Ectopic

So ultrasound today was interesting. I now have a new diagnosis of ectopic pregnancy...which had been whispered about early on with the way my betas went, but I certainly never really took it seriously (silly me) because I only have one tube. Although they did not see a heartbeat, and therefore cannot say with 100% certainty that is an embryo in the tube...even I could see the gestational and yolk sac. I thought this appointment was going to be a quick ultrasound then a prescription for the miso, it turned out to be much more involved. I was there for a total of about 3 1/2 hours. I had to have labs drawn and processed before they would even mix up the methotrexate. My beta went up (WTF?) since the last draw. I am now out from work until at least Monday, no folic acid or alcohol for me, and I cannot travel very far away from the hospital "just in case". Oh, and I asked for an antidepressant today.....

Betas betas everywhere

I don't think I mentioned what my beta was after my ultrasound. It was 1415 and that was pretty much the nail in the coffin...so to speak. I went out of town this weekend, mostly just to get my mind off of all the usual. We spent it with family, and although we did not talk directly about what was going on, it was very healing. Both my parents wrapped me up in a huge hug and simply said "we love you so much" and that was enough to lift up my soul. The only thing that was hard was that there was some chit chat about two of my cousins who have had twins via IVF in the last year and of course there was baby talk about them.

Unfortunately nothing has happened on the miscarriage front. I am at the point where I have mended (at least somewhat) on the emotional front and I just want to move on. My manager called this morning (not the same person that sent me the amazing email) and asked when I was coming back. Apparently there was a little miscommunication about my time off and they were expecting me there today. I was really hoping to go back by Thursday, but that doesn't look like that will happen. Since I have had no bleeding (only some very light and very small amount of spotting) they wanted me to repeat my beta today (it was 685) and follow up with an ultrasound tomorrow. Because of the slow rise of my betas they are concerned about a tubal pregnancy...what are the odds of the that, considering I only have one tube. Anyway, if they can rule out a tubal, and I still have not had a flow, then it looks like misoprostol for me.

I just want this chapter to be over. I have already started to calculate when I would likely cycle again...maybe fourth time will be a charm for me. Maybe we will switch things up a bit and do a 3dt. I'm sure they will also want to check an FSH with my next AF. In the meantime, I've got to get back on the exercise band wagon and focus on my diet...I have been doing nothing but emotional eating for the last few weeks...and it is starting to show.

The Silver Lining

The silver lining is that I have truly discovered that I have the most wonderful and compassionate boss EVER. I emailed her last night to give her the heads up on what was going on and that I would need some time off. I had planned on going into work today (I have burned up all of my earned time as of late, so any time I take off would be without pay) but taking the bulk of time off next week. This is her response to my email:

• I feel very sad for you. Your heart is breaking. Words won't comfort.
  I wish you could go to a place to be with women where they would surround you, and attend to you, and hold you, and let you be as raw as you need to be. We would do that here if we could, but we can't, or we can, but only intermittently, moments instead of hours. I fear the reality of what is going on in the external environment will crash into what is going on internally; physically, emotionally, and spiritually for you. I don't want where you are and what you are called to do to create more pain for you in this process. I think you should take care of yourself and think about being away from here now, not next week, but now. This may not be the best place for you to be, in fact, it may be harmful to your vulnerable heart. You are brave. You are strong, but perhaps not that strong. Who could be?
  I trust you to make the decisions that best serve you. I will honor whatever you decide is best and right for you. You are a wonderful nurse, and we appreciate your work here- but not if comes at too great a cost to you. If on the other hand, you will find solace in the rythym of the work, the never-ending cycle, the company of women engaged in carinig for women- then of course, you should come. Only you know.
  I am so very sorry. all my best to you. k

She ended up calling me later in the evening to "warn" me about a fellow co-worker who just announced her pregnancy and people have been talking about it. She didn't want me to walk in and be surprised by this news. In the end, I decided to take today off. I didn't sleep more than about 3 hours last night and yesterday I hurt my back and have not really been able to stand up straight. As it turns out I believe it was a good idea all around, shortly after I woke up I noticed the faintest of spotting, so I think that this pregnancy is declaring itself on its own. I took the progesterone last night, and originally had planned on taking it again today and repeat one more beta tomorrow, but now I truly feel like this is the end. I checked my work email this morning and this is another email from the clinical educator, not really a supervisor, but she has known pretty much every step of my journey.

• I'm so sorry for your loss. While I want to see you and hold you and cry with you, you can know my heart and thoughts are with you now and through the day. I'm glad you chose to stay home where you have more contol over your environment. Please let us know if we can do anything for you. Thank you for letting me journey with you.

I couldn't ask to have a more supportive work environment, I am blessed in that regard. So now I guess I just wait. We are planning on going out of town this weekend, it is my niece's birthday and we have been organizing this for quite some time. I'll call this the clinic this morning to see if there is any reason I shouldn't go. My family knows what is happening and they will all be supportive if I need time just to hang out in the corner. I'll have the next 3 days to myself and any longer than that and I may go batty.

Nothin' good

Today's ultrasound was dismal, although we are not totally out of the game...yet. Gestational sac was seen, but no yolk sac. The gestational sac was not "plump", so the RE said she was not optimistic about the outcome. Of course there is still that miserable thin shred of possibility that things could turn around next week, so for the moment we are hanging on. I got the oh too familiar "I'm so sorry" hugs on our way out of the ultrasound room. It appears that although this cycle is not officially over, hope is gone from a medical stand point. We head over to the conference room to have a little more in depth conversation with the RE now that I am clothed and without a probe up my chickie. She is on vacation next week so she will not be able to follow up personally with me and she wanted to go over some possible scenarios. She is amazing. First off she asked who I wanted to have the appointment with in her absence, which I thought was very sensitive. Then we got down to brass tacks. If this is indeed a nonviable pregnancy, then she doesn't feel like I need to have a D&C, especially given how small the gestational sac is, so the next step could possibly include misoprostol to induce miscarrying the "products of conception". Anyone have any experience they would like to share here? Is this painful? Is it awful? I'm anticipating needing to miss a day's work or so.

I guess I shouldn't get too far ahead of myself, but this is where I feel we are heading. I am also trying to wrap my head around doing another cycle. Because of my age I have always felt like I need to press full steam ahead...I'm not getting any younger after all. The RE did say that she would be ok with a 2 month break for me, but not 6. Maybe that would be just enough time to feel a little more normal, a little less hormonal and perhaps, dare I say it, a little more in shape.

In the mean time, another beta tomorrow. If has plateaued or dropped, then that indicates things are going south. If it continues to rise, then it could mean continued growth of placental tissue, but not embryonic...so that really doesn't mean anything.

I'm working really hard at trying to not feel anything. I don't want to give up totally, but I don't want to have false hope either. I wish I could just find a state of numbness and stay there for at least a week or so. Boy, do I want a drink!!

More Beta news

I'm not even sure where to start. Yesterday would have been my due date from IVF#1/miscarriage. I was sad, and funky, but was relieved to have some good news with my last beta and a smidgen of hope.

Today I was called in to work and I thought "well, this will be good, I will work today and all weekend and it will keep my mind off the impending ultrasound on Monday". I've been having some pregnancy symptoms and was expecting to have a nice jump today. The nurse on Wednesday said she was hoping the beta would be in the 1,000 range. Today's beta is...drum roll please.....874. Fuck! Now it has done it's 66% rise in 48, so officially things are still okay. But the nurse also said that for as far along as I am, 23dpo, she would expect the number to be higher. And then....I lost it. I went into 3 separate fits of uncontrollable crying while trying to hide myself away from my co-workers. I'm getting the double whammy of reliving the miscarriage as well as this freakin' back and forth with the betas. I am trying to hang on to the idea that 1/3 of women don't have a typical rises in their betas, and I now wonder what happens to the betas to those fertiles that don't have all of this lab work. I don't think I ever had a beta with Z.

Anyway, I was able to leave work...well I HAD to leave work, they really didn't have a choice. I would have been circulating and recovering a c-section which means I would have been one on one with this cute little fertile intact family. The idea of having to handle the baby was enough to send me into a small panic attack. So here I am at home, trying to find some sanity so that I can go back in to work tomorrow....and the next day, and not lose my ever lovin' mind.

Just a quick post...beta yesterday was 503, which more than doubled. Still extremely cautious, but feeling a little less insane. One more beta tomorrow, then ultrasound on Monday.

Thank you everyone for your encouraging words. I'm so behind on my commenting....part of my grand effort to keep myself out of the house and very busy so I don't have time to mope. I've also been on call for the last couple of weeks, which is good money, but lots of extra time at work. I'll catch up soon.

...and the roller coaster starts to climb.....

I called my IVF nurse on Saturday and talked with her a little more about my third beta. I didn't think that I could wait until Monday and asked if it was okay if I had it drawn on Sunday. She said "sure" and that she understood that the waiting can be torture. I was relieved that I would not have to wait....but then I started thinking.... I would be at work on Sunday and if it was bad, which is what I was expecting, then I don't think that emotionally I would have been able to stay at work. As it turns out, Sunday was a mad house, partly because a couple of nurses called out sick, so it would not have been good to risk it by having the beta and then be miserable at work, surrounded by babies. So I decided to do the beta on Monday. Right after I got the results of beta #3, I thought "I just can't do this again". In an effort to start formulating my next plan, I took a look at job postings in other departments and other hospitals. I also did some research on adoption (which was terribly depressing) and finally I started looking into a Master's in Nursing Informatics. Then I thought about when I would go out and get good and drunk and color my hair (my mousy brown and grey roots are tragic).

Yesterday, I met a friend of mine who has also had fertility issues and some pretty horrific pregnancy related losses. Anyway, she has been doing IUIs over the last few months and she had her last IUI 2 days after my retrieval. (Can you see where this is going?) Well she is pregnant and she had to have her second beta drawn on Monday as well. We decided to make a day of it to take our minds off waiting around for the phone call. We went to the hospital, then lunch, then shopping. On our way home the clinic called. My beta is 194. I was in shock...it is still not where they would like it to be (they wanted it around 216), but they are encouraged. In a daze I heard her saying things like "we are optimistic" "there is reason for concern" "we are just going with it" and my personal favorite: "one third of all betas don't have the rise they expect, and everything turns out fine". It was the most bizarre feeling to be sitting there, not happy, not sad, just surprised. I have learned to live my life in 48 to 72 hour increments...and I think that I am doing fairly well. I'm trying to keep myself real busy, lots of activities planned on my days off. My ultrasound is scheduled for next Monday and the nurse said to keep the appointment...at least for now. My next beta is tomorrow morning...stay tuned.

Incidentally, my friend's beta was over 700.