7w3d ultrasound: it's over

Went to the RE, who didn't like what he saw and sent us on to a radiologist who specializes in OB at the hospital.

Just to confirm.

Both saw debris in the gestational sac. No yolk sac. Small subchorionic hemorrhage. No fetal pole, let alone heartbeat. Not sure what to think of Monday's reassurance ultrasound.

But it's clear now.

Pregnancy #6 is over.

They are adding me to the OR schedule for today.

Will and I can't believe it. We thought this one might be the one that made it.

Walking between the two doctors' office buildings, I thought, Maybe I haven't woken up yet. Maybe this is a bad dream.

But it's not. It's happening again.

Mo

*****

Update: Surgery rescheduled for tomorrow. I forgot completely that I'm on lovenox and aspirin. My RE wants to wait 24 hours for the lovenox to get out of my system and will fit me in tomorrow afternoon for the procedure.

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Q: What does a beta of 12,691 look like on an HPT?

I know you've been wondering. Just what does a beta of 12,691 look like on a home pregnancy test?

It's a popular question. One that maybe has been nagging at you, just at the edges of your mind.

Well, wait in suspense no longer. Turns out, I can help you out here.

First of all, let me show you what it doesn't look like.

It doesn't look like our home pregnancy test on beta day. Which looked, well, like not a whole lot really (beta = 26.8).

Instead, a beta of 12,691 (31dp5dt) looks like this:

Yowza, no mistaking the line at this point. Although when I first saw the FRER test, I panicked for a milisecond because the one line was so faint. But then I realized that the test line had soaked up all the ink, leaving the control line looking woefully insufficient.

That's some line, though, isn't it?

It's probably getting really tiresome to see these POAS posts, but I guess I just remain incredulous that we are pregnant at all, let alone that we are still pregnant.

I wonder how long it will take to sink in?

Mo

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Reassurance is such a lovely thing

Will and I went in to the hospital (I ended up doing most of my day but trying to stay off my feet, no major walking and just taking things super slow). Will wrote scripts for me to get my progesterone, estrogen, and beta level checked, as well as platelets and anti-Xa factor (both of which can be impacted by the lovenox). It didn't look promising that we would be able to arrange an ultrasound on the down low, but around 2:30, Will was able to work something out and we got snuck in.

And folks. I'm telling you, maybe, just maybe, everything will be ok. They couldn't locate any source of bleeding, and they could locate the heartbeat. They couldn't figure out how to do the counting of it, so we have no idea how fast it is beating, but it was visible, even to Will and me. That was a huge phew! moment. Especially as I have continued to cramp significantly all day (but no more blood!)

Most of the test results are back and look good. Estrogen is 615, progesterone is 23.12, and the beta (drum roll...) is 12,691 (doubling time 91 hours, which is just dandy at this point). Which makes me think that the ever-so-slight nausea I've been thinking I might be feeling may just be real after all. Yeah!!

So, um, it seems that there might be a baby inside this ole' uterus. Wow.

And based on how things are feeling, it's a baby with very long, very sharp claws.

We still have the "official" heartbeat ultrasound on Wednesday. But Will and I are breathing much, much easier over here.

Mo

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Mystery spot(ting) and return home

I am safely home. But boy, what a day it has been.

I awoke this morning in the hotel, went to the bathroom, and then all hell broke loose a bit (emotionally for me, at least). TMI to come, so warning to stop reading now if you're squeamish.

As I was finishing up with my first morning pee, I glanced down at my pad and saw a smear of red. No clots. I started freaking. Took off the pad and turned it over to see how much blood was really there. It had saturated to the back of the pad at one small point, but mostly seemed to be more superficial. I began an investigation into where the blood had come from, and came up with nothing. Despite fervent TP wiping, there was nothing but clear white vaginal mucus. Put in the endometrin suppository and the applicator came back clean. Which was weird. I would have thought there would be a bit of red or brown or something if this is where the blood came from. Began to think maybe somehow it was rectal? I am on lovenox, so anything is possible. But all investigation in that area (I'll spare you the details) also turned up negative.

So bleeding, folks, but no idea from where (although I fear I DO know. Sigh). Welcome to Mo's world, the land of the Mystery Spot. Ugh.

On a bright note, despite two flights and lots of airport walking, there has been no more bleeding. I know, because I have been obsessively checking.

I am feeling very uncomfortable, though, on the left side of my abdomen. Uterus is still somewhat crampy, but on the left side am feeling pulling, almost a stabby feeling. Like an implantation feeling, or a (ugh) deplantation feeling.

Besides all that, the day has been uneventful. I've been pretty much horizonal since I got home. And yes, I practically kissed the ground when I got here. It is SO good to be home.

My local RE is out of town until Weds., which is when I have my ultrasound. And I'm sort of between OBs with first appointment for new one not until the day before Thanksgiving. Will is trying to scare someone up to do a scan tomorrow off the record, but I don't know if we'll be able to arrange this.

Not sure what to do about the workweek. I have a fairly important day tomorrow with several things (including patients) I'd have to cancel (and let my team down with) if I don't go in. But on the other hand, if I have a subchorionic hemorrhage (one guess, if the baby hasn't already died), I'm thinking maybe I should be staying pretty still and not going in. Geesh, I don't know. On the other hand, I feel like everyone would tell me that there's nothing that can be done at this point anyway. So maybe I should just go about my day as usual? If I did call off from work, what should I say? (I'll need to be near death to cancel out of one of the events for tomorrow - it's a big deal for our team. so no typical "I'm sick" will cut it, I don't think). What would you do?

And those of you who had a subchorionic hemorrhage, aside from the bleeding, did you have any other symptoms? How was the SCH treated?

Feeling that hope is dwindling over here. Just feeling doomed. Hopefully, I'll be pleasantly surprised. Trying to remind myself that until I am told otherwise, there's a baby in there. A miraculous green pea to blueberry size little creature. Please hang tight in there, little one!

As always, guys, thanks for listening, and for your thoughts.

Mo

p.s. In response to a couple of you asking, the co-worker/supervisor who wanted to drink at the conference turned out to be so swamped preparing for her symposium talk that hanging out and drinking wasn't ever an issue. And she never asked if I was pregnant, so I wasn't faced with that, either.

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Talk completed and uterus hanging in there

Phew! Can't believe it, but the talk is over. What a relief!

I think I did OK. Rebecca, thanks for your ideas from toastmasters - I kept repeating that the audience wanted me to succeed, wanted me to succeed, before I stood up to speak, and I think it helped. Towards the end, I started stumbling over my words a bit and could hear my anxiety in my voice, but I gave the talk, no one threw fruit, people asked thoughtful questions when it was over. All in all an acceptable experience.

Big plus: didn't start hemorrhaging during the talk, despite my fears that something BAD like that would happen. In fact, leading up to talk and during and after it, I actually forgot about being pregnant for a bit. Wowsers. Maybe it seems strange, but this whole pregnancy business is typically never far from my thoughts. So it was interesting to just be completely catapulted in to a different place and to be so focused on it that I had no room to remember my pregnancy. Cramps stopped for a while too, which was a nice relief. they are returning now - I think they seem to be worse when I have to sit at a desk....strange...(baby doesn't like me working?)

Going to one more workshop today and then taking it really easy tonight before flight back tomorrow. It will be so nice to be home.

Uterus, I beg you, please behave until I get back to the States!!

Mo

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Update

No more spotting since yesterday, as of now, at least. The cramping continues (although it stopped for a while this morning). Things feel ominous to me, but of course my feelings could mean anything, could mean nothing. Am drinking lots of water and trying to stay off of my feet.

I deeply appreciate all of your thoughts. Really do. Thanks for taking the time to share all your bleedy, crampy stories. My gosh you people bled and cramped a lot! An impressive bunch, you are! Especially for getting through it with your sanity intact.

I don't mean to whine, but forgive me for a moment while I do anyway. Folks, I know you know, but I want to say it anyway: this is so, so hard. Being sort-of pregnant, I mean. The farther we get, the more anxious I become. Every twinge, every non-twinge, completely stresses me out. And to have the pink tinge yesterday? To be full-on cramping? oh.my.god. completely.over.the.edge.

And add to that the fact that I am so far away from home, in a place where English is not the main language... What was I ever thinking agreeing to come here?! What I was thinking then eludes me, but what I am thinking now is that I am in my hotel room in my pajamas, and I plan to stay here the rest of the day, not even venturing out to fill my ice bucket.

I checked out where my symposium will be taking place tomorrow. It's going to be, um, in a full size ballroom - seating capacity 500 or 1,000 or something. Like completely out of control. I have NEVER spoken in front of such a large audience. (and have I mentioned that I deeply fear public speaking?) I guess it should have occurred to me since this is an invited talk and is a "featured" symposium, that it would be getting prime billing (usually my talks are in some musty basement room that seats 15-20 people). Oh, and have I mentioned that I have nothing to say in my talk? Or at least pretty sure nothing of importance to say? No data to present (seriously), because my research study hasn't started recruiting patients yet. So I'll be, I don't know, talking about the research study I *will* be doing. Maybe I'll try something novel, like blowing up balloon animals in front of the esteemed researchers in my field. Oh, and cramping. Since it appears that I'll be cramping as well, maybe I'll make a point to mention it during the talk, just to make the whole occasion more memorable.

OK, Mo. Deep breath. What's the bright side? Major bright side is that aside from that minimal spotting yesterday, I am NOT bleeding. And I am not doubled over cramping, which would be BAD. I am feeling very menstrual, I am feeling achy in my uterus, and this could be bad, or it could be good, or it could mean absolutely nothing at all.

This morning I braved the outside world to find a pharmacy and bought a bunch of water (because the tap water here is bitter and nasty) and some crackers and juice and (cough) some HPTs (I'm like an addict at this point, spending time planning when can I buy more HPTs, planning how can I procure more HPTs, avoiding other activities and role functioning because I am too busy peeing on my HPTs!!!). I think even though they aren't in English I should be able to figure this out. Two lines = Argh, who the hell knows anymore? Well, it at least equals that things haven't taken a precipitous dive for the worse. Also, did you know that in other countries they have HPTs that say how many weeks pregnant you are? I bought some of those too, although I'm afraid to use them. Why do we not have this in the U.S.? Seems like a fine invention.

In twenty-four hours my talk will be over (hopefully not my career as well) and then I can just rest up and take it easy until I fly back home. Flight home currently scheduled for Sunday morning. Wish I could move it up, but it doesn't look so likely, unless I want to spend another $800 or so.

Breathe. Breathe. Breathe. And thank you, seriously, for being out there, and for listening.

Mo

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Guess who just arrived in a foreign country and is spotting?

Not to mention mildly cramping.

You only get one guess.

Fuck fuck fuck fuck fuck.

It is just a bit of pinkness on my endometrin suppository stick, and then later a light pink mucous on the TP when I wiped, but it is definitely there. And the cramping is definitely there too. Hoping I'm just having minor cervical irritation - I must have thrust that suppository in there too enthusiastically! But I'm not really able to convince myself.

I do not want to be at this conference. I do not want to give this talk on Saturday.

I want to be with Will right now.

I want to go home.

Mo

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Mo and embryo take their 1st international trip

Tomorrow morning, I will leave on a flight for an international conference I am presenting at over the weekend. The whole trip has felt very surreal and up in the air to me, because part of me has been waiting for Something Bad to Happen. This conference is a big one in my clinical and research area and two of my colleagues will be attending - not to mention many collaborators and colleagues from other institutions. It's been strange to have my co-workers all hyped about the conference and me to be secretly thinking "sure, if I go," or "great, if I'm not miscarrying or getting a D&C instead of giving a symposium presentation," etc. I haven't said anything to anyone because of course no one knows I'm pregnant. But in my mind it has felt far from sure that I would be attending (a bit awkward since I'm an invited speaker). I was so uncertain about things that I didn't even buy my plane ticket until this past weekend. (All this uncertainty is very costly in so many ways, I tell you!)

But here we are, less than 24 hours from my scheduled departure, and I am going! Still pregnant! Still giving my (completely unprepared-yikes!) talk on Saturday (hmmm...that better change and soon).

I am a fearful public speaker, even though it is a not insignificant part of my job as a researcher/clinician in an academic medical center. Don't like it. Kind of accept that I may never like it. So it will be very helpful that I won't be standing up there alone, that this little embryo will be giving the presentation with me. I defended my dissertation during pregnancy #5 and it was pretty awesome to know that I had a very small person on my side (and inside of me) while doing that. I'm hoping this time it will be just as comforting to know that there is a little tiny one in there with me as I'm going about my days out of the country and giving my talk.

There are two issues that I'd love to get your thoughts on:

• One of my colleagues - who is a friend but also a superior - has already expressed her excitement about getting to drink together at the conference. Of course, I won't be drinking. Wondering how to handle this without having a neon flashing sign that says "I AM PREGNANT!!" She knows we have been through multiple losses, have been trying IVF, etc. So I'm pretty certain she will surmise the situation, but because I am in the middle of negotiating a promotion, I don't want to acknowledge that I am pregnant. Since we're friends, I also don't want to outright lie. Any thoughts? Also, how do I handle it if she asks me directly if I am pregnant?

• It also just occurred to me that I'm now on daily PIO shots. Which is the one shot I don't give myself. The lovenox will be fine, but the PIO has me a bit unnerved. Come hell or high water, I will be giving myself this injection every night while I am away. But any advice on ways to make it easier? Because of all my med allergies (sesame, peanut, olive oil injections were all a no-go), I'm taking progesterone in ethyl oleate, which is thinner than some of the other oil concoctions, so that will help I think. I'm also going to have Will draw two bull's eyes on my rear tonight so I don't end up injecting in the back of my knee or something by accident. But would love any thoughts you self-PIO folks have.

I'm hoping the trip will be a good distraction from all of this pregnancy panic going on over here. Because you know that ultrasound yesterday? That made me feel reassured until, oh, just about 4pm yesterday, at which point I returned to my fearful baseline. I think fear of presentation will compete nicely with fear of pregnancy doom, which is a good thing. And by the time I get back, the presentation will have been given (phew!) and I will be only a few days away from having another ultrasound (gulp), that will hopeful reveal a heart beat (double gulp).

Mo

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6w2d ultrasound

We went in for the ultrasound today, nervous, nervous, nervous. It is so easy now to imagine a bad outcome because we have had so much practice at these ultrasounds going poorly. We know exactly what it will be like, or we think we do.

My NYC RE began the scan and at first I thought to myself, Oh, Good! The sac looks larger! This was all I was hoping to see at this reassurance appointment.

But then the RE kept scanning.

And scanning and scanning and scanning.

He said not a single word as he continued.

This has never been a good sign. You know the AIDS project "SILENCE = DEATH"? Well, whenever we've seen the baby lying still on ultrasound, whenever there is bad news, it has always been accompanied by utter prolonged silence.

So my heart starts beating in my chest. I reach up and grab Will's hand. He is sweating. With every second that is passing, I am increasingly certain that it is over. Will tells me later that he felt a lump rising in his throat.

Eventually, the RE speaks, although he is still scanning.

He says that he thinks he can see the fetal pole (!)

What?!

He demarcates it with his little pointer things. He says that what he is looking at is soooooo sooooooo small still that it is hard to tell. That sometimes he thinks he is imagining things when it is this early. He says he thinks he can also see a tiny flickering but that everything is really too small to tell for certain just yet. Yolk sac still there, and gestational sac definitely larger (4 days larger than last scan 4 days ago), so growing just fine.




Will and I breathed a huge sigh of relief and both scrambled to pick our own hearts up off the floor.

So it was good news. Good news after prolonged silence. Never had that before.

Progesterone is now 23, estrogen 615. According to the RE, "This pregnancy is on full life support."

The real test, the RE says, will be the next ultrasound. He will be away until next Wednesday, which is his surgery day. But he's going to come in at 7AM that day before scrubbing in just to do our scan (isn't he great?!). He said we should definitely be seeing a heartbeat by then.

Until then, he said, "Just keep doing what you're doing."

To which I replied, "You mean keeping taking estrogen and progesterone in oil and freaking out daily?"

Apparently, yes.

And note to RE: Dude, we love you, but you have got to say something a little sooner. Before both Will and I go into cardiac arrest.

Mo

Click here for an interesting guide to hcg and ultrasound milestones in early embryonic development.

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