It occurred to me recently that I am approaching this pregnancy a little (okay, a lot) differently than I would have if I'd gotten pregnant quickly and much younger. The biggest difference is that I am definitely not afraid to look for ways to make my pre-baby life easier / more relaxed!
Acupuncture
As I think I mentioned before, I think a fair number of women who face infertility eventually consider / partake in acupuncture. I started it several years ago as something--anything--to help with our infertility and ended up really loving it. I still go at least once a month now to prepare my body / mind for labor.
Prenatal Yoga
In an attempt to de-stress during our struggles with infertility, I decided to try yoga. Again, it ended up being something I absolutely love. So no surprise I switched to prenatal yoga once I got pregnant. And, again, I absolutely love it. I go at least three times a week and I love the community of pregnant women. It's a huge resource of positive energy for my pregnancy.
Doula
This is not an "activity" like some of the other things, but my prenatal yoga classes exposed me to the concept of a birth doula and we decided to utilize one. The idea that someone very calm, rational, and experienced is going to be by my side is very comforting. They (we hired two women who work together) have already provided us with a ton of information and comfort. We're even hoping--with their help--to achieve a natural birth! (More on that later.)
Chiropractor
I know some pregnant women have back issues and start seeing chiropractors. Well, I'm in my third trimester and the back is starting to ache. So yes, I went to a chiropractor. Not sure what I think about it so far, but she assures me that regular alignments can help women have shorter childbirths. We will see....
Therapeutic Massage
Massages are not something I ever really got into. But I read that they are a good idea prior to labor, as a relaxed soon-to-be-mom has an easier time in labor. And with the aching back (and, frankly, work stress), massages seem like a really good idea. I chose to go to a specialist with pregnancy pillows and special bench (so I can actually sorta lay on my front) and the massage was heavenly. Definitely going to be part of my routine until labor... and maybe beyond.
Pilates
Relatively soon after my diagnosis of diastasis recti, I found a pilates instructor who has knowledge of the condition and booked myself some private appointments. Most of the work on this front will happen after baby's arrival, but she showed me some exercises that can help now. No tummy tuck for me.
I also have a shit load of books on pregnancy, labor, baby, etc. And I have been reading them obsessively. (I haven't done any pleasure reading in months--very unlike me!) I love having information, so the different books have been very comforting--even if some of the information in them is quite terrifying! But the books have given me a lot of good ideas about ways to help me relax, to make my labor easier, and to prepare me to be the best mom I can be.
I don't think I would have engaged any of these amazing women to help me if I hadn't had trouble getting pregnant. And I sincerely doubt I would have 10+ pregnancy / labor / baby books on my nightstand. So while I'm certainly not glad that we had so much trouble, I am happy that I'm taking advantage of my increased knowledge, maturity, and, frankly, money, to make my pregnancy and labor the best they can be! Not sure how much this will spill over to me being a better mom, but it can't make me worse (right?!).
Sunday, November 20, 2011
Monday, November 14, 2011
Third Trimester
Just hit the third trimester. It feels good!
Things are going great. I love being pregnant. I think I'm much more appreciative of the whole pregnancy process because of all we had to go through to get here. Not that I'm saying I'm glad we went through everything we went through... but it feels good to be here now.
Baby is great--bouncing all over the place. We cannot wait to meet him... once he's fully cooked in about 11 weeks!
Nothing much to report. My weight gain has been strong and steady. I thought I was going to be a low weight gainer because I eat healthy and exercise moderately, but not so much. I'll be 29 weeks tomorrow and I've gained over 20 lbs. Funny enough, it's still mostly just in the tummy (and a little bit in the hips). Because I was a healthy weight when I got pregnant, my target weight gain is 25-35 lbs. I'll probably be pushing the upper limit. But my belly is measuring perfectly, so nothing to worry about. I plan to breastfeed, so hopefully the pounds will just melt off.
So far only one downer--I have diastasis recti. (Separation of the ab muscles.) I guess it's relatively common, but it's still awfully disturbing to get out of bed and see what appears to be a roll of cookie dough bulging under your skin from your belly button to your chest. (Okay, it's not cookie dough--it's my organs trying to make their great escape. Not sure that's any better.) Once baby is born, I'm going to have to work pretty hard to get into pre-pregnancy shape. Oh well, I'll cross that bridge when I come to it!
Other than that, things are good. We're getting excited for baby's arrival. We're getting the nursery together and just ordered our baby furniture. We've done all of our research on all of our baby products. I've been reading tons of books on babies and sleep schedules and other things. And I've already started planning out what I want to carry with me to the hospital.
Also, hubby and I have gotten mildly obsessed with the actual birth process. I never thought I would be a natural birth fanatic, but... well, I think we're getting there. We hired a doula, have done tons of research on different hospitals in the area, are thinking about delivering with a midwife, and have a pretty detailed birth plan worked out. I'm scared for the labor but my excitement about finally being a mom will hopefully overrule any nerves on the big day.
Bring on the baby!
Things are going great. I love being pregnant. I think I'm much more appreciative of the whole pregnancy process because of all we had to go through to get here. Not that I'm saying I'm glad we went through everything we went through... but it feels good to be here now.
Baby is great--bouncing all over the place. We cannot wait to meet him... once he's fully cooked in about 11 weeks!
Nothing much to report. My weight gain has been strong and steady. I thought I was going to be a low weight gainer because I eat healthy and exercise moderately, but not so much. I'll be 29 weeks tomorrow and I've gained over 20 lbs. Funny enough, it's still mostly just in the tummy (and a little bit in the hips). Because I was a healthy weight when I got pregnant, my target weight gain is 25-35 lbs. I'll probably be pushing the upper limit. But my belly is measuring perfectly, so nothing to worry about. I plan to breastfeed, so hopefully the pounds will just melt off.
So far only one downer--I have diastasis recti. (Separation of the ab muscles.) I guess it's relatively common, but it's still awfully disturbing to get out of bed and see what appears to be a roll of cookie dough bulging under your skin from your belly button to your chest. (Okay, it's not cookie dough--it's my organs trying to make their great escape. Not sure that's any better.) Once baby is born, I'm going to have to work pretty hard to get into pre-pregnancy shape. Oh well, I'll cross that bridge when I come to it!
Other than that, things are good. We're getting excited for baby's arrival. We're getting the nursery together and just ordered our baby furniture. We've done all of our research on all of our baby products. I've been reading tons of books on babies and sleep schedules and other things. And I've already started planning out what I want to carry with me to the hospital.
Also, hubby and I have gotten mildly obsessed with the actual birth process. I never thought I would be a natural birth fanatic, but... well, I think we're getting there. We hired a doula, have done tons of research on different hospitals in the area, are thinking about delivering with a midwife, and have a pretty detailed birth plan worked out. I'm scared for the labor but my excitement about finally being a mom will hopefully overrule any nerves on the big day.
Bring on the baby!
Friday, September 16, 2011
Half way!!
Twenty week appointment today! Things are going really welly. Baby looks fantastic. We got the confirmation--it's a boy!
My tummy is still small, but I'm definitely pregnant. (Strangely, more on the right than the left. I think I might end up with a belly button that's half innie half outie!) I'm really lucky because my placenta is in the back, so there's not much between my tummy and baby. That means I will be able to feel all the little kicks etc. that much easier. Just two weeks ago I felt the first flutters and since then... I feel little nudges and rolls all the time! In the last few days both hubby and I have felt baby move just by putting our hands on my tummy. AND one time I actually saw a little movement!
So exciting!!!
It's hard to believe we had to go through so much to get to this point. Much like I've heard people forget about how painful labor is, I'm starting to forget all of the stress and anxiety of the last few years. Not that I'm a blissfully ignorant pregnant lady... but I'm allowing myself to feel pretty optimistic!
Half way--go baby!
My tummy is still small, but I'm definitely pregnant. (Strangely, more on the right than the left. I think I might end up with a belly button that's half innie half outie!) I'm really lucky because my placenta is in the back, so there's not much between my tummy and baby. That means I will be able to feel all the little kicks etc. that much easier. Just two weeks ago I felt the first flutters and since then... I feel little nudges and rolls all the time! In the last few days both hubby and I have felt baby move just by putting our hands on my tummy. AND one time I actually saw a little movement!
So exciting!!!
It's hard to believe we had to go through so much to get to this point. Much like I've heard people forget about how painful labor is, I'm starting to forget all of the stress and anxiety of the last few years. Not that I'm a blissfully ignorant pregnant lady... but I'm allowing myself to feel pretty optimistic!
Half way--go baby!
Wednesday, August 3, 2011
No more weekly baby pictures
I had my last appointment with the high risk OB last week--it was mostly to do my genetic counseling / testing but also to take one last peek before classifying me as "cured." It went well. Doc was basically like, "why are we tormenting you--go home and be normal." Yay! I was like, "does this mean I can swim, walk, ride a bike, do yoga, have sex, etc.?" He says, "yes, but maybe not all at the same time."
Ha!
My anxiousness did not, however, evaporate. After the genetic testing I spent HOURS reading about results and next steps. I guess I'm just that crazy anxious pregnant lady.
Anyway, results came back. 1/1500 chance of Downs. (Good.) And one in 1/10,000 chance of trisomy 18. (Great.) I think (but don't quote me) that my 13w5d measuring fetus had a 1.8mm nuchal fold measurement. So that's fine. My blood work was good, baby looked good, etc. For my age (33 when I deliver) I can't really ask for much more. I did opt for the second round of blood tests in week 16 for additional certainty.
I think this is the longest I've gone without checking in on baby in over a month. I'm going to take my slightly rounded belly as a sign things are still going well and try... really try!... to calm down, especially now that I am into my second trimester!
Ha!
My anxiousness did not, however, evaporate. After the genetic testing I spent HOURS reading about results and next steps. I guess I'm just that crazy anxious pregnant lady.
Anyway, results came back. 1/1500 chance of Downs. (Good.) And one in 1/10,000 chance of trisomy 18. (Great.) I think (but don't quote me) that my 13w5d measuring fetus had a 1.8mm nuchal fold measurement. So that's fine. My blood work was good, baby looked good, etc. For my age (33 when I deliver) I can't really ask for much more. I did opt for the second round of blood tests in week 16 for additional certainty.
I think this is the longest I've gone without checking in on baby in over a month. I'm going to take my slightly rounded belly as a sign things are still going well and try... really try!... to calm down, especially now that I am into my second trimester!
Friday, July 22, 2011
Cured! For reals!!!
I. Am. Speechless. Went to the high-risk OB yesterday for a follow-up on my issue. Ultrasound tech was so nice. (I like the tummy ultrasounds MUCH better than the vaginal ones, although my husband correctly complains that the picture quality is not as good.) Ultrasound tech was like your baby is perfection. It has a strong nose (unlikely to have Downs), very little fluid behind the neck (unlikely to have other diagnosable cognitive issues), fluid in the tummy (also good), two symmetrical brain halves, etc., etc. And it's moving all around and growing ahead of schedule--two things babies with restricted oxygen / blood do not do.
AND he couldn't even find anything wrong with me. He looked all over but could not find any abnormality at all. What!?! Shut the front door! The doc came in and confirmed--my uterus / placenta is perfection.
The bleed (or whatever) appears to have resolved. [Let's not discuss how this would never even have been diagnosed if I'd been a normal person having my first appointment this week.] So it probably was just a simple subchorionic hematoma / hemorrhage or whatever and, as all the docs I saw hoped, eventually resolved. (Although last week the high-risk OB I saw said he expected it would take 3-6 weeks to resolve, not 1 week!) Not sure WHAT is up with the wonky vascular system, but who cares?!
The high-risk OB was like, there is literally nothing wrong with you, get out of here and start seeing a regular OB. I've never been so excited to get kicked out of something in my whole life! Although I do have ONE more appointment there next week (to do the full first trimester screen for potential issues) so they're keeping my activity light until then (no exercise, sex, etc.), although I was okay'd to walk around. Walking?! What a treat!
Oh, and did I mention that the ultrasound tech made a prediction on gender? (Certainly not a sure thing at 12 weeks and 2 days, although he seemed pretty confident even though he warned me not to paint any rooms just yet.) It's a... secret for now!
U.S.A.! U.S.A.!
AND he couldn't even find anything wrong with me. He looked all over but could not find any abnormality at all. What!?! Shut the front door! The doc came in and confirmed--my uterus / placenta is perfection.
The bleed (or whatever) appears to have resolved. [Let's not discuss how this would never even have been diagnosed if I'd been a normal person having my first appointment this week.] So it probably was just a simple subchorionic hematoma / hemorrhage or whatever and, as all the docs I saw hoped, eventually resolved. (Although last week the high-risk OB I saw said he expected it would take 3-6 weeks to resolve, not 1 week!) Not sure WHAT is up with the wonky vascular system, but who cares?!
The high-risk OB was like, there is literally nothing wrong with you, get out of here and start seeing a regular OB. I've never been so excited to get kicked out of something in my whole life! Although I do have ONE more appointment there next week (to do the full first trimester screen for potential issues) so they're keeping my activity light until then (no exercise, sex, etc.), although I was okay'd to walk around. Walking?! What a treat!
Oh, and did I mention that the ultrasound tech made a prediction on gender? (Certainly not a sure thing at 12 weeks and 2 days, although he seemed pretty confident even though he warned me not to paint any rooms just yet.) It's a... secret for now!
U.S.A.! U.S.A.!
Tuesday, July 19, 2011
No news is good news!
Not much to report today... except I'm 12 weeks pregnant! Big (arbitrary) milestone. I'd be feeling pretty good if not for all the medical issues that continue to plague me.
My fertility doc officially transferred my care to the high risk OB. I think I was my fertility doc's longest running post-pregnancy patient! But I wanted to make sure I had the screening testing that takes place between 11 and 13 weeks, so I really needed a full-time OB. And the high risk OB's office refused to see me beyond my specific referral for a second opinion unless I was transferred to them. So it was time.
I'm going to miss my fertility doc. I've gotten attached to him. And I am NOT excited to start going to a new doctor that I've only met one time. (And I'm doubly not excited to go to an office that is impossible to make appointments at. Oi!) I want to switch back to my regular OB (who knows me really well, helping me with my ectopic pregnancy and miscarriage, etc.) as soon as possible.
Oh, one other good piece of news--I'm FINALLY off of the progesterone! Not sure how long "normal" patients are on it, but I got the impression I was on it a little longer than normal. Anyway, I am now--for the first time in MONTHS--taking no meds. Yay!!!
So next up is check-in appointment with the high risk OB this week to check the bleed (?). Next week I have a "new patient" appointment and genetic counseling. Good times.
My fertility doc officially transferred my care to the high risk OB. I think I was my fertility doc's longest running post-pregnancy patient! But I wanted to make sure I had the screening testing that takes place between 11 and 13 weeks, so I really needed a full-time OB. And the high risk OB's office refused to see me beyond my specific referral for a second opinion unless I was transferred to them. So it was time.
I'm going to miss my fertility doc. I've gotten attached to him. And I am NOT excited to start going to a new doctor that I've only met one time. (And I'm doubly not excited to go to an office that is impossible to make appointments at. Oi!) I want to switch back to my regular OB (who knows me really well, helping me with my ectopic pregnancy and miscarriage, etc.) as soon as possible.
Oh, one other good piece of news--I'm FINALLY off of the progesterone! Not sure how long "normal" patients are on it, but I got the impression I was on it a little longer than normal. Anyway, I am now--for the first time in MONTHS--taking no meds. Yay!!!
So next up is check-in appointment with the high risk OB this week to check the bleed (?). Next week I have a "new patient" appointment and genetic counseling. Good times.
Wednesday, July 13, 2011
Maybe it's a subchorionic hematoma after all
Saw the high risk OB today. I had my first "tummy" ultrasound today. The ultrasound tech was super nice. She was so excited when the ultrasound started and baby was standing on his/her head. (Baby slid down on its side soon after the ultrasound started.)
After she was done with ultrasound, she went and talked to doc, and then he came and talked to me. He asked me what my fertility doc thought and I told him that the fertility doc had not seen anything like it before. He seemed surprised. He looked at the pictures and films she took and said he thought it was a past bleed. (He did not use the words subchorionic hematoma in our appointment, but that's what he wrote on my form.)
What? I thought we ruled that out weeks ago, right?
Well, high risk OB said he thought I just have a wonky vascular system (which is where the strange pumping blood in my uterus is coming from) and, totally unrelated from that, I had a bleed (which is what caused the lake). He pointed out that it had shrunk from the last time I had an ultrasound. He said it was good that baby was measuring slightly ahead of schedule--it suggests that blood is getting to the baby. He gave me the same diagnosis that the fertility doc gave me when he originally thought it was a subchorionic hematoma--no activity, no sex, hope it shrinks. But he wants to see me next week just to be sure.
I was so excited I was speechless.
When I was leaving, I overheard him talking to the ultrasound tech about me. She asked him something and he said, "pray that it gets smaller." She said, "what if it doesn't?" He responded, "pray harder."
A little cryptic, but I was still excited for a diagnosis and the first good news I'd gotten in a while. I actually allowed myself to get excited for the first time that this pregnancy might last. I'm 11 weeks and 1 day, less than 1 week to 12 weeks!
But later I started thinking about it... and I saw what he wrote on my form... how can it be a subchorionic hematoma? That's generally a past bleed, not an active bleed. Over the course of almost two weeks my fertility doc monitored the bleed, and it was pulsing with my heartbeat. That's not a past bleed. That's connected to my vascular system. The high risk OB did not watch the ultrasound, he just looked at the pictures and videos. Is it possible the high risk OB just missed what the fertility doc saw--namely an active bleed? That seems impossible, considering my fertility doc sent all of his notes along.
Also, I'm not bleeding. I have not had a single spot of blood. If it was a past open bleed, wouldn't blood come out? Again, fertility doc thought all blood was still in my vascular system. But high risk OB thinks that the blood is leaving my vascular system, even though it's not coming out of me.
On the other hand, for the first time in two weeks it's shrinking, which IS good.
I wish I could have articulated why fertility doc ruled out subchorionic hematoma (also known as a blood clot or chorion), but I did not realize that was the actual diagnosis until I left. (That's what doc wrote on the patient form.) I was just so excited for good news. Also, I'm not a f-ing doctor!!!
Let's be clear, a subchorionic hematoma is NOT a good thing to have. It can cause a miscarriage. It also means you're at a greater risk for placental abruption. But I was excited for that diagnosis because the outlook is generally good--most people end up delivering healthy babies.
I'm so confused. Which diagnosis is correct? What the hell is wrong with me?!?
After she was done with ultrasound, she went and talked to doc, and then he came and talked to me. He asked me what my fertility doc thought and I told him that the fertility doc had not seen anything like it before. He seemed surprised. He looked at the pictures and films she took and said he thought it was a past bleed. (He did not use the words subchorionic hematoma in our appointment, but that's what he wrote on my form.)
What? I thought we ruled that out weeks ago, right?
Well, high risk OB said he thought I just have a wonky vascular system (which is where the strange pumping blood in my uterus is coming from) and, totally unrelated from that, I had a bleed (which is what caused the lake). He pointed out that it had shrunk from the last time I had an ultrasound. He said it was good that baby was measuring slightly ahead of schedule--it suggests that blood is getting to the baby. He gave me the same diagnosis that the fertility doc gave me when he originally thought it was a subchorionic hematoma--no activity, no sex, hope it shrinks. But he wants to see me next week just to be sure.
I was so excited I was speechless.
When I was leaving, I overheard him talking to the ultrasound tech about me. She asked him something and he said, "pray that it gets smaller." She said, "what if it doesn't?" He responded, "pray harder."
A little cryptic, but I was still excited for a diagnosis and the first good news I'd gotten in a while. I actually allowed myself to get excited for the first time that this pregnancy might last. I'm 11 weeks and 1 day, less than 1 week to 12 weeks!
But later I started thinking about it... and I saw what he wrote on my form... how can it be a subchorionic hematoma? That's generally a past bleed, not an active bleed. Over the course of almost two weeks my fertility doc monitored the bleed, and it was pulsing with my heartbeat. That's not a past bleed. That's connected to my vascular system. The high risk OB did not watch the ultrasound, he just looked at the pictures and videos. Is it possible the high risk OB just missed what the fertility doc saw--namely an active bleed? That seems impossible, considering my fertility doc sent all of his notes along.
Also, I'm not bleeding. I have not had a single spot of blood. If it was a past open bleed, wouldn't blood come out? Again, fertility doc thought all blood was still in my vascular system. But high risk OB thinks that the blood is leaving my vascular system, even though it's not coming out of me.
On the other hand, for the first time in two weeks it's shrinking, which IS good.
I wish I could have articulated why fertility doc ruled out subchorionic hematoma (also known as a blood clot or chorion), but I did not realize that was the actual diagnosis until I left. (That's what doc wrote on the patient form.) I was just so excited for good news. Also, I'm not a f-ing doctor!!!
Let's be clear, a subchorionic hematoma is NOT a good thing to have. It can cause a miscarriage. It also means you're at a greater risk for placental abruption. But I was excited for that diagnosis because the outlook is generally good--most people end up delivering healthy babies.
I'm so confused. Which diagnosis is correct? What the hell is wrong with me?!?
Thursday, July 7, 2011
Arteriovenous malformation? Why not!
Yet another doc appointment. Doc doesn't think I have pseudoaneurysm like the ones terrifying me in medical articles. Among other reasons, he pointed out those generally dealt with arteries external to the uterus (ones that could have been affected by trauma) instead of internal ones. He said my issue is inside the uterus--outside of the placenta. He thinks it could be congenital like an arteriovenous malformation. (Also rare. I've decided NOT to spend this weekend reading about them... maybe....)
We looked at it again--the blood rushing through it is definitely from me, not baby.
Doc said he did not think it appeared like it was at an immediate risk of rupture (and again suggested it might never rupture and instead be squeezed by baby), but still wants me to keep activity light. I can go back to work (desk job), but no exercise, cleaning, etc. He also referred me to a high risk OB for a second opinion / further consult. Awesome!
I left the appointment about as upbeat as I've been since I started this whole process.
Oh, and baby looks fantastic.
We looked at it again--the blood rushing through it is definitely from me, not baby.
Doc said he did not think it appeared like it was at an immediate risk of rupture (and again suggested it might never rupture and instead be squeezed by baby), but still wants me to keep activity light. I can go back to work (desk job), but no exercise, cleaning, etc. He also referred me to a high risk OB for a second opinion / further consult. Awesome!
I left the appointment about as upbeat as I've been since I started this whole process.
Oh, and baby looks fantastic.
Tuesday, July 5, 2011
Status Quo - Almost done with a week of bed rest
Back at the doctor today. Nothing has changed. Good news is that baby looks good, heartbeat strong, still growing, etc. Bad news is that blood is still flowing into a contained mass in my uterus and I'm still on bed rest.
The appointment was funny because it was an epic ultrasound procedure. We saw the mass, we saw baby, we looked for source of blood flow, etc. At the end they could not find the mass and the doctor told me it was probably because my uterus contracted because it did not like the ultrasound and the bleed was temporarily cut off. (Not cured, just temporarily slowed.) I joked with a girlfriend that if it does rupture and I start bleeding, I know what to do to stop it--jam a huge dildo up there. (Just kidding, I would not do that, nor do I own a dildo!!!)
I spent a significant part of the weekend reading medical journal articles on pseudo-aneurysms of the uterus. I read about diagnosis (they sound like what I have--pulsating mass connected to a parent artery by a narrow neck, often diagnosed during pregnancy because of increased blood flow), treatment (potentially they close on their own, but usually need to be treated if >2 cm, preferable treatment option is to embolize the pseudoaneurysm), outcome when pregnant (depends on how far along, where it is, etc., but there are very few cases of successful treatment during pregnancy), causes (usually trauma such as c-section or, rarely, ivf egg retrieval), etc. It's an extremely rare condition, but it happens. Not sure if that's what I have (it could be lots of things, I also read about arteriovenous malformations, but it doesn't seem like I have that because I'm not bleeding), but I mentioned what I'd read to the doctor. I was happy when he told me to send him the journal articles.
My next appointment is in two days. The doctor seemed optimistic that it might resolve on its own--especially when the baby gets big and started putting pressure on it. He also did not seem to think we were at an immediate risk of rupture. Of course, he's concerned enough that I'm still resting (although he did suggest I could increase my activity a little bit--maybe cook, go out to dinner).
I also started reading articles about what to do in case of an extended bed rest. I think I might go crazy if that happens. I never realized how much I like my job until I wasn't allowed to do it!
The appointment was funny because it was an epic ultrasound procedure. We saw the mass, we saw baby, we looked for source of blood flow, etc. At the end they could not find the mass and the doctor told me it was probably because my uterus contracted because it did not like the ultrasound and the bleed was temporarily cut off. (Not cured, just temporarily slowed.) I joked with a girlfriend that if it does rupture and I start bleeding, I know what to do to stop it--jam a huge dildo up there. (Just kidding, I would not do that, nor do I own a dildo!!!)
I spent a significant part of the weekend reading medical journal articles on pseudo-aneurysms of the uterus. I read about diagnosis (they sound like what I have--pulsating mass connected to a parent artery by a narrow neck, often diagnosed during pregnancy because of increased blood flow), treatment (potentially they close on their own, but usually need to be treated if >2 cm, preferable treatment option is to embolize the pseudoaneurysm), outcome when pregnant (depends on how far along, where it is, etc., but there are very few cases of successful treatment during pregnancy), causes (usually trauma such as c-section or, rarely, ivf egg retrieval), etc. It's an extremely rare condition, but it happens. Not sure if that's what I have (it could be lots of things, I also read about arteriovenous malformations, but it doesn't seem like I have that because I'm not bleeding), but I mentioned what I'd read to the doctor. I was happy when he told me to send him the journal articles.
My next appointment is in two days. The doctor seemed optimistic that it might resolve on its own--especially when the baby gets big and started putting pressure on it. He also did not seem to think we were at an immediate risk of rupture. Of course, he's concerned enough that I'm still resting (although he did suggest I could increase my activity a little bit--maybe cook, go out to dinner).
I also started reading articles about what to do in case of an extended bed rest. I think I might go crazy if that happens. I never realized how much I like my job until I wasn't allowed to do it!
Saturday, July 2, 2011
A uterine aneurysm?!?... Maybe....
Went back to the doctor. Both he and the ultrasound tech seemed shocked by what they saw.
It looked almost exactly the same as yesterday. It still appeared to be an active bleed--the blood was pulsing with my heart beat--but the "clot" had not gotten any bigger and the blood did not appear to be going anywhere.
It turns out I don't have a blood clot or an active bleed.
Instead, I have an enlarged blood vessel. Blood goes in (like a river) expands into a large space (like a lake) then goes back out (river again). Sounds like an aneurysm, right? (Although the doctor never actually used the "a" word.)
My doctor has never seen something like this before. (That's never good.)
He ordered that I remain on bed rest. He did not seem overly worried about my health, although he said to contact the office immediately in case of any bleeding. (Obviously if there's a lot of blood I'm going to the hospital.) The prognosis for baby is less clear. If this thing never ruptures or gets any bigger (it's like 3cm x 3cm now) the doc seems to think that would be okay (not ideal). If it blows or grows, that's obviously really bad.
I have another appointment early next week. Depending on what we see, I'm going to see about having him refer me to a high-risk OB.
Unbelievable, right?
It looked almost exactly the same as yesterday. It still appeared to be an active bleed--the blood was pulsing with my heart beat--but the "clot" had not gotten any bigger and the blood did not appear to be going anywhere.
It turns out I don't have a blood clot or an active bleed.
Instead, I have an enlarged blood vessel. Blood goes in (like a river) expands into a large space (like a lake) then goes back out (river again). Sounds like an aneurysm, right? (Although the doctor never actually used the "a" word.)
My doctor has never seen something like this before. (That's never good.)
He ordered that I remain on bed rest. He did not seem overly worried about my health, although he said to contact the office immediately in case of any bleeding. (Obviously if there's a lot of blood I'm going to the hospital.) The prognosis for baby is less clear. If this thing never ruptures or gets any bigger (it's like 3cm x 3cm now) the doc seems to think that would be okay (not ideal). If it blows or grows, that's obviously really bad.
I have another appointment early next week. Depending on what we see, I'm going to see about having him refer me to a high-risk OB.
Unbelievable, right?
Wednesday, June 29, 2011
Subchorionic Hematoma (aka If it's not one thing it's another)
Had a follow-up ultrasound today. Was feeling anxious because I STILL don't feel pregnant. (Although I have noticed a slight rounding of my abdomen. Baby or too much ice cream?)
Baby is great. I'm 9 weeks and 1 day, but his crown to rump length was measured at 9 weeks and 2 days. My little over achiever. We also saw it moving all over the place--busting a move, if you will.
Unfortunately, the blood clot is still there and bigger than ever. (3 cm x 2 cm) AND the doc and ultrasound tech kinda freaked out because not only is the mass still there, it was moving as well. I.e. I was bleeding during the ultrasound.
As the doc pointed out, any clot was once a bleed. On the other hand, to actually SEE an active bleed is really, really rare. Hopefully it just opened up and will stop shortly. But if a clot is potentially bad news, an active bleed is really bad news. (Continued bleeding could eventually affect the baby.)
There's nothing that can be done. For now I am on bed rest. Technically I'm not even supposed to be on a computer, so I'll keep this short. I'm going to have it checked again tomorrow. Hopefully it will no longer be bleeding.
Booo subchorionic hematoma.
Baby is great. I'm 9 weeks and 1 day, but his crown to rump length was measured at 9 weeks and 2 days. My little over achiever. We also saw it moving all over the place--busting a move, if you will.
Unfortunately, the blood clot is still there and bigger than ever. (3 cm x 2 cm) AND the doc and ultrasound tech kinda freaked out because not only is the mass still there, it was moving as well. I.e. I was bleeding during the ultrasound.
As the doc pointed out, any clot was once a bleed. On the other hand, to actually SEE an active bleed is really, really rare. Hopefully it just opened up and will stop shortly. But if a clot is potentially bad news, an active bleed is really bad news. (Continued bleeding could eventually affect the baby.)
There's nothing that can be done. For now I am on bed rest. Technically I'm not even supposed to be on a computer, so I'll keep this short. I'm going to have it checked again tomorrow. Hopefully it will no longer be bleeding.
Booo subchorionic hematoma.
Monday, June 13, 2011
Heartbeat!
Sonogram today. (6wks 6days)
I still don't feel pregnant, so I was preparing myself for the worst. I was almost crying when the tech started the ultrasound.
My near-tears of sadness turned to tears of joy when I saw the little heartbeat. It was a black and white image with a quick little flickering. Dr. said it was a strong heartbeat. Yay! At this point, my chance of miscarriage is about 10% and it's almost always a genetic issue that we have no control over. My odds of success are looking better and better!
They noticed a small bleed / clot, though. Dr. said it's not uncommon (~30% of his patients have something) but they still want to monitor it.
So I just have to continue the same course of action--meds, no exercise, no sex, no booze (although Dr. did say small amounts of alcohol would be fine after 12 weeks!), etc.
I still don't feel pregnant, so I was preparing myself for the worst. I was almost crying when the tech started the ultrasound.
My near-tears of sadness turned to tears of joy when I saw the little heartbeat. It was a black and white image with a quick little flickering. Dr. said it was a strong heartbeat. Yay! At this point, my chance of miscarriage is about 10% and it's almost always a genetic issue that we have no control over. My odds of success are looking better and better!
They noticed a small bleed / clot, though. Dr. said it's not uncommon (~30% of his patients have something) but they still want to monitor it.
So I just have to continue the same course of action--meds, no exercise, no sex, no booze (although Dr. did say small amounts of alcohol would be fine after 12 weeks!), etc.
Tuesday, June 7, 2011
Morning Sickness? I Wish!
I don't feel pregnant at all. It's making me really, really nervous.
I read that a lot of women start getting morning sickness in week 6, which is what I just hit. But right now I feel nothing. No nausea. No sore boobs. Nada.
I also read that women who experience morning sickness are 2-3 times less likely to have a miscarriage.
I want morning sickness.
The good news is that I had another blood test today. HCG over 25,000. Progesterone 37. Both fine numbers, although my HCG has not been doubling every two days like it was in the past. I asked the nurse about it and she said at this point, they are less concerned about the exact HCG number--as long as it's high, whether it's doubled every two days is less important. I'll take her word for it. (I like getting my blood drawn--it gives me peace of mind.)
One blog I saw said no woman looks forward to morning sickness.
WRONG.
I can't be the only woman who hopes for morning sickness, right?
I read that a lot of women start getting morning sickness in week 6, which is what I just hit. But right now I feel nothing. No nausea. No sore boobs. Nada.
I also read that women who experience morning sickness are 2-3 times less likely to have a miscarriage.
I want morning sickness.
The good news is that I had another blood test today. HCG over 25,000. Progesterone 37. Both fine numbers, although my HCG has not been doubling every two days like it was in the past. I asked the nurse about it and she said at this point, they are less concerned about the exact HCG number--as long as it's high, whether it's doubled every two days is less important. I'll take her word for it. (I like getting my blood drawn--it gives me peace of mind.)
One blog I saw said no woman looks forward to morning sickness.
WRONG.
I can't be the only woman who hopes for morning sickness, right?
Wednesday, June 1, 2011
So far so good!
At 5 weeks and 1 day, HCG is 7519. This is about the same time in my ectopic pregnancy it was diagnosed--cramping, bleeding, and HCG of 682. So, HOPEFULLY this means we have a healthy pregnancy so far! Now just to make it to the 10/12 week mark (when miscarriage rates fall sharply).
Saturday, May 28, 2011
Two-Week wait -- or a little shorter when the egg percolates for the first five days
I forgot to mention one other side effect of IVF--pregnancy! Got my initial result on Tuesday. Pregnant! HCG 146. (Good.) Had a second test on Thursday--still pregnant! HCG 480. (Really good!)
Blood tests every week for first 12 weeks to check progesterone and HCG. Wish me luck!
Blood tests every week for first 12 weeks to check progesterone and HCG. Wish me luck!
Wednesday, May 25, 2011
IVF side effects
I would be remiss if I failed to at least mention some of the side effects of IVF.
Headaches
Like I mentioned, the lupron gave me really bad headaches. They went away when I decreased my dose.
Acne
I don’t know which drug (or combination of drugs) caused it, but I got the worst acne of my entire life. My forehead was literally covered in pimples. It was really, really embarrassing. Sometimes husband would run his fingers along my forehead and pretend like he was reading Braille. “It says we should be watching hockey.” I cannot imagine what people at work thought.
It seems to be clearing up now.
Bloating
I bloated like crazy during the stim cycle. I literally looked three plus months pregnant.
After we started having trouble getting pregnant, I cut back on my exercise. Once we started IVF, I cut way, way back. (My acupuncturist told me sweat is bad for egg production.) On the day of my retrieval, they told me I was at a high risk of developing ovarian hyperstimulation syndrome (because of my large number of follicles—more than 16—and high estrogen on the day of the trigger shot—over 4000), and even moving around can make it worse. So I cut back on exercise entirely and started drinking protein shakes and Gatorade to try to decrease the chances that I would develop it.
No surprise that I gained weight, right?
On the day of egg retrieval, the doctor asked me if I'd had a lot of bloating. I noticed some, but I told him I didn’t think it was too bad. (I'd taken to wearing dresses to work and pj pants at home.) I almost fainted when I went home and weighed myself—I’d gained over 10 pounds! And, after studying my stomach, I realized that it was basically all in my midsection. It looked like I was pregnant. And not just a little bulge. A pooch.
Fortunately in the days since transfer the bloating has gone down, but I’m still a little chubby. (I have not gained the 2 pounds a day they were worried I might, so no ovarian hyperstimulation syndrome!) I’m worried it’s the no-exercise and protein shakes weight!
Yes, yes, if I get pregnant it's all worth it.
Headaches
Like I mentioned, the lupron gave me really bad headaches. They went away when I decreased my dose.
Acne
I don’t know which drug (or combination of drugs) caused it, but I got the worst acne of my entire life. My forehead was literally covered in pimples. It was really, really embarrassing. Sometimes husband would run his fingers along my forehead and pretend like he was reading Braille. “It says we should be watching hockey.” I cannot imagine what people at work thought.
It seems to be clearing up now.
Bloating
I bloated like crazy during the stim cycle. I literally looked three plus months pregnant.
After we started having trouble getting pregnant, I cut back on my exercise. Once we started IVF, I cut way, way back. (My acupuncturist told me sweat is bad for egg production.) On the day of my retrieval, they told me I was at a high risk of developing ovarian hyperstimulation syndrome (because of my large number of follicles—more than 16—and high estrogen on the day of the trigger shot—over 4000), and even moving around can make it worse. So I cut back on exercise entirely and started drinking protein shakes and Gatorade to try to decrease the chances that I would develop it.
No surprise that I gained weight, right?
On the day of egg retrieval, the doctor asked me if I'd had a lot of bloating. I noticed some, but I told him I didn’t think it was too bad. (I'd taken to wearing dresses to work and pj pants at home.) I almost fainted when I went home and weighed myself—I’d gained over 10 pounds! And, after studying my stomach, I realized that it was basically all in my midsection. It looked like I was pregnant. And not just a little bulge. A pooch.
Fortunately in the days since transfer the bloating has gone down, but I’m still a little chubby. (I have not gained the 2 pounds a day they were worried I might, so no ovarian hyperstimulation syndrome!) I’m worried it’s the no-exercise and protein shakes weight!
Yes, yes, if I get pregnant it's all worth it.
Monday, May 23, 2011
Everything you ever wanted to know about IVF... but didn't really want to know
Once we decided to do IVF, our lives (okay, mostly my life) was filled with endless doctor visits (one time I went when I didn't even have an appointment--I had so much trouble keeping my schedule straight), shot teaching classes, and enough drugs to open a small pharmacy.
I found the whole thing very, very overwhelming.
We ordered the drugs from Walgreens, which was really easy. The drugs are really, really expensive. (We were told they could easily run more than $6,000, but lucky for us insurance covered a large part of our cost.) We shopped around to try to find the best deals (crazy enough, pharmacies charge different amounts for drugs and they do not make it easy to price comparison shop), so if you don't have insurance or if insurance won't cover much (or even if it will, just out of principal) I suggest you do the same.
Here's a summary of the drugs and procedures I faced:
Lab work (March-April)
Blood tests for me (follicle stimulating hormone and estradiol blood tests on day three of cycle)
Hysterosalpingogram test (the one with dye that hurt like a bitch) - it showed I had major scarring in my right fallopian tube--much worse than the result two years earlier--and my doc thought I had a 50% chance of having an ectopic if I conceived naturally; looks like at least one of my miscarriages might've done further damage
Blood tests for hubby (STD, other?)
Semen analysis
Birth control (March - April 20, only active pills)
After my period, I started on birth control. Funny, right? I can't get pregnant--what's the point of birth control? Well, it suppresses your ovaries (no early ovulation). Also, they run some nasty tests and you wouldn't want a little guy trying to party in there. More importantly, they can control the start date of your cycle.
The birth control was easy. I'd been on it for over a decade before.
Antibiotics (early April)
Not sure why I was on these. I guess they really don’t want you to be sick. They made me a little sick (nauseated).
Lupron (AM med, 20 units April 17 - April 26, 5 units April 27-May 8)
On April 17, four days before I went off of birth control, I started the lupron injections. (Lupron is used to suppress your ovaries and prevent untimely ovulation.) Lupron was my first shot. It was relatively easy. Not as easy as my pre-filled ovidrel syringes, but still pretty easy. There was nothing to mix--just pull some liquid out of a vial and inject it into your abdomen with a tiny (insulin) needle.
I only made one mistake with the lupron. Even though I was warned, I did not put air back into the vial before I pulled the liquid out (due to a misunderstanding in what my husband told me), so after a few days I started pulling against a pretty strong vacuum, making exact measurements really hard. I just put some more air in and fixed the problem.
Lupron did give me some monster headaches though. When I went from 20 units to 5 units, they went away. Also, early on in the lupron (after my period) I had some spotting, which made me nervous but is apparently normal.
There's no set date to stop lupron, the doctors monitor you and then have you stop before the HCG trigger shot.
Dr. Appt (April 26)
Checking things out. Ovaries quiet. Lining thin. Let's get this party started.
Menopur (AM med, April 30 - May 8)
On April 30 I started my stimulation meds. (These are the meds that make you ovulate like crazy.) The first one I had to take was menopur, and that one was a little tricky. (Menopure stimulates follicle production and helps your lining grow.) It involved mixing a vial of powder with a vial of distilled water. The mixing process was a little complicated (q-caps, taking the needle off and on, etc.) but I got the hang of it. (I did accidentally fling one vial of distilled water across the bathroom. Good thing I had extras!)
The needle on this one was bigger than the lupron shot (or at least it seemed bigger--maybe I was just sick of giving myself shots) and I did get a few bruises. One time I had a needle with a small curve at the tip (I realized after I gave myself the shot) and that hurt like crazy. It took a lot of force to push into my stomach and pull out. If you notice you have a dull or otherwise messed up needle tip and it's easy to switch out, get a new one!
Follistim (PM med, April 30 - May 8)
The second stim med I took was follistim. (Stimulates follicle production.) That was also kinda tricky. It was easy because I didn't have to do any mixing or measuring. Instead, you pop a pre-mixed cartridge into the "pen" and then dial your dose. Literally. It was tricky because dialing the dose was scary--what if I go too far!? (I never did)--and you have to keep track of how much is left in the vial inside the pen from day to day so you don't accidentally give yourself a shot only to find out the cartridge is empty.
The mistake I made with follistim was when I pushed the top down to give the shot, I let my thumb fall over the side. So when I pushed, it seemed like I also had to twist to dial it down. I'm not talented enough to push and twist. And it caused me to move around when I was giving myself the shot, increasing the pain. Once I realized what I was doing, I was more careful with my finger placement and it was easier to push the plunger.
I was on a 225 dose. The medicine comes in a 600 unit cartridge, so you have to change it out after every three shots. In theory, you can save the remainder (approximately 75) and give yourself one of your 225 dose shots by spreading it out over several cartridges, but I said nuts to that. I'm not giving myself any more shots than I absolutely have to. (This medicine is really expensive. I still have several mostly empty cartridges, maybe I'll use them next time around.)
Husband -- Doxycycline (April 30 - May 6)
On day 1 of my stim cycle, husband started taking antibiotics. Why? I have no idea. I guess nobody’s allowed to be sick.
Dr. Appt (May 2)
Checking things out. Follicles are growing.
Dr. Appt (May 4)
Follicles are growing. Seven are between 10-15, so getting close.
Dr. Appt (May 6)
Follicles still growing. Nurse thought I’d get six mature follicles—that’s about ½ the normal amount. Commence freaking out.
Dr. Appt (May 7)
Three mature follicles and three close behind. Still only six. Still freaking out. Estrogen 2200. Lining 9b. (Good.)
Dr. Appt (May 8 – happy mom’s day!)
12+ follicles today! More likely to mature. Yay! Estrogen over 4000. Lining 8b. (Good.)
HCG (May 8)
After monitoring, my HCG shot was scheduled to take place on May 8. HGC is the shot that finally causes your eggs to mature and release (ovulate). This was the first scary shot because it's intramuscular (into a muscle). This is opposed to all of the other shots I'd been doing, which are subcutaneous (under the skin). Basically, I have to use a needle the size of a toothpick.
You have to be really careful about where you have an intramuscular shot. You can do some serious damage if you hit a nerve, and after you insert the shot you have to pull the plunger out a bit to make sure you're not in a vein or anything before you inject.
It also had to be given at a very specific time—exactly 36 hours before egg retrieval. For me, 10:30PM.
So around 10:15, husband and I prepared the shot. I iced the hell out of my butt, and then laid on the bed. He bravely stuck it in. Honestly, I barely felt it at all. (Icing was a GOOD idea.) [The last few sentences of this paragraph are very awkward. I think you get the gist.]
The next morning it felt like I'd bumped my butt on something and had a bruise, but there was no visible injury other than a little red needle mark. So it was sore, but not too bad.
I was really, really glad I iced before the shot.
Egg Retrieval Day (May 10)
This was the easiest day of the entire cycle:
Eat nothing after midnight. (So you don't throw up during surgery while you're unconscious and get anything in your lungs. Bad news.)
No perfume, scented lotion, make-up, fingernail polish, etc. (Everyone knows eggs hate smells!)
Talk to doctor about the procedure. In my case, the doctor said because of my large number of follicles (more than 16--that's actually not too many) and high estrogen number (I was over 4000 on the day I took the trigger shot) I was at risk for developing ovarian hyperstimulation syndrome. (Less than 1% of women have this, but it can be bad news.) More on that later.
Get totally knocked out through an IV. While unconscious, doctor uses a needle to suck every last egg out of all of your mature follicles.
Husband gives "the sample." Because husband's sperm is sublime, we did not use ICSI (intracytoplacmic sperm injection)--injecting a single sperm directly into the egg.
Wake up to be told how many eggs they retrieved. They got 16 for me. Apparently anything from around 10-20 is normal. I was totally stoked.
Veg out all day.
Tetracycline (May 10 - May 13)
Antibiotics for me. Four times a day. Oral. Easy.
Progesterone (May 12 - ???)
The shots that were REALLY stressing me out were the intramuscular progesterone shots. Huge needle. Every night. The shot is suspended in oil and the oil beads sit under your skin causing great discomfort. You have to try to rub them in and walk around, possibly while using a heating pad. No ice because it makes the oil beads even more viscous and harder to rub in.
I have a friend who did one failed round of IVF and chose not to do it again because of the agony of progesterone shots.
And my husband travels for his job, so most of the time I'd be giving them to myself. In my ass. Not sure how I was going to manage that feat of flexibility.
The stress was literally keeping me awake at night.
Fortunately, I mentioned the stress to my acupuncturist (yes, my acupuncturist) and she said, tell your doctor you want to use a suppository instead. Mayo doesn't even use progesterone shots anymore.
If it's good enough for Mayo, it's good enough for me!
I have no idea if Mayo uses progesterone shots anymore, but when I called my doctor's office and asked to be allowed to use a suppository instead, they said okay right away.
My husband was livid that I wasn't given that as an option originally.
I was just deliriously excited that I wasn't going to have to go through with those awful, terrible, downright nasty shots.
Who knew I could get excited over suppositories? Give me an S! Give me a U! Give me a P!... You get the gist.
Embryo Report -- First Call (May 12)
Two days after the egg retrieval, the doctor's office called to tell me how the eggs and sperm were getting along. (Swimmingly. Ha!) Of our 16 eggs, 14 were mature and 10 were fertilized. So that wasn't too bad. (Good job sperm!) Because we had enough embryos, we decided to go for a day five transfer instead of a day three transfer.
If you don't have a lot of embryos, better to put them in mom right away to give them the best chance of making it. But if you've got enough for them to fight it out a little longer, better to see who's strong enough to survive to day 5.Battle
Embryo Report -- Second Call (May 14)
All I got was the transfer time -- 10:00 AM tomorrow. Everything was "looking good."
Valium (May 15 - one hour before transfer)
I'd never taken a Valium before. I took it at home and then we drove to the doctor's office. Husband asked how I was feeling. I said I didn't think it had kicked in. Then we parked and when I went to get out of the car I felt a little woozy--like tipsy, but with none of the nauseated side effects. So I guess it was working.
Day 5 Transfer (May 15)
This was a very stressful day (as I discussed in my second post). When we got to the doctor's office, only two of our ten embryos had made it to the blastocyst stage. The doctor said he would have expected a couple more. And of the ones we had, one was a B2 and one was a B3. So we had no B1 superstars. But we got to see a picture of our little B2 and we picked that one to go in. (Apparently B3 was the better looking embryo early on, but B2 bypassed him at the last minute. Everyone loves a comeback story.)
Husband and I decided to do a single egg selective transfer. Using two eggs significantly increases the chance of getting pregnant (in our case, we had a 50% chance with B2, so that might raise as much as 65% if we added B3), but it DRAMATICALLY increases chance of twins (from less than 1% to over 30%). Yes, twins are twice as nice, but husband and I agree that we want to give mom and baby best chance at health and that means single birth. And we’re good candidates for single egg selection—this is our first IVF attempt, we’re both under 35, we had at least a B2, and we had one to freeze for later.
On transfer day, drink so much water that you think you might explode. Okay, not really, but they want a full bladder to make it easier to place the embryo. If you forget, they’ll make you use a catheter.
Procedure was quick and easy. I actually got to see B2 getting put in. As did husband and half a dozen other people. IVF is not for the meek.
Froze B3 for later.
Rest for next two days. No exercise or sex until pregnancy result. (Boo!)
Embryo Report -- Last Call (May 16)
One more guy made it to a B3, so we froze him too.
Vivelle Estrogen Patches (May 19 [transfer + 4 days] - ???)
The patches are also really easy. Basically two clear stickers you have to wear on your abdomen. The only bad thing is if you wear anything dark / fuzzy, it's going to get stuck to the edges of the patches. Then they become very conspicuous very fast. They are switched out every three days.
And that’s it. Simple, right??
I found the whole thing very, very overwhelming.
We ordered the drugs from Walgreens, which was really easy. The drugs are really, really expensive. (We were told they could easily run more than $6,000, but lucky for us insurance covered a large part of our cost.) We shopped around to try to find the best deals (crazy enough, pharmacies charge different amounts for drugs and they do not make it easy to price comparison shop), so if you don't have insurance or if insurance won't cover much (or even if it will, just out of principal) I suggest you do the same.
Here's a summary of the drugs and procedures I faced:
Lab work (March-April)
Blood tests for me (follicle stimulating hormone and estradiol blood tests on day three of cycle)
Hysterosalpingogram test (the one with dye that hurt like a bitch) - it showed I had major scarring in my right fallopian tube--much worse than the result two years earlier--and my doc thought I had a 50% chance of having an ectopic if I conceived naturally; looks like at least one of my miscarriages might've done further damage
Blood tests for hubby (STD, other?)
Semen analysis
Birth control (March - April 20, only active pills)
After my period, I started on birth control. Funny, right? I can't get pregnant--what's the point of birth control? Well, it suppresses your ovaries (no early ovulation). Also, they run some nasty tests and you wouldn't want a little guy trying to party in there. More importantly, they can control the start date of your cycle.
The birth control was easy. I'd been on it for over a decade before.
Antibiotics (early April)
Not sure why I was on these. I guess they really don’t want you to be sick. They made me a little sick (nauseated).
Lupron (AM med, 20 units April 17 - April 26, 5 units April 27-May 8)
On April 17, four days before I went off of birth control, I started the lupron injections. (Lupron is used to suppress your ovaries and prevent untimely ovulation.) Lupron was my first shot. It was relatively easy. Not as easy as my pre-filled ovidrel syringes, but still pretty easy. There was nothing to mix--just pull some liquid out of a vial and inject it into your abdomen with a tiny (insulin) needle.
I only made one mistake with the lupron. Even though I was warned, I did not put air back into the vial before I pulled the liquid out (due to a misunderstanding in what my husband told me), so after a few days I started pulling against a pretty strong vacuum, making exact measurements really hard. I just put some more air in and fixed the problem.
Lupron did give me some monster headaches though. When I went from 20 units to 5 units, they went away. Also, early on in the lupron (after my period) I had some spotting, which made me nervous but is apparently normal.
There's no set date to stop lupron, the doctors monitor you and then have you stop before the HCG trigger shot.
Dr. Appt (April 26)
Checking things out. Ovaries quiet. Lining thin. Let's get this party started.
Menopur (AM med, April 30 - May 8)
On April 30 I started my stimulation meds. (These are the meds that make you ovulate like crazy.) The first one I had to take was menopur, and that one was a little tricky. (Menopure stimulates follicle production and helps your lining grow.) It involved mixing a vial of powder with a vial of distilled water. The mixing process was a little complicated (q-caps, taking the needle off and on, etc.) but I got the hang of it. (I did accidentally fling one vial of distilled water across the bathroom. Good thing I had extras!)
The needle on this one was bigger than the lupron shot (or at least it seemed bigger--maybe I was just sick of giving myself shots) and I did get a few bruises. One time I had a needle with a small curve at the tip (I realized after I gave myself the shot) and that hurt like crazy. It took a lot of force to push into my stomach and pull out. If you notice you have a dull or otherwise messed up needle tip and it's easy to switch out, get a new one!
Follistim (PM med, April 30 - May 8)
The second stim med I took was follistim. (Stimulates follicle production.) That was also kinda tricky. It was easy because I didn't have to do any mixing or measuring. Instead, you pop a pre-mixed cartridge into the "pen" and then dial your dose. Literally. It was tricky because dialing the dose was scary--what if I go too far!? (I never did)--and you have to keep track of how much is left in the vial inside the pen from day to day so you don't accidentally give yourself a shot only to find out the cartridge is empty.
The mistake I made with follistim was when I pushed the top down to give the shot, I let my thumb fall over the side. So when I pushed, it seemed like I also had to twist to dial it down. I'm not talented enough to push and twist. And it caused me to move around when I was giving myself the shot, increasing the pain. Once I realized what I was doing, I was more careful with my finger placement and it was easier to push the plunger.
I was on a 225 dose. The medicine comes in a 600 unit cartridge, so you have to change it out after every three shots. In theory, you can save the remainder (approximately 75) and give yourself one of your 225 dose shots by spreading it out over several cartridges, but I said nuts to that. I'm not giving myself any more shots than I absolutely have to. (This medicine is really expensive. I still have several mostly empty cartridges, maybe I'll use them next time around.)
Husband -- Doxycycline (April 30 - May 6)
On day 1 of my stim cycle, husband started taking antibiotics. Why? I have no idea. I guess nobody’s allowed to be sick.
Dr. Appt (May 2)
Checking things out. Follicles are growing.
Dr. Appt (May 4)
Follicles are growing. Seven are between 10-15, so getting close.
Dr. Appt (May 6)
Follicles still growing. Nurse thought I’d get six mature follicles—that’s about ½ the normal amount. Commence freaking out.
Dr. Appt (May 7)
Three mature follicles and three close behind. Still only six. Still freaking out. Estrogen 2200. Lining 9b. (Good.)
Dr. Appt (May 8 – happy mom’s day!)
12+ follicles today! More likely to mature. Yay! Estrogen over 4000. Lining 8b. (Good.)
HCG (May 8)
After monitoring, my HCG shot was scheduled to take place on May 8. HGC is the shot that finally causes your eggs to mature and release (ovulate). This was the first scary shot because it's intramuscular (into a muscle). This is opposed to all of the other shots I'd been doing, which are subcutaneous (under the skin). Basically, I have to use a needle the size of a toothpick.
You have to be really careful about where you have an intramuscular shot. You can do some serious damage if you hit a nerve, and after you insert the shot you have to pull the plunger out a bit to make sure you're not in a vein or anything before you inject.
It also had to be given at a very specific time—exactly 36 hours before egg retrieval. For me, 10:30PM.
So around 10:15, husband and I prepared the shot. I iced the hell out of my butt, and then laid on the bed. He bravely stuck it in. Honestly, I barely felt it at all. (Icing was a GOOD idea.) [The last few sentences of this paragraph are very awkward. I think you get the gist.]
The next morning it felt like I'd bumped my butt on something and had a bruise, but there was no visible injury other than a little red needle mark. So it was sore, but not too bad.
I was really, really glad I iced before the shot.
Egg Retrieval Day (May 10)
This was the easiest day of the entire cycle:
Eat nothing after midnight. (So you don't throw up during surgery while you're unconscious and get anything in your lungs. Bad news.)
No perfume, scented lotion, make-up, fingernail polish, etc. (Everyone knows eggs hate smells!)
Talk to doctor about the procedure. In my case, the doctor said because of my large number of follicles (more than 16--that's actually not too many) and high estrogen number (I was over 4000 on the day I took the trigger shot) I was at risk for developing ovarian hyperstimulation syndrome. (Less than 1% of women have this, but it can be bad news.) More on that later.
Get totally knocked out through an IV. While unconscious, doctor uses a needle to suck every last egg out of all of your mature follicles.
Husband gives "the sample." Because husband's sperm is sublime, we did not use ICSI (intracytoplacmic sperm injection)--injecting a single sperm directly into the egg.
Wake up to be told how many eggs they retrieved. They got 16 for me. Apparently anything from around 10-20 is normal. I was totally stoked.
Veg out all day.
Tetracycline (May 10 - May 13)
Antibiotics for me. Four times a day. Oral. Easy.
Progesterone (May 12 - ???)
The shots that were REALLY stressing me out were the intramuscular progesterone shots. Huge needle. Every night. The shot is suspended in oil and the oil beads sit under your skin causing great discomfort. You have to try to rub them in and walk around, possibly while using a heating pad. No ice because it makes the oil beads even more viscous and harder to rub in.
I have a friend who did one failed round of IVF and chose not to do it again because of the agony of progesterone shots.
And my husband travels for his job, so most of the time I'd be giving them to myself. In my ass. Not sure how I was going to manage that feat of flexibility.
The stress was literally keeping me awake at night.
Fortunately, I mentioned the stress to my acupuncturist (yes, my acupuncturist) and she said, tell your doctor you want to use a suppository instead. Mayo doesn't even use progesterone shots anymore.
If it's good enough for Mayo, it's good enough for me!
I have no idea if Mayo uses progesterone shots anymore, but when I called my doctor's office and asked to be allowed to use a suppository instead, they said okay right away.
My husband was livid that I wasn't given that as an option originally.
I was just deliriously excited that I wasn't going to have to go through with those awful, terrible, downright nasty shots.
Who knew I could get excited over suppositories? Give me an S! Give me a U! Give me a P!... You get the gist.
Embryo Report -- First Call (May 12)
Two days after the egg retrieval, the doctor's office called to tell me how the eggs and sperm were getting along. (Swimmingly. Ha!) Of our 16 eggs, 14 were mature and 10 were fertilized. So that wasn't too bad. (Good job sperm!) Because we had enough embryos, we decided to go for a day five transfer instead of a day three transfer.
If you don't have a lot of embryos, better to put them in mom right away to give them the best chance of making it. But if you've got enough for them to fight it out a little longer, better to see who's strong enough to survive to day 5.
Embryo Report -- Second Call (May 14)
All I got was the transfer time -- 10:00 AM tomorrow. Everything was "looking good."
Valium (May 15 - one hour before transfer)
I'd never taken a Valium before. I took it at home and then we drove to the doctor's office. Husband asked how I was feeling. I said I didn't think it had kicked in. Then we parked and when I went to get out of the car I felt a little woozy--like tipsy, but with none of the nauseated side effects. So I guess it was working.
Day 5 Transfer (May 15)
This was a very stressful day (as I discussed in my second post). When we got to the doctor's office, only two of our ten embryos had made it to the blastocyst stage. The doctor said he would have expected a couple more. And of the ones we had, one was a B2 and one was a B3. So we had no B1 superstars. But we got to see a picture of our little B2 and we picked that one to go in. (Apparently B3 was the better looking embryo early on, but B2 bypassed him at the last minute. Everyone loves a comeback story.)
Husband and I decided to do a single egg selective transfer. Using two eggs significantly increases the chance of getting pregnant (in our case, we had a 50% chance with B2, so that might raise as much as 65% if we added B3), but it DRAMATICALLY increases chance of twins (from less than 1% to over 30%). Yes, twins are twice as nice, but husband and I agree that we want to give mom and baby best chance at health and that means single birth. And we’re good candidates for single egg selection—this is our first IVF attempt, we’re both under 35, we had at least a B2, and we had one to freeze for later.
On transfer day, drink so much water that you think you might explode. Okay, not really, but they want a full bladder to make it easier to place the embryo. If you forget, they’ll make you use a catheter.
Procedure was quick and easy. I actually got to see B2 getting put in. As did husband and half a dozen other people. IVF is not for the meek.
Froze B3 for later.
Rest for next two days. No exercise or sex until pregnancy result. (Boo!)
Embryo Report -- Last Call (May 16)
One more guy made it to a B3, so we froze him too.
Vivelle Estrogen Patches (May 19 [transfer + 4 days] - ???)
The patches are also really easy. Basically two clear stickers you have to wear on your abdomen. The only bad thing is if you wear anything dark / fuzzy, it's going to get stuck to the edges of the patches. Then they become very conspicuous very fast. They are switched out every three days.
And that’s it. Simple, right??
Sunday, May 22, 2011
Diagnosis: Get it on
In September 2010, we finally went to see a fertility doctor. I really, really did not want it to get to that point, but once we made the decision I felt like a huge weight had been lifted off my shoulders.
We were going to get some answers.
They ran a battery of tests over the course of the month--blood tests, ultrasounds, etc. The result? Husband's sperm was absolute perfection. (Reading the results was pretty funny--did you know sperm can have two heads, or two tails, or no heads or tails at all? Ew!) So that was good to know.
But something was definitely wrong with me.
Because of a hormone issue, my body prepared an egg, but then didn't release it for a while. By the time it was released, it was basically overripe. (So we were wrong about the "luteal phase defect"... or were we?... but we correctly identified a problem about my body releasing eggs too late.) The fertility doctor suggested that it could have caused both the ectopic and the miscarriage or it could be totally unrelated.
I asked the doctor if my hormone imbalance was a common problem. He said no. He told us that older women often have all kinds of hormone imbalances, but for someone my age (early 30s) to just have this one issue was unusual.
He gave us several potential treatment options. The least intrusive was for them to monitor my follicles, and then when they reached a mature size (18-22) trigger ovulation using a shot of ovidrel (human chorionic gonadoptropin) to make sure a mature egg was released on time. Other options were more invasive, such as IVF, which I hoped never to have to do.
So we chose the "easy" option. It just made me normal. One egg. Released on time. Sperm still had to find it. Etc. But at least I had a chance of getting pregnant.
Over the next six months, we followed this "natural cycle" method. (It always amused me when the nurses said, "oh, you're on a natural cycle" as they were monitoring my follicles with an ultrasound and telling me when to give myself a shot. There's nothing natural about that!) It involved several days of follicle monitoring each month and then an ovidrel shot from a small pre-filled syringe into my abdomen when the follicles reached a mature size. (The shot did not hurt.) Then we had "timed intercourse." They actually wrote times and dates on a sheet of paper and gave it to me! My husband and I both travel for work, so the timed intercourse involved several funny and desperate attempts to "meet up" at the right time. I joked one month that if it worked we'd have to nickname the kid "booty call."
I also had to follow-up the shot with progesterone suppositories, which just make sure you don't get your period before the embryo has a chance to implant and develop. I tried to convince the doctor's office to allow me to take an oral pill instead of being forced to deal with sticking leaky nasty pills in my who-haw, but they wouldn't budge, saying the oral pills were not as effective.
The ovidrel shot varied from day 10 of my cycle to day 16 of my cycle.
We never got pregnant "naturally."
After I got my last failed pregnancy test in March of 2011, we decided it was time to get more aggressive. We met with the fertility doctor to discuss more options. After talking about the potential treatments (injectables, IUI, IVF), we decided that IVF was the best option for us.
We put an end to booty calls. We decided to get serious.
We were going to get some answers.
They ran a battery of tests over the course of the month--blood tests, ultrasounds, etc. The result? Husband's sperm was absolute perfection. (Reading the results was pretty funny--did you know sperm can have two heads, or two tails, or no heads or tails at all? Ew!) So that was good to know.
But something was definitely wrong with me.
Because of a hormone issue, my body prepared an egg, but then didn't release it for a while. By the time it was released, it was basically overripe. (So we were wrong about the "luteal phase defect"... or were we?... but we correctly identified a problem about my body releasing eggs too late.) The fertility doctor suggested that it could have caused both the ectopic and the miscarriage or it could be totally unrelated.
I asked the doctor if my hormone imbalance was a common problem. He said no. He told us that older women often have all kinds of hormone imbalances, but for someone my age (early 30s) to just have this one issue was unusual.
He gave us several potential treatment options. The least intrusive was for them to monitor my follicles, and then when they reached a mature size (18-22) trigger ovulation using a shot of ovidrel (human chorionic gonadoptropin) to make sure a mature egg was released on time. Other options were more invasive, such as IVF, which I hoped never to have to do.
So we chose the "easy" option. It just made me normal. One egg. Released on time. Sperm still had to find it. Etc. But at least I had a chance of getting pregnant.
Over the next six months, we followed this "natural cycle" method. (It always amused me when the nurses said, "oh, you're on a natural cycle" as they were monitoring my follicles with an ultrasound and telling me when to give myself a shot. There's nothing natural about that!) It involved several days of follicle monitoring each month and then an ovidrel shot from a small pre-filled syringe into my abdomen when the follicles reached a mature size. (The shot did not hurt.) Then we had "timed intercourse." They actually wrote times and dates on a sheet of paper and gave it to me! My husband and I both travel for work, so the timed intercourse involved several funny and desperate attempts to "meet up" at the right time. I joked one month that if it worked we'd have to nickname the kid "booty call."
I also had to follow-up the shot with progesterone suppositories, which just make sure you don't get your period before the embryo has a chance to implant and develop. I tried to convince the doctor's office to allow me to take an oral pill instead of being forced to deal with sticking leaky nasty pills in my who-haw, but they wouldn't budge, saying the oral pills were not as effective.
The ovidrel shot varied from day 10 of my cycle to day 16 of my cycle.
We never got pregnant "naturally."
After I got my last failed pregnancy test in March of 2011, we decided it was time to get more aggressive. We met with the fertility doctor to discuss more options. After talking about the potential treatments (injectables, IUI, IVF), we decided that IVF was the best option for us.
We put an end to booty calls. We decided to get serious.
Saturday, May 21, 2011
What more can go wrong? (Luteal phase defect?)
I started using ovulation predictor kits pretty early on in our (in)fertility journey. My husband was the one raised a concern with the fact that I got my period really soon after the kits detected the LH surge (which happens right before ovulation). We just thought that seemed wrong--how could you get pregnant if you were getting your period just days after ovulating?
Reading on the internet we decided I might have a luteal phase defect.
Basically, “luteal phase” is the time between ovulation and your period. Makes sense if you ovulate and get your period a day later, that’s not enough time for the egg to get fertilized and implant, right? Well, some doctors think if your time from ovulation to period is not long enough you have a “luteal phase defect.” I found many websites that claimed that the luteal phase is normally 14 days long and on an average it can be anywhere from 10 to 17 days long. They claimed that a luteal phase of less than 10 days it is considered a luteal phase defect, and it can be a problem if the luteal phase is less than 12 days. (One thing I should note—apparently there’s no agreement in the medical community about whether there is such a thing as a luteal phase defect. My obgyn poo-pooed it.)
I didn’t have to read much to worry that I had a luteal phase defect. Using ovulation predictor kits, I found that my luteal phase was consistently less than 10 days. (The predictor kits recognize an LH surge, which means you’re going to ovulate in the next day or so.)
One thing I read was that taking vitamin B6 can help with a luteal phase defect. I called my doctor’s office and they said there was no risk and I could take B6 vitamins. The B6 actually seemed to lengthen my luteal phase to more than 10 days, so that was good.
For the next six plus months after my miscarriage, we never had a positive pregnancy test. (I actually had two separate times where I had pregnancy symptoms, but that was either just my mind / body playing tricks on me or I had two more chemical pregnancies.)
With heavy hearts, in September 2011, after going off birth control in March of 2008, suffering an ectopic pregnancy, and suffering at least one miscarriage, we decided it was time to see a fertility doctor.
Friday, May 20, 2011
Miscarriages Suck!
So apparently I've decided to just go through my entire infertility history in a countdown to the result next week.
Fun!
My ectopic pregnancy was diagnosed in April of 2009. In September 2009, after I had recovered, my doctor ran a test called a hysterosalpingogram to take a look at my tubes. During an "HSG" test, the doctor puts dye into your uterus that runs out the fallopian tubes. Then they use an x-ray to look at everything.
This test hurts like a bitch. Like the worst period cramp you've ever had. At least it doesn't last very long.
The test showed that I had some minor scarring in my right fallopian tube. It could have been there all along and caused the ectopic pregnancy, or it could have been fine and then scarred during the ectopic pregnancy. There's no way to know. Whatever the cause, I now had an significantly increased risk of having a future ectopic pregnancy. Boo. (There are lots of different risk factors for ectopic pregnancies--pelvic inflammatory disease, intrauterine device use, exposure to DES, tubal surgery, intrauterine surgery, smoking, tubal ligation, etc. I had none of them.)
So husband and I started trying to conceive again, but this time with the realization that it's not always so easy to get pregnant. Enter ovulation prediction kits and "baby making sex" (shudder).
By January, we still had not gotten pregnant. I was feeling pretty down about it. After taking yet another negative pregnancy test at the end of the month, I allowed myself to cry a little bit. But I had "pregnancy symptoms" (that I now recognized from the ectopic--including super duper sore boobs) and the period that followed was strange and light so I took another test a couple of days later. Positive. But the bleeding continued and got heavier.
Miscarriages suck. At least mine was an early one, I knew it might not be a viable pregnancy even when I got the positive pregnancy result, and I did not have to go into the doctor's office to have anything further resolved.
Tomorrow let's talk about luteal phase defects! Yay!!
Fun!
My ectopic pregnancy was diagnosed in April of 2009. In September 2009, after I had recovered, my doctor ran a test called a hysterosalpingogram to take a look at my tubes. During an "HSG" test, the doctor puts dye into your uterus that runs out the fallopian tubes. Then they use an x-ray to look at everything.
This test hurts like a bitch. Like the worst period cramp you've ever had. At least it doesn't last very long.
The test showed that I had some minor scarring in my right fallopian tube. It could have been there all along and caused the ectopic pregnancy, or it could have been fine and then scarred during the ectopic pregnancy. There's no way to know. Whatever the cause, I now had an significantly increased risk of having a future ectopic pregnancy. Boo. (There are lots of different risk factors for ectopic pregnancies--pelvic inflammatory disease, intrauterine device use, exposure to DES, tubal surgery, intrauterine surgery, smoking, tubal ligation, etc. I had none of them.)
So husband and I started trying to conceive again, but this time with the realization that it's not always so easy to get pregnant. Enter ovulation prediction kits and "baby making sex" (shudder).
By January, we still had not gotten pregnant. I was feeling pretty down about it. After taking yet another negative pregnancy test at the end of the month, I allowed myself to cry a little bit. But I had "pregnancy symptoms" (that I now recognized from the ectopic--including super duper sore boobs) and the period that followed was strange and light so I took another test a couple of days later. Positive. But the bleeding continued and got heavier.
I was diagnosed as having a “threatened miscarriage” on January 26, when I was less than 20 days post ovulation. The doctor said about half of women who have heavy bleeding go on to have miscarriages, but as long as your cervix remains closed you still have hope.
My cervix did not remain closed and I did have a miscarriage. It was a super early miscarriage--if I hadn't been monitoring my fertility / period timing like a hawk and if I had not been familiar with pregnancy symptoms I probably would not have noticed. My HCG numbers fell pretty quickly, which was good.
HCG
01/26/2010 34
01/28/2010 64
01/30/2010 41
02/03/2010 31
02/26/2010 1
Miscarriages suck. At least mine was an early one, I knew it might not be a viable pregnancy even when I got the positive pregnancy result, and I did not have to go into the doctor's office to have anything further resolved.
Tomorrow let's talk about luteal phase defects! Yay!!
Thursday, May 19, 2011
The Time I Probably Could’ve Almost Sorta Died… Maybe
One Saturday about a month after I had the methotrexate shot, I was feeling particularly uncomfortable. I was in a lot of pain—cramping, etc. I called my doctor’s office, but they told me that, unfortunately, significant physical discomfort is part of the process of recovering from a methotrexate shot after an ectopic pregnancy diagnosis. (They did not entirely blow me off—telling me to call back if the pain reached a certain threshold.)
One of my best friends had invited us over for dinner that evening. She just moved in with her boyfriend and it was going to be our first time over to their house. I hadn’t gotten out much in the past month and I wanted to have a life again, so even though I felt like a bag of hell we decided to go.
In retrospect, I should have cancelled dinner.
Usually, I’m the kind of person who dresses up a little bit when I go out. Nothing too fancy--you know, ball-gown, tiara, the usual stuff. But I felt really awful, so I ended up wearing a long-sleeved cotton tee-shirt and a pair of cotton track pants. Pajamas, basically. Not my best look. (My friend told me later that she immediately realized how sick I felt from my physical appearance—namely ashen face and overnight wear.)
On our way to her house, I asked my husband to stop before we drove over every speed bump (there are a few in her neighborhood) because it hurt so much to drive over them.
Because it was our first time at his (now their) house, we brought over a really, really nice bottle of wine. Of course, I was still in the not-allowed-to-drink mode, which sucked. They were making pasta from scratch. Yum. We stood around in their kitchen chatting and nibbling olives and other yummies while they cooked. Everyone was enjoying the fantastic wine. I decided to have a very small glass. Good idea? No. (My husband gave me an I’m-not-your-mother-but-if-I-were-I-would-scold-you look, but said nothing.) I poured myself about 2 shots worth of wine and slowly sipped it, standing next to the counter. I started feeling sick and switched to water. The next thing I knew, I felt dizzy. I thought I was going to throw up and the words “I think I’m going to be sick” were on the tip of my tongue, but I couldn’t say anything. Time slowed down. I heard the sound like a train rushing in my ears, and then I blacked out.
I’d never fainted before, but this was a good one. Like movie good. The delicate water glass slipped from my hands, shattering. I followed it as I slumped to the floor in a heap. My husband claims he managed to catch me at the very end. I was unconscious, but I’ll take his word for it.
From that moment, the house was in organized chaos. My husband scooped me up and dragged me to the front door. My friend, who was aware that this was a potentially serious situation, followed behind us and helped him put on my shoes and jacket. Her boyfriend grabbed their dog to stop him from running into the kitchen and getting cut on broken glass. By the time we reached the front door I was conscious enough to walk to the car with help. We hauled ass to the hospital, which was—fortunately—close by.
Keep in mind, at that point my poor husband was thinking that my tube just blew and I was about to bleed to death in my friend’s kitchen.
We got to the emergency room and I immediately confessed my transgression to the nurse who first inspected me. She assured me with a laugh that a few sips of wine did not cause me to faint or cause my tube to explode. (Not that her assurances stopped my husband from giving me the stink eye a few more times.) They were pretty sure my tube had not ruptured (I think because I could still walk and talk and was not hemorrhaging blood), but there was a lot of blood in my abdomen so they wanted to keep me overnight just to make sure.
My husband was beside himself. I told him to go home and sleep—otherwise he had to either sleep in my tiny little hospital bed or a really stiff looking chair, but he refused to leave me. He’s such a sweetie. They took my blood every hour or so all night long. I wasn’t bleeding to death.
My hemoglobin level suggested that I had lost somewhere around a quarter of the blood in my body in the past month. (It was 10.7 the night I was admitted to the hospital, compared to over 13 when I was first diagnosed with the ectopic and after I’d already been bleeding for a week.)
The next morning I was discharged. I never did get to try the pasta. The wine was good, though.
Wednesday, May 18, 2011
Ectopic Pregnancies Suck!
On May 21, 2009, a doctor told me I was suffering from an ectopic pregnancy, that it was not a viable pregnancy, that I was at serious risk of having my fallopian tube rupture and of then of potentially bleeding to death, and that I needed to have it terminated immediately.
May 21, 2009 will not go down as the best day of my life.
A. Ectopic-Pregnancy-Wa?
B. Treatment Options--How to do the Most Damage for the Least Damage
I was given two options, and I needed to decide pretty much immediately: (1) have the pregnancy surgically removed from my fallopian tube or (2) take a shot of methotrexate--a form of chemotherapy that stops new cells from growing.
The upside to the surgical option is that when it's done, it's done. The ectopic pregnancy is removed immediately. The downside was that I would actually have to have surgery (I think laproscopic), increasing risk of infection etc. Also, surgery worsens the scarring that’s probably already in the tube, making future ectopic pregnancies more likely.
Considering how early along I was in the pregnancy (about 35 days past ovulation) and that my tube did not appear to be in immediate danger of rupturing, the doctor recommended the shot. (She all but said we would be idiots to do the surgery when methotrexate was a viable option.) My husband (who was actually out of town for work) and I did some super quick research (me from the hospital on my phone, him at work) and decided the risk-reward of methotrexate made it a better option, especially because we wanted to avoid any further tube damage.
The hardest part of the recovery was the blood loss. I did not expect it. And I bled A LOT. I had period-like bleeding for one hundred and nine days. ONE HUNDRED AND NINE DAYS. And this is with the banana pads. Boooooo.
May 21, 2009 will not go down as the best day of my life.
A. Ectopic-Pregnancy-Wa?
The ectopic pregnancy was the worst thing that ever happened to me. If you’re going through this right now, I’m so very sorry.
For those of you who don't know what an ectopic pregnancy is--it's a pregnancy that's growing outside of the uterus. In most cases (including mine) that means the fallopian tubes. Fallopian tubes do not have the resources and are not big enough to support a pregnancy. Some will resolve (end) on their own. Others will continue to grow and will, most likely, cause your fallopian to rupture, causing massive internal bleeding and possibly death. Ectopic pregnancies are not viable pregnancies. They are also extremely dangerous to the mother's life.
I've read that ectopic pregnancies are the leading cause of pregnancy-related death in the first trimester of pregnancy.
You do not want to mess around with an ectopic pregnancy.
B. Treatment Options--How to do the Most Damage for the Least Damage
I was given two options, and I needed to decide pretty much immediately: (1) have the pregnancy surgically removed from my fallopian tube or (2) take a shot of methotrexate--a form of chemotherapy that stops new cells from growing.
The upside to the surgical option is that when it's done, it's done. The ectopic pregnancy is removed immediately. The downside was that I would actually have to have surgery (I think laproscopic), increasing risk of infection etc. Also, surgery worsens the scarring that’s probably already in the tube, making future ectopic pregnancies more likely.
The upside to methotrexate is that it’s just a shot. No surgery and no risk of further damaging the tube. Of course, methotrxate is chemotherapy. There are all kinds of unlikely but serious risks (hair falls out, etc.). And, there's still a risk of the tube rupturing because the pregnancy is not gone--it's just going to stop developing and eventually shrink / absorb. For this reason, not all ectopic pregnancies are even eligible for methotrexate. If the ectopic is too far along or seems like it might burst at any second, methotrexate is not a good option. Also, the methotrexate stays the body for a while, so my doctor said no trying to make babies for at least three months after the shot.
So I went with door number 2--the shot in the ass.
Fortunately, my husband arrived back (barely) before I had the shot. It was administered by a chemo nurse and, no lie, was fluorescent green. (Or at least, that's how I remember it.) It was a big honkin' needle, too.
C. Methotrexate No-Nos
After the shot, I wasn't allowed to be alone or drive for several days because of the continued risk of tubal rupture. (Think Moby Dick--"thar she blows!") Also, I had to have my blood monitored every week to make sure my HCG levels were falling--demonstrating that the pregnancy was actually terminating properly. There were also some other things I couldn't do while recovering:
1. Take prenatal vitamins.
Folic acid—which helps new cells grow—is the enemy of methotrexate—which is trying to stop the cells from growing. So those vitamins you've been so carefully taking to make sure you have a strong little fetus? Dump 'em.
2. Wear tampons
This might not seem like much of a sacrifice, but it really sucked. A lot. I hadn’t worn pads since I first got my period as a teenager. I guess I hadn't really given a lot of thought to how much blood I would lose in the process, but it was epic. Seriously. The amount of blood in this process required those big industrial pads, the ones that would shift around and make me feel like I was smuggling a banana around in my underwear. And it was swimsuit season during my no-tampons time, which was unfortunate.
3. Drink
I read another blog where the blogger said, “just when you need a drink the most, you can’t have it.” That is the truth! Again, the methotrexate shot is out there killing your cells—including liver cells. You aren’t allowed to drink because it's not the best for your poor beaten upon body. But I agree, there were definitely times I really, really wanted to have a drink during that time.
4. Have sex
Considering sex was what got me into the whole mess, and considering the copious amounts of blood pouring from my body for months, this was not as big of a sacrifice as you might think. My husband was not very happy, though.
D. The Second Shooter
The day my ectopic pregnancy was diagnosed, my HCG level was 682--not a good number for a pregnancy that far along, demonstrating that it was already unhealthy. My doctor said if it did not fall by enough (I think she wanted 30%), I'd have to have another shot, but most people only needed one shot. If I had another shot, my doctor said no trying to make babies for six months instead of three.
A second shot was unthinkable.
A week later, my HCG was 546--it had not fallen enough and I needed another shot. That was the first time I really broke down and sobbed. Up until that point, I was in survival mode, I think. Hearing I needed a second shot was even more devastating than the original diagnosis.
Strange, right?
[Although I will say this--to this day my husband and I proudly joke that our first pregnancy was a tough little guy and he was not coming out without a fight.]
The doctor's warning about no trying to make babies for six months after two shots ended up not being as much of a sacrifice as I thought it was going to be.... because that's almost how long it took for me to recover.
E. Recovery--The Fall of HCG
It took a little over two months (of dreaded weekly blood draws--the bruises on my arms made me look like a junkie) for my HCG to fall to "not pregnant" levels (and the weeks where it barely fell were truly irritating). One of the things I found most frustrating about the recovery from the ectopic pregnancy was not knowing how long it would take for my numbers to fall, so here are my numbers (to give you a sense of one person's experience):
05/21/2009 682
05/28/2009 546
06/04/2009 240
06/06/2009 180
06/07/2009 180
06/12/2009 135
06/19/2009 65
06/26/2009 65
07/06/2009 35
07/13/2009 29
07/20/2009 13
07/27/2009 5
I was pretty stoked when my levels finally fell to 5, aka no longer pregnant. Please pass the Merlot. No honey, I'm still not in the mood for sex. Maybe tomorrow.
F. Recovery -- The Crimson Tide
Not only was I bleeding outside, but I also had internal bleeding. To the best of my understanding, the internal bleeding was caused at least in part by my body trying to flush the embryo out of my tube. It really sucked. First, my abdomen was distended. I looked perpetually bloated, which I guess I was. Second, and this is something I’m a little embarrassed writing even now, going to the bathroom (number two) was agonizing! I would, literally, sit on the toilet and dig my nails into my thighs when I was going to the bathroom. My doctor told me that all of the blood sitting around my organs caused them to be irritated, and “straining” to go to the bathroom caused the pain. (I am NOT a "strainer"!) All I know is that at work one time I almost screamed out in the bathroom. That would’ve been awkward.
The combination of the internal and external bleeding had the expected consequences. I bruised more easily. I was weak. I was dizzy. The experience reminded me—blood is good.
The doctors measured my hemoglobin during that time and confirmed that I lost a lot of blood.
Tomorrow I'm going to tell the story about how I almost died, too. Fun times!
Tuesday, May 17, 2011
Origin Story
A little about me (me, me). I’m a professional in my early thirties living in the Midwest . My husband and I started our (in)fertility journey a few years ago.
We started trying to get pregnant in 2008, when I was in my late twenties. We thought it would be sooo easy. (Oh to be young and naive!) For the six months or so, we were not super "serious" about it. (Again, anyone who's gone through this knows what I'm talking about... the time before ovulation predictor kits, basal body temperature thermometers, business trips cut short for "booty calls," etc.) We even actively stopped trying for a while after I switched jobs.
In April 2009, when we were still in our not super serious phase, my period was late. Excited, we (okay, I was the one peeing on a stick, but he was around!) took a home pregnancy test. Negative. A day later, still no period in sight, we took another one. Still negative. The next day, period. Light period, but I counted it and moved on.
Over the next few weeks, I became increasingly uncomfortable. Cramps in my back. I got what I thought was my next period early, but it lasted much longer than usual. During that time, I went to a friend's wedding, had a teeny bit too much to drink (I've always loved sparkling wine!) and ended up throwing up before dinner was even served (in a bathroom, not in the grand ballroom) and spending the entire night in bed. My husband and I discussed the next day how very extreme my physical reaction was to what would usually have been just enough social lubricant to make me a good dancer. Anyway, my physical state got worse and worse over the next couple of days and my period threatened to last as long as the great flood, so finally a friend convinced me to call a doctor.
When I called my doctor's office the nurse said, "oh, it sounds like you're having a miscarriage." No, I explained, I had failed two home pregnancy tests and was currently on my second period of the month. [Cut to me looking into the camera while filming an episode of I Didn't Know I Was Pregnant.] She convinced me to go take a home pregnancy test.
The last few times I'd taken home pregnancy tests, I'd splurged on the really nice ones. You know, brand name, digital read-out, tells you if you're pregnant 15 minutes sooner, leather seats, etc. This time I bought the cheapest one at the pharmacy a block from my office and took the test in my office bathroom. Positive. Immediately. I cried, mourned my until that moment unknown pregnancy, and called my doc's office to let them know. They wanted to check me out immediately, so I went to the hospital.
After a very stressed out ultrasound tech spent a long time looking around inside my... you know... and anxiously demanded that I not go anywhere until my doctor talked to me, I was informed it was an ectopic pregnancy.
I'd never even heard of an ectopic pregnancy before that day.
And so began our (in)fertility journey....
We started trying to get pregnant in 2008, when I was in my late twenties. We thought it would be sooo easy. (Oh to be young and naive!) For the six months or so, we were not super "serious" about it. (Again, anyone who's gone through this knows what I'm talking about... the time before ovulation predictor kits, basal body temperature thermometers, business trips cut short for "booty calls," etc.) We even actively stopped trying for a while after I switched jobs.
In April 2009, when we were still in our not super serious phase, my period was late. Excited, we (okay, I was the one peeing on a stick, but he was around!) took a home pregnancy test. Negative. A day later, still no period in sight, we took another one. Still negative. The next day, period. Light period, but I counted it and moved on.
Over the next few weeks, I became increasingly uncomfortable. Cramps in my back. I got what I thought was my next period early, but it lasted much longer than usual. During that time, I went to a friend's wedding, had a teeny bit too much to drink (I've always loved sparkling wine!) and ended up throwing up before dinner was even served (in a bathroom, not in the grand ballroom) and spending the entire night in bed. My husband and I discussed the next day how very extreme my physical reaction was to what would usually have been just enough social lubricant to make me a good dancer. Anyway, my physical state got worse and worse over the next couple of days and my period threatened to last as long as the great flood, so finally a friend convinced me to call a doctor.
When I called my doctor's office the nurse said, "oh, it sounds like you're having a miscarriage." No, I explained, I had failed two home pregnancy tests and was currently on my second period of the month. [Cut to me looking into the camera while filming an episode of I Didn't Know I Was Pregnant.] She convinced me to go take a home pregnancy test.
The last few times I'd taken home pregnancy tests, I'd splurged on the really nice ones. You know, brand name, digital read-out, tells you if you're pregnant 15 minutes sooner, leather seats, etc. This time I bought the cheapest one at the pharmacy a block from my office and took the test in my office bathroom. Positive. Immediately. I cried, mourned my until that moment unknown pregnancy, and called my doc's office to let them know. They wanted to check me out immediately, so I went to the hospital.
After a very stressed out ultrasound tech spent a long time looking around inside my... you know... and anxiously demanded that I not go anywhere until my doctor talked to me, I was informed it was an ectopic pregnancy.
I'd never even heard of an ectopic pregnancy before that day.
And so began our (in)fertility journey....
Monday, May 16, 2011
Blastocyst Blues
I was feeling a little blue yesterday. I think I thought that after the transfer I would just KNOW that it worked. Instead, I started getting really nervous that it wouldn't work.
Part of my anxiety stemmed from the fact that of the 10 fertilized eggs we managed to have on transfer day, only two made it to the blastocyst stage. I don't know why I thought when we showed up the Dr. was going to say, "wowza! We've never had a patient with ten perfect blastocysts. When this is done, I'd like to study what it is that makes your eggs so incredibly awesome." I mean really, was that too much to hope for?
Instead, only two made it to the blastocyst stage, and neither was "perfect." In our Dr.'s office, they rate them B1, B2, or B3, with B1 being the best. We had a B2 and a B3. So we picked little old B2. (I have his/her picture sitting next to me right now.) B3 is going to be iced for later use.
So I spent the day fretting about my underdog blastocyst.
This morning the embryologist called and said one more of our little guys managed to make it to B3, so we're going to freeze that one as well. I took the chance to ask her the questions I wished I'd asked yesterday, but that my vicodin addled brain must've forgotten. (Oh, and because my husband put the kibosh on questioning the doctor. Literally when my legs were in the holster and they were ready to launch B2, I asked what my infertility would be classified as for reporting purposes (see http://www.sart.org/find_frm.html) and my husband was like, "no more questions." We'll get that one answered later.)
So I asked the embryologist how common it is to have a B1 and she said pretty unusual. So I'd been thinking B2 was a failure when really s/he is pretty darn good.
You go little B2!
Part of my anxiety stemmed from the fact that of the 10 fertilized eggs we managed to have on transfer day, only two made it to the blastocyst stage. I don't know why I thought when we showed up the Dr. was going to say, "wowza! We've never had a patient with ten perfect blastocysts. When this is done, I'd like to study what it is that makes your eggs so incredibly awesome." I mean really, was that too much to hope for?
Instead, only two made it to the blastocyst stage, and neither was "perfect." In our Dr.'s office, they rate them B1, B2, or B3, with B1 being the best. We had a B2 and a B3. So we picked little old B2. (I have his/her picture sitting next to me right now.) B3 is going to be iced for later use.
So I spent the day fretting about my underdog blastocyst.
This morning the embryologist called and said one more of our little guys managed to make it to B3, so we're going to freeze that one as well. I took the chance to ask her the questions I wished I'd asked yesterday, but that my vicodin addled brain must've forgotten. (Oh, and because my husband put the kibosh on questioning the doctor. Literally when my legs were in the holster and they were ready to launch B2, I asked what my infertility would be classified as for reporting purposes (see http://www.sart.org/find_frm.html) and my husband was like, "no more questions." We'll get that one answered later.)
So I asked the embryologist how common it is to have a B1 and she said pretty unusual. So I'd been thinking B2 was a failure when really s/he is pretty darn good.
You go little B2!
Sunday, May 15, 2011
Inception
Hello everyone.
This is my first attempt at a blog. Originally, I was going to call it the "Two Week Wait." Anyone who's trying to get pregnant knows what that means. (It's the time between when you ovulate and the time you find out if you're pregnant.) But that name was taken. :) And, frankly, the "Two Week Wait" is not actually the whole story.
As anyone who has struggled with infertility and has finally decided to take the IVF plunge knows, my journey started just a little bit before the day the doctor squirted my hopefully soon-to-be child into my uterus while a room full of people (including my husband) watched on a monitor. Instead, my story really starts a few years ago. A little over three years ago, actually. And I always thought that when my little journey (quest?) was all over (for better or for worse), I'd go out and offer thanks and additional thoughts on all of the blogs and forums that I have turned to over the past few years for information, inspiration, guidance, and a lot more. Instead, I've decided to put all of my thoughts here, while I embark on my two week wait.... the culmination of my three year wait.
Wish me luck!
P.S. Please forgive any melodrama. It IS the first day of the TWW. :)
This is my first attempt at a blog. Originally, I was going to call it the "Two Week Wait." Anyone who's trying to get pregnant knows what that means. (It's the time between when you ovulate and the time you find out if you're pregnant.) But that name was taken. :) And, frankly, the "Two Week Wait" is not actually the whole story.
As anyone who has struggled with infertility and has finally decided to take the IVF plunge knows, my journey started just a little bit before the day the doctor squirted my hopefully soon-to-be child into my uterus while a room full of people (including my husband) watched on a monitor. Instead, my story really starts a few years ago. A little over three years ago, actually. And I always thought that when my little journey (quest?) was all over (for better or for worse), I'd go out and offer thanks and additional thoughts on all of the blogs and forums that I have turned to over the past few years for information, inspiration, guidance, and a lot more. Instead, I've decided to put all of my thoughts here, while I embark on my two week wait.... the culmination of my three year wait.
Wish me luck!
P.S. Please forgive any melodrama. It IS the first day of the TWW. :)
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