Adding Insult to Injury

As an added bonus for my return to work today - a co-worker found out that she was pregnant! By mistake! With an IUD in place!

Here

* pregnancy loss and child mentioned*

I'm slowly coming back out of my shell. Going back to work was brutal. Being around a unit full of new moms and babes is not exactly therapeutic for me. I had to leave early the first two shifts, but actually did make it through a full 12 hours last Monday. Since then I have been off on "vacation". We did not go anywhere, but this was planned time off from many months ago.

My daughter turned 4 this week, and this has been a non-stop celebration with family coming and going throughout the week. It has been a good distraction, but as tomorrow grows near, I am becoming more tense about going back to work. This time of year is always emotionally charged for me because not only is it my daughter's birthday (we started ttc when she was 18 months old), but in a few days it will be the anniversary of the death of my dear friend. She passed away 12 days after the birth of my daughter.

As far as work goes, I ended up sending out an email to the people that I work with on day shift. I have not been myself, people have seen me crying in the corner when a co-worker is asking how I'm doing. I sent the email partly to squelch rumors, but also to gain a little slack when it comes to assignments (I don't think that I could handle doing a 2nd trimester termination for genetic anomalies right now). I told them in the email that I have experienced a pregnancy loss and I am trying to figure out how to cope in an environment filled with babies. My hands were literally shaking as I pushed the "send" button. It is terrifying exposing myself to co-workers that I don't know very well. However, I have to say that the response has been overwhelmingly supportive.

Going back a week or so.....the D&C was awful. I was given 5 mg of valium and 2 percocet to take 45 minutes before the procedure (which was to be done in the office). I was so loopy by the time we got to the clinic, that C had to get a wheelchair for me just to get me from the car to the office. The RE went through instructions and a brief description of the procedure, all which were very fuzzy to me. The D&C itself was profoundly painful, and I do remember crying during the procedure. (I have made a not so subtle mental note that if there is a next time, this will be done in the OR and I will be COMPLETELY anesthetized!!!). Afterwards I started throwing up, I think it was from the percocet. No one seemed too concerned about the vomiting, and C had to go find someone to make sure it was okay that we just walked out. I slept most of the way home, then threw up some more once we got back to our house. The rest of the day I hung out in bed, sleeping intermittently. It took me exactly one week to stop bleeding. Now I just wait until AF, then I suppose we start over again. I have not heard from the RE's office, other than a letter regarding the pathology from the D&C. It was one of those template letters..."[insert name] hope you are recovering well from your procedure...." blah blah blah. And by the way you don't have cancer. WTF?! I guess I didn't realize that is what they were looking for when they were doing the pathology. Is it too much to expect my IVF nurse call after a pregnancy loss just to say "are you okay?" I've checked the stats on my clinic and although it is a large teaching hospital, they do not do large numbers of IVF....I guess I thought I would get a little more personalized attention....silly me.

C and I are dealing with things quite differently. I am trying to figure out how to get by day to day, and sometimes hour to hour. A dear friend sent some books on coping with a pregnancy loss, I've tried to read it, but every time I start, I begin to crying and can't see. C is very supportive, but he is looking to the future. I once said that if IVF did not work for us, I would concentrate on getting my master's. So he has brought up me going back to school, as well as trying multiple IVFs. Our insurance will pay for 5 more fresh cycles.....still don't think we would take it that far, 40 is looming and I don't want to keep doing this for another year. But for now, we wait. Waiting again for AF. I do want to jump right into another cycle, I'm just hoping that it won't take AF 12 weeks to show up.

Did I mention that another cousin's wife is pregnant.....with twins.....through IVF? *sigh*

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.............