Friday, February 13, 2015

Headed in the right direction with beta and perspective

I've never been so relieved to see a dropping beta (as of yesterday, HCG = 237.3, progesterone = 11.12). Ultrasound for ectopic was negative, as expected. In my mind this has been over since Monday's results came in. Glad my body seems to be getting the picture too. Lingering in this semi-pregnant but not heading anywhere good state is not recommended. I just want this limbo situation to be over with.

In your experience, at what point does an actual miscarriage commence? Is it when the progesterone drops low enough, and at what level does that tend to be?

I am sad, but knowing I will miscarry while simultaneously having Ms. Magpie here in my life is a qualitatively different experience. I would love to have a sibling for Magpie, but I am thrilled with her presence in our lives. She changes the experience of this miscarriage so deeply for me. So this feels hard, but it is not the profoundly hopeless, filled-with-fear-that-I-will-never-get-out-the-other-side sadness I have experienced with all of the other losses. I am sad, but definitely still intact.

Magpie, on the other hand, is magnificent. I am even more grateful for her presence in our lives than usual, and she feels ever more a miracle.

On the day I went in for the induction before Magpie's birth, I quoted Carole Maso (with thanks to Gwinne): "I dream of the one yet to be born. The one still curled in my womb. The one who will open like a star." 

And Magpie has opened like a star - she has unfurled into our lives in all her glory, a shining, living, breathing, amazing girl, one who came so close to never existing. I still can't quite believe it.

Now, as if on cue, she is calling from her crib: "Mommy?".... "Mommy?".... "Mommy?" And so I will go to her for some morning cuddles in the rocking chair, warm milk in her sippy cup to hand her for this cold, cold morning.

Mo


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Thursday, February 12, 2015

Groundhog day: The HPT version - edited

Another day, another pee stick. They test lines look remarkably the same across days, don't they? Not a good thing at all to not see the lines darkening. And yet, the lines don't really look significantly lighter to me either. Sigh.

Still waiting to hear from the OB, which seems rather unbelievable. I put a call in this morning asking for where to go from here, so hopefully I'll get a response later today.

Mo




********************************
I heard from the OB's nurse and they want me to get an ultrasound today to rule out an ectopic. Plus repeat the beta so we can get results before the long weekend. Both seem like reasonable next steps.


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Wednesday, February 11, 2015

The sadness of waiting for the inevitable


I'm still technically pregnant. Walking around in bit of a sad haze. I think the reality has mostly sunk in, although my body hasn't gotten the message. No bleeding, still slightly queasy with sore boobs. Pee stick still darkening but not in any dramatically different, hope-inspiring way.

I'm frustrated to say that I'm still waiting on my OB's office to call and discuss the findings with me. Thank God I have other avenues to access my blood test results, because can you imagine the state I'd be in if I were still waiting two days later to hear the numbers from the test drawn Monday morning?! And having no idea it is bad news, thinking that no news must mean all is well? It's Wednesday, people!

I'm not in the mood to go chase them down to hear the bad news, and I've been on this merry-go-round ride enough times previously to know that even if there were some infinitesimal chance of a turn around, there's nothing else I can do to try to make it happen. I'm taking my prenatal, I'm taking extra folic acid, I'm on lovenox (still, begrudgingly), I'm taking prednisone, I even plunked down major cash for the IVIG. The outcome is completely out of my hands.

I'm guessing that when the OB's office gets around to calling, I will be told to come in for another beta draw to receive the final nail in this pregnancy coffin.

I'm trying to view this whole surprise pregnancy as a gift as well as a "warm up" to our next FET, but at this moment I just feel tired and worn out and sad.

Thanks for waiting with me. Reading your thoughts and supportive words helps.

Mo



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Monday, February 9, 2015

Pregnancy #8: Beta #3

Results are back and are decidedly not good.

Beta HCG = 264.0
Progesterone down to 20.71.

I haven't heard my OB's take on this yet (obtained results elsewhere), but I can't imagine there's any hope with a rise like this and drop in progesterone.

Oh well. Looks like it wasn't meant to be. I am more sad than I thought I would be to hear this news.

Mo

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Early pregnancy land and waiting for beta #3

Pregnancy is so so different this time around. I have my beautiful take home girl already. I never thought we'd get out the other side to her. And she is incredible, intense, full of life and personality. We were cuddling this weekend all together in mama and daddy's bed and I was just relishing her little nose brushing against my cheek, getting to gaze into her eyes that are smiling right back into mine. My little girl and I have a bit of a love affair going on. I would love to give Magpie a sibling, but this little embryo is fairly abstract and she is so very real, so my thoughts tend to revolve around her and her needs...how my reticence to heft her 25 pound body around while in these early pregnancy stages is frustrating to her.... How I'm tired already, seemingly only minutes into the pregnancy, making me a less good mom.

This weekend, I was very crampy in a way that felt menstrual and unsettling. No spotting, thankfully. I started to feel really scared until I looked back and saw that I had experienced similar sensations around the same time in my pregnancy with Magpie (that I subtly described as feeling like I was carrying Rosemary's Baby). So that was a bit reassuring. Then last night, the cramping subsided entirely, and instead of being relieved, I freaked out about that too. This is the awfulness of early pregnancy. There is just a lot of not knowing you have to tolerate. Not exactly my strong suit. Now I'm feeling little twinges and pulls and burbles, which are easier to interpret in a positive way, although I know better than most that these early symptoms could mean anything. The embryo is growing! The embryo is dying! Sigh.

So as of late this morning, blood has been drawn for beta #3. Unfortunately, I feel certain that nothing the results can tell me will comfort me. The options are: (1) unambiguously bad news - e.g., dropping beta; or (2) unclear - beta is doubling or almost doubling. We had great doubling numbers with pregnancy number 5 (the triploidy), so while great doubling numbers are certainly better than non-doubling numbers, I'm thinking this time that feeling more certain will come much, much further down the road. This morning, I kept thinking, What will another number really tell me? Not much. Along with, This whole pregnancy is just such a gift! A bonus, however long it lasts, that I considered just not going for another beta and instead waiting a couple of weeks to do an ultrasound to see if there's a heartbeat.

But I went. And now I wait. We will see what we shall see. Thanks so much for your support and thoughts. They really help.

Mo

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Sunday, February 8, 2015

Dotting my I's and crossing my T's


Still here.

Still about a minute pregnant, last I checked. Future very uncertain, but of course this uncertainty is a lovely unexpected development that I'll take any day.

Trying to keep my feet in reality (that this probably won't work out) while simultaneously allowing some hope and making sure to do my part to improve my chances in any way I can.

Due diligence steps included going back Friday to see Dr. Miscarriage Wizard. He was much less difficult than I recalled, thankfully, much less crowing from the rooftops trying to sell his position. It seemed that he's accepted that despite my skepticism, I've drunk the Koolaid enough to decide to engage in this reproductive immunology stuff. And I guess I've accepted that he's a bit of an eccentric. But for whatever reasons, it was a much easier appointment than some of my previous ones, from a relational standpoint.

As he read over my chart, he said "Wow, you have a number of immunological issues, all across the board, don't you?" Um, ok.... So he drew a bunch more blood work, in addition to all that had been drawn on Friday. There's some other test (something to do with T regulatory cells, I think, but not sure) that has to be shipped to California, so I have to come back for that. So we'll see how all of this comes back. Not that I care so much, because my leaning is to just do what we know worked before. Although, hey, if everything has normalized out of the smorgasbord of things he looks at, that would be nice, too (hard to imagine - you run that many tests, something's bound to turn up, no?)

The day before, when I had talked to his nurse, she let me know he had an extra dosage of IVIG in the office and space to accommodate me. She said maybe he'd let me do an initial IVIG treatment without the results (with Magpie's pregnancy, I started IVIG even before the transfer to help with implantation, so I was worried I was already a bit late to the game in this case). "Bring all of your fluids and start hydrating right now. I think we can convince him," she said to me. So I did.

I went to my hospital lab first thing in the AM with a prescription from Will to get another beta and progesterone drawn STAT, hopeful I could get the results in time to be able to make a decision about IVIG that day. I did not want to shell out the IVIG money if the beta was already dropping. On the other hand, if there seemed to be some hope, how could I not do what we can to try to give this little embryo a chance?

So we got the beta back, and as you know, it almost but not quite doubled. Good enough for me. The Wizard though, was more cautious, "Are you sure you want to do the IVIG? The number didn't quite double." I did want to. And we did. So that was how I spent four hours of my Friday afternoon. It went fine, with no major side effects.

Regret management, what an expensive and time-consuming endeavor!

But the more important bottom line - I am still pregnant, as far as I know.

I took the outrageous step of buying a prenatal vitamin today to replace my regular multivitamin. I asked the young store clerk at Whole Foods where the prenatals were and she showed me. She then asked, "Are you expecting?" And I said, "I might be. It's very early." She looked confused. You and me both, sales clerk! So hard to fathom.

I will get another beta drawn tomorrow from the OB. And we'll see where that leaves us.

One step at a time. It is all just crazy. Crazy good. But crazy.

Mo



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Friday, February 6, 2015

Beta #2

Beta HCG # 2 was drawn this morning and came back at 198.1, so an 86.9% increase, doubling time of 53.2 hours or 2.2 days.

Not sure what to make of it, as it's not a 48 hour doubling time... but maybe it's close enough? Anyone have any positive outcomes out there from a doubling time like this early on?

Progesterone looks great at 30.2. No supplementation; my body is doing that all on it's own.

So it's not bad news....but perhaps it's not exactly good either.

I welcome any thoughts or experience with this.

Mo



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Thursday, February 5, 2015

Pregnancy #8: The backstory



So how did this happen?

Chalk it up to a relaxing vacation in Central America and the timing being "rightish." I was not testing for ovulation. In general, we try every month at approximately the right time, but I don't go to any great lengths to test and track my cycles or ovulation. I tend to think that the fertility ship has sailed for us, although I have kept a corner of my mind open...my cycles are still 28ish days apart, I generally feel the pinch of ovulation, and, hey, you never know, right?


How far along am I?

I'm not exactly sure. I thought my period was probably due on Sunday. When it didn't come, I tested Monday morning and got a negative on an HPT. Despite feeling "pregnant," strange tugging and cramping, corpus luteum pain, notable breast tenderness, dizziness, I told myself that I wasn't pregnant. Every time I noticed some other twinge and had the thought that I know my body, and my body was telling me it was pregnant, I told myself, Well, you obviously don't know it as well as you think you do, because you tested negative. When my period still hadn't arrived by Wednesday, I tested again, thinking I'd get a negative and need to go to the doctor to figure out what it meant to have no period and not be pregnant...but well, the hpt was positive. So I'm guessing the timing of Wednesday's beta fell somewhere between 15 dpo and 17dpo. So getting back an HCG of 106 is low. But maybe not terribly low, according to betabase.info. Hard to tell in natural pregnancy land. The doubling will be the bigger factor.


Where are we at now?

We are cautiously excited. But I tend to think of my uterus as a place where good embryos go to die. Plus, I'm 43, so my population-based chance of a chromosomal issue in any given pregnancy is 1 in 33. I've had a lot of chromosomal losses anyway, even when I was younger. So there's a significant chance this may not be a chromosomally normal embryo. But then again, it could be. Two years ago, we had Magpie, but that was with pre-testing, and then a whole cocktail of things going on from prior to transfer through to delivery, including IVIG, lovenox, prednisone, etc.

When I talked to my OB this morning, she poo pooed me requesting lovenox (I knew enough to not even suggest the other medications). So I called the Miscarriage Wizard reproductive immunologist guy I saw when I was carrying Magpie. I really don't like this guy very much, don't totally trust him. But I thought he'd agree that at least while we are trying to get an implantation going, we probably need some help. We have a history of six losses. One of them a documented chromosomally normal male. Until we get out of the starting gate, I feel I'd be stupid not to try to replicate what worked to get Magpie to term, despite all of my misgivings about the lack of evidence, unclear mechanisms of action, etc. But Dr. Miscarriage Wizard also poo pooed me on the phone. "Oh, these immune things often improve after a successful pregnancy! Let's do some blood work first!" (Um...it will take over a week to get natural killer cell results back...and the baby will be dead by then probably, but ok...). He did agree to prescribe some prednisone, so I started that last night.

Amazingly, Will is similarly minded to me in thinking if we do nothing, the embryo is doomed (He also agrees might not be a good embryo anyway, but also that you never know...). As of last night, I'm taking baby aspirin, pepcid, claritin, extra folic acid, and fish oil, plus the just prescribed prednisone, which were all recommended by the Denver clinic and others as part of a benign cocktail that they use with recurrent miscarriers.

In addition to the beta blood draw tomorrow, I'm having immune bloods drawn this afternoon for the Miscarriage Wizard, and I'll be seeing him tomorrow in his office. Perhaps he will suggest a single IVIG treatment or decide to add lovenox once he sees me and I remind him of the string of losses. I hate the way IVIG makes me feel. And it's really expensive. The lovenox is merely annoying. On the other hand, there is also the reality that I have a beautiful little girl dancing in my living room. Would she be here without the IVIG and lovenox? I don't know. It seems like maybe a "better safe than sorry" situation.

I'm cautiously excited. And, yes, I'm also somewhat anxious. But I think I'll feel a whole lot better if I believe we're doing what we can to give this situation a chance to succeed.

OK, let's be honest, I'll feel a whole lot better 9 months from now if there's a second baby in my arms.

I'm not the cliche, urban legend yet, right? Oh, God, maybe I am.

Mo

PS - someone mentioned thinking of my sister on a prior post. She is pregnant again right now too! She's about 8 weeks along, with heartbeat and measuring on track, and also cautiously optimistic. I am very, very hopeful for her.

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HCG results for pregnancy #8

I have a lot to say and no time at the moment...but I don't want to leave you guys hanging any longer.

My OB called this morning (I love her!) and spoke to me before I left for work.

HCG level yesterday was 106.5, so a tad low, but I like that it's three digits, instead of two. I'd call it decent, and hey, you've got to start somewhere. I didn't expect it to be too high because I tested on Monday morning with a First Response Early Result (FRER) pee stick and got a negative.

Progesterone looked great at 28.08. So that's a relief.

Going back in for a second beta tomorrow to see what is going on with the doubling situation, which is what really matters.

I diligently peed on a FRER this morning...looks basically the same to me as yesterday's (or even a bit lighter, what do you think?). Unfortunately, not seeing a big change in the right direction did not reassure me. I realize the pee sticks do not constitute a quantitative analysis, but I couldn't help myself. Shouldn't it be clear to me by now that mostly the pee sticks just make me more scared? Some people never learn.



Bottom line, as of now, I am a very little bit pregnant. Who ever thought I'd be having this experience?!

Hanging on for the ride!

Mo

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Wednesday, February 4, 2015

You will NOT believe this




This is from this morning:

Can you see it too? There's a second line there, right?

After seven IVFs to get to Magpie and then after trying monthly since Magpie was
8 weeks old with no results, could this be true?

I mean seriously...I was last "naturally" pregnant in 2009. This is SIX years later. At age 43, I am reproductively ancient, and it's not like I was exactly Ms. Fertile when I was younger.

I went unannounced to the OB's office this morning and begged for an HCG and progesterone level.

I'm just... color me completely stunned.

Mo




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