Dec 16, 2012

week 10 update

Today I am 10 weeks + 2. I am beginning to gain a little more confidence in this pregnancy, or at least feel a little more positive about our chances of making it through the 1st trimester, but I still worry constantly that everything could change in a second, maybe without me even knowing it.

I know I have written about it many times before, actually in a way that was eerily foreshadowing when I was pregnant with the twins, but I hate how when things go wrong you feel like such a sucker - like how could I have even thought that everything would turn out ok or how was I was oblivious to my fate.

Yet when things go well, you tend to feel just a little smug or you even berate yourself for having so much unfounded anxiety when everything is just dandy. And as I have also written before, of course the only thing separating Mrs. Sucker from Mrs. Smug is, well, the outcome of the pregnancy, but it's really something you have zero control over and sometimes while all available data points to yes, the outcome is still a no.

In the past week, we unearthed the doppler and I've been able to listen to the babe's heartbeat, so that has definitely been reassuring. Morning sickness has steadily gotten worse, which makes sense because it peaked pretty late with the twins, too. So far I have needed IV rehydration twice which is pretty unpleasant, but the intense vomiting (fun!), still hasn't been as frequent as with the twins. I am now taking diclectin a few times a day, which is a combo of vitamin B6 and antihistamine and that does seem to help, though it makes me really drowsy.

I also started packing up clothes that are clearly too tight and I've now taken out my maternity clothes. This feels like a leap of faith that I am just not totally comfortable with, but I am beginning to grow (mostly just bloat, I think) and it is pretty impractical to have all of these clearly too-tight clothes taking up space. I am more comfortable in mat jeans now than my regular jeans, but I don't plan on putting on any maternity shirts until the start of the new year, which will correspond to the beginning of 2nd tri, if I make it that far. I feel like maternity shirts make it really obvious, so in the mean time I prefer sticking to big sweaters.

I am weaning off of progesterone now, though the plan is to continue Prednisone until 12 weeks and then slowly taper between weeks 12-20. Even though I am on a low dose, I am definitely beginning to feel the side effects of 2 months of Prednisone but I can't complain.

I still have so much unresolved grief for Naava and Aminadav, which isn't at all surprising, but this new pregnancy definitely sometimes intensifies my grief. I just wish so so badly I had the chance to really get to know them and raise them. It is all so confusing - I know I wouldn't have THIS little one on the way if they had survived and I feel much more of an attachment to them than I do to this baby (I feel horrible just writing that) and I suppose all of that makes sense because I carried them for much longer and delivered two very real to me little people, whereas at 10 weeks this pregnancy is still obviously much more abstract.

Sometimes it definitely makes me feel guilty, like I am not 100% there for this little one. But I know that should this pregnancy G-d willing continue, my love for this baby will grow and grow, even if it might take me longer to become attached due to my past experiences and my ongoing grief. And little baby, I can't wait to get to know you and learn who YOU are.

 I think that is all the news fit to print in our corner...pretty boring, I think, but for now boring is good!

Dec 4, 2012

an eventful & stressful week

Sorry for the lack of updating. I still have a hard time writing about pregnancy. I apologize that this will likely get long since I am so far behind. It is always good to type things out, though - I hope that my experiences will be helpful to others and I also like having a written record for myself, too.

The past few days have been incredibly stressful. To rewind a bit, last Thursday I went in for my second scan. In typical fashion, I spent most of the day before day dreaming about a negative result…you know the positive visualizations they teach you to do in fertility mind/body meditations? I tend to take the skills learned there and adapt them for the bad. Anyone else do that?

Instead of visualizing my body doing something great (lots of follicles for IVF, many embryos fertilizing in their dishes, a strong embryo implanting), I visualize the worst in all of its sad, morbid detail and somehow I think this is some sort of amulet against it actually happening.

Or perhaps more accurately, I feel like if I visualize it first, I am easing myself into the possibility of bad news, adjusting my expectations so if something isn't right, I am not shocked, or so I don't feel like the 'fool' again.

There is some famous quote you often see on miscarriage forums about how if you worry about something bad or imagine it in your head and then it does happen, then you've had to live through it twice instead of once (and if it doesn't happen, you've unnecessarily subjected yourself to anxiety and fear). I guess I take the opposite approach -- I believe it is easier to experience the reality of bad news if you are already half-expecting it and have already walked around in it a bit.

Anyhow, enough about neuroses for now! The scan actually went really well. I was measuring 8w0d -- still a day ahead -- and we got a nice strong heartbeat of 167 bpm. Also, we are at the gummy bear stage -- little limb buds beginning to form and I saw the spine, too.

So I left last Thursday's appointment feeling pretty good about things. On Saturday afternoon I got a headache, which over the course of a few hours turned into a bad headache with very severe vomiting. Over the course of about 6 hours, I vomited 15-16 times. I could just not get a grip on the vomiting and I was really miserable. Y brought home IV fluids and Zofran and managed to rehydrate me at home.

Sunday I was still feeling under the weather but had some things planned and yesterday I was really dragging my feet at work -- just didn't feel like myself. Around 3pm I started to get very intense contraction-like pains. After two waves hit (with about 10 minutes in between) I realized it wasn't going away and I left work as quickly as possible, highly suspicious that the contraction-like pain was the early stages of miscarriage. Bleeding all over the place at work is basically one of my worst nightmares, so I high-tailed it out of there.

Managed to make it home and to the couch. The pain was intensifying. In between waves, I was merely uncomfortable, but the contraction-like pains themselves felt EXACTLY like how I felt when I received Cytotec to complete my 1st miscarriage. Y came home and squeezed my hand and we were both so upset. After a couple hours of this with no blood in sight, Y suggested that we head to the ER to see if we could get some idea of what was going on.

We went to the hospital in the city that specializes most in pregnancy issues and has 24/7 ultrasound facilities. The ER was a horrible experience. We waited just over 5 hours to be seen. In the mean time, the contraction-like pain slowed to 15 minute intervals and then 20 and then eventually stopped, thank G-d.

They wouldn't allow me to drink a cup of water over those 5 hours which in retrospect makes me livid (they weren't giving me IV fluids, either). I assume the reasoning is that they don't allow patients complaining of abdominal pain food or water in case they have a surgical abdomen, but after waiting over 5 hours to see a doc, you can be pretty damn sure no one REALLY thought I had a surgical abdomen.

Anyhow, we finally see the doc who doesn't examine me but brings in a portable ultrasound. He says he sees a flicker and suggests I come back in the morning for a full ultrasound and sends me on my way. He also says my labs look fine.

Today I saw the lab results from last night and my ketones were +3, so I don't think there was any doubt that I was at leastly mildly dehydrated. I now suspect that I never fully recovered from my dehydration on Saturday and that I was walking around trying to do too much while dehydrated -- hence setting of the contractions. What is maddening is the three other women being seen for early pregnancy issues who were sitting in the same waiting area all had IV drips and they wouldn't let me have a sip of water or give me fluids! So basically I went to the ER to become more dehydrated than I already was against my will.

I also don't think it would take Dr. House to look over my lab results and my complaints and think "Oh severe dehydration 48 hours ago + current severe cramping + currently throwing ketones - must be dehydrated!" But since I didn't have access to my lab results while we were in the ER, I never got the opportunity to put 2 and 2 together.

This morning's ultrasound was good, thank G-d. I am still really shaken, though - that level of pain was really unnerving and definitely not normal. They sent me to a nurse to get the results. She had a prepared speech that the risk of miscarriage at this point is 50/50. Even I the eternal pessimist call bullshit on that.

Maybe the risk of miscarriage is 50/50 around the time of implantation, but after seeing a good heartbeat and good progression over the course of 3 ultrasounds (now 8.5 wks), I am quite sure the risk of miscarriage is well below 50%.

I asked her whether the chance of a miscarriage might be lower based on seeing a good heartbeat on multiple occasions in hopes that she would revise the 50/50 statement and she said "Yes -- definitely -- once you see a heartbeat at the NT scan and then at the anatomy scan at 18-20 weeks, the chance of miscarriage is much less."

She then went on to describe if the baby is healthy and no anatomical problems are found at the anatomy scan, you are almost home free. If she is an OB/gyn nurse, I would hope that she knows that most late pregnancy loss is due to maternal factors. I thought it was super ironic that she was telling me that a good anatomy scan means you are almost home free less than a minute after I told her I had a partial abruption followed by PPROM at 19 weeks, while she was reviewing my history. The whole experience just made me upset.

Right now I am feeling incredibly grateful to still be pregnant but really down-trodden over the events of the past few days. This is the hospital that deals most with high-risk pregnancy and the place where I will be receiving my care and frankly, so far I have found the level of care appalling compared to Israel and I have very little confidence in them, which is a really sucky feeling.