little down time to sit and write (or read, still catching up).

I have about a million feelings about this pregnancy. I actually ended up in the ER a couple days after the first positive test. I was having a lot of cramping and that morning I started spotting a little. The symptoms were so similar to the ectopic that I freaked out and went in to the ER because the RE clinic wasn’t returning my calls. But it was crazy early (I was something like 3w3d) and so the ER really couldn’t tell us much. The RE clinic, when I finally got them on the phone that night, said it was probably implantation.

I’ve had two ultrasounds now and we know there is a pregnancy in the uterus. The first doctor was still concerned about the possibility of a second pregnancy in the tubes, but the second doctor was not. However the second doctor was awful so her lack of concern wasn’t exactly comforting.

The main things I am feeling are: overjoyed, guilty, and terrified. They are all probably self-explanatory but I’ll break them down for you anyway.

Overjoyed. Duh. I’m pregnant. We know it’s in the uterus, not the tubes. At our ultrasound next week we should get to see/hear a heartbeat. Our family is, for the most part, really happy for us. My mother-in-law’s joy and optimism were contagious while she was here. My husband is so freaking thrilled he wants to tell way more people than I’m prepared to tell yet. He has christened the embryo “Blobby” after I tried to explain what the yolk sac looked like after the first ultrasound. We are so much further than we ever got last summer, it’s hard not to feel hopeful that this good luck will continue.

Guilty. I think most of the women in the infertility community who I know who have gotten pregnant have dealt with guilt for the pregnancy alone. I’m feeling extra guilt on top because this was relatively so easy for us. We just used Femara and did timed intercourse. I feel so incredibly lucky. I won’t even get into how lucky I am about the money part too. It’s so hard to see so many amazing, deserving women and men in the community who are having no luck at all. Every canceled cycle, failed treatment, or god-forbid loss breaks my heart. I’m at a loss for what to say to people. How do I say my heart is breaking for them and have it be sincere when I know that I have inside me right now what they want more than anything? People keep telling me not to feel guilty. And I get it (aside from the whole don’t tell me how to feel thing), but that doesn’t change anything. I know people are happy for me and wishing me good things as I have done with so many others. I just wish I could take whatever magical unicorn dust got me here and spread it around.

Terrified. Like I said, we are so much further along than we ever got a chance to be last summer. But it’s still early. I’m still waiting for the other shoe to drop. I was telling my mother-in-law that one of the difficult things about this community is that I have heard so many stories of loss. It’s hard to feel confident in any pregnancy when I know how easily it can all be taken away. My hope increases every day but I really do have to take this thing one day at at time.

The other big issue has been the pregnancy side-effects (symptoms doesn’t seem right when I know for sure I’m pregnant). I have been having a really difficult time with “morning sickness” that has been more like all-day sickness. I haven’t actually vomited, thankfully, but I feel nauseous all day long. It’s exhausting. I had no idea it would be this hard. Which sounds naive and crazy, maybe. But damn. I’ll still take this over not being pregnant in a heartbeat. And people keep pointing out that it’s a good sign. I refuse to complain about it on Twitter because I know how hard that is to hear. So my husband bears the brunt of my pain and whining.

The internship I was hoping to do this summer isn’t going to work out in the way I had hoped because of the pregnancy but they are still trying to find ways for me to come into the studio and be around my fellow artists and such, so I greatly appreciate that. My husband is having surgery on his foot next week so I’ll be highly distracted by taking care of him for a while too.

In the meantime I’ve been thinking a lot about what to do about this blog. I want to keep blogging but it feels weird blogging under this name while pregnant and even weirder if I become a parent. So chances are I will start another blog in a few weeks where I will blog about pregnancy, birth, and parenting after infertility. I will absolutely not forget where I came from. Said blog will also likely be more personal, with names and photos. It will also probably be something I’ll share with friends and family, so less raw honesty. When I set it up I will let you all know so you can decide if you want to follow me there. I fully expect most of you won’t and that is totally okay. I get it. In the meantime here is my promise to you. When it comes to this blog I will never post: ultrasound photos, bump photos, pics of any sort of baby items, or lengthy complaints about side-effects. I’m also not going to post the whole weekly breakdown thing, because honestly, nobody really cares about that stuff. I will talk about the pregnancy. I probably won’t post very often. And I will absolutely keep reading and commenting and thinking of all of you.

Unicorn dust for everyone!

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Memories That Don’t Fade

First, I should say, this is potentially triggering for loss. Which is an ironic thing to say because I’m writing it because I’ve found myself triggered a lot lately. And I realized there’s a lot of the story that was never shared. And even though it hasn’t quite been a year, a lot of things just have this on my mind.

So I’m going to write about the story of last year’s ectopic.

It all starts with the 36 joyous hours when we thought we would be getting our baby. And then were told we were probably miscarrying. Some of this has been covered in the blog. Over the next week we were in wait and see mode while issues with blood work taking forever went down. It was late on a Wednesday night when we first went to the ER. The following Thursday morning we were told the pregnancy was not viable. They gave us choices: miscarry naturally or have a D&E. I think they might have even offered methotrexate at that point too but I’m not sure. We decided to try to miscarry naturally. We thought that was it. We went had a pho for lunch (I needed comfort food) and then I went to class because it was the final metal pour of the summer session and it was important to me to be there. Plus it would take my mind off things.

Except it didn’t because I checked my phone at one point and there were multiple missed calls from the clinic. Based on my blood work from that day they suspected an ectopic. I was told to return to the clinic at 8am the next day and they would fit me in. Physically and emotionally exhausted we went in the next day and were told a natural miscarriage was no longer an option. After yet another ultrasound they still weren’t sure if it was ectopic or not. The doctor thought she saw something hiding behind my right ovary, but again, she wasn’t sure. We were given two options. 1. Take methotrexate then and there. If it was ectopic or not that would “resolve” the pregnancy. 2. Have a D&E, have them biopsy the tissue, find out for sure if it was ectopic, if there was no fetal tissue from the D&E take methotrexate. We decided we wanted to know for sure and elected to have the D&E.

The D&E was not done in the OR or under general anesthetic, something I am just now learning is unusual. They put in a prescription for a pain medicine, an anxiety medicine, and an antibiotic. We picked it up from the pharmacy (same building) and eventually went back to the clinic for the procedure. There was actually a whole issue with the doc not getting the antibiotic script in on time and then we had to go back and wait and it was taking a really long time and finally the doc went up to the window with us to demand they fill the prescription right then.

We went into the procedure room and got set up for the procedure and then hubby was kicked out. The doctor we’d been working with did the procedure, another doctor was there to run the ultrasound during it, and the nurse was there basically to hold my hand (and also in case anything went wrong). They also used local anesthetic on my cervix but it was still really fucking painful. I pretty much sobbed hysterically the whole time with the nurse cradling my head in her ample bosom. At one point they thought they were done but checked with a transvaginal ultrasound and saw more tissue so they had to go back in again.

When it was over they let hubby back in and gave me some time to recover. I was still in a lot of pain so they gave me a shot of IM painkillers. Eventually I was able to stand and dress and we were sent home with instructions to have another blood draw the next day (Saturday) and then come back for more blood work and a follow up on Monday.

We came back Monday hoping for good news. We did not get it. Although my hcg levels had finally stopped rising and had started going down, it wasn’t enough to indicate that the pregnancy had been in my uterus. The biopsy results should have been in, but of course, were not. Another ultrasound. They were confident it was ectopic. And so I needed methotrexate. Back to the same procedure room for this shot, because that wasn’t traumatic at all.

We were sent home with a severely restricted diet and instructions to have blood drawn on day 4 and 7. Day 7 would be on Sunday and I would need to have the blood drawn in freaking Labor and Delivery. That turned into a six and a half hour ordeal that you can read about it detail here. The short version is I had to have another, this time double, dose of the methotrexate.

In the end it took nearly seven weeks from that first trip to the ER to finally getting the phone call saying that my hcg was a zero. Those seven weeks were absolute hell. At one point my numbers stalled again and they said I might need surgery. I kept having to go to L&D for blood draws. It was a nightmare.

I fear never getting pregnant again but more than that I fear going through another loss. This all started at the beginning of June and I was physically and emotionally a wreck for the entire rest of the summer (things like my cat getting sick didn’t help). The pain is still very much there. The guilt is still there. It was godawful and I wouldn’t wish it on my worst enemy.

I will never, ever forget.

Finish Line

I survived the first week of classes. I feel like this semester is going to be a lot of work even though I’m only taking 12 credits and 3 of those are a class I’m a TA for and the professor is super laid back. I can’t believe I’ll have a bachelor’s degree in four months. It’s surreal. Then we have to figure out what the hell I’m doing next. Scary. I wanted to update everyone on what’s been happening over the past week or so since I last posted, but I’ll tell you now that if you follow me on Twitter you probably already know most of this. It’s so easy to pop over to Twitter and post a quick update about what’s happening, but I like to sit down at home and take my time posting here. So if you want up to the minute info about me, go there.

School

Like I said, I’ve had the first week of classes. I like all my professors and I’m feeling good about the classes I selected to finish this degree. I’m taking advanced steel sculpture, which is a little scary because of the possibility of getting pregnant. How am I going to weld or even just lift heavy steel if I’m preggers? Well, the good news is that the new lady teaching it (I had a dude when I took the intro class last spring) is really flexible about using steel. She calls the class “steel and other materials.” So I don’t even have to use any if I don’t want to. I actually spoke to her on the first day of class and mentioned that we were about to start fertility treatments and that while I prefer working with metal, safety is my first concern. I just wanted to give her a heads up. Turns out she went through IVF herself. While a grad student at my university. So she completely and totally gets it. I feel like her coming into my life right now is fated. She is the right professor for me at this time.

The professor I’m TA-ing for told me to get a book about health and safety for artists. It’s actually a really good resource and I’ll be happy to have it in my library. I was flipping through the other day and there’s a chapter in the back about reproductive safety. It addresses both hazards to fertility and hazards to pregnancy. It was fucking terrifying. Basically everything I do is super dangerous. It honestly left me wondering if some of my past exposures have affected my fertility. But at least I can go forward with increased knowledge about how to protect myself.

My sociology professor went to grad school as a single mom. Which is to say that she understands the life of the non-traditional student. And let’s be honest, when a military member is deployed the spouse with kids is essentially a single parent.

Liver

So, my liver. It’s not great news. I had the ultrasound on Tuesday and the follow-up yesterday. Everything came back normal. All the blood tests were normal. Blood glucose, tests for celiacs and autoimmune hepatitis, iron levels: all normal. The ultrasound showed normal liver and gall bladder, and normal kidneys and pancreas as far as what they could see of those two. So my worst fear came true: they want to do a liver biopsy. The doctor actually didn’t order a retest of the liver enzymes with all the other blood work (oops!) so I had that drawn yesterday and should hear the results Monday. But if they are still elevated he wants to do a biopsy to figure out what the fuck is going on. Considering they have been elevated to varying degrees for the past 2 years I don’t expect them to come back normal. So I tentatively scheduled the biopsy for Valentine’s Day. So romantic! I’m freaking out a little. The procedure itself is relatively minor, just a needle biopsy, they said it takes like five minutes. But recovering is going to suck. After the four hours recovery in the hospital I have lots of restrictions. For instance, I’m not allowed to lift anything over 10 pounds for two weeks. That is going to make school interesting. Not only will I be limited in what I can do in sculpture class, but I’m going to have to be careful with even just my backpack. And I’m not allowed to take ibuprofen for 7 days prior to the biopsy. I’m expecting my period during that week and ibuprofen is usually the only thing that keeps me functional. So that should be fun.

I actually went ahead and posted about the biopsy on Facebook. Normally I don’t share medical stuff even if it has nothing to do with infertility but I was freaking out yesterday. I almost broke down crying in the hospital while waiting for them to draw blood. People have been really kind and supportive, but they don’t know that the only reason we know about this is because of the ectopic or that the main reason we are trying to diagnose it is so I can try to get pregnant.

Pregnancy?

It is within the realm of possibility that I could be pregnant. We managed some well-timed sex this month so if I actually ovulated then who knows. Of course I’m already totally symptom spotting. My boobs are all achy this morning so obviously that means I’m pregnant, right? Ha. I have a feeling I’m going to give in and buy some sticks to pee on this week. Unless the achy boobs are a sign of another short cycle and my period comes early again. Have I mentioned I hate my body? Of course, if I’m pregnant the biopsy is cancelled. They can’t put me under anesthesia while preggo. So I guess they would probably just keep a close eye on my levels during a pregnancy. I don’t know. I should probably have asked. I’m kind of kicking myself for mentioning the biopsy on fb before we knew for sure that it was happening. What if I have to cancel it because of a pregnancy? What do I say? But really, this is probably not the case. I just have my hopes up the same as every fucking cycle. I blame my boobs.

 

I think that covers the major things I wanted to share. I have lots to do today and should probably get off the computer, although I also want to catch up on reading everyone else’s blogs. Hmm. Oh well. Later gators.

Write It Down

I’m feeling very frustrated today. My liver ultrasound got cancelled because of weather even though I would have been on my way home by the time snow really started coming down. But safety is important and it got pretty nasty out there so I guess I can’t totally fault them for closing today.

In the meantime I’m also dealing with a debacle with some solar panels the owners are having installed on our house. Without getting into the long story, today we/they failed the third electrical inspection. We knew the solar people still had a couple small things to fix before the inspection and they didn’t show up at all (I’m guessing because of the weather?) but the inspector sure showed up. So yeah, just another thing we have to try to fit into our schedules now. At least it looks like my hubby won’t lose leave for today since he didn’t have to work because of weather anyway.

But none of that is what I wanted to write about today. I wanted to write because I’m am really, really nervous about the liver ultrasound and blood tests. I basically did not sleep last night in part because I was stressed about weather and if they were going to close the hospital, but also because I kept running over all these worst case scenarios in my head. And I have found that if I write stuff down here I tend to obsess about it less. So I just want to get these fears out.

1. I’m afraid that I’m going to have the ultrasound and they are going to see there is a problem with my gall bladder and tell me I need emergency surgery to have it removed. This is largely sparked by a recent blog that was Freshly Pressed where there author wrote about needing emergency gall bladder surgery. It is also because the P.A. mentioned that the problem could be gall bladder related and gall bladder problems run in the women in my family. So it wouldn’t surprise me if there is a problem, but the emergency surgery scenario is really not likely. It still scares me. Last night I was thinking about what would happen if I needed the surgery and my husband had to drive to the hospital in all the snow. I’m insane.

2. I’m afraid I have autoimmune hepatitis. Like I said, it’s the one condition the doctor mentioned. And although my friend who had a liver transplant also had other factors that contributed to her extreme condition, the idea of having the same autoimmune condition as her scares the crap out of me. I can’t describe in words how difficult it was seeing her in the hospital before her transplant when we were waiting on a liver and thought she wasn’t going to make it. That’s the closest to death I’ve ever seen someone.

3. I’m afraid I’m diabetic. My dad is but whenever my blood sugar has been tested in the past I’ve always been in normal range. But as I learn more about PCOS and its link to insulin resistance I get more and more afraid of being told I’m diabetic or pre-diabetic. My dad has lost 6 toes to the disease.

4. I’m afraid they aren’t going to find anything wrong and I’m going to need a biopsy. I’m afraid of a biopsy. I’m afraid of even a biopsy not giving us answers.

I think those are all the big ones. I’m really scared and it’s not even about infertility right now. I’m just scared about my health and my life and my future.

Trauma

The good news is that they let me have the HSG today. The bad news is that it did not go well at all.

The short version is that I was in a lot of pain and they couldn’t get the dye to flow through either of my fallopian tubes.

The long version will have somewhat graphic detail. You’ve been warned.

I was super nervous and my hubby couldn’t be there. I was grateful that they let me do it today, though. Most of the other women having it done seemed to be there with their husbands or at least another person. I was jealous. They told me that since I was the last person to schedule for today that I would be going last, so I was prepared to wait.

They finally called me in and the woman whose job involved inserting the catheter (I honestly don’t remember her title other than that) was really nice and friendly. She chatted with me about the origins of our similar names while she was getting things started. I was expecting pain from the speculum, just as I get during any pelvic exam I’ve ever had and similar to what I sometimes get during sex. I was not really prepared for the pain from the catheter, but it wasn’t too bad at first. Then they lined me up to take the x-rays and started injecting the dye. The cramps were very painful, like the worst menstrual cramps I’ve ever had. And there was a problem immediately because the catheter somehow came unseated and the dye was flowing out of me instead of up into me. So they had to reset. This time they left the speculum in so that the catheter would stay in place. Fun!

I was already crying just when she first inserted the catheter so at this point I was just trying my level best just to keep it together. I don’t remember exactly the order of everything that happened next, it was all a blur. They tried again, this time when they inserted the dye the pain was unbearable at times. I was screaming in pain. I was crying, shaking, trying to hold still enough for them to take x-rays. And then they tell me that while my uterus looks great, the dye isn’t going into either tube. They had stopped injecting more dye because of my pain. They had me try turning side to side to see if that helped, but it didn’t. They asked if it was okay if they tried more dye. I said okay. It hurt. Still no flow in the tubes. I was a mess. They decided to end it, because they “don’t believe in torture here.”

The woman who injected the dye stayed with me, talked to me for a while, helped me get up. They told me that it might just be my uterus seizing (I think that’s the word they used) or there might be blockage. They told me that I’m probably going to have to go through it all again. They suggested I schedule my follow-up with the clinic before I leave. I did, but it’s not for almost another month.

On the positive side, every person in the room was really supportive and kind and took good care of me. I could not be more grateful for that. I don’t know what I would have done if they had been any different. My husband has been amazingly supportive and loving. I’m so lucky to have him.

On the negative side, I’m still getting cramps off and on tonight. And I’ve been crying off and on since the procedure.

I keep telling myself that next time I have this done it won’t be in the middle of an already incredibly stressful week and I’ll be able to take Ibuprofen beforehand. Because I don’t know how else I’ll be able to do this again.

In the meantime I’m terrified of what this all might mean. I told my mother-in-law that she was there with me in spirit reminding me to focus on my breath. I keep returning to that focus. Being present is the only thing getting me through right now. What ifs are not allowed.

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