Friday, April 28, 2006

A Breakthrough?

I smiled at a kid this morning. Granted it was at Starbucks and that always makes me happy, but I smiled at him all by myself. Now this past year...let me be honest...I glare at pregnant women and I sneer at children. I've become that fashionably dressed woman in her fitted clothes and high heels who obviously does not have children and by the looks of her doesn't want them, the one who acts annoyed by the screaming or running kid....but that's all it act.

I want so badly to pat them on the head, to smile knowingly to the pregnant woman, to laugh as the kid tells me an unintelligible story...but to open myself up to that opens me up to the pain of thinking that may never be me...

For whatever reason, this jealousy only applies to strangers...I'm finally able to rejoice when a friend is pregnant (although there is that initial pang of jealousy and a knot in my stomach when I see them start to show)...but thankfully, all of that goes out the window when the baby is here. Maybe it's because only she can enjoy the pregnancy, but I can enjoy the baby. There have however been 2 friends who's actual pregnancy did not bother me at all even from the initial announcement. One who's had 2 kids (which feel more like my niece and nephew!) and one who is halfway through her pregnancy right now (but who struggled through this with me....she gives me hope that this will happen for both of us...because that's how the story is supposed to end...).

What was I saying again? Oh yeah, so I smiled at a kid this morning...all by myself. He was just sitting there looking cute, and he just made me smile as I walked by. He smiled back, and then I saw that the mom had noticed this little exchange and she was smiling too...and it made me feel good. Not sad, not mad, not jealous...but peace.

Also this past weekend, I found out another friend (one who we don't see much anymore) is pregnant as well...and I didn't cry. Still haven't cried...haven't felt the need...

I think in therapy terms they would call this a breakthrough...I'm not quite sure where I've broken through to...but it's nice here...a little less bitterness, a little more tolerance, a lot more happiness. Maybe I'm finally learning to let go...and let it be.

Que sera, sera....for now.

Thursday, April 27, 2006

Not so bad day...

There's not a whole lot going on, but I discovered that today I feel pretty's that for optimism.

Who knows what's going on with this cycle! We're just waiting a few days to decide whether we induce a period with meds or I let it come on it's own...which means I'm trying to figure out if I've ovulated or not based on a couple of days of temperatures...LOL! Can you imagine? After 2 years, I for once, have no idea if I ovulated or not...actually, it's kind of nice...almost liberating! Maybe I'll try the Britney Spears get pregnant quick plan and get wasted for 5 days straight...

Anyway, I think the reason I'm in such a good mood is because I have a new furry niece!!!!

So we went to Dallas this past weekend for Patrick's volleyball tournament. On Saturday, I went to lunch with one of my friends. We were headed to Starbucks afterwards, and I see this big black dog. I immediately knew it was a Great Dane puppy and I had to go pet it. When I got closer, I realized it was a mobile adoption site, and she was VERY skinny. They estimated her to be 6months-1year old. They found her wandering the streets of Dallas, and she had been at the shelter for 1 month...with NO ONE interested. I was so upset. She was super sweet, great temperament, and she looked like she could have been Tristan and Skylar's sister. So we went to Starbucks...and I called Patrick...and he didn't say no. We both knew it wasn't a great decision, but he said that he knew we had to do something because big dogs like that just don't get adopted from shelters. We figured we could contact a rescue group and somehow get her to them or something. Anyway, I went back and got contact information and told them I'd call on Monday to leave my information so that they would call us before they decided to put her down or anything (we would just take her before we let that happen)...but we wanted to see if she would get adopted that weekend.

Sunday I went to lunch with my little brother who goes to school in Denton. Patrick had noticed they were doing mobile adoptions at the same location, but we were convinced there would be different dogs. Nope, she was there. Patrick decided he had time to meet us there, so my brother and I went to have lunch. I told my brother that I knew it wasn't the best idea, but that I couldn't leave her there. Out of nowhere, he says "I think I'll take her sis"...and then proceeds to say all the right things...he's graduating in August, he has a yard, he has a flexible schedule, he just started a part-time job so he'll have the money, he's wanted a dog for a while, and he really likes her. We went back and spent more time with her (while other people were also looking at her...this really rude guy that was trying to do obedience training with her and being a jackass, meanwhile she would sit and lay down for me with no problem...LOL!). That idiot guy sealed the deal for my brother and he started filling out paperwork.

She got spayed Monday, and my brother picked up my new furniece Chloe on Tuesday!!!!! I'll have to get him to take pictures!!!! So far she's doing great, and I'm equally happy for her and him....he really needed this.

Wednesday, April 19, 2006

Getting Back on the Bike

So I recovered from the D&C, went off to school in January, passed my comprehensive exam with flying colors, and came back to real life. I actually went on the pill for the month of January...only to discover that it makes me a real bitch, so I went right back off of it in February. I had a random day of fertile stuff in February, so we went for it, but my period came on big deal.

During Feb 2006, we got the results of our testing. They had tested the last miscarriage....46XX...a perfect girl. This was good news since it proved that we were capable of producing genetically normal offspring. But the reality of it hit me, and I still hurt when I see little girls with dark brown wavy hair and big brown eyes...what would she have looked like?

Anyway, my thrombophilia panel came back as well. I'm a compound heterozygote for MTHFR. Could that have caused my miscarriages? Maybe. Regardless, it seemed to indicate that I needed more medication...mostly holistic. So now I take 9 pills a day...I hate taking pills.

March 2006, we decided to try again. Our plan: go in for a mid-cycle u/s, and if my uterine lining is good and there's a nice big follicle, we'll trigger (like what we did in September 2005). All went well, even though my progesterone was not as high as I would have liked at 7dpo (14.7). But no luck...I had a rough time with it. I know it was our first cycle back trying, but the weight of 2 years was getting to me. We talked about taking a break, but in the end, decided that it was best to keep trying.

April 2006, I was ready to go. And then my mid-cycle u/s sent that plan to hell. Even after getting a positive ovulation kit on day 14 (which has NEVER happened...the earliest I ever ovulated on my own was day 21), the u/s that afternoon showed NO dominant follicle and a crappy lining. I was nowhere near ovulating...

It sucks...a lot. So we're on a break of sorts (do you think GOd decided to make the decision for me?). When May comes, we'll decide whether I'll let this cycle play out or go get provera to induce my period. Next cycle, we'll do another mid-cycle u/s to see if a trigger is worth it. Just taking it day by day at this point I guess.

A New, just the same old crap

So after recovering from surgery, we were at it again! At my follow-up just before Labor Day weekend (early September 2005), the ultrasound showed a follicle that was ready to go. So that weekend I gave myself my first shot in the stomach (the hcg trigger), and we were off. Two weeks later, I had a beta....I already knew what it would be. I was still taking my temperature and had reached my "pregnancy temperature". It was positive...hcg was 113, progesterone was like 29 or something. Then 2 days later, I had another beta run at our was down to 67. This was in the midst of preparation for Hurricane Rita. Dr. Mac's office was already closed to prepare for the storm, but I knew there was nothing they could do. I went to the store to buy more pregnancy tests so that I could watch them turn negative...and know when to expect the bleeding. The hurricane passed through Friday night, and I started bleeding Sunday morning.

We couldn't do any drugs the next cycle, but we were told there was no harm in trying naturally. I ovulated late (cycle day 26), and I was pretty sure that I wasn't pregnant. Then the calendar finally showed the date I had been dreading for months....October 31....the twins were due on Halloween. So that morning (at 12 days past ovulation), I decided to take a pregnancy test. My intention was that I would get a negative, spend the day in mourning for the twins, and not feel guilty about the mango margaritas I intended to drink at my neighbors that evening....but the damn thing was positive.

The first words out of my mouth (as Patrick ironed and I brushed my teeth)..."You've got to be kidding me". Patrick thought he was in trouble for something...and then I showed him. Neither of us knew what to do. I remember sitting at the top of the stairs in shock asking what we should do now. We agreed to wait a couple of days before going to the dr. for a beta. Meanwhile, the tests kept getting darker. The next couple of weeks were textbook: hcg levels kept rising. I did end up having to be on progesterone suppositories (oh joy), but it was no big deal. My 5w ultrasound showed a perfectly measuring gestational sac with a yolk sac. My 6w ultrasound showed a perfectly measuring embryo...with a heartbeat. We actually got to hear the heartbeat and of course, I started crying as usual. Everything was going perfectly. We told the family...and everyone was so excited...everyone thought it was a miracle and a sign that I'd gotten the positive test on the twin's due date. But apparently it wasn't my turn for a miracle...

About 2 days before my 8w ultrasound (late November 2005) I started to have strange feelings. My boobs hurt a little less, something didn't feel right. I tried to shake it off as nerves, but in all honesty, I knew (AGAIN) that something was wrong. The u/s showed that she had stopped growing at 6.5w and there was no heartbeat. I don't even think I cried the first few minutes. I remember looking over and seeing this horrible look on Patrick's he wanted to throw something. Then I just started asking lots of questions (did the septum grow back, can we see where the problem was, does it look like I will miscarry naturally). I finally cried when everyone left the room...and I proclaimed that I didn't want to do this anymore...that I couldn't do this anymore. We also decided that it was best for me to miscarry could take weeks.

So 2 weeks later (mid December 2005), nothing was happening. My beta had actually gone up (94,000), so I went in for another u/s. Everything was still in there. After much discussion, we decided to try to induce the miscarriage with Cytotec. We got movies, firewood, dinner...and I started the pills. They gave my Vicodin as well since it was supposed to be very painful. There was bleeding, there was pain, but neither was as much as I had expected...and I had a sneaking suspicion that it wasn't over. Beta dropped, but not as much as they would have liked. One last u/s on Dec. 22 showed that everything was STILL on December 23, I had a D&C....

Merry freaking Christmas....

Tuesday, April 18, 2006

The Twins

It's eerie even writing seems like a lifetime ago...but it was just over a year...

We found out I was pregnant one weekend in mid-February 2005. We couldn’t believe it, we were floating in the clouds for a week since we'd been trying for a year at this point. That next weekend, we told my parents and my grandmother…gosh how they needed some good news because we were all still grieving so hard for my grandfather (we had lost him just before New Year's). Then that Monday, something happened…I can’t explain it, but I was just filled with this overwhelming feeling that something was wrong. I had some minor cramps, and my mom convinced me to call the dr. Wednesday (March 2) we went into the dr. Patrick wasn’t going to go (they were supposed to just be checking me for a bladder infection), but he surprised me and was there at the office when I got there. My dr. did a quick ultrasound, and I could tell she was worried. She saw no pregnancy sac in the uterus. She said it could depend on my levels, they would need to be over 2000 to see something on ultrasound. I asked her about the chances of everything being fine, her response “It’s possible”. She asked if I was going to be home alone that day, and I said no, Patrick would be with me…but I knew the fact that she had asked wasn’t a good sign. They drew my blood, and we left. Patrick and I drove home in separate cars, and I was crying so hard I could barely see the road. I remember my dad calling me on the way. Patrick had called mom, mom had called dad, and he had called (he’s better with these things than mom). He said some wonderful things, and it helped to calm me down.

Patrick and I sat at home for a couple of hours, he was doing research on ectopics and I was staring at the TV not really knowing what to do. Then at 2pm, we got a phone call. It was the nurse wanting to know where I was and how fast I could get to the hospital. My levels had come back at 3500, and they needed to do an emergency ultrasound to see what was going on. After all was said and done, the radiologist said “I don’t see a pregnancy in the uterus, but I do see one in the left tube. I’m sorry.” The rest of the night was kind of a blur. I’ve never seen Patrick so upset and worried. We were told to go to a treatment room, and before I knew it they were taking blood, asking me to change, putting more armbands on me, I didn’t understand what was happening. And then they told me I was being admitted. They didn’t want to take the chance of me rupturing the tube at home, and I had eaten that day so they wanted to wait to do the surgery the next morning. My dr. came and talked to us. She was as upset as we were. She said that they had to get it out…if they didn’t, I could die. It was that simple.

By the time I was settled in my room and had almost run out of tears, my mom was there. It gave Patrick a chance to take care of things at home…and to deal with his feelings. Later I would find out that when he had gone outside to call my mom about the surgery, he had lost it and was crying with her. Mom and Patrick went through a lot together those few days. The next morning I had laparoscopic surgery. We didn’t really know what they would need to do: excise it from the tube, take out the whole tube, even take my uterus. The incision could be the three small incisions that are common in lap surgery or it would be the type of incision they do for a C-section.

When I got back to my room, Mom and Patrick both looked pretty happy given the circumstances and they told me what had happened. I only needed the three small incisions. My tube was saved, and while they were in there, they found something else. I have endometriosis. We had no idea. It was pretty mild. Stage I maybe Stage II, but while they were in there, they got rid of it. In essence, I came out of the surgery more fertile than when I went in. I felt good, and except for the puking spell from the morphine, it wasn’t so bad. The next few days were annoying because I needed help going everywhere and doing anything, but all in all I felt lucky.

This is where the story changes. ….there is no happy ending.

One week later, we went for my follow up. The dr. said I was healing great, and that we would just need to monitor my levels. On the way to work the next morning, I got a phone call. It was my dr. They were very worried, my levels had not gone down, they had doubled (somewhere around 7000). They thought something was left in the tube and that it could be getting big enough to rupture. I was to go home, get Patrick (luckily he was on Spring Break), not eat or drink anything else, and head back to the hospital for an emergency ultrasound… again. I packed my bag at home, and we were fully expecting that I would be back in surgery having my tube removed by the end of the day. Once in the ultrasound room, the tech was really sweet. Then she says, “Well, I can’t say anything until the radiologist comes in, but I can tell you that it’s better than last time.” Patrick and I didn’t know what to think. Then my dr. comes barging in, and in the middle of saying hi to all of us, she looks at the screen and blurts out, “Is that a pregnancy in the uterus?” The tech smiles and says yes. My dr. is freaking out she’s so excited, punching Patrick in the arm even, Patrick is standing there stunned, and as usual, I’m bawling uncontrollably. The radiologist comes in and confirms that there is a gestational sac with a yolk sac. When I ask how it’s measuring, she says 5.5 weeks. I immediately start to panic. I should be 6.5 weeks. No one else seems concerned….but I know again, something just isn’t right. But everyone else is just saying what a miracle it is...a heterotopic pregnancy (one in the tube, one in the uterus)...a 1 in 40,000 chance...

Over the next week, my parents, the dr, Patrick, everyone tells me not to worry about my chart, that things just happen sometimes, that this isn’t an exact science. But I look at my chart, I see when I ovulated, I see the last time we had sex, and I see when I got my positive test…and I know…something isn’t right.

One week later, we went for another ultrasound. There we saw a pregnancy sac, a yolk sac, and an embryo with a heartbeat. But when I asked what it measured, they said 6.5 weeks…I should have been 7.5 weeks. Again, everyone said this was good progress, and not to worry about it. We were sent home with our first ultrasound pictures. So I stopped worrying about it, but in the back of my mind, I couldn’t help feeling that something was still wrong. Over Easter weekend, that feeling got stronger. My mom would talk about someone else that was pregnant or complain about wanting to tell people, and I would snap at her. My grandma would ask about names, and I would tell her I didn’t want to talk about it. Patrick tried several times to rub my stomach, and I would pull away instinctively...something wasn’t right.

On Tuesday (March 29), I woke up to a tiny bit of light spotting. I freaked out. Called Patrick. He called the dr. and met me at the office. We went through all the motions of a first prenatal visit, but all I could concentrate on was the ultrasound…I needed to know. I could tell from my dr.’s expression that it wasn’t good. Based on her measurements, the baby was a little over 6.5 weeks, meaning it had stopped developing shortly after the last ultrasound. I should have been 9.5 weeks. There was no heartbeat. I needed to go to the hospital for my third emergency ultrasound in a month to have it confirmed….but we knew what had happened. The ultrasound at the hospital confirmed it. It’s called a missed miscarriage. Patrick called my family and told them, and let them know that I wasn’t ready to talk to anyone. Apparently Mom left Dad a message that he couldn’t understand, so he ended up calling me while I drove home. Again, he said all the right things…instead of the consoling things he said the first time, this time he was angry. He was flat out mad, and I appreciated that so much. I didn’t need to hear that “God has a reason” or “It wasn’t meant to be”. I needed to hear him rant about how some women do drugs and have a baby and here I was not even eating peanuts or drinking Coke.
The dr. called the next morning and gave me my options: wait for it to happen naturally or do a D&C. The natural miscarriage could take weeks, and could lead to a D&C anyway, so she chose to do the D&C for both my physical and emotional well-being. Thursday morning (March 31), we were back at the hospital. The D&C was pretty easy compared to the previous surgery. I felt good enough to eat Freebird’s that night, so it really wasn’t so bad. I was out shopping by the weekend, and back at work that Monday.
In the recovery room after the surgery, they drew my levels. I found out at my appt that week that they were 29,000. The numbers were good, we’re not sure what happened. But both my dr. and I ran across the same statistics in the medical journals. In heterotopic pregnancies, the uterine pregnancy has a 50% chance of miscarriage.
Two months later we found out the real reason for the miscarriage. One of the radiologists had mentioned that she saw evidence of a uterine septum on the ultrasounds. An HSG in May 2005 confirmed it. In July 2005, I had laparaoscopic and hysteroscopic surgery to remove (resect) the septum and they also removed more endometriosis. We hoped that the septum was the cause of all of the problems (the endo, the ectopic, the miscarriage), but my journey wasn't over yet....

From the beginning....

OK, where to start...I guess it's time to tell the sad story. It really is one, too. A few months ago, I read through my medical records as I was changing doctors (going from an ob/gyn to a reproductive endocrinologist), and I seriously thought to myself...this is the saddest story I've ever read. If I'd only known it would get more depressing...

But I digress....

How about the short version for now and when the mood strikes I will elaborate on the various "incidents".

We've been trying to conceive (hereon referred to as TTC) since February 2004. I have long cycles...which sucks. So eventually they put me on Clomid (a fertility drug in pill form), and one the third cycle, I got pregnant in February of 2005. Turns out the pregnancy was ectopic (in the tubes) After surgery and the discovery of mild endometriosis, my tube was saved and we went on our merry way. Only to find out a week later there was a second embryo in the uterus...and then discover that one had miscarried as well at 9.5 weeks (stopped growing at 6.5 weeks). They would have been twins...

So then we found out I have a uterine septum...great big piece of nonvascularized tissue dividing my uterus in half...BIG problem, definitely caused the ectopic and the miscarriage. I had it removed in July 2005.

Our first try after surgery, I was pregnant again....but miscarried a few days later in the middle of Hurricane Rita (Sept 2005). The very next cycle, we threw caution to the wind and tried again...and got pregnant again. Everything was textbook...until we got to our 8w ultrasound only to find out that she stopped growing at 6.5 weeks and her heart wasn't beating anymore (November 2005).

Chromosome testing was normal...she was a perfect 46XX. My thrombophilia panel showed that I'm an MTHFR compound heterozygote though. It may or may not have caused this last miscarriage. So now we're trying again on a new medication regimen per Dr. Mac (my fertility specialist's) recommendation, we're combining medication with a holistic approach!*Prenatal vitamin*Extra 3mg folic acid*Metformin 500mg*Baby aspirin*L-arginine*Garlic*Grape seed extract

We shall see where we go from here....

That Girl....

So here's the poem that made me decide to start writing all this crap out....inspired by a girl who was drawing my blood who wished me "good luck" and gave me a pitiful look...and I realized I was "that girl"....

I’m “that girl”….
…the one everyone whispers about,
…the one everyone feels sorry for,
…the one everyone feels inclined to tell “If it’s meant to be, it will happen.”

I’m “that girl”…
…the one whose friends with kids don’t know what to say anymore,
…the one whose family has stopped mentioning kids,
…the one who looks at the overstressed mother with 3 kids with envy.

I’m “that girl”…
…the one who is the real-life anecdotal story of “infertility”,
…the one who is the medical mystery that doctors love to treat,
…the one who knows all the REs staff members by their first name.

I’m “that girl”…
…the one no one wants to be,
…the one everyone is afraid they will be,
…the one we wish nobody had to be.

I’m “that girl”….
But that’s not all I am…

I’m also…
…the one who chooses to talk about this instead of hide behind the pain,
…the one who is not afraid to say the word miscarriage in public,
…the one who is not afraid of what people think of her anymore.

I’m also…
…the one who realizes she is married to the most amazing man in the world,
…the one who has found true friendship through these struggles,
…the one who gets out of bed every morning when she has every reason not to.

I’m also…
…the one who will not give up,
…the one who is not finished with this battle,
…the one who IS strong enough to do this.