"Womb" for Improvement

Post-Partum: Breastfeeding

2010-04-02T14:40:00.004-05:00

So, I didn't get the natural birth I so desperately wanted. But I sure as heck wasn't going to give up on successful breastfeeding. No how!

I was asked at the hospital several times for the record whether I was planning on breastfeeding or formula feeding. I proudly answered each time that I intended to breastfeed. Having a c-section automatically precluded me from having an optimal start, since I, and Lily by proxy, had to have significant anesthesia from the surgery and couldn't be together right away. In the first attempts, we were both quite sleepy and so hoped it would go better next time.

In the Mother Baby room the first night, Lily was brought to me every three hours to keep trying nursing. I would express a little colostrum (which always excited the nurses when a few drops would appear, and I found that slightly amusing) and try to get her interested, but she was always either too sleepy or not interested in latching. Add to that the fact that I was still very groggy and on heavy painkillers, not to mention unable to use my abdominal muscles and therefore fairly immobile and helpless to get her into a good position on my own, and it's clear we started with a few setbacks.

But for some reason that I now attribute to Hypnobabies, I stayed calm. We would eventually learn and she would eat and be nourished. For now, she barely needed anything and I knew I had colostrum for her. It's a very good thing I stayed calm. The second night in the hospital, Lily was screaming and crying and wouldn't latch. The nurse was there helping me. Well, not really helping, as she kept suggesting we just give her a little bit of formula. That was so annoying! One of the easiest ways to undermine the breastfeeding relationship right off the bat is to give unnecessary supplements with an artificial nipple. I ignored the nurse's suggestions as I tried on my own to get Lily to latch. Then she made a new suggestion: "What if I just get a little bit of formula to put on your nipple to try to get her to latch?"

"Sure, do that," I said. I could see everyone would benefit if there was just one less person in the room. The nurse left to go get a bottle and within two minutes the crying stopped and Lily was eating. It was a personal victory for me that we never had to use that formula. I was annoyed that I pretty much had to use deception to get rid of someone who was supposed to be helping me, but thankfully that was not the attitude of the whole staff.

And even though I wasn't worried, Lily's weight kept coming off. At 8lbs 6oz, she had lost a little more than 7% of her birth weight when we left the hospital on Monday. I had an appointment with the lactation consultant the following Friday. In the meantime, we kept working at it.

When we took her to the doctor on Wednesday, my milk had finally just come in. The nurse put her on the scale and said, "I'm getting eight pounds on the nose." My heart sank. She lost six ounces in two days? I thought she was eating! I knew we were still getting the hang of this, but I didn't think it was going badly. Seeing a horrified mommy, the nurse checked the calibration of the scale and reweighed her. This time it was 8lbs 8oz. So, two ounces in two days. Perfect! The doctor was pleased.

Then Friday rolled around and we took Lily to the hospital for our visit with the lactation consultant. Not having read the directions left to us (lack of sleep made us irresponsible, I guess), we went to the wrong part of the hospital, and I hadn't brought any supplies I was using, such as the manual breast pump or the parts to the hospital pump I had been given. Our lactation consultant's name was Sue and we had met her in the hospital during our stay. She is right up there among the people who are the nicest in the world. But she raised her eyebrows at my engorgement and seemed concerned about that. We got Lily on the digital scale, the same type she was weighed on at her discharge: 8lbs 3oz. Not good. She had continued to lose weight after my milk came in and she lost more than 10% of her birth weight. Not good.

Sue had me hand express as much milk as possible into a towel before putting Lily to the breast. I was just so clueless. Lily did latch but we found her to be ineffective. She swallowed infrequently, and she made smacking sounds. Sue found that she has a high palate, which makes nursing difficult. I was given things to try, like breast compression, and was told to feed her every 2-3 hours round the clock for at least 20-30 minutes worth of frequent swallowing. But Lily was a very sleepy newborn and it was sometimes difficult to wake her up. And at night, even though I set alarms, I couldn't wake up to feed her and many nights she was happy to sleep for a 4-5 hour stretch. So on top of sleep deprivation, I worried constantly about whether she was eating enough.

We returned the following Monday, and she had gained almost 4 ounces, which was right on target. We made an appointment for a week hence to check her weight. After another week, she had gained a little less than 4 ounces and was just barely up to her birth weight. NOT so good. Not alarming, but not good. We hunkered down and I did little else but encourage Lily to drink her fill, perfecting her latch, persistently burping her. No one had yet mentioned supplementing her diet, and I didn't want to get to that point.

Lily got gradually less sleepy and more interested in nursing. The smacking continued, but we were getting somewhere. After another five days, she finally, FINALLY gained the target ounce-per-day and was safely above her birth weight. I didn't need to return to the LC, but I have to say I think about Sue often and kind of miss her. I've looked for reasons to go back, as I've seen Lily through setbacks in her nursing. She's already had a few mild colds and an ear infection, through which we discovered a possible penicillin allergy. I'm disappointed that she's had illness. I thought breastfed babies were supposed to get fewer ear infections! The antibodies! The wonderful, magical properties of breast milk! But despite each setback, Lily always continued to make improvements and I never did have to drag her back to the LC.

Just when I thought the smacking would never stop, it did. Her palate has flattened out or she's just finally good enough at sucking that she can nurse pretty quickly and effectively. She's been sleeping through the night for several weeks now, though there are the off nights that she wakes up to eat. Each time we've been to the doctor, she's been in the 90th percentile for length and ~60th for weight. I confess I'm proud of her delightful little chubs. She's never had a drop of formula in her life (unless they snuck her some in the hospital), and her health is a testament to our hard work.

I'm glad I know how to breastfeed now. My next baby and I will be 50% better off (hopefully even better, if I get my VBAC!), though I understand a lot depends on the baby. I may have a whole different host of problems, but I've learned a lot this time around. And I'm extremely grateful that I didn't have more issues than a sleepy baby such as thrush, mastitis, cracked and bleeding nipples, etc.

I don't care what anyone says, you can be doing everything right and it will still hurt. And nursing isn't totally free if you factor in the electric pump (I have a relatively inexpensive one, but it still wasn't cheap), bottles for the one or two times per week I have to be away from her, nursing pillow, and special wardrobe items. Still, the two words I would use to describe breastfeeding in general are: WORTH. IT.

I may doubt my body's ability to bring a baby into this world, but I know that it can nourish a baby, and that helps a lot.

Birth Story, Part 5: The Birth

2010-03-24T12:58:00.001-05:00

Time flies when you are finally no longer pregnant or recovering from surgery, freeing you up to become some sort of super-wife who keeps the house clean and does laundry!

Back to the story, and sorry for the delay:

Once I sadly nodded my consent for a surgery I really, really didn't want, the whole mood changed. Extra nurses showed up and put my lower legs in compression socks. The Pitocin drip was stopped. The anesthesiologist (the same good-looking one from my first D&C, I believe) came in to prepare me for the spinal and drink some horrible antibiotic. This was really one of the worst times of the day. It didn't feel like it was all about getting to meet my baby soon. I knew I wouldn't get to hold her right away, and I was about to be sliced open. Those aren't happy thoughts. I had to comply with everything the team of professionals told me to do, but at every turn my mind screamed in protest: I did not want this. I had no choice.

I pretty much cried continuously. As I got wheeled down the hall, probably looking like the saddest person in the world, several nurses tried to comfort me by telling me I was going to meet my baby soon. Well, yes, but... you know.

We got into the OR, which was about 30 degrees, cold and sterile. Oh, and the effects of the Pitocin had not worn off, and I had all but abandoned my relaxation for emotional turmoil, so I was now in pretty bad physical pain with each joke of a contraction, freezing cold, shaking, and very sad for myself. I had to sit very still for the spinal which was trying. The surgery prep seemed to take forever, though I suppose I should be glad it wasn't a true emergency c-section as I have a better hope for a VBAC in this case. Shivering and shaking, I was laid out, numbed from the chest down, arms spread out crucifixion-style, Erich was allowed in, and then they cut me open.

A few minutes later, the anesthesiologist told me to expect some pulling and tugging. And I did. There was absolutely no pain, but it also felt like my whole torso was being kneaded like bread dough. For the first and only time, I felt like I might throw up.

That feeling passed quickly, as Dr. P announced, "It's a baby girl! And she's big, eight pounds, I think." Less than a minute later, a doctor or nurse or someone weighed her and announced triumphantly: "NINE pounds, one ounce!" Big baby! No wonder I felt like a whale! Dr. P said in a I-told-you-so voice, "In another week she would have been ten pounds." For the sake of cordiality, I replied, "Okay, you win."

(Time-out, though. Let's just remember that I had been on IV fluids for about 28 hours by this point. I'm sure this effected Lily's birth weight.)

Someone in scrubs flashed her into my view from across the room and my first thought, which I may have said out loud, was, "Oh my gosh, she looks like me." And she does. Once I get a scanned copy of my newborn mug shot, I'll show you.

After she got all wiped up, Erich got to hold her by my face while I covered her in kisses. It was lovely to have an outside baby right there, but it just couldn't be real until I could hold her in my arms. There's another c-section drawback.

I got stitched up and wheeled to recovery. I had to be able to move my feet before they would let me hold Lily, so I patiently waited till that happened. Well, I wasn't so patient as completely exhausted. Finally, finally I got to hold my baby after who knows how much time had passed. She was quite sleepy as we tried nursing and not much happened. Despite my preparations, I really couldn't tell if she was latching.

More time passed and I was wheeled up to the Mother Baby unit. I had to scoot my half-numb, super-swollen, recently-de-babied self over to the bed. That must have been amusing to watch. My heart was full of joy just knowing I had a baby... out there, somewhere. I was way too tired to insist on keeping her with me, so I tried to sleep. That would have been easier if the nurse hadn't kept jabbering on about newborn stuff and handing me pieces of paper. I was going cross-eyed and clearly wasn't absorbing anything she said. WHY WOULDN'T SHE LET ME SLEEP. And then, when I was left alone, I couldn't sleep because my compression boots periodically squeezed my lower legs to prevent clots and the IV made buzzing sounds each time it went off every few minutes.

And the rest is recovery. I'll probably post about that too, but this concludes the birth and events leading up to it. I'd like to reiterate that my very disappointing experience did nothing to diminish my love for my baby. But to be honest, for a few weeks, every time I looked at her bulbous little 14.5-inch head, I felt the slightest twinge of resentment, as I had been made to believe that this was the main reason she wouldn't come out. (I later decided this is hogwash: clearly the Pitocin failed to bring on truly effective contractions.)

I've finally gotten to the point where I can say out loud "I had a c-section" and not risk welling up. The fire in my belly has been lit and I will do everything I can to ensure I will have a VBAC next time. The first step is firing my doctors. More on that later!

Thanks for reading my saga.

Birth Story, Part 4: Nighttime

2010-02-23T17:03:00.005-06:00

The sun was down and it was dark. At about 5:30pm we decided to do another internal check for progress. I'm pretty sure Cathy was hoping things would get moving before her shift ended. She loved us and we loved her.

2-3 cm dilated, about 80% effaced. Still.

I believe this is when I broke down. It started to seem like my worst prediction was coming true. This induction was failing. These contractions were worthless. Though I had successfully kept the pain at bay, I was getting pretty exhausted from the effort. I know Erich was too--he was the one getting me ice chips, popsicles and damp towels for my neck and food and coffee for himself in between being there with me for every contraction, helping me manage the pain.

But I needed a break, and if this baby was going to come out naturally, it was going to take a long time, and something had to give. I asked for a narcotic to take the edge off. Erich knew how I felt about pain medication and encouraged me to wait half an hour. I waited for about one more contraction, and then I really knew I couldn't continue like this. Within 30 minutes or so, I was hooked up with a dose of Dilaudid and very quickly got to rest.

I continued to feel everything, but the edge was definitely off and furthermore, I just didn't care. The room seemed quieter, probably because everyone was acting like I was asleep. I wasn't. I could hear everything and responses to conversations going on took shape in my head, but I couldn't care enough to make them come out of my mouth. I decided to enjoy this sensation, and I tried to visualize my cervix thinning and opening with every wave. The theme was relaxation.

After probably about an hour, the narcotic started to wear off a little and I started to get more active. Though all the changing positions I had done all day hadn't seemed to do much yet, gravity was my best chance of getting the Pit to work.

It was time for a nursing shift change. Cathy bid us farewell by taking my hands, praising me again for my stamina and telling us how much she liked us. (Cue the tears.) She assured me I was "doing everything right" and whatever happens, even if I have to have a section, there will have been some reason I didn't progress, like a big baby or something along those lines. She asked for permission to call and find out what happened later that night, which I of course granted.

To be honest, at this point I was nearly certain this would end in a c-section. Wanting that not to be the case hadn't helped yet, and it seemed like I was running out of time. My water had been broken for nearly 12 hours, and they would certainly expect me to deliver within 24 hours of rupture. Doing the math, I knew my progress would have to speed up a whole lot for that to happen. I knew I could still try an epidural, but I would want to be more than 3cm dilated for that. And even then, I would use it only to see if it could help the Pitocin work better and not because I really needed it for pain. So I tried some optimism. Labor is unpredictable--maybe at my next check I would magically be in transition and deliver soon after!

Our new nurse, Melinda, was also very nice. She came in focused and ready to get down to business. She laid out the situation: progress was slow. I was up to 28 mU/min of Pitocin--most women deliver at half that amount. She checked the contraction printout and observed that this was not a normal contraction pattern. Luckily, the baby was doing splendidly and was tolerating everything well. My BP was fine, except for the one after the last exam, which was sky high for understandable reasons. Her recommendation was to get serious about moving around and trying more aggressive positions, hopefully to even out the contractions and make them effective. Meanwhile, we would stop the Pitocin and start increasing again from zero, as my uterus might be building up a resistance.

Dr. P called and asked how much longer I wanted to go. It seemed like she knew a section was inevitable and was simply allowing me to retain the illusion that I would have this baby the way nature intended, but once I got over that, she would come in and cut me open. Yeah, I've been known to read into things a bit. Regardless, I did not want to see her. I decided to give it two more hours and let her come back at 10 to check me.

Melinda got me on the ball, knees spread far apart. I rolled side to side, front to back. After a while, I stood next to the bed and squatted with each contraction. Just as that started to get more comfortable, she had me on the bed on all fours, shifting my weight back and forth. She was a bit drill sergeant-esque, which I really needed at this time of the day. My contractions continued to be irregular, especially after they cut the Pit. I remember waiting 5-7 minutes between them for a while. Erich and I both started entertaining a small hope that I had made no more progress because some progress would prolong this nightmare and it might still fail.

It was a burden and a relief when Dr. P arrived. I didn't want the c-section, but I couldn't do this any more. She asked how I was doing. "Pretty miserable, actually," I replied. "You poor thing!" she said. That was nice of her to say, but I blamed her for my situation. I still feel that if my bag of waters were still intact, we could have just stopped for the night and tried again later. Lily was fine, I was fine. And, incidentally, and to the surprise of no one, I had not progressed any further. 2-3 cm. Maybe some improvement in effacement, but I don't remember. It didn't matter any more. It was time to have major surgery because all these artificial interventions did what statistics say they will do (or fail to do) 50% of the time. My body and my baby were not ready for birth, so they were going to be forced into submission with the scalpel.

I don't think anyone even said the word at this point. Through my tears and utter defeat, I simply nodded.

Part 5

Birth Story, Part 3: It's the Pits

2010-02-20T21:13:00.004-06:00

For weeks before I gave birth, I had contractions. Pitiful little tightenings of my belly, which I would have to touch to verify that I was contracting. And, given that they did nothing to progress my cervix, they weren't "real." After my Cervidil was started, these contractions got to be more noticeable, and I hoped labor would start before the Pitocin. It didn't really.

First thing in the morning, I got checked and was somewhat pleased to learn that I was now 1.5cm dilated. Not much, but more than nothing! The nurse hooked me up to the Pitocin drip and informed me that the doctor would come in soon and would probably break my water.

What.

As I keep having to remind myself, I am NOT a doctor. HOWEVER, there's a few things I know about labor and contractions. One is that Pitocin contractions are much harder than natural ones. Two, contractions get harder after the water is broken. I also (legitimately) feared that breaking my water too soon would give Lily less of a cushion for moving into the correct position to be born. Thus far, I had not been successful in standing up to Dr. P, but I was pretty sure I didn't want my membranes ruptured so early in the day. If you've been following along, you know by now that "pretty sure" is not nearly sure enough.

Around 7:30am my ray of sunshine arrived: Cathy the nurse. One item on my birth preferences list that actually worked out and was granted was my request for a nurse who enjoys working with couples who have prepared for a natural childbirth. Cathy was the bomb. I told her I didn't want my water broken. When Dr. P arrived to do it, I asked her if we could wait because I didn't want to be "on the clock." (Deja vu! I also wanted to wait to be induced, and we know how that worked out.) She got her annoyed/frustrated look that I now know well and asked when we should do it instead. I didn't really know how to answer that question, so I...gave in (regret #5--huge, huge regret). Cathy looked at me and asked if I was sure, standing up to Dr. P's mumbles of protest better than I could. But I continued the theme of resignation and let her get it over with. (I now believe I should have said I wanted to be at least 5cm before breaking my bag of waters. I now also regret not hiring a doula, who would have done the thinking and advocating for me.)

After a pull, a tug, a pop and a gush, I was on the clock. Labor was henceforth messy and drippy, and besides all the legitimate reasons not to have the membranes ruptured so early, I wished I could have had a few hours to labor without all the messiness. It was hard enough to lug my belly around without having to place towels and pads everywhere as well.

Oh, and by now, my contractions were real. I didn't have to wonder whether I was having any. Within an hour or so, I couldn't talk through them and I needed to enter hypnosis to keep the discomfort at bay. For the whole first part of the day, I thought I could handle this. Every fifteen minutes they upped the Pit until I was contracting regularly. Unfortunately, even when the contractions got to be close together, they were never really regular. I'd get one every 2-3 minutes and then go 5 minutes before having three every minute, etc. Furthermore, from looking at the monitors we could see that they didn't have normal peaks. They felt strong and looked strong, but it was impossible to measure their strength without internal monitoring, which I never had.

But I labored on and impressed Cathy with my pain management. I started needing Erich more and more with my hypnosis cues, and he was there each time with a hand on my forehead and/or pressure on my shoulder, helping me relax through the painful artificial contractions. My parents stopped by at one point, but they didn't stay in the room long. It's hard to receive visitors when everyone needs to shut up ever 2-5 minutes while I breathe through a contraction. I had ice chips and yummy cherry-pineapple popsicles. It seemed okay as long as I could concentrate.

Then, around 1pm we figured it was a good time for an exam to check my progress. The verdict: 2-3cm, 80% effaced. I was disappointed. I was prepared for a number lower than 5, but I was hoping for more than 3. All that work hardly did anything! I wondered whether an epidural or other drugs would help me relax more and let the Pitocin do its work. Cathy encouraged me to keep doing what I was doing, keep taking the contractions one at a time and don't think hours in the future because it was impossible to know what was going to happen and it wasn't worth the stress. Her attitude helped me soldier on, and I kept finding labor demanding but manageable.

They cranked the Pit some more. The contractions got pretty bad. I was still managing without pain meds, but if I found myself mentally unprepared for the next one, I was in a world of hurt. We had the iPod going, alternating between Hypnobabies scripts and quiet music. I moved around and changed positions. Cathy went in search of the perfect birthing ball as the one in the room was under inflated. She praised me for my coping skills, for vocalizing through the contractions. Erich was my rock, but Cathy really kept me going.

Four more hours went by and I consented to another internal exam...

I'll leave it here for tonight, but I will say that (spoiler alert), it doesn't get any better from here.

Part 4

Don't Starve Me

2010-02-11T19:57:00.004-06:00

The Birth Story shall continue, probably next week. This weekend is LILY'S BAPTISM EXTRAVAGANZA! and I have a lot of cleaning to do.

But in the meantime, enjoy this article that explains why I should have been allowed more than popsicles and ice chips and why I'm liking hospitals less and less:

http://www.nytimes.com/2010/01/26/health/26child.html?ref=health

Birth Story, Part 2: The Storm Begins

2010-02-06T21:59:00.005-06:00

In the intervening days between my last prenatal checkup and my induction, I tried to remind myself that recent-miscarriage-sufferer Susan would be annoyed at hugely-pregnant Susan for being so upset about an induction and heightened risk of c-section. Anything for a baby, right? Unfortunately, that did pretty much nothing to improve my mood. I was sure that recent-miscarriage-sufferer Susan would understand.

So, Thursday the 7th arrived, and Erich and I worked around the house nonstop to get as much ready as we could. I finally had my motivation to pack my bag for the hospital! I packed comfy clothes for myself, none of which I wore because it was all pants and shirts. I also packed a zillion other things that I did not need or use. Live and learn!

My mom came over to help us and she actually stayed till after we left getting the nursery ready. Thanks, mom! At around 4:00, it was time to head out into the gloom. The predicted snow storm was arriving, and Erich was on edge, not wanting to take any chances on getting delayed in trafic or, worse yet, slipping and falling in the slush. We went first to our favorite Chinese restaurant for our last meal together as a family of two. I got orange peel chicken. I wasn't that hungry, but I ate anyway since hospitals are mean and don't let laboring women eat anything substanial.

We arrived in the Labor and Delivery ward at 6pm sharp. We felt weird showing up at a scheduled time to have our baby. It felt like we needed to make excuses to the world and assure them that we are not "those people" who schedule their baby's birth for convenience. This was not our choice! But, we got over it and got shown to our room, the same large but awkwardly laid-out corner suite we had seen in the tour of the hospital. When I had first seen this room, I solidified my desire to labor at home for as long as possible. (Aaaand, so much for that!) Despite the wood floors and other attempts at a homey feel, this was a very medical place.

The nurse took my vitals and asked again why I was being induced. Why, for high blood pressure! Except, over the next 24 hours, my blood pressure stayed in the normal range. I asked for clarification as to when and what I was allowed to eat, and she reminded me that I would not be allowed to eat the next day, "because we have to treat everyone like a possible c-section." Well, with a 30% c-section rate at this hospital, I'm not surprised. Except very, very few c-sections even require general anesthesia and only a small percentage of those have any complications with vomiting and aspiration, and effectively no one ever dies from that. Yet that is the reason I was allowed nothing more than ice chips and popsicles. Ridiculous!

Ah, but I'm getting ahead of myself. And I digress. Sorry.

Another nurse poked and massaged my crazy-swollen arms for about ten minutes, unable to find any veins for the IV. She finally settled on my wrist so that I couldn't bend or flex my hand. They put contraction and fetal heart monitors over my massive belly, and then I was really tethered. From that point onward, just to get to the bathroom six feet away I had to unplug the monitors, drape the cords across my shoulders and have Erich follow me with the IV stand. It's already hard to remember the sheer effort it required just to get out of bed and waddle across a room. I really don't miss being pregnant, to be honest.

By about 7:30, after a baseline internal check (still no dilation or effacement--"unfavorable cervix," further upping my chances of a c-section), the nurse placed the Cervidil behind my cervix. At this point, Erich took the final pictures of me as a pregnant lady:

This is actually one of the only pictures that doesn't make me look frightening. There's another one I won't share that actually scares my own mother. No joke. Btw, my face is at least 30% smaller now, thank goodness.

The bed is pretty close to the bathroom door on the right there. On the left in the background is the couch where Erich slept. You can also see my awkward IV.

All we did that evening was watch TV, get ready for bed, and try to sleep. I was helped by a dose of Ambien, but Erich had to battle hospital noises and a drafty window. He's a real trooper, and I'm not being sarcastic. I think he worked even harder than I did this whole long weekend, but we'll get to more of that later.

I'll have to leave it there for today. The sleeping baby who's been farting on my lap for the last ten minutes is starting to stir a bit more. Sidenote/question of the day: will this baby ever consent to not being held while she sleeps?

Part 3

Birth Story, Part One: Pressure

2010-02-04T16:11:00.005-06:00

This whole mess started on Tuesday, January 5th when I went in for my 39 week (minus one day) appointment. This appointment happened to be with Dr. P, who I hadn't seen much, but she and I go way back. She was the one who discovered my septum and always seemed pleasant, if a bit different manner-wise, probably due to her being from a different culture.

Anyway, Erich came with me to this appointment but had trouble finding a parking space, so he dropped me off so I could go and check in. I went down the dark corridor to the office, opened the door, and was greeted immediately by the backs of at least six other people in line. In line to check in. JUST TO CHECK IN. I've often been annoyed by the check-in process at this practice. It seems like they see about a thousand patients at any given time, and there are only two people in the reception area, one checking in and one checking out while the phones blink, all the lines busy as people also wait on hold to talk to a human. Every time someone checks in, the receptionist will not even make eye contact with the next person in line until they have everything organized, forms and insurance cards copied, etc.

Lots of women see their gynecologist once a year. And for some dumb reason, it seems a lot of them go in the first week in January. And once the calendar changes, the office people have to check everyone's insurance again, even if they're huge and pregnant and are there every week. So! It took at least five minutes per person in front of me to check in. And by the time I checked in, I had been standing there for

TWENTY MINUTES.

And the waiting room was PACKED. And, as usual and for some unknowable reason, the heat was cranked ridiculously high. Far too close to 80 degrees for anyone, let alone the hugely pregnant. Erich offered to stand in line for a while, which I should have taken him up on (regret #1). But it started to feel like my battle. When I got to the front of the line and the chick finally stopped ignoring me, I politely asked if the wait was a "Tuesday thing, or a first week in January thing?" She said, "Both." The usual two doctors were in and seeing patients, and it's a day the NP and u/s tech are there. So there were all kinds of people to be seen, yadda yadda THIS PRACTICE IS TOO BUSY. I know a lot of OB practices are crazy busy, but I have hope for the future. I won't stand for this.

Understandably, I was pretty grumbly by the time I finally got to sit down. Unlike the week before, when Dr. B said everything was fine, this week I didn't focus enough on staying relaxed and focused for my blood pressure's sake (regret #2). Despite the large crowds, I didn't have to wait super crazy long before getting called back. Urine was fine (I think), weight was fine, BP... "Hmm," said the nurse. "Oh no, what is it?" I asked. 120-something/90. That "over 90" part is what they really don't like. Crap crap crap. And she didn't even let me relax for a minute then take it again. I was concerned but didn't know what to expect next, so I just waited patiently.

Erich joined me in the exam room, and Dr. P came in shortly after. She studied my chart, measured my belly, took about a zillion hours to find the heartbeat (thank goodness for movement, which helped me narrowly avoid a freak-out), checked my cervix--still barely 1cm--and then looked at my chart again. "You know," she announced, "I'm looking at your blood pressure and you've already been to labor and delivery and you're about 39 weeks, so I'm thinking to myself... I'm going to induce you. I think Thursday would be a good time to start."

She went on to briefly describe how the process works, but I didn't care to bother to hear over the roaring in my ears. Induction. My first thought was, I'm going to have a c-section. No no no no no. This is not what I want at all. A small part of me was so very ready to be done being pregnant, but I had resigned myself to 2+ more weeks of hugeness. Anything to let my body and my baby decide when to be born and not my doctor.

I asked if we could at least wait until my due date, and Dr. P immediately seemed annoyed. "Then I'll have to send you to Labor and Delivery right now, and you'll have to come in every few days to be monitored." Should have said, "Fine! I'll do that." But she was wearing me down. (Regret #3.) I don't like to make people annoyed at me. She said, "You have to weigh the risks versus benefits." However, she never explained to me what those were.

In fact, no one ever really explained to me what pregnancy-induced hypertension is all about. I can't work a regret into this one, though, because I did call and ask. And I was threatened with a stroke if I didn't consent to the induction. *eye roll* Don't get me wrong, risks are risks, but I've had major abdominal surgery now. Isn't that risky too? (The answer is yes. Yes, it is.)

So Dr. P left the room and I lost it. That evil I-word enveloped me in fear. So much for my natural, drug-free birth. Now drugs were going to START and control my labor. I was automatically signed up for a hospital stay, IV, continuous monitoring, and a feeling like I had no say in what was happening to me. Because their stupid office can't manage its patient load (okay, that may not have been the total cause of my high-ish BP, but it did NOT help), I was now merely a sick patient instead of a mother giving birth.

Erich and I sadly went home, signed up for an induction starting Thursday evening with Cervidil and Pitocin on Friday morning. DID. NOT. WANT. I thought about how excited Lily's grandparents would be to know when to expect her, but it was at least a few hours before we could let them know while I tried to process this game plan. I was looking forward to her arrival and genuinely happy that I knew when it was going to be, but I was extremely unhappy about the induction, for reasons I believe are obvious by now. :)

Throughout my work with Hypnobabies, I knew there were tools for dealing with fear. However, in these couple of days, I was too afraid to use them. Stupid. Regret #4. I'm sure half-expecting a c-section, if it did anything, only made it more likely to happen. Instead, I focused on the last few things I could do around the house to get it ready for baby. That was worthwhile, of course, but I did spend too much time worrying and frantically seeking out anecdotes of successful inductions.

And I gave active patient-hood the ol' college try, but was shut down when the nurse on the phone told me that the numbers from my PIH labs were "going up" and it's much safer for me and the baby to have her out. In the words of any petulant adolescent, FIIIIINE.

So we were stuck with the induction, and I tried to feel resigned. A big storm was predicted for Thursday, but it didn't much matter for us since we'd definitely be stuck in the hospital.

To be continued...

Part 2

Preface

2010-02-02T15:29:00.002-06:00

I'm getting so close to being ready to post my birth story. Again, it will be in several parts. I'm nothing if not thorough on this blog! But first I have to start with a preface.

I have never agreed with the sentiment: "at least you have a healthy baby" in regards to the manner in which the baby was born. Now that I have been forced into a c-section, it irritates me even more.

The arrival of my daughter into this world was wonderful and amazing. I'm absolutely thrilled to have her on the outside and I wouldn't change a thing about her. The birth? Just thinking about it still makes me bitter, upset, and fearful. Yes, fearful for the future. Because the Birth is not just about the health of the baby. It has implications for me, my health, and the success of any future births. So please keep in mind, I will not abide any comments implying that I should be happy with the birth because my baby is healthy. Or that it could have been worse, so just buck up. I'm allowed to mourn the birth I didn't get to have, and I intend to do so on my very own blog that has always been about grief.

In sum: baby's arrival and birth are two separate entities and my emotions surrounding each are completely separate.

Ugh, sorry for the downer. Happier days are ahead, Internet, I promise. Just bear with me for now.

Oh Hi

2010-01-22T23:58:00.003-06:00

Hello, blogosphere! I forgot you were there for a while. Awkward! So uh, my baby is two weeks old today. Sorry for just letting you know now!

Lily is the best. We're definitely going to keep her. The birth and everything leading up to it? Decidedly not awesome. Look forward to a doozy of a multi-part birth story...later. For now, enjoy gazing upon her lovely visage:

A Very Short Long Time

2009-12-23T23:01:00.003-06:00

And here is my poignant, "isn't it funny?" post for the day.

One year ago today, two days before Christmas, I was going through one of the worst times of my life for the second time in one year. For the second time, I had to go to the hospital, months too soon, to evacuate my womb of the products of conception, our baby whose life was over before it ever really started. It was hard to think of a worse way to spend Christmas, bloated and sad, wallowing instead of joyfully sharing the news of our pregnancy with our families.

It was an easy D&C, compared to the first one. It was the first time I met Dr. J, who was so kind and supportive. My recovery was physically easy and I wasn't plunged into a world of questions and uncertainty, also in contrast to the first time. Still, I couldn't help but wonder whether I would ever be pregnant for more than one trimester. Could I ever expect my babies not to die? Would I always just cycle through TTC, early pregnancy, and miscarriage?

Then there was this little taboo that seemed to come along with multiple miscarriages. One was horrible and tragic. But two? After two, we seemed to enter the realm of "they have problems." I was dissatisfied with how even close family seemed to try to sweep this under the rug. I'm sure they were following my lead, and I sure didn't want to bring it up. But I would have liked to talk about it a little bit more. Instead, I got depressed. But we all know I came out the other side and was finally able to move on, eventually.

And fast forward: today, December 23, one year after my D&C, I turned 37 weeks, technically full-term, with our expected first born. Instead of lonely, bloated and sad on Christmas, I'll be... well, still a little bit lonely since we can't travel, definitely bloated, but excited and expectant--no sad. I'm finally pretty much on the other side of that "perspective" that the whole crappy year of 2008 was supposed to give me.

I can't say it all worked out for the best. While I'm glad I'm not huge in the summer, I'm not exactly loving being huge during ice storms either. I am glad we're already in a house and not still in the old duplex. I could probably come up with a whole list of pros and cons of now versus what would have been, but it's not worth my time.

The point is, I'm not trying to be super sentimental here and say that one outcome is necessarily better than another. Clearly, we would not have Lily if Vector had survived. Is this a good thing? Not necessarily--it's not for me to know. The contrast between December 23, 2008 and December 23, 2009 shows how much can change in a year, and I'm glad for the changes. Having a baby wiggling in my belly is so much better than being freshly scraped out. Changing holiday plans for late pregnancy is so much better than changing holiday plans for miscarriage recovery.

A year past always feels so much shorter than a year ahead. Being full-term pregnant a year after a D&C shows just how short that long time can be.

Not a Boring Appointment

2009-12-23T20:57:00.003-06:00

I had in my head a post to write tonight, pondering the changes that can happen in one year.

I'll get to that in a while, but I have to be newsy first! See, I'm 37 weeks today, and I had one of my weekly appointments today. The appointments have all been pretty in-and-out, and I thought today would be no exception. I did have Dr. J, my favorite who is the best at listening, so I decided to write out my "Birth Preferences" so she could look them over and give input. Turns out, we didn't get to that.

First of all, I had a 3:15pm appointment time, different from the norm lately when they've been mostly in the morning so Erich could go. We figured he'd be okay to miss this one. However, as the ice storm rolled into town, he decided to come home early so he could go to the appointment and work a little from home afterward.

He met me at the office and we waited at least 40 minutes before I got called back. I pulled out my little alarm clock that I use for piano lessons which happens to have a thermometer and learned that it was almost SEVENTY-SEVEN DEGREES FAHRENHEIT in there. Yeah, I was boiling. Why would they try to cook the pregnant ladies? I don't get it. Anyway, I went back with the nurse, gave my urine specimen and she had me get on the scale right away. After many weeks of varying by one pound up and down, today I was up four pounds. I was not very surprised as I have been very swollen lately, though not as badly in the last few days. Then she took my blood pressure and frowned. At 130/90 it was, in her exact wording, "borderline-ish." Not wanting to sound the preeclampsia alarm prematurely, she said she'd give me a few minutes of sitting down and take it again. Indeed, it was lower just a few minutes later: 120/80.

The nurse got me and Erich into the exam room, and I got ready for the internal exam. Dr. J came in around 4:15 and said that if it weren't so close to "the holiday" (that's Christmas, btw) she would just watch me, but since my blood pressure was so much higher than the 110/52 from early pregnancy AND because there was protein in my urine, she was sending me to Labor & Delivery for monitoring. Ugh. Next came the measurements, and as I scooted to get into position, she poked my lower legs and I admitted I've been swollen, and she seemed concerned. Baby's heartbeat was present and accounted for, she didn't say anything about my belly's measurement, so I assume that's okay. The dreaded internal revealed that I'm not quite a fingertip dilated (so not really at all), but the cervix is soft and the head is down nice and low.

Dr. J gave us a flurry of instructions: go to L&D, hopefully they'll let me go after an hour, come back to the office on Monday, take it easy--let Erich do everything now (so much harder than it seems), blah blah. I have to pat myself on the back here for staying completely calm after a very fleeting moment of OMGWTFBBQ. I knew it was unlikely I would have a baby that day and I knew worrying about it too much would do nothing to help my blood pressure, so I just went with it. It was also at this point I realized how lucky it was that Erich was at my appointment so he could do the short drive to the hospital and be with me through the whole ordeal.

Into the hospital we went, I changed into a gown, peed in a jar, and a nurse hooked me up to the fetal monitors and BP cuff. I had to answer a million questions and get blood drawn. Then we just got to wait, watch TV, surf the web on our phones, etc. Each time the blood pressure cuff went off, I practiced my Hypnobabies techniques, and each time my BP went down. The final reading was 119/65! I'm thinking it helped that I was still and relaxed and it wasn't a burning furnace there in triage. It was fun to hear Lily's heartbeat and all the whooshing sounds when she would move around. It saved me the trouble of telling Erich when I could feel her move! At about 6:10 the nurse came back to say my labs came back normal (yay), my urine was clear and I'm plenty hydrated (yay) and I could go along home. She sent supplies for a 24-hour urine collection (YAAAAYYYYYY), which we can drop off on our way to church for Christmas Eve services, heh.

On the way out, Erich had to make me walk slowly. Oops. "Do I still have to rest?" I wondered aloud. "YES, you still have to REST," said my wonderful, supportive and incredulous husband. That's just the problem--I don't feeeeel like I have to rest. Erich said it's not bed rest or anything, but it is "butt rest." As in, I have to stay on my butt as much as possible. Again, I'm as lazy as the next guy, but I have presents to wrap! A baby's room to organize! This is so much easier said than done.

Aside from all that, I have to say a big thank you to Baby Jesus for letting Lily stay in to cook a bit longer. I want to avoid an induction and/or c-section at all costs, which is much easier if I stay low-risk! I wouldn't mind a 2009 baby, but I'd rather she come on her own when she's ready in 2010.

Lightening!

2009-11-30T13:00:00.002-06:00

Why, hello blog! I haven't forgotten you; it's just that this pregnancy has been blessedly boring. Praise the Lord!

This past Friday, I had one of my boring, quick, bi-weekly appointments. This was with Dr. B, the one male in the practice who I've felt iffy about in the past, but he's actually pretty funny and personable, so I feel better now. Also, he walked in the exam room before I had even had a chance to climb up onto the table! So he gets a bonus for not making me wait. We were leaving the office only 15 minutes after my scheduled appointment time. That's pretty much unheard of! Anyway, when he walked in the room, he studied Erich's beautiful curly locks and asked if he had a perm. "It's too perfect! It must be man-made!" Nope, all natural. :)

After he measured my belly, Dr. B gave the baby a little squeeze and declared that the head is down in the pelvis and will now stay that way. Having a breech baby was one last little fear I had left, so this was a great relief!

The more I thought of it, the more I realized that I had felt Lily drop the day before. After Thanksgiving dinner, I was relaxing in a La-z-Boy at my parents house and had a few Braxton Hicks contractions. I gradually began to notice that my baby, who usually crushes my ribs and crowds my lungs, was being a bit kinder. Now it is unmistakable: my once-high bump has lowered significantly.

I hadn't realized that babies could drop so soon (at 33.5 weeks), but Google confirms that that's okay. And I have found myself pretty excited about this! I know I have a way to go yet, and my bladder is getting abused more and my waddle is out of control, but this feels like the first real sign of the beginning of the end--the first significant step before birthing my baby! It's like this is real!

To be perfectly honest, though, I still get irrational fears. I'm sure I'd have these fears with or without my miscarriage history, but it's still difficult to fully accept that I will be taking home a live baby from the hospital in about six weeks. The more our house fills up with furniture, clothes, and supplies for the baby, the more my nervous level increases. We have to plan for a permanent situation here, and even though I'm 99% sure we will not regret having so much for the baby, I'm still not 100% sure. I think this is a symptom of just general anxiety--normal pregnancy stuff. But I sure don't like it!

Let's just say I thank Lily profusely every time she wiggles, kicks, or presses against my skin. Stay strong, Little One!

Quick Post

2009-09-28T16:26:00.002-05:00

I got a call from my OB's office today, and the news is that I officially do NOT have gestational diabetes.

So now I don't know whether the three most boring hours of the year were worth it last week. But this is good news, for sure!

Good News/Bad News

2009-09-18T10:58:00.003-05:00

Well, the good news is I didn't accidentally drink the glucola before the specified time. And I didn't forget to fast long enough. I finished the orange drink (not tasty, but not horrible) at 7:45 this morning and had my blood drawn at 8:45. More good news: my iron levels are wonderful.

Bad news: my blood glucose levels are not ideal. They like to see a number at 140 or below, and I came in at 142. What does this mean? Well, I may not have gestational diabetes, nor can they say that I definitely don't. Therefore, I have to go to Quest Diagnostics next week sometime, drink some more lovely glucola, and then sit there for THREE HOURS before they draw my blood and tell me if I'm the range for GD.

Pros for having GD:

I'm still relatively early at just over 23w, and I would most likely be able to get this under control with diet (and I might be the kind of person to do well on a doctor-enforced diet) before worrying that Lily will grow to be too big to deliver vaginally.

Cons for having GD:

I'd be at an increased risk of developing Type II Diabetes later in life.
Risks to Lily include macrosomia (large size), greater chance of childhood obesity, hypoglycemia, and diabetes.
Being on an enforced diet would not actually be fun.
It would be a big pain in the butt.

And the cons have it. Please pray that I pass the three-hour test!

We'd Have a One-year-old

2009-08-28T11:23:00.003-05:00

Time, like an ever-rolling stream, soon bears us all away.*

Can you believe that my first baby was due more than a year ago? I can, but that doesn't make it easy to picture what it would be like to have a one-year-old already. Time continues to heal and I can view last year's emotions from a comfortable distance. I spent a lot of last spring and summer thinking about how far along I should be. To a lesser extent, I thought about how old Keiki would be after the EDD passed. But as life continued, the stream of time rolled along, those thoughts simply faded.

Anniversaries, though, have a way of bringing things back to the surface. In the past few weeks, I've seen a few one-year-olds and was struck by the notion that I would have one of those had things been different. I can't be sad about these thoughts; it's just not worth the turmoil. One thing miscarriage has taught me is that I just have to let myself feel what I'm going to feel and not try to force any emotions.

And I really am doing well continuing to look at the silver lining. If we had a one-year-old, we almost certainly would not have bought a house and moved. I would be a different kind of parent than I plan to be for this little one. I've had longer to think about pregnancy and parenting and my views have matured in many facets. And, in a general sense, I've learned to appreciate pregnancy far more and in different ways than I might have otherwise.

Now that I'm more than halfway there (!), I'm feeling Lily move around more and more, and I can barely change the size of my bump by sucking in. I'm really, really pregnant. I finally told all my piano students' parents so that they know what's going to happen after the baby comes. None of them knew about my miscarriages, and they still don't.

But the more people know and can tell I'm pregnant by looking at me, the more I feel compelled to explain my history. For every ten people who are really excited and happy for us, there's one or two that I suspect might be dealing with pain as regards pregnancy. Like that lady who just had her second child after a nine-year-gap. And that not-old-but-no-longer-childbearing-age couple who may not be childless by choice. My heightened sensitivity feels the need to explain to them that I have put in my time in the school of hard knocks, that even though I'm young and a relative newlywed, this road hasn't been as easy as you might assume. I'm pregnant, but I'm trying not to flaunt it.

That's just another unfair thing about miscarriage. Why should anyone's pain make someone feel better? Why should I feel like I have truly earned the right to be pregnant with a healthy baby by virtue of what I've gone through? No amount of explanation or attempts at justification will make my or anyone else's situation fair. There's just no fairness to be had in this fallen world. All I can really do, therefore, is to be at peace and pray. Pray for myself, for my Lily, and for all others out there who long to be parents but for whom the unfairness of life has intervened. Amen.

*from the hymn "O God, Our Help in Ages Past"

Fourth Appointment

2009-08-21T19:38:00.002-05:00

Now that the wonderment of actually getting to go to my scheduled second appointment has faded, these regular appointments are getting to be pretty boring. And that makes me happy. :)

I was also glad to have an afternoon appointment--the office is much less crazy in the afternoon than in the morning. Today was pretty routine. Lily's heart rate was 152 and found easily on the Doppler, and Dr. J confirmed that everything looks fine and normal from the ultrasound. And the nurse gave me a small bottle of glucola for my next appointment.

I'm not looking forward to fasting for my gestational diabetes test, but I know it's an important test, especially since I have family history of diabetes. I've also heard that the glucola is pretty gross, but we'll see. Luckily, they scheduled me for an 8:45am appointment so I don't have to fast through the morning. I have to drink the elixir within 15 minutes an hour before the appointment. I'm expecting Erich to be Harry Potter to my Dumbledore at the end of Half-Blood Prince, making sure I drink it all so we can be sure I'm healthy.

The bigger task at hand is keeping that little bottle of orange potion safe in the next four weeks. I keep having visions of accidentally grabbing it and drinking it. As if!

Ultrasound Pictures

2009-08-16T14:48:00.003-05:00

As promised, I have ultrasound pictures to share and show off. Lily is still pretty little and skinny, so some of these pictures came out a little creepy. I don't think it makes me a bad mom to say that. :) To the left here you can see her little face. The 3-d ultrasound doesn't give the clearest picture ever, and sometimes parts of the baby are missing in the pictures where she's up against the uterine wall. So, just like with the 2-d ultrasound, we have to use our imaginations a little bit to fill in the blanks. And what I see is my daughter! [That feels weirder to say than "my husband" felt in the first few weeks of marriage.] And she's darn cute!

So without further ado, here are the results of Lily's first glamor shots photo shoot:

Here you can see her little feet off to the left attached to skinny little legs, and her non-butt is on the right.

Here is the "alien baby face" shot. You can see the head on the left and the abdomen on the right. Through the first half of the scan her head was on the right, then she wriggled around to this position.

The very top is my skin, then you can see the layers of flesh. Right above the baby is the placenta. This image shows how her motions are cushioned from me by the placenta. Also, right above her head is her arm. This next 3-d picture gives a better idea of what she's doing:

She's got her elbows out and hands behind her head. Aawwwww.

In these two images above, she's getting physical. Doesn't it look like she's doing sit-ups? :)

Sucking on her fist.

That concludes Lily's first photo shoot. Hope you enjoyed it!

It's a...

2009-08-15T18:31:00.002-05:00

...baby! Yes, we found out the sex today in our big ultrasound. But before I tell you what that is, I have to pause to reflect on my excitement that Wrigley's gender was the most significant thing we found out today. The tech obviously couldn't tell us if everything was completely fine and that there were no concerns, but in my semi-educated but completely amateur opinion, everything looked great.

Okay, I don't want to be pronoun-neutral any more, so here it is: it's a girl! Little Lily Anne was calm for a while and halfway through started jumping around like crazy. It was so cute! She lived up to her now-defunct nickname as a little wriggler.

A few items of note:

1. I have an anterior placenta, which means the placenta is laying across the front part of my uterus. I have felt not much more than flutters in the past few weeks, and it turns out it's pretty amazing that I have felt anything at all. Now I have permission not to worry if I don't feel big kicks for a while! I hope for Erich's sake that it's not terribly long; we're both looking forward to feeling it from the outside.

2. Lily measured 19w2. I had a feeling all along that she'd measure big. My official due date puts me at 18w3d, but that was from a transabdominal ultrasound at 7 weeks. I theorized at the time that because it's hard to get a clear picture so early that Wrigley might have actually been a little bigger. I'm 18w5d according to when I ovulated, so 19w2d is only four days ahead of that. But the big question is: will my doctor change my due date?

On the one hand, having an EDD of January 13 and delivering early would be quite nice. But having an EDD of January 7 and going a week late would be rather agonizing. I suppose I'd rather stay 18 weeks pregnant now than deliver past 41 weeks. I'm sure Lily will have her own plans, regardless.

3. Lily's overall measurement was 19w2d, and I'm not sure how they calculate that. Her estimated weight right now is 10 ounces. As the tech measured each body part, Erich saw different gestational ages pop up, and he noted that her head measures 19w4d. Not shocking at all, as Erich and especially I have proportionately large heads. But I'm hoping I also have a proportionately wide pelvis internally, you know what I'm sayin'?

Okee dokee, next up: ultrasound pictures!

EDD #2

2009-07-26T23:04:00.003-05:00

It's late at night, and I'm going to ramble a bit.

I mentioned the other day that I've been thinking about Vector more often. Well, today was Vector's estimated due date. I have to say, it's a lot easier to deal with the EDD for a child that will never be born while carrying a 15-week baby than it was while still waiting for a baby, like the first time.

After we lost Keiki, and I had to go through the pattern of tests and waiting, tests and waiting, I found myself remembering often just how far along I should be. And then I would get sad and bitter (rinse, repeat...). With Vector that wasn't the case, and I'm not exactly sure why. Perhaps I didn't get as attached since I never heard or saw a heartbeat. Perhaps my earlier experience had prepared me for another miscarriage, and, in a sick way, I expected it. I was extremely unhappy that two miscarriages make miscarriage an expected outcome, but I couldn't let that sink my hope for long. It also made a difference knowing we could TTC again virtually right away. After Keiki, I wasn't sure when we'd ever get to TTC again.

Miscarriage #2 was just easier in every way. Physically, the D&C was a piece of cake and I bounced back physically in no time. Emotionally, I think I can pinpoint a time when I completely snapped out of it. Yes, there was a relapse or two into despair, but I didn't lose any ground in emotional growth since the first miscarriage.

And maybe that's why I don't remember my second pregnancy as well, and I certainly don't dwell on it very much. It got swept under the rug relatively easily. And with Wrigley on the way, I haven't spent any time at all in the last few months reflecting on how pregnant I would be if things had turned out differently. There would be no Wrigley if Vector were still with us, and I really, really love my Wrigley.

But still. In a world with no miscarriage I'd have an 11-month-old and a brand-newborn right around now. (It would be unlikely, but both babies could--technically--have made it to term without Keiki negating Vector's existence.) And perhaps we'd have to have stayed in our 2-bedroom apartment a bit longer with two babies sharing a room. The Lord works in mysterious ways, doesn't He? As I've stated before, I don't believe God plans for these things to happen, but He can certainly make good come out of it.

I guess we really have made it out the end of the dark tunnel, because I really wouldn't change anything right now. I'm a mom to three babies, two in heaven and one on the way. And that's totally okay.

Baby Nicknames

2009-07-25T11:10:00.005-05:00

I have recently come to realize that I've never really gone into explanations of our babies' nicknames here. Each one has a meaning, albeit not always a profound one. We have fun naming our babies before we can give them proper names, so here's a brief description of each one.

Baby #1: Keiki

Before Erich and I got married, we decided that we wouldn't use any birth control. So we were already aware that we could get pregnant pretty soon when we were on our honeymoon in Hawai'i. When there, we learned some Hawai'ian lingo, including the word keiki. It's Hawai'ian for "child" or "kid." Erich thought it would make a great nickname for an unborn baby before we know if it's a boy or girl, if we were to find out. I agreed, and when I did fall pregnant, Keiki was the nickname for the little one.

Erich continued in the assumption that Keiki would be the name of all of our unborn babies. I assented while I still assumed that our Keiki would eventually have a real name. However, after the miscarriage, never having found out if it was a boy or a girl, I couldn't bear the thought that our first baby would never have a unique name. I didn't really think to assign a new and meaningful name to our first baby: we had already continued calling him/her "Keiki." I didn't want this baby to have to be Keiki the First or Keiki 1. Thus, the Keiki nickname was retired.

Baby #2: Vector

It took a few weeks to settle on a nickname for our second baby. I had pitched a few, but Erich rejected them. It was then decided that Erich would be the official nicknamer, though we would decide together on actual names. One of the nicknames we threw around was Wrigley, after the field where our beloved Cubs play. That was eventually rejected, however. As this was mid-November, we still stung from their extremely poor performance in the play-offs that Fall.

"Vector" came about while we were watching an episode of House Hunters, set, coincidentally, in Hawai'i. The final scenes of the episode showed what the buyers had done with the house, and they showed a picture of a bedroom in which they had put down new wood floors. I quickly went into minor conniptions, convinced they had oriented the slats wrong (perpendicular to the bed, not parallel! Wrong, I say!). Erich, attempting to understand, said something sarcastic about the vector of the angles or some such gobbledegook. I laughed that my engineer husband could pull out such math-y terms in conversation. "Ha!" I quipped. "We should name our kids Vector and [other math-y word we can't remember]." I was joking about these being real names, but Erich got thoughtful and declared that Vector would be our baby's nickname.

One time, on a long car ride, I asked Erich one more time what a vector actually is. He patiently and succinctly explained it again, and I replied, "Wrong! It's a little baby." We laughed together, so excited to start telling our family that we were expecting a baby in July. Two days later, we found out that our little Vector's physical form had never been bigger than microscopic. This being the earlier of our two miscarriages, gestationally-speaking, and being crowded into a busy December, it's easier to forget the details of my second pregnancy. I've been thinking about Vector more often recently, though, remembering our baby who never developed a hearbeat.

But now, onto happier thoughts...

Baby #3: Wrigley

On the morning of April 30, I had a feeling I should take a pregnancy test, so I did, Erich close by. We waited patiently as the field of pink cleared, the control line darkened and so, very gradually, did the test line. We shared a high five and a hug before Erich went off to work. We did it again! It was Springtime. Unlike our last two babies, this one would be due in the Winter. Unlike our last two babies, this one we would expect to take home to our new house, which we would have plenty of time to get ready for a baby. And maybe unlike last year, the Cubs wouldn't play like champions in the regular season only to embody complete losers and be swept in the post season.

Yes, this was a new season of hope for our Cubs and for our fertility, so Erich soon decided that we could use our previously-tabled baby nickname, Wrigley. It fits much better for this baby than for Vector, since I've already had the joy of feeling this one wriggle around.

And, to answer the question I've gotten a few times already in the comments, we do hope to find out if Wrigley is a boy or girl at the big ultrasound. If we do get that info, Wrigley may be known as Wrigley for only a few more weeks!

Butterflies

2009-07-24T13:41:00.002-05:00

Last night, Erich and I went to a concert held at our church. It was a group of four young men singing a capella. I wasn't sure what styles to expect; I thought maybe they'd sing some hymns in Barbershop harmony. I was delighted, though, that the program included mostly 16th century polyphony. I'm a total geek about old music like that.

I quickly found I could enjoy the music better with my eyes closed. Watching them was rather distracting, since people make weird faces when they sing and there were only four of them with no conductor. No, it was better to close my eyes, my tummy happily full of Chinese food, and let the sound wash over me.

During one particularly peaceful number, I opened my eyes with a start. I was only aware of something because if that something really WAS something, it had just stopped. Could it be? I set to work on feeling as much as I could feel. Closing my eyes, I focused on my torso. Soon enough, I felt it again: little butterflies, like that feeling you get in your stomach, only this was far, far too low to be in my stomach.

Maybe it's my dinner? When I focused enough, I could feel a few digestive processes. This was not digestion. The butterflies continued a few more minutes, gently tickling my insides, below my navel and at least a few inches back. I grabbed a piece of paper and a pen. "I may be crazy," I wrote to Erich, "but I think Wrigley likes this music!" Erich raised his eyebrows and made a "kicking" gesture with two fingers. "Butterflies!" I wrote. That's the best way I can think to describe it.

I wouldn't have posted this today for fear of being thought an overly-imaginative, crazy-type person, but I'm more and more convinced that I felt our little baby moving around. I have several reasons for this thinking:

I can be pretty attuned to my uterus when I concentrate. I remain convinced that I felt implantation in my last two pregnancies.
15 weeks is early for a first-time mom to feel movement, but not too early to feel anything at all. For example, I never fancied at 10 or 11 weeks that I felt something. That makes me think I might not be crazy this time.
I have heard movement described in several ways, including little taps, little bubbles popping, a fish swimming, and of course, butterflies. I wasn't looking for any particular sensation, but I did notice it when in a state of relaxation, relative sensory deprivation, and at a time when my mind wasn't abuzz with random thoughts. Basically, it was as distraction-free as I can imagine!
I told my mom about this and she's convinced I felt the baby. She felt me move while on jury duty at about 15 weeks (granted, I'm her third child, but that goes to show that 15 weeks isn't too early to feel movement!) and feels it's all come full-circle.

There you have it. I may be crazy. Or this could be the beginning of the really fun part of pregnancy. :)

By the way, I'm aware that it's quite unlikely that Wrigley could actually hear and enjoy the music. Soon enough, though.

Third Appointment

2009-07-24T12:54:00.004-05:00

Forget second appointment, that's old news. I've now made it to my third appointment, and I have no reason to worry that I won't make it to my fourth!

I was supposed to be seen yesterday by the wonderful Dr. J. I had the earliest appointment time, 9:15, and naively assumed I could make it back home in time for a 10:00 piano lesson. My last couple of morning appointments were indeed pretty fast, but I quickly learned never to assume I won't have to wait forever. The office was swamped when I went in, and I didn't even get to the front of the line until 9:25, when I was told Dr. J had been in surgery and wouldn't be back for at least 20 minutes. The stars seemed aligned against this appointment happening: Erich was supposed to come with me, but he got stuck an extra night out of town for work. I happily rescheduled for today with Dr. B.

Dr. B is the only male doctor in the practice and I hadn't met him until this pregnancy. I'm supposed to rotate through all four doctors, but due to my reschedule I've now seen him twice in three appointments. No biggie! But he is an interesting fellow. Imposing presence, distinct accent (probably Polish), and a quick, direct manner.

We finally got into a room about 30 minutes after the appointment time. My blood pressure had come in at 122/64--my lowest for an office visit during this pregnancy. I was definitely feeling a lot less nervous! I couldn't conjure any meaningful feeling of doubt if I tried. So I've stopped trying. Erich also reported being much more bored than nervous.

Dr. B burst into the room, exclaiming, "Okay! 17 weeks and according to this everything's just perfect!" I liked the "perfect" part, but I wasn't exactly sure where he got the 17 weeks part. Maybe he glanced at my LMP? Oh well. I swelled with pride about my beautiful BP and on-track weight gain as I laid back and got squirted with the gel. Then came the heartbeat! Erich finally got to witness how ordinary it is to hear a baby's heartbeat. He showed us the readout when he found it and it flickered around from 150--149--147--145--148 and it faded away. "It keeps moving!" boomed Dr. B. Yay! He cleaned off the gel, grabbed my arm and lifted me to a seated position. I choose to find this type of behavior amusing. Apparently he can't be bothered with simple directions like, "You can sit up now."

"You've only had one ultrasound?" asked Dr. B. I replied in the affirmative. "Then we'll get you in for another one. And if you want to know the gender, you have to ask!" On our way out he gave me an order for the ultrasound--held at the same imaging center as my ultrasound in April of last year. It had today's date on it but didn't say when to get it done. I asked Dr. B when I should schedule it. And he said in the next week or two. I said, "I'm 15 weeks now, would that be too early?" He replied, "You're actually 16 weeks [seriously, is he making this up?] but that is early. Just call them and schedule it for about 3 weeks or so." Gee, I'm glad I asked!

My next appointment is set for Friday, August 21 at 1:30 with Dr. J. Erich agreed that he doesn't really have to be there (thank goodness for the boring second tri!), especially since he'll definitely be at the "big show," the ultrasound still to-be-scheduled.

My Sincerest Apologies

2009-07-16T20:33:00.003-05:00

I have neglected this blog with real news for too long. But as you've probably gathered from my last three posts, I'm pregnant! And, in fact, I would even go so far as to say I'm expecting a baby. Now that I can look at the first trimester in hindsight, I must say it's been a pretty fun time so far.

Remember this post? Yeah, let's just say I ovulated a few days later and I'm now 14w1d pregnant with our (probably) firstborn. I fully credit my healthy attitude with my relatively early ovulation (CD24!!!) and conception.

As you also probably gathered from the last three posts, we opted to tell our immediate families fairly soon. I was almost five weeks pregnant on Mother's Day when I grunted the news to my siblings on an outing to a Cubs game. Erich chided me for making it sound like I had a terminal illness. Truly, I didn't try too hard to be excited at that point. That's the curse of two miscarriages. And all I felt I had at that point was a handful of positive tests, a good initial hCG level, and a diagnosis of low progesterone (11.2 at about 4.5 weeks).

Luckily, I've found it doesn't take immaculately positive thoughts at all times to make a baby thrive. We were blessed to see and hear the heartbeat at 7w1d. Actually, based on my ovulation it should have measured 7w3d, but I didn't even let this discrepancy bother me. For long. Really, assurances are few and far between in the first tri when you've had two missed miscarriages. I knew our baby was fine at seven weeks, but how could I be sure at nine weeks that nothing had gone wrong? I just had to trust my continuing symptoms and keep going.

11w finally rolled around: my second appointment. I heard that brilliant heartbeat and was super thrilled. We could go ahead and tell the world! But I couldn't shake that feeling that we thought we were in the clear at 11.5w in my first pregnancy and told the world, only to have to untell a few days later. Yes, we hadn't heard the heartbeat in two weeks in that case, but I just couldn't be comfortable with telling a wide circle of people this time before we were in the safety of the second trimester.

And I hit the second trimester this past Saturday. I'm getting bigger, but I've been feeling down about my body. My limbs, butt and face seem to be getting as big as my belly, and I just haven't been feeling really pregnant. We'd been finding it easy enough to wait to tell everyone, so I was almost leaning toward waiting to tell more people till after the third appointment at 15w.

But our little baby is an overachiever and I'm really proud of him/her. You see, I've been cursed this week with the yeastie beastie, which took me to the doctor yesterday. The brilliantly lovely CNP at the office, who I hadn't met yet, checked for the heartbeat. She warned me that the only functioning doppler they had was for later pregnancy, so I shouldn't be alarmed if she couldn't find it. No worries, though! She found it within thirty seconds, thumping away. I am really, really, for serious in the second trimester. This gut I'm developing and this fullness in my lower abdomen is from an actual, living, growing baby.

So now Erich and I are finding it pretty easy to be thoroughly excited. We're starting to accept the reality that we need to start getting our new house ready for a baby, due around January 13. And now I know that my appointment a week from today will be icing on the cake! I think I can stop being nervous every time I go to that office! We're having a baby!

Email #3

2009-07-16T17:51:00.001-05:00

from Susan K
to [close family members]
date Thu, Jun 25, 2009 at 5:40 PM
subject Another Good Day!

Hello, Family!

Today was my first second appointment ever. It certainly felt good not to have it canceled like the others. I was still nervous, however. I was glad to bring along my mom, who helped me talk out my nerves through the inevitable wait. When the doctor finally came in, she set to work right away to find the heartbeat with the Doppler machine. We heard some static right away and I thought I heard a faint beating which could have been my own heartbeat, and she said it might be too early to hear. As she started to look at her watch to check the rate, the wand turned slightly and we heard something much louder. After a little more searching, we heard it! The beautiful swish-swish-swish-swish of a little baby heartbeat. The nice doctor said, "Oh, hello baby!" and we knew it was a good day. The doctor also told me to start looking for a pediatrician. I guess that might be because I'm probably having a baby. Weird!

So we couldn't go straight home after that! We had to celebrate with some shopping. I finally had permission from myself to get my first article of maternity clothing, and can't wait to wear my super comfy, stretchy new capris for the rest of the summer. :)

Can't wait to see you all!

Love,
Susan

Email #2

2009-07-16T17:49:00.002-05:00

from Susan K
to [close family memberrs]
date Fri, Jun 12, 2009 at 11:40 AM
subject Passing Milestones

Hello Family!

I'm pleased to report that I'm officially past the point where my last two pregnancies ended. And what's better is that I'm fairly certain I'm still pregnant! Every time I encounter the mild nausea that just doesn't go away, I have to celebrate a little bit. Every time I have to trudge to my bed to lay down because I'm so fatigued I can't think straight, I'm so happy. My dreams get weirder and more vivid every night. Yay!

I still have my moments, however. I actually went several days last week assuming that the baby had passed away. Perhaps I was too distracted by the move to notice my symptoms as much, but my attitudes and beliefs were that we were doomed again, we'd be back at square one in no time and have start all over again... AGAIN. Irrational, perhaps, but it happens. Erich and I eagerly await my next appointment in two weeks, when we might get to hear the heartbeat again. If there's still a heartbeat. See? It's pessimistic and unlikely, but that's how we think. We can't breathe easy till we get the NEXT reassurance. After the next appointment, we will wait for the next ultrasound. Hopefully then we can sit back and breathe a bit easier, but it's too soon to know just how easily we'll be able to breathe.

So just remember, that's why we still don't consider our news public yet. We'd like to be the ones to tell people, and we want to tell people when we're happy and excited and not still scared pooless that something bad is going to happen any minute. You all know, of course, because you are our closest family and can understand how scared we are and are scared with us. We can't do this alone and appreciate your support no matter what the outcome. For some reason, the thought of having the whole world know long before we're out of the murkiness of the first trimester enhances our fear. Thanks to this stupid History, we just have trouble being plain ol' excited like regular people. So please, bear with us, don't assume anyone else knows that we are expecting, and hopefully come January we'll all be able to joyfully greet our son or daughter, grandson or grandaughter, niece or nephew.

Thank you so much for all your love and support!

Love,
Susan (and Erich)

Email #1

2009-07-16T17:42:00.004-05:00

from Susan K
to [close family members]
date Mon, May 11, 2009 at 10:52 AM
subject hCG

Hello Family!

The results from my second blood draw are in and it's good news so far. The hCG level doubled over two days, as it should, going from 1020 to over 2600. My first appointment was already scheduled for Tuesday, May 26 at 11:00am, and they're now having me come in at 10:30 that day for an ultrasound to make sure everything is going well. I'll be 7 weeks 1 day by my calculations, so if there's a heartbeat, we'll definitely see/hear it then.

We're still hoping and praying that the low progesterone as of 4 weeks 3 days (now supplemented) wasn't a bad sign. I'm 5 weeks today--a looong way to go!

Love,
Susan

[and this follow-up:]

One slight change: because of the ultrasound tech's schedule, my ultrasound and first appointment have been moved to Thursday, May 28 at 8:30am. Pray for a heartbeat!

1 Year and 1 Day

2009-06-24T22:38:00.004-05:00

I forgot to post yesterday, but it has now been one year since one of my favorite ultrasound experiences ever, despite the discomfort and um, well, you know... immodesty. Yes, I'm talking about my hysterosonogram, the saline ultrasound performed by the magnificent Dr. M (maybe I should refer to him as Dr. Magnificent?) which finally, definitively diagnosed my crazy uterus as septate.

I think those five days, starting with the Monday I had the ultrasound and concluding with the surgery the following Friday were some of my most joyous of 2008. Throughout my entire fertility journey of 2008, this was one string of happy days that had nothing to do with miscarriage or TTC. It was filled with pure hope. I had a fixable problem and my childbearing years would not be condemned to more problems or, worse, futility.

It's hard to believe an entire year has gone by. A lot has changed in the last year, but from a fertility standpoint I still feel a bit stagnant. And I'm already 26 years old. I find myself disbelieving I'm so old--I know it's not very old, but I first got pregnant when I was 24, and I should have had a baby in the first half of my 26th year. Now I'll consider myself lucky if I have a baby by the time I turn 27. I used to think I'd be on the young side as a first time mom, but that is just no longer true; I shall be merely average. Ever since I turned 21 I've stopped wishing I were older, but I didn't realize that my desire to stay the same age for a while would hit the fast forward button on these years.

So, what gives, Science? Why haven't you yet found a way to slow down time?

Hm

2009-06-11T17:58:00.000-05:00

Nope, no news here.

'Tis the Season

2009-05-14T11:43:00.003-05:00

...for anniversaries. I had one yesterday: it's been one year since my first appointment with the RE, Dr. M.

It's funny, I wasn't planning on it, but I went out to the area of town near his office, which is rare. I stopped by Bath & Body Works because I wanted something that smells good, and I went to the Walgreens to get a Neti Pot and cough drops because I seem to be catching every virus that comes my way this season. And between these errands, I contemplated what I've been through since one year ago, when I was in hopeless limbo, still worried about whether I would ever have children.

I haven't seen Dr. M since my follow-up appointment last July after my surgery. The last thing he told me was to let him know when I get pregnant and have a baby and to send pictures. I know he would just love to add me to the photo album and count me as one of his success stories, but I still took hope from that. I knew it wouldn't be long.

Well, it wasn't terribly long until I got pregnant, but I never did notify him before I had another miscarriage. And now, it's been so long I hardly even think about my RE experience any more. But my outing yesterday reminded me of my hope and determination to be one of his success stories. I know I can have kids, even though I have trouble believing it sometimes, and when I do, it will be thanks to Dr. M, who made my uterus a hospitable place for a baby.

On House-Buying vs. Homeownership

2009-05-04T22:33:00.004-05:00

As I've mentioned here before, DH and I are in the process of buying a house. We're in the lull right now between the acceptance of the offer and closing, which is in about three and a half weeks.

When we first walked through "our" house, and we both started to know that this was where we wanted to live, I felt such excitement. But that excitement was rightfully restrained. This is where I want to live, but that has little to do with actually living in this house. There are a thousand steps in between those two things, and a thousand chances for something to go wrong, something to send us back on the search at square one. But after passing a few big hurdles, the chances for disaster go way down.

On our way home from this our last round of house-hunting, we made plans to go back that night and bring my parents and get their blessing. Back at home, Erich and I talked excitedly about all we could do with the house and why it was so right for us. But we knew not to get ahead of ourselves--NOTHING was written in stone. That's when I realized that deciding to buy a house is a lot like finding out you're pregnant.

Knowing this is the house you want to live in as as much like homeownership as two little lines on a pregnancy test is like a baby. One leads to another, but they aren't really anything alike.

Putting in an offer is making your first prenatal appointment. You want a response on the offer, and you want to hang onto the baby long enough to make it to that appointment. Getting a counteroffer is not having spotting or significant cramping in the first few weeks. Getting acceptance of the contract from the seller is seeing the heartbeat for the first time.

Getting a mortgage is making it to the second trimester. Closing is making it to the third. Moving is giving birth. (Not looking forward to that part!) And then that's it, right? Nope, homeownership is parenthood. And then I can't really continue the analogy, but there you have it.

I'm excited to be just about to the "second trimester" on the road to homeownership. Now if only I can ever make it to the second trimester of pregnancy, I'd be even happier to have passed the major hurdles!

Psalm 113:9

2009-05-02T10:43:00.003-05:00

I've taken to reading Psalms at bedtime. I like to read in bed, and that is when I do most of my book-reading, but sometimes an action-packed novel or weighty non-fiction gets to be too much stimulation for my brain, which needs to wind down and rest. The Psalms are generally short and easy to read, and I have the added advantage of getting to know my Psalms better, which is useful for me as a church musician.

The other night, my final reading was Psalm 113. The final verse, verse 9, reads:

"He gives the barren woman a home,
making her the joyous mother of children.
Praise the Lord!"

I could not have found a more comforting verse on which to meditate if I had been searching for it. Praise the Lord!

Still Trying

2009-04-20T10:21:00.002-05:00

But what else is new? I really don't mind, though. It'll happen eventually.

Erich and I were on our way home yesterday from a very short weekend in St. Louis where I held no fewer than three babies, and we spent time with very good friends and family. Erich remarked to me over our cups of Wendy's chili that it was a refreshing change to spend time with family and friends of all ages, i.e. kids included. Not many (not any, I think?) of our friends we see regularly have any kids, and of the four siblings in my family, who we spend a lot of time with, three of us are married but only one of us has one child.

I agreed with Erich. We love our local friends and family, but spending time with self-absorbed young adults all the time can get a bit confining. We restlessly search for something a bit more than day-to-day goings on, career news, and the like. Watching babies and children grow and change is always exciting, and we just don't see enough of that at this stage in our lives. As our conversation continued, Erich gazed out the window into the rain, trying to find the right words. "I just think," he said, "that it's just about having a bunch of kids and going to church."

As I searched for the right "Yes! And..." thing to say, I stopped and realized that he had just said something very close to everything I had ever wanted out of an extremely good-looking husband. I had to melt just a bit. "What?" he said in reply to my stupid smile. "Oh, you just ovulated, didn't you?" *wink* As soon as I could get my convulsive laughter under control, I squeaked out, "Well, I wouldn't be surprised!"

It's easy for us at the moment not to feel terribly impatient in the TTC department because we are currently in the process of buying our first house, and that's a wonderfully exciting endeavor in and of itself. From the perspective of our young adult-style self-absorption, buying a house is so great! But we are already more than ready to be on our way to filling that house with kids.

Sick of This Stupid Journey

2009-02-21T22:47:00.002-06:00

In a vacuum, I am doing spectacularly well. I am amazingly well-adjusted and healthy. I have no unrealistic expectations of myself. I am okay with my super long cycles--hey, at least I ovulate! I see every period of waiting as a chance to improve my life in all areas, and I never nurture any irrational doubts that I will ever be a mother. I am the very model of mental calm.

Unfortunately, life doesn't happen in a vacuum. It's in real life that I find this exemplary balance I've struck is actually extremely delicate. A breeze renders it unsteady; a gust can obliterate it. I've recently received some news (external, nothing to do with me directly*) on par with tornado-strength winds. I now have to do what I wasn't planning on having to do any time soon: pick up the pieces yet again and build a new support for the ever-elusive Hope.

I'm feeling angry at the world. Where yesterday my long-term view of the year ahead of me was simple and devoid of any major limitations, I now see timelines spring up, deadlines for maximum possible happiness. I really REALLY don't need to add that kind of stress to TTC. That's soooo 2008. This year was supposed to be different, but from my perspective right now, it's looking to be equally stressful and disappointing. I can't be more optimistic than that at this point: again, Hope has lost all foundation. It'll take some time to get that back.

Mostly, I'm resentful. I'm normally perfectly happy to fade into the background, so it's all the worse that Erich and I are now "that sad couple." "Better be nice to them, they're having problems." In my little vacuum, I'm so blessed and happy. Despite--and also because of--the challenges we've faced, our marriage is stronger than ever. Outside that vacuum, I feel exposed and vulnerable to pitying glances. Every glass of wine I drink is proof to others that I'm not yet truly fulfilled. Someone else's exciting news is a knife to my heart. It seems I'm having to choose between being emotionally on-display and total reclusiveness.

I just want to quit it all and have a whole separate miscarriage life that I don't have to live every day.

*Imagine a world where TWO positive pregnancy tests is incontrovertable proof that a baby will arrive, healthy and whole, nine months later. In this magical, mythical world, you can get pregnant without even meaning to--in fact, you can get pregnant while specifically trying not to. You don't have to worry about keeping your baby alive through pregnancy, you just have to worry about feeding and clothing it. There's no need to fret about whether this baby is healthy, but you do have to watch out for the possibility that there could be two in there. Did I mention the streets are paved with gold, the shores are lined with baby powder, and diapers are the universal currency? Such a marvelous, magical world! If only we could find a way to get there!

Have you cried yet today?

2009-02-21T01:37:00.003-06:00

No? Here, let me help you:

I've seen this video posted from time to time over the past year and a half or so, on message boards and blogs. It didn't used to make me cry, but now it does. It didn't used to apply to me, but now it does. Time is powerful.

An Excuse for Sad

2009-02-13T11:39:00.004-06:00

Why might I be a little down in the dumps today? Because it's Friday the 13th? Well, no--but yes. You see, it's been one year to the day since the worst day of my adult life. No Heartbeat Day, the First.

Yes, that is my excuse to be sad. That is, if I needed one. But I don't! I just can't muster up sadness just to "celebrate" an anniversary. Now, I wouldn't want to hop in a time machine to a year ago and tell younger me that a year later, I would still have no baby or even a pregnancy. This is certainly much, much less than I had hoped for. That's okay, though. Surviving sure beats the alternative.

I can't pinpoint the moment it happened, but sometime in the last month, someone turned off the grief switch. Sometime between my D&C follow-up appointment--when I was a hot mess of tears and sadness, feeling hopeless and utterly drained from the simple effort of being in that office with all the pregnant ladies for over an hour--and now.

Let us flashback to my follow-up appointment. Dr. J was great, but I just couldn't keep it together. I had sat in the waiting room for over an hour, watching tons of happy pregnant people come and go. I kept it together, but then I had to see the nurse (serious Laurie, who is actually really nice) and Dr. J, and they had to be nice and sympathetic, and that just opens the door for emotion. Blech. I've got nothing wrong with emotions, but I hate making a scene.

This is how my plan backfired. My whole "just let it out" idea actually led Dr. J to observe that I wasn't handling this grief very well, and that I must wait to TTC again, lest another loss thoroughly crush me. Uh oh. I asked her if it's absolutely necessary to avoid conception before I get my first period. You see, it takes me forever to ovulate, and I hate having to wait forever. She hesitated. "It's not absolutely necessary," she said. But then she went on to tell me that if I did have another loss, it would be bad to wonder whether I should have waited. ("Ignore," said my brain.) She went on, "So just wait till you get your period, and if everything seems normal, go ahead and wait another cycle, and if that seems normal, you can go ahead and start trying again." ("Ign--wait, what??") I stopped asking her advice. I knew this waiting wasn't necessary. I wailed again about how freaking long my cycles are, so she attempted to placate me by offering Clomid. No thanks.

I left the appointment feeling worse than ever. But over the next few days, I started clinging to those words, "not absolutely necessary." Physically, I was ready. And I just knew that my cycle wasn't progressing yet. This would be a very late ovulation, which was perfect to give me a chance to move on. The closer I got to ovulation, the more I knew this would be a TTC cycle, and I was totally at peace with that decision. And seeing how mentally balanced I was about everything, DH was totally enthusiastic and on-board.

I'm currently 9DPO. So even though I'm not knowingly pregnant and I don't have a baby, at least there's a possibility of being knocked up a year after my first m/c (given our track record, a 2 in 5 chance). If I'm not, then at least I will get that one cleansing AF the doctor ordered. I'm completely disregarding the fact that Dr. J recommended I wait two cycles. I'd be so much worse off emotionally if that were my plan.

Lastly, it has been warm this week. Record highs on Tuesday, and our many inches of snow are now completely gone. It's getting colder, but the sun is shining. It's nothing like the weather a year ago. Also, this time of year is pretty much the perfect storm for me (aside from Holy Week), professionally, with accompanying for band students' solo contest. I didn't do much accompanying last year because I had too much fatigue from being pregnant. This year, I'm adequately distracted from any opportunities to make myself sad.

And that's all I have to say about that. Still miss you, Keiki. S/he'd be almost six months old already.

Get Me Away

2009-01-23T00:28:00.003-06:00

Not sure why it suddenly seems this way, but it seems like my Facebook is absolutely exploding with babies. None are mine. Never mine.

Luckily, I still don't have many friends IRL going through successful pregnancies... but I've seen enough happy families, easy pregnancies, and unspoiled notions of "BFP=baby" to make me feel like I'm going crazy. [I'm happy for them, but each time I see it I feel that much worse for myself. And THAT makes me feel guilty.] It makes me want to scream.

WHY WHY WHY WHY WHY NOT ME? Why should anyone ever have to go through two miscarriages (or more) with no healthy child first or in between? Why do I have to be one of that 1% of the female population with a uterine septum? Why do I have to be in the less than 5% of the population who has two miscarriages in a row?

If I actually believed I were being punished for specific sins, I'd be flogging myself right now. At least then I could blame it on something. I'd at least have some excuse, something I could know not to do wrong next time. But there's nothing. All I can do is stumble through life and find some reason to hope that things will work out next time. It's all so very, very tiring.

Hi. My name is Susan, and I am bitter. And infertile.

The D&C, Take Two

2009-01-21T10:48:00.002-06:00

I'm not in the mood to post as in-depth as I did last winter on my first D&C. But I do want to describe it to highlight how it was different from my first one.

I was very surprised at how easy it was! After two similar surgeries under general anesthesia, I thought I knew what to expect. But when we met the anesthesiologist, he told us that I would be under deep sedation, and he'd only go to general anesthesia if I moved around too much. I didn't yet understand what that meant for me, but it sounded good.

Then we met Dr. J, who was on call to do my surgery. She was wonderful, and I got to know why she was the doctor particularly recommended to me in this practice. She listened to me and gave me a chance to ask every question I could think of and thoroughly answered them to the best of her ability. Excellent bedside manner. I had expressed concern about my abnormal uterus and whether there might be any leftover septum that had a role in this loss. As I expected, she answered that it was unlikely since it was a blighted ovum, and she couldn't promise to be able to verify that there was no septum leftover, but she would certainly mention if she noticed anything.

The hospital seemed pretty empty, probably due to the fact that this was two days before Christmas. It seemed like I got to go through each step of the process relatively quickly, all while repeatedly answering questions as to my name and DOB, what procedure I was having done and whether I was allergic to anything. My mom and Erich were there with me, and we took our turns crying. Erich had to go to a rehearsal later that day, so the plan was for me to go to my parents' house and hang out on the couch for the rest of the afternoon and evening. I foresaw being out of it, hugging my box of kleenex, wallowing in sadness.

Then I was wheeled into the OR. The last thing I remember the anesthesiologist telling me that he was putting something in my IV that would not put me to sleep. Yeah, right.

Then I woke up, being wheeled into the recovery room. I opened my eyes and could see Dr. J and she was saying, "It went great! Textbook!" I felt joy at the idea of a textbook uterus. The nurses were fluttering around and one sat me up. I was waking up so fast! I felt like I had taken the most beautiful and restful nap ever, and I felt that weight-lifted-off-my-shoulders sensation I had expected with my first D&C but never had.

After only about ten minutes of hanging out on the bed, I was escorted to the recliner. There was very little bleeding. Erich and my mom got to come over soon after, and then I was eating snacks (delicious, wonderful FOOD after fasting for 14 hours!) and just generally feeling really good. I knew the emotional distress would hit me later, but for the time being I was just enjoying my comfort level. And I continued to enjoy it for the next few days, with negligible bleeding that day and none for the next five days. We were in and out of the hospital in about 3.5 hours, as opposed to the 5.5 hours last February.

So thank you, normal uterus, for not setting me into an abyss of confusion this time. Thank you, body, for not starting to miscarry naturally before the D&C. That really helped my mental health. And, above all: thank you, deep sedation, for not being general anesthesia and allowing me to feel normal so soon after my procedure. You guys really came through for me.

A Little Math

2009-01-15T10:36:00.003-06:00

My first pregnancy ended at 12 weeks. My second ended at 9 weeks. 12+9=17.

Okay, okay, they were both missed abortions. (Cruelty, utter cruelty!) So if we count how long the babies lived, let's go with 9 weeks for the first pregnancy, and 6 for the second. There was no baby visible in the second, but at six weeks there would only be a fetal pole, which is small enough to disintegrate in three weeks' time. So I'm assuming I had a baby until about six weeks, since that's how big the sac was.

9+6=15.

My point is, I have been pregnant with a living baby for a total of 15 weeks. Shouldn't this give me a free pass to go directly to the breathe-easy second trimester next time? I've put in my time worrying through first trimesters. Been there, done that. My next BFP should make me 15 weeks pregnant. It's only fair!

Why don't the BFP gods ever pay attention to what's fair?

The Bad Ultrasound

2009-01-12T10:57:00.004-06:00

I feel like a very unsteady wagon, passively pulled along. But the wheels are about to fall off. At the beginning of the coldest week in ten years. Awesome.

From the day we found out we lost our Vector (baby #2's nickname, long story), I made it my policy not to be strong for anyone. The only way to get through the grieving process is to get through it, cry when I feel like it, all the sooner to feel normal again. But grief appears on its own time. I was extremely sad at first and then I floated along, comfortably numb. But today, for whatever reason, I'm riddled with anxiety, unwilling to face the day, the week. What is the reward for persisting through each day? I'm having a hard time seeing it.

I must continue my policy. I have to continue to face this second loss, or I'll never be able to face another venture into the land of TTC. I can't ever be happy to become pregnant if this blighted ovum becomes merely a vague fear, an expectation of disappointment. This is a sad post, but it's my therapy. Read if you want; it's mainly for me.

We were finally home. It was Monday morning, and we had been in Michigan the preceding weekend, celebrating Christmas with the two sides of my extended family. We intended to be home Sunday night, but a horrible snow storm had us seeking refuge in NW Indiana at Erich's aunt and uncle's house. Early in the morning, we got up and drove the remaining 90 minutes home, glad to do it in the daylight. We had a few hours at home to unpack and shower, then we went off to the scheduled ultrasound, the one I hoped would confirm my own dating of the pregnancy: 9w1d.

Perhaps it was the significance of that date--the fact that Keiki was 9w1d when we saw the heartbeat--or the fact that we had finally started to tell people over the weekend, sharing our joys and nerves that made me very nervous for this ultrasound. The first appointment the week before had served to make me very excited, but the low progesterone issue shook me and I was half expecting bad news.

We had to wait for about 10 minutes before we were called back. The nervousness continued. The tech finally led us to the room, the same tech I had at my other two ultrasounds, the first one good, the second one bad. She asked if I'd had any spotting. Nope! She looked at my chart and said I should be around 11 weeks. I told her that I'm a late ovulator and was looking for nine. Okay then!

She blooped the gel onto my lower abdomen and pressed heavily on my very full bladder as my heart raced. My uterus came into view. It appeared pregnant to me, but we could not see a baby. No comfort had yet arrived. The tech zoomed in a little then asked: "Would six weeks make sense?" And my heart stopped. No. "NO!" I wailed, panicking. It was over, all over. My head started reeling as I heard her say that she could see a sac but that it looked tiny, tiny. No. No. NO.

Then my second least favorite statement, given my history: "I'm going to do an internal." I sat up and looked at Erich, who looked confused but hopeful. It wasn't quite over for him yet, which would be a normal, hopeful person's response. My hope was gone; reality had already crushed me. I left the room, crossed the hall and emptied my bladder, feeling there was no point. I went back in, and the tech left to give me a chance to undress my lower half. I sobbed and sobbed while Erich stayed by my side. "I'm not doing this again, I can't do this again," I kept saying. The tech came back in and was very sweet. She did the internal ultrasound and I didn't even bother to look at the screen. I knew Erich was looking, getting his conclusive proof that hope was gone. She didn't say much else--I know she's not allowed to, but it was clear to her that I already knew what she wasn't allowed to say. This was bad.

She kindly patted me on the knee one more time before she left to see if she could get a doctor to talk to us. We were escorted to Dr. D and Dr. J's office to wait for one of them to come in. I was so, so glad Erich was with me this time. We comforted each other, and I think we were trying to figure out if and when I should have a D&C, given this was three days before Christmas. Dr. D came in. Last time she gave me the platitudes and didn't have much to say, but this was loss #2, time to get down to business and figure this out. I asked some questions as she scrutinized my chart. She was looking for answers, and I appreciated that. We didn't leave with any conclusions, but the point we seemed to be hurtling toward is that my first loss was almost certainly due to the septum; this second loss was earlier and not consistent with any leftover septum or anything. Therefore, they were unrelated and bad luck. I asked if my very long cycles could have anything to do with it, and she was unable to answer.

Numb, sad, and disappointed. We cycled through those three throughout the day, taking turns comforting each other. Disappointed that we never got to tell Erich's family we were expecting, disappointed that we won't have a summer baby, or perhaps any baby in 2009. Sad to have lost another baby, sad to be that sad couple that everyone feels bad for, sad to be missing out on a joyful Christmas holiday. And numb when it all got to be too much.

The more we talked, the more I realized it would be better to get the D&C over with. How nice that I never started bleeding on my own. I felt relieved to be able to schedule it for the next day, even though that meant asking the other organist to cover the Christmas services I was supposed to play. I still regret not getting to play organ this Christmas, but c'est la vie.

Truth be told, I'm still pretty numb a lot of the time. And depressed. I hate winter.

MAs in the News

2009-01-06T10:00:00.004-06:00

Here's the latest in TOTALLY AMAZING and UNBELIEVABLE news from the UK: a woman with two wombs has fallen pregnant!

Read all about it at the Daily Mail.

Perhaps I've become a snob about müllerian anomalies since my months immersed in learning as much about them as the internet had to teach me. Heck, I even make sure to put the umlaut over the "u." So, as such, I find it very hard to be amazed by this news item.

Sure, uterus didelphys is one of the more rare MAs, but it's not unheard of. And pregnancy is very possible and probable. Even the doctors cited say her chances of pregnancy is (only) HALF those of regular women. Dear me!

Here are some of my favourite [see what I did there?] parts of the article:

She was unaware of a bigger surprise to come. Her rare condition, uterus didelphys, had not been detected because her body is normal externally.

Wait wait wait wait wait wait wait. You can't see a womb (or even two!) from the outside? (They're probably talking about how her dual bajingos have only one opening to the outside, but still.)

Although eight in 10,000 women in the UK have some form of uterus didelphys, only one in a million has exactly Mrs Hasaj's anatomy.

And I bet no one else's septum looked exactly like mine. And no one has my exact liver or just that exact curve of my left fallopian tube. Big deal.

'The baby was kicking and wriggling and it felt wonderful. It made me feel like I was any other mum experiencing the joys of pregnancy.'

Despite the double womb, she's most likely pregnant with a human baby.

The condition does pose some problems because the two wombs are considerably weaker than a normal one.

Well, that's true. I believe UD is like having two unicornuate uterii, so there's risk of intra-uterine growth restriction, premature birth, breech presentation, etc.

Doctors have also told her this will probably be her only baby and her dreams of a large family are unlikely to be fulfilled. 'I'm just happy that I've been given the chance to be a mum at least once,' she said.

Those doctors are complete idiots.

I hope you have enjoyed, as I have, our romp through "MAs in the News" today. It feels good to be such a know-it-all, doesn't it?

I'm Transparent

2009-01-01T15:01:00.003-06:00

In the interest of full disclosure, I want to say that the last three posts were actually written today. I hated to see that the first post on the page was filled with such hope and confidence (even though I was the only one who could see it), and there was so much to say since my 12/5 post. Yet I didn't want to write about everything from the perspective of my second loss. I hadn't gotten around to making my update posts, but I had intended to. It was difficult at times, but I tried to accurately portray the emotions I felt at each stage.

I will fill in the rest of the story. I feel as though I have to. It hurts a lot to pull it out of myself, but it's healing as well.

For now, I'll just say that miscarriage completely sucks and I totally hate 2008. 2009 hasn't started off very rosily either.

The Nightmare Begins Again

2008-12-22T13:00:00.001-06:00

We're back from the ultrasound. No heartbeat. No baby, actually. Just an empty gestational sac and a yolk sac measuring around six weeks. That would explain the low progesterone. And now there's no hope left for this one. D&C is tomorrow.

Merry f***ing Christmas.

Bump in the Road

2008-12-19T17:00:00.001-06:00

I got up to a very strange voicemail today: it was nurse Laurie from the doctors' office. She said something about how my blood work results came in and she was "really confused" about something and that I need to call her back right away. So I did.

She informed me that my progesterone is low and needs to be supplemented. I tried not to go into panic mode as the questions flooded my mind. Low progesterone is not good, but if it were a problem, I'd already know about it, right? I'd have spotting and cramping and I'd know that I were losing the pregnancy, right? The reason Laurie was confused was because according to my chart I was already 11 weeks along and I had only just now had my progesterone tested, even though I had had a miscarriage and should have come in for a progesterone check within a week after my missed period. OH, NOW YOU TELL ME. Bugger. Okay, does it help that I'm actually not quite nine weeks along? Hmmm. It was hard to ask her many questions, as she seemed to be semi-frantically trying to figure out my situation. I would only be on progesterone for two more weeks! Well, at least until my next appointment. Yes, I could come in for a sample right away and fill my prescription right away and that will help.

At this point, I had to cut in with questions. I was still stuck on, "It's low?" It just would not compute in my layperson's brain. How could it be low? So I asked what's normal. She told me normal is around 20, and mine was 8.72. YIKES. That just didn't sound good. But I keep telling myself that if it were a big problem, I would already know about it. And as soon as we see that heartbeat on Monday, we'll be in the clear, right? RIGHT??

Laurie urged me to come in immediately for a sample to use right away and for my prescription to fill, again, right away. I still hadn't showered. Erich was home for a snow day. While I showered and struggled to remain clear headed, Erich googled progesterone levels during pregnancy. When I came downstairs again, he showed me a chart that said normal for the first trimester was 9-42. Quite the range, and I was just below the low end. And progesterone levels can fluctuate. I'm probably fine...probably, hopefully.

I fishtailed through four inches of slush to the doctors' office. I picked up my sample and prescription and asked to talked to a doctor or nurse about this. She managed to pull Laurie away from the phone and I asked her some more questions. I can't even remember what all I asked, but I wanted to know how much I should worry. "Not at all," she assured me. Well, her words assured me, but her face and manner were so serious! I asked what kind of signs I would have that something was already going wrong. She answered, "Cramping and spotting." I remembered some crampy feelings I had had the other night. They weren't painful, but they gave me pause. "Some cramping can be normal," she said. Gee, thanks. She told me again to use the sample right away and fill the prescription TODAY. Yes, ma'am. And if I get pregnant again, come in right away for a blood test. Thanks for all the hope you're showing in THIS pregnancy.

I filled my prescription. I'm now on Crinone vaginal cream inserts. We'll see how this goes.

The First Appointment

2008-12-17T20:00:00.003-06:00

I had my first appointment today and it went really well! It really made feel excited about this pregnancy, and that I should actually expect to have a baby next July.

Erich was able to go with me, which was awesome. We had to wait a while, as usual, and then I was called in for a weight/BP/urine check with a nurse. She used the little useless wheel calendar to determine my due date based on my LMP: July 11. Not gonna happen, but she wasn't allowed to go by anything other than LMP. She gave me an order for standard blood work, and I went back to wait. Even though I hadn't been looking forward to returning to this office for the first time since my D&C follow-up, the more I sat there, the better I felt about everything. I'm pregnant, it's early, and I was there for my first appointment. One day at a time. Big whoop.

Before too long, Erich and I were called back to wait in an exam room for Dr. P. On our way, the nurse stopped me to reclaim my blood work order and cross out the cystic fibrosis screening since I've already had it done.

In the exam room, I undressed and prepared to be examined for the first time in a long time, relatively speaking. When Dr. P burst into the room with a huge smile and a "Congratulations!" I couldn't help but feel happy and excited. "And you're ten weeks already! Wow!" I told her that wasn't accurate since I'm a late ovulator and she automatically responded, "Oh, that's okay, we can just do an ultrasound." I did a little happy dance. :) She immediately wanted to know what happened with me after she finally referred me to Dr. M. She seemed really pleased and proud of herself that it was a uterine septum, which I believe was her original theory. After a medical history questionnaire, she did a quick pap and then felt my uterus. She had to search a little since I'm retroverted, but when she found it, she said, "Oh yes, getting bigger!" This was a contrast to my first appointment last time: I was about a week further along, but when Dr. D went to find my uterus, she frowned and said, "You're not twelve weeks," which I knew, but then she went on to say, "You did get a positive home pregnancy test, right?" I guess my little septate uterus wasn't stretching at all.

Once the exam part was over, Dr. P assured us again that we would come in for an ultrasound as soon as possible, and we should be able to see a heartbeat on the ultrasound. The thought of seeing a heartbeat within a few days just made me sigh with relief and happiness. I know Dr. P appreciated that. She also said that by my next appointment they'd probably be able to hear a heartbeat with a doppler. And the next appointment feels so close since I'm doing such a great job of taking this one day at a time! On our way out of the exam room, Dr. P told the receptionist to schedule me for another appointment in four weeks and for the first available ultrasound. she emphasized again: "FIRST AVAILABLE." Then she asked for my blood work order again to add progesterone. She and I both know that low progesterone wasn't the cause of my miscarriage, but she said that since I had one they should test for it and they can always supplement if it's low. Okay, whatever! Since we had time, I went ahead and got my blood drawn right away after the appointment.

Second appointment is for 1/14 with Dr. D. And the first available ultrasound isn't until Monday at 10:30. Booo. But at least we're getting one before Christmas so that we have a visual aid when we tell people!

I Had a Dream!

2008-12-05T18:07:00.004-06:00

Okay, I dream pretty much nonstop when pregnant--vivid dreams that I remember upon waking. But something I never dreamed about with my last pregnancy was either being pregnant or having a baby. I didn't find that significant before the loss, though I was anxious to finally have a baby dream, but afterward it made me think. Maybe my subconscious knew it wasn't meant to be, and that's why I never had a baby or pregnancy dream? Or maybe it meant nothing.

Of all my crazy vivid dreams this time, there have been three of note:

1. About a week before my BFP, I had a dream of five positive pregnancy tests lined up on the bathroom counter. They were VERY positive and one of them was actually saturated with pink dye. In fact, it was a picture similar to this real one:

I like to think that the middle one where I smudged my sharpie was the saturated-dye test of the dream.

2. The weekend after Thanksgiving, I had a dream that I was spotting at 6 weeks. I kept checking with my finger and coming back with a little spot of thin red blood. Just so you know, that's not realistic at all. In my dream, it was my knowledge that 6 weeks pregnant+blood=bad that made me freak out, but the emotion of the dream was not actually scary at all. I knew I was dreaming, and this was just a manifestation of an incident the day before involving a chapped but mostly healed cold sore that split a little bit and left tiny drops of blood on my fingertip.

3. This very afternoon, I had a dream that I was caring for a little infant boy--MY newborn baby. Now, I'm pretty sure this dream was due to the fact that I fell asleep in the living room while watching Bringing Home Baby on TLC, but I still enjoyed the dream. I was about to start breastfeeding the baby, and my dad handed me a pink afghan that I had made (but not specifically for myself) so that I could cover myself up. Throughout the dream I either held the baby or sat him in a carseat, and he was smiling the whole time. Sometime he let out a really relieved and satisfied sigh as only a dreambaby newborn can.

I wouldn't call that last dream particularly realistic, and therefore it can't have been prophetic, but I'm still taking it as a good sign nonetheless. And I'm almost seven weeks pregnant! Halfway through the first trimester, 12 days until my first appointment (and then the real worrying begins, but we won't ponder that right now).

Thanksgiving

2008-11-29T23:04:00.003-06:00

Tomorrow, I get to the six week mark! This pregnancy is moving slowly because I'm anxious to get out of the first trimester, but I really can't complain. I'm happy it's still going. Plus, WOW, did my symptoms suddenly show up! I wasn't worried about the mildness of my pregnancy symptoms earlier because I knew it was still very early. In my first pregnancy, I had nothing that made me feel far out of the normal range until about 5.5 weeks.

Well, as of Thanksgiving Day, I was 5w4d and started to notice a major onset of symptoms. My yucky bloat turned into major bloat--certainly helped by the large meal. My tiredness has turned into major fatigue. And I'm pretty sure I've grown at least half a cup size in just a few days. I FEEL pregnant, and it's wonderful.

But, Erich and I, the receptionist at my doctor's office, and the girls on thebump.com are still the only ones who know I'm in the family way. We got together with Erich's entire extended family for Thanksgiving--36 people in all. We knew we wouldn't be announcing any news at this gathering. I know the family will be so excited, but I can't imagine that everyone would be able to hide their apprehension. Heck, I'm still nervous. So we enjoyed having our little secret, though I was surprised at the number of times I had to suppress little urges to exclaim, "We're pregnant!!"

Anyway, I wish I would be further along than 9.5 weeks at Christmas, but nonetheless, that's when we've decided to tell our families. I just hope it's at a time when everyone, including me, can be purely excited and not too worried that this one will end the same way as the last. I mean, I know it CAN'T end the exact same way, i.e. baby getting choked out by uterine septum, but this is a touchy subject now, thanks to all my reproductive baggage.

There is just no erasing my happiness, above all. I love that my current worries are of the somewhat trivial nature, compared to worries as to whether I would ever get pregnant again or have kids. And I LOVE the fact that I'm virtually six weeks along with no signs of anything but a healthy, normal pregnancy. Praise the Lord!

The Mantras

2008-11-16T12:51:00.002-06:00

On ~~the nest~~ thebump.com, the ladies at the Success After a Loss message board have list of mantras, which I shall repost here (cleaned up for grammar and structure, because that's the kind of girl I am):

Today I am pregnant and I love my baby.

I am pregnant until someone tells me otherwise.

My past does not dictate my future. A previous loss does not mean I will have another loss.

Just because something sad is happening to someone else, does not mean it will happen to me. Miscarriage and complications are not contagious!

Hope does not make bad things happen. I cannot "jinx" my pregnancy by creating a ticker, getting excited, or telling someone. Live in the positive!

And this is the hardest one: There is nothing I can do to prevent a miscarriage from happening. Worrying myself sick won't prevent a miscarriage. And if, God forbid, it were to happen again, I know I will survive.

Intuition or Impatience?

2008-11-15T10:49:00.002-06:00

Still pregnant! I took a third test in as many days this morning, and the second line was much, much darker. I'll still breathe easier when my period is actually late, but for now I can definitely say I'm knocked up!

It's funny how different I feel with this BFP compared to last January. Last January, I was definitely happy, but I was just so confused for the first three weeks. I couldn't figure out how far along I was. Actually, I thought I knew, but I turned out to be wrong--I had been pregnant for at least three weeks longer than I had thought. While I was happy to learn I was already nine weeks along and the time of greatest miscarriage risk was behind me, I still had trepidation. I couldn't bring myself to buy any maternity clothes or start registering for shower gifts. It just felt too soon. I was so glad I hadn't done those things when I did eventually find out about the miscarriage.

Did I know, deep down, my baby wouldn't live? Perhaps. But I think my trepidations were mostly a result of how new I was to the whole baby-making game. My second cycle off the pill had confused me greatly, and it resulted in a baby without my knowledge. In retrospect, I wish I had charted, but at the time I thought it would make me too obsessive. I can't say whether I really knew that pregnancy wasn't meant to be or whether I was just being cautious. It's too difficult not to view the past through the lens of the miscarriage.

Fast forward to today, and while the doubts and cautions are sneaking in, I am very excited. I believe that I will have a baby in July or early August. I found myself thinking in the past few days about how I want to get a onesie or a maternity shirt. I'm barely four weeks pregnant! Is this my intuition telling me that everything is going to be okay, or is it just that I'm so prepared and so ready to be pregnant that I'm not worrying too much about anything else? Either way, that's a good thing.

So it's going to be hard to keep this a secret. I feel like shouting it from the rooftops. But whenever I think about actually doing that, I do come to my senses. I wasn't sure before if we'd even tell family as early as ten weeks, but that's how far along I'll be at Christmas, and what a perfect time to announce. But we will not tell our larger circle of friends or the general public until well into 2009. I don't really want to wait that long, but from where I stand that wait looks a lot easier than the waiting I faced last February.

For now, I'm doing a pretty good job of taking this one day at a time. Now that my septum is fixed, I'm at no increased risk for miscarriage. And since I made it past nine weeks last time, I have no reason to believe I have any condition that might cause an early miscarriage. So I'll just keep taking this day by day while I stare at my three (and counting, to be sure) positive pregnancy tests!

Here We Go Again

2008-11-13T11:51:00.003-06:00

It's been nine months to the day since I found out about my miscarriage. This is not sad for me, because I got my first positive pregnancy test this morning! I cannot contain my excitement. I thought I wouldn't blog about it, but I can't help myself. Therefore, this blog has become private for the time being.

Anyway, how about a story? This is our third cycle TTC since my septum resection surgery. I had a lot of hopes riding on the first cycle, as it was my only chance at a BFP before my original EDD. I was not pregnant. This was sad, but I got over it. However, I was a bit annoyed that I did not ovulate until CD28.

Cycle number two was even worse. CD28 came and went and I still hadn't ovulated! I was really depressed. I felt like my body didn't work, that I would never get pregnant. I made the decision to stop charting for a while and try to put it out of my head. I knew that trying to predict when I was going to ovulate is probably what delayed it. Sure enough, I started to feel PMS symptoms, and my best guess led me to figure that I had ovulated on CD32. Oh, and I was still not pregnant.

Luckily, I had a plan. I had done some reading about soy isoflavones, and how, when taken for five days at the beginning of the cycle, they would help stimulate my hormones to make me ovulate earlier. So when I got my period at the beginning of TTC Cycle #3, I already had the supplement on hand, which I took daily CD3-7. And to help predict ovulation and help reduce stress, I bought a pack of ovulation predictor kits. I knew Erich had a few business trips planned, so I really hoped that I wouldn't ovulate in the middle of him being away.

In mid-October, Erich and I visited his family down in southern Indiana. On our way home, we decided to do some shopping in Terra Haute. We wanted to buy Rock Band 2, which had just come out. And I knew there was a Dollar Tree store there, and I've heard lots about their pregnancy tests. So we stopped by, and I picked up five. No, six. And, of course, a bottle of water and some paper plates. I wasn't JUST buying pregnancy tests, no sirree.

Anyway, I ran out of the first pack of OPKs and decided to buy cheap ones in bulk from the internet. That was a good plan. Because I had to use a LOT of those puppies. Even though the OPKs continued to be negative, I started to be hopeful that I would ovulate around CD21. And then... spotting?!? WTF. Was this my period? What was wrong with me? I felt really horrible for about half a day. Luckily, though the spotting lasted a full 48 hours, it was never heavy and it did cease. My cycle was still in progress.

Halloween day I got my first positive OPK. I was readying the house for our Halloween party, and Erich had just gotten home from work. I was so happy about this, because if it weren't for the positive OPK, I would have had no idea that ovulation was imminent. Even though we both got pretty sauced that night, we made sure to give it the ol' college try. I got another positive the next day, and a few more days of high temperatures indicated that I ovulated on Sunday, CD29. [So I guess the soy did basically nothing but make me spot. I only took the smallest dosage, though, and was planning on upping it the next cycle if needed.]

I worried about the chances of conception based on when we "tried," but all-in-all I felt rather at peace. I felt really good knowing that I could see ovulation coming and that we did our part to make a baby. The "two-week-wait" was not too bad for the first eight days or so. But then the questions started flooding my head like they always do. "Is this PMS or pregnancy? Was that a menstrual cramp or implantation?" Tuesday I felt a few cramps, and I really thought it could have been implantation. Yesterday, after registering my highest temperature ever, I was feeling super curious. But I scolded myself not to test early. I hated getting BFNs that first cycle, and if I had just waited a few days, I wouldn't have wasted the tests because my period arrived right on time. But THIS time I had cheap tests on hand.

I told Erich my notion of testing on Thursday or Friday, thinking my good rational husband would talk me out of it, but he was actually in support of testing early. See, he's going on a big hunting trip with the men of my extended family this weekend (my period is due Sunday), and he didn't like the thought of me testing and getting a positive without him there. And plus, even if it were BFN, I still have five other cheap tests, so it's barely a waste. So with his permission, I got up this morning after another record-high temp, peed in my special pee mug (which says "I <3 Jim Halpert"), took out the test, used the dropper to carefully drop four drops of pee in the proper place, and we watched the line of pink move across the test. The control line came up right away and no second line, but it had only been about 90 seconds. Erich walked away, but I kept staring, fully prepared for a BFN. But then... it started to appear. It was faint but undeniable. I could see it without squinting or holding it up next to my face or tilting it just right. It was there.

Erich's reaction took me right back to my original BFP back on January 5th. His logical, rational brain just cannot equate the faintest of faint lines on a cheap little object to a baby. As for me, I am excited already. It's a bit daunting that I'm only 3 weeks and 4 days along, but getting pregnant at all is a big first step. And this time, I was expecting it. I already know I'm pregnant; there's none of the confusion or wondering "When did this happen?" that I had last time. And my uterus is remodeled and, as far as I know, totally baby-ready.

Barring any unforeseen difficulties, I'm due July 26. Yippee!!!

Another Septum Resection

2008-11-01T12:23:00.003-05:00

Thursday night I managed to procure three pumpkins for carving. Actually, I really just wanted the seeds, but if you're going to cut open pumpkins, you may as well make jack-o-lanterns, right?

Why am I telling you this? Because one of the pumpkins had a definite septum! It was broad and three-pronged near the base and extended up into the cavity of the gourd. I successfully resected it by hacking away at it with a steak knife.

Happy Halloween!

Pregnancy and Infant Loss Remembrance Day

2008-10-15T11:46:00.003-05:00

Today, October 15th, is Pregnancy and Infant Loss Remembrance day, for all those who have had a miscarriage, stillbirth, or who lost an infant due to illness or SIDS.

The loss of a pregnancy is the loss of a life, a unique individual with his or her own DNA and fingerprints. When parents mourn the loss of a pregnancy or an infant, they mourn not only the loss of the life but the loss of that individual's future and what could and should have been. Every single human life has value, and every single loss is felt deeply.

Please show you support by visiting this website, www.october15th.com, reading the information there, and, if you wish, join others in lighting a candle this evening at 7pm in honor of those who have lost a child through miscarriage, stillbirth and other complications.

The EDD

2008-08-27T16:50:00.005-05:00

Today was the estimated due date for our baby.

I didn't expect today to be emotionally difficult. When we first learned our baby's due date on January 24, I was excited that I was already nine weeks along, and I earmarked August 27th in my mind as the general time of year that our baby would be born. I knew it wouldn't happen on that day. That day is already taken by my sister. :) Only 5% of women deliver on their due date, so I knew I would have a baby anywhere from mid-August to early September. August 27th was a ballpark figure, an idea, not a SUPER SPECIAL DAY.

So as this day approached, I was aware of it looming in the distance, but I didn't give it much thought because I thought I hadn't attached much importance to it. But really, I had. I had thought about how I would be gigantically pregnant in the dog days of summer. I thought about the kinds of clothes I would wear and what the baby would wear. I thought about how I would still have a few months to be able to go outside with the baby without bundling up. Because I had heard that glorious heartbeat, I assumed that by August 27th I would either be big as a house, in labor, or caring for a newborn for the first time.

That dream, as we know, was dashed to pieces only three weeks later. I went to the hospital six months too soon and the pregnancy was over, the baby gone. August 27 went from the symbolic day back to only my sister's birthday. But in the back of my mind, I kept it earmarked. Before I knew about the septum, I hoped, prayed, and even assumed that I would be pregnant again before that day. After everything I went through in five months, I still saw August 27th as the deadline for maximum possible joy. Luckily, I realized I'd have to be extremely fortunate to be blessed again already. (I'm not.)

So, yes, today has been difficult. I tortured myself by reading through chats and emails from before and after the miscarriage. I can't stop thinking about where I should be. Today has been a flood of memories, and while it feels healthy, it certainly doesn't feel good.

I had a chilling moment the other day. I was doing something insignificant and I thought of myself in the future, and I couldn't imagine myself pregnant. I had thoughts like that before I got pregnant the first time. "Other people have babies, but I can't possibly be worthy of something so wonderful," I thought. Even when I found out I was pregnant, I found it hard to believe. After my surgery, I found optimism and hope: I was certain that I would be pregnant again soon and that I would have a baby. But now I feel like that view has fizzled. Pregnancy is for other people; I'm not so lucky.

I know it will happen, but sometimes I don't believe it. Funny how that works.

But enough about me. Today is a day to remember our baby, the baby we will meet in heaven. We love you and we miss you, dear Keiki.

Comparison

2008-08-11T10:23:00.003-05:00

I don't know why I was thinking about this the other day, but this is a post I had composed in my head shortly after my last surgery that I never got around to writing. But now I feel compelled, so here it is.

This is D&C and Septum Resection: A Comparison

Time of year
D&C: February 18, cold and blustery dead of winter
SR: June 27, gloriously sunny ideal summer day

Time of day
D&C: 6am, dark
SR: 8am, warm promise of a new day

Location
D&C: large hospital, parking garage, multiple wings, etc.
SR: Center for Surgery, not intimidating at all

Nature of Surgery
D&C: general anesthesia, performed via cervix, altering inside of the uterus
SR: same

Surgery preparation
D&C: no food or drink after midnight the night before, IV, pushed around in wheelchair/bed
SR: no food or drink after midnight the night before, IV, walked around myself when awake

Physical effects
D&C: pain, grogginess, feeling of rawness in the womb
SR: same, with slightly more pain

Psychological approach
D&C: sad, end of pregnancy, feeling of necessity to go through with it
SR: happy, joyful, beginning of hope for future pregnancy, spring in my step in the days leading up to it

Psychological effects
D&C: even more sadness in facing the loss, feeling of being thrown into a state of confusion and doubting ability to have children
SR: smile plastered to face, a sense of returning to normal and feeling completely renewed hope in having children

I really feel as though I've returned to normal in many ways. I am forever changed by my experiences, but they haven't destroyed me in any way. A few days ago, something compelled me to pick up and read the journal I wrote in right after my loss. The tears sprang up anew, which was okay because it reminded me that I'm human and will always be affected by my loss. But reading the confusion and doubt that I expressed in that long, cold winter reinforced my hope for the future.

Truth be told, I'm getting a little bit obsessed with TTC, but not in a totally crazy way. I'm enjoying learning about my body yet hoping not to have to wait too long before I'm expecting again. But, TTC is not the topic of this blog, so I'll leave you here. I just wanted to say, now that it's been six weeks since my surgery, that I am very happy and hopeful!

BIG GIANT HINT

2008-07-15T15:11:00.003-05:00

Someone posted this on the Nest, and I need it. I've been saying for a while that I need a stuffed uterus, and this one seems cute. So, someone should buy me this:

Mission Accomplished

2008-07-11T12:25:00.003-05:00

It's not my intention to let this blog die, but at the same time, I don't really have much to say anymore.

According to my drop in temperature today and my spotting yesterday, today starts the first full cycle with my newly remodeled uterus. [I have no idea whether to expect a normal period--can any former septum-ites give me some insight?] I no longer feel compelled to share the nitty-gritty details, since I'm now "normal." And given my history and as I've discussed earlier, we won't be quick to announce to the world when we get a BFP. Part of me doesn't want to tell anyone until it's really obvious to the naked eye, but my family may rest assured that they'll probably hear of it before that. :)

I'm also unsure whether I'll start posting in this blog again with updates down the road or whether I'll start a new one and let this one remain archival. Decisions, decisions. I'm glad they're some of the toughest decisions I'm facing right now!

I don't think this blog will die. But it may be pretty quiet for a while. Thanks for reading.

The Photos

2008-07-01T20:59:00.004-05:00

I've alluded to the fact that Google and I are friends again. That is, of course, because Google doesn't have to try to figure out what kind of uterus I have. I finally know for sure! And I've got the pictures to prove it. Get ready for these; they're not for the faint of heart.

Here we go:

Consider this the "Before" picture. When I first looked at this (I was still heavily drugged) I thought the black things were shellfish eyes. But no! Those are the two sides of my uterine cavity. Our little Keiki grew in one of those sides till s/he ran out of room. :(

This is right after Dr. M started cutting the septum away. You can see the top and bottom starting to pull apart.

And now we shed light on the black holes. Here's one tube...

And here's the other.

And here's where the septum once was! All cauterized away. Erich described it as looking like cooked chicken. I believe that description is apt.

Consider this the "After" picture. I believe the hysteroscope is in the same position as in the first view. Big difference, no?

And for the cheap cartoon version:

Dr. M did this illustration to describe the procedure to Erich while I was still flying high. It's pretty self-explanatory. :)

P.S.: I've had on and off pain and bleeding since Friday, but I think the worst is behind me now. I shall patiently wait for AF (piece of cake!) then it's TTC, here we come!

The Septum Resection

2008-06-28T20:57:00.004-05:00

My life is filled with hope again.

Yesterday morning, Erich and I arose around 7am after I had bad dreams that I was eating and drinking in the morning when I was not supposed to. I was glad to wake up and realize that I did not disobey the rules for anesthesia. :) We arrived at the Center for Surgery around 8:20--10 minutes early. I got called back about 20 minutes later, gave a urine specimen (giggle), changed into the oh-so-flattering hospital gown and got an IV. The nurses at this surgery center are very skilled. I could barely feel the IV in my hand! I appreciated that. I also had my blood pressure checked a few times, and the cuff totally squeezed too hard the first time, and I have streaks of broken capillaries on my upper arm. Yay, battle wounds!

Erich got to sit with me for the last 30 minutes while I waited to go in for my 9:30 procedure. The nurses were more anxious for Dr. M to arrive than I was. They seemed a little uptight, but I'll take that over careless any day. Then again, he did kinda swoop in at the last minute. He explained the procedure again and told me what to expect afterwards then went to get ready. I was walked to the OR and got on the table. Soon after the anesthesiologist told me she was putting the sleepy-time drug in my IV, my arm felt that familiar tingly discomfort, and that's the last thing I remember.

Before I was aware of anything, Dr. M went out to show Erich pictures of the procedure and described how everything went. (I scanned these pictures already, but I'm going to tease you, Scheherezade-style, and post them later. ;) Shortly after I came to, a nurse brought Erich to the recovery room. Remembering that first half-hour or so is like remembering a dream. Last night, I kept saying things to Erich like, "I had a tube in my nose!" and "You fed me ice chips!" [ETA: "I ate crackers!"] I thought I was awake, but MAN was I drugged.

During the procedure, saline was pumped into my uterus to keep it inflated (for lack of a better word) to give Dr. M room to work. My body absorbed that saline, and a catheter drained it out through my urinary tract. The nurses would not release me until I had passed enough fluid. So while we were waiting, my recovery nurse went on lunch, and I got another one, who was very concerned about sending me home with written recovery instructions. She went out to go find Dr. M and I heard her say to him, "Susan K---- has a few questions for you." And I was like, "huh?" So when he came in and looked at me expectantly, I explained that the nurses just wanted him to give me instructions again. He nodded and said, "My instructions are to go home." Heh heh. But he reminded me of what he had said earlier while the nurse wrote it down on my discharge sheet. Basically, I can't take a bath for a few days. Whatever.

We got home a little before 1pm. I pretty much relaxed on our La-Z-Boy loveseat, watching Pride & Prejudice (BBC version) and the Cubs (who LOST, boooo) while Erich tried to remember that I was recovering and not just being lazy. Kidding; he did a great job. There was moderate bleeding, but I'm pleased to report that there is now next to none! Last night, I stepped on the scale (I weigh myself far too often) and was horrified to see that I gained six pounds in a day. Then Erich reminded me, "Baby, you drank saltwater through your uterus!" Oh yeah. That's why my eyes are half-closed from puffiness. :)

Today I'm less puffy, but I've had more pain as the anesthesia has entirely worn off, and I'm afraid I may have overdone it a bit when Erich and I went out to run a few errands. But I have some Darvocet which they had already called in for me (and which I definitely WON'T be taking more than I need to--I hate that drugged feeling), and after relaxing for the rest of the afternoon, I'm feeling generally pretty good.

So I believe we can now consider my womb improved. I started reading Mayo Clinic Guide to a Healthy Pregnancy again today. I want to get a good start for our next baby! :)

A Letter

2008-06-27T23:32:00.005-05:00

Dear Septum,

You don't know how long I've been waiting to tell you my feelings. See, even though you've been with me all my life, I never really understood what you meant to me until recently.

You've been pretty quiet all this time. No offense, but I didn't even know you existed. In fact, I found out from Google that you were supposed to disappear before I was born. I won't say I'm offended that you wanted to stick around and make a home in my uterus; it's just that you weren't really invited, were you? Kudos to you for some Grade A squatting. You basically lived rent-free for 25 years, and that's no small feat.

I understand you might have felt a bit threatened when you got a roommate in the uterus. But, Septum, you need to realize that you had overstayed your welcome. The uterus is supposed to be a place for a baby, and you just couldn't let go. You refused to budge and the roommate had no choice but to leave. Was that right? In your heart of inadequately vascularized fibrous hearts, you knew that was not the best choice.

You had one chance, Septum, and you blew it. That's why I invited a surgeon to slice and vaporize you into oblivion. So this is my farewell to you, O Uterine Septum. I hardly knew you, yet you made an impression on my life that will never go away. I won't miss you.

Sincerely,

Your Former Landlady

The Next Biggest Viral Video

2008-06-26T09:09:00.002-05:00

....NOT. I tried to make Erich watch this, and he just couldn't quite stomach it. Me? I found it fascinating. That's a little weird because I'm the one who can't watch a needle go into my skin.

Thanks to Google (we're friends again after our love/hate relationship), I found these totally awesome videos of real, live septum resections. It's what they're going to do to me tomorrow!

Enjoy:

http://www.layyous.com/root%20folder/hysteroscopy_videoclips.htm

Also, Dr. M still rocks my world. I had a few questions for him, so I sent them to him electronically through his really cool website, and he called me back yesterday evening and cheerfully answered them all in detail. I think he may be the best doctor I've ever had for anything. :)

The Hysterosonogram

2008-06-25T11:46:00.006-05:00

Thank you to everyone who left me a comment, both here and on Facebook. It's humbling to have so many people pulling for me and my little ute!

I feel compelled to post in detail about my experience, as in days of yore.

As you've probably gathered from my preceding posts, I was not feeling particularly excited about my saline u/s. I was annoyed that my last cycle was so long, which delayed scheduling the test that I was absolutely certain would tell me what I already knew. And then, I was sure I would have to wait another cycle to schedule surgery, and just to tease me, my body would come up with an even longer cycle to make me wait through. All I saw was more waiting, so it was definitely difficult to muster up excitement for one short and possibly painful stirrup experience.

But by Sunday night, I was excited. Dr. M just exudes knowledge and experience, and I was so glad that he was finally going to be the one looking at my insides. The procedure was all I had on my schedule for Monday, and I was finally looking forward to it.

I showed up a few minutes early, and promptly had to wait another 20 minutes before getting into the exam room. But hey, what's 20 minutes after four months? A nice assistant who didn't tell me her name escorted me to the bathroom, where I emptied my bladder, and then to the exam room, where I was glad I hadn't brought along Erich or my mom. There would have been no room for anyone else! I hopped up on the table and covered my lower half with the paper sheet. Now, as much as my modesty has gradually flown out the window since I found out I was pregnant, it's still difficult to greet people wearing nothing below the waist--and then have those same people do things like visualize my cervix and insert instruments. Just makes me feel like I deserve some flowers or something; that's all I'm saying.

The catheterization was no picnic, but it was nothing compared to my HSG. I think the radiologist had a "get it over with" style whereas Dr. M was "steady as she goes." Much better for pain management. Within minutes, he was performing the internal ultrasound and I could watch on a little screen right by my face. Before he injected the fluid, he gave his prediction that I have a uterine septum and not bicornuate. Very little after that surprised me.

The saline felt weird, a little like peeing in reverse. On the ultrasound, the saline showed up as bright white and the walls of my uterus were dark. Dr. M very skillfully moved the probe and pointed out to me the division in my uterus. As he moved the image upward he pointed out how the two sides of the cavity get narrower and further apart as the septum broadens near the top. Then he slowed down at the point where the fundus of the uterus filled the screen. He had me note how it was solid and dark from one side to the other and told me that if it were bicornuate, there would be some open space across the middle. He told me that the two sides join at the bottom and I have only one cervix. It just seemed so clear and so simple. I know from my research that I have every reason to be extremely grateful that Dr. M is so knowledgeable and experienced, yet it seemed like any doctor should know this. Knowing that so many other women go through much more just to get a simple diagnosis like mine... well, let's just say I'm very grateful.

And just like that, it was over. I sat up and Dr. M mentioned the hysteroscopy and I was like, "sign me up!" so he asked where I was in my cycle. I told him day 12, and while he thought about that I told him that I take my temperature every morning, and even though I know that's not the best way to pinpoint ovulation, I think it's pretty clear that I ovulate late. "How late?" he asked. I told him Fertility Friend put it at day 25 last cycle. He said, "Oh that would be fine. Let's see if I have any openings this Friday." I was delighted and just a teensy bit incredulous. I had no idea it would all happen this fast! He gave me that professional smile that seemed to say, "I know how much of a difference this makes to you to have this done so soon." I was so excited but not yet getting my hopes up for surgery this week.

But after I reclothed myself and walked out to the common area, the nice nameless assistant gave me the same knowing smile and told me they would call me to let me know what time my procedure would be this Friday. It was all I could do to keep from clicking my heels. I got a bunch of PNV samples and went on my way. About half an hour later, they called me to confirm surgery for 9:30am this Friday.

I'm still just so happy I don't know what to do with myself. In less than two days my septum may be completely gone! We could be TTC by next month!

And I have learned through all this that God's time is best. Thanks to my long cycles, I can have surgery this week. Thanks to my last cycle ending when it did, I could schedule the test for just the right time to be free for surgery before it's too late in this cycle. And I'm glad I take my temperature and know that I ovulate late, and I'm glad Dr. M is a great doctor who took me at my word. And best of all, I have learned the extremely important virtue of patience.

Hysterosonogram: Done

2008-06-23T14:47:00.003-05:00

Bad news: I have an abnormal uterus. (But we already knew that!)

Okay news: the abnormality is definitely a uterine septum, and not bicornuate. (We were pretty sure of that.)

Absolutely fantastic news, deserving all-caps:

I AM GOING TO HAVE SURGERY THIS FRIDAY TO FIX MY UTERUS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Patience, my friends. Patience pays off. After more than four long months of waiting, waiting, and more waiting, I'm finally, officially, on my way. I feel so grateful (thank you, God!), relieved (aaahhhhh), happy (HOORAY!!), and if you looked those words up in a thesaurus I'd feel all those other words too.

I don't think anything could spoil my day now. :)

Excitement

2008-06-22T19:43:00.002-05:00

Okay, I'm starting to get pretty excited. Less than 18 hours until my hysterosonogram/hsg/sonohysterogram/shg/saline ultrasound/whatever you wanna call it.

Bring on the saline and tell me what I want to hear!

A Decision

2008-06-20T17:24:00.004-05:00

My hysterosonogram is getting closer, and I'm trying to muster up some excitement. It's difficult, though, because I don't expect to get a lot of new information and I'll certainly have to do more waiting afterward. It will be nice to have a final word (I hope) from Dr. M and to find out whether/when I may have surgery this summer. Beyond that, this is yet another step, and I don't expect to feel much different after the procedure than I do now.

My moods and feelings have evolved in interesting ways in the last four months. Right after the miscarriage, I was so anxious to try again. It felt like I had to make up for lost time. I no longer feel that way: I now want to be pregnant again because of my pure desire to be a mother. It felt good to turn over that leaf, as though my grief had come to completion. I still get sad and cry over the baby I lost, but I can function again, and it feels good.

Another way my feelings have evolved is in regards to transparency. Having been active on thenestbaby.com, where perfect strangers share all, I got into a mindset that I'll be open and up front about our TTC journey on this blog. Last time, we cautiously waited to tell family and friends about our BFP, but it was still too soon. On the other hand, I was glad people knew, as we received so much support from said family and friends. We felt bolstered by their thoughts and prayers, and for that we are still grateful. So, I thought we wouldn't wait at all to tell at least our families next time we get that BFP. The more people we had praying for us and our baby, the better, I thought.

Erich has been of a different mind all along, and now I fully agree with him. We are jaded. We have lost the innocence that goes along with being first-time parents. Not only do I worry that it will be difficult to get pregnant again, I also dread that second pink line. It signifies so much that could be and so much that could be lost. We had no choice but to share our grief last time, but if, God forbid, there should be another loss, we would prefer to limit the number of people who know about it.

So the decision is this: if and when my uterus is ready for pregnancy, this blog will have served its purpose. Posting won't necessarily stop, but it will probably slow as we move on to the next stage. I plan to resume posting when I'm pregnant again, but only after we feel comfortable announcing it to our family and friends, which may be after I'm out of the first trimester.

As soon as we're TTC, I'm going to stop drinking, I'll cut back on caffeine, and I'm going to eat and behave as though I'm pregnant so that no one IRL will actually know if I am. We don't wish to be secretive or anything, but we have learned that "being pregnant" and "expecting a baby" are two very different things.

I'll let you know when we are expecting a baby.

CD 2

2008-06-13T10:03:00.002-05:00

This has been a rough cycle, folks. Very long--38 days. But at long last, my favorite auntie has come to town and today I scheduled my hysterosonogram.

June 23 at 1:15.

Time to wait!

OMG, Cyanide and Happiness

2008-06-12T11:50:00.008-05:00

I like this comic. Sometimes it flies over my head, but most times it just puts me in stitches. I read today's and first said, "Whaaaa?" and then I was like, "Oh I get it, people can be rude in insensitive. I know what that's like!"

Enjoy. (You'll have to click on it, which will take you to the site so that you can actually read it.)

Cyanide & Happiness @ Explosm.net

ETA: Tim helped clarify the genesis of this comic for me in his comment. Still funny, I think. :)

All I ever do is wait

2008-06-04T16:22:00.003-05:00

The day after I made my last post, Fertility Friend decided that I ovulated on CD23, so at least I'm in the latter part of my cycle now. So AF is due around Monday, which puts the CD6-12 window for the saline ultrasound... (drum roll)... simultaneous with my trip to Galena, IL! Hooray! (NOT.) But, I know I'll be able to work around it. At the very least, I can beg them to let me do it the next week, since I ovulate so freaking late. On the other hand, I want this done ASAP. I guess I'll just see when dear auntie rears her ugly head.

In other news, I recently read about someone (whose screen name will go unmentioned) who just had an MRI to diagnose an MA. She is, get this, hoping for bicornuate because, GET THIS, she doesn't want surgery! I'm having trouble wrapping my head around this. For a recap:

Septum:

up to 90% miscarriage rate
easily treated with simple, non-invasive surgery and short recovery time
normal post-op miscarriage rate with no other increased pregnancy risks

Bicornuate:

miscarriage rate 40-60%
only surgery to treat is horribly invasive and not usually ordered (and when it is, you sit and cross your fingers, hoping scar tissue won't make you infertile)
heightened risks of preterm labor, intrauterine growth restriction, cervical incompetence, and breech presentation, necessitating c-section

Everyone has a right to want what they want out of their own bodies. But as for me and my uterus, I pray for septum.

Still Waiting!

2008-05-29T23:26:00.002-05:00

For the record, I'm still just sitting around, waiting for AF so I can schedule (then wait for) my saline u/s, which will be performed to confirm what I am 90% sure is true.

CD25 and I haven't even ovulated.

I hope there's an extra special reward in heaven or on earth for patient waiters like me.

Here's some inspirational quotes posted by a gal on the MA Yahoo! Group:

I've started to realize that waiting is an art, that waiting achieves
things. Waiting can be very, very powerful. Time is a valuable thing.
If you can wait two years, you can sometimes achieve something that
you could not achieve today, however hard you worked, however much
money you threw up in the air, however many times you banged your
head against the wall. . .

--"The Courage to Change" by Dennis Wholey

The people who are most successful at living and loving are those who
can learn to wait successfully. Not many people enjoy waiting or
learning patience. Yet, waiting can be a powerful tool that will help
us accomplish much good.

We cannot always have what we want when we want it. For different
reasons, what we want to do, have, be, or accomplish is not available
to us now. But there are things we could not do or have today, no
matter what, that we can have in the future. Today, we would make
ourselves crazy trying to accomplish what will come naturally and
with ease later.

We can trust that all is on schedule. Waiting time is not wasted
time. Something is being worked out - in us, in someone else, in the
Universe.

We don't have to put our life on hold while we wait. We can direct
our attention elsewhere; we can practice acceptance and gratitude in
the interim; we can trust that we do have a life to live while we are
waiting - then we go about living it.

Deal with your frustration and impatience, but learn how to wait. The
old saying, "You can't always get what you want" isn't entirely true.
Often, in life, we can get what we want - especially the desires of
our heart - if we can learn to wait.

Today, I am willing to learn the art of patience. If I am feeling
powerless because I am waiting for something to happen and I am not
in control of timing, I will focus on the power available to me by
learning to wait.

--"The Language of Letting Go" by Melody Beattie

That said, I'm trying my darnedest to just live my life. I have plenty going on to keep me busy. I am calm; I am patient.

Birthday Today

2008-05-21T09:55:00.001-05:00

I was supposed to have a baby when I was 25. I hope that can still be true!

That is all.

New Theory

2008-05-17T16:18:00.003-05:00

MAYBE during the HSG, the pressure of the dye from the catheter pushed my septum to the side, mimicking a blockage. That HSG sure did hurt. I renew my supposition that the HSG will eventually be disregarded, and I find myself wishing that Dr. M had been in on all this from the beginning.

I told you it was going to be a long month before the next test. Stuff like this goes through my head NON. STOP.

My Crazy Uterus!

2008-05-16T16:19:00.004-05:00

My uterus is strange. My uterus is a mystery, a shape-changing enigma just waiting to be figured out by the medical professional who endeavors to study it.

I got a call back from Dr. M today. There's good news and weird news. (No bad news!) I'm liking lists lately, so here's the good news:

He's already looked at my HSG and U/S, only three days after our appointment, two days after I dropped them off.
Based on the U/S, he thinks it looks pretty clearly like a uterine septum with maybe (MAYBE) a little bicornuate-ish (his words) split on the outside.

Weird news:

Paraphrase from voicemail: if both CDs didn't have my name on them, he would have thought they came from two different patients.
Based on the HSG, he would not have called my uterus abnormal: not bicornuate, not unicornuate, no septum. He would have called it a normal uterus with a fallopian tube blockage.
"Looking at the ultrasound, there is nothing that looks at all like the HSG."

He mentioned the possibility that films got mixed up. If I hadn't witnessed both tests myself and already known how different they were, I'd agree with that as a possibility. I still vote for disregarding the HSG, but I know all things should be taken into account for now. And that's why Dr. M will perform a saline u/s, which I will schedule when AF comes to town again, in about three weeks.

So for the timeline update, it looks like I'll have a saline u/s around mid-June, and I'll most likely have a septum resection, probably in July. That would mean being able to try again by August! That would help keep with my goal of being able to try again before the EDD of my first pregnancy.

Even though this is going to be a long month before the next test, and even though I wish things could be moved along a little faster, I'm in a good mood right now. It won't be long before my "Womb for Improvement" is cleared for renovations! Then I can hang an imaginary "room for rent" sign on my cervix.

(That was a little crass. I don't apologize.)

:)

Back from RE

2008-05-13T11:39:00.005-05:00

I like Dr. M. He knows what he's doing, so I don't have to, and that is a great relief. We have a plan! And he confirmed the plan by sending me a letter via the patient portal on their website within minutes after our appointment. I like that.

The one frustrating thing is that due to HIPAA stuff, he has not yet been able to look at the images from my HSG or U/S, so I will have to obtain those and give them to him. If I had known that already, I would have gotten them ahead of time. But luckily, I don't have to worry too much about wasting more time. Without further ado, I present to you Our Plan, which I will transcribe/paraphrase from the letter.

From this point, there will be one of three outcomes:

1. If I have a definite bicornuate or unicornuate uterus, then he will not do surgery now but instead have me attempt pregnancy.
2. If I have a uterine septum, he will discuss hysteroscopy further for septum resection.
3. If he can't say with certainty what I have, he will perform a hysterosonogram [saline ultrasound].

Whatever the outcome, we can expect to be able to try again within a few months. Hooray! I'm still putting all my hopes into SU, since pregnancies can be so complicated and uncertain with BU or UU. (Even though my HSG report says UU, that's extremely unlikely, so I can pretty much not worry about that one.)

Some other things of note which Dr. M shared:

1 in 200 women has a bicornuate uterus.
Surgery is not usually done right away for BU, but is considered if it is determined to be the cause of multiple miscarriages.
He has performed surgery on BU, but only about once a year or less. (That sounded like a lot to me, which means he's experienced!)
He can usually tell from hysterosonogram the difference between SU and BU, and if it's SU, he does the resection via hysteroscopy. He said there would be no incision, so I guess he does not feel the laparascopy is usually necessary.
He performs septum resections several times per month. (Yes! Yes! Yes!)
He saw no reason to do any other kind of infertility work-up, blood work, semen analysis, etc. I love that he's not ordering all kinds of unnecessary tests!

So, by tomorrow I should be able to have obtained digital images from my HSG and U/S. I'll drop them off at Dr. M's office (which is less than 10 minutes from where I live!), hope he has time to review them soon, and find out what happens next!

Hopeful Mother's Day

2008-05-11T12:54:00.005-05:00

My MIL wished me a hopeful Mother's Day. Her wish is coming true! Turns out, I'm just not bothered at all. Though I honor all mothers this day, I realize that it is kind of a made-up holiday to sell cards and flowers. Just saying.

But anyway, Erich FTW!

I came home to this yesterday afternoon. Here's the note:

It's perfect!

I love these reminders that it's all about him and me. We want children badly, but it starts with us and our love for each other. Pardon my mushiness, but it's true!

To all mothers: Happy Mothers Day!
To all mothers of lost babies: Hopeful Mothers Day!

To all women: You are special on this and every day!

Mother's Day

2008-05-09T16:53:00.007-05:00

Talk about a hairy subject. I still don't even know what to think about it. Prior to 2/13 I was kind of looking forward to it--my first Mother's Day! Now I feel as if it's been taken away from me. Sure, I'm a mother, but the world doesn't see me that way, and even if they did, the fact remains: Mother's Day is not a happy occasion for a mother like me.

So now, as usual, I'm torn between wanting to be acknowledged and hoping to be overlooked while focusing on mothers around me who have been blessed with the ability to hold their children. As the day draws closer, the more I realize I wish it didn't exist at all.

I've also noticed another trend: my fertility journey has been defined by small incremental steps. Between each step, I go through a particular emotional process:

Part 1: Frantically try to process newly learned information.
Duration: ~1 day

Part 2: Experience relief that another step has been completed.
Duration: ~2 days

Part 3: Wait patiently with hopes that the next step will be progressive.
Duration: however long it takes to get to Part 4

Part 4: Worry that the next step will not be productive, nothing new will be learned, and/or I'll have to tell the doctor what to do or find a new doctor.
Duration: 5-7 days preceding next step

Part 5: Depression. Preparing myself for the worst: total and hopeless infertility.
Duration: concurrent with the final days of Part 4

Guess which part I'm experiencing right now? Yes, part 4. And Mother's Day comes just two days before my RE consult, so I'll probably be in the depths of part 5 just when all of America gets gooey about new and expectant moms. I'm not trying to be pessimistic, but I can't help it that my excitement wanes as my worries resurface.

So I'll cling to something totally arbitrary and choose to call it a good sign: my RE appointment is May 13, exactly three months after I failed to hear my baby's heartbeat.

Baby Mama

2008-05-03T18:02:00.004-05:00

Erich and I went to see Baby Mama last night, the new movie with Tina Fey and Amy Poehler. I knew I wanted to see this movie because it looked pretty good and both those women CRACK ME UP. But I knew I HAD to see it when I found out that Tina Fey's character has a t-shaped uterus.

Did you know that a t-shaped uterus is a Müllerian Anomaly? If all your info on MAs has come from this blog alone, you probably didn't. I haven't discussed it since it doesn't apply to me. It's one of the rarest MAs, and it usually can be traced to the mother's ingestion of diethylstilbestrol, or DES. Sometimes prescribed to mothers between the 1950s and early 1970s, DES was thought to help prevent miscarriages. Despite insufficient study data, doctors continued to prescribe it through the '50s. In the '60s, data suggested that miscarriage rates for mothers prescribed DES were no lower than the general population, but doctors continued to prescribe it. And finally, in the '70s, scientists began to discover all the bad side effects of DES. In addition to uterine malformations (sometimes lacking a uterus entirely), the so-called "DES Daughters" were also more prone to various cancers, including cancer of the vagina and cervix.

In the movie, Tina Fey's character is 37 and trying to get pregnant via a sperm donor. All her attempts fail, which a doctor finally blames on her t-shaped uterus. (The line often featured in promos: "I just don't like your uterus.") In reality, a t-shaped uterus doesn't necessarily effect fertility. Like other MAs, it's associated with higher miscarriage rates as well as heightened risk of preterm labor, incompetent cervix, and fetal malposition. Also, her mother claims to have taken DES (though I don't think they name the drug in the film) to cure liver spots. I don't want to give any spoilers, so I'll just say that in sum, the movie has several inaccuracies.

Did these inaccuracies bother me? Not in the least! Anyone would be crazy to go into a comedic film hoping for a science-based anatomy lesson. Her uterine anomaly is simply a device to get to the main plot of the movie, which is the rocky friendship between Tina Fey's character and her hired surrogate mother, played by Amy Poehler. I really liked this movie. It was very funny and sweet in the right places without being sappy. And it is quite refreshing to see a real comedy with substance headlined by two female leads. My verdict: thumbs up.

Infertility Blog

2008-04-26T14:27:00.014-05:00

There is a certain Dr. Licciardi who specializes in infertility and keeps a blog. As blogs go, I wouldn't say this is an absolute gem, but he does give good information for those struggling with infertility. Back when I was googling up a storm, I came across a few posts of his, which touched upon septate/bicornuate uteri. Thanks in part to his info, I am not ready to believe my uterus is bicornuate.

In this post, he describes the difference between SU and BU in a straight-forward manner:

This is an issue I have been dealing with since the start of my practice. It’s the identical story over and over again. I came across the same thing 2 times this month. The issue is far from trivial because the proper diagnosis will change the method of treatment. Delayed diagnosis (sometimes for years) will delay and sometimes prevent pregnancy.

OK, what’s a bicornuate uterus? A bicornuate uters is an abnormality in the way the uterus is shaped. It does not develop; some women are born with them. Uterine and/or vaginal abnormalities that are present from birth are lumped into a category of Mullerian Abnormalities. There are many different varieties, and all are rare.
In a girl embryo, the uterus starts as 2 tubes that merge together to form a larger hollow structure. If the 2 tubes do not completely come together, a bicornuate uterus develops. It is a uterus with 2 horns , one going out to the left and one going out to the right.

This is a very general description. There are tons of variations. Some bicornuate uteri have larger horns and are not connected in the middle, and others are mostly connected in the middle with just a small amount sticking out as horns.
Here's the rub. I have seen many patients who were told they have bicornuate uteri but their real diagnosis was a septum. This mistake has happened even if the patient had a HSG, 3-d ultrasound, 3-d sonohysterogram, MRI or even hysteroscopy.

So what? It’s a big what. The uterus with the septum is smooth over the top. The bicornuate dips at the top, sometimes considerably.

So one nurse telling me it's "bi-corny-it" doesn't do it for me. I expect my RE to know the difference and properly diagnose me.

Dr. Licciardi describes the implications of different diagnoses in this post:

The reason it is vital to know your diagnosis has to do with treatment. If you have a septum, most (not all) doctors would recommend treatment. This is because an experienced reproductive surgeon can fix a septum relatively easily. It’s done through the vagina using a hysteroscope. The doctor looks in, then slides a tiny scissors through the scope and makes small cuts at the septum until it is gone, making the uterus normally shaped. Some doctors will recommend a laparoscopy at the same time to guide themselves through the surgery. Others will perform the surgery using the hysteroscope and an intra-operative ultrasound to guide them, avoiding the laparoscopy portion. In either case, patients go home the same day.
A bicornuate uterus is a whole different story. To fix this a doctor needs to perform a laparotomy (an incision into your abdomen), then slice the uterus wide open, then sew it up in such a way that the 2 sides come together to make one round uterus. As you can imagine, this has a much higher complication rate, and has a higher rate of infertility due to post-op scar tissue. Hospitalization can be 2-3 days. Full recovery is 6 weeks. Because this procedure is more difficult and has a higher complication rate, it is rarely performed.

This gets us back to the very beginning. If you have a septum, but your doctor calls it a bicornuate, you probably will not be offered treatment and be faced with continued increased odds of infertility and miscarriage. If the correct diagnosis of a septum is made originally, you could have a more simple procedure that may increase your odds of reaching your goal.

Many patients have come to me with a diagnosis of a bicornuate uterus. Told surgery was not a good option, they ask me what else can be done to help them get pregnant or reduce their odds of miscarriage. Some actually have a bicornuate uterus. Some are very surprised when I tell them they really have a septum and should revisit the surgical option.

If it turns out it is BU, so be it. But I won't believe it till I hear it from a specialist. Oh, and have I mentioned that SU is twice as common as BU? According to this study (PDF document; scroll to the second page for a chart), SU occurred in 1.4% of the population, and BU in only 0.7%. Now, we all know how I feel about the odds, but now that I'm much, MUCH more hopeful and optimistic (I WILL have babies), I feel comfortable with hoping for the most common of the MAs.

"ABNORMOL"

2008-04-24T00:16:00.003-05:00

At the imaging center when I was checking in for my ultrasound, I peeked at the chart, and I saw the above written in big letters. I had to grin. "Abby someone. Abby Normal." That's me!

Just now, I asked Erich, "Why do I have to be the one with an abnormal uterus?"

His answer, with his signature dimple and eye-sparkle: "Because I don't have a uterus!"

Love that man.

The Next Step

2008-04-22T11:16:00.003-05:00

I'm so glad I didn't have to wait too long to get to this point: I have been referred to an RE. Though I was expecting an MRI (and may still have one), I find myself very relieved that no more time is being wasted on tests ordered by someone who just doesn't have enough knowledge about my problem. So, goodbye for now, Dr. P and hello, Dr. M!

The person who called me this morning (another office monkey, I don't know if it was a nurse or what), said my uterus is bicornuate. She pronounced it "bi-corny-it." I still refuse to believe that's the final answer. I know for a fact that the ONLY 100% reliable diagnosis is the "gold standard" laparascopy/hysteroscopy combination. Unless surgery confirms complete bicornuate, I choose to believe I have a treatable problem. I'm so happy that I'll be able to make a list of all my questions and have a hope of getting them all answered by a person who specializes in uterine abnormalities and surgery!

My appointment is May 13, three weeks from today. Again, I wait patiently. I realized after my last post that I have reached some kind of mental equilibrium. I find I worry less and less about what's going to happen as I gently oscillate between waiting with mild depression and waiting with patience and optimism. I feel pretty confident right now that I'll be able to wait out the next three weeks with optimism.

Three weeks really isn't long to wait to see an RE. I have a lot to keep me busy in the meantime. I can stay positive.

Waiting

2008-04-21T23:48:00.004-05:00

Always, always waiting.

Life is going on: everyday activities are not on hold. But right now, my life seems to be a series of waiting for the next thing. Waiting for my stupid period, waiting for a test, waiting for test results, waiting for another test, waiting for more test results and waiting to hear what test I'll have next.

Hope has been a constant ebb and flow. Every fresh surge of hope starts to fade before I'm done waiting for the next thing. I'm hoping for the hope surge that lasts nine months and is only the beginning.

I'm getting used to this process. I've come to assume lots of things. For one thing, I assumed I would not get straight answers quickly. I still assume straight answers will be hard to come by for a few months. I assume I'll have to ask questions and be insistent about what I know in order to keep moving forward. I assume I'll be put through more diagnostic tests before the word "surgery" is even mentioned by the medical professionals. And, of course and above all, I assume there will be much more waiting.

I'm waiting for my doctor to call me with results from the ultrasound. I hope she calls me soon and that she is knowledgeable about my problem. I assume that MRI is up next. I'll wait for that test. I hope it shows that I have only a septum and an otherwise normal uterus. I assume that no matter the outcome, I'll have to wait several weeks or months for treatment/surgery. I hope diagnosis/treatment/surgery is successful. I assume that I'll be able to have kids in the future. I hope I don't lose any more babies....

It doesn't end.

Optimism Returns!

2008-04-17T14:21:00.006-05:00

Just as I had feared: the HSG was almost a complete waste of time. It was such an uncomfortable procedure, it yielded unexpected results, and the cramping and need to wear pads afterwards brought back some really painful memories from my m/c and D&C. Up until last Thursday, I was thinking, Okay, I have either SU or BU. The HSG had me thinking I either had a unicornuate uterus (do not want!) or a normal uterus tipped to the side for some reason. It took the wind out of my sails and left me quite depressed for a week, though I didn't realize how much it directly affected my mood until...

I had my ultrasound today, and it was a very good experience! I cannot express how much better I feel now. All the people at this imaging center were extremely nice, including the tech who answered all of our (my mom went with me) questions to the best of her ability. Compared to the HSG, this test was downright pleasant. Without going into all the particulars, I am happy to report that I do indeed have two ovaries, and a normal-sized uterus. There is a definite division inside--the tech guessed that the septum goes all the way down to my cervix or near it. We were unable to get a good picture of the outside contour, so I'll probably have an MRI next to determine whether it's normal on the outside (totally fixable) or heart-shaped (partially fixable).

Granted, this is only what I learned from the tech today. The radiologist at this facility will look over the images and make his/her report to my doctor, at which point I'll learn the official findings. But I feel confident now that it is only a matter of time before my uterus becomes "good enough" to support a pregnancy. Please keep the prayers and well-wishes coming that everything will continue promisingly.

And pardon me while I go frolic in the beautiful spring sunshine! :D

HSG Follow-up

2008-04-16T19:07:00.001-05:00

Just a quick post today.

I finally got a call from Dr. P's office today. They basically confirmed everything I had suspected. The left tube didn't open, so they will do a pelvic ultrasound to determine whether it's a simple blockage or not. If it is, I'll be referred to another doctor who will "take care of it and [I] can become pregnant." If not? ...I don't know. If it's not a simple blockage, does that mean it doesn't exist? I suppose that's a "wait and see" item.

The lady on the phone also talked about uteruses that are shaped "differently" and they're called "bicornuate." Mmmhmm. I refrained from the urge to explain MAs to her. I had been warned that doctors use "bicornuate" as a catch-all term. Anywho, I asked about the shape of my uterus itself (I'm not as concerned about the tube since I know I have one that works well) and she said "it's bicornuate," then hedged and said the ultrasound will show everything that's going on. I hope that's true.

Here's the absolute best news: I already talked to the imaging center who will do the ultrasound (the staff were really nice!) and they had available appointments for TOMORROW! Hooray. I can't say I'm actually excited to learn more; I'm still a little bit afraid at each step in this journey, but I'm really glad that I won't have more than one night to sit and dissect everything I found out from Dr. P.

10:30 tomorrow. Here's hoping everything looks normal on the outside (two ovaries, two tubes and a normal-shaped uterus). I can deal with things that aren't normal on the inside.

Let Me Off

2008-04-14T10:12:00.003-05:00

I've changed my mind. I don't want miscarriage. Who do I see to get my baby back? I'd be cool if we could just pick up where we left off, really.

After two months, it hasn't gotten any easier. If anything, it's gotten more difficult. Every time I see a pregnant belly, there's a squeezing sensation in my chest. It's a picture of what my life would be right now if it had continued to be easy. But alas, it feels like my days of getting through life easily are over.

I have a lot of things I want to call my doctor about right now. But I'm still waiting for HSG results. So I'm stuck in limbo again, unable to decide whether to just go ahead and call or wait another day or two for them to call me.

This will probably turn out to be an inaccurate perception, but I feel like I'm waiting for a phone call that will tell me whether I still have hope of having my own children. I do realize it's more complicated than that and at best, there will be more testing to figure out what, if anything (grr), is wrong. But I need something new to look forward to. I need to be told that the next test will give a really clear picture of what's going on and treatment (or cure!) will be right around the corner. I'm losing hope that it will be that relatively simple.

I'm running out of hope on my own; I need someone else to give me some.

I should be finding out if it's a boy or girl right now, not waiting to find out what's wrong with my uterus. So, it would just be much better if I could get my baby back. Please.

Progress

2008-04-11T00:14:00.004-05:00

I've been really depressed all week. I know much of it was due to jetlag, being away from Erich, and apprehension about the HSG. As thrilled as I was to schedule it, once it sank in that it was so close, I started getting very nervous about the next step. I realized that there was still a chance that my uterus could be normal, or there would be a clear problem (like a clearly divided uterus indicating SU or BU), or much worse, inconclusive. And lo and behold, I've got a big fat inconclusive as of immediately after the test.

So I felt really down about it all day. And even though the initial cramping went away when the liquid drained out (thank you, leftover extra-huge miscarriage maxi pads), a general feeling of crampiness and gassiness returned and did nothing to help my mental state. (And neither did the dark and rain that persisted outside!) I let the feeling of hopelessness wash over me. Though I still officially didn't know anything, I started thinking my uterus is just inhospitable to pregnancy and always will be. Not a happy thought at all.

My best option was to consult Google, with whom I have a love/hate relationship. It's good for finding out about things about which I have no knowledge, and it's abysmal at personal diagnosis. But I needed something--anything--to grab onto. And I'm glad I did. I googled "uterus tipped side" and got results, enough to know it does happen. That fact was enough to remind me that I'm not a health professional, and even though I've gotten to be pretty knowledgeable about MAs, there are plenty of other possibilities as to what my problem may be (if anything).

As Erich helped articulate for me, it's a fine line between being an advocate for my own care and trusting the professionals to come up with real answers. Luckily, I have to wait only 3-5 days for results. I believe that's short enough for me to be able to stave off excessive googling and speculation. After all, there's still a chance that I'm normal.

(But if I'm normal, why did I have a miscarriage??)

My HSG

2008-04-10T11:39:00.004-05:00

Here's what I know: not much.

But I should start a little closer to the beginning. I got to the hospital, registered, and got called in pretty quickly. I got to wear two hospital gowns, so no embarrassing openings (bonus!). A very nice nurse walked me through the procedure before the radiologist came in and offered reassurance.

Then the radiologist came in, a pleasant enough man. He echoed much of what the nurse had already told me: this procedure was not going to be fun and there would be pain, but most people do okay with it. So now that I was totally excited about the HSG, he asked a bit about my history and why I was there. He also asked if I'd ever been told my uterus was abnormal before, and I casually mentioned that I had been told it was tipped during my first ultrasound. Then it was down to business!

Let me reiterate: absolutely nothing about an HSG is pleasant. First there was the dreaded speculum, then he cleaned my cervix, then the catheter went through my cervix and my uterus was flooded with an iodine solution. Sounds simple, but let me tell you: It. Hurt. But once everything was in place there was some relief.

The large x-ray machine hovered over my midsection and started taking pictures. Luckily, I could see the screen and watched it with apprehension. The radiologist removed the speculum (more pain relief, thank goodness) and had me move from one side to another and then all the way over on my right side then to my back again. It seemed like only one side filled up with the dye, and I could see only one tube. Could it be unicornuate? I wondered.

Afterwards the Dr. confirmed that the dye didn't go into my left tube, which he shrugged off as one of those things that happens sometimes. He asked me whether I was told to which side my uterus was tipped. I replied that I assumed it was tipped back, not to one side. He proceeded to tell me that it looked like it was tipped a bit to the right, and he was not ready to call it abnormal yet. He would look at the images more closely and then send a report to my doctor. He told me he would recommend some follow-up ultrasounds to get a better look at everything.

[In retrospect, that's pretty annoying: ultrasound can be done at any point in the cycle, and I wouldn't have had to wait this long to get going on diagnosis. It's been 8 weeks and 1 day since my m/c!]

Dr. Radiologist will send a report to my doctor, and I'll hear back in 3-5 days.

Optimism Continues

2008-04-06T09:21:00.005-05:00

Spain was wonderful. The first weekend was especially grand, as we spent Saturday in San Sebastien, a beautiful tourist town with a beach, and it was gloriously sunny and warm, a wonderful contrast to the snow and wind we left in Chicago!

By Sunday night, though, I started to return to reality. The distractions of culture shock had completely separated me from my physical troubles and memories, which was nice at first. And then I discovered that emotional pain is like a toxic substance that needs to be constantly vented. The toxic substance built up until it all burst out at once, and I hit a low point. I went from the happy traveler to a miscarriage sufferer in a matter of moments. The PMS and nasty yeast infection with no hope of treatment for over a week made matters much, much worse. I forgot my optimism and felt some despair, compounded by the stresses of jet lag and being in a new country where I didn't speak the local language.

[By the way, this post is about menstruation. If this doesn't interest you, you may want to just skip to the last paragraph.]

But then, the flicker of hope. That twinge of pain in the lower abdomen which grew into definite, obvious menstrual cramps. I know those and remember those; there was no more guesswork as to whether it was just ovulation or my uterus simply changing size and shape (like when I was pregnant and afterwards). The pain was the worst on Wednesday morning. I had forgotten just how bad my cramps could be before I ever went on BCP. And I absolutely reveled in it. And, indeed, AF arrived that morning. Despite my fatigue, cramps, and bloating, I had a big spring in my step when I went out to explore Bilbao that day. The thought of tampons put a huge smile on my face. I knew I was looking forward to AF, but I was even more relieved and delighted than I thought I would be. This signified not only moving toward the next step but also moving away from the past. My body had done the most obvious thing it could do to prove it could behave normally; it cleansed itself of its own accord and I felt the last physical remnants of the miscarriage leave. The sense of relief was palpable.

When Erich got back to the hotel room that evening, I told him my good news, and he helped me make that wonderful phone call. I have scheduled my HSG for this coming Thursday. I'm hoping that I will either be able to look at the screen during the test (I've gotten a good idea of what septate/bicornuate uteri look like on an HSG by now!) or that I will at least have results soon after the test. The fact that I won't get a full diagnosis from this test no longer concerns me in the least: it will be a valuable first step, and when all is said and done, I really didn't have to wait that long. I'm feeling good about this. Thank you, Optimism!

Optimism

2008-03-27T10:04:00.002-05:00

I'm going to try something new. I'm going to try thinking/assuming that everything is going to work out just fine, at least in the short term.

The bad news is that AF did not show last week, but the good news is that she is not here yet! We're leaving for Spain today and I'll be gone for 9 days. So if she holds off till at least Saturday, I will definitely be home for the HSG window. I'm thinking my chances are good. Plus, based on what I've read, it's not taking abnormally long to get AF after a m/c.

(Here's the thing, though: I've been having phantom pregnancy symptoms for the past few days! Nothing major, and nothing that couldn't possibly be PMS, but it's still a little freaky. Examples: when I was pregnant, I was fatigued like crazy, I had vivid dreams, and I got tonsil stones constantly. [I won't link to the Wikipedia article on tonsil stones: search at your own risk. They're very gross.] So I've been pretty darn fatigued lately, I've had a few vivid dreams, and I woke up Sunday morning coughing up a tonsil stone. Oh, and I've had to pee waaaay more than average lately. I've tested three times, all BFN, though one turned positive outside the time window. I have one test left, which I'm taking to Spain to use when I feel necessary. Pregnancy would be extremely unlikely right now, but see this post for my views on the odds. "Very unlikely" doesn't mean as much to me any more. I'm 99% sure I'm not pregnant, which is a great relief, but it sure is hard not to want to be pregnant. That is the goal, right?)

Yes, optimism. Patience. Going with the flow (hahahaha, pun!). I'm all over it.

Patience

2008-03-18T23:29:00.003-05:00

CD 30 and no AF in sight. I've been having PMS symptoms on and off, but all I can really gather from my body's signals is that my hormones are still completely messed up and I have no idea what to expect. But while two weeks ago I was very anxious to get AF by 3/17 (or 3/19 at the very latest), at this point I'm just rolling with it. What will be, will be.

Patience is probably the strongest theme on this blog and in my life right now. Each time I have a tiny sliver of new information about this whole ordeal, I get very worked up and eager to have answers NOW. Finding out that the HSG requires a very specific situation in order to take place only made matters worse. I told myself to be patient; others reminded me that I would have to be patient. Well, patience is not a switch I can turn on and off. Patience must be practiced. In the past month, I have found patience through the turning of the earth, through the simple fact that life can and must go on. In the past few weeks, I have gradually become more calm, more peaceful, and I attribute that to increasing numbness, forgetting what it's like to go through what I've been through this year. And, happily, I've had distractions. I'm a church musician and it's Holy Week, so obviously I'm keeping myself busy. As far as taking care of my anatomical problems is concerned, patience is the only option. And that's okay.

Now as my "AF Deadline" is imminent, I am trying to wake myself up from this numb, sleepy patience. I'm trying to remind myself that I mean to take charge of my own care; I need to be my own advocate in the medical world. Unless AF arrives tomorrow (not likely), I intend to call my doctor on Thursday to see if she can order an MRI. It is not outside the realm of possibility that she doesn't know that MRI is better for diagnosing MAs. (It's also possible that it's not feasible to have an MRI before HSG. I don't know--but there's no harm in asking.) And I think as soon as I finally have a period, I'm going to start charting my basal body temperatures daily so that I can have some clues for myself, or a doctor if necessary, as to what is really going on in my crazy body.

Can I remain patient while arming myself with as much information and knowledge as I can? That remains to be seen. But I don't doubt that patience will find me when it becomes the only option, and I'll be okay.

Müllerian Anomalies Explained

2008-03-11T10:49:00.004-05:00

I am not a doctor. But if I were, I probably wouldn't know much about Müllerian anomalies, so I don't mind sounding like I know what I'm talking about. As a reminder: my doctor told me immediately after my D&C that I have something in my uterus that may have caused my miscarriage. It could be a septum or I may have a bicornuate uterus. At the follow-up appointment, she did not say the words "septum" or "bicornuate," but when I mentioned a septum, she hinted that that's what she thinks it is. I await further diagnosis through HSG.

Someone on the Nest pointed me to this Yahoo! Health Group: Müllerian Anomalies. It has, by far the most comprehensive information on the web on MAs. Rather than putting it all into my own words, I've decided to copy/paste from their FAQ page, and put in bold the statements I find to be important.

1. What does müllerian mean?

The uterus, fallopian tubes and upper vagina are made up of two partially fused tubes, which, in the embryo, are known as müllerian ducts, named for physiologist Johannes Peter Müller, who first described them in 1830. They are also known as the paramesonephric ducts, and are at first present in embryos of both sexes.
Normally, these ducts run down vertically from flank to pelvic floor in the young embryo and eventually fuse into a double-barreled tube with two loose ends, known as the uterovaginal primordium, or UVP. The double UVP will eventually merge into a single-barreled uterus, cervix and upper vagina, while the loose ends develop into the fallopian tubes. In adulthood, these organs are referred to as the müllerian tract and congenital malformations of this tract are called müllerian anomalies, or MAs, as we call them on this list.

2. What are the different types of müllerian anomalies?

d. Bicornuate uterus (BU): The uterine fundus fails to fuse and a myometrial division extends down to the cervix in a complete bicornuate uterus, or part way to the cervix in a partial bicornuate uterus. The division is visible on the outside of the uterus, evidenced by a groove or cleft in the uterine dome exceeding 1.5 centimeters. Cervix and vagina are usually single but may be septate or duplicate. BU has relatively few pregnancy complications when compared to SU or UU, with breech presentation being one of the most common.

e. Septate uterus (SU): The müllerian tract has fused properly and the uterus looks single from the outside, but the inner duct wall (i.e. the median septum) has failed to dissolve around 20 weeks of gestation, and the uterus retains a double cavity. There may or may not be a shallow groove of 1.5 centimeters or less on the outer uterine dome, and sometimes even a whitish triangle of tissue, the septum itself, is visible. The somewhat fibrous inner septum extends to the internal cervical opening or beyond in a complete septate uterus, and extends only part of the way down in a partial septate or subseptate uterus. The inadequate blood supply and progesterone receptors of the median septum may cause problems in pregnancy, giving the SU the worst pregnancy outcomes of all the MAs.

Obviously, there are other types of MA, such as unicornuate, arcuate, and didelphys, but SU and BU are the most common and seem to be the most relevant to me at this point.

7. Is HSG alone good enough for diagnosis?

First of all, in an infertility work-up, a hysterosalpingogram (HSG) should be done to either rule out or assess the presence of a two-chambered uterus, the depth of the division, as well as tubal patency. But an HSG alone cannot differentiate between septate and bicornuate uterus. Misdiagnoses of BU by HSG are very common.

Other methods have better levels of reliability:

• Transvaginal ultrasound is nearly 100% successful in detecting a bifid uterus, but only 80% successful in differentiating between SU and BU. It can be a helpful tool in the diagnostic process, but should not be relied upon alone.
• Three-dimensional ultrasound (3DUS), is 92% accurate in differentiation of BU from SU, according to one 1997 study, but not widely available at the time of this writing. It should not be relied upon alone, with an 8% margin of error.
• According to two studies done in 1994 and 1995, MRI can reliably differentiate between BU from SU, with an accuracy of 100% in comparison with laparoscopy/hysteroscopy. More recent studies cast some doubt on this. Proceed with caution after an MRI.
• Concurrent laparoscopy and hysteroscopy are considered the "gold standard” of BU/SU differentiation. This test is invasive, but if needed, corrective hysteroscopic metroplasty can be done at the same time.

8. Should I have my uterus surgically repaired?
Hysteroscopic metroplasty, abdominal metroplasty, hemihysterectomy, vaginoplasty

The quick, reflexive party line here is that if you have a septate uterus, yes, you should have it fixed. Studies tend to show a poor pregnancy outcome in the uncorrected SU, but a near-normal pregnancy outcome in the surgically corrected SU. Of course there are exceptions, and we should not forget that most women with a septate uterus are never diagnosed, and may indeed have no trouble with reproduction.

Bicornuate, arcuate and didelphic uteri are generally thought to do well in pregnancy, but some studies show correlation to miscarriage and other problems. Again, take your history into account, first and foremost, and weigh the benefits versus the risks. Surgical correction of a bicornuate uterus involves an open (laparotomy) procedure in which the surgeon cuts through the uterine wall of each horn and then sews them together. Unlike most septum surgeries, abdominal metroplasty is a major procedure and carries greater risks of bleeding, infection, adhesions, infertility and rupture during pregnancy. Recuperation takes at least twice as long, and greater pain control is required.

The FAQ page continues with details about surgeries and diagnostic tests as well as success stories. In the past few days, I've also been reading the huge backlog of posts on the message boards. It's refreshing to see so many people who live and deal with these problems, most of them able to have children. I'm finally to the state, emotionally, where I can deal with reading so much information, accepting the risk of getting very worried about the type of care I will receive. Will my doctors be familiar with these problems? Why am I wasting time waiting for an HSG when it doesn't even show the outside of the uterus? How long will I have to wait to see a specialist, if indeed I will have to see one? How long will it be before I can have the surgery, if I have a SU? Is it realistic to hope I can get pregnant again before the end of the year?

It's frustrating that no one can answer my questions, though I am tempted to call my doctor and share my concerns about the HSG. If my safe window for HSG falls while I'm overseas in a few weeks, it will be very hard to wait another month. I will still know nothing! On the other hand, I may be premenstrual right now and don't yet have reason to give up hope that I will be able to have the HSG done in the next few weeks, in which case I can be patient. I suppose.

For the first time, I feel like God is trying to tell me something. Maybe this wasn't the right time to have a baby, and from this experience I will learn the very great importance of patience.

The Follow-up

2008-03-05T00:11:00.005-06:00

It has now been over two weeks since the D&C. The time seemed to go fast--I need to embrace that feeling, because there will be many more periods of waiting from now until we have a baby.

The appointment time was 10:45. I was so happy that Erich could go with me; we got there right around 10:45. We finally got into an exam room at 11:40ish. That was the longest I've ever waited in that office in the short time I've been going to that practice. I know, however, that the wait was due to the fact that the other doctor that day was not able to come in. Luckily, it was not the doctor I was seeing, so at least we weren't sent home.

There were a lot of largely pregnant women in the waiting room. And there was a newborn. I'm not bitter enough to hate these people for remaining pregnant, but it sure makes me uncomfortable to be around them. I should be 15 weeks pregnant already. Booo.

So a nurse finally took us back, took my blood pressure, apologized kindly for our loss. It was nice of her, but the sympathy of strangers irl always throws me off kilter a little bit. When we got to the exam room, Erich and I were both feeling a bit nervous. But as we got used to our surroundings, we calmed down a bit--we had plenty of time, anyway. Dr. P came in a few minutes after noon--only 1 hour and 15 minutes after our appointment time!

I've decided I really like Dr. P. She's very pleasant, has a great bedside manner, and seems very capable. She did a quick internal exam, seemed very glad to hear that the bleeding has stopped, and then got right down to business with this little possible-septum problem. She was more non-committal this time; though she didn't exactly imply that there could be anything besides a septum in my uterus, she also didn't seem to be working with an assumed diagnosis. She did say that whatever it is could have caused the m/c if the baby implanted in a part of the uterus that was tighter and unable to stretch properly. She ordered an HSG, or hysterosalpingogram, to see the interior of my uterus and determine what's there, and from there they'll determine what happens next--whether it will be removed and how, or if no action will be taken. I asked how long it will take before I can have this done, and she said there's no big delays in scheduling--within the next few weeks. I took this as good news. I think she totally understood our desire to get this figured out and fixed as soon as possible.

When we checked out, I got a card with a number to call at the hospital to schedule the HSG. They told me to wait 2-3 hours for them to get the order into the computer system before I called. Around 3pm, I had a free moment, so I called Central Scheduling. After being put on hold for a while then asked a few questions ("Do you have the order?" No, they said it was in the computer system. "What's the diagnosis?" Um, I have no clue? Isn't that why I'm having a test?), they finally asked when my last period was. I couldn't tell them; I said I just had a D&C two weeks ago and am waiting for my first period. The lady said the test HAS to be done on CD 8, 9 or 10. So I have to call back the day I get my period to schedule the HSG for 7, 8, or 9 days later. Oh yeah, and NO INTERCOURSE from the time I get my period until two days after the test. Otherwise they WILL NOT do it and I'd have to reschedule.

Complication: Erich and I are leaving the country on 3/27 and I'm returning 9 days later. AF may arrive anytime between two and four weeks from now. We're involved in a very intricate dance in which my body has to fully cooperate if I'm going to have this HSG before we leave. I've already figured that AF needs to arrive on 3/17 (28 days after D&C, what wishful thinking) if I'm going to have a good window before we leave. The second best option would be if AF arrives while we're gone. I'll just make an expensive phone call to schedule it for the following week. Unacceptable would be AF arriving the week before we leave. This timing would necessitate waiting for another cycle before HSG.

As I get nervous about what might happen in the next few weeks, I get very frustrated at my body, because I don't trust it to cooperate. Heck, if my body were cooperative, this stupid septum would have dissolved when I was a fetus like it was supposed to. Stupid body. (Even as I type, my left forearm is seizing up with tendonitis pain. This is just insulting.)

The D&C helped trigger deep feelings of loss and grief. This follow-up appointment has sparked feelings of frustration, a dash of bitterness, and did I mention frustration? I just want to move forward, to achieve my goal faster than is actually possible at this juncture. I wish there were some way to peer into the future, to get some real reassurance that someday we'll be able to have a family of our own. Right now it feels like I'll never know. Blergh.

The Memory of a Two-Year-Old

2008-03-03T23:21:00.003-06:00

I stopped by my parents' house today because my grandparents were in town visiting, and my two-year-old niece was there as well. The girl is brilliant (and she needs cousins!). We told her along with the rest of the family that we were having a baby back in January, but we couldn't tell if she really "got" it.

This afternoon, she was sitting on my lap and picked up a baby bib that my mom had been working on, a counted cross-stitch project. She said something about how the bib is for a baby. Then she said, "Susan having a baby. Mama Elaine [my mom]! Susan having a baby!" as though announcing something exciting that she had just remembered. I took a deep breath, hugged her, and replied, "Not any more, sweetie."

This is a sob story, right? Indeed, it was very cute and sad and bittersweet. But it didn't shake me to my core, make me tear up and run out of the room to relive the devastation. You see, I've developed a pretty good skill for detaching myself. In the face of this sad yet remarkable (she is quite intelligent for a two-year-old) moment, I became someone else, like a relative of the sad girl who lost her baby. I understand how sad this must be for her, but I'm not her.

I suppose I don't want to appear overly fragile to the people around me. I don't want people to worry that I'm going to lose it at any moment and that they have to be careful around me. If I can keep it together, then the miscarriage can remain a safe topic of conversation. In my mind, not talking about it is tantamount to pretending it never happened, and that's the last thing I want.

What to Say

2008-03-02T11:36:00.005-06:00

I am so blessed and fortunate. I hear anecdotes all the time of people saying "the wrong thing" to someone who has suffered a pregnancy loss. I've also read other blogs on the topic of miscarriage, many of which include a list of "what not to say," which is often copy/pasted from another blog. I've read that list and agreed with it a little bit, but I find my reactions to vary somewhat from others', and for that reason, I'm going to compose my own list. But first, I need to explain a few things.

A few short weeks ago, I had no idea what I would have said to someone who's had a miscarriage, beyond "I'm so sorry." Well, it turns out, that's one of the best things things I've been told, besides "you're in my/our thoughts and/or prayers." What I want people to understand is that there's nothing that can be said, no statement to wrap up the grief in a neat little package, to make everything better. That's the nature of miscarriage: there was nothing I did to cause it, there was nothing I could do to stop it, and now there's nothing that can be done to erase the loss. Even though I continue to feel better and may eventually feel no more sorrow, the loss still happened. I will always have one baby that was never born.

Before I launch into my list, I want to make clear that no one who said anything to me or Erich made us feel worse. There are certain things that make us feel better, but no well-intentioned person said anything to worsen our state. (This is mostly a sort of disclaimer to stop anyone we know who is reading this wondering if you said "the wrong thing." You didn't.)

What NOT to say:

"Get over it." or any variation thereof. This definitely tops the list of insensitive things to say. It would be far, far better to say nothing.
"There was probably something wrong with the baby." In the majority of miscarriages, this may be true. The baby probably had some kind of chromosomal defect. But offering this statement as comfort is tantamount to saying the parents would have loved a disabled child less. Unless the fetus was tested and a profound chromosomal disorder was found, this statement does not offer much comfort. Furthermore, in my case, there is a very good chance that nothing was wrong with the baby, so I don't want to hear it.

What is not very harmful, but doesn't really help either:

"It's all part of God's plan." I consider myself a devout Christian. Lutheran, specifically. I believe that God is loving and powerful, but I do not believe that God planned for my baby to die. Good has come out of this situation and good things will happen that couldn't have happened otherwise, but my baby died as a result of sin in the world. The new "Christian Lite" Evangelical idea of God having a plan for me that extends to my finances and friendships and weight loss endeavors--I think it's all fluff, and its rhetoric turns me off. It's best avoided.
"It wasn't meant to be." Similar to the above. Not harmful, but not very helpful. Who says it wasn't meant to be? In any case, I'm still very sad and disappointed. Why couldn't I keep that baby? "It wasn't meant to be" doesn't answer the question.
"At least you can get pregnant." This does help a little, but not a lot. Yes I can get pregnant, but can I stay pregnant? The jury's still out on that one.
"I know how you feel." I truly believe that the people who have said this to me believe it to be true. On the baby-loss aspect, I'm right there with them. But now I just want to say, "Really, do you have a weird uterus that caused your miscarriage?" They know how the loss feels, but they don't know how I feel.
"I'm sure you'll go on to have many children." Do you know that, really? I believe it in my heart, but I still have doubts. Legitimate ones.
"It could have been worse." Yes, it could have. I think a later loss or stillbirth might be worse. But it's not very helpful to minimize my grief. And it's the worst thing I've experienced, so let's not introduce the possibility that something worse could happen in the future, k?

What to say:

"I'm so sorry."
"I'm thinking about you."
"You're in my prayers." This experience has taught me the power of prayer. There were times when I felt no strength to carry on, but I did anyway. I attribute this to faith and prayer.
"Is there anything I can do?" Erich and I found in the first few days that we had no motivation to cook. I appreciated going to my parents' house for meals, getting asked out to breakfast with my sister-in-law, whatever could keep me from doing the mundane things like cooking that seemed so difficult.
"It's okay, let it out." Or any variation. I appreciate my grief being acknowledged, and though it's not all I want to talk about, I don't want to be avoided. It is a little surprising how little miscarriage is talked about, considering how common it is.

Thank you, everyone, for your thoughts and prayers! Those help the most. :)

Note

2008-02-29T12:12:00.002-06:00

For those having trouble keeping up with the abbreviations, I've added a glossary on the side bar. I hand picked terms from the glossary on the Nest that I have used and/or may use in the future.

The Odds

2008-02-28T23:54:00.004-06:00

This whole experience has changed the way I view statistics as they apply to me.

The chances of a healthy, fertile couple conceiving in any given month is 1 in 4. I got pregnant on my second cycle. I beat the odds by a slim margin. How joyous!

The chances of having a miscarriage are thought to be up to 30%. Certainly, the odds of miscarriage in clinically recognized pregnancies is a full 20%. So, I beat the odds again.

The chances of miscarriage after a heartbeat is detected is 10%. Really beat the odds there.

The chances of miscarriage after 12 weeks is less than 2%. I'm one "lucky" gal.

About 4% of women have a Müllerian anomaly (MA). I'm not sure if I can count myself as beating the odds on that one. Really, there's nothing else wrong with me. Sure, I'm a little overweight, I have acne, tendonitis, TMJ, and I'm kind of hypersensitive about certain things. But, I suppose I was bound to have some wacko problem that no one else I know has. The average woman does not have a weird uterus. Hmmph.

Of women who have an MA, most have a septate uterus (SU). Miscarriage rates with SU approach 90%, depending on the size of the septum. The next most common is a bicornuate uterus (BU). Miscarriage rates are lower for BU, more like 40%, but there is an increased risk of preterm labor, and breech positioning.

Will I actually win out and get diagnosed with an SU? Will I, for once, be grouped with a majority for something? That would be nice. 90% miscarriage rate sounds scary, right? But the good news is, most septi can be resected with a simple surgery, bringing the chance of miscarriage back to normal (15-20%). A BU cannot be treated with surgery. Well, it can, but the surgery is very invasive and carries a good chance of leaving the patient infertile anyway due to scarring and all that fun stuff. Do NOT want.

[Of course, if I do have a BU and end up having to get a c-section at 35 weeks in order to have a healthy baby, I will deal with that. I don't feel hopeless, like I'll never have a baby. Several professionals will have to tell me I can't until I'd be ready to give up. ]

It was hard to keep my head about all this for a while. I've sure beat the odds on a lot of things pregnancy-related! Who's to say I won't keep having rare diagnoses, rare problems, and unlikely, sad outcomes?

Despite what's happened to me, I still can't live my life in fear that way. I used to proclaim rather adamantly that it was silly to waste energy worrying about miscarriage since the chances of my baby dying were about the same as ME dying. It doesn't seem nearly so silly now. But that doesn't justify spending all my energy now, worrying about what kind of MA I have. It's out of my hands, and all I have is faith and hope. It will have to work out. And at the tender age of 24, I am blessed with time. Thank you, God!

The Very End

2008-02-28T00:15:00.004-06:00

So many things have come to an end, all signifying the end of the pregnancy. First, the baby died. Then, I found out about it. Then I started bleeding--the beginning of the end. Then the D&C removed the products of conception. I continued to bleed after the procedure.

But today I believe I can officially say the bleeding is done. There is no more physical evidence that I was ever pregnant. My belly and breasts have returned to their normal sizes. I don't know how much hCG is in my system--enough that I can feel hormonal fluctuations. But I don't really care; the levels are on their way down and will soon be zero. Now I wait for AF and hope it doesn't take forever.

It's over.

Therapeutic Distractions

2008-02-27T22:21:00.011-06:00

Everyone grieves differently. I have been grieving in unexpected ways. Other girls on the Nest had the most emotional trouble before their D&Cs. I found the most difficult time to be the 3-4 days after D&C. I have learned that the key to healthy mourning is to have a proper outlet. I have several.

One is obvious: this blog. However, I went through a little journey before deciding to start a new blog. I thought about it right away, but didn't think I would start one. But if you refer to my first post, the impetus was finding out about the uterine anomaly. A lovely side-effect was feeling compelled to tell the entire story from the beginning, which has been cathartic beyond words.

My first outlet I have also mentioned before: the Nest. It's been the best grief-support group I could hope for. I was on the Pregnancy Loss community almost nonstop for the first two days. I don't spend quite as much time on it now. For one, a lot of the ladies there are in the "trying again" phase (predicting ovulation, figuring out their fertility charts, waiting to POAS), and I'm not there yet. Also, it gets to be depressing after several weeks, seeing all the new people posting about their recent miscarriages. It starts to feel like everyone has a miscarriage/stillbirth, when really it's just everyone on this particular message board.

The Friday after the bad news, I went out to breakfast with my mom. We went to Barnes & Noble afterward. I scoured the store for any books on miscarriage and found NONE. That was surprising and disappointing. No worries though; I had already ordered one from Amazon. My main goal was to get a new journal. I had actually just been looking for a journal the week before to document the pregnancy (ooh, I should add that to the list), but I didn't really like any of them. But as the goal was different this time, I thought I might have some luck. Indeed, I did. It was a very nice little journal that I never would have considered before, but it just grabbed me when I spotted it.

The artist is Laurel Burch and it's her "1999 Self Portrait." On the spine it reads, "The soul would have no rainbow if the eyes had no tears." Again, not something that would normally appeal to me, but I'm a different person now. And I had to have this journal. I've already filled up about a fifth of the pages. It remains a good complement to this blog, as I can pour my unrefined thoughts into it. No worrying about grammar and comprehensibility!

That Friday night, Erich and I knew we were going to want to get out of the house again. Wednesday and Thursday we had gone to my parents' house. Friday we went out. We had dinner at Stir Crazy and were going to see a late showing of Juno. ("A movie about a pregnant girl right after having a miscarriage? What were you thinking??" I don't know.) But during dinner the bleeding ramped up, and we were both kind of tired anyway. We stopped at Target on the way home so I could get some big ugly maxi pads, and I decided I wanted some crayons and a fun coloring book. I splurged on the box of 120. I thought about 64 or 96, but really, when it comes to getting a ton of crayons, why not just go for 120?

(The surprise inside is a crayon sharpener.) And there are crayon colors I'd never seen before. Wonderful, beautiful colors with great names like "fuzzy wuzzy" and "purple mountain's majesty." When we got to the coloring books, the announcement came that the store was closing in 15 minutes, so I settled on this one:

I think it was a good choice. And with 120 crayons, I can be really true to color. Very fun.

The next night, Erich and I went out again to a very nice Argentinean restaurant in downtown Naperville. We got a fruit/ice cream/champagne drink concoction for dessert, which was delicious and fun, but it was deflating at the same time. Alcohol is one thing I can enjoy at most times, but it's harder to enjoy now--I would gladly keep giving it up entirely. But I digress. After dinner, we headed to Barnes & Noble and I checked out the coloring book selection and came across this gem:

I've since learned that a "mandala" is a repetitive design within a circle. It's very fun and relaxing to color these. The intro to the book begins: "We often forget that children need a way to relieve stress, too. Coloring mandalas is perfect way to help them to relax and focus, while also fostering a love of art." And I'm here to attest that they also work for 24-year-olds. I've filled the majority of the book. I may soon have to get Kid's Flower Mandalas!

In addition to coloring and journaling, I've also been reading. Sunday, the day before D&C, I picked up a book from the library, Miscarriage: Why It Happens and How Best to Reduce Your Risk. It was one of only two books on miscarriage the library had. It felt good at first to just read a book. Something in-depth, written by a doctor, with no distracting animated ads all around it and no scrolling, unlike many Google search results. But as a book, it was pretty dry and merely listed all the reasons that people have miscarriages. The best thing that came out of skimming the whole thing was a basic knowledge of Müllerian anomalies, which I was very glad to know when the doctor said "septum" and "bicornuate" without further explanation.

The book I had already ordered on Amazon and received last Tuesday was recommended by someone on the Nest. It's called Avoiding Miscarriage: Everything You Need to Know to Feel More Confident in Pregnancy. It's good. It goes through all the reasons that miscarriages happen like the other book, but it goes a step further by helping the reader discern what may have caused her own miscarriage(s) and whether/when to pursue treatment as well as what treatment entails. It also touches upon emotional aspects, includes true stories/testimonials, and is very sympathetic, as the author wrote and published the book herself after four miscarriages of her own. I read a lot of it in the few days after I got it (which was my worst time, emotionally), but have put it down for the time being. Since the book is about miscarriage, most of the real pregnancies mentioned in the book end in miscarriage. And 100% of my pregnancies have ended in miscarriage! (Yes, it's only one, but still.) So I started taking a break from this book and vowed not to ever read it at bedtime--one night I woke Erich up because I couldn't stop crying! I felt so helpless and hopeless. But do I recommend this book to anyone who's experienced a miscarriage? Yes, I do. Just don't read it within a week of a first miscarriage, and don't read it at bedtime, when you might spend too much time reflecting on sad stories and all the things that could possibly go wrong.

My latest distraction is getting back into normal life. I'm teaching my choir and piano lessons again. And it's easier than I thought it would be. Next week, I'm going to start exercising with Erich again like I did before I got pregnant, and I'm really looking forward to it. Life will never be the same, but I will heal.

Things I'm Glad I Hadn't Done Yet

2008-02-26T11:53:00.005-06:00

This list goes hand-in-hand with "The Silver Lining," in that I was very glad there are certain things I hadn't done yet. Things that may have served as very painful reminders later on.

I did not:

Buy any baby clothes.
Take pictures of my belly. I had intended to start this pretty soon. My belly had already grown, but it was almost completely bloat--gross!
Buy any maternity clothes. Again, something I was going to start shortly.
Tell any of my piano students/parents about the pregnancy. (One knew because they're members at our church and heard us in the prayers.) That's at least one sector of people I didn't have to tell the bad news to.
Actually get around to moving things around for the nursery. It's still a fresh slate of horrible, disgusting mess we still have to sift through after moving in late August.
Sign up for classes at the hospital--birthing, newborn care, breastfeeding, etc. I had looked at the schedule the week before the m/c and had already decided on some dates in June, and we had already been told to sign up soon as classes fill up quickly. I thought it couldn't hurt to wait till after our next prenatal checkup (which never happened). I was right!
Buy or order extra fabric for my bridesmaid dress mentioned in the previous post. In fact, I still haven't picked up the dress!
Sign up on too many websites/mailing lists that may send me coupons/whatever around late August, expecting me to be a new mother requiring their services. At least I hope I'm not on any mailing lists.
Start any baby registries in anticipation of baby showers later on.
Buy any baby furniture or supplies, even though Target and other places had it all on sale a few weeks ago.

Maybe I have good intuition. Maybe I have a good sense of the "right time" to do certain things, and I don't let excitement and impatience lead me to do them too soon.

One thing's certain, I'm definitely a procrastinator. And, kids, let me tell you, sometimes it pays to be a procrastinator!

The Silver Lining

2008-02-26T11:12:00.007-06:00

No longer being pregnant can simplify life in many ways. And there are some things I can be happy about:

I can drink beer again.
I will be able to fully enjoy the local culture (a.k.a. drink wine, etc.) when we travel to Spain this spring.
I won't have to spend beaucoup bucks getting my bridesmaid dress augmented for my good friend's wedding in late May.
I don't have to worry about my large girth and advanced pregnancy affecting summer travels.
We can take much more time to save money for a baby (assuming insurance covers the vast majority of all the impending medical expenses).
We don't have to worry about traveling with a newborn for the holidays.
I can refocus on exercise and diet to get down to a decent weight, as I intended to do before I got pregnant.
I can eat sushi.

But one thing I would like to make abundantly clear: I would give up all of these things in a tiny fetal heartbeat if I could only have my baby back.

The D&C

2008-02-25T10:04:00.008-06:00

One week ago, Monday, February 18, Erich and I got up before dawn and drove to the hospital. I wasn't really nervous about the procedure; I was more worried about the emotional upheaval associated with the absolute end of the pregnancy. We were going to the hospital, six months too soon, and we weren't going to get to take a baby back home with us.

There's something so peaceful about being awake when the sun comes up. It always makes me wish that I were an early riser, but I value my morning sleep too much to ever actually consider it.

We got to the surgical waiting room at 6:30 exactly--right on time! We signed in and were taken to a room where I changed into a hospital gown, got a bracelet and an IV. I signed forms and answered a bunch of questions. (I should have tallied the number of times I was asked if I was allergic to any medications because it felt like a thousand.) Then I had my first wheelchair ride ever to another room with curtains, where I waited on a bed and met more nurses, the anesthesiologist, and another doctor from the ob/gyn practice, Dr. P, who performed the procedure. She told me that she wouldn't see me after the procedure unless there was something to tell me. I thought it made sense that she wouldn't wait around for me to wake up if everything was normal. Everyone was nice and I felt well taken care of. Edward is a great hospital. My mom arrived around 8:00 and waited with me and Erich. We got to watch TV. And I got to experience the wonderful sensation of having to go to the bathroom without having had anything to drink, thanks to the wonders of IV.

Just a little after 8:30, my bed was wheeled to the operating room. It's odd to be wheeled around on a bed--it makes me feel pretty helpless, but there's something luxurious about it as well. The OR was overwhelming. It was a big room with a high ceiling and just lots of medical stuff all around. I hoisted myself onto the operating table, which came equipped with the most monstrous stirrups I've ever seen. They looked like bisected ski boots. Nurses were flurrying around, moving me every which way and preparing equipment. They stuck a big sticker on my back to monitor my heart. The anesthesiologist described everything he was doing. First he gave me some drugs to help ease the discomfort of what was going to go in next. The main drugs did hurt. It felt like my arm was being squeezed and twisted. I writhed in pain a little, and that's the last thing I remember.

As I woke up in the curtained waiting area, there was a nurse or two on my left attending to me. I think they asked me if I remembered getting a shot in my arm. I did not. Then there was one nurse and she told me I could keep dozing as there was nothing going on. But she told me what to expect (the shot was for making my uterus contract, yay!) and then informed me Dr. P would be there to talk to me. I turned my head to the right, and there was the face I did not expect to see! In my drugged state, I didn't have a chance to get worried, but I was very curious as to why I got to see the doctor a full hour after the short procedure began. She smiled and told me that when she was doing the procedure she saw a septum and I may have a bicornuate uterus--this may have caused my miscarriage. My absolute first gut reaction was to be glad there was a possible reason for the miscarriage. Everyone wants an explanation, and I didn't expect to get one, but here was a possibility presented to me. But my mind automatically leaped to the implications: what is my prognosis? I asked if it can be fixed and she said it could, and that we'd talk more about it in my follow-up appointment. Then she was gone.

My mind was reeling. It was hard to know what to think or feel. In fact, it was hard to even think or feel much at all due to the effects of the anesthesia. I thought about septate and bicornuate uteri. I had actually read about these things in a book on miscarriage I had gotten at the library. I remembered that a septate uterus is normal on the outside but has a septum on the inside. A bicornuate uterus is essentially heart-shaped. I didn't know what either of these meant as far as treatment and chances of success. I was so relieved and so scared at the same time. Obviously, we weren't dealing with a fertility problem (unless getting pregnant so easily the first time was a fluke), but if my anatomical problem will prevent me from staying pregnant, we weren't going to be able to abide by our original goal of getting pregnant again before my birthday (May 21). At the very least, I would have to get my problem fixed with surgery before we could have a baby.

I pondered these things as I was taken to a recovery room, cramping and bleeding. I sat in a big chair and a nurse covered me in warm blankets and then brought Erich and my mom to me. I tried to explain to them what Dr. P had told me. I tried to remember the look on her face and the tone of her voice when she talked to me. Her calm demeanor and pleasant European accent made her a little inscrutable, but I knew that nothing she did or said was alarming in nature. She had made it seem like this was something she had seen before. But it was impossible to know, and still is, until I can meet with her to gather more information.

I started to slowly feel more normal and the nurse came in to remove my IV. Erich helped me walk to the bathroom where I put my clothes back on. Not much time passed before Erich went to get the car and I was wheeled outside into the cold wind, on my way home. We were home by 11:30.

I spent way too much time the rest of the day and the next day, perched on my hard chair at my computer, looking for all the information I could find. There were almost no girls on the Nest who had been told they had a septum. But then one came through and pointed me to a good online resource for people with Müllerian Anomalies, which is what I apparently have. I read and Googled, took breaks, then Googled some more. But, sadly, Google could not tell me what my uterus looks like. (Sensing a theme here?)

By Wednesday I had had it. There was no sense in researching when I didn't have enough information about myself. I am glad I know what I know now, and I'll share my information in subsequent posts, but there had to be an end. I had learned my lesson of patience and I lost all desire to keep scouring the internet for answers. The answers will come, and it will start a week from tomorrow, when I have my follow-up appointment with Dr. P. In the grand scheme of things, two weeks is not too long to wait. And very hopefully, in the big picture, it won't even be too long before we have our first of several babies.

It was time to stop speculating and worrying about the future and start facing what had happened to me. I needed to acknowledge the baby we lost and mourn properly. I started this blog and forced myself to remember what it was like when we were expecting a baby. It was painful to draw it all out, but it needed to be done, and I'm so glad I did it. This hurts so much, but it is better than being numb. The future will take care of itself. We are letting go of what was never in our hands to begin with and taking charge of our healing.

The Aftermath

2008-02-22T23:40:00.005-06:00

First reaction: anger. I was so angry that we had just told everyone, and now we'd have to immediately deliver the news of our loss. I was angry at myself for thinking I was still pregnant for three weeks after the baby had died. Just as I had failed to recognize my pregnancy when it began, I completely missed any signs that it was over.

The news of the miscarriage had a memory-altering effect. Though I now realize that my body had continued to believe it was pregnant because the baby was still inside, for the first few days, I could not remember consciously believing I was pregnant in the preceding weeks. I knew that I had thought I was pregnant; but because the cold, hard facts confirmed that our baby was dead and had been for at least a few weeks, I could not remember honestly believing in my heart that I was pregnant. It's very difficult to describe that sensation. It creeped me out.

I now recognize my altered memory as a psychological defense mechanism. I was protecting myself from feeling a strong sense of injustice. I kept myself from asking "why?"--at least of God (sure, I wanted a doctor to tell me why)--and thus protected myself from strong, uncontrollable emotions. Within two days, I was saying to myself and others: "Bad things happen to good people. There's no sense in asking why. It's not about what is deserved because we all deserve death. Our baby died and it's very sad. The end." But I knew this was not to be the conclusion of my grief. I felt eerily well-adjusted, so much so that I found myself waiting for the other shoe to drop. I wasn't letting myself miss being pregnant. I wasn't allowing myself to feel robbed of having that "baby belly," of giving birth in August, bringing home a newborn, or experiencing all the joys of parenthood. I couldn't think about these things yet.

I focused solely on starting again, on conceiving another baby soon. I thought, if we could just get pregnant again before this first baby was due, then I could see this as two children who could not have lived at the same time. A modification of "it's all for the best." I don't believe it's all for the best, but good things can happen after bad. I knew it wouldn't be good to think about replacing our lost baby. Sooner or later the grief would surface and I would have to face it. I didn't think I was keeping it buried, but I was. I was thinking about "replacement." I had my eyes on the future because it was too painful to consider the present.

I spent a lot of time on thenestbaby.com, on the Miscarriage/Pregnancy Loss community message board. It helped me feel like one of many. Miscarriage is extremely painful, but it's a common, almost normal, end to pregnancy. The ladies on that message board know what to say and are happy to give support. There I found much comfort as well as information. I asked the others about the D&C, and the responses helped me to realize I needed to have it done. I had started to bleed much more, but it would be impossible to tell how long it would take to "pass" everything. It finally dawned on me that I had already been carrying a dead baby for weeks--perhaps it would be easier to heal emotionally if I didn't have to go through the potentially drawn-out physical pain of a natural miscarriage. I called my doctor's office and scheduled the procedure for the following Monday morning.

Throughout the weekend, I continued to have cramps and bleeding, like a bad period. I continued to (unwittingly) suppress my grief. All I could do was move forward, and the only person I know how to be is myself, so I laughed; I talked about things other than our loss. Erich and I spent a lot of time with my family--it was easier to be away from home and with other people. I started keeping a journal and poured my thoughts into it daily. I heard of other women (my grandmother, a friend of my mom's) who had had miscarriages many years before and now couldn't much recall the details. I hoped and believed that would be me one day. We'll have our four kids in our lives filled with love and joy and I might have to be reminded of the one we didn't get to keep. I still hope that is the case, but I can't imagine forgetting.

The D&C was the turning point, mentally and emotionally. But I shall save that for another day.

Thank you

2008-02-21T11:54:00.004-06:00

I just want to take a break from the story to thank those who are reading. And I especially thank elephantschild and pianomomsicle for your very nice comments. I feel very gratified to know that so many people are thinking about us and praying for us and that my story is appreciated.

I feel a particular drive to tell the story for several reasons. First of all, our baby was a person who existed, even though no one ever got to meet him or her. This loss is real and will never go away. But the real itch to write came after I was told there may be an anatomical reason for the miscarriage. While I'm relieved to have a possible reason, I feel the injustice even more acutely: there may have been nothing wrong with our baby. This may not have been a chromosomal abnormality, incompatible with life. Don't get me wrong, the loss would still be very real. But I feel now that the story has changed and we are truly on a journey now. At the point of my story where I've left off, I focused on "trying again." I wanted to move on, to make another baby who wouldn't die. Now I see there are a few steps to take before we get to that point.

In the world of fertility, everything requires patience. Waiting to start to try, waiting for peak fertility, waiting to see if it worked, then waiting to see if the baby survives the first trimester, the rest of pregnancy, birth... (SIDS, illness, accidents, childhood; it really doesn't end). The main theme of our story was always going to involve a lot of patience. But it is not as simple any more. We have to wait for our follow-up appointment, further diagnosis, weighing treatment options, treatment itself, waiting again to TTC, waiting to see if it works, and then we're "back on track" with the original list of worries.

I'll continue to tell the story. We've had "The Beginning," "The Middle," and "The End." I anticipate "The Aftermath" and "The D&C." After that, I'll supply updates. And again, I want to thank those of you who are reading, even if you don't leave comments, for thinking our story is worth telling. (But comments make me feel even better. ;)

The End

2008-02-21T10:14:00.005-06:00

Even as the pregnancy didn't feel "real," I knew that it was normal, because nothing had given me a reason to believe it wasn't. Simply put, the pregnant woman cannot feel the baby. Many women have some spotting or bleeding in the first trimester--I had none. I couldn't yet feel my uterus emerging from my pelvic region at almost twelve weeks, but that too was not enough of a problem to make me worry seriously. I had been told I have a "tipped" uterus at my ultrasound. My reaction was, "Oh really? So does my mom!" Not worried; my mom had four healthy, full-term pregnancies. So maybe my uterus was still righting itself before becoming noticeable from the outside.

But my fatigue did lessen noticeably, well before the end of the first trimester. How could I have known that was the only clue that anything was wrong? Why shouldn't I have been glad that I didn't have to spend most of my days sleeping?

[TMI alert!] Two weeks ago, I started to have yucky trouble with hemorrhoids. It was scary to see blood at first, but as soon as I confirmed the source (NOT the baby), I was relieved. I had constipation problems throughout the following weekend. Monday evening, there was something new on the toilet paper when I wiped (I always checked the toilet paper). A very, very small amount of brown mucous. I thought it was hemorrhoid-related and tried to put it out of my mind. But on Tuesday, this problem continued. I consulted my Mayo Clinic book, which is very comprehensive, but I couldn't find anything specifically about brown spotting at 12 weeks. The best I could come up with was that brown means old blood, so maybe this was leftover from my pap smear or intercourse or something. But I couldn't stop the bad thoughts from rushing in all around me. I felt numb as I considered the possibility that the baby was in danger. I started to cry, knowing I would call the doctor the next day and there was a strong possibility I would be told that everything was NOT okay and nothing could be done. Erich comforted me and resisted thinking the worst, but I know he was very worried as well.

Wednesday, February 13, 2008. The Cantor was out of town, so I played organ for school chapel in the morning, followed closely by midweek Lenten Matins. After matins, I had about two hours until I had to teach choir. I called my doctor's office. On hold as usual. I didn't know whether to talk to a nurse or schedule an appointment, so I stayed on the line and got to the office staff. They couldn't tell me what to do, so transferred me to a triage nurse. More sitting on hold. They play Enya on their hold music. The nurse finally picked up.

Me: "Hi, I'm scheduled to come in for my next prenatal appointment next week, but I don't know if I should come in sooner because I've had a small amount of brown spotting and--"
Nurse: "UH OH! Did you have intercourse recently?"
Me: (thinking) "Um, no, not really recently."
Nurse: [asks my name, what kind of insurance I have, puts me on hold] "Where are you right now?
Me: "I'm at my workplace, my church."
Nurse: "Are you close by, can you come in now?"
Me: "Yeah, I'm about ten minutes away..."
Nurse: "Start drinking water, don't empty your bladder until you've had an ultrasound. Come now!"

I hung up and barely kept myself from dissolving. I had my almost-full one-liter bottle of water that I started drinking as I picked up my phone again to call Erich. I barely squeaked out the words, "They're having me come in for an ultrasound! I'M SCARED!" I couldn't stay on the phone long because I had to drink water while I drove to the office. I got there in less than ten minutes, and the water was almost gone. I went in, told them I was there for an ultrasound; they knew who I was without me having to say my name. I had to wait a few minutes in the waiting area. My heart was pounding in my ears. I thought to myself, "It's not good for the baby to be so stressed out!" A darker, strengthening voice interceded, "If the baby's even alive." I waited as a very pregnant lady walked in, also for an ultrasound. She looked full-term. The dark voice in my head told me that wouldn't be me. This was the end of the road. But I couldn't yet believe it was over until a doctor told me so.

The ultrasound technician escorted me back to the room and asked how I was doing. "A little nervous!" I said. "Of course, stupid question!" she replied sympathetically. I got up on the table, she squirted the gel on my abdomen and started the ultrasound. I watched the screen. The technician remained silent. I saw the baby; it looked like the last ultrasound, but more opaque. And I knew deep down that it wasn't moving. But I wouldn't let myself think. "I think I'll do an internal.... Yes, an internal will get me a closer look. Go empty your bladder and come back in." I didn't need an internal ultrasound at 9 weeks. If I were going to be reassured, it would have happened by now. When I came back in the room, she had changed the angle of the screen so that it would be difficult for me to see it; I no longer wanted to look anyway. The internal seemed to last forever as she tried different angles. At one point, she turned on the sound, and I knew that's where a heartbeat should be--but there was only silence. All I could do was tremble. "Is it bad?" I asked. "Dr. D will talk to you. I'm sorry, but I'm not really allowed to say anything," and she patted me on the arm. The only reason I could hold myself together is that no one had actually told me it didn't look good. But I saw the screen just as she flipped it off: "9w0d."

I was escorted to Dr. D's office and left in there alone for what felt like forever but was probably only about three minutes. As I wept, I played over and over in my head the doctor coming in and saying, "It doesn't look good." I thought there still might be hope that things were okay, but really, I already knew. "It doesn't look good." "It doesn't look good."

Soon enough, the door opened, and the doctor walked in and sat on the edge of her desk, close to me. I could barely make eye contact as I heard her say, "It doesn't look good." And I finally fell apart. She told me 15% of all pregnancies end in miscarriage, and it doesn't increase my risk of having another one. But that couldn't bring my baby back. I said we had heard the heartbeat, and she said it's very rare to lose a baby after hearing the heartbeat. I asked what happens next, and she told me I'd schedule a D&C. I didn't know if I'd want to do that. It's hard to go from thinking you're pregnant to talking about having the "products of conception" scraped out of you within half an hour. She told me it's up to me. I asked how soon we could try again, she said one month after D&C. I whined that we had just told all our friends. She tried to comfort me. But she had to go. She handed me a brochure for a grief support group and the calling card of their office manager who schedules surgical procedures. She told me I could stay as long as I liked and didn't have to stop at the desk on my way out.

I couldn't move. I was paralyzed and numb. I sobbed. But I had to call Erich, and I had left my phone in my car. And there was nothing else I could do. I collected myself as well as I could, silently escaped to my car, and picked up my phone.

"Erich? We lost the baby. Can you come home?"