Saturday, May 30, 2009

10 weeks

Day before yesterday I had my 10 week appointment. It was a daunting task - we were headed for the "same" appointment at which we lost our first pregnancy, with the same Nurse Practitioner - I was concerned I'd go through the same experience, but we did not. I remember our first OB appointment with our first pregnancy. It was at 10w5d, the appointment started with details about how much I should eat, what exercise I should/shouldn't do, information about upcoming classes I should consider, etc. It wasn't until I had been inducted into the club (given a handbook and everything!) that we did the ultrasound and found that our baby had died. I left the exam room puffy eyed and crying, carrying my farce of a handbook - I had been kicked out of the club so quickly.

But like I said, this week's appointment went much better. After waiting 20 minutes in the exam room, pacing the floor in my gown I jumped up on the table and took Berilac's hand, we prayed that this baby would be healthy and that this appointment would go well. The NP entered and said, "hey, I recognize you! Is this baby number two?" ... without hesitation I said, "no, this is pregnancy number 5 and hopefully baby number one." ... she responded, "let me get the ultrasound machine, let's start out by giving you some reassurance" and I genuinely thanked her, I did not want to be inducted into the club without proof this time.



She opted for the trans vaginal sonogram and I made myself vulnerable in this journey once again. The minute we could see the baby she said, "oh there we go, that's good news" and I didn't know what she meant, could she see the heartbeat? 'cause I sure couldn't! She said, "look, your baby is dancing" I squinted my eyes and moved my head a little closer ... sure enough, it seemed like the baby wasn't staying still. "But is my talking and movement causing that?" I asked. She said, "hold your breathe" and as I lay as still as I could, we watched as little Flicker reached his hand to his forehead and mouth and eventually put his thumb in his mouth; he rounded it off with a nice dancy, shaky move and some twisting - it was fantastic. Flicker is the size of a kidney bean .... this was the most advanced kidney bean size baby I've ever seen! (He takes after Berilac ;-) Then little Flicker started, what looked to be, pounding his fists at us and I told him we would take away the evil ultrasound, and so we did. She didn't measure Flickers crown-rump-length, nor the heartrate - we are just reassured that movement is good.

The rest of the appointment was unremarkable.

Miscarriage rate: We asked her what our chance of miscarriage is at this point and she said 5%. I'm not sure that number will get any lower, but I will feel better if/when we make it to the second trimester. There are many ways to think of the second trimester: does it start at 12 weeks, 13 weeks, 14 weeks? We have our next appointment at 12 1/2 weeks (on June 15th) so we might "jump in with both feet" after that appointment if it goes well. The next appointment might be awhile, so perhaps we should "announce" after that appointment? (Yes, yes, this blog is open to the world, and I've been out of the closet here for months, even many IRL friends read this blog ... but none of my work friends know, nor do other random people I run into.) So perhaps we make it to one more appointment before I start thinking that this pregnancy will last, that I will stop looking with disdain and actually consider maternity wear, plan for a baby shower, consider birthing preferences, and plan around a due date. I want so badly to have this infertility loosen it's grip, to enjoy this pregnancy and to take it all in - like so many women can do.

Meds: I told her of the meds I'm on: Prenatals, Omega 3 vitamins, Folgard, Baby Aspirin, Lovenox, and Progesterone. She gave her sympathies and made notes, evidently, the OB will want to run special tests for women on Lovenox. We told her this was an IVF pregnancy and she asked where we had been cycling, we told her CCRM and she asked if Schoolcraft was our doctor - that was nice, it always surprised me when I would talk with OB staff and they didn't seem to know a thing about the infertility business/community.

Genetic testing: The NP heavily suggested the Full Integrated Screening (1st trimester bloodwork, NT Scan, 2nd trimester bloodwork) given our history of loss. We told her about our conversations with our local monitoring clinic RE and how he indicated that if we weren't willing to terminate, then there's really no point. We told her we were against the CVS and why would we take the screening tests that could provide us with more worry, rather than conclusive information. She understood about the CVS, given it's increased risk and she let us know that the one advantage to doing that early screening, is if they find a "soft marker" at the 20 week scan, they can refer back to the early screening to confirm if the screenings are consistent ... to know if they are dealing with false positives or real problems. That was persuasive, so we are considering doing the non-invasive screenings.

The ins and outs of being an OB patient: The strangest experience was having the NP run down the list of appointments we'd need to make (should this pregnancy progress) evidently, my OB office wants to see me once a month, and that's for just a "normal" patient ... I thought for sure they would want to see me next time at 20 weeks for the anatomy scan ... I thought I would have to suffer between 12 1/2 weeks and 20 weeks, but no, they include something like 13 appointments in the "maternity" package. I'm so not used to being a maternity patient.

So that is it for 10 weeks, we are now double digit weeks pregnant, we have surpassed the second longest pregnancy we've had and if we make it two weeks to our next appointment we will have made it further than we ever have.

We celebrate today because Flicker is a dancing (seemingly happy) baby and we are still pregnant.

Friday, May 15, 2009

Celebration

What I know for sure: recurrent pregnancy scars run deep.

Heading into today's ultrasound I was sure I was going to get bad news. All I've ever known in this journey is waiting and heartache; I'm having a hard time getting used to the idea of thinking that things might work out ok.

I'm almost in shock that today's appointment went so well. I literally had imagined myself calling in sick today, curling up in a ball on my couch crying my eyes out while I rock back and forth holding my little doggie. But instead the appointment went great and I'm nearly in disbelief.

I want so badly to embrace this pregnancy. I want to celebrate the life inside me. But as a protection mechanism, I've disconnected quite a bit from this experience. I struggled today to remember that there is a baby in my womb. Even if the baby doesn't make it, it doesn't mean it wasn't God's creation. It's really awe-inspiring and I'm trying to minimize it, in order to survive should we lose the baby.

"The baby" ... there is a baby in there. Wow.

I thought today if other women would be telling people at this point. I thought about how other women might head to the baby store and purchase a cute little outfit or two to celebrate. I want to start looking at maternity clothes and dream about my body with a protruding belly. I want to argue with a close friend over how early to send out baby shower invitations. I want to plan a babymoon that will allow me to wear a bikini that showcases a beautifully full belly. I want to believe that this Christmas will bring us a child. But as I said ... the scars of recurrent pregnancy loss run deep.

I hope that as the weeks pass, not only will we experience more and more encouraging doctors appointments, but that we'll also learn to dream and to trust. I so badly don't want to be jaded anymore.

Ok, ok, enough about my heart ... let's get on to the details!

As I mentioned in a previous post my local monitoring fertility clinic offered to give me one more ultrasound before being transferred over to my OB's care ... and because that means one more look at our precious little "Flicker" (with a higher quality machine, I might add) I was on board for it.

Let me start out by saying that the doctor's summary of our appointment today: "it couldn't have gone any better" ... if I could encourage any RE out there who might be reading this (um, yeah, all those RE's that read infertility blogs!) these are the exact words I wanted to hear.

Reasons for the great ultrasound:
  1. Today was my 7w6d appointment and the baby was measuring ahead at 8w0d-8w1d.

  2. The baby had a strong and steady heartbeat (they don't measure rate unless there is a problem)

  3. The placenta is in the fundus (high in the uterus - I guess this is good so as to avoid previa)

  4. There is no blood anywhere (it is very common that IVF pregnancies deal with bleeding)

Berilac and I were so relieved. We called our parents and we praised the Lord. I thought for sure I would need to cancel my plans for the weekend and for next weekend, but today we are still pregnant, so we have reason to celebrate - now I just have to remember what it's like to be happy and celebrate (stick out tongue here).

I will leave you with this: our 2 month old precious Flicker (aka, the blob in the center ... The black space is the gestational sac, the round thing at the top is the head, the rest is the body and the umbilical cord.)


Our next ultrasound is with our OB on Thursday, May 28th ... Lord keep our baby healthy and safe.

Tuesday, May 12, 2009

Update

First off let me start out by saying that I'm still pregnant. It seems that every time I see friends I carry a less than ecstatic expression on my face and they are wondering (usually without asking) if I'm still pregnant and really, it's understandable. So yes, nothing has happened that I know of, so I must still be pregnant.

I mentioned in my previous post that our next ultrasound appointment is on 5/20 with our OB/GYN office (since I have graduated from CCRM's care) however, my local monitoring fertility clinic offered to give us a scan (without CCRM's involvement and before being transitioned over to the OB's office) so I'm taking them up on their offer. I will have an ultrasound this Friday (5/15) at nearly 8 weeks and I have pushed out seeing my OB - so no scan for me on 5/20.

There is not much to say on the "how's the pregnancy going?" front. Things seem to be going fine, I have slight symptoms all around: fatigue, indigestion, food aversions, tender bbs, uterine cramping/twinging and really just an overall feeling of blah in the evenings when I get home from work. It seems so ambitious to consider cleaning the house or doing the dishes.

I am surprised at how well I'm holding up since our last ultrasound. Prior to the ultrasound at the cadence of about every other day I had emotionally all but given up on a healthy pregnancy. Since our last scan I have attacks of fear, but I remember back to the successful milestones we've already encountered and I remember that God is in control, not me. There's no amount of worrying or not worrying that will help or harm this baby - if there was something I could do to cause a miscarriage of a baby that God has made healthy - then why would abortion clinics be in business these days? ... So I try to just accept that whatever will happen, will happen. I am trying to enjoy each day as much as possible.

I am highly anticipating Friday's ultrasound. I think it stands to reason that if last week was my first good ultrasound ... then each "good" ultrasound that I have from this point forward, will also be a new experience. In looking for examples of what a good 8 week ultrasound should look like, on You.Tube I've found video blogs of women's pregnancies - and of course I get sucked in! I watch these fresh faced, optimistic ladies gush about their pregnancies - one girl even "revealed" her pregnancy to her friends and family (in a cute way) when she was "already 5 weeks" pregnant. I always preface my pregnancy stage with "I'm only X weeks pregnant " .... it just amazes me how cynical I've become. I get that our situations are different and that of course I'm hesitant, but I guess I just have a hard time accepting that anyone would get pregnant and assume that there is a healthy baby inside, that they will make it to the end of the 40 weeks with a baby to show for it. I think most young women are confident in their pregnancies - and it just floors me. I must admit that I grieve the loss of innocence, I grieve the innocence that not only Berilac and I no longer experience, but the innocence that my friends and family no longer have in relation to me. There will be no "cute reveal" of our "bun in the oven." Each time I get pregnant and I tell friends, they are hopeful, concerned about me, and wondering if this time will be different (at least that's what I assume they are thinking?) ... so, as you can imagine, it's hard to watch those uneventful video blogs ... why do I keep torturing myself?!!?

There was another torturous event recently - ok, a couple. Sunday was Mother's Day and yesterday was my birthday ... both are so difficult. I know I'm young, but as I've mentioned before: holidays mark another year gone by that you've been in this battle, and I know it seems like I might be in the midst of the end of my battle - but I've still got a ways to go before I can start popping the Martinelli's and begin proposing nursery theme ideas. I went to church on Sunday - my first Mother's Day service in a few years. When the time came to honor mother's, I didn't stand. I sat and wept for the many women in the congregation (and in congregations around the world) who only wish they could stand - only wish someone would recognize their hurting hearts. For what it's worth - I grieved with you and for you on Sunday and I wondered if next Mother's Day will be a joyful time, or if it will be filled with even more heartache.

Lastly, I just wanted to share my friend's story and send her a hug - my girlfriend in Colorado. We met awhile a go in the blog sphere. She is my age and has dealt with elevated FSH (like in the 20's!) I initially found her blog because I was searching for an image of an intramuscular shot being given, I found this lovely image of her rear end and her husband priming a big juicy 25 gauge-r to stab her with. I complimented her cute hiney and we've been kindred spirits ever since. Only months after I started following her blog - she got pregnant naturally - and we all celebrated! (Her infertility site has been shut down or else I'd direct you there.) This past summer she and her husband welcomed a precious little girl that I've had the opportunity to fawn over during one of my CCRM trips. More recently, it came with mixed emotion when I received news this past March that she was pregnant again, and again au'naturale (it was difficult only because she was the third pregnancy announcement I had gotten in days, on the flip side, I was definitely in awe that lightening had struck twice - score another point for team infertile!!) Well, on Thursday night, just shy of 15 weeks pregnant, my friend sent out an email that I surely didn't want to read ... she was in for a routine mid wife appointment and they found that the baby's heart had just recently stopped beating. I broke down in sobs. I know the pain of loss, but I do not know the pain of loss after you've crossed so many milestones - thinking that you were "in the clear" ... my heart breaks for her and her family - and I can't even imagine how bittersweet this Mother's Day was for her. So Sweety, if you're reading this - know that we are still praying for you - and we are here for you.

Tuesday, May 5, 2009

We took home a picture

Today was ultrasound number 5 for me in terms of number of ultrasounds I've had where I should have gotten good news and should have been able to take home a picture. I've always wanted to take home baby's first photo - and today I finally did.

Berilac and I were so grateful to see in this morning's ultrasound a precious little baby measuring exactly on at 6 weeks and 3 days with a strong heart beat! (rate was around 130).

It was so amazing to finally see a little heart beating away - the way it's supposed to. I didn't cry, I didn't laugh, I just breathed deeply and thanked God - I am so incredibly grateful.


It's my understanding that although miscarriages can still happen after you see a strong heartbeat, the chance of miscarriage, at this point, for my age group is 7.6%

We are praying that this little one will stick around for another 7 and a half months. We are so happy to have today's results and what seems to be a healthy little baby tucked away nice and tight. But we are saddened that the other little Gamwichs didn't make it.

We have our next ultrasound scheduled with our OB/GYN on Wednesday May 20th.

Today we celebrate Cinco de Mayo style because today we are pregnant.

Monday, May 4, 2009

Anticipation

On Friday we got more good news on the hormone front. After cutting out estrogen support entirely my hormone levels came back higher than they were when I was on support! (Up to 862 from 739). And the progesterone level stayed the same (31.4) even though I had cut my progesterone support in half. So we are staying off of estrogen support and we are done monitoring estrogen levels and Saturday night was my "last" Endometrin, we will check the progesterone level tomorrow morning and if all looks well, I will have weaned off of hormone support at 6 weeks. Although scary for me, this is good news.

And if you're paying attention ... tomorrow is our first ultrasound. After so many things going well, many people think that:
1.) I'm ecstatic to be pregnant
2.) I am hopeful

... now don't get me wrong, I'm very grateful to be pregnant, but I've been here before, and because of that - I'm scared that this one will end like all the others before it. I do want to be hopeful, but I have such major trust issues. I have such a hard time not thinking that everything is going to come crashing down around me - that's how I feel in life in general, imagine how it must feel in this circumstance!

Berilac and I had a long conversation this weekend. Berilac was really thinking that I had been lifted out of my depression (for lack of a better term) and while it's true that my emotional state has lightened dramatically, I'm still not "happy" or "back to my old self" ... if anything, I'm struggling to stay hopeful as the days pass after good hormone results and I try my best not to think that yes the recent hormone results were good, but TODAY (2-3 days past the last good hormone level results) ... the worst is happening - but it's hard. In our conversation we realized that I look at this experience as one long running 3 year heartache and Berilac looks at each instance (each pregnancy and each treatment) as a seperate event, and this "event" is going well, so he's excited.

I want to be hopeful, but I'm scared ... and for good reason. I've been burned before.

When the nurses told me that my second beta was great and that my ultrasound would be scheduled for 6 and a half week check-in on Cinco de Mayo I thought ... how am I ever going to make it to May 5th before getting an ultrasound? And of course, the days at work DRAGGED by. The weekends provided a much needed break from the slow motion experience of 9 to 5. Then I wake up this morning to realize that the ultrasound is tomorrow ... and I'm practically having a panic attack, today can't go by slow enough ... I don't want to go to an ultrasound tomorrow! What if we get horrible news? When we had first learned of our Tuesday appointment, Berilac and I had toyed with the idea of postponing the ultrasound until Friday (as we've never gotten good news at an ultrasound and it's much easier to be alone when you're dealing with difficult news like a poor ultrasound rather than at work) but then we realized that we'd rather know sooner than later if things weren't going well - so we've kept our Cinco de Mayo appointment.

When I think of our appointment tomorrow, I'm not excited ... I'm terrified. The anticipation is grueling ... I think I'll go back to work and pretend like nothing is going on ... (visualize me: plugging ears and humming "la, la, la, la, la, la, ...") ... yeah, denial and distraction ... nobody can compete with these rock solid coping mechanisms.

Friday, May 1, 2009

Shameless Endorsements

Today, I have two endorsements to share.

ENDORSEMENT #1 SILENT SORORITY: I never was lucky enough to go away to college directly following high school graduation like many of my peers. I never had the chance to join a sorority (in the common definition). However, I am now apart of the sorority that I wish no woman had to be apart of ... this endorsement is a "birth" announcement of a blogger friend's soon-to-be released book, Silent Sorority. The author, Pamela, doesn't know that her website and her brief 2008 New York Times story inspired me to continue sharing my story - in the face of so many people that just want us to "get over it" and to really consider that this story might not end with one of Disneyland's fairytale endings that I thought I was entitled to; reading Pamela's blog has allowed me to "go there" and consider that my life can still go on if Berilac and I are not able to become parents.

So, thank you Pamela. I'm sure your book will be just as touching. Hats off to you sister! I look forward to receiving your book and uniting my heart and my experiences with your story in paperback.

To everyone else: it is my understanding that this book is not only a great way for infertiles to feel connected (rather than isolated) in our journey, but it also can be used as a tool for those that haven't experienced this road and don't understand this struggle - to get to know the heart of it a bit better ... so get out there ladies and buy this book!



ENDORSEMENT #2 MISCARRIAGE SURVEY: Now you may or may not notice the groovy new link in my right nav bar? If you've been the unlucky recipient of the miscarriage experience - take a moment to click on it. I was recently contacted by a Doctoral candidate in Counseling Psychology from Teachers College at Colombia University. She is completing her dissertation and could use our help. She is trying to inform future research and modify current practice regarding miscarriage among health and mental health providers, ultimately improving care for women and families affected by miscarriage. I align with those endeavours and so have decided to cooperate with her request to make this survey available through my blog.

This is what she had to say:

Everyone has a unique experience with miscarriage and many find help and support through websites like this one. Unfortunately, little is known about women's experiences of support and how this may affect responses to miscarriage, and so I invite you to participate in my dissertation research study examining women’s experiences following a miscarriage. Although there is no direct benefit to you, survey results may help healthcare providers better understand and meet the needs of women following miscarriage. This online survey takes approximately 15-20 minutes and is open to women who have miscarried a wanted pregnancy in the previous 6 months who are 18 years of age or older, living in the United States, and involved in a relationship with a significant other. Participants are eligible for a raffle for a $50 American Express gift certificate.


To the ladies who have experienced miscarriage: my heart is broken with you, and I'm so incredibly sorry for your pain and loss - I know it all too well. If/when you feel strong enough to participate, click on this survey link (as I mentioned, I will also leave it in the nav bar for future opportunities) and take 15-20 mins to complete it. If you've had multiple losses, it is recommended that you keep a single pregnancy loss in your mind as you respond to the questions.

Thank you for your help in contributing to hopefully changing the way our medical community views and ultimately handles our circumstance. And if the dissertation doesn't get that much industry exposure, at least you know you've helped someone who cares about pregnancy loss - and that too is worth something.


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Ok, this here infomercial is over! Back to your regularly scheduled blogging ...