Saturday, January 26, 2008

A rotten week

It has been a bad, bad week.

First, Baby M managed to come down with the flu* despite having had the flu shot in the fall. She was miserable, and I must observe that there is nothing sadder than a 17-month-old who has the shakes from a 104.5 degree fever. She spent a good bit of time limp in our arms and spent a couple of fitful nights in our room because I was too worried to leave her in her crib. It was exhausting for all of us.

Coupled with the worry and stress of having a sick baby, was the stress of juggling her care during a particularly busy work week. Because we were interviewing candidates for a faculty position in my department, there were meetings, job talks, and lunches with candidates that I could not miss. This meant that J and I spent the week frantically shuffling what we could shuffle and trying not to fight about whose commitments were more important at any given moment. We managed to muddle through, but it was not pretty and by week's end we were both exhausted from it.**

On Friday, I woke to light pinkish-brown spotting. It stopped quickly and I had no cramping so I wasn't terribly worried. I called the nurse for reassurance and she felt that it was probably just irritation from the progesterone suppositories given that I was having no heavy cramps. Even so, she put me in with my OB so that I wouldn't spend the next week (until my 8 week appointment) worrying.

At my appointment, the OB went through the checklist again:

Any more spotting? No? Good.
It was brown, not red? Yes? Excellent.
Still having nausea? Yes? Good sign.
Strong cramping/ contractions? No. Very good.
So let's take a look.

Out came the ultrasound machine. First he tries the abdominal probe. I see my uterus and the black gestational sac and nothing else. He says he is having a hard time scanning through because of my retroverted uterus, so let's try the internal probe, OK?

Again, he scans. Again a black hole. Nothingness. Nurse and doctor exchange looks. The nurse moves Kleenex box closer to the exam table.

"I'm concerned because by now we should see the contents of the gestational sac," he says at last.

"Blighted ovum?" I ask, knowing the answer already. I am calm, detached.

"It is certainly suspicious," he concedes.

He decides that I should return in a week to confirm. If I haven't passed it on my own by then, I can either take a pill to induce contractions or I can schedule a D&C. ***

So I am pregnant, but not. My breasts ache, my tummy is bloated, waves of nausea grip me, and I am in the grips of that bone deep fatigue that is exclusive to pregnancy. But there will be no baby. No payoff for the hard work my body has done. No sweet baby kicks and no ultrasound peeks at my sweet one. Nothing.

I'm OK. I've shed no tears. I am numb. I am empty.

*This was confirmed with a rapid flu test at the pediatrician's office.
**On the bright side, Baby M is feeling better and should be able to return to her center on Monday.
***Thoughts on this?

Monday, January 14, 2008

My Little Houdini

To celebrate surviving the first OB appointment--complete with a breast exam, pap smear, internal exam, labs and ultrasound*-- I decided to go buy some fabulous boots. After cooking dinner, bathing the girls, and putting Baby M to bed, I left the house for some serious shopping.

As I was walking into the first shoe store, J called to inform me that Baby M had climbed out of her crib, walked to her door, and started knocking on it like a Jehovah's Witness on a mission. He lowered the crib the last two inches and she repeated her escape act. Another call. Could I please come home? Now?

Bootless, I headed home. By the time I walked through the door, Baby M was asleep in her crib. I asked J how he had managed to settle her down, to which he replied, "Duct tape."

Somehow, given his propensity to use duct tape on, well, everything, this seemed more than slightly plausible. So it was with great trepidation I opened the door to Baby M's room.

This is our crib:

I am happy to report that no duct tape was used. What J did was to turn the crib around so that the lower side is facing the wall and the high side is facing outward into the room. It is only a matter of time before she manages to hoist herself out the sides, but it buys us time to get one of these fancy crib tents:

*Gestational sac spotted; repeat ultrasound in two weeks to look for a fetus and heartbeat.

Saturday, January 12, 2008

Quick update

Thanks for the kind thoughts in response to my last two posts. I've been intending to update, but there isn't much to say at this point. The hard thing about being a "regular" OB patient is the lack of early monitoring. Here is all I have to share at this point:

My first (and only) beta was 86. I surged on December 20th so I'm assuming I ovulated on the 21st. I think that 86 is a decent beta for 14 dpo--not as high as Baby M, but high enough. My anxiety would be lower (or higher) had I had a second beta, but the OB wouldn't order another-- I had the sense that he was indulging me with the first. I almost called Dr. Negative for monitoring, but I decided against it.

All I can say is thank goodness for HPTs. I've taken a LOT of them. At first, I just took pleasure in watching the First Response brand get progressively darker. Then I switched to the cheap dollar store hpts. These are great because they keep getting darker for quite a while. Did I mention that I have bought a LOT of these? Even the clerk at the dollar store looked at me funny when I was checking out, prompting me to snap, "Yes, I'm a bit obsessed, Okay?" I remember my grandmother, a gentle alcoholic*, used to hide her wine bottles so her sister wouldn't find them. I've started to do that with HPTs so that J doesn't think I've gone completely insane.

I'm going to see the OB on Monday. His nurse said that he was concerned that my one beta was low. I was confused about this until I realized that he was going by my last menstrual cycle start date, assuming that I ovulated on day 14 rather than day 21. I could have cleared this up by telling the nurse that I was sure I ovulated late, but when I realized I would probably get an early scan out of it, I said nothing. I'm evil that way. My name is Em, and I am an ultrasound whore.

*Seriously, I named little E after her. She was the best grandmother in the world. She just happened to be an alcoholic, too.

Friday, January 04, 2008

What does it take to get a beta around here?

Little E was conceived on an injectable/ IUI cycle. We tried on our own six months and then had eight months of fertility treatment. Had we not conceived that cycle, we would have moved on to IVF. We started trying for Baby M when little E was six or seven months old. That took eight months. She was conceived naturally, with progesterone support while we were waiting to travel to a high FSH friendly fertility center for IVF.

This time, we tried once. Once. I've read that pregnancy cures infertility, but damn. Once.

While conception was alarmingly easy, getting a beta was a battle. First I called the OB's office at 8:30 a.m. and the receptionist cheerfully took my information and said, "We'll see you February 1."

Having had my first two pregnancies monitored closely by an RE for the first two months, I thought I had missed something. So I asked when my blood work and ultrasounds were happening.

She said, "We don't do anything before eight weeks."

So I asked to speak to a nurse.

Who called me back at 11:30 and said there was no need for a beta as long as the pregnancy was progressing normally.

So I asked how one can tell the pregnancy is progressing normally in the absence of repeat betas and ultrasounds.

She said she would talk to the doctor.

So I reminded her of my thyroid cancer and thyroid replacement and asked that they check my levels to be sure that things are OK there.

She said she would speak to the doctor.

She finally called back at 3:15 and said that I could have my beta and thyroid labs on Monday morning. When I asked why I couldn't have it today, she said that they were closing at 4:00.

I'll be there, I said. And I was. Barely. With a wide-eyed three-year-old in tow.

But now I have to wait until Monday for beta results (and it doesn't sound like there will be repeat betas). So I went to the store and bought six more HPTs.* Just to get me through the weekend.

*I just used one. Line is definitely darker.

Thursday, January 03, 2008

Stick Confusion, Part II

I'm freaking out a little right now. I tested Tuesday and it was snowy white. So I:

--indulged in alcohol

--indulged in a ton of caffeine

--took advil for these "menstrual" cramps

--took cold medicine

I also convinced myself that it would be better wait a little longer to really try since having a baby in September would mean I would have to start teaching again when the baby was three months old.

Tonight I decided to test again, not because I really suspected anything, but because my luteal phase has lasted so long. I was absolutely shocked to get a positive. I mean, we did it once, no preseed, no wheat grass, no progesterone support, no charting.

I'm elated. I'm scared. I'm thinking this isn't very dark for 14 days past ovulation. I'll call my doctor for a beta tomorrow and will report back when I have word.