Gone

Ultrasound today at 8w1d.

No heartbeat.
No growth.

D&C Monday.

I was happy....for about 5 minutes

So u/s today.....I saw a sonographer that I had never met before and she was not very warm and fuzzy. When the image came up on the screen I immediately saw the sac, and the flicker. I was overwhelmed and thrilled. C and I held hands, so happy that our worries were for not - UNTIL the RE came in. He asked how I was doing, I said "I'm great now". Then he goes into a little sidebar with the sonographer. They talk about gestational sac size and crown to rump length, which are all just fine...this clinic doesn't really give out specifics very freely so I just typically take the no news is good news approach when it comes to statistics. Then we get to the heartbeat. It is 97. NOT good. It seems silly and maybe even trivial, but they wanted to see it over 100. So back for another u/s next week. Which is going to be tricky with my work schedule. They said I could be seen in 7-10 days...hello! How could I wait 10 days? So right now my appointment is for next Friday, but it might get bumped due to lots of retrievals that day. If Friday is a go, then I have to do some fancy rescheduling with work - I'll work on that tomorrow.

As I left the u/s room I ran into both of the IVF nurses that I have worked with, they were very supportive, but not saying terribly optimistic things. I got "at least you got pregnant" and "maybe things with turn around next week". I have no idea what to think right now. 3 beats per minute off doesn't seem like much to warrant such a dismal outlook, but that is the impression I was getting from the IF team.

Unfortunately we had to take my daughter to the appointment. I have never done it before and will do everything I can from doing it again, there was just no other choice. Luckily the clinic is not crawling with infertiles, I rarely see anyone else when I go. And the clinic shares the space with the regular OB clinic, so the place is lousy with pregnant women. Anyway, we have not talked about the pregnancy with her in weeks, but when she walked into the u/s room (I was already there seated with a sheet over my lap) she blurts out "are you having a baby?" Before the RE came in the room (and we were still happy) we pointed to the screen and showed her the baby. So all afternoon she has been pulling up my shirt and asking where the baby is. Boy do I regret saying ANYTHING to her earlier - and you can't just take something like that back.

So off to work tomorrow, I'm hoping that nobody comes up and congratulates me...I know that I won't be able to hold it together.

Back to worry and anticipation

So the last week has been somewhat of a blur. I have been trying to keep myself (read: my head) occupied and away from Dr. Google. We had a little family outing over the weekend to an amusement park that is just for little kids (Z will be 4 in a few short weeks). We had a blast and I saw a part of New England that I hadn't seen before. The White Mountains are truly spectacular and we are already planning our next trip up there before the end of the summer.

I've been struggling with my emotions and optimism this week. The "bump" and the lack of a definitive gestational or yolk sac is freaking me out. The radiology report also mentioned that the pocket appeared to have "collapsed" in the middle - that surely doesn't sound good. I did phone my IVF nurse and talked with her briefly. Although she didn't say anything along the lines of "don't worry about it, I'm sure it will be fine"....which was the answer I was fishing for. She did say at least one reassuring thing: embryonic development happens so fast this early in the game that an u/s done in the morning might not show anything, but an u/s that same afternoon might show something completely different.

I have been able to remain relatively calm. I am actually confident that I am pregnant. I don't think that my betas would have risen like they did if the pocket on the ultrasound was just fluid (which was a possibility also outlined in the radiology report). BUT, my fear right now is that there is some structural or chromosomal abnormalities that will prevent this pregnancy from resulting in a real live baby. Friday morning's ultrasound is huge. We will be out of limbo one way or another. I will be 7w1d at that time so they should see something. I've let my mind wander to the possibility of needing to make a decision about another round. I know it seems like a no brainer to do another, but truthfully I don't know if we would.

In other news, the cat is totally out of the bag all over town and work. Yesterday someone who I don't even really talk with all that much congratulated me. I was so taken a back, I had no idea what to say. I didn't want to deny it, but I also didn't want just say "thank you" and let it spread further. I ended up saying that nothing was certain yet and we were waiting for another u/s before we got too excited. She apologized and said that she was under the impression that "everyone knew". I have no idea where the leak happened. I can only imagine that someone overhead a conversation I had with my friend from work who also went through IVF. There are 4 people who I have told at work, and I know that none of them would say anything. I guess I'm not really angry....I'm trying to push anger out of my life right now anyway....but I'm disappointed that I was not able to tell people on my terms. Which wouldn't have been for a few more weeks. I suppose this is what I can except working in an environment of 95% women. I dread having people come up to me at work on Saturday and say "congratulations" if we get bad news on Friday. This is just bad timing.

Me and my bump

Isn't a bump what everyone wants? I hear it so many times now with the celebrity "bump watch". My bump is not making me happy. As every hour goes by I am growing more worried. My ultrasound was yesterday at 5w5d. I was reassured before they even started the scan that all they were looking for was "how many and where". They didn't expect to see anything else. The APRN was in with the u/s tech to point out on the screen what I was looking at. Pretty early into the ultrasound the APRN says to the tech "are you seeing that bump?" Oh, no, please....let this be just a normal boring early ultrasound. I get the "it's probably nothing, we'll know more what we are looking at during the next ultrasound" speech. So I have to wait until next Friday the 20th.

So in the meantime, I check out my office notes for the ultrasound (because I have access to my own medical record), and get an official name for what they were seeing - a chorionic bump. In the notes it also says that there is not definite yoke sac or fetal pole, but from what I understand it can still be a little early to see that - am I wrong? The office note said that the gestational sac may just be fluid....

Just to add to my distress I decided to google "chorionic bump" and I came across an abstract from research that my clinic was involved in, including my specific RE. Here is the name of the article: A First-Trimester Pregnancy Sonographic Finding Associated With a Guarded Prognosis. Well THAT doesn't sound good. Here are some nuggets of information from the article:

Results. The difference in outcomes between the patients with bumps and the healthy control subjects was statistically significant (7 live births versus 13 live births; P < .03), but the difference in outcomes between the patients with bumps and infertility control subjects was not statistically significant (7 live births versus 11 live births; P = .1). Conclusions. The finding of a chorionic bump on the first-trimester sonogram is associated with a guarded prognosis for the early pregnancy (live birth rate <50%);>

So now I have THAT rattling around in my head. I'm going to have to keep myself extremely busy between now and next Friday, otherwise I will go out of my mind. I keep on trying to reassure myself that fluid would not cause the rise in hCG that I have. I've been told that with the rise in my betas it is a good indication of viable pregnancy....so that can't JUST be fluid, can it? C thinks that we got too excited too fast about the pregnancy. I know that this is all completely out of our hands now, there is nothing that I can do to change the outcome. I suppose it is back to just a waiting game. A game that I have been playing for a very long time, but I still suck.

tired, tired, tired

Did I mention that I was tired? Just a short post as I am, well, tired, and my parents are in town so I don't want to spend lots of time on the computer. My beta on Friday was 2,482 - yea. I go in for an u/s on Tuesday. My goal is to sleep as much as possible......zzzzzzzzzzzzzzzzzzzzzzzz.............

Scared and happy

I've decided that it is possible to be scared to death and thrilled at the same time. My beta yesterday was 950 (I think....isn't that funny after obsessing for so long about numbers I can't remember this exact one). All I know is that it doubled in 48 hours and the clinic is pleased. Right now that is all that really matters....except that lurking fear that it is ONLY doubling. It seems that there are so many more women out there with much higher betas at this point (yesterday I was 20dpo). Anyway, I go back for what will hopefully will be the last beta tomorrow, then ultrasound at 8:00am on Tuesday.

I've allowed myself to pull out my two pregnancy books and start re-reading them. I went into the attic and took inventory of my maternity clothes - I'm definitely going to need some more pants. And I have begun the wonderings of what we are going to do with the spare bedroom. I haven't done anything crazy like actually BUY anything, but I have been looking. It will be quite a while before I am that confident to make a purchase. Now all that sounds very well and optimistic, right? Well, then there is the flip side. I can't say the words "I'm pregnant" without the sidebar of "at least for the moment". Most of our talks about the future start off with a big "IF". C knocks on wood (literally) whenever we speak about the idea of another pair of footsteps around the house. We had made plans to go to Disney this fall (I would be 24 weeks). The trip was going to be a big one - I would be off for 12 days. We would drive down and stop in Atlanta to see C's sister, then spend on full week in Orlando. My parents have a time share that has 2-3 bedrooms, a full kitchen and a pool that is 1.5 acres. There are so many unknown factors right now, physically and financially, that I'm not sure it is going to happen. Anyone have an opinion about Disney in October at 5 months pregnant?

I am also very nervous about the actual delivery. Z's delivery turned into a bit of a nightmare. I was 9.5 cm at 11am and delivered (by c-section) at 7:20 pm. I pushed for at least 4 hours. So now I am faced with the decision on whether or not to TOLAC (trial of labor after cesarean) and where to deliver. I feel a strong bond with the small hospital that I just left and it is only 25 minutes away, but they do not have anesthesia in house 24 hours a day, so if we needed to go to a c-section it might be delayed, which is scary. The standard is "30 minutes from decision to incision", but 30 minutes can be a lifetime when the shit is hitting the fan. The hospital where I am now is over an hour away and I don't care for about 1/2 of the attending physicians, but I could be seen by a midwife and anesthesia is right there all the time. Someone told me the fastest c-section they ever saw was 9 minutes from decision to baby. That is extremely reassuring. But the hour drive in late January/early February makes me nervous. I have until the 20th of June to pick a provider.

So, I'm trying to stay in the moment and be happy, even added a baby ticker, although it is low on my sidebar. But I am also focusing on keeping my feet on the ground in the reality that all of these wonderings may be a moot point. I'll move that ticker up the sidebar as my confidence in the outcome increases.

My new favorite number...

...is 427. That is today's beta. In the words of my IVF nurse "it's marvelous". I will repeat my beta again on Wednesday. I am to call today to schedule an early OB ultrasound for either the 10th or the 11th. I am trying to remain calm and reserved on the outside but on the inside it is one constant "yippeeee".