The Bad Ultrasound

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

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

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

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

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

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!

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).