Space Camp

What has shocked me the most about our loss is how unshocking losing this pregnancy was, despite the fact that everything was going so well until it wasn't. I remember when I was little, whenever something I deemed to be very important occurred, I divided my life into the before and after based around that single event. Inevitably, I would find the after incredibly depressing - the let-down after a big trip or significant event and all of the anticipation that led up to it.

When I first became pregnant and then later when we learned that our baby didn't have a heartbeat, I came to believe that these events would be the same - defining points against which everything that followed would be subsequently measured - separations differentiating the old before from the new after. Perhaps if my pregnancy had been healthy and marked the beginning of the life of a child we brought into this world alive and into our arms, this would have been true. Instead, I have found it surprising that the loss hasn't really felt like a defining point at all.

Perhaps it's because I spent so long hoping and praying to be pregnant and comparatively so little time actually pregnant (just shy of 8 weeks when I was admitted to the hospital for Cytotec), but the pregnancy itself feels like a strange but hopeful dream I had for 10 minutes one night. Now that its been a week since the miscarriage, nothing about the pregnancy feels real anymore. More accurately, I've been asking myself, did it ever feel real?

Not really. In fact, the whole time I was pregnant, I felt like an impostor. Part of me could never actually believe it was true or that it finally happened. I kept repeating over and over again to myself, to Y, to anyone who knew and would listen, really, that it was too good to be true.

Sure, I clumsily stumbled through all the motions of being pregnant. I was starving for lunch every day at 10:30am and ready to go to sleep at 7. My breasts increased a full cup size and I finally worked up the courage to buy a copy of The Book - What to Expect When You're Expecting, which lay splayed open proudly on the couch, not tucked away in a drawer like infertility books. I ordered cooked salmon maki and veggie rolls at sushi and sipped Cokes and Shirley Temples at our friends' wedding. I turned down wine, quit coffee cold turkey, and when the bloat made it impossible to comfortably wear jeans, invested in 2 pairs of elasticized maternity pants. I secretly enjoyed it when people would stare down at my protuding little belly (in reality more bloat than bump) and wonder.

On the outside, I acted like someone who believed she would have a take-home baby and yet on the inside, I was just an opportunist - a little kid version of myself who wanted to take full advantage of this longed-for virtual reality experience before school was back in session.

That's because in reality, I felt like a nine-year-old girl who wants to be an astronaut when she grows up more than anything else in the world. Finally, she gets to go to space camp. She is delighted and squealing with excitement- how lucky she is to get such an authentic experience! But even as a young girl, she still knows in the back of her head that this is just make-believe, a token or morsel of her real dream. This is all a high-tech stimulation - she has yet to see the moon.

And so, ultimately, my brush with pregnancy amounted to a few weeks at space camp. In the end, the only moment of my pregnancy that stands out in my mind as being real was lying on the crinkly paper of that ultrasound table with three technicians and one doctor crowded around me, nodding and talking to each other about the body on the table and the image of a womb on a screen, not a single word uttered to me.

That's when I knew that my time at space camp was through. Catapulted back to the reality of Earth, I was no longer an astronaut or mom-to-be, but an infertile finally pregnant, but with a baby without a heartbeat. All of those prayers and wishes and dreams for that miraculous ball of cells, that splendid little life growing inside me, slipping further and further from my reach, like so many dreams of outer space or Orion descending. I am here in Jerusalem, Israel, Planet Earth. I am 238857 miles from the moon.

Serial Killers and Statistics

Last night, 2:15am -- I am awoken from a nightmare when Y comes into our room to go to sleep.

Me: Can you please make sure that the door is locked.

Y: Okay...

[returns]

Me: Did you check?

Y: Yes.

Me: Are you sure?

Y: Yes.

Me: It's just that I was having a nightmare, so I want to be sure that you checked.

Y: Yes, I definitely checked.

Me: There was a serial killer in my nightmare.

Y: You know, serial killers are extraordinarily rare.

Me: We've fallen on the wrong side of the statistics more than once.

Harder than we imagined, stronger than we thought

The physical part of the miscarriage has been much harder than we thought. After reading the experiences of others with Cytotec, I knew it was a dreadful drug. In addition, a miscarriage in of itself, whether induced or natural is no picnic to begin with. Still, I think Y and I both underestimated the physical pain and the physical recovery.

I had it in my head that the worst of it (physically) would be over after 48 hours and that after that, the pain and bleeding would be similar to a very heavy period. In truth, the heaviest bleeding didn't occur until 3-5 days after the Cytotec and while the worst pain was definitely a few hours after they put the Cytotec in, I had intermittent severe pain that was completely incapacitating until today.

The mornings have generally been my good hours, with the worst pain in the late afternoon and evening. Luckily, Y has been home for most of the severe pain. Without him and his grade A back rubbing and culinary skills, I wouldn't be able to be manage. Finally, this morning (Sunday), which marked 7 days since the Cytotec, I was able to get up in the morning and feel functional.

Since I hadn't had a "good" straight 24 hours, Y thought I should take today off, too. In the end, I decided that today was a gamble but a week was enough, and it was time to tough it out and see if I could make it through the day. It was definitely the right choice. I made it through a hectic day and it felt right to get out of the house for the first time in 7 days and face the outside world.

Only 2 of my co-workers know about the miscarriage. The rest, including my boss, just know that I was out with some vague illness (however, my boss does know that I was hospitalized because Y called him to say I'd be out for the week when I was being admitted). In some ways, it feels odd that people think I've been out with "flu", but on the other hand, the ones who do know have of course managed to put their foot in their mouth ("You are so young and healthy." "At least it was your first." "It's not the end of the world." "You shouldn't worry." "Haha, now you don't even have an excuse to yawn.") You know, all the standard gems. Whatever.

Part of me wishes that I could muster up the gumption to respond and make them very uncomfortable. The truth is, I know people mean no malice. I have learned umpteenth times from the first "Just relax and it will happen" that many smart people are totally moronic when it comes to "consoling" or "counseling" those of us with fertility problems.

I think part of it stems from the fact that trouble TTC or IF is something that many fertile women think they can relate to, since to some extent it does fall within their spectrum of personal experiences (i.e. most women in a committed relationship have indeed gone through the life experience of trying to getting pregnant). They just sort of miss out on the nuances of how the experience might be completely different if you're, you know, broken.

Anyways...I am proud of myself that I went back to work and had such a productive day. Physically this has been much harder than we imagined but emotionally, I think we are perhaps more resilient than we thought. We'll take what we can get.

Broken

Baby G was never growing hands and feet or developing a brain or any of the things I wrote about in my 7w post, because on Sunday (7w3d, or 7w5d by LMP) when I went for my 2nd ultrasound, we received the horrible news that Baby G had no heartbeat. In the end, that slight brown spotting from last week was an ominous foreshadowing of what lay ahead. My cervix was still closed, my uterus measured 7w0d, and there was no active bleeding, so my body was essentially staying pregnant even though the pregnancy wasn't viable. This meant we had to make the horrible decision of how to complete the miscarriage.

The two choices were either a D&C or Cytotec. With the Cytotec, they place the medication in the cervix and contractions are induced. Since the process can take days to be complete and can be extremely painful and since there is only an 80% chance of "success", I decided I wanted the D&C, which would be over quickly and give definite closure.

Unfortunately, there was a 12 day wait for a D&C and I didn't want to remain pregnant carrying around a non-viable pregnancy for that long. That is how we came to choose the Cytotec. I was admitted to the hospital yesterday morning and had the drug administered. Just before the doctor put the Cytotec in, I saw 2 little drops of blood. I know this sounds silly, but seeing those two drops made me feel much more at peace, like my body was perhaps beginning to realize that this was not a viable pregnancy.

I felt nothing but mild menstrual cramps for about 3 hours. Then the cramps steadily worsened until they became full-on contractions with 5-10 second breaks in between. The pain was absolutely excruciating -- well beyond anything I had ever experienced before. I was in a room with 3 other women (two of whom were pregnant), and at first I felt really self-conscious about my moaning. Later on, this gave way to full-out screaming and wailing, which I had really no self-control over. I just remember screaming "Oh my G-d" over and over again. Y held me and rubbed my back and squeezed my hands. He was so brave for me. He was and is my rock.

The doctors and nurses kept referring to "performing my abortion" and "you're now in the middle of the abortion" etc., which really upset me. I know it is the medically correct term, but since they also perform elective abortions in the department, I really wondered how many of them looked at my chart and history closely enough to know that I was an infertile who lost her baby, not someone trying to undo a bad choice. It also upset me to think that the other women with whom I was sharing a room may have thought I was having an elective abortion if they overheard the doctors and nurses talking to Y and me.

Eventually, the worst of the pain subsided and I waited to bleed. It took a while for the bleeding to start, though it did pick up around 12am. By morning, I was still too nauseous to eat or drink so I got IV fluids and IV Zofran, which made me feel a whole lot better. They sent me for an ultrasound, which showed that the miscarriage was still in process. However, the gestational sac was no longer intact and we were told that the Cytotec was likely a success. Finally, I was discharged around noon.

Now we wait and go back for an ultrasound and a follow-up appointment in 2 weeks and we hope that I won't need a D&C. The doctor said that we can return to fertility treatments after I have one normal menstrual period. Hopefully, this will happen by the start of the new year. Speaking of the new year, it upsets me to think that we were 25 and 33 when we started TTC. In January, we turn 27 and 35, and still no baby or even viable pregnancy to our name. I have faith that some day we will have our healthy, take-home baby, I just spend a lot of time questioning how much pain and suffering it will take us to get there.

7 week update

The spotting seems to have stopped and I still feel pregnant, so now we are just hoping and praying for the best. Today I am 7 weeks and 1 day pregnant. Baby G is now the size of a blueberry (about half an inch long -- twice the size of last week!). Baby G is growing hands and feet. The only thing shrinking is Baby G's tail -- yup, embryos have a tail, which is an extension of the tailbone and decreases in size until it disappears. Baby G's brain is growing and its liver is making red blood cells. Baby G is now connected to me through an umbilical cord. I am sending lots of good vibes to our blueberry for lots of continued growth!

Here is a bump pic from yesterday at 7w0d. So far, I think the only thing increasing in size are my breasts (anything else is just bloat), but it will be fun to chronicle the progression to a real bump.

Scared

A couple of days ago I noticed a tiny bit of dark brown CM. It freaked me out a little but it was such a tiny bit I didn't dwell on it and almost forgot about it. Fast forward to today and I have seen brown-streaked CM every time I've gone to the bathroom (you can thank me now for all of the graphic detail). The only other time I have seen this happen is a couple days before AF. All I can think of now is that I knew being pregnant was way too good to be true.

I am supposed to have an u/s on Sunday (7w3d) to confirm a heartbeat, but I know I could probably go in tomorrow if I want. The truth is, I think I am more scared of having an u/s and finding out "the truth" and the anxiety leading up to it than I am to just wait it out and let nature take its course until my original appointment on Sunday.

I have just been resting in bed for the past few hours since I got home from work. Harriet, ever needy for affection, is keeping me company and enjoying lots of her favorite behind-the-ear rubs. I hate being in limbo and I am really scared. If I am going to miscarry, I just want it to happen already, but I pray that we get to keep our baby.

6 week update

Today I am 6w3d. Last Monday I had my 3rd beta draw at 25 dpiui (5w4d). My hcg level was 3567, up from 279 at 18 dpiui, so thankfully my numbers were doubling nicely. We also saw Prof. L that same afternoon. He answered many of our remaining questions about lean PCOS, PCOS and miscarriages, and my over-response to the Clomid last treatment cycle. He did do an u/s, though he warned us that there would likely not be much to see. All we could really see was a small gestational sac, but it did give us peace of mind that at least Baby G implanted in my uterus. Also, we only saw one sac, so while we can't quite yet rule out multiples, all indications point towards a singleton pregnancy.

Prof. L told us that our chances of an early miscarriage are 15%, compared to the normal 10% (50% higher than average), but if we are able to detect a fetal heartbeat, the chance will decrease to ~7% and will again further decrease to 3% at 12 weeks. I am still so scared but at the same time so hopeful, too. When I was struggling to get pregnant, it was difficult to think beyond the excitement and thrill of some time getting a BFP. Now that I am there, I haven't really experienced the ecstacy I imagined because I am so frightened to lose the little life growing inside me. I am so scared of waking up one day soon to "game over" and having to go back to square one with the dreaded fertility treatments.

Everything about this process has been so hard and uncertain until now, it is difficult to imagine that anything could proceed smoothly without lots of emotional pain. In short, after a lot of disappointment, finally being pregnant just feels too good to be true. I am just trying to remember, that even if our odds ARE worse than the average couple, the odds are still in our favor that this pregnancy will continue and we will get our Baby G at the end of it all.

This weekend I had some serious stomach issues. We went up to the Golan for Shabbat and I was scared I was going to not make it during the 3 hour car ride. Thankfully, Y picked up some Zofran before we started our trip and things got much better for me. Since then I have felt much, much better.

Our next u/s will be next Sunday (exactly a week from today) at 7w3d. Unfortunately, Y won't be able to join me because the appointment will be in the middle of the day, the only appointment time we could get. We have another u/s at 9w0d, and then assuming all is well until that point, the next time I will see Prof. L is at 10w0d. I pray that I will get to see our baby's strong and perfect heartbeat next Sunday, the most beautiful image I can possibly imagine.