Jan 26, 2013

a quick week 16 update

I was just updating the "our journey" tab of my blog and it made me so sad to think, when will I ever update the "Aminadav and Naava" tab? I can't believe we are quickly approaching a year since they were born and died. A little trite to say, but it certainly doesn't feel like a year since I lost them and yet my pregnancy with them and the happiness of that time feels like it was so long ago.

I have been thinking lately what I might want to do to acknowledge the one year anniversary of their birth and their death and I am still stumped. I just don't know. Unfortunately, early March is not such a nice time of the year for a special hike or outdoors activity. And of course the creeping thought has occurred to me: Will I still be pregnant with this baby on March 7? G-d I hope so.

I haven't even wrapped my head around what exactly this one year anniversary is - to be born and die on the same day - a birthday and a death day - what is that exactly? A celebration? A somber remembrance? I am not really sure. I guess it is up to us to make up the rules of this day.

In happier news, I had my weekly clinic appointment and the MFM was thrilled with the way my cervix looks. It is measuring around 3.4mm, so I actually gained a bit of length over the past two weeks' measurements, and she said it is curved (not stretched taut) and has a glandular pattern, which is also apparently a good prognostic marker. I am happy to be boring and hope to stay boring for a long time.

We also found out that baby appears to be a GIRL! I am equally thrilled with either prospect, but I was pretty convinced that this babe is a boy, so it was a bit of a surprise :) I had my quad screen drawn this week as well as a bunch of platelet function tests.

My only complaint is that I continue to have weird cramping and what I think are probably sporadic Braxton-Hicks contractions, but painful ones. The various pains definitely put me on edge. I just have no idea what's normal and since I had some pretty significant cramping both before my partial abruption and before my water broke, I never know whether any given 2am cramps are just insignificant, normal pregnancy pains, or whether they are the harbinger of a new disaster.

Does anyone have some ideas of what we might do to acknowledge the one year anniversary of Aminadav and Naava's birth and death? Unfortunately, since we are currently in Canada and they are buried in Israel, visiting the cemetery isn't an option.

Jan 21, 2013

these two lands

I hold a kernel of hope deep in my heart that this pregnancy is going to end in a baby that we get to take home. It seems a bit bold and gutsy to confess to that, but it's true. I am not confident in my ability to carry to term, but I think the odds of me getting to something like 28 weeks are much better with a singleton and I think that each new week that passes by with no bleeding bodes well.

Still, it is hard not to be consumed by my fear. This is a different pregnancy, a new pregnancy, and yet it all feels so familiar. I have done this before, walked many miles in these shoes exactly a year before, and we all know how that turned out. Sometimes I even slip up, forget it's not Aminadav and Naava in my belly, and sometimes friends and family slip up, too, asking a question about 'the babies.' If only we really got a do-over, but Aminadav and Naava are still buried in the ground in Israel and in my belly I carry a brand new little one in Canada - the little sister or brother we haven't met yet.

I suppose it makes perfect sense that this winter feels like an extension of last winter and that my pregnancy with this baby feels like an extension of my pregnancy with the twins. After all, this winter and last winter, those babies and this baby are part of the same story and the same journey.

The memories of the terrifying moments are so visceral, so engrained in who I am, it is hard to not constantly relive the sheer terror of my water breaking (exploding really) way too soon and all of the sensory details of the experience.

I was really nervous during the first trimester about an early miscarriage and then I had a brief respite from anxiety, but now I feel my fear slowly creeping back up as I approach the gestation where I began having complications with Aminadav and Naava. 

Every morning I wonder is this the day I will go to work, end up in the hospital, and not come home? Is today the day I'll start bleeding or the day my water will break? Is today the beginning of the end, or just the beginning of the beginning, like it should be? 

I exist straddling a weird in-between of hope, excitement, and fear. Just like last time, I want to read reviews of fancy stroller models and daydream about baby-wearing and making my own baby food, but in my sleep, I give birth in tens of bizarre and disturbing ways to a baby that is not yet viable. Sometimes in these nightmares the baby is somewhere on the floor but so small I wonder if I will find him at all. 

There are limitless demons that can haunt you once one truly awful thing happens - one of those sort of things that isn't supposed to happen. It opens so many new possibilities and avenues of horror. All of the sudden every freak complication seems equally possible because you are one of those people.

The belief that there are those people and then there's you is what keeps your imagination from plunging too deeply into the menagerie of horrors that could befall you. But once you become one of those people that wall comes down and you skate on thin ice because every manner of disaster could happen to you. Suddenly, the improbable odds and freak statistics feel very personal.

So I carry this kernel of hope deep in my heart; this belief that this time will be different but I have another foot grounded in a land of fear and disaster. Praying that in the right time I will land, two feet on the ground, with a screaming, cooing bundle in the 'normal' world - the land of the lucky.

**In mundane medical news, I had a MFM appointment on Thursday. Cervix is funneling a tiny bit at the top, but with fundal pressure, the cervix doesn't go below 2.8-2.9cm and my baseline measurement at 13 weeks was 3.0cm, so there is very little if any change there. The NT results combined with the first trimester screen gives us a 1:29000 odds of trisomy 21 and the appropriate PAPP-A levels combined with u/s suggest that my placenta is functioning well at this point. I think we will do the quad screen at my appointment this week.

I had a hematologist appointment on Friday. They asked me to enroll in a study following pregnancy and medical outcomes of women with bleeding disorders. There is so much known about the role of thrombophilias (clotting) disorders in pregnancy but much less known about the implications of bleeding disorders in pregnancy. The suggestion that my bleeding disorder may have played a role in my abysmal obstetric history is actually pretty unsettling to me.

Jan 13, 2013

14.5 weeks - long overdue update!

I am so far behind, I am not really sure where to begin. I often wish I had been much better at documenting my pregnancy with Aminadav and Naava since in the end, my pregnancy was the only time I had with them. I have mused about how I did a good job recording all the mundane details of our fertility treatments and yet I did such a crappy job of documenting the next stage. And here I am again, doing the exact same thing. Actually, I have been even worse about documenting this pregnancy than my pregnancy with the twins.

I suppose it gets back to the age-old question that has boggled many an infertility blogger - how do you blog about the next stage? Who is your audience? And based on your answers to those questions, how comfortable do you feel writing about pregnancy and maybe even parenting? 

I still feel pretty uncomfortable writing about pregnancy. I realize this is pretty stupid given that despite several pregnancies, including one that came very close to living take-home children, I know firsthand that pregnancy doesn't necessarily translate into a baby or babies in your arms and that pregnancy isn't always the holy grail to The Other Side. It is just another stage in the journey to The Other Side. Yet regardless of these experiences, it seems like I will never make the easy transition from infertility/baby loss blogging to pregnant after infertility/loss blogging. 

But I do still feel a tugging to document this pregnancy for myself, for this babe, and for anyone else out there who is experiencing something similar or will in the future. I am so incredibly grateful for this pregnancy. I still can't believe that it is my current reality. At the same time this pregnancy is also of course really complicated for me emotionally. I am very fearful that it could all be taken away from me at any moment and with each day further I get, I feel the stakes increasing. 

I also still desperately miss and long for Aminadav and Naava. I feel like I knew them. I still don't understand why they aren't here with me and I know if they were here, this baby wouldn't exist in the first place. That's complicated. I feel like I knew them. But not this little one. Not yet anyway. I ask all the time: Who are you? Who are you in there? 

And while I have not been busy imagining up a personality for this little one, I think of this baby as a he. I am nearly convinced of it. I will honestly be so happy with either a girl or a boy, but I will be a little surprised if this baby is a girl :) 

On the practical front, I had my first MFM appointment at 13 weeks. I stopped progesterone supps at 11 weeks and I am now tapering off Prednisone while continuing baby aspirin. We did the NT scan and the first tri screening blood work, but I won't have the results until my next appointment. I was just really satisfied to see that baby was still alive! I am so far very impressed with the MFM - he seems very compassionate and knowledgeable. 

At this stage, I will be going to the MFM every other week and they will check cervical length by u/s. I will also continue to be followed by the RPL specialist. At 20 weeks (assuming I get that far), we plan to start progesterone to prevent PTL. Since it is not so clear-cut whether there may have been an element of incompetent cervix in my PPROM and since the 2 D&Cs for retained placenta could have caused cervical damage, cervical change is something they will be closely monitoring. The other thing they will be monitoring closely is my placenta since I had a partial abruption with the twins preceding PPROM. The good news is no bleeding so far in this pregnancy. My next appointment is this Thursday at 15 weeks.

To wrap things up on a light note, here is a recent bump pic. I still treasure my bump pics from my pregnancy with the twins, so I know even if things don't turn out well this time, I'd still like the little momentos. Lastly, in silly news, the most exciting thing that happened this past week was that I got a Snoogle. I can't believe I was deprived of a pregnancy body pillow when I was pregnant with the twins and spent so much time in the hospital and on bed rest - I guess what I didn't know I was missing then couldn't hurt me.