Tuesday, November 23, 2010

The next chapter . . .

I apologize for my absence during the last week or so.  As a graduate student, I am extremely busy finishing up coursework this semester, and the kids have had loads of school related activities going on.  B has been sick with some kind of stomach bug as well, in fact, a trip to the pediatrician this morning resulted in an script for a stool culture.  As she handed me the sterile cup in a brown bag with orders to deliver the "sample" to the hospital within 20 minutes of collecting, I had to chuckle inwardly.  Ha ha ha . . .  humor that only an infertile can understand. 

I want to continue the story of my loss.  It is helping me to get it out, written down.  I feel like everyone else has forgotten about this pregnancy because it has been almost three years and  was able to conceive and successfully deliver another baby.  And while I am thankful every day for the miracle that she is, I still can't forget what that experience did to me.  It affected my entire family in more ways than anyone can realize.  But that is fodder for another post . . .

So I think we left off with the REALLY BAD ultrasound at my RE's office.  At this point, I need to point out that my RE's satellite office was across the hall from my OB's office.  Unfortunately, because it was his satellite office, he did not have the best equipment at this location.  We were sent downstairs to the hospital for a high resolution ultrasound.  The results of this ultrasound were inconclusive.  The sonographer's best assessment was that the pregnancy was located in the lower uterine quadrant but not quite in the cervix.  My RE took a look at the data and let me decide how I wanted to proceed, although he warned me that my prognosis was not good.  I chose to skip the methotrexate and see how things unfolded.

I contacted my OB's office and they recommended no heavy lifting and pelvic rest, as I was still bleeding, and weekly ultrasounds.  My decision to switch to my OB was mainly due to the fact that they had awesome equipment in their office while on the other hand, my RE's main office was almost an hour away.  Under other circumstances, I would have stayed with the RE, but it just wasn't practical with the kids or for my husband, and I had no reason to doubt my OB's care at this point.

On a side note, one weekend after that initial ultrasound and months before I knew I was pregnant, DH and I had actually lined up an all night babysitter so that we could see a concert downtown and spend a rare night in a nice hotel.  We were in DH's company's box seat with catered food and the whole nine yards.  It should have been a great experience. But it wasn't.  It was miserable.  I continued to bleed, and actually passed some black clots (which the nurse assured me was "old blood") that night in the hotel.  The pelvic rest eliminated any prospect of other recreational activities, too.  My next ultrasound showed that the pregnancy was till hanging on, however, so I tried my best to remain hopeful.

At home, I spent as much time lying down as I could with two young children to look after.  It seemed that the bleeding increased when I was more active, although I was not given specific instructions to go on bed rest.  I still wonder if I could have saved that pregnancy if I had remained flat on my back during this time.

The fool that I am scoured the Internet for any information regarding cervical ectopic  and pregnancies with low implantation.  Nothing I looked at was very promising, although many women carried close to full term pregnancies with low implantation.  I realized that if the pregnancy progressed, I was most likely looking at a placenta previa situation, which was both hopeful, as many of the stories I read had a positive outcome with bed rest,  and terrifying, in that I had NO idea how I would manage a 2 year old and a 4 year old on bed rest and many of the stories did not have a positive outcome.

Eventually, the nature made the decision for me.  At one of my routine weekly ultrasounds, we saw that there was no longer a heartbeat.  Ironically, earlier that week, I had a sharp pain in my abdomen and the bleeding stopped almost immediately.  The ultrasound tech noted that it looked like the heart had stopped several days before, as the measurements, which had always been right on for the gestational age, were a few days off.  I, again, was given a decision,  to  either proceed with a D & C or wait and see if I would miscarry on my own.  Given that I was only about 8 weeks along at this point, and I wanted to avoid another surgery, I decided to wait it out.

I could write an entire post on the significance of the decisions we make and how we will forever wonder if we made the right one.  I sickened myself over the decision to terminate this pregnancy with methotrexate.  In the end, I just couldn't do it.  Especially since there was a heartbeat, the pregnancy had not been formally diagnosed as a cervical ectopic, and at least one medical professional was giving me hope for  successful outcome.  Like I mentioned above, nature (or God, I guess, depending on how you look at it) ended up making that decision for me.  As sad as I was to no longer see that little flicker of life on the screen, I was and am eternally grateful that I was not the one who made the decision to snuff it out. 

Two days later, on a Saturday right before Halloween when DH happened to be working, I lifted M, who was two at the time, into his car seat and I felt a tug then a gush.  I looked down and blood had saturated my pants and was running down my leg.  Since I knew what was happening, I called my DH, who could not leave work at that time, but would be home as soon as he could, and my MIL,  who unbeknownst to me happened to be out of town on a shopping trip.  My  20ish BIL, who had no children of his own, ended up driving 30 minutes to pick up the kids and watch them for the day.  Since I was determined to miscarry on my own, without surgical intervention, I stationed myself in the bathroom and waited.

This was a BAD move.  It was a bloody mess.  My OB, who just happened to be on call that weekend encouraged me to call him if it got to be too much to handle but to otherwise come in on Monday morning.   I was bleeding and cramping a lot, and I kept watching to see if I was going to pass the products of conception, as my OB called it.  It concerned me that after spending literally all day on the toilet, I still hadn't passed anything that looked like an 8 week pregnancy, although I realized there wouldn't be much to see.  I called the OB again and he mentioned that it may have passed unnoticed inside a clot.  I foolishly believed him, and when the bleeding slowed down later that night, I assumed the worst was over.  Once again, I was dead wrong.

To be completed . . .

Friday, November 12, 2010

Running away from infertility

I wanted to post something quickly while I was working on second part of my pregnancy loss story.  When we were in the midst of infertility treatments, I did a lot of stress eating.  My weight fluctuated quite a bit as a result.  In fact, after my loss and during my subsequent pregnancy, my weight reached an all time high; I still can't believe I let it get that out of control.  I have been slowly losing weight after the birth of my last child (who I will refer to as B from now on).  Since her birth 15 months ago, I have lost about 45 pounds (and I only gained about 25 during my pregnancy), but I am still about 25 pounds away from where I would like to be. The only way I have ever been able to lose weight is by running and cutting back on my eating.  When I'm angry, running is a huge stress relief.  I'm sure it has something to do with natural endorphins and a runner's high, but the truth is, I haven't found any other exercise that is as effective as running.  I think I enjoyed it so much because it didn't require much thought (like other more complicated aerobic exercises), and I could completely lose my self in the repetitiveness.  My mind could wander, and in a sense, I was literally running away from my problems.  The problem is that now I can't seem to find the time, the motivation, or the energy to run.  And I'm still breastfeeding, so that ties me down a bit.   So I'm curious, how do you best manage stress and keep yourself healthy?  

Wednesday, November 10, 2010

It's that time of the year again . . .

First of all, I'd like to thank every one of you who stopped by and left a kind welcome.  It makes me wish I had started blogging long ago.  I am so excited to share in a forum where everyone "gets it", that I hardly know where to begin.  I feel like I'm going to be jumping around a lot in my storytelling.  Please bear with me.  This will be Part 1 in probably the most tragic chapter of my infertility history, although chronologically, this occurred somewhere in the middle of the book, so to speak.  Because my pregnancy loss and recovery occurred in the fall, the months of October, November and even December will always remind me of that time.  I know from reading my share of loss blogs, that many of you feel the same way.  In the past three years, I haven't been able to make it through this season without remembering, experiencing life through both my memory and reality simultaneously.

As we begin the holiday season, I remember how difficult this time was for my husband and I before we had children. But as a child and young adult, until infertility and loss muddled my perception, I loved the time between Halloween and Christmas.  It was easy to get caught up in the wonder and excitement,  the anticipation. The year we received our diagnosis, DH was a graduate student, and we were living too far from our families to make a trip home.  I was a teacher, off for Christmas break, and I gladly took a seasonal job wrapping Christmas gifts at a local department store to pass the time.  We decided to splurge on Christmas Eve, and we got a room at a fairly prestigious golf resort close to where we were living. It was cold and snowing lightly as we arrived, very unusual weather for the region.  I vividly remember how empty the lobby was that evening,  how our voices echoed,  how lonely it was.  We ended up going back to our room to order dinner and my husband commented on how quickly we received our meals.  I wondered how many other guests were staying at that hotel on that night, and what their stories were.  Was there anyone else out there alone on Christmas Eve, as miserable as I was?

Over the next few years, Christmas became a time of rejoicing again, as we brought not one, but two precious miracles into the world.  Twice I was able to celebrate the birth of Jesus, while I, too, was heavy with child.  For a while, I felt like I could experience that childlike wonder again; I almost felt . . .  normal  . . .  fertile . . . .

In the fall of 2007, when my older children (who I will from now on refer to as F and M) were 4 and 2,  I found myself in an unusual situation.  I was actually content with life.  I had taken up running, participated in my first 5K, and lost all of the infertility and baby weight.  My life was busy as a SAHM, but fulfilling.  We hadn't used birth control after M  was born, but with our history, I just didn't see it happening.  Besides, I truly felt blessed to be the mother of two.  As September turned into October, I got the shock of my life.  When we found out I was pregnant again, we were overjoyed.  We immediately told the children (and everyone around us), because our problems were getting pregnant, not staying pregnant, right?  I hadn't had any complications with the other two until delivery.  I was young, I was fit, and I really thought we had crossed our biggest hurdle by seeing two lines on the pregnancy test.  How truly naive I was.

Everything was fine for a while, until I started spotting.  My OB, who I had complete faith in, assured me that some spotting was normal.  My HCG continued to double, even quadruple and my progesterone looked good.  I tried to convince myself that everything would be alright, but I knew right away something was terribly wrong.  In addition to the spotting, I had pain and more cramping then I remembered with my other pregnancies.  When my OB wouldn't get me in for an ultrasound, I called up my RE.  He got me in that day, and that day quickly turned into one of the worst days in my life.

As it turned out, did have a viable pregnancy with a heartbeat.  The spotting was because of where it was implanted.  I tried to read my RE's face as he did the scan.  It seemed to take a long time for him to find anything, and I started to panic.  With my history of tubal infertility, I was at higher risk for a tubal ectopic pregnancy, so this was my immediate first thought.  When he located the baby, he was quiet for a while and mumbled, "Well, it's not in the tube."  With sadness and compassion, he explained that he was fairly certain we were dealing with a cervical ectopic pregnancy, a very rare condition.  In fact, only 2% of ectopics occur outside of the fallopian tube.  In the past, cervical ectopic pregnancy was associated with significant hemorrhage and was treated with hysterectomy.  My RE (who I have a good relationship despite his directness) commented , "Cervical ectopics will bleed like hell."   He also shared that in his 20 or so years of practice, I was the first he had ever seen.

Today, because of earlier detection with ultrasound, there are fertility-preserving treatments available. A common conservative method of treatment is methrotrexate.  DH and I left the office in a daze, wondering how we were supposed to fill the next three hours while we  waited for the hospital ultrasound.  On my way out the door, I grabbed a handful of pads and shoved them into my purse.  I felt as if I carried a ticking time bomb inside of me . . . wondering when and where it was going to detonate.

To be continued . . . .


Friday, November 05, 2010

In or out?

Until making the decision to move forward with this blog, I had been very private about my fertility struggles.  From the outside looking in, we are just your average family of five.  Especially now, since our journey is over.  Back in the days when I was still in the trenches, though, I felt a strong need to conceal the truth.  I just couldn't deal with a daily barrage of questions regarding the state of our fertility.   Maybe I was ashamed, fueled by my desire to appear normal to the fertile world around me; maybe it was my fear of being pitied (or any number of other factors), but I was very selective about who had knowledge of my infertility issues.  I still feel this way to an extent.  However, I am happy to discuss my experiences if I feel it will help someone and they show a genuine interest in my story.  So I'm curious blogging world,  in a real world scenario, are you open with your infertility struggles or do you hide it?  Are you in, or are you out?

Thursday, November 04, 2010

How did I get here?

With this post, I finally enter the online world of infertility bloggers.  I've spent the last 4 years or so lurking on your blogs, too timid to share my thoughts, but to conflicted to turn away.  Now that it is certain that my baby making days have come to a close, I am compelled to offer up my voice.  I have closure on my infertility and pregnancy loss, but I still have plenty to say about it.

So how did I get here?  My husband and I have spent the last 10 years dealing with the wide spread effects of infertility and pregnancy loss.  Since 2001, we have been subject to nearly every diagnostic infertility test our team of RE's had to offer.  Our official diagnosis was male factor and tubal infertility.  I have undergone 3 HSG's, 2 laparoscopies (one which removed my left fallopian tube and due to a hydrosalpinx), 2 hysteroscopies, and a D & C that almost resulted in an emergency hysterectomy because of excessive bleeding.  We've also tried numerous medicated and unmedicated IUI's, with the next step being IVF, that, thankfully, was not needed.

We've celebrated 4 joyous pregnancies, two that were complicated by a defective C-section scar, one  which, sadly, resulted in a possible cervical ectopic pregnancy and a very bloody, traumatic miscarriage  Add three C-sections (one of them performed in an emergency situation due a decrease in fetal heart rate and one performed almost a month early because of a high risk of uterine rupture) to the mix, and I feel it is safe to say that nothing about my reproductive history has been normal.

Three beautiful, healthy babies later, DH and I are certain that we are finished.  I feel old and broken, but I also feel triumphant.  We have fought the good fight, finished the marathon, and we are ready to settle back into some semblance of normalcy with our family.  But as many of you who have walked in my shoes know, it's just not that easy.  We are forever changed.  With that said, this will not be your typical mommy blog.  I'm ready to share my stories not only as a form of therapy, but also to use some of my experiences to help and encourage you, in the same way that you encouraged me when I was suffering through the nightmare that is infertility and pregnancy loss.  Please stop by, and leave a comment.  I look forward to getting to know you better.