Does My Loss Count?

I’ve been thinking about this a lot lately. I’m not sure what I want to say about it, but I feel like I have some kinks to work out in my head.

The question that’s been on my mind: Was the loss of Baby B not a real loss?

It doesn’t seem to count as a loss in the medical community. When I first met with the maternal fetal medicine doctor, he told me that I technically don’t have enough losses for him to officially say I have antiphospholipid antibody syndrome. “You need three early losses to qualify,” he said. I didn’t say anything at the time because I suck at saying things in the moment, but now I wish I would have asked him, “What about this baby’s twin? Why doesn’t that count as a loss to you? Is it because I had no bleeding? No D & C? Is it because half of the pregnancy continued to grow?”

It doesn’t seem to count in the general population either (present company excluded, of course). I’ve mentioned to several friends recently that this pregnancy started out as twins, but one didn’t make it. And you know what? Not one person said they were sorry to hear that. There was no acknowledgement whatsoever. Doesn’t that seem kind of…odd? On the one hand, I completely get it. I have a healthy pregnancy, which is freaking amazing, and I’m sure these friends just wanted to focus on that. I understand, I really do. Their responses, or lack thereof, made me feel weird, though.

And sometimes, the loss doesn’t even seem to count in my own head. For instance, I haven’t named Baby B yet. I named Anna and Gabriel right away, but Baby B remains without a moniker. I suspect this is in part because Baby B is inextricably connected to Baby A, and it doesn’t feel quite right to name B before the birth of A.

But still, I wonder about my lack of interest in choosing a name.

I’ve also spent far less time thinking about this loss than my last two losses. Practically speaking, I think it needs to be that way, at least for now. I have a little girl growing inside of me that requires my love, care and hope, and it doesn’t feel right to focus my energy on the pregnancy’s darker beginnings.

But still, I wonder, am I a bad mother for not grieving for Baby B more?

I feel confused about all of this. Because when it comes down to it, Baby B was alive. He or she had a beating heart. He or she was loved. And most importantly, I truly believe he or she helped her sister to grow and thrive.

And that, in my heart at least, counts for a lot.

28 Weeks And We Are Still Ok

I’m 28 weeks. Which means I’m in the third trimester. Say what? For some reason it really hit me today that, holy crap, I’m in the third trimester. And then I started crying. Because how did that happen? How did I get this far? I’ve said this every step of the way, but I never thought I’d be here. It’s truly humbling. Currently, the baby is kicking my bladder and I’ve never been so happy to have to pee every five seconds in my entire life!

I’m not going to lie and say my head is screwed on straight and I’m the very picture of calm. I’m still scared, I’m still anxious, but both baby and I are doing ok. We had a 3D ultrasound last Saturday and we saw the little nugget yawning and smiling and sticking her fingers in front of her face. I won’t post any pictures here because I don’t want them to upset anyone who’s having a bad day in Infertility Land. But if you actually want to see alien baby shots of the inside of my uterus, send me an email at theskyandbackblog@gmail.com and I’ll pass some along.

On Monday we had a growth scan and the doctor told us that baby was growing on target. Then on Wednesday I found out that I don’t have gestational diabetes! I was certain I would have it because prednisone raises your risk, but I passed the test with flying colors. In my pregnancy with Lettie I was borderline, so I had to watch my sugar. This time, though, it’s Coke Classic and Sour Patch Kids and gluten free Oreos all the way! Actually, I probably should watch my sugar anyway because I’m still gaining weight like an ox, but….nah. Maybe tomorrow.

So I’m hoping that even though this pregnancy started out in a dramatic fashion, the last third will go smoothly. Please, please, pleeeease.

I don’t have much else to report. Tim is painting the nursery today, which freaks me out, but like we need to do it at some point. We’re going with mint green. I always laugh as I write these update posts because they are so blah. Like you guys care that we’re painting our walls mint green!

I took this week off and we’ve been doing things around the house (today guys are here jack-hammering our basement). But we did take one overnight trip to the Pocono Mountains to visit Great Wolf Lodge. This is basically a hotel with a giant water park inside of it. It was completely insane (think Lord of the Flies), but fun, and most importantly Lettie had a blast. She said it was “a million fun.” I’ll leave you with a few pictures from our trip.

Happy Friday! Love you guys!

The Things She Carried

[inspired by Tim O’Brien’s novel, The Things They Carried]

She carried 758 needles, 170 suppositories of the vaginal variety, and hundreds of blood draws—she was told she had good veins, like that was some kind of prize to win. She was weirdly proud of her awesome veins, because in this game of carrying and dropping, losing and winning, there’s not much else to be proud of.

She carried 63 ultrasounds, some of them a routine check for follicles, some looking in vain for beating hearts, some checking to make sure “the products of conception” no longer existed inside of her.

She carried names of drugs she could barely pronounce—Menopur, Follistim, Ovidrel, Ganirelix, Intralipids, Lovenox, Prednisone.

She carried four IUIs, three IVFs, 66 follicles, 33 eggs and 20 embryos. Some of these embryos were placed back inside of her, and some never grew beyond a handful of cells. All were loved.

She carried lesions on her ovaries, cervix, uterus and bladder. She carried a blood clotting disorder called antiphospholipid antibody syndrome. She carried overactive natural killer cells, which weren’t really killing much except teeny-tiny embryos too little to fight for themselves.

She carried one laparoscopy attempt. One actual laparoscopy. Three egg retrievals. Two transfers. Two D & Cs.

She carried 1,938 miles of travel—from the house to the fertility clinic; from the clinic to work; from Philadelphia to Manhattan for surgery; from Philadelphia to Woodbury to visit what she hoped would be a miracle doctor; from Philadelphia to Woodstock to spend the day with a fertility visionary. She carried $726 in parking garage fees, and even one parking garage accident.

She carried Please Gods and plea bargains. She carried what-ifs and what-will-I-do-nows.

She carried special diets—no gluten, no dairy, no sugar, no air.

She carried the love of a good man, but she carried it clumsily and sometimes carelessly. She lashed out. She yelled. “Why can’t you carry any of this for me?” she wanted to know. There was no good answer to that question—he knew it and she knew it, and at the end of the day she was lucky to still be holding his heart.

She carried the memory of lost babies—three at last count. First was Gabriel. She lost him on the bathroom floor at work, and by the time she got to the hospital she was so bloody it looked like she was starring in a Carrie remake. Then there was Anna, who was confirmed genetically normal and therefore should have lived, but didn’t. Anna, who said au revoir to the world on Christmas day, but who would never open a single present. Finally, there was Baby B, a loss too new to even get a name.

She carried a persistence that even she admitted was insane. She carried advice from relatives, friends, acquaintances, the checkout lady at Target, wondering why she was doing this to herself, why she didn’t just give up. Stop this nonsense. Be happy for what you have. Halt. Cease and desist before you ruin yourself, your job, your marriage. And she did want to stop, she did. But she needed to try one last time. One more needle, one more blood draw, one more doctor. One more.

And now.

Now she carries a baby inside of her, a little girl, no bigger than a winter squash. She feels her kicks, taps and nudges, and they feel like hope. She still carries the what-ifs—so many what-ifs—but now she carries something else as well—trust. Trust that this is the soul she is meant to meet. She sings to her baby every night, hands on her belly, heart wide open as a summer sky: ‘twas grace that brought you safe thus far, and grace will lead you home.

It’s A…

My heart is bursting right now. As they say, a picture is worth a thousand words, so I’ll let them do the talking…

Today We Celebrate

Today I am 20 weeks pregnant. Halfway home.

Boy, that time sure didn’t fly.

Needless to say, I’m happy to be here, waving goodbye to the first half of my pregnancy.

Yesterday I had my much-dreaded anatomy scan. I had tears in my eyes on the way up the elevator. In the waiting room, I felt sick to my stomach.

But you know what?

Once I finally got in and got scanned, that baby looked perfect. Absolutely perfect. He or she was quite cooperative, too — turning just so for its measurements and letting the tech get a good look between its legs. The tech wrote down the gender and sealed it in an envelope. We’ll find out with our friends on Sunday if we’re having a boy or a girl. I will, of course, let you guys know.

The tech didn’t give us much during the ultrasound, but the doctor came in afterwards and told us everything looked good. I asked him about downs and trisomy 13 and 18. He said the scan doesn’t always detect downs (about 50% of the time), but that it almost always detects trisomy 13 and 18. “These things are not subtle,” he said. So we are hopefully in the clear from the big, bad guys at least.

At the end of that conversation the doctor looked at me and said, “That kid is fine. I don’t want you to worry about this. I want you to go home and have a healthy pregnancy.”

You can’t get much more reassurance than a high risk OB telling you your kid is fine.

I asked the doctor about non-stress tests because my regular OB mentioned that I might need them later on in the pregnancy. He said I didn’t technically need them, but it seemed a little strange to him to have me so closely monitored in the first half of the pregnancy and then nothing in the second. Then he said, “Non-stress tests are also good for our anxious patients. They put their minds at ease.”

Boom. Nail on the head, buddy.

I told him that I definitely qualified as an anxious patient, so we agreed that I would come back at 32 weeks for a growth scan and my first non-stress test. He also told me that he was totally fine with me coming in for a scan before then, too, if I felt anxious and wanted reassurance. How cool is that?

Later that night, we told Lettie she was going to be a big sister. She was completely underwhelmed. I pretty much expected that. She’s jazzed about the gender reveal party this weekend, though. Girlfriend loves her a good party.

And that’s about all I got. I just wanted to share the good news. Of course, scary things could still happen and my anxiety is not going away any time soon, but I might let it hibernate a little. For five minutes at least.

Because it finally — finally — feels like it’s time to celebrate.

Huzzah!

18 Weeks & Everything’s Still OK

Hi, friends. First of all, thank you for your comments on my last post. They were all wonderful and heartfelt, and made me feel significantly less crazy town. I’m sorry I haven’t responded yet, but I will. I love you guys.

I don’t have a single profound thing to say today. I’m thinking this is going to be a semi-boring update, so get your yawn faces on. In a nutshell: baby and I are ok. As of today, I am 18 weeks and 2 days. I had an OB appointment on Wednesday and that kid was moving around so much that my doctor couldn’t lock down a heartbeat! All we could hear for a minute were these swishing sounds. I’m thinking that means there’s a hyperactive boy growing in there. Anyone else have any gender guesses? When the doc finally got the heartbeat locked it sounded nice and strong at 158 bpm.

Following that appointment, I went to my dentist and got two more root canals. I only have three non-root-canaled teeth left in my mouth now. Can you even believe that? I kind of can’t. I half-jokingly asked my dentist if I had the most root canals out of any patient he’s ever had and he said “yes.” The man has been practicing for 33 years. Dude. I don’t even know what to say about that, so I’ll just leave it right there. Anyway, the one root canal went smoothly. The other was bleeding so much he couldn’t finish it. The dentist said he suspects it’s cracked, which means the root canal might fail. Which means a tooth extraction. The last time I had a tooth extracted, it took two hours and the head of dental surgery had to call over his colleague to help. Apparently I have the longest roots this side of the Mississippi. I do not want to go through this ordeal while pregnant. It’s already stressful enough getting root canals while pregnant. I’m really bummed about all of this, but it’s beyond my control.

I’m not sure if I told you guys about this yet, but I got a call from Dr. Braverman a few weeks ago. My long-awaited test results came back and according to him my immune system was “acting up again.” He doubled my prednisone dose. Dr. B assured me that he wasn’t worried about miscarriage at this point, but rather complications later in pregnancy. This increased dose will supposedly help prevent that. I was supposed to stop my intralipids after the first trimester, but those are continuing on for now, too. For those of you who don’t know, prednisone is kind of evil. I really try not to complain about it because honestly I am just grateful that it’s helping me stay pregnant. However, it causes major insomnia. I lay awake from roughly 1 am to 5 am every night. Once in a while I’ll take a Unisom and that helps, but I don’t feel comfortable doing that every night. More or less, this lack of sleep makes me feel insane. In-f*cking-sane. Like totally bonkers. I prowl around the house at night like a freaking cat, scouring the fridge for midnight snacks. Speaking of snacks, another fun little side effect of the pred is that I’m huge. I’ve been gaining a pound a week and my face is like a mylar balloon. Again, I’m growing a human, so whatevs, but it’s a little freaky to see the scale jump so much every time I go to the OB. The good news is that Dr. B wants to wean me off the prednisone by 24 weeks, so there is a light at the end of the tunnel.

All of the above BS aside, I really am doing ok. I’m still nervous as hell about our anatomy scan in two weeks, but other than that, I’ve been managing the anxiety. Here’s a couple of things that have been helping:

*The gym! I haven’t gone to gym with any regularity in three years (you can thank fertility treatments for that). But now that I don’t have endless doctors appointments and the first-trimester nausea has subsided, I have a little more energy (even with the lack of sleep, boom). It feels awesome you guys. I only do a half hour on the eliptical machine like three or four times a week, but even that feels like such a treat.

*I’ve been taking some space from Blog Land. I’ve found that it’s for some reason easier to manage my anxiety if I just keep my head down and don’t write about it.

*Staying busy. If I’m constantly moving or doing something I don’t dwell as much on the what ifs. I’ve been doing a lot of baking, organizing and even (gasp!) folding laundry.

*Planning a staycation. Tim and I booked a hotel in the ‘burbs next weekend. Lettie will spend the night with her grandparents. We’re going to get a couples massage and eat in a chain restaurant and swim in the hotel pool. I’m gonna get me a bottle of non-alcoholic wine, pop a Unisom and get a full night’s sleep. Romance, people!

Speaking of sleep, if you’re not snoozing yet, you deserve an award. I mean, I know how riveting reading about me folding laundry must be. Anyway, that’s about all she wrote. I’m still scared every single day, but I’m doing fine.

 

 

The Ghosts Of Christmas Past

On paper, I’m all set up to have a Norman Rockwell Christmas. I’m a mother to a three year old who has stars in her eyes about the season. I’m approaching the 14^th week of what is, as far as I know, a healthy pregnancy. We have a tree with an angel on top and garland around our banister. Our house smells like cinnamon.

But then, underneath, there’s so much sadness.

Last Christmas, I woke up covered in blood. I left my daughter just after opening stockings to get an ultrasound. And at that ultrasound we found out our much-longed-for baby no longer had a heartbeat. It was one of the worst days of my life. I came home from the clinic and put on a good face. I didn’t want to ruin the magic for Lettie, my living child. We opened presents and I exclaimed in excitement over every little thing. I pushed all that grief aside, put it in a neat little box marked “Christmas,” and left it there. And sure, I did grieve some over the next few weeks and months, but my deepest, most secret sadness remained tucked away.

Here’s the thing about grief: it doesn’t like being ignored. It’s stubborn, and it comes out one way or another.

Two weeks ago, we went to the hardware store to pick out our Christmas tree. The same hardware store we went to last Christmas. As we were paying for everything, I found myself in the middle of a panic attack. Last year I was pregnant, just like this year. Last year I felt so much hope for the future, just like this year. It’s going to happen again, I thought, I’m going to lose this baby, too, just like last year.

And it’s not just the miscarriage that is making me melancholy. I miss my mom more than usual this time of year, too. I wish she were here now. I wish she were here last year. I wish she were here always.

Christmas is hard. Pregnancy after infertility and loss is hard. I keep waiting for someone to come along and say, “Just kidding, we’re taking this baby away from you, too! Sorryyyyy!”

There is always something to be fearful about. Last Friday, we met with a genetic counselor, and it’s official: we can’t do any non-invasive blood testing because the vanishing twin could jack up the results. So we’ll be going into our 20-week ultrasound blind. The genetic counselor warned us they might find “soft markers” for genetic disorders at this ultrasound. The markers are pretty common and often mean nothing, but sometimes they’re indicative of downs or trisomy 13 or 18 or whatever else awful thing they’re on the lookout for. I am now terrified of this scan, and it’s still six weeks away.

On Monday, I brought homemade cupcakes to work. I tied a tag around each that said, “Baby B, due June 2016.” I wanted to do something fun to announce my pregnancy. I wanted to give this baby the celebration he or she deserves. But after I carefully placed the cupcakes on my co-workers’ desks, I walked to the bathroom and cried. My pregnancy was out there now, and I couldn’t take it back. No matter what happened, I couldn’t take it back.

And the thing is, I feel guilty for feeling all of this. I’m finally pregnant after wishing for it for so long, and I can’t even embrace it? What is wrong with me? I have a beautiful daughter who is beyond excited for Christmas. Why can’t I be excited right along with her?

I’m having a tough time of it, you guys. I’m trying, I truly am, but some days the ghosts are really loud.

 

Graduation Day & Baby B

Friday was an amazing day. I “graduated” from my fertility specialist. That means, from now on, I am under the care of an OB, just like a regular pregnant lady. To say it was emotional is a big, fat understatement. The ultrasound tech gave us our final ultrasound and Baby A was looking good, right on track for 10 weeks, even moving his or her hand in a waving motion.

I haven’t mentioned our ultrasound tech yet, but she is wonderful. Not only technically good at her job, but extremely calming and caring. She never seemed rushed and always took the time to answer all of our questions thoroughly. And believe me, my science teacher husband had a ton of questions about not super-relevent things, like ultrasound views and such. After our scan, I thanked her profusely for being so good at her job. And then I started to cry. Not tearing up, but like actual shaking cries. Then Tim started crying, too. The tech gave me a big hug and said, “I’ve been doing this for a long time, I understand. That kid is growing so well. You’re doing great.” I’m pretty sure she even teared up a little, too.

Afterwards we met with our doctor and he officially released us from the practice. I didn’t cry again, but I did give him a bear hug and several “thank yous.”

Wow, you guys. Just wow. I really never thought I would see this day. Truly. I know we’re still not out of the woods yet, but this is a huge milestone. So for now, I’m putting the worries aside and I’m just going to bask in this glow, and give thanks to the Universe and those babies and my body for getting us this far. I can’t even write this without crying.

In sad news, at our 9 week ultrasound, Baby B no longer had a heartbeat. I haven’t updated you guys on this yet because I don’t really know what to say. I’m not sure how I feel, honestly. It’s a loss, for sure. But then there’s this miracle growing right next door. It’s just a weird situation. I do know, however, that I am extremely thankful to Baby B for coming here briefly and helping his brother or sister.. I will be grateful for the rest of my life.

Next up: final visit with Dr. Braverman tomorrow and first OB visit on Friday. Keep growing big and strong, Baby A. You’re doing great!

8 Week Ultrasound Update

Just a quick post to give you the deets on Friday’s ultrasound.

Baby A was looking good! measuring on track with a heart rate of 166. Yay, Baby A! We could see his or her arms, legs and even a tiny spine. It’s kind of amazing how much growth there was in just one week.

Baby B had not grown at all in a week, which means he or she is ultimately not going to make it. Strangely, there was still a faint heartbeat present. Needless to say, it was rough watching that little embryo trying to hang on, fighting a losing battle.

All in all, though. I’m ok about it. Yes, it is another impending loss, which is never easy. But I still have one healthy baby going strong and I am beyond grateful for that. Also, I was really nervous about a twin pregnancy and all the risks that go with it. I already have enough anxiety as it is without adding Twin Mania on top of it. So while I would’ve been thrilled with two healthy babies, part of me is also relieved to not have to worry about the additional risks that blessing would’ve brought.

My next ultrasound is on Friday again and I’m really nervous. I’ll be nine weeks. When I went on my ill-fated google fest a couple of weeks ago I read about a lot of people miscarrying at nine weeks, plus I know of some other bloggers who have miscarried at that time. So that week just feels ominous to me. Also still haunting me from my googling binge are the heart rate fears. Baby’s heart rates have been fine since 6 weeks, but I still feel sketched about it.

I’m still scared every single day, you guys. Grateful as hell, but terrified. There seem to be so many more hurdles left to get through. One of the biggest being, is this baby genetically normal?  I likely can’t do the non-invasive first trimester blood tests because there’s a chance the twin could throw off the result. And I refuse to do any invasive testing (amnio, CVS) — I’m not down with the risk of miscarriage that goes along with them. I don’t care how small it is. So we may not know until our 20 week scan (or longer) if the baby is genetically normal. I know this is how our moms did it, but it seems crazy to me. Oh, and we also need to make it to 20 weeks to even have that ultrasound to even find out about genetic anything. Hurdle 7,654. Need to get my track shorts on, stat.

Other than the physical symptoms like nausea, this pregnancy doesn’t feel quite real to me. Like, how could this actually be happening to me? How could I possibly be lucky enough to bring a baby home in 8 months? I’m trying to believe. I want so much to rise above the fear and just have confidence that this little miracle is here to stay. I want to be brave for him or her. But, crap, it’s really, really hard.

Dr. Braverman, Helper Embryos & Why I’m Never Googling Again

First of all, thank for all of the awesome comments on my last post. I’ve said it before and I’ll say it again: I sure do love you guys.

The morning of the Dr. Braverman appointment started off kind of disgustingly. I typically leave a banana by my bed and take bites throughout the night if I wake up feeling nauseous. That morning I woke up and realized the banana I had been eating was covered in ants. I ate ants, you guys. Probably lots of them. Gag.

After de-anting myself, we drove from Tim’s parents’ house to Dr. Braverman’s office. I fully expected to wait a long time, since I had read in reviews that the wait times were out of control. However, we were seen right away. Dr. B. came in wearing a pink polo shirt and got right to business. The ultrasound screen was tilted away from me, so I couldn’t see what he was looking at. He immediately said, “You have one viable pregnancy with a heartbeat and another sac.” The heart rate of baby A was 115 bpm. Doc B. said 90 – 110 was normal, so 115 was great. Then he let us listen to the heartbeat. It was freaking awesome. He said that Baby B could still develop a heartbeat because it had a fetal pole, and the sac looked normal and not collapsed. He gave it a “better than 50% chance” of seeing a heartbeat at our next ultrasound. He then looked at blood flow to my uterus and said that looked good as well. I was expecting to not be wowed by his personality. The one time we Skyped with him, he was short and not super personable. I don’t actually care at all if he’s personable because he knows his stuff, and that’s what matters. That said, I liked him a lot better after meeting him. He seemed gentler somehow. All in all, it was a great visit. If fingers-crossed-all-goes-well, I will see him again at 10 weeks. And oh yeah, he told me the burning I’m experiencing is “just pregnancy,” so that made me feel better..

All was well. And then I had to go and ruin it. On Tuesday, I had the brilliant idea to google “normal fetal heart rate 6 weeks 4 days.” Whhhhhy did I do that to myself? WHY?! I found lots of people whose babies had higher heart rates that 115. And then I found this terrifying study that said 110-119 bpm between 6.3 and 7 weeks was “borderline” and had a “slightly elevated risk of fetal demise.” Then I asked my OB friend and she gave me a range of normal, and 115 was at the bottom of the range. So then I was just a wreck. And completely pissed at myself for googling in the first place. I emailed Dr. B in a panic and he wrote back right away saying 115 is a very common heart rate in his practice for that stage in the pregnancy. After reading his kind email, I felt better, but not as much as I should have. Like, ok, one of the world’s leading miscarriage specialists said it was fine, so it’s probably fine. Still, I was ridiculously nervous for my next ultrasound on Friday.

Finally, after about six years, Friday arrived. I barely slept the night before. But all was well. Baby A’s heart rate had gone up to 132 bpm, solidly in the normal range. I can’t even tell you how relieved I was. And then I vowed never to google again.

Baby B now had a “flickering” of a heartbeat. A faint flickering is obviously not great for 7 weeks, though. The doctor gave the twin a 10 -15% chance of making it. I asked what the chances of it being genetically normal if he or she did make it, and the doctor immediately started talking about CVS and selective reduction. Whoa, whoa, whoaaaaaaa. Slow down there, buddy. I am NOT ready to think about any of that scary stuff. Eesh.

Anyway, we are still in limbo with baby B. My greatest wish at this point is that we have a clear resolution one way or the other soon. Our doctor said that in animal science you see a lot of “helper embryos,” These are basically embryos that exist for the sole purpose of assisting the stronger embryo, and when their job is done, they pass on. He suspects that Baby B is a helper embryo. This is a really sweet thought and makes me feel better about the whole thing.

I talk to both of my babies every day. I tell Baby A I am thankful he or she is growing big and strong. I tell Baby B that I love him or her no matter what happens. If he or she decides to keep growing and turns into a healthy baby, well then that is just amazing. And if he or she is just there to help out a sibling, then thank you from the bottom of my heart. And once he or she is done helping, it’s ok to go.

And that’s about all there is to tell at this point. Next ultrasound is Friday. I’ll let you know how it goes.