Monday, April 29, 2013

JK. D&C.

Omigod you guys! I was totally kidding when I said I wanted to avoid a D&C. You thought I was serious?! Hilarious.

Got my first HCG beta back and it's higher than my doctor would like to see. Dr. M, who had been a big champion of my miscarrying naturally and advised against a D&C due to the inherent risks, now more or less insists on a D&C tomorrow. Things have changed. He is concerned that my HCG levels suggest that I have abnormal tissue growth and have failed to completely miscarry. I anticipated the incomplete miscarriage part. It just hasn't been the blood bath I expected.

It's not like me to sign up for a medical procedure without researching until I feel that I could perform it myself in a dark alley. I really don't know much right now. Would I eventually miscarry completely on my own? I'm sure I would though "eventually" doesn't feel like a time frame I can work with. I don't know the risks of not doing the D&C, aside from the emotional fuckery. Right now I'm putting my faith in Dr. M. I really do trust that he's looking out for my best interest. Throughout my IUIs and IVF cycle, I've felt a driving need to exhaustively research every single possible answer for my infertility. I know an absurd amount about medications, various freakish disorders and complications not seen in the western world since 1978. I've diagnosed myself with all of them. At this point, I need to give up just a little bit and put my trust in the establishment that Blue Cross and I have been investing in so heavily. I'll learn more tomorrow and I'll write when I'm sobered up from the anesthesia.

Not Okay. Plan Fail.

Hmm... how to write this post. I suppose I should begin with the obvious statement that pretty much everyone knew but me: I'm not okay. I said I was okay. I was quite convinced of it myself. But things started sneaking up on me, things that I didn't plan, and my iron-clad plan of being totally-okay-at-all-times-no-matter-what started to fail. I should provide a week+ in review.
After Dr. Robot delivered the news a week and a half ago that there was no heartbeat, I didn't cry. Instead, I went back to work in a complete daze and, a few hours later, left with my coworker for a quickie business trip. Emotions? What emotions? Instead of thinking or feeling, I had no choice but to enjoy the company and the state of Michigan. I suppose I could have called off the trip but I opted for distraction. That was Thursday and Friday. On Saturday, my first unoccupied day, I crashed. I was hugely, impossibly depressed. I laid on the couch, watched Hoarders* and, when the spirit moved me, cried and made more tea.

*Hoarders is an incredible show to watch when you're feeling sad. It is the only place where you can watch truly mentally ill people on television. It makes you feel like you have your shit together. I kept telling J that I was going to start collecting things. He was only somewhat amused by this.  Hoarding: Buried Alive is a pale imitation of Hoarders and is generally a total crap show. Avoid.

Sunday I felt much better and life resumed. Monday I began "positive bleeding" and was actually quite proud that my body was figuring things out for itself. I was relieved to not have to make a decision about a D&C. Work was insanely busy and left me racing through the week, changing my maxi pads (it's like the 1950s in my pants, no tampons), and answering thousands of emails. At moments where I got to pause, I even felt happy, reminding myself that I did indeed get pregnant. I do still focus on this positive aspect. On Saturday, as with the previous Saturday, I crashed again though not quite as hard. Picked myself up on Sunday, had a lovely day where I laughed and felt very nearly normal, and then life intervened. My cousin announced her pregnancy. I realized with horror that my whole "okayness" scheme hinged on nobody getting pregnant ever again. Perhaps not a fool-proof plan.

Here's the thing. My cousin absolutely deserves to get pregnant. She has spent much of her adult life helping her parents care for her developmentally disabled brother and thought for many years that his was all the care taking she could manage. She met and married an incredible guy who has wholeheartedly accepted that her brother is an integral part of their marriage, and all of a sudden having a family became a possibility. And now she's 12 weeks pregnant and that is wonderful. Only a year and a half of infertility and actively miscarrying has sucked out my soul. I have almost no ability to share in other people's joy over pregnancy. I can intellectually acknowledge that happy things are happening to them but simultaneously I feel completely and heartbreakingly empty. Unbearably sad, envious and furious with the universe. It doesn't feel like the me that I know. At horrible moments in this difficult journey, I completely lose myself. I know that I need to give myself a break. Nine days is not a reasonable amount of time to expect to heal from losing the first glimmer of a baby you've ever had. There's just no speedy recovery from losing a second heartbeat that you've grown yourself. I think I need to reframe my "okayness" plan. From now on okay is a relative state. Time will heal and my anger and disappointment will fade. The me that I know will come back, perhaps a little wind beaten and with any luck, stronger.

Thursday, April 25, 2013

Story Telling

As soon as J and I started "outing" ourselves as (please whisper the following) *INFERTILE *, everyone and their sister began sharing stories. I totally get the impulse, I do it too. It's human nature to share similar experiences, be they yours or anecdotal, to demonstrate empathy. However, the stories were always along the same lines: My coworker/friend/sister/college professor tried to get pregnant for THIRTY YEARS and they had totally given up when they became pregnant at age 75 with healthy twins! Implication being that that could totally be me! I'd love to slog through this for years and years on end! Actively trying to get pregnant for more than (enter your threshold here) is generally hellish so the thought of the experience lasting for several more years is not appetizing. This is the lens of infertility. The stories that seem so encouraging to the reproductively blessed or those not proven otherwise, are nothing but nails on a chalkboard to you. It's too hard to see the larger picture, that in the end things will be okay, because the only way to get through this trial is to trudge through the daily emotions and physical challenges with your head up. Ten years later your friends concieved naturally? All I hear is ten years, lady.

Once we began doing IVF, the stories changed to couples who had done multiple rounds of IVF with no success and then, once they had completely given up, (Notice a theme here? You have to abandon all hope and live as though you have stage 4 cancer) they got pregnant naturally. Another miracle! Despite statistics posted by reproductive endocrinology clinics boasting otherwise, science apparently does not work. Only magic.

Getting pregnant really did feel like magic. And miscarrying like an unfair roll of the genetic dice (we hope, as opposed to across the board chromosomal problems from here on out). But once again, people have more uplifting stories to share with us. You miscarried? My grandmother miscarried SEVEN times before she had her children. The worst part of that story is that it came from my own husband. He told me not once but twice to encourage me. While communication surrounding fertility has been somewhat trying with my usually emotive J, this miscarriage business has proven especially difficult. He doesn't get it and doesn't know what to say. He's torn between feeling incredibly sad and very hopeful, just like me, but can't relate to the physicality of it. How could he? I couldn't before this happened. I am in a fertility support group full of amazing smart and funny women. Like in most other aspects of my life, I can't stop talking at those meetings. Until the subject of miscarriage invariable comes up. And, in meetings past, when other women cried, I sat staring at my hands knowing what they were saying was sad but with no ability to relate. It's just one of those things in life where you just can't grasp it until you've gone through it yourself. And thank God for that.

J's grandma really did lose 7 pregnancies. And did go on to have healthy babies. But all I hear in that story is, "You think this is bad? It's going to be so much worse the second, fifth, and seventh times!" I have thought about the fact that if I'm lucky enough to get pregnant again, that it could end the same way. It is what I think about the most now.
I've decided to filter out everyone else's stories. They mean well but they are keeping me from moving forward which is all I want to do. Eye on the prize. Instead, I'm thinking of all the women I know who had one miscarriage and went on to have successful pregnancies or "live births" as they call it in the biz. So far, I've thought of 5 including my aunt and my own grandma. I welcome all just plain happy stories.

Is my story just plain happy? A simple test. If it includes the words, "and just when they had given up all hope..." then no.

Monday, April 22, 2013


It's taken me a long time to finish this post. I started Thursday and it's now Monday. I had some really dark, sad moments in between and writing came in starts and stops. I'm feeling much better now, ready to move forward.
So, here's how it's gone...

My body responded to bad news in what I believed to be rapid fashion when I started bleeding Wednesday evening. Not spotting, but full on bleeding. Yes, it felt sad but on the heels of that day's crappy ultrasound but I felt ready and even a little relieved. If it's over, let's get it over with. J and I laid in bed, awake because of an epic thunder and lighting storm, and told each other how sad we were. And eventually, fell asleep. I woke up the next morning to no blood. Nothing after a night of Niagara-esque flow.
I called my doctor's office and they had me come in for another ultrasound. I saw another doctor from the practice, one I hadn't met before. She confirmed that there was no longer any heartbeat. She was incredibly thorough, zooming in on the gestational sac, listening for a long time with the audio function. When she was certain there was no heartbeat, I was able to feel the same. Completely sure. And then the doctor became an emotional robot. She had obviously been trained for this moment.

Dr. Robot: I'm sorry, there's no heartbeat.
Me: Ok, I suspected that was probably the case.
Robot: Yes, but it is one thing to suspect and another to actually find out.

This is, by the way, the correct thing to say. It's just that she said it in a complete monotone without eye contact. Just super awkward. And then it got way more awkward. Mind you, I'm still lying on my back with a wand in my vagina. Me and Dr. Robot are just hanging out, having this conversation.

Robot: (Angling the wand to show the gestational sac) So, there's still STUFF in there.

What? Stuff?!? There's STUFF in my uterus? Like what? Loose change, lint, crumpled receipts? A note to all the future gynecologists, obstetricians, and reproductive endocrinologists of the world: Please do not refer to a non-viable embryo as "stuff." It's a super icky robot thing to do.

Me: What?
Robot: There's still a pregnancy in you that you'll need to pass.

At that point she got into her comfort zone and explained my treatment options. I could wait and let it happen naturally, take medication (methotrexate and misoprostol - not recommended due to a relatively assured side effect of blinding pain and deluge style bleeding), or have a D&C. I opted to wait for a natural miscarriage with the option of scheduling a D&C. Dr. Robot told me to call Monday if I hadn't started bleeding. It is Monday. I haven't.

My doctor, Dr. M, who is an actual human being with real emotions and children that presumably began life as embryos, called me and was completely wonderful. He said I could wait up to a couple of weeks to miscarry naturally though frankly that sounds like torture. If, after weighing the risks, I do opt for a D&C, I will definitely schedule so that he does the procedure. No more robots.

Yet another option was presented by my witch doctor acupuncturist. She has herbs that can assist with the natural miscarriage process (ie. cause uterine contractions). I may go that route and then, should nothing happen, opt for the D&C next week on Tuesday, Dr. M's procedure/surgery day.

Taking acupuncture herbs to cause a miscarriage makes me feel like a character in a grim movie set during Prohibition. Raised in the backwoods of Appalachia, I have found myself in the family way after a regrettable encounter with the film's villain. Under cover of night, I run barefoot to a shack where this mystic with cataracts is boiling sticks and rodents in various pots in her dimly lit cabin. She gives me a filthy mason jar filled with translucent liquid, I drink it and run back into the woods where, as depicted in a series of emotional but bloodless frames, I miscarry. Obviously my face is smeared with dirt so as to highlight my tear tracks. The end.

These are my options. I get to choose my own adventure.

(I wonder why I don't get many messages on my blog. Clearly it's because I'm insane and nobody knows how to respond to my movie plots and such. The fantasy is so clearly spelled out, I leave almost no room for comments.)

Wednesday, April 17, 2013

6w3d or 5w5d. Wolf?

How many times can one cry miscarriage until people start to roll their eyes and shrug? Well, I'm going to find out. The ultrasound this morning went really shitty. The upside: there was a heartbeat. The doctor saw it, we didn't. Ultrasounds look like Rorschach tests. The downside: the embryo is measuring at 5 weeks 5 days instead of 6 weeks 3 days, my actual pregnancy stage.

First the resident was fumbling around down there, enjoying what appeared to be his second trip to a woman's vagina (last week was his first). The doc identified a faint heartbeat and then took over the wand. Then it got really quiet and serious. He took a measurement. More quiet, more serious. Then he turned the lights on and broke it down.  "I am concerned. Based on the measurements, this is very likely not a viable pregnancy. I suspect you will miscarry." Something very close to that. This kid is measuring a full 5 days behind and apparently that is far from okay. It didn't occur to me to worry about the size. All I wanted was a heartbeat.

As advised, we made another appointment for a week from today and then walked back to the car. I texted everyone who needed to know and then I cried and cried. J is staying positive. He says he's convinced that "Lucky" is a fighter and is going to hang in there. I don't know. How many bad signs (low beta, epic bleeding, slow embryonic development) can I get before reality sinks in? Hopeful was last week. This week...I don't know. I'm only a few hours in. Somehow I don't see this week as the week of rainbows and glitter. I think this will be my week of getting by.

Friday I get to visit my client who has NINE children. So that should be fun.

After all the "trying" and failing, the multiple IUIs and one IVF, this is the first time I've been really angry. I'm pissed. Pissed in a grand scheme of things, universal kind of way. Millions of people have sex, get pregnant and deliver healthy babies every day. I want that. It's not fair. It's an immature way to put it but that's my all-consuming feeling right now. I just want what most people get without trying.

Monday, April 15, 2013

6w1d. The Learning Curve.

After the cautious joy of last week's post, I have come down a bit. I am still happy and still in a dazed state of disbelief. But, as is the case with the infertility-addled brain, I have shifted my worries of negative tests, low betas and chemical pregnancy to heartbeats and miscarriage. Why? Because it's what I do. And frankly, it's what we do. We being the legions of women (1 in 10 or 1 in 8 depending on who you believe) who don't get knocked up by brushing up against a virile checkout boy at the grocery store. You try and try for so long and with so many failed medical interventions that when by some miracle of science, you actually do get pregnant, your happiness has to share crowded space with all the disappointment and fear of the past months or years. It's a tight fit.

All of my worry and nervous energy has led me to ignore Dr. Google for once and just live normally. Nearly to the detriment of my gestational sac. At brunch this weekend I mentioned how good a dish with feta cheese sounded. My sister immediately reminded me that I couldn't eat that. I thought she was referring to the fact that I was lactose intolerant and I told her I would just have a tiny bit. No, pregnant ladies can't eat unpasteurized cheese. Right. I need to learn this stuff. Not that a crumble of feta would destroy the balance of the universe. My sister was kind enough to rattle off the list of things that you obviously shouldn't eat during pregnancy. Thank God someone is paying attention.

I think I felt that if I acted for real pregnant and did my homework then I'd jinx myself. Clearly not the right approach. I don't think that pregnancy is very susceptible to jinxes. Hexes are another story.

Of course the risk of all that learning is that when you find out that your growing cellular bundle is now the size of lentil and is developing a face, you feel like you're putting your heart in the middle of a four-lane highway. All that love and hope and fear is scary. I think that is how it will go forever.

Wednesday, April 10, 2013


I have nothing glib or sarcastic to say today. Today at the ultrasound, the doctor saw a gestational sac and a yolk sac, exactly where things should be for 5 weeks, 3 days. I know that people get pregnant every single day but for me, this feels like a complete miracle.
It's still very early and we are still deep in the woods but this is the first time I haven't been completely terrified in a week and a half. I am grateful and happy.

Here's a picture from the ultrasound. That black jelly bean-shaped object is a fluid filled-gestational sac right in my uterus, where it's supposed to be. There is gray fuzz in the black jelly bean that is the yolk sac.

Another ultrasound next week and, if things progress as they should, we'll be able to see a heart beat. Amazing.

Monday, April 8, 2013


A pretty great thing happened this weekend. Scary, heavy bleeding slowed to occasional spotting. Sushi and shots for everyone!

There is still blood, just not very much. I've been down-graded from 1950s mattress-style pads to liners. And still, I do not know what this means. I know it's not bad news but it doesn't mean things are going as they should. Obviously they're not. But I shall try to revel in things going better.

An attractive side effect of this roller coaster has been my constant need to check what's going on down there. As of Sunday, I was dropping trou in my kitchen with frequency to make sure there wasn't a blood bath in my sweat pants. (You know I didn't dress myself properly this weekend.) I am now back at the office and am pretty sure that exposing myself, even in the privacy of my own cubicle, would be frowned upon.

Despite the humor, I am frankly afraid to write and publish this post. I feel as though typing it is tempting fate. I'll click "publish" and the bloody flood gates will open. That is not how science works. I know that.

By the way, I am 5 weeks pregnant today. A new personal record.

Saturday, April 6, 2013

Being Dramatic = Excellent Service

You would not believe the level of service you get when you call the doctor's office and tell the receptionist, "I am about 5 weeks pregnant and bleeding heavily." Incredible. Frankly I felt like a princess. I'm going to try that line next time I'm at an exclusive restaurant and am told that there is an hour wait for a table.

Really I'm 4 weeks and 6 days but that just doesn't have the same poetic effect.

I was put through to the resident who conferred with the director of the clinic. There's not much that the doctors can do or say at this point other than try to confirm that this isn't an ectopic pregnancy. I'm not in pain so it's unlikely - silver lining du jour! They have me supplementing with additional progesterone bring my vaginal excursions to a total of 4 times daily.
Today the bleeding has slowed down a lot. Don't get me wrong, there's still blood. Just much less. Which means...who knows. So we continue to wait until Wednesday for the OB scan.

Today J admitted that he's jealous when he hears other people are expecting. Major victory. Hetero infertility is so unfair both biologically and emotionally. As a woman, your partner often has the coping skills of a carrot.

Friday, April 5, 2013

Beta #4 - Still Pregnant, Still a Horror Show.

So this is getting really fun! I had my follow up HCG beta this morning and my levels more than doubled. Up to 175. Simultaneously, I am bleeding all over the place. I am surprised that there isn't a trail of blood from my apartment to the clinic to my office. This is my version of bread crumbs. Anyone can find me.

I met with the head IVF nurse this morning before my results came back in. She confirmed things did not look good. Yes, these scenarios sometimes turn out okay with healthy babies but usually not. She agreed this limbo status was worst case scenario. When she called me back later with the results she seemed pretty surpised with the number. They're putting me on an additional progesterone supplement. That's all they can do. I need to schedule an ultrasound scan for Wednesday and hopefully then they can tell me what's going on. That is, if I don't bleed to death by then.

I've thought long and hard and I think the only solution is to hang upside down for the forseeable future.

J is as confused as I am. He was planning on going up to Michigan to with friends this weekend but I asked him to stay here. I rarely pull the wife card but if this doesn't merit it, I don't know what does. I shall not bleed alone.

Thursday, April 4, 2013

Film Debut

My upcoming documentary will be titled, If These Underpants Could Talk. Ira Glass is going to narrate it and Yo Yo Ma will perform the soundtrack. It's going to be really special. And gross.

More WTF. The Fat Lady's Warm-Up.

Dear WebMD,
What does it mean when your pregnancy tests look like this...

And your trips to the bathroom more like this...
(I exaggerate a bit.)

And your uterus is tied in knots...
Ah yes. That's what I thought.
My HCG levels are still going up. I can tell because the lines on the tests are getting progressively darker. Seemingly in direct correlation, my underwear are getting progressively more frightening. So this if fun. Fat Lady, your warm up is kinda fucked up.

Wednesday, April 3, 2013

Beta #3 - The Snowball

This morning I went back for my 85th HCG beta. The word was if the number went above 50, they'd have me retest on Friday. If not, I'd stop my meds and let it flow... You're welcome for the imagery.
My favorite salsa singing tech drew my blood again today. "Are your levels going well?" "No, they're not." "But they're going up?" "Barely." "Then you have to have faith." Um, no I don't. Why have faith in something impossible? This pregnancy has a snowball's chance in hell. The tech promised that he'd add a little extra HCG to the mix.

I think he did. My HCG came in at 65. This snowball is apparently scrambling to hang in there. I know that my chances are still really bad. Perhaps not quite as bad as I thought they were on Monday but still quite dismal. So now we wait again... continued meds, more bloodwork on Friday.

Tuesday, April 2, 2013

This is very much like breaking my foot.

I have this feeling similar to when I broke my foot as a teenager. Let me explain. When I was 15, I broke my foot during a dance rehearsal. For months after that, I would watch people leap and jump and was shocked every time they landed safely. If my foot couldn't sustain an impact, how could theirs? Jumping rope looked like a suicidal act. And then eventually, that feeling disappeared. I healed, I walked, I jumped, ran and danced and nothing else happened. My foot has remained unbroken for the ensuing 15 years.
I have to say, this admittedly very fresh experience has made me view pregnancy in the same light. "Excuse me pregnant woman, how did you make that fetus stay in your uterus? Tips? Pointers?" And to the woman pushing a stroller down the street, "I assume you grew that person inside of you for 9 months without it falling out. Exactly how did you manage?" It just seems absolutely impossible. I jumped, I broke my foot. I got pregnant, I lost it immediately.
I know that the vast majority of chemical pregnancies/early miscarriages are caused by chromosomal abnormalities, same as regular later first trimester miscarriages. I really do intellectually understand and accept that. The annoying side of my brain (There's a logical, intellectual side and an annoying side. I googled it.) thinks I should have taken Chinese herbs last week and probably shouldn't use so much Splenda. Again, I get it. It wasn't the Splenda or the gluten. It was the chromosomes, the science, the fact that this bundle of cells wasn't the gestating type.
Honestly, really honestly, that's okay. I'm alright. I am sad. Absolutely sad about how this little hint of joy and excitement turned out. But this is not the same as a miscarriage in the 8th or 10th week or, God forbid, later. I never connected the positive pregnancy test to a person. Instead, I became very enamored of the possibilities. For two days I had a due date. December 8th. A baby before Christmas. Amazing. Even more amazing, this could all be over. The constant ultrasounds and wands up in my piece, belly injections, intimate suppositories, nearly done! So that is why I'm sad. I'm sad to let go of this little glimmer of hope but anxious to move on. I am alright. A little foggy and dazed, not terribly productive and more prone to curling up on the couch. I'm in the process of mending.
HCG beta #3 tomorrow. If it raises above 50, I go in for a 4th beta. I'm still on progesterone, waiting for the clinic to officially call it.

Monday, April 1, 2013

Beta #2 - Fun While it Lasted

It's pretty much over and fun while it lasted. My HCG level did rise but only from 25 to 32.9. It needed to double.
I stay on my meds and go back for more blood work on Wednesday. Prolonging the agony.
I am spotting, too. At first friendly, not so worrisome spotting and now more. Angry, foreshadowing spotting. I wish I didn't have to hang in there for two more days. I want to dive into a bottle of wine and reemerge in a few days.
And I am sad. I was pregnant for 2 whole days.