tag:blogger.com,1999:blog-24901792687657610752024-02-21T12:12:57.980-05:00A Thousand OceansA.http://www.blogger.com/profile/00949343025406168591noreply@blogger.comBlogger140125tag:blogger.com,1999:blog-2490179268765761075.post-54397126120577190782015-07-15T07:09:00.002-04:002015-07-15T07:17:23.441-04:00full arms, full heart<div class="separator" style="clear: both; text-align: center;">
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<span style="font-family: Verdana, sans-serif;">E.den and A.diel were born healthy and at term on April 5, 2015. I have three children I carry in my arms and two children I carry with me in my heart. They are always with me. A.minadav and N.aava who made me a mother. N.aama, E.den, and A.diel who fill my days with light. I am so lucky. I thank G-d for all of them every day. It has been a hard road but it was always worth it.</span></div>
<br />A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com11tag:blogger.com,1999:blog-2490179268765761075.post-8829546263916306412014-11-14T01:43:00.002-05:002014-11-14T01:51:35.952-05:00and I'm back...<span style="font-family: Verdana, sans-serif;">It's been a few days over a year since I last posted and I am ready to start this up again. We started TTC again in March 2014. I weaned N around that time for fertility reasons, which was a difficult choice.</span><br />
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In early June we thawed our four frozen day 3 embryos. Our hope was to thaw them on day 3 and try to grow them to day 5 and then do SET if any of them made it blastocyst. We knew the embryos weren't great quality and we didn't want to transfer more than one because we were explicitly trying to avoid twins because of what happened with our first twin pregnancy. We figured growing to day 5 would be a good selection device.</span><br />
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I guess it was too good of a selection device, because after preparing a fluffy lining with a couple of weeks of estrogen, none of the embryos progressed to day 5 after thawing. It was disappointing to have nothing to transfer, but I guess it also wasn't shocking since we knew the embryos weren't great and I didn't regret that we chose to attempt a day 5 transfer.</span><br />
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After the transfer that never was, I had a meeting with my RE to decide where to go from there. I knew that I wanted to get pregnant soon and never having had a spontaneous pregnancy, I knew that I wanted to continue with treatment. I was uncertain whether I wanted to start with something less invasive and emotionally consuming like Clomid IUI or whether I wanted to dive right back into a fresh IVF cycle. I also didn't know what our health fund would cover based on our circumstances at the moment.</span><br />
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Our RE advised that he would support me in whatever treatment that I wanted to do and in whatever order or combination I wanted, but that he still thought IVF was our most efficient path to pregnancy. Fair enough. After talking it over with Y and some soul-searching, we decided to proceed with our fourth fresh IVF in July 2014.</span><br />
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We did the antagonist protocol and the stimulation went fine. We got 10 eggs, which is pretty standard for me. Unfortunately, only 5 fertilized with ICSI which is a pretty low fertilization rate for us. Our embryos were in an incubator with an embryoscope, a time lapse imaging system that takes video of the developing embryos. It is a pretty cool recent invention that is supposed to help in embryo selection and gives the embryologist and RE real-time info about the embryos without disturbing them in the incubator.</span><br />
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Our hope was still to do a day 5 SET but based on our lower fertilization rate and underwhelming embryo quality, my RE advised we do a day 3 transfer. We weren't so psyched about this, both because day 3 hadn't brought us success in the past and because suddenly it made the question of how many embryos to transfer much more confusing, since day 3 SET doesn't have such great results.</span><br />
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The day of the embryo transfer, the embryologist and our RE reviewed the video clips from the embryoscope. Our RE told us none of the embryos were more than 6-cell, all had significant fragmentation, and none of them met the freezing criteria. He and the embryologist recommended that we transfer three (!) We decided to settle for two, even though Y had significant reservations since we were (and are) still both traumatized from the pregnancy with Aminadav and Naava.</span><br />
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Needless to say, much to the shock of our RE and myself (and not to Y), we got pregnant with twins again. I am now 17w3d pregnant with a boy and a girl, and it's been a challenging and scary road so far. I had light bleeding from weeks 5-7 due to a subchorionic hematoma. At the NT scan I was diagnosed with partial placenta previa, and during week 13 I was hospitalized due to a major bleed. This was really scary since chronic bleeding is what we believed caused PPROM (premature rupture of membranes) with Aminadav and Naava -- basically due to blood wearing down the amniotic sac like sandpaper. I rested at home for a week and then returned to work.</span><br />
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I also had a worrisome cervical length ultrasound about a week ago. It shortened significantly based on that measurement but then when another technician measured it a few days later, all was good. I am not sure whether my cervix is dynamic or whether maybe the first measurement was incorrect or what, but I will ask my doctor what she thinks when I have my regular appointment next week.</span><br />
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This whole ride is very scary for us....every day I just feel thankful to wake up still pregnant. The only way through this is to make it to each new day as uneventfully as possible -- 10.5 weeks til our first big goal. Meanwhile, N fills our lives with so much joy (and activity!). We are so blessed to have her here with us.</span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com10tag:blogger.com,1999:blog-2490179268765761075.post-63114744922530265142013-11-11T04:25:00.000-05:002013-11-11T15:18:45.052-05:00snapshots: parenting after loss<div>
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<span style="font-family: Verdana,sans-serif; font-size: small;">I know I haven't written here in many months. In
fact, I haven't visited at all in many months. During my pregnancy with
Naama, returning to this place became too much, this special and sacred
place where over the past few years I opened up my heart and received so much from you in return. For anyone
following along, I hope you will forgive me for my absence. I still
can't quite explain why I couldn't write or come here for so long, other
than being quiet was what I needed most during the spring and summer.</span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">Naama was born on June 26, 2013
at 37 weeks gestation. Her name means pleasant and calm. She came into
the world with a full head of black hair weighing 2700 grams (just shy
of 6 pounds) and measuring 20 inches long. She has made my wildest dreams come true.</span></div>
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<span style="font-family: Verdana,sans-serif; font-size: small;">I
don't go over all the details in my head constantly anymore. The
details of what happened to me, to us, is too painful to take in all at
once. But not infrequently, I catch a glimpse of something and I am
transported back to that cruel, rainy winter and everything that
transpired then and in the years that preceded it and during the months
that followed. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">Sometimes I am walking down the windowed
staircase of the medical school research building to my research lab and
I catch sight of the old inpatient building that is now defunct. I look
across at the windows (shutters now drawn) and balconies of the third
floor -- the women's ward -- where Aminadav and Naava were born and died
in the final months of the building's use, before all the inpatient
wards were relocated to the new tower. </span></div>
<span style="font-family: Verdana,sans-serif; font-size: small;">And I am back.</span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">I
remember my view from the hospital room, a nice view, really, with the
Judean hills off in the distance. The grayness and bleakness
of that drab winter, which was particularly cold and rainy. Early mornings being sent down with an orderly in my wheelchair for
ultrasounds -- during the first hospitalization, hopeful -- just a bleeding spot in the placenta --
and then more bleak, the ones where I asked the technician to turn off
the big screen and only Y could bear to look at the small monitor: two
hearts beating, two beautiful, healthy babies, except one immobilized by
no fluid left and the death sentence that awaited my two precious bubs.</span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">I remember lots of the little details, and
perhaps they are the ones that hurt most: the moment of shock and horror
of my water breaking all over the bedroom floor while on bed rest after
being discharged from my first hospitalization following my partial
abruption. Knocking frantically on my next door neighbor's door, the one
with the balloon animal-covered van who ran children's birthday
parties, whose popcorn cart infringed slightly on our storage space in
the basement. "It can still be, it can still be!" she exclaimed, mostly
to herself.</span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">Leaving the hospital through the mall once it was all
over, walking past the baby store with my deflated belly and empty arms
with the realization that Y and I were leaving the hospital as two and
that was it, having gone from a family of two to four and back to two
again. It would never be all four of us again. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">Y telling me on
the way to the car: Just so you know, we're not going back to my car,
it's a rental because my car is in the shop because I swerved off the
road and totaled it three weeks ago in the rain on my way home and I
didn't tell you because I didn't want you to worry. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">I
remember going home for three weeks and then going back to the hospital
and my massive hemorrhage and the new worries about my platelets. It
seemed like I couldn't keep myself out of the hospital. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">My mother came
from Massachusetts to Israel to stay with us and I wanted her in the
apartment but not in the same room. I sat on the computer by myself and
discovered a Glow in the Woods and searched every variation of
"abruption" "PPROM" and "twins" on PubMed again and again, searching desperately,
pleadingly, for a way to save my dead babies. If only I could figure out
the magic formula retrospectively, maybe I could bring them back. Maybe
I would get a do-over and they would live.</span></div>
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<span style="font-family: Verdana,sans-serif; font-size: small;">Then, finally,
is the second half of my story: redemption. When Naama was born,
right after her Apgars, the nurse placed her immediately on my chest. I
remember looking down at her in shock, stunned -- was this really my
baby with her mop of thick black hair? <i>Mine? Alive?</i> Even when I was in labor, the sublime reality of it all seemed thousands of miles away in time and space. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">But
the photograph Y took in that moment captures something else -- a tiny
hand reaching up, up, tightly clasping the round "N" and "A" discs on my
necklace. Reaching out into the big world and embracing
her big brother and big sister. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;"><i>Does she know?</i> I often wonder. </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">Usually
I am not prone to those type questions, but I like to believe that my
beautiful, vibrant, living daughter is connected to her older brother
and sister in ways we don't necessarily understand. I do know that she
would not exist had they survived. This is the complicated reality of
parenting after loss. I could never had all my children alive, for
Naama's existence is a direct consequence of Aminadav and Naava's death.
To pretend anything else would be dishonest, though the reality is
impossible reconcile.</span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">When Naama was three days old, I read her her first book, Goodnight Moon: </span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;"><span style="color: black;">Goodnight room, </span><span style="color: black;">goodnight moon, </span><span style="color: black;">goodnight cow jumping over the moon. </span><br /><span style="color: black;">Goodnight light </span><span style="color: black;">and the red balloon. </span><span style="color: black;">Goodnight bears, </span><span style="color: black;">goodnight chairs, </span><br /><span style="color: black;">goodnight kittens, a</span><span style="color: black;">nd goodnight mittens.</span><span style="color: black;"> Goodnight clocks </span><span style="color: black;">and goodnight socks. </span><span style="color: black;">Goodnight little house </span><span style="color: black;">and goodnight mouse. </span><span style="color: black;">Goodnight comb </span><br /><span style="color: black;">and goodnight brush. G</span><span style="color: black;">oodnight nobody, </span><span style="color: black;">goodnight mush </span><span style="color: black;">and goodnight to the old lady whispering "hush." </span><span style="color: black;"> </span></span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;"><span style="color: black;">Goodnight stars, </span><span style="color: black;">goodnight air, good night noises everywhere --</span></span><br />
<span style="font-family: Verdana,sans-serif; font-size: small;"><span style="color: black;"> </span><span style="color: black;"> </span></span></div>
<span style="font-family: Verdana,sans-serif; font-size: small;">This
part came out in a choked whisper. Hadn't I recited those same lines
for Aminadav and Naava in my head when they left us? Many parts of this
parenting gig have left me in tears of both gratitude and the knowledge
of what was lost, especially in those first few days, when the details
of another labor, another birth story, came flooding back. It all felt
very familiar. And I suppose that in some parallel universe, I had done
all of this before. It was all for the first time just as none of it was
for the first time. </span><br />
<span style="font-family: Verdana,sans-serif; font-size: small;"><br />One of the most helpless
things about losing children at birth is the inability to parent them.
It is a biological cruelty that when you are left empty-handed, you are
still flooded with the same maternal hormones that catapult the rest of
us into the nurturing and caretaking of mommy land. And so all of
these rituals of newborn care, the tedium of the feeding and rocking and
diaper changing, took on new meaning for me, all of the things I
couldn't do for my sweet twins.
In her memoir "An Exact
Figment of a Replica of My Imagination" Elizabeth McCracken writes about
her son Gus, born after the stillbirth of her first son Pudding, and
captures the notion of the parallel universe far more eloquently than I
ever could:</span><br />
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<span style="font-family: Verdana,sans-serif; font-size: small;">Sometimes I look
at Gus, and it all feels very familiar. Not him. He was a skinny
just-born, with cheekbones and an incensed cry: he looked like an old
man who’d been outfitted with hands and feet a size too big and he
wanted to know to which knucklehead he should address his complaint. Now
he is fat and looks like a retired advertising executive. He is
gorgeous and inscrutable. I tell you, I’ve never seen his like. But
taking care of him, changing him, nursing him, I felt as though I’d done
it before, as though it were true: time did split in half, and in some
back alley of the universe I took care of Pudding, when he was a tiny
baby, and this reminds me of that. There’s a strange museum/ gift shop/
antique store/ tourist trap in Schuylerville, New York, the next town
over. In front is a reconstruction of colonial Fort George done in wood
cutouts — a soldier in stocks, Revolutionary soldiers in profile, all
cut with a jigsaw and painted in bright colors. In front is a sign that
says: An exact replica of a figment of my imagination, and that is what
this life feels like some days. It’s a happy life, but someone is
missing. It’s a happy life, and someone is missing. It’s a happy life —</span></div>
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<span style="font-family: Verdana,sans-serif; font-size: small;">I think she has it just right: "it's a happy life, but someone is missing. It's a
happy life, and someone is missing. It's a happy life --"</span></div>
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A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com18tag:blogger.com,1999:blog-2490179268765761075.post-61974564458323477272013-03-25T11:41:00.000-04:002013-03-25T11:43:43.643-04:00a new spring<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: Verdana,sans-serif;"><a href="http://www.gvp.co.il/images/GV/kalaniot.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://www.gvp.co.il/images/GV/kalaniot.jpg" /></a></span></div>
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<span style="font-family: Verdana,sans-serif;"><span style="font-size: x-small;">photo credit: Gazelle Valley Park, gvp.co.il</span></span></div>
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<span style="font-family: Verdana,sans-serif;">As an update to my previous post, at this past week's appointment I got to speak with the other MFM in more depth about the steroid shots. There are two MFMs who run the prevention of prematurity clinic, so I volley back in forth between them during my clinic visits. I think they are both really competent, and I appreciate having the two different perspectives.<br /><br />In short, we've decided we will definitely do the shots at 28 weeks unless something changes in the mean time, in which case we would do them immediately. As <a href="http://aidanbabyofmine.blogspot.ca/">Emily</a> pointed out in her comment to my last post, Dr. W. said they work most effectively on more mature lung tissue, so from a lung maturation standpoint, they don't function optimally at 24-26 weeks. However, in this age group, they do decrease the likelihood of intraventricular hemorrhage (IVH), which in addition to the respiratory issues, is a major obstacle for micropreemies. <br /><br />In the absence of any indication that I am going to deliver in the near future, she felt pretty strongly that it is best to optimize the lung maturation benefit we will get out of them and get good coverage during the 28-32 week window, which she sees as a more likely scenario than something catastrophic happening over the next few weeks. So I feel better having some resolution on that and I feel comfortable with our choice of waiting a few more weeks.<br /><br />Baby girl is a bit of a chunker, which is great :) Last week her estimated weight was 1 lb. 9 oz., about a week ahead. Her other measurements put her in the 65% percentile for her gestational age. I am happy she is measuring a little big. I did my 1-hr GTT last week. I am a bit nervous about the results, because I didn't know I was doing the test and I had a couple of glasses of cranberry juice with breakfast before I drank the glucola.<br /><br />I have a bad cold which is annoying, but it is nothing more than a nuisance. It felt really good passing V-day, but I will feel even better next week once we G-d willing pass 26 weeks and I am holding out for 28 weeks even more so. The outlook would still be quite bleak if our little girl was born this week, but still, reaching the point when there would at least be an attempt to intervene feels significant. I am hoping for this pregnancy to stay boring for quite a while longer!</span><br />
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<span style="font-family: Verdana,sans-serif;">I am also looking forward to March being over. February and March 2012 were two terrible months for us punctuated by complications, hospitalizations, and of course the loss of Aminadav and Naava. Since then, it has always felt to me like February and March were out to get us. Just one more week and we can kiss my dreaded season goodbye.</span><br />
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<span style="font-family: Verdana,sans-serif;">As the days get longer and warmer and we enter the spring holiday season, I remember the emptiness and hollowness of last spring. Most of all, I remember my empty empty arms after a winter spent gestating two vital little lives. This spring, I still carry that emptiness and hurt in my heart everywhere I go, but I feel thumps and spins and all sorts of acrobatics on the inside that I can't help but admit make feel hopeful and vital again. I guess you could say that finally I am expecting. </span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com11tag:blogger.com,1999:blog-2490179268765761075.post-34952556038086911052013-03-17T22:42:00.000-04:002013-03-17T22:44:23.397-04:00the steroid shot dilemma<span style="font-family: Verdana,sans-serif;">At my last MFM appointment, my doctor let me know that this coming week (24 weeks), I am eligible to receive a course of steroid injections, which will help to mature the baby's lungs should she make an early arrival. Since respiratory issues are the most significant obstacle for many preemies, the ability to jump-start lung maturation is obviously a pretty big deal. There are 2 decisions we need to make 1) whether we want the steroid shots (or under what set of circumstances we would want them) and 2) when we want them.</span><br />
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<span style="font-family: Verdana,sans-serif;">I think it is the second issue - the timing of the injections, that I am having the greatest difficulty with. The potential side effects of the steroids to the baby are fairly minimal in my opinion - babies who have been subjected to repeated courses of steroid injections in utero tend to weigh less than their untreated counterparts. However, this is much less of an issue today.</span><br />
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<span style="font-family: Verdana,sans-serif;">Apparently, because there is a long-held belief that the steroids are no longer maximally effective after 7 days, it was common practice in the 1990s to give a course of steroid injections around viability to at-risk women and then to give repeat doses every 7-14 days if the woman hadn't delivered yet.</span><br />
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<span style="font-family: Verdana,sans-serif;">That is no longer done today - my understanding is that at most you might receive an initial course of steroid injections and then if you still haven't delivered, say 2 months later, but you are in imminent danger of delivering and the baby is still <34 weeks, then they might give a rescue course, so that is 2 courses of injections at the most. </span><br />
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<span style="font-family: Verdana,sans-serif;">The second minor concern is that in animal studies some rats exposed to steroids in utero at doses many, many times higher than the dose given to human patients showed minor neurodevelopmental deficits. Again, this doesn't really concern me very much, especially knowing that steroids have been used in the context of speeding up lung maturation in utero since the 1970s, so pretty good follow-up data exists for humans. In short, I see little downside to getting the injections.</span><br />
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<span style="font-family: Verdana,sans-serif;">The second issue is timing - a long-held belief is that the maximal effect begins to dwindle 7 days after the 2nd (final) injection. However, newer studies have called into question the original data that led to this conclusion and it seems possible that you actually get pretty good coverage past 7 days - maybe even up to a month after the 2nd injection.</span><br />
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<span style="font-family: Verdana,sans-serif;">That being said, there is no doubt that after a certain period of time, the effect diminishes, so if you don't deliver within x weeks of the 2nd injection, it is probably not super helpful. I found it really hard to get a good sense from the literature exactly how quickly and at what time point the effect of the shots becomes worthless...I think it is still a contested issue. </span><br />
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<span style="font-family: Verdana,sans-serif;">I could get the shots this week at 24 weeks, which could be really nice from an emotional perspective - knowing that if G-d forbid something happens during what is a disastrous gestation for birth, our chances would be better. On the other hand, there is no hard data that leads me to believe I am in imminent danger of giving birth, just a whole lot of fear based on my past.</span><br />
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<span style="font-family: Verdana,sans-serif;">So far, my cervix has stayed stable. I have been contracting fairly regularly, but my doctors assure me this is much more annoying than worrisome since my cervix hasn't changed. My placenta scan looked great and I haven't had any bleeding. Aside from my awful past, there is nothing concrete to suggest imminent danger (in spite of this, of course I worry like crazy - I don't ever want to be the sucker who assumes everything is going to be just dandy only to be rudely awakened).</span><br />
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<span style="font-family: Verdana,sans-serif;">Based on this information, it seems wise to hold off on the injections for a few more weeks -- maybe wait until between 26-28 weeks, when then at least I will hopefully get some coverage from them until at least 30 weeks. But then there is the emotional part of me who doesn't want to say "I told you so!" if something horrible happens in the next few weeks.</span><br />
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<span style="font-family: Verdana,sans-serif;">So what do you guys think? What would you do? Clearly there is no single right answer here - if there was, I am pretty sure my doctor wouldn't be leaving the decision in our hands.</span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com13tag:blogger.com,1999:blog-2490179268765761075.post-61684944436247191642013-03-14T00:45:00.001-04:002013-03-14T00:56:09.854-04:00dusting off the cobwebs<span style="font-family: Verdana,sans-serif;">Its been a while. Quite a while. Since I last posted, we passed a lot of significant milestones. All of these milestones were pretty hard, and they actually made me feel less like writing. Instead, they made me want to crawl into my own little cocoon and burrow there for a while.<br /><b><br />The Big Dates</b><br /><br />The first big date was 19w2d, which was my PPROM milestone with the twins. It happened to coincide with the weekend before my SIL's wedding, so it was also a hectic family time. I spent a lot of time crying in the shower and crying in bed that weekend. Hitting my PPROM milestone was harder than I anticipated and made me sadder than I thought it would. <br /><br />I was also incredibly fearful. I knew there were no ominous warning signs that my water was about to break, but it still felt like maybe there was something karmic or evil about that particular gestational age that would rob me of this little one, too.<br /><br />My FIL made a toast at dinner in which he listed month by month all of the babies born in our extended family over the past year and he omitted Aminadav and Naava. Given my already fragile emotional state, this really made me feel like crap even though I know he meant no harm by it. I didn't think it was worth it to call him out on it, especially not on my SIL's wedding weekend when the attention should deservedly be focused on her, but it did really upset me and the timing was just very poor. <br /><br />Y's grandmother noticed the omission and also commented that she always remembers them. We shared a little cry and that made me feel much better.<br /><br />Later in the week, I reached the gestational age where I lost Aminadav and Naava. Getting to that point was surprisingly less emotionally charged and sad for me than my PPROM milestone. I felt a small weight lift from my shoulders as the day ended.<br /><br />And just a few days after that was the Hebrew anniversary (yahrzeit) of Aminadav and Naava's death. I knew that being essentially on the same calendar with this pregnancy as I was with their pregnancy, all of these significant dates would come one after the other. <br /><br />Their yahrzeit falls on the Jewish holiday of Purim, a particularly joyous holiday, ironically. Y and I decided not to celebrate. Instead, I lit their yahrzeit (memorial) candle and we went out snowshoeing in a nature reserve. I wanted to do something solitary in nature, so this felt right to me. In the evening, we went out to dinner. I spent a lot of time crying on their yahrzeit and the crying was very therapeutic for me and actually made me feel better, as I find sitting in the depth of my pain on occasion often does.</span><br />
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<span style="font-family: Verdana,sans-serif;"><br /><br />Then about 10 days after that was the one year anniversary of their birth/death on the English calendar. That date was actually much easier and lighter for me than their yahrzeit. I focused on my appreciation for the blessing of their brief existence instead of on all of the hurt, pain, and what-ifs and should-haves. <br /><b><br />The Babe and Me</b><br /><br />Thank goodness this pregnancy continues relatively uneventfully. My only major complaint is that I have frequent contractions and cramping/pressure, which coupled with my anxiety makes me really nutty. I go in weekly for a tv u/s to measure cervical length and take a quick look at the babe. My cervix continues to hold stable, usually measuring between 3-3.7cm. This is obviously a big relief. <br /><br />At 21 weeks, I had my anatomy scan. Everything looked good and we were told for the 4th time that baby is a girl :) The only notable finding was an echogenic focus on the heart, but we are told that with improving ultrasound technology, this finding is becoming increasingly common and is very unlikely to have any significance in light of our first trimester screening and quad screen results.<br /><br />Baby girl was super active during the anatomy scan, which was pretty cool to see. I have an anterior placenta again this time around, so movement was a little muted at first, but during the past few weeks I have been feeling consistent movement including some really good jabs and kicks that are visible from the outside, which is pretty cool. I started progesterone on the same day as the anatomy scan.</span><br />
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<span style="font-family: Verdana,sans-serif;"><br />I had a detailed placenta scan at 22 weeks, which showed my placenta looks great. This is also a big relief since it seems placental issues are what began the series of disasters that ultimately resulted in the loss of the twins.<br /><br />I've made one trip to L&D, which was actually a positive experience, but hopefully we won't have reason to repeat it for many more weeks. I was having menstrual-like cramping and lower back pain for a few days that wasn't going away and I was scared of PTL. My MFM happened to be on call that night and she was very reassuring. We were in and out within an hour with the knowledge that even if I was contracting, my cervix was stable.<br /><br />I met with the hematologist again a couple of weeks ago. The current plan is that I can get an epidural as long as I take clotting drugs prophylactically beforehand (the concern with an epidural with a bleeding disorder is a subdural hematoma). I will see her again in May.<br /><br />I am really fearful and anxious these days. I am so scared my body will screw up. I know these next few weeks until 28 weeks are really critical. I relive my water breaking all of the time - it was such a strong sensory experience. </span><br />
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<span style="font-family: Verdana,sans-serif;">I know that right now I am very "lucky." Lucky in that I had a relatively easy journey (relative to my previous history, anyway) conceiving this pregnancy after losing the twins and lucky in that so far, I have had a pretty good go of it this time around. (It feels a little ominous and foreboding to write that.) I have experienced enough to realize that this journey has everything to do with dumb luck and little to do with deserving. </span><br />
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<span style="font-family: Verdana,sans-serif;">I exist in this really weird place where I am constantly trying to mentally prepare myself for losing this dream little girl while in the same moment I can look at cute baby clothes and read carseat safety reviews. Stuck between preparing for the future I have dreamed about for so long and preparing for the death that I pray won't happen. </span><br />
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<span style="font-family: Verdana,sans-serif;"> 23 weeks </span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com22tag:blogger.com,1999:blog-2490179268765761075.post-1640099245734378612013-01-26T21:24:00.000-05:002013-01-26T21:29:44.545-05:00a quick week 16 update<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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 <i>this </i>baby on March 7? G-d I hope so.</span><br />
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<span style="font-family: Verdana, sans-serif;">I haven't even wrapped my head around what exactly this one year anniversary <i>is -</i> to be born and die on the same day - a birthday <i>and</i> 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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<span style="font-family: Verdana, sans-serif;">We also found out that baby appears to be a <span style="color: magenta;">GIRL</span>! 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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<i><span style="font-family: Verdana, sans-serif;">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.</span></i>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com9tag:blogger.com,1999:blog-2490179268765761075.post-72614517876331858202013-01-21T13:45:00.001-05:002013-01-21T14:12:44.559-05:00these two lands<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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. </span><br />
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<span style="font-family: Verdana, sans-serif;">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? </span><br />
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<span style="font-family: Verdana, sans-serif;">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. </span><br />
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<span style="font-family: Verdana, sans-serif;">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 <i>those people.</i></span><br />
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<span style="font-family: Verdana, sans-serif;">The belief that there are <i>those people</i> and then there's you is what keeps your imagination from plunging too deeply into the menagerie of horrors that <i>could</i> befall you. But once you become one of <i>those people </i>that wall comes down and you skate on thin ice because every manner of disaster could happen to <i>you. </i>Suddenly, the improbable odds and freak statistics feel very personal.</span><br />
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<span style="font-family: Verdana, sans-serif;">So I carry this kernel of hope deep in my heart; this belief that this time <i>will </i>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.</span><br />
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<span style="font-family: Verdana, sans-serif;">**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.</span><br />
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<span style="font-family: Verdana, sans-serif;">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.</span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com7tag:blogger.com,1999:blog-2490179268765761075.post-48958791149053947072013-01-13T23:04:00.001-05:002013-01-13T23:07:27.667-05:0014.5 weeks - long overdue update!<span style="font-family: Verdana, sans-serif;">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.</span><br />
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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? </span><br />
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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. </span><br />
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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. </span><br />
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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? </span><br />
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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 :) </span><br />
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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. </span><br />
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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.</span><br />
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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.</span><br />
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A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com12tag:blogger.com,1999:blog-2490179268765761075.post-25482135023614545352012-12-16T18:15:00.001-05:002012-12-16T18:15:37.840-05:00week 10 update<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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. </span><br />
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<span style="font-family: Verdana,sans-serif;"> I think that is all the news fit to print in our corner...pretty boring, I think, but for now boring is good!</span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com11tag:blogger.com,1999:blog-2490179268765761075.post-59948402374427157722012-12-04T15:41:00.000-05:002012-12-04T15:46:10.080-05:00an eventful & stressful week<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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? </span><br />
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<span style="font-family: Verdana,sans-serif;">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. </span><br />
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<span style="font-family: Verdana,sans-serif;">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. </span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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%. </span><br />
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<span style="font-family: Verdana,sans-serif;">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."</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;">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.</span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com7tag:blogger.com,1999:blog-2490179268765761075.post-3622959013138554842012-11-21T21:44:00.000-05:002012-11-24T22:44:47.652-05:00our little squiggly & welcome iclw<span style="font-family: Verdana,sans-serif;">Today we went in for our first ultrasound - a day earlier than planned due to some pretty bad cramping I've been having. I have been really terrified the past few days, so I was really happy to get it over with. Thankfully, the news is good. </span><br />
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<span style="font-family: Verdana,sans-serif;">We have one beautiful squiggly measuring a day ahead (6w6d) with a heart rate of 139bpm. I am happy. I am feeling more hopeful than I have in a very long time. I was terrified that we would see an empty sac, but I was also really scared we'd see more than one baby. Twins are so special and wonderful, but after losing Aminadav and Naava, a twin pregnancy is too risky for us. With a singleton, I hope I will have a good shot of carrying close to term. Of course we have a LONG way to go before we are back to the prematurity/PTL concerns.</span><br />
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<span style="font-family: Verdana,sans-serif;">I will do another ultrasound next Thursday and then we will take it from there. This was my first pregnancy-related ultrasound in Canada and it was weird to me that they didn't allow Y into the room, didn't let me see the screen, and would only give me results via my doctor. It felt really paternalistic to be honest. However, they did give me a nice picture of Squiggly. It feels so strange to say that I am feeling happy and peaceful, but it's true!</span><br />
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<span style="font-family: Verdana,sans-serif;">For those just joining us through ICLW, welcome! For a brief recap, we recently learned that we are rather unexpectedly though wonderfully pregnant after a long-shot Clomid/Prednisone cycle while waiting to start a new IVF. We started fertility treatments in August 2010 and since then we've done 6 IUIs and 5 IVF transfers (3 fresh, 2 frozen).</span><br />
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<span style="font-family: Verdana,sans-serif;">We've had many failed treatment cycles and several losses - two early miscarriages and the loss of our beautiful twins, Aminadav and Naava, who were born catastrophically early last March due to PPROM/PTL.</span><br />
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<span style="font-family: Verdana,sans-serif;">This blog has been an infertility blog turned pregnancy after infertility blog turned infertility blog many times over. Through the past few years, I've written quite a bit about unexplained infertility, the IVF process, miscarriage, high-risk pregnancy, and baby loss. The posts that are most meaningful to me are those about Aminadav and Naava, my lost hopes and dreams for them, and my grief.</span><br />
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<span style="font-family: Verdana,sans-serif;">Whatever brings you to our community, I am so sorry for your struggles. This is a sucky club to be a part of, but thankfully for us it is populated by many courageous, funny, resilient, and bright women.</span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com23tag:blogger.com,1999:blog-2490179268765761075.post-335215896279254112012-11-17T21:51:00.000-05:002012-11-17T21:51:50.182-05:00quiet<span style="font-family: Verdana,sans-serif;">I know I have slipped back into my cocoon the last week or so. There is not so much to say about my pregnancy. It is basically a black box until our first ultrasound on Thursday (7 weeks).</span><br />
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<span style="font-family: Verdana,sans-serif;">The days are passing very slowly and I constantly worry that my symptoms are too mild. But I suppose it boils down to something pretty simple -- either there will be a heartbeat(s) on Thursday or there won't be.</span><br />
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<span style="font-family: Verdana,sans-serif;">It is a little haunting how this pregnancy came almost exactly a year after my pregnancy with the twins. The two due dates are just 15 days apart. I can't help but be transformed back to last November -- every little detail of where we were, of how my pregnancy with the twins began to unfold. But it is strangely comforting, too. I feel Naava and Aminadav's presence more strongly now. It is a sweet, bright presence that brings me nostalgia and warmth. </span><br />
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<span style="font-family: Verdana,sans-serif;">Israel has obviously been weighing heavily on my mind. Seeing on the news what it going on back home and not being there -- it is all very strange. Also, now living outside of Israel and seeing the way (some) of the outside world views the conflict is truly distressing and frightening to me. Those who question the right of Israel to exist and defend herself disturb me greatly.</span><br />
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<span style="font-family: Verdana,sans-serif;">Here's to a quieter, calmer week for everyone. </span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com11tag:blogger.com,1999:blog-2490179268765761075.post-43786302416061774672012-11-08T22:59:00.001-05:002012-11-08T22:59:37.998-05:00beta #4 and RPL appointment<span style="font-family: Verdana,sans-serif;">Yesterday beta #4 (20dpo) was 2341, up from 955 two days before (I think I originally wrote that it was 956...I was off by the last digit!). I was pretty relieved and quite pleased with that. My progesterone took a nosedive though, which is weird. I think my dose probably needs to be upped a bit. Of course it makes me nervous...just like everything else.</span><br />
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<span style="font-family: Verdana,sans-serif;">I have another beta draw tomorrow (#5). Hopefully this will be my last. I find the betas really nerve-wracking, so I would be very happy to be done with them, but the RPL doc wants two to compare that were drawn at his clinic since there can be inconsistencies between clinics.</span><br />
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<span style="font-family: Verdana,sans-serif;">Speaking of which, we had our appointment yesterday afternoon with the RPL specialist. It was originally set up as an IVF consult, so I am quite grateful that he was still willing to see us in the context of this rather surprising pregnancy. I did all the first tri bloodwork as well as screening for a bunch of antiphospholipid antibodies.</span><br />
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<span style="font-family: Verdana,sans-serif;">Truthfully, I didn't look too carefully at the requisition sheets so I am not exactly sure of everything we did (very unlike me) but it amounted to 15 vials of blood. Apparently, false negatives for antiphospholipid antibodies are common during pregnancy, but a positive result could change our current management, which is why we still did the tests.</span><br />
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<span style="font-family: Verdana,sans-serif;">In the mean time, I am continuing on with the progesterone and Prednisone (until 12 weeks) and starting low-dose aspirin. I know I spoke to several doctors in Israel who don't believe that baby aspirin does anything, but this doctor felt pretty strongly about it, and I don't think it can hurt...hopefully it will help. He will continue to follow the pregnancy and then if I am lucky enough to make it past first tri, I will be referred to the high-risk clinic.</span><br />
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<span style="font-family: Verdana,sans-serif;">Overall, I feel like we have our bases covered and I am so relieved my beta didn't drop but we have a long way to go, baby - just 5 weeks today.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com7tag:blogger.com,1999:blog-2490179268765761075.post-81464676357976903552012-11-06T07:56:00.001-05:002012-11-06T07:59:20.679-05:00beta anxiety (second edition)<span style="font-family: Verdana,sans-serif;">Last night Y got a script from his dad for a beta, if I wanted to repeat it today instead of waiting. I toyed with idea - I figured if this pregnancy is truly on its way out right now (a possibility), it would be reflected in a beta that is the same as yesterday or falling. But an equally likely possibility, perhaps even more likely, is that the number would be up, maybe another slow rise, and repeating it within 24 hours instead of the traditional 48 would just make it unequivocal and hard to interpret. The final possibility, that my hcg is playing nice again, is also definitely possible, but just having the 24h result, I'd still be nervous.</span><br />
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<span style="font-family: Verdana,sans-serif;">So...I decided I would POAS this morning and if the FRER was clearly getting lighter, I would go in for another draw this morning to confirm a fall, if it looked the same or even darker, I would wait 48h for the next draw....very scientific, I know :)</span><br />
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<span style="font-family: Verdana,sans-serif;">I had a really weird dream that I was getting some work done in an empty classroom, which apparently involved spreading my possessions about, including a massive collection of saved FRERs from this pregnancy. In the dream, I proceeded to pack up most of my stuff, forgetting the FRERs, and realizing only too late that a class had begun and a bunch of kids were now in the room...WEIRD.</span><br />
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<span style="font-family: Verdana,sans-serif;">In my second dream, this morning's FRER shattered before I could really interpret the result. And for what it's worth, in reality, today's FRER looked the same as the one from 2 days ago, but since the pregnancy line is so much darker than the control line, it is hard to interpret beyond safely saying that my beta is not likely plummeting.</span><br />
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<span style="font-family: Verdana,sans-serif;">So now I get back on the waiting train. I know I was a bit dramatic last night....but I was really so sad and disappointed. I know I have a tendency to jump right to the post-mortem before disaster has been confirmed (or sometimes even, denied).</span><br />
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<span style="font-family: Verdana,sans-serif;">What doesn't help this tendency to jump to the worst conclusion whenever anything is less than perfect is my history. It seems that anytime anything is slightly less than stellar for me pregnancy-wise, it inevitably leads to a succession of events that culminates in something bad.</span><br />
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<span style="font-family: Verdana,sans-serif;">The truth is, I am barely coping with my fear and anxiety when everything is going perfectly, so when stuff goes less than perfectly, it really throws me a curve ball. For now, I am just trying to get through the day.</span><br />
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<span style="font-family: Verdana,sans-serif;">I know that betas that stop doubling nicely can be ominous and unfortunately, the first sign of a pregnancy that isn't doing well can be jittery betas, even if it's only weeks later that the pregnancy actually fails.</span><br />
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<span style="font-family: Verdana,sans-serif;">Two rather innocuous possibilities for the slower rise:</span><br />
<span style="font-family: Verdana,sans-serif;">1) There were two embryos and now there's one....a vanishing twin. My betas have been higher than average, even for a twin pregnancy, according to betabase, though I know there is no hard science to predicting multiples based on betas...high betas can also of course correspond to a singleton who implanted on the earlier side. If there was in fact a vanishing twin, my betas should recover with the next draw.</span><br />
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<span style="font-family: Verdana,sans-serif;">2) Y suggested that perhaps I was a bit dehydrated for beta #2, artificially raising the result. If you consider only the first and third beta values, the overall doubling time is still within 48 hours.</span><br />
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<span style="font-family: Verdana,sans-serif;">I am so anxious about the future, but like with everything else, unfortunately only time will tell.</span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com7tag:blogger.com,1999:blog-2490179268765761075.post-69065615039334249242012-11-05T20:49:00.000-05:002012-11-05T20:51:41.114-05:00beta blues<span style="font-family: Verdana,sans-serif;">I wish those magical two pink lines didn't make my heart sing with glee every time I see them. I wish those magical two pink lines didn't tempt me to fantasize about my dream life, the life I took for granted that would be mine for so many years every time I see them.</span><br />
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<span style="font-family: Verdana,sans-serif;">Every time so far that I've seen those magical two pink lines, I've been duped, and yet, every time I seem them again, I am filled with renewed hope and anxiety and fear and forboding, yes, but also so much joy too.</span><br />
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<span style="font-family: Verdana,sans-serif;">Why? Why can't I view those magical two pink lines of a pregnancy test with the same detachment I view the two very unassuming lines on an ovulation predictor stick? Why can't I just learn my lesson? In my world, those magical two pink lines -- they pretty much mean...nothing. But I seem to be very late to the game in accepting this on an emotional level.</span><br />
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<span style="font-family: Verdana,sans-serif;">The doubling time between betas 1 and 2 was 33 hours -- from 146 at 13dpo to 391 at 15dpo. Those were some pretty strong betas. However, beta 3 at 18dpo was 956, a slowing to a 56 hour doubling time. Coupled with the awful headache and lower back cramps I've had today, I can't help but worry that this pregnancy has begun to fail.</span><br />
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<span style="font-family: Verdana,sans-serif;">Also, this is ridiculously subjective, I know, but I POAS yesterday morning and the pregnancy line was soooo much darker than the control (it stole most of the dye from the control line), I really think that it would have corresponded to a beta of at least 1000 and that things just took a downturn in the past 24 hours.</span><br />
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<span style="font-family: Verdana,sans-serif;">I know a beta can take 72 hours to double and it can still be okay. I know the 48 hour doubling time rule is a little arbitrary and that there is a whole spectrum, but I have never had betas not double in 48 hours and had it been okay. Also, these cramps are for real. So, I think I might be pretty close to bidding pregnancy #4 goodbye. I only hope that if it's not meant to be, it won't be a protracted ordeal with unequivocal betas and ultrasounds and that it will end quickly.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">I am sad tonight. I really believe in my heart every time that this is the time that will be different, but sometimes to continue trying just feels like punishment. I also believe in my heart that this is a problem with my body and not our embryos.</span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com6tag:blogger.com,1999:blog-2490179268765761075.post-53849705688652446462012-11-04T06:16:00.000-05:002012-11-04T10:22:13.774-05:00that other 2ww - TO2WW<span style="font-family: Verdana,sans-serif;">The 2ww (or more) between a +hpt and an ultrasound to confirm the heartbeat(s), now fondly dubbed 'TO2WW': biggest mindf*ck ever. Of course its redeeming quality is that it is for a great cause, because until proven otherwise, you are pregnant. Its undoing is that the stakes have been upped over the previous 2ww yet the potential for disaster is still quite high.<br /><br /> After the two pink lines is both the best and worst place that an infertile can be. <br /><br />Here is a (maybe not so) brief history of the reason why TO2WW makes me nutty:<br /><br />October 2010 - pregnancy 1 (IUI 2): <br />Looks like a late implanter, but in Israel all of the drugstore hpts are pretty crappy, so….the most expensive stick I could find, the "Yes or No Professional" test, doesn't yield a faint positive until 14 dpIUI. And the underwhelming 1st beta …<br />14 dpIUI: 42<br />18 dpIUI: 279<br />25 dpIUI: 3576<br /><br />Guiding initial thoughts of pregnancy 1: Betas start off low but the numbers (more than) double nicely. It is my first pregnancy and I am pretty anxious but I haven't yet actually had a loss so oblivion is still (sort of) my friend at this point. An ultrasound at 5w2d reveals just a GS - but again, I am too naive to think disaster at every turn. I still have some trust in the process and in my body. Brown spotting for a few days during week 6. Ultrasound at 7w3d - no heartbeat - missed m/c. Game over pregnancy #1.<br /><br />new neuroses developed: Late implantation is an ominous sign of bad things to come. Brown spotting means the baby has died.<br /><br />November 2011 - pregnancy 2 (IVF #2):<br />Guiding initial thoughts of pregnancy 2: I am a smart girl and stockpiled FRERs during my trip to the states so pesky subpar hpts won't keep me from a successful pregnancy test this time around (since that was clearly the problem last time). First +hpt 6dp5dt - see these pee sticks are worth their weight in gold! Initial thought: Not a late implanter this time, an auspicious start, in my mind timely implantation = successful pregnancy.<br />beta 1 (11dp5dt): 308<br />beta 2 (13dp5dt): 849<br /><br />Guiding thoughts con't: Well this is definitely different from last time, so hopefully it is going to work out. Wait, no, not enough symptoms…they come, they go away. This shit is crazy. Night before 1st <br />u/s (6w2d) - I'm not even tired anymore, another missed miscarriage, I think. Arrive to clinic for ultrasound dejected - we both expect bad news (I have also convinced Y without doubt that the pregnancy is doomed because, well, I am not tired anymore, I am not nauseated, etc.). Ultrasound #1 - 2 heartbeats! <br /><br />Week 9 - start bleeding bright red. Previous experience dictates that blood = dead babies. Shocked and relieved to find out that bleeding is 'only' from a SCH - the same SCH that rears its ugly head again at week 16 and leads to the succession of events that ultimately result in the death of both my beautiful babies, but I don't know that yet.<br /><br />Week 19-20 - Aminadav's water breaks - PPROM. I lose both my little loves to PPROM/PTL.<br /><br />new neuroses developed: It's never too late in pregnancy for your bab(ies) to die, either inside of you, or by arriving a few weeks short of viability (or as it also often happens, after…). Bleeding is a harbinger of disaster. If you PPROM before viability, you are in a bad, bad place.<br /><br />June 2012 - pregnancy 3 (IVF 3): <br /><br />Day 3 SET after a bumpy cycle and premature luteinization (premature progesterone rise). SET on day 3 is pretty low yield and at this point 6/8 of the embryos we have transferred via IVF have not implanted, so our IVF history doesn't bode so well for day 3 SET, but it is what it is. We are super surprised to get a +hpt at 6dp5dt. <br /><br />Guiding initial thoughts of pregnancy 3: A singleton pregnancy with strong implantation bodes well for us. There is no reason to believe this won't work, other than the fact that it never has in the past.<br /><br />beta 1 (12dp3dt): 138<br />beta 2 (14dp3dt): 139<br />very early m/c at 5w2d<br /><br />Continued guiding thoughts: So clearly early implantation and a solid first beta doesn't necessarily stop the pregnancy from falling off a cliff with style. Weird…I thought most chemical pregnancies started with dubiously low betas and late implantation. Seems more likely due to a maternal factor than a genetic problem, but that's just a guess. <br /><br />new neuroses developed: A +hpt early on or a nice first beta doesn't protect against a chemical pregnancy or early miscarriage. Those beta hCG numbers can come crashing down from anywhere.<br /><br />October 2012 - pregnancy 4 (Clomid/Prednisone/TI…surprise!)<br /><br />+hpt 11dpo (I just corrected that from '6dp5dt' - apparently I am still in disbelief that this wasn't an IVF cycle!)<br />beta 1 (13 dpo): 146<br />The pee sticks keep getting darker.<br /><br />Guiding initial thoughts: Expect nothing. All bets are off. Well, a nicer way of saying that is "expect the worst, hope for the best." My symptoms come and go. I understand that every tiny thing could mean either nothing or everything, but only time will tell, and the wait is maddening. I have now been waiting over 72 hours for the results of beta 2 (in Israel I never waited more than 2.5-3.5 hours for a beta result!) and the wait is driving me nuts, as is the knowledge that by the time I receive the result, it will be obsolete (i.e. so 3 days ago!).<br /><br />new neuroses: Everything. Pregnancy is a mine-field that can be cut short or go wrong at any point due to an endless combination of disasters. But with each new chance, there is always the possibility for all of the stars to align so that we bring home a living child, and that little bit of hope propels us forward, and so we keep on keeping on. In the meantime, I think I need a therapist. </span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com10tag:blogger.com,1999:blog-2490179268765761075.post-976730309671613542012-10-31T23:09:00.000-04:002012-10-31T23:21:55.010-04:00the (great) unexpected<span style="font-family: Verdana,sans-serif;">So…this is very strange for me. This was something I wasn't anticipating at all. I actually feel pretty uncomfortable writing about it. In my last post, I mentioned that before getting back into the IVF grind I was doing a long-shot Clomid/Prednisone cycle, just to help pass the time. <br /><br />I also mentioned it was a bit of an experiment - I thought it was a little uncanny that both of the 2/5 IVF transfers when we used Prednisone I conceived. With IVF, there are so many variables, it was obviously impossible to speculate too much about the role of the Prednisone. I did wonder, though, if our problem was really of the implantation/autoimmune variety, whether I might be able to get pregnant with minimal intervention if I was on Prednisone. <br /><br />It still obviously seemed like a total long-shot with my history -- after 6 IUIs and 5 IVF transfers you don't realistically expect to get KU with $60 worth of pills. But it happened. Y and I are both shocked that this far-fetched experiment to pass the time before our upcoming IVF consults following the epic Canadian wait has worked…at least so far. <br /><br />Even if this cycle doesn't result in a successful pregnancy, I think it has taught us a lot. We really need to re-address some of our most basic assumptions about the nature of my infertility and its treatment -- specifically, considering the autoimmune angle.<br /><br />I got a positive hpt at 11dpo, the day after I wrote my last post. Today my first beta at 13dpo was 146. Obviously, we are feeling very cautious and guarded. We've experienced so many different ways of pregnancy not working out, it feels like a bit of a mine field and it is really hard to have any expectations at all, especially this early.<br /><br />Also, I have been spotting the last 2 days which makes me pretty nervous, though the first beta helped to allay my fears a little bit. I go back on Friday for beta 2. Please keep us in your thoughts that this turns out well. <br /><br />I am feeling really guarded in sharing the news this time around even on the blog -- still trying to process this really surprising but obviously extremely welcome news myself.<br /><br />Here we go again. Let's do this.</span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com22tag:blogger.com,1999:blog-2490179268765761075.post-17199018086778688792012-10-28T21:34:00.001-04:002012-10-28T21:35:23.788-04:00well, hello there :)<span style="font-family: Verdana,sans-serif;">After a lengthy break, I am going to try to get back into the writing groove again. I know I have been pretty silent over the last few months, but I have been following along in my reader most days and thinking of all the courageous, strong, smart, and funny women out there. My grief does tend to turn me inwards for long periods of time and it is hard for me to write, but now that we are getting back into the concrete stuff, there should be more to write about than my sadness.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">Where are we? Well probably pretty close to getting right back in the thick of things. After our long Canadian-style wait, we have 2 consults coming up the week after next. I am due to get AF in a few days and then I go to get my AMH drawn and the usual CD3 bloodwork. Y did a new S/A last week and he also did the DNA fragmentation test for the first time.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">I have a SHG scheduled for the week after this coming one, right before we dive into the consults. The SHG will be important because we need to reach a final consensus on those damn fibroids before proceeding (the current leaning is no surgery, but we need to reach a confident decision) and because it will hopefully rule out scar tissue/adhesions.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">My cycles have been a good deal shorter and lighter since I gave birth and the complications that came after, so the hope is that the shorter and lighter cycles are a good thing and not indicative of Asherman's Syndrome, which I am unfortunately at pretty high risk for due to my history of multiple D&Cs and retained placenta.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">I am sure I will have lots to talk about when we look into both clinics we are considering. Both clinics have different options which could be interesting or useful to us -- Clinic A has a very well-regarded RPL specialist who conducts clinical trials in that area. They also do a lot of blastocyst transfer and offer PGS (need to clarify which type of PGS). Clinic B offers endometrial co-culture and routinely prescribes intralipids.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">We might end up not going for any extra bells and whistles at all, but it will definitely be interesting to learn about the different possibilities and also to have a fresh set of eyes review our case. All that being said, I am still feeling ambivalent about getting back into cycling from an emotional perspective, not to mention the immense cost.</span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">In short, these upcoming consults will hopefully be worthwhile and interesting but we are not yet 100% committed to cycling again in the near future. Also, the SHG results could be a big game changer -- potentially surgery vs. beginning the path of working towards surrogacy if Asherman's is an issue. </span><br />
<span style="font-family: Verdana,sans-serif;"><br /></span>
<span style="font-family: Verdana,sans-serif;">This past cycle has been somewhat of a hail-Mary-type (I don't think we have an equivalent expression in Judaism) long-shot attempt...since I am still unexplained and we thought it was uncanny that the 2/5 IVF transfers that yielded a positive pregnancy test were the only transfers I took Prednisone, we did a cheapy Clomid/Prednisone cycle this month just for the hell of it before we prepare to shell-out big time to re-enter the IVF circuit. I will of course let you guys know if anything comes of it, but it is a real long-shot.</span><br />
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<span style="font-family: Verdana,sans-serif;"><br /></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com8tag:blogger.com,1999:blog-2490179268765761075.post-38780797721034135432012-10-07T00:29:00.000-04:002012-10-28T07:34:25.692-04:00the worst thing that could happen<span style="font-family: Verdana,sans-serif; font-size: small;"><span style="font-weight: normal;"><span class="messageBody" data-ft="{"type":3}"><span class="userContent">Funny story: We met a couple at my in-laws' synagogue today who had lived in Israel for a while. Their 4th child was born in Israel at Hospital X. The wife was
saying to us that having a baby in Israel was difficult and that
Hospital X was a bad experience for her. </span></span></span></span><br />
<span style="font-family: Verdana,sans-serif; font-size: small;"><br /><span style="font-weight: normal;"><span class="messageBody" data-ft="{"type":3}"><span class="userContent">She detailed her list
of complaints (I do not judge them at all, but suffice it to say her and
her child are both happy & healthy today). Y and I were both
smiling and nodding when she exclaimed "Omg! I
hope I didn't just scare you from having a baby at Hospital X!" Once
she walked away, we couldn't stop laughing. Needless to say we didn't mention our twins born there.</span></span></span></span>
A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com2tag:blogger.com,1999:blog-2490179268765761075.post-29170930665970188432012-09-02T14:08:00.002-04:002012-10-28T07:30:10.613-04:00dreams<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Our housekeeper back in Israel would base major life decisions based on revelations in her dreams. She believed strongly in the ability of dreams to inform, clarify, and portend. She was a little nutty (though a very conscientious cleaner).</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">A few nights ago I had a pretty interesting dream. It was the first adoption dream I had in a couple of years. The last one I remember distinctly must have been around two years ago, when we were doing IUIs. In this dream we were presented the option of a newborn boy or girl or both for adoption.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">The interesting twist (because this was a dream there has to be an interesting twist) was that we were also involved in surrogacy at the time, but we didn't actually know who our gestational carrier was or whether she was in a successful pregnancy. </span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">So in the dream, it was unclear whether we were being offered our own biological children, whether neither of them were our biological children, or whether it was a mix. Y was very concerned with clarifying the origin of each baby before agreeing to anything. </span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">The revelation in the dream was that I hardly cared -- if the information was readily available, I wanted to know it, but in the absence of that, it didn't really bother me whether or not the children were biologically ours.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">The dream actually wonderfully clarified for me that I just really want to be a mom. I want a child in my home that is our child. The details of how that child comes to be -- in whose uterus and with whose genetic material has become a lot less important to me.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">For a long time, I wanted to be pregnant so so badly. I wanted to experience pregnancy at least as much as I wanted to experience motherhood. I don't count the first trimester losses because I never got very far, but with the twins I was really pregnant and I got quite big, too. </span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">I found out being pregnant had its magnificent aspects, for sure - watching my belly grow and swell and my body change to support life, feeling the babies, the happy ultrasounds. But for me, pregnancy was also not everything it was cracked up to be. I had a difficult go of it and spent a lot of my pregnancy in bed at home or in the hospital. </span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">The total length of time when I had a real bump but was still out in public, not holed up in my bedroom or a hospital room, probably comes out to about 3 weeks. I still associate pregnancy with illness and fragility. I think deep down it's really better not to move. </span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">I see very pregnant women all of the time doing normal people things -- shopping, pushing strollers, exercising. All of it just blows my mind. They can do all of those normal people things and the baby just stays inside, growing away!</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">I watched my body change in these extraordinary ways, I got the huge belly, but still I didn't get the babies -- or I did get the babies, but I didn't get the babies to bring home and keep, which is a pretty big detail.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">Wanting to experience pregnancy and wanting a baby are two different things, it turns out. Now I am mostly focused on the part of the journey I've missed out on. It would be nice to repeat the first leg (pregnancy), albeit successfully, but I know the first leg surely doesn't guarantee the second leg (motherhood), nor is there an absolute requirement to personally complete the first leg in order to experience the second leg.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">This forced break is allowing me lots of time to reflect and entertain different possibilities more seriously. At this point we are on a forced break because in Canada it takes months to get an initial consultation with a RE. We are currently scheduled for mid-November, and then it would take a couple months after that to begin a new IVF cycle.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">I have come to the conclusion that carrying my own baby and/or a genetic connection to the baby are not deal breakers for me anymore. For Y it is different -- I think he is more open-minded towards surrogacy but adoption is still out for him. I can't force him to get there.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">I don't think either of us is quite ready to abandon traditional IVF and using my uterus, but it is both liberating and comforting to be open to the possibility of other options (surrogacy, adoption, etc). </span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;">I am trying to set some sort of timeline for us pressing forward with new options -- drawing a line at what point I give myself permission to say I've had enough and it is time to pursue a new option. Ultimately, I am willing to be flexible with my timeline when the milestones and dates on it loom close if it is appropriate, but for now a self-issued ultimatum might be my ticket to freedom.</span></span>
<br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span><span style="font-size: small;"><br /></span></span>
A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com8tag:blogger.com,1999:blog-2490179268765761075.post-89217168682558937222012-08-12T15:39:00.000-04:002012-10-28T07:28:22.838-04:00what we (think) we are owed<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">A few weeks back, Y and I went to our first infertility support group meeting. I am not sure that it was super helpful to us because most of the couples were at a different stage of their infertility journey, but the facilitator was great. One comment she made in particular stuck with me.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">She said that when we first set out trying to conceive, we think that we are going to get the gold -- the gold being everything we want and on the time scale we want it. And then maybe it turns out it is taking longer than we thought and we need a little pharmaceutical help -- we are now going for the silver. Maybe then it turns out our problems are in fact pretty big so after the silver doesn't pan out, we're going for IVF -- now we're aiming for the bronze. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Maybe after that we are in a position where we are getting comfortable with the idea of donor egg or a gestational carrier or we are pursuing adoption, and so we give up a little more of the original dream. I don't think the point was that any of the outcomes that aren't the first one -- everything we want and on the time scale we want it -- is somehow ultimately less good, but more that in order to get it, we may be finding ourselves sacrificing more and more of our original vision and all the while time is passing. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">The truth is, I don't remember the original context of her remark, but it crystalized for me something really important. When we found out we were expecting twins and then later on, when we found out we were expecting a boy and a girl, I felt like everything that had been taken away from me in this journey was suddenly and unexpectedly gifted back, just like that. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">In other words, we were going to get the gold. It wasn't without lots of sweat, tears, perseverance, sacrifice, and hard work, but we would get our happy ending -- what we were owed. The world was suddenly a fair place again, just as I had always known it to be until infertility and loss entered our lives. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">We would have the two children we would have had if we had control over our reproductive fate and in the same time frame! A son and a daughter! It seemed too good to be true, but we did work really hard to get there, so why not? Why couldn't we have it all, get the gold, after our shit luck until then? It happens to others in the infertility community all the time, really -- from zero to two -- just like that. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Everything that happened to us until then infertility-wise sucked but it was tolerable and livable. It was something I was willing to put up with and rationalize, if we could then just get our happy ending. For lack of a better term, it was all within the realm of normal infertility suckiness. Par for the course.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">And while it might have seemed sudden and unexpected when it finally worked and we conceived two beautiful babies, I felt like we <i>deserved</i> it because we are fundamentally good people who had worked very hard to get there. (But the unanswerable question that many of us avoid altogether in the moments of dazed self-congratulations then becomes what about everyone else on a similar road who has not been granted the same good fortune?) </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><i>Owed, deserved</i> -- what dangerous words and concepts these are. I think you can probably already see where I am going with this.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I wasn't naive about the risks of a twin pregnancy -- if I look back at my posts during that period of time I don't think I was every really happy-go-lucky or flippant about the pregnancy. But deep down, even when the pregnancy became complicated, I fundamentally believed we would get our take-home babies -- that this would be very hard and scary, sure, but that we would also all make it out of this alive. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Even if you are particularly anxious and fearful, I don't think you ever really believe that you will be the horror story. In fact, isn't imagining the worst over and over again supposed to be some sort of protection mechanism? I am pretty sure that I subconsciously thought so.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">So, obviously, in the end, we did not get the gold -- we came really close but we didn't get gold. Or silver. Or bronze. Actually, we didn't even place, we just pretty much careened off the course entirely. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">What I want to get back to is this idea of what we are <i>owed</i> and what we <i>deserve</i>. It is something I struggle with in the present constantly -- this notion that we do all of this stuff and go through all of these trials and therefore it has to lead somewhere. It all has to be for <i>something</i> -- to ultimately fulfill some purpose. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">But sometimes it's not.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Many times I see that women who have achieved their happy ending attempt to rationalize what it took to get there and find some meaning in it. For many of us, the journey can never just be an endless trek of failure, pain, and suffering -- it has to mean something and it has to have all been for something. The alternative is just too depressing and soul-crushing. It is not too difficult to rationalize the journey if you do get the happy ending, as I would have if Aminadav and Naava had come home with us. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">But what about when that doesn't happen?</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I know now I will never get the gold. I missed it entirely. What I mean by that is even if I do eventually get my living child(ten) in one way or another, I have lost too much that is irreplaceable for it to ever 'make up' for what I have experienced and what I have lost -- there will forever be my son and daughter missing from our lives, and that is not something fixable. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Until I lost them, the loss and sacrifice that I had experienced along this road deeply affected me, but there was nothing I had given up or lost that was unredeemable or unforgivable with the good fortune of the twins. It's not that I would forget the journey, but I was willing to bargain <i>this</i> for <i>that</i> and <i>this </i>(6 IUIs, 4 IVF transfers, a miscarriage) certainly seemed 'worth it' for what I could get in return (a son and a daughter).</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">How do I shake this idea of being <i>owed </i>a living child for what I have endured? It is so naive -- and yet a testament to how good and straightforward my life was until infertility -- this belief everything I work hard at will be handed to me. Life doesn't really work like that, I know, but part of me can't shake the idea. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">When I had the very early miscarriage that resulted from the IVF cycle we did after losing the twins part of me was like "C'mon -- what did you expect, A? Of course it didn't work out. It never works out for you. Don't you get it by now?" but part of me was suspended in disbelief "How could it not work out -- after all of this don't you just <i>deserve</i> for things to work out?" </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Part of me just can't shake the belief in the Very American Happy Ending. Hard work = a great reward. I try to shake it but there is a girl underneath who still believes in it. And yet it is ultimately so damaging to subscribe to that idea when life keeps throwing lemons at you -- if life hands us what we <i>deserve</i>, what does that say about Y and myself? </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I still try to bargain all of the time. It is disastrous. I think to myself -- if we couldn't keep Aminadav and Naava, then the second best thing would be to have twins again. A second chance. We deserve to have twins. Twins are so special, I think. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">But I know this is totally unrealistic, especially because we plan to only do SET in the future (as we did with our last IVF) since another twin pregnancy is too dangerous for us. Even if we did transfer more than one embryo, realistically our chances of both sticking around are quite low given our IVF track record. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I keep reminding myself that the goal is to have one healthy, living child who I can carry to term. Let's not get ahead of ourselves and get greedy, here, I tell myself. So I guess along side mourning the loss of my particular, beautiful twins, I also mourn the loss of ever having twins again, which often felt like something special to make up for the lousy hand we had been dealt until then. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I have lost too much to ever think I can have it all again -- the gold has clearly evaded me -- but still there is that stupid quiet voice who says don't you <i>deserve</i> a happy ending? This can't all be for nothing, right? Aren't you owed a living child? Or two.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><i>How about you? Do you struggle with this idea of being owed something or deserving it? Did you feel the gold or silver or even the bronze was taken from you only to unexpectedly get it all back (or not)? If you've had your happy ending, do you rationalize what it took to get there?</i></span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com18tag:blogger.com,1999:blog-2490179268765761075.post-67192738767481967872012-08-06T01:27:00.000-04:002012-10-28T07:28:55.189-04:00searching for a new lightness<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I used to smile A LOT. I was always a very smiley person. I also used to be kind of famous for my laughter, which was totally contagious. I can sort of boast about these things because it is so removed from who I am now. My fourth grade teacher overhead me laughing in a restaurant from another table without seeing my face and she instantaneously knew it was me. I was 22 years old. I hadn't seen her in 12 years.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">People from all corners of my life always used to comment on my smile and laugh. It was something that stuck with them. My physical chemistry lab instructor approached me one day in the middle of lab, three weeks into the semester, and quipped disappointedly "A., I hear you are so much FUN! You haven't said one fun thing yet!" </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">In my new life, I never say anything funny, either on purpose or unintentionally, and I don't smile or laugh very much, either. I think I am actually a total downer to be around. I have been thinking lately that I wouldn't want to spend too much time around me. Poor Y.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I have slowly, over a long period of time, turned more and more inward. Most people who have met me in the past few years would probably describe me as awkward, serious, introverted, and well, <i>whiny</i>.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Infertility and loss has made me more empathetic and given me depth and maturity, but those things are much harder to see and appreciate, at least on the surface. Infertility and loss has also made me less vital, less zany, quirky and fun -- a muted, subdued version of myself. And I think I might also be less good-natured and more inclined to hold a grudge, especially if you were a jerk to me when I lost the twins.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">More and more turned inward. I think that really accurately describes it. Not self-involved in a narcissistic or conceited sense, but in a darker self-obsessed way. Self-obsessed with my misery, my bad fortune, my inability to understand or answer all of the whys of how this came to be our lot. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I realized recently that I have been complaining a lot about stupid things. Mostly things that are within my control. And I realized this all serves as a cover. I think I have a compulsion to complain because of what really bothers me and how freaking unfair it is, but because it is not socially acceptable to talk about my infertility or my dead babies, I just complain about completely stupid inane stuff instead:</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Y hasn't yet taken me to a baseball game this summer, we will probably never go, pity me, etc. etc. <b>Read: </b><i>My babies died and I am still incredibly pissed and sad and confused about it</i> pity me, etc. etc. It must be so annoying to listen to.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Self-pity. Well, there is not much more to say than that
self-pity really blows. No one wants to be proficient in the art of
self-pity, but thank goodness, those of us who have gotten really adept
at it are usually too self-involved to notice, save for the brief
glimpse of self-awareness. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I wonder if I actually talked about the heart of it and acknowledged it outside of this blog like it is a normal topic of conversation: That I have had a really shitty, disastrous go of it conceiving and maintaining a pregnancy. That I had babies but they died and I don't know why things happened the way they did, but that it is really unfair and sucky. That I wish and pray for a living child every day -- whether maybe some of the burden would be relieved and I could find some lightness again and stop acting like a crochety old hag who is so hard done by.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I wish I could act like someone I would actually like to spend time with, but I am not there yet and instead I am too involved in self-pity and self-loathing to have an open heart. How can I find the beauty and the fun in simple things and in my friends and family again? Can I reclaim my smile and my laugh, even if I never feel my old, unhinged lightness again? And can I learn to find a new kind of lightness among the heavy things?</span></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com6tag:blogger.com,1999:blog-2490179268765761075.post-27029035548630045442012-07-30T23:04:00.000-04:002012-10-28T07:29:33.910-04:00on gravesites, due dates, and the after<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Last week was Aminadav and Naava's due date (by 40 week standards, though I knew with twins I was never going to make it that far even under the best of circumstances). I found myself becoming increasingly miserable as the due date approached.<i> </i> It meant another degree of finality was closing in surrounding their death -- almost as if the possibility of their existence slightly existed in some alternate universe until that date came around and slammed shut any possibility. As if they existed in some suspended in-between until now, certainly not here, but the possibility not entirely gone, either. The difference between gone and <i>really gone.</i> I know it's wacky and illogical, but it is the best way that I can describe it. </span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">I felt like we were supposed to do something special to commemorate the day but I wasn't sure what, and so I was left grasping for something that felt very elusive while feeling like I was failing extraordinarily to honor them properly. Should I buy a bundle of sunflowers -- too cheery? Light a candle -- tacky or a little macabre? Nothing was really speaking to me.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">The day before I was positively wallowing in dread watching the calendar inch closer and closer to what never was and never will be. In order to cross between the research lab and the main hospital building to go to the coffee shop, I go through the traffic circle entrance of the hospital out back, where parents load their newborns into the car to take home.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">That afternoon as I walked into the hospital, there was a family parked in the traffic circle with their two kids and newborn daughter. The father was videotaping the mom carrying her to the car narrating, "And here is her first time in the car! Here she is coming home!" Watching the happy new parents load their newborn into the car struck a raw chord. I couldn't hold back my tears thinking of my poor babies who never got to come home with us. I wasn't jealous, just so sad for Aminadav and Naava and sad for us, especially knowing that the babies coming home healthy now are their compatriots.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">One thing that has grated on my conscious constantly is being physically so far away from Aminadav and Naava, with them buried in Israel and us here, and also not having a special place to go to that acknowledges them. One thing I have not written about at all here -- perhaps because until now it was too painful -- is the reality of what happens to babies lost during late pregnancy or shortly after birth in Israel.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">While the notion of a proper burial applies, there is a long-held belief that parents of young babies should not participate in the burial and should not know where the baby is buried. Different chevrot kadisha (ritual burial committees) enforce this policy with varying degrees of strictness and leniency, but in the hospital they don't really present the different options to you -- you just sort of get stuck with whatever chevra kadisha serves that particular hospital.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">At first, when we signed their bodies away to the chevra kadisha, I was pretty naive and I was just happy that my babies would get a proper burial and not be considered medical waste or some similarly horrible fate. I wasn't thinking about it so clearly at the time, but I didn't realize I might never find out where they are buried.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">In the months after we lost Aminadav and Naava I began to wonder more and more where they were buried and began to develop a desire to find out and visit the place. In the process, I learned more & more about what this might entail. Not shockingly, I am not alone, and you can find many similarly-minded posts on the Israeli pregnancy loss forums, of women months and sometimes years later, trying to figure out where their babies are buried.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">I learned that oftentimes it is difficult to just get in touch with the correct chevra kadisha and if you do, getting any information at all can be extremely difficult if the person you are in contact with thinks he is protecting you by refusing to give any information. If you are lucky enough to find someone willing to help locate the body, the records are sometimes kept shoddily, and especially if time has elapsed, it is sometimes impossible to find a record of the body. I also found out that the babies are generally buried together in mass graves that are either unmarked or poorly marked.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">I know this reality may sound shocking and horrible to many, but this is the situation we are dealt in Israel. Of course now I would like to spread awareness among women in similar circumstances -- that at least there is a choice in which chevra kadisha comes for the body and that some are much more willing to involve the parents in the burial itself and the details surrounding it, but this was not information at hand for us when it was relevant.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">I had a very strong desire to find out where Aminadav and Naava were buried before we left for Toronto, but I had an oversimplified fantasy of how we would find out before I started fact-finding and reading the forums. I have a wonderful book on pregnancy loss in Hebrew - כחלֹום יעוף - <i>Like a Fleeting Dream</i>, which to my knowledge is the only Hebrew language book on pregnancy loss written for religious couples. The book has a listing of phone numbers for the chevrot kadisha serving various Israeli hospitals. I thought we would just call the listed number, they would look up our babies in their records, and we would have our answer.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Of course it wasn't simple at all. After a long and convoluted goose chase, Y did succeed in tracking down the cell phone number of the man who took their bodies. However, he only finally succeeded getting his cell phone number the night before we left Israel, which made visiting them impossible. Also, I was really adamant that we try to track down the information before leaving because I figured that as more time passed, the chances of getting the information would just become increasingly slim.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Sure enough, the man remembered our babies as "the twins from Purim" (Purim is the Jewish holiday on which our babies died -- ironically, it is a particularly joyous holiday.) However, he would not agree to tell us where the babies are buried, at least not outright. Instead, he spoke in riddles, I assume because he had a moral opposition to telling us, but at the same time had some empathy for our situation. We understood from what he told us what city and what cemetery the twins are buried in but not the location of the plot.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">For then, that was all the information we had, and it gave me some peace at least knowing the location of the cemetery, but not enough. I thought if I could just go there, maybe I could find a kind person who works there who could tell us where they bury the small babies and since we know they were buried fairly recently, maybe we could deduce which plot.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">But we were leaving Israel and it wasn't going to happen this way, at least not maybe until we got back. My babies are in some unmarked mass grave with the chance of ever identifying the spot dwindling with each passing month, I am moving 6000 miles away for the year, and I can't even visit their spot, I thought. Here I go failing them again. And again. First it was my body, now it is practically almost willful. </span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">So on the eve of their due date, here I was more than 6000 miles away, with a vague general idea of where they are, and no way to properly visit or honor them. Thankfully, there is another part of the story:</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Two acquaintances back in Jerusalem also lost babies this past year and subsequently became good friends (yes, it is both sad and ridiculous that we only became good friends after losing our babies, because they are two wonderful women). One of them delivered her baby stillborn during her 22nd week of pregnancy at the same hospital in the same room where I delivered Aminadav and Naava about 3 weeks later. Recently, she also got the urge to track down her baby.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">She had a similarly difficult time tracking down the information (though it seemed very likely that her baby was in the same cemetery, perhaps even the same plot as the twins since it was at the same hospital only a few weeks apart). Indeed, she eventually traced her baby to the same cemetery. She and my other babylost friend, N, went on a pilgrimage together to the cemetery in an attempt to find the grave. It happened to be on Aminadav and Naava's due date.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">Just like in my fantasy, the staffer, a kind older man (Sephardi and very gentle as decribed by my friends) pointed them in the right direction and led them to three plots with small babies. Based on deductive reasoning, they figured out which of the three plots they think has E's baby, and they think Aminadav and Naava are in the same plot, too. They recited some tehillim (psalms) and placed stones on the grave for E's baby and for Aminadav and Naava, a Jewish tradition that signifies someone has visited the grave. The elderly Sephardi cemetery staffer and my friends recited the names of all of our lost babies and prayed for them together.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">So, over the course of their due date, not only was the site of their grave discovered, but Aminadav and Naava got their first visit, not from me directly but from my messengers. Their names were recited, stones were placed, and my sweet babies were remembered by Y and me in Canada, and by two very special friends in Israel, N and E, who I am very blessed to have in my life. E reported that after the visit, she felt "this powerful urge to nap -- not in a tired way, but in a peaceful, relaxed way that I haven't felt in a long time." </span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;">I cried all morning, but not the sorrowful tears I cried the night before -- instead, these were more tears of relief. Relief that I felt right was finally done by my babies. Like E, I found some new peace, too. Thank G-d my friends decided to visit the cemetery on their due date. Thank G-d they found the grave. Thank G-d for these small blessings -- they amount to a big deal in my life.</span></span><br />
<span style="font-family: Verdana,sans-serif;"><span style="font-size: small;"><br /></span></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com14tag:blogger.com,1999:blog-2490179268765761075.post-30829912100853824212012-07-22T17:16:00.002-04:002012-10-28T07:31:08.123-04:00I don't know what I want anymore<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I know I haven't been writing much lately. I feel that I have a lot of negativity and sadness lately and sharing my negative feelings over and over again serves no real purpose. Also, not much to update on in terms of action, since we aren't cycling right now.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I have received some good recommendations for clinics and doctors in Toronto, and I keep saying that I am going to set up some appointments, but something is keeping me from actually doing it. This is a real change for me because until now, I have always been extremely proactive and have often done cycle after cycle in quick succession. My governing philosophy has always been the quicker I can do whatever it takes to have a living child, the better, like ripping off a band-aid. </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">Lately, though, I have had strong mixed feelings about how and when I would like to proceed. I really don't have a big problem with the IVF - I feel like I can keep doing it over & over as I have. It can be emotionally and physically exhausting, but it is sort of my norm and it is not disruptive to my normal routine and daily life in the way it was in the beginning. (Actually I will revise that slightly - it makes me feel pretty crappy and less productive in all other aspects of my life but I am used to functioning that way.)</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">For better or worse, it turns out that you can pretty much get used to IVF as a 'lifestyle' in the same way people with all sorts of chronic diseases get used to whatever repeated invasive treatments they need to keep their condition in check.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">What I am having more trouble managing lately is the uncertainty - that I will go to such epic lengths to get pregnant in the first place, but that we still don't know why I need IVF to become pregnant and then the larger issue of whether I can have a healthy pregnancy that I am able to carry past viability. It feels like a cruel science experiment - mostly cruel to the to-be conceived baby - to attempt to carry him/her when my ability to do so, at least in my mind, is so gravely in question.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I am really terrified by the prospect of being pregnant again. It's a shame, because the IVF cycle we did so shortly after losing the twins, I was in a much better mindset to be pregnant again, and then I was of course very briefly pregnant again, but now that's over and I feel like I am in a much worse place than I was then to attempt another pregnancy.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I guess this is all pretty normal - I have heard of others in the babyloss community who are very anxious to become pregnant again immediately after the loss, and then a few months later, once the shock wears off and the real grief work begins, the initial desire turns into fear and reluctance.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I think the main issue here is that I am becoming increasingly ambivalent about exactly what it is that I want. I also feel increasingly tortured about both our losses and our infertility being unexplained and I am not sure exactly what is that I want from that either.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">We could do a second round of more extensive testing - many of the autoimmune tests, for instance, but then as I have probably written about before, it is so unclear what to do with that information. If everything comes back negative I guess you get some peace of mind but you still have no answers. If one or two tests yield a positive result, I think there is oftentimes a temptation to attach too much importance to it as "The Answer."</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">And let's say we proceed with immune testing, for instance, and get some positive results, are we willing to try the therapies for it even though there are no good large-scale clinical studies or really evidence-based medicine to support it, especially considering the potential side effects and the cost? If we aren't willing to attempt immune treatment, there is probably no point in doing the tests.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">The other unopened can of worms is doing a laparoscopy to rule in or rule out endometriosis. I do have some of the symptoms but my doctors in Israel felt that once we were doing IVF anyway, it didn't matter whether I do or don't have endo unless it is a major quality of life issue. Their reasoning was that they would recommend IVF in that case anyway and the added value of excisional surgery when doing IVF already is really unclear.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">There is actually a series of two articles in this month's Fertility & Sterility about endometriosis and pregnancy outcome - basically saying that women with endometriosis have greater risk of bleeding during pregnancy due to placentation and implantation issues, greater risk of inflammation to the membranes, and greater risk of pre-term labor and birth. Sound familiar? Of course I was struck with the fleeting (very hypothetical) thought that maybe endo could explain my seemingly unrelated fertility and pregnancy-related fiascos. With that said, the thought of very possibly unnecessary surgery makes me cringe in a major way.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">I guess the options at this point are:</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">1) Set up a few consultation appointments here in TO and see what the docs recommend with an open mind </span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">2) Same as #1 but go in with the intention of proceeding with a new IVF as opposed to doing further testing</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">3) Same as #1 but explicitly ask for certain additional testing (i.e. lap, immune testing, etc.)</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">4) Do nothing (though continue to try on our own, for what it is worth) and 'enjoy' my break until we return to Israel next summer and/or I return to Israel to do an embryo transfer.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">5) See a counselor with Y and see whether we can get anywhere on the adoption issue (he is very much against it).</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">6) See a counselor so I can work on figuring out for myself what it is that I want...no other plans in the mean time.</span></span><br />
<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;">7) Put starting a family on hold indefinitely and contemplate what being childfree would look like. </span></span><br />
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<span style="font-size: small;"><span style="font-family: Verdana,sans-serif;"><br /></span></span>A.http://www.blogger.com/profile/00949343025406168591noreply@blogger.com22