A Late Night Scare

26 weeks 4 days.  Just when I was starting to feel more secure, to start entertaining the possibility of actually agreeing to have a small baby shower at the gentle prompting of friends and family, and after my husband and I gave each other some sentimental baby-related Christmas gifts, the insecurities of infertility and repeat loss became reality again last night around 12:30 a.m. when there was red blood on the toilet paper after I went to the bathroom.  It was mild, but it was bright red.  And I was jolted awake from my drowsiness by the sight of it and also jolted my husband awake in my panic.  My fears were heightened by the fact that I really hadn't felt the baby move since lunch time yesterday.  That alone wouldn't have freaked me out because I have yet to experience any patterned movement by our little one and what I have experienced has been inconsistent.  Some days the little one is more active than others and I have just come to expect that as normal for me and this pregnancy - especially because I have an anterior fundal placenta which apparently makes it more difficult to sense the baby's movements.  But that combined with the blood caused immediate fears.

I called my OB's answering service and got a call back from the doctor on call within 10 minutes.  By that time, we were already on our way to the hospital.  The OB on call asked me a series of questions - was the blood red or brown? [red] Did I have any cramping? [no] When was the last time we had intercourse? [a long time ago because I have been too nervous to have anything potentially disrupt this pregnancy].  When I told her that I had multiple miscarriages in the past, she told me to go to Labor and Delivery to get examined.  I thought she said she would meet me there, but as it turned out, once I was there and being monitored, one of the residents did the examination and consulted with the OB on call.  The OB had called L&D and they were expecting me when we got there to check in.  I was quickly taken back to a bed and placed on a fetal monitor and we were able to hear the baby's heartbeat right away.  It was strong and we were so relieved.  We spent a few hours at the hospital on the monitor while they ran a series of tests.  Everything came back normal and the cause of the bleeding could not be determined.  I wasn't having any contractions, my blood pressure was low, I didn't have a UTI, my urine tests came back good, my cervix was closed and the resident couldn't see any blood anywhere.  In addition to hearing movements on the monitor (which sounded pretty forceful and strong, but I couldn't feel), we had a quick ultrasound and saw the baby, too.  We headed back home around 4:00 a.m. and all the excitement apparently made the baby finally decide to be more alert.  Thankfully, I was feeling the baby on and off on the drive home and as I was finally able to fall asleep once we got home.

I stayed home from work and spent the day in my PJ's on my couch.  I'm drinking tons of water and just hope that I won't see any more red blood any time soon (although I was forewarned that I might spot for a few days since they were poking around in there last night).  The baby has been pretty active today, maybe because I have been lounging around so much more than I have been lately.  I know that we are technically in the viability stage, but I really want this baby to stay safe inside for as long as possible and continue to grow before making his or her grand debut.  At my last appointment with the OB, we discussed the possibility of delivering either by induction or c-section around 36 weeks due to my prior losses and the increased risks of cord complications and meconium poisoning beyond that point. Basically, my OB is of the opinion that once we make it that far, he wants to avoid any other potential complications at the end.  Last night's bleeding scare has brought back the lack of trust in my body.  Keep growing strong, baby!  Only 10 more weeks to go!!



Today marks 20 weeks and this pregnancy is still somewhat surreal to me mainly because I really haven't felt much movement from the baby yet, if any at all.  Because I have an anterior placenta, my OB told me that I might not feel any of the movement until 20-22 weeks.  I must admit that I am starting to get impatient.  As someone who has experienced multiple losses, it is still hard to accept this pregnancy as a reality especially because I have been waiting and waiting for a physical sign of life that I can feel.  I think I will start to feel more attached to this pregnancy once I can feel the baby bouncing around in there more often.  There have been a few times over the past week where I thought I may be feeling a kick or punch or something, but I am honestly not sure.

Another ironic pregnancy symptom I've been experiencing is increased vaginal discharge.  All of the books and websites say this is completely normal, but I'll tell you what, as someone who has had multiple miscarriages, this symptom is enough to drive me crazy.  I'm constantly holding my breath every time I go to the bathroom because I am afraid one time it isn't going to be just plain ol' increased vaginal discharge.

I also occasionally get these sharp pinching jolts of pain in the right side of my abdomen.  Because they only seem to happen in the same spot, even though they are not all that frequent, it has been freaking me out a bit.  It's probably just this round ligament pain I have been reading about, but I will be asking about it at our monthly appointment next week.

I haven't been able to bring myself to start thinking about childbirth classes, nursery decorations or baby registries yet.  I still feel awkward talking about my pregnancy with friends and co-workers who keep fussing over me and asking me all sorts of questions.  I wish I was able to embrace this pregnancy with 100% joy, but the scars I have from our other losses have been holding me back some.  I am just thankful at each appointment that everything seems to be progressing as it should be and I have been taking this pregnancy one appointment at a time. 


Happy Halloween!

My creative and artistic hubby decided to make this costume for me and the baby this year (mask was purchased, shirt was designed and painted by my talented husband):

Trick or treat!  I love Halloween!  Time to pass out candy to the little goblins who come by.  We usually get close to 150 kids at our house every year.


Sharing the News

We started spreading our news more publicly over the past couple of weeks.  I was reluctant to let our secret out for fear that once we did something would go wrong.  But it was getting harder to hide and actually now that the news is out I feel a sense of relief.  Honestly, if something does go wrong at this point, we will need all the love and support we can get.  And our announcements (we made them in stages) of this pregnancy have always included some kind of disclosure of our prior losses.

We started by telling our close relatives in person.  We visited Grandma WOW and gave her an enlarged version of one of our 12 week ultrasound pictures which my husband photoshopped to include a cartoon bubble with the baby introducing his/herself as her great-grandchild who she would get to meet in the spring.  Her reaction was priceless.  Before we told her the news, she was lamenting over how old she is.  She can't believe she is almost 86.  But a few minutes later when we told her that she was going to be a great-grandma, she laughed and said, "but I'm too young!"  Although her memory has been fading more rapidly, she seems to have remembered this news over the past couple weeks and I really hope that she will have the chance to meet her first great-grandchild.

A few days later we sent emails and text messages to some select people, close friends and extended family, who have known about the struggles we have endured.  The subject of the message was "We've Been Keeping a Secret" and the message included a photo of me wearing a tshirt we had made that says "Future Indians Fan" with an arrow pointing to my belly.  If I haven't mentioned it before, my husband and I enjoy going to baseball games and listening to them on the radio if we aren't at the game itself.  We wanted to make sure these people heard the news directly from us first before we shared the news with coworkers and others.

I shared the news at work last week.  I met with my supervisor first to let her know the news and that I planned to tell the office right after we met.  She's not that great at keeping secrets so I made sure to tell her just moments before my big reveal.  The night before, my husband and I went to a party supply store and bought this baby balloon which I brought and hung outside my office door:

I also brought in munch.kin donuts from Dunk.in Donuts and sent out an email (which also included the pic of me in the tshirt) which said:

There are Dun.kin Donut munchkins on the conference table for everyone to celebrate the announcement of the little “munchkin” Hubby and I are expecting on April 1, 2012 – just in time for the start of the next MLB season!!

A few days later, after much back and forth in my head about if and when to share the news on Face.book and how to share it without sounding like your average fertile, I decided on the following post which also include the photo of me in the tshirt (I have not posted any ultrasound photos):

Our journey to become parents has been anything but easy. We have spent years trying to start a family of our own and have endured multiple losses along the way. Now into the 14th week and out of the first trimester, we are hopeful that this pregnancy continues to progress beautifully and that we will experience the joy of meeting this little one some time early next spring!! :)

We have received lots of congrats and supportive comments since posting the announcement.  I have also heard from others who have had difficulty themselves.  Although I continue to wonder every day if everything is still going well with this little one, I'm glad we have shared the news and I am not stressed by trying to keep it a secret anymore.  Our next appointment isn't until a week from tomorrow and our anatomy scan is scheduled for the end of the month.  This is the longest I've gone without an appointment of some sort so I am a bit anxious about everything still being okay.  I'm still sleeping more than normal for me, but am not as tired as I was in the first trimester.  Other than some occasional twinges, abdominal aches and now this weekend some short, sharp pains in what feels like the cervical area (I haven't started to worry too much about these yet since I've read similar experiences from other bloggers), I'm feeling pretty good.  I will be so much more relieved and relaxed once I can feel this baby moving around.  Pregnancy is such a mystery as it is and, for someone who has experienced multiple losses, it seems harder to wrap your head around when you have no idea if what you are feeling, or not feeling, is normal.

On another note, my sister got engaged this week and I am so absolutely happy for her.  She and her fiance are a great couple.  No specific date set yet, but the wedding will probably be some time next summer.

The weather is beautiful here this weekend and I have tomorrow off so I am off to enjoy the sunshine while it lasts.  :)


Starting to Feel More Relaxed

Today marks the beginning of 13 weeks and I am so grateful to have made it this far.  Although I haven't gained too much weight yet, my waist line has started to expand and my belly has morphed into different stages of "pooch"-iness which has become more difficult to hide.  I must say that I have had a sense of reluctance throughout this pregnancy.  With three miscarriages in the past, it's hard not to be reluctant and have this underlying worry that something is bound to go wrong.  I am looking forward to the day when I can actually feel this kid moving around so I don't have to continually wonder what is going on in there.  I decided not to purchase a doppler because I am afraid it will cause me more stress than I need or want.  I know many people in situations similar to mine find comfort in these devices, but I just can't seem to shake the idea that at some point I won't be able to find the heartbeat, even if it is there, and that I will panic.  So I am just relying on the fact that everything seems to be going smoothly for the most part.

I can't believe that I have made it through the first trimester.  I have mixed feelings about the limited symptoms I have experienced these first few months.  I'd like to explain because the lack of many of the common physical symptoms so many people experience freaked me out to the point of causing me psychological/mental/emotional anxiety.  I don't know what I expected, but I don't think I expected to feel relatively normal these first few months.  My "worst" symptom was fatigue.  I definitely slept more than normal, took uncharacteristic naps and found myself wishing I was napping while at work and having a difficult time concentrating at the task at hand.  I had occasional bouts of queasiness, but not much.  The lack of "morning sickness" freaked me out because I heard/read that nausea is a good indicator that the baby is growing and healthy.  When I wasn't nauseous or throwing up and can't feel whether or not the baby is growing, I was convinced there must be something wrong.  Now I have been taking Fol.gard since April (three months before this baby was conceived) and perhaps there is some merit to the thought that increased amounts of B6 lessen the effects of morning sickness.  I also can't say that I have been urinating more frequently yet.  Maybe some at the beginning and I often do have to get up once in the middle of the night to go to the bathroom which isn't typical for me.  But overall, I expected the symptom of "frequent urination" to remain a constant throughout the first trimester and that really hasn't been the case.  I have also been somewhat fixated on the changing shape of my belly and waistline and wondering what it means, if anything.  I think I expected it to be a gradual outward development into the cute little bump.  Early on, I had a low pouch for a few days.  That pouch has seemed to move upward and at times I think my belly is getting flatter instead of rounder.  The shape seems to change some on a daily basis which keeps me guessing whether that is normal or not.  The only other symptoms I am linking to this pregnancy are vivid dreams pretty much every night (or at least ones I actually remember when I wake up because before this pregnancy I rarely remembered my dreams if I had them), my face breaking out a lot more than normal and more recently, I haven't been very hungry throughout the day.  I am sharing my experiences and symptoms here in case there are other women out there who are wondering if their seeming "lack" of the more common symptoms is normal because I think that the absence of the common physical symptoms can be disconcerting and nervewracking along the way.

We also had the NT scan earlier this week.  Because I was out of town for work last week, it had been almost three weeks since our last ultrasound.  After our history of recurrent losses, this was a LONG time especially since I had been getting ultrasounds on practically a weekly basis before then.  The measurements came back good and combined with the bloodwork results, the chances of Downs and Trisonomy issues were greatly reduced which was a big relief for me since I am 37 years old and already in a higher risk category.

For now, I am becoming more comfortable with the fact that I am really pregnant.  I can talk about it more with my husband and family which I had been avoiding for fear of jinxing something along the way.  We are planning to tell Grandma WOW today and some of my husband's closer relatives who don't know yet.  I have also been trying to figure out a clever way to tell my co-workers which I plan to do this week because it is getting harder to keep secret.  My job also requires me to frequently wear business suits and I only have a few left that are bearable to wear.  I've been starting to look for some more comfortable clothes that I'll be able to wear for work and that aren't terribly expensive.  I think I may have to switch to dresses instead of business suits if I don't want to break the bank to have work clothes for the remainder of this pregnancy.  Or I am going to have to figure out how to pick a few pieces that I can mix and match so it doesn't look like I am wearing the same thing every day.

I am also in a stage where I am hesitant to blog, on one hand, because I don't want to seem like I am bragging about finally being pregnant.  But, on the other hand, I want to continue to share my story so those of you who are still waiting for that BFP know that pregnancies can happen after recurrent losses.  Others have blogged about this awkward new position we find ourselves in.  My experiences with infertility and loss have shaped who I am today and have still affected my approach and anxieties with this pregnancy so I believe it is still important to share my story.  I hope you all feel the same.


Double Digits

Today marks 10w0d.  No matter how much time has passed, I still can't believe this seems to finally be happening for us.  I'm still nervous that something could go wrong, but at the same time I am hoping that everything goes smoothly for the remainder of this pregnancy.  I mean, we've been through enough heartache already, right?  We definitely seem to have a little fighter this time.

We "graduated" from our RE's office and had our first appointment with my new OB on Thursday.  If first impressions mean anything, I LOVED the OB.  He was so nice and compassionate about our situation.  He took his time with us and never made us feel rushed.  I had my first non-vaginal ultrasound at the appointment.  The OB didn't do a physical exam because he said given the weekly appointments I've had along the way that I've had enough "intrusion" down there for the time being.  He emphasized how he is part of a small group practice.  Only 4 OBs who deliver.  And he told me to call any time and he would call me back or if I was ever concerned for any reason or didn't feel like something was right, I could just drop in unannounced and he would see me.  Loved him!  The best part of the whole appointment was the ultrasound.  At first we just saw the baby and the heartbeat like the past few times.  About a minute or so into the ultrasound, after taking the measurements, we were amazed to see his/her arms and legs move!!!  It was like s/he was swimming or running.  Completely amazing and both my husband and I teared up. 

I'm supposed to start weening off the estro.gen and endometrin over the next couple of weeks, but I am not sure that I am ready to do that yet.  The OB said there is a good chance that I will experience some bleeding/spotting as I ween myself off of the extra hormones and I'm definitely not looking forward to that . . . especially since I have to travel out of town to DC for work the week of September 12.  So I think I am going to wait until after I return from my business trip to start the weening process.  And I am so lucky that my husband is able to travel to DC with me.  Thankfully, we are only about a 6 hour drive from DC and I was able to drive instead of fly for this trip (it actually turned out to be a bit cheaper that way anyway).  It may be silly, but I was scared to fly and since it is still technically the first trimester, I was nervous travel alone.

I've been bad about commenting on everyone else's blogs these days and for that I apologize.  I have been reading them, but have been so tired after work I just haven't had the energy to write entries or comment.  I hope everyone enjoys the holiday weekend with family and friends!!


An Overdue Update

I can't believe it's been over two weeks since my last post.  I've had two more appointments over the past two weeks and am happy to report that, despite some additional spotting here and there, everything is looking good.  It's 8w4d today.  At our appointment last week at 7w4d, we saw a tiny little baby with a heartbeat at 156 bpm.  I didn't see the heartbeat right away when the image popped up on the screen and I freaked out a little inside until I heard the RE say he saw it and then had us listen to it.  Truly amazing sound and something I wasn't sure I'd ever be fortunate enough to hear.  We went back again yesterday and the little creature was still there, measuring pretty much right on target with a heartbeat of 178 bpm. 

Honestly, we are both still a little stunned that this is actually happening.  We've been trying for so long and have had soooo much disappointment along the way so this is all a bit unreal.  I made our first OB appointment for next week today with a doctor that our RE recommended and who has a lot of excellent patient reviews online.  Our RE said he would continue to see us every week or every other week if we weren't able to get an appointment with an OB until 10 or 12 weeks (since I've been stalling on looking for an OB until I started feeling more comfortable that this pregnancy was actually progressing).  But when I called the OB's office today, explained that I had been seeing the RE and gave her a brief summary of our RPL history along with the disclaimer that I would be a paranoid pregnant patient, she said "oh honey, I'd be paranoid, too" and then said the OB could see us next Thursday! 

As for symptoms, I would say that I have been feeling relatively normal for the most part.  I have been sleeping more and my bo.obs seem fuller and bigger (they are sore on and off).  I usually have to get up once per night to go to the bathroom when I used to sleep through the night.  I've started experiencing some queasiness this week, but nothing particularly unbearable.  I suppose I should feel fortunate for that, but feeling normal most of the time makes me worry that something isn't going right.  That's what years of RPL and anticipating a viable pregnancy does to mess with your head I guess.  I don't know if I will ever feel confident in this pregnancy, but I'm trying to be as optimistic as possible.  This the farthest we've made it so far and today I am happy about that.



We saw a heartbeat today - for the first time ever in any of our four pregnancies.  The cause of my on and off bleeding/spotting remains a mystery however and will probably continue to cause me anxiety until it stops. Our RE didn't see any clots and gave me a number of other possible causes.  I'm hoping that it is just the Endo.metrin irritating my cervix because I tend to notice the spotting shortly after inserting the tablets, especially the evening dose for whatever reason.

Today the baby was measuring 6w2d (one day less than actual time by my calculations) and had a heartbeat of 120 bpm.  My RE said they prefer to see anything 120 or above, but at this early stage I've read that 90-110 bpm is typical.  We go back next Wednesday to check on the progress.  Today has been one of mixed emotions and I'm not ready to process it all and write what I am feeling yet.  But tonight I will go to bed a little more hopeful about this pregnancy.


Weird Dreams

It's Day 3 of my self-imposed bedrest.  I didn't have any bleeding for over 24 hours between Thursday afternoon and Friday evening, but last night when I inserted my evening dose of Endo.metrin there was some red blood on the tip of the applicator when I took it out.  I had just started to relax yesterday after no signs of bleeding all day until that happened.  Now twelve hours later with my morning dose of Endo.metrin, no traces of blood on the applicator.  This is enough to drive me crazy!!!  Hopeful one minute to panicked and stressed the next minute. 

The physical symptoms I was experiencing earlier in this pregnancy also seem to be disappearing, but I've had weird, scary dreams the past two nights.  My boobs are not really sore anymore (despite two days of the estrogen patch which the RE told me would cause a lot of breast tenderness).  I'm not going to the bathroom nearly as much anymore.  My fourth week of pregnancy I was going to the bathroom a ton and even had to get up once in the middle of the night every night that whole week which is very uncharacteristic for me.  But, take last night for example, I went to the bathroom at 8:00 pm before inserting the Endo.metrin and then didn't go again until I woke up this morning at 7:30.  I also don't get severe bouts of exhaustion like I was experiencing earlier.  With Thursday's bleeding and these disappearing symptoms, I don't know what to think anymore.

What I have been lacking in physical symptoms has been replaced with creepy dreams.  On Thursday night I had a dream that I was entrusted with the care of two tiny preemie twin babies.  They weren't mine.  I don't know who they belonged to.  They were in a shoebox and were sleeping.  When it came time to feed them, I couldn't find them or the shoebox they were in.  I was panicked searching all over the place for them with a feeling of dread that our cat had eaten them.  Turns out I found them somehow although I don't know where or how and then I woke up.

Last night I woke up heart racing and sweating after dreaming that hubby and I were about to leave to go to church (which is something we don't do in real life), I was wearing shorts (also something I don't often do in real life) and I started hemorrhaging with blood running down my legs and puddling onto the ground.  Then I started vomitting blood, too, and ended up on the floor in a pool of my blood yelling for my husband to call 911.  That's when I was startled awake.

My next ultrasound on Tuesday afternoon can't come soon enough.


And this morning there is blood . . .

red, red blood when I wiped on my "before I run out the door to drive to work" bathroom stop.  My response this time was a loud "F**KING A!!"  No one but my cat probably heard me because my husband had already left for work.  I called him and told him to come home.  He got home in record time and we went immediately to the clinic.  I spoke to my RE on the phone on our way into the clinic.  He was going to be in the west side office today and told me not to go there because the ultrasound machine isn't as good there.  So we saw one of the other REs at the main campus.  When he examined me, he only found "brown" old blood and said my cervix was still closed so that is a somewhat positive sign.  This morning's ultrasound showed the sac still there and no indication that it had detached from the placenta wall.  Also a good sign for now.  We still didn't see a heartbeat, but that wasn't too surprising since our last ultrasound was only 17 hours earlier.  When he removed the vag wand, it was clear and not covered in blood like it was the last two times I miscarried.  They took a bunch of bloodwork again, gave me a prescription for the estrogen patch since I got a bad rash the last time I took Es.trace, my husband is getting the prescription filled now and I just plan to lounge on the couch all day long hoping that  this is just a scare and not the beginning of the end again.


Today's Ultrasound

We saw a sac! But we weren't lucky enough to see a heartbeat yet. At 5w4d (based on my counting) I wasn't expecting to be able to see a heartbeat today, but it would have been more reassuring if we did.  Our RE said that everything looks exactly as it should at this point and that if he didn't know our history he would be very satisfied with today's ultrasound.  However, since he does know our history, he said he won't be satisfied until he sees us make it to three months under his care.  I am so glad to know that he is going to continue to monitor me closely even though we didn't have any medical assistance with this pregnancy.  We go back for another ultrasound next Tuesday when the RE expects to be able to see a heartbeat and make a determination as to whether this pregnancy is viable or not.

We also discussed the possibility of using heparin at this point and our RE was willing to start me on the injections today, but after some additional discussion we decided to see what happens without it.  I seem to have had more symptoms this time around and although I am still nervous about this pregnancy I also have a feeling of calm about it.  My symptoms seem to come and go though and that is driving me a little crazy.  I told my husband and my RE that I wish I would feel constantly pregnant just so I know everything is developing as it should be.

So we continue to hope that everything will progress without complications.


Friday's Beta

My HCG on Friday was up to 1557.  I have an early u/s scheduled for Wednesday afternoon.  By that time I will be 5w4d along and it will probably too early to see a heartbeat.  The RE has decided against heparin or lovenox at this point, but I haven't heard why directly from him yet so we plan to discuss that with him on Wednesday if everything is still looking good. 

We spent the weekend out of town visiting my sister and her boyfriend.  I wasn't ready to share the news, but it was nice to at least be preoccupied with something else than wondering if everything is still growing as it should be.  We watched a couple movies, went to a baseball game and did a little shopping.  We just got home a little bit ago and I have a bunch of work to do before tomorrow comes.  Yuck!


Still Doubling

Beta #3 today = 515.  That's up from 175 on Monday.  They want me to come in on Friday to get my levels again and then I will be scheduled for an early u/s next Wednesday or Friday.  By my calculations, I am 4w4d today.  At this point, everything looks good on paper, but I'm still very apprehensive given my past losses.  I am continuing with the progesterone suppositories and baby aspirin, but the RE isn't convinced that I need heparin or lovenox yet - that's according to the nurse anyway.  She didn't call me with today's results until almost the end of the day and I didn't ask to speak with the RE.  I think I am going to call tomorrow and ask to speak directly with him to find out what he is thinking and why.  On one hand, I don't want to do anything unnecessary, but on the other hand I think I would regret not trying something different this time if this pregnancy ends like my others.  I wish there was some magical way that I could look inside my uterus and see what is going on down there.  You know, like some sort of 24 hour video surveillance I could check in on whenever I felt like it just to reassure myself that everything is progressing as it should be.  Maybe I could try to invest in my own personal vag cam!  Wouldn't that be something?  Still hoping that this little one decides to stick around.


Take Four - Beta #2

The results just came in from my bloodwork this morning.  HCG = 175.  According to betabase, my levels have doubled in about 27 hours.  My progesterone was 19.3.  I honestly don't know if that is good or not, but the nurse told me that the RE would like me to start using progesterone suppositories for now and come in again on Wednesday for repeat bloodwork.  Good thing I still have some Endo.metrin left over from last time that will cover me for at least a few days.  The nurse said that they would wait for Wednesday's results before deciding whether to add Lovenox or Heparin injections this time.  I did a little reading up on the difference between the two and honestly think I would be comfortable with Heparin over Lovenox, but I guess that it something I can wait to discuss with my RE on Wednesday.  In the meantime, I am continuing to take my prescription strength folic acid and am going to add baby aspirin to the mix.  I'm still spotting a little, but it has slowed down to almost nothing at this point.  Today, things look good I suppose.  I hope this one sticks around for the long haul.


No IVF This Month After All

Rewind to Wednesday afternoon when it was CD26 - I started spotting dark brown stuff, usually a sign that the red witch is about to make a full fledged appearance in the next day or so.  This continued on through Thursday only a bit heavier, but still dark brownish black and what I would describe as almost tar-like, but lighter. I took a HPT on Thursday evening because I planned to call my clinic on Friday to discuss my concerns with our upcoming first IVF cycle.  Come Friday, the spotting had diminished somewhat, but still the color of "old blood" and no sign of any red.  I spoke with a nurse Friday afternoon, described what had been going on and confirmed that so long as the full flow started on or before Sunday that I should start taking the birth control pills for the IVF cycle.  She told me that even if I got full flow on or before Sunday I could wait until Wednesday to start taking the pills because they were going to have to push back my cycle a bit because their move to the new facility has been delayed (I mentioned my concern with this possibility in my last post, guess my gut was right on that one).  My hubby and I talked about it yesterday and decided that we would rather wait until the clinic has relocated and is up and running and fully functional before we drop a buttload of cash on IVF only to have our cycle disrupted and possibly cancelled because of the move which isn't "set in stone" yet.

Last night we had dinner with one of my co-workers and his long-time girlfriend.   She had an accident a few years ago that has left her paralyzed.  They are truly an amazing couple and after I recently opened up about our fertility struggles, my co-worker confided in me that they also had been trying for over a year without any success.  While we were hanging out, they told us that she had just confirmed earlier in the day that she was miscarrying.  We are heartbroken for them because we are all too familiar with experiencing pregnancy loss and given the struggles she has already had because of her accident, this miscarriage just seems too cruel.  We had a few drinks and spent most of the rest of the night talking about fertility issues and commisserating about how people say the dumbest and most insensitive things.  I shared our plans to start IVF this month and told her about the reluctance I was feeling at this point and the fact that the red witch wasn't really being cooperative at the moment.

This morning I woke up, checked for red and flow before going to the bathroom and when I still wasn't greeted by the red witch, I decided to pee on a stick again as it is CD 29 (one of my longer cycles) and I have been debating about filling the prescription for the birth control pills today.  This put a little kink in our IVF plans for this month:

I went back to bed, where hubby was still half-asleep, and told him matter-of-factly, "there are two lines."  We have been robbed of the joy of sharing pregnancy news by surprise and in some cute way because of our three miscarriages.  It's all very clinical now.

I called my RE's answering service to request bloodwork.  After the woman who answered my initial call got my name, DOB and doctor's name, I told her that I wanted to speak to the doctor on call.  She responded, "are you pregnant?"  I said, "I might be, that's why I am calling.  I've had three miscarriages and now I have a positive HPT, but I'm bleeding."  She then proceeded to say, "Okay, I'll take your call.  Someone should call you within 20 minutes."  She'll TAKE my call?????  What was that all about???  If I wasn't pregnant or my reason for wanting to talk to the doctor on call wasn't good enough, she wouldn't refer me???  Whatever. 

Anyway, a doctor I've never heard of called me back almost immediately and got me in for bloodwork today.  Based on first impressions, she was awesome.  She didn't treat me like I was crazy or overreacting or blow me off and tell me I should wait to come in on Monday.  She isn't one of the REs so she must be one of the OB/GYNs on staff.  I think I might see if she is accepting new patients since I need to find a new OB/GYN anyway.  She called me back about an hour ago and told me that I'm pregnant.  HCG was 55.  That actually seems like a pretty decent number for me on CD29 based on my past records.  My first beta on my last pregnancy was 109 on CD31 - that was an IUI assisted pregnancy.  The pregnancy before that one was au natural, but I didn't get a positive HPT (which was super faint) until CD33 and my first beta on CD34 was only 37.

I should be happy, right? Instead I feel a bit numb.  Maybe the fourth time is a charm??  I don't know what to think anymore.  Why can't I just miss my period without any signs of bleeding so I don't have to constantly wonder what the heck is going on down there?  Is that too much to ask???


This Month or Wait?

So it looks like the red witch is imminent.  I've had some spotting since yesterday which increased a bit earlier today, but has since slowed down a bit.  Definitely not what I would consider "flow" at this point, but I took a HPT after work today and it was negative.  I took the test just for good measure given my history of three pregnancies all with some sort of spotting and bleeding because, for obvious reasons, I'm never confident that I'm not pregnant at the first sign of blood. 

Assuming my period truly arrives in full force on or before Sunday, I am supposed to start my first IVF cycle beginning with birth control pills on Sunday.  I'm also supposed to call to schedule our nurse teaching, order meds and schedule acupuncture appointments.  But now that IVF has become a reality, I'm not sure I'm ready to do it yet.

Here are some of  the reasons I am reluctant right now:

(1) At our IVF consultation, I asked our RE if I could possibly have endometriosis and if we should try to figure that out before moving onto IVF.  When I read the signs and symptoms of endometriosis, I don't seem to have any of the common, major symptoms, but I do experience some of the "other" symptoms.  But other than examining egg quality, which only seems possible by retrieval, endometriosis is the one thing we have never explored or ruled out.  My RE said that there are many women who have endometriosis and don't experience any of the symptoms at all or the symptoms are mild so it is never detected.  So there is a possibility I could have it and it could be affecting my fertility.  However, he said he doesn't think it is necessary for me to have a laproscopy to find out because even if I do have it, IVF is the best treatment for fertility problems related to endometriosis.  His explanation pretty much follows the information shared in this post.  So at the moment I'm struggling with this issue.  On one hand, I think it is important, and I'd like to know, if I do have endometriosis.  I think it might just be for peace of mind so I know going into my first IVF that it is a potential problem and before we drop thousands and thousands of dollars.  What's another month, right?  On the other hand, does knowing really matter if IVF would be the recommended course of treatment anyway? In that case, I might as well just take the plunge and do the cycle this month like we planned - why wait any longer, right?

(2) No insurance coverage for IVF - now that IVF has become the reality we are facing, I fear that it won't work and we will be throwing thousands of dollars away.  If somebody asked me whether I'd risk $12,000 for a 30% chance of success at a casino, for example, I would say no.  I wish I didn't have to be concerned by the cost of it all, but I do and I don't like thinking about it.  It would be so much easier to accept if we were fortunate to have insurance coverage.

(3) Our clinic will be moving to a brand new facility soon and if the move is delayed during this cycle I am concerned that our retrieval will get messed up.  Actually, our clinic didn't want us to do IVF last month because based on the way my cycle would follow, the retrieval fell right smack dab in the middle of the week of their targeted move so they weren't scheduling any procedures that week.  The targetted week of the move is the second week of August, but we all know about the best laid plans.  What happens if the clinic doesn't move that week and instead moves when my retrieval and transfer should take place based on my current protocol at the end of the month??  Maybe we should just wait until the move is over and done with so I don't have to worry about that, too.

(4) the lupron shortage - when I was calling different pharmacies for price quotes on meds, I learned about the nationwide lupron shortage.  Has anyone out there had problems with this recently?  What happens if I can't get everything I need by the time I need it?? 

(5) some possible work obligations/conflicts - although nothing is definite at the moment, I will probably have to travel out of town at a couple points of time in August and September and I only recently learned about this possibility.  I work for a government agency and come October 1, the beginning of the new fiscal year, we are expecting another freeze on spending.  In the meantime, our agency is trying to squeeze in certain trainings and conferences by September 30 and given my responsibilities I will likely be required to attend one or more.  As an IVF novice, I don't know if I am going to want to have to figure out how to travel with meds especially since I will be travelling with co-workers or will be brave enough to face the injections alone.

So I'm not sure what to do, but it looks like I have to figure it out by Sunday.  I would welcome any thoughts or advice you all are willing to share with me.


The Conundrum of Recurrent Pregnancy Loss

co-nun-drum ~ \kə-ˈnən-drəm\
noun ~ an intricate and difficult problem

Once we officially started trying to make a baby, it took ten months before we saw our first positive home pregnancy test, but, in hindsight, I wouldn't describe it as a BFP.  Our excitement was brief.  I was spotting from the beginning and the series of subsequent blood tests by my OB/GYN revealed that my HCG levels were decreasing instead of increasing.  My first pregnancy ended in my first miscarriage shortly before Christmas 2008.  The pregnancy was over basically at the same time we learned it even existed.  We were sad and disappointed, but we had conceived within a year's time so we weren't technically "infertile" by textbook standards.  If I wouldn't have miscarried, we would be celebrating that baby's second birthday right about now.

We spent the next two years, or 23 months to be exact, trying to conceive again.  First on our own, later with the assistance of various artificial reproductive technologies and then, again, on our own for a bit.  The goal was to just conceive again.  Get pregnant, that's all.  How hard could it be, right?  We technically did it once before even though it didn't result in a take home baby.  We were assured that the chances of a second miscarriage were unlikely.  Month after month the pregnancy tests were negative.  Were we considered "infertile" yet?  Maybe "subfertile" was the more appropriate term.  Month after month I wanted that darn second line to materialize.  It didn't show up again until November 2010.  Needless to say, when it did, we were thrilled.  Our second baby was conceived while we were on a long vacation to celebrate our 10th wedding anniversary.  No clo.mid, no jerking off into a cup, no doctor intervention.  Just the way nature intended.  My HCG levels were doubling.  No signs of spotting like the first time.  Our goal was accomplished!  Surely this was it and miscarrying twice in a row wouldn't happen. A couple of weeks went by.  We attended a pregnancy info session at my OB/GYN's office and had our first ultrasound scheduled.  Then one morning, the unlikely happened.  I rolled out of bed to get ready for work, half awake like I usually am in the morning.  I went to the bathroom before heading into the shower and was jolted awake by the sight of bright red blood on the toilet paper.  Because it was early and no one was answering my OB/GYN's 24 hour call line, we headed to the ER and confirmed that I was miscarrying again.  How could this happen a second time?  This wasn't supposed to be happening.  I think our grief was worse this time.  At moments I felt betrayed and angry.  At moments I felt depressed and numb.  At moments I felt all and none of these things at the same time if that even makes sense.  We wanted answers.  We were still determined to make a baby of our own.  Baby number two's due date would have been next Friday, July 8. 

Another five months pass by and we conceived for a third time after an IUI.  I blogged about the  progression and ultimate demise of this pregnancy in March.  It seemed to start off on the wrong foot right from the get-go.  I had bleeding that started right around 11dpiui and mimicked Aunt Flo despite multiple positive HPTs and the best and most promising HCG levels I've ever had.  The bleeding eventually stopped and my HCG levels continued to rise.  The doctor and nurses at our clinic assured me that many women bleed early in pregnancy and it doesn't mean anything.  Given my history, I don't believe that.

So where does that leave me now?  Three pregnancies, three miscarriages, no babies.  Not technically infertile, but not really fertile either.  I'm left with a problem, the conundrum I don't know how to resolve or reconcile.  You see, after multiple losses, I find myself conflicted.  Still hoping for a miracle take home baby that is biologically ours, but honestly afraid to get pregnant again.  Hoping each month I'll see that second line on the home pregnancy test, but honestly a little relieved when only the control line appears because at least I know I don't have to worry about facing yet another loss.  Testing each month even when I start bleeding and I'm pretty sure it's my period just to make sure I'm not pregnant because based on my past experiences bleeding doesn't mean I'm not pregnant. 

Some people have said to me, "at least you know you can get pregnant."  I'm not sure why anyone thinks that comment is reassuring or comforting.  Is it somehow better to have been pregnant just for a little while than never pregnant at all?  I honestly haven't figured out the answer to that question and don't know if I ever will.  Maybe my inability to stay pregnant is a sign that any new pregnancies or pregnancies of longer duration will only be plagued with complications.  Maybe it doesn't me anything at all and is just bad luck.

As we approach our first IVF cycle, tentatively scheduled for August, I find myself conflicted about the possibilities.  Wanting to believe that it will be successful, but fearing a BFN or another loss, only this time with thousands of dollars involved.  It will be so worth it if it works, but even more devastating and disappointing if it doesn't.  And that's the conundrum I face as a wounded veteran of recurrent pregnancy loss.


Back to Day One

Looks like we're one month closer to our first IVF cycle.  CD1 again today.  I don't know why I continue expecting or hoping for anything different.  One more month of trying before we bring on the big guns and drain a significant portion of our savings.  I will be calling our clinic on Monday to schedule a sonohysterogram and trial transfer for some time next week.  Let the comparison shopping in search of the cheapest med prices begin. 


It's Always Something

Sometimes I just have to shake my head in disbelief and laugh at the fact that nothing ever seems to go smoothly in our journey to become parents.  I had many of these moments over the past week or so.  When we returned from our trip to Texas, I decided  to start seriously looking into IVF and what all it would entail.  I was familiar with the basics, but avoided getting into the nitty gritty until now because I was hoping that I wouldn't need to resort to IVF as an option.  Anyway, I went to one of our local big box bookstore and bought Infertility for Dummies since it has a pretty decent chapter on IVF and also some information on the adoption process.  As I was waiting in line, there was a young couple in front of me.  The woman was pregnant and they were purchasing baby name books.  After seeing the books they set on the counter, the cashier engaged them in conversation congratulating them on their baby, asking if this was their first, suggesting potential baby names and wishing them good luck before sending them on their merry way.  My purchase came next and I wonder what the cashier was thinking when I set my selection down on the counter because all she did was ring up my purchase and ask me if I wanted the receipt with me or in the bag.  The universe can be funny sometimes.

We also had an IVF consult at our clinic this week.  The appointment was scheduled for Wednesday at 3:30 p.m.  On Wednesday morning, one of the nurses called me to ask me if we could possibly come at 3:00 instead so that one of the nurses would have time to review what our anticipated protocol would be after the doctor met with us.  We arrived at 2:45, 45 minutes earlier than originally scheduled, and got in to see the RE with minimal wait time.  We were taken to the consult room where the RE reviewed our history with us, explained why IVF was a promising option for us, and discussed the IVF process with the aid of a power point presentation - except the computer wouldn't load the presentation even after he shut it down and tried to reboot it.  The RE said he had never had that problem before.  Of course the first time he ever had this problem would happen with us, why wouldn't it?

Then we were moved to another office where the presentation loaded.  Once we were done with the RE we were supposed to meet with one of the nurses, BUT all of the nurses had already left for the day even though they knew we had the appointment and requested that we come in earlier to accommodate them!!  Of course none of the nurses were there when they were supposed to be and now we were going to have to make an additional appointment for yet another day.  We also learned from the RE at this point that my favorite nurse will be leaving the clinic for a new position in another department within the larger hospital system.  Of course she is leaving just as we are about to commit to IVF - that's just what happens to us so I shouldn't be surprised. 

We went back to the clinic this morning to meet with the nurse to discuss the protocol we should have discussed on Wednesday.  Luckily, we got to meet with my favorite nurse.  We were planning to cycle next month, but as the nurse started going through our protocol she realized that our retrieval and transfer would fall during the week that the clinic will be moving to a brand new facility and that they weren't scheduling for that week so our cycle has to be delayed until August.  Can't anything work out the way we want it to??  I guess on the positive side, we still have this month and next month to hope for a pregnancy without IVF and if IVF is the route we ultimately do take, we will be doing it in a brand, spanking new facility that is just opening.  But seriously, what's with all of these hiccups along the way??


I've been a slacker

At least when it comes to blogging lately.  Thank you for the comments and messages checking in to see how I am doing.  Honestly, I can't believe it's been over two weeks since I last posted.  If only a 2ww would go by that quickly!  After mother's day, I wasn't really motivated to write about anything.  Actually, I just wanted a break from thinking about everything for awhile and fortunately (or unfortunately) I've been extremely busy at work these past few weeks so I haven't had time to be preoccupied by my fertility woes very much.  A lot of my "busy-ness" at work had to do with getting ahead of the game so my hubby and I would be able to go on a somewhat impromptu trip to the great state of Texas for 10 days starting tomorrow.  One of my closest friends (who moved to Texas a few years ago) called me about a month ago,  told me that she would be getting married on Memorial Day weekend while her family would be in town for her oldest son's high school graduation, and asked me if I would be her matron of honor.  How could I say no??  I'm super happy for her.  Her first marriage wasn't so great and her current beau treats her like gold, the way she deserves to be treated.  Initially, I was just going to cash in some frequent flyer miles and go for a long weekend myself.  But my hubby and I decided that it would be more fun to go together and make it into a full blown vacation.  Needless to say, I had a lot to accomplish on short notice and that has contributed to my absence in the blogging world the past few weeks.  We will be spending time in Austin, College Station and San Antonio.  I'm looking forward to the heat and sunshine as this spring has been very gray, rainy and dreary in the Midwest.  I was in San Antonio about 10 years ago, my hubby was in College Station for a conference a few years back and neither of us has ever visited Austin so we are looking forward to this unexpected vacation!  See you all when we are done messing with Texas!


How Today Was Supposed to Go

I would have been exactly 12 weeks pregnant today.  I thought how great it was going to be to finally be happy about Mother's Day and to have my own reason to celebrate.  I was looking forward to announcing that we were going to have a baby and also share the news about our prior losses more openly.  All the dates seemed to be perfect this time around - my cycle started the day after attending the concert of my favorite band, our IUI happened on the anniversary of the day we met, 12 weeks would fall right on mother's day, our baby would be due in November adding another possible Scorpio to the mix of other important Scorpios/November births I have in my life including my husband, my mother and my grandmother, and there was a slight possibly our little one (which we now know was a girl from the genetic test results) could have been born on 11-11-11 if she decided to make an early appearance.  I wish today was different.  Instead we lost our baby girl and shared the news of our multiple losses during NIAW and today I am just feeling sad and conflicted about what to do next.


Aw Shucks!

I've been on a bit of a blogging hiatus the past couple weeks because I haven't had much down time to write.  But while I've been away two of you lovely ladies nominated me for my first blogging awards for which I am truly grateful.  Thanks to Jen at the Chronicles of Violetta Margarita for the Versatile Blogger Award and Cyndi at Then Comes the Baby in the Baby Carriage for the Stylish Blogger Award.

So, here's how this works:

1.  Winners grab the image and put it in your blog.

2.  Link back to the person who gave you it.

3.  Tell 10 things about yourself (per award)

4.  Award 5 bloggers (Stylish Blogger) and Award 15 bloggers (Versatile Blogger).

5.  Contact the bloggers you have awarded to let them know they have won.

Since I was nominated for two separate awards, it looks like I should technically share 20 things about myself.  So here it goes:

1.  My husband and I live in a Sear.s kit house from the 1930s and I love its big front porch.

2. I'm a serial "snoozer" and hit the snooze button 4-5 times a morning before I actually roll out of bed. 

3. I'd rather spend the money we will likely spend on IVF to make a large down payment on a Syn.ergy Green Cama.ro.  :)

4. My husband bought me a pair of Heely's for Christmas in 2009 and I still haven't figured out how to use them.  I don't understand how kids zoom around in them so easily!!

5. I probably eat popcorn for dinner more often than I should.

6. I love to travel.  In addition to many places in the U.S., I've also been to Spain, Guatemala, Costa Rica, Honduras, Peru, Mexico, U.K., Scotland, France, Italy, Canada, Jamaica, Grand Caymans, the Bahamas and the Domincan Republic.

7. I've watched Grea.se more times than I can remember.

8.  I've never been one to nap much unless I'm feeling under the weather, but when it is time for bed I shut down like clockwork.

9. I love a good thunderstorm.

10. I don't have a cell phone with a data plan. 

11. I love going to baseball games with my husband and rooting for our home team (who currently hold the best record in baseball so far this season).

12. I like wandering around cemeteries.

13. I wish I was more creative.

14. I prefer pie over cake.

15. I don't have any tattoos, but if I was forced to get one it would say "Made in Hawaii."

16. I've only been downhill skiing once.  I was in fourth grade and broke my leg.  Never tried it again after that.

17. I was a competitive swimmer throughout most of my childhood and college. 

18. I went to a frog jumping contest and festival last summer and plan to go again this year.

19. I think coffee smells good, but don't really like to drink it.

20.  We're taking care of a cat that belongs to our neighbor.  He's an indoor-outdoor cat who abandoned his home after their daughter moved back with a small dog of some sort.  He was spending cold winter nights between our garage and our fence so we started letting him into our house so he could stay warm.  Our neighbors know he has been staying with us, but have never asked us to return him.  He's the first pet I've ever had.

And the nominees for the Stylish Blogger Award are:

1.  Lauren at Every Word Is Nonsense
2.  Tracy at My Seriously Broken Oven
3.  Ed at Things People Said After My Miscarriage
4.  Reusethematerialgirl at Take Home Baby
5.  Jill at musicmakermomma

And (some of) the (15!!) nominees for the Versatile Blogger Award are:

1.  Cheers at I Just Relaxed. It Didn't Work.
2.  The Infertile Gynecologist
3.  Pendiente
4.  embracingtherain


Another Year Older

Today is my 37th birthday.  I'm not generally someone who laments about getting older because in my mind I still feel young.  But this year, just in case I forgot my advanced maternal age, AF decided to bust in with all her might yesterday to remind me.  It wouldn't normally bother me that she decided to visit on my birthday, but did she really have to make her reappearance for the first time since early February and after my last loss now? Sometimes I truly hate her timing.


So Much to Catch Up On

I have been so busy this past week and haven't had much time to blog even though I have wanted to on a number of occasions.  I have a bunch of things to post about including my NIAW experiences, our follow-up appointment with the RE, test results we received today, and acknowledging the first award I received from Jen at the Chronicles of Violetta Margarita for which I am so appreciative!  I hope to be able to write more this weekend and to be able to catch up on everyone else's news from the past few days.


I'm a ICLW Virgin

Welcome, April ICLWers!  Thank you for stopping by to visit and say hi.  I finally started blogging last month after years of lurking while trying to cope with my own fertility struggles.  This is the first time that I am participating in ICLW and I look forward to visiting many of your blogs this week.  You can see a timeline of our TTC journey to the right.  We only recently shared our fertility struggles with our family and friends and I'm contemplating going public during NIAW on Face.book.  We just experienced our third loss on March 25 and will be going to a follow-up appointment with our RE tomorrow.  I've been compiling a list of questions I'd like to ask including quesitons about moving onto IVF as a potential next step.  I'd really welcome any suggestions you all may have for questions I should ask that I might not be thinking of at this point.  My husband and I want to make an informed decision before we pursue IVF as an option . . . especially since we've conceived and miscarried three times already.  I guess I'm just not sure how IVF would improve our chances of preventing another loss.  Any thoughts, suggestions or experiences you are willing share would be greatly appreciated!! Also, if anyone visiting has been diagnosed as heterozygous MTHFR C677T after experiencing pregnancy loss/losses, I'd love to hear if, and how, you were treated. Happy ICLW!


What the MTHFR???

So in preparation for our upcoming post-(recurrent)miscarriage follow-up appointment this coming Friday, I requested a copy of all of my medical records so I could review them in advance.  The receptionist told me that I would have to pay $2 per page since I wasn't requesting the records to be transferred to another physician.  After the money we've already spent, what's $2 per page at this point?  I told her I didn't care and that I wanted the records at least 1 week before our appointment so I would have enough time to look them over.  The records arrived about a week ago with a highlighted notation that said "**no charge**".  I guess they must have felt bad for me and decided to cut me a break or something.  However, they didn't include copies of any of the records they have that were transferred from our former clinic so I guess I will need to request those separately.

As I was reviewing the records, I was pretty annoyed when I came across a lab report from the initial bloodwork I had done in November after my second miscarriage which indicates that I am heterozygous for MTHFR C677T.  This was news to me.  No one told me about this and I bet I still wouldn't know about if I hadn't requested my records.  I've since done enough Google research to know that this particular mutation may or may not have something to do with my recurrent pregnancy losses depending on whose medical opinion you choose to believe.  Based on the fact that my RE never shared this particular result with me, I'm assuming he thinks that this mutation does not play a role in my miscarriages.  And, actually, if I'm understanding everything I have read thus far correctly, it isn't the mutation itself that is exactly problematic; rather it is just an indicator that I might be prone to having elevated homocysteine levels which are known to be associated with clotting disorders.  From what I can tell, my homocysteine levels have never been tested.  I will definitely be requesting further tests in this regard when we meet with our RE on Friday and also asking him why he never shared this information with me before.  I also learned that elevated homocysteine levels have been linked to cardiovascular disease which makes me wonder if this could also be the cause of the consistently high cholesterol levels I've had my whole life despite being a relatively athletic and fit person.

Maybe this isn't the answer, but I am holding on to a tiny bit of hope at the moment that it is and that once it has been identified as a potential problem that we will be able to address it in some way that will help me carry a pregnancy to term.

Any other RPL veterans out there who have had experience with this MTHFR-ing gene?  Which mutation did you have?  Any success stories post-diagnosis and treatment?  I'd really love to hear about them so I can be prepared to ask my RE some very specific and pointed questions on Friday.


Adding Insult to Injury

Nothing like getting an EOB from your insurance company in the all-too-recent wake of your third miscarriage that reads a little something like this:

Date of Service: 3/25/2011 (click here for a recap)

Type of Service: Anesthesia and Outpatient Physician

Total Charges: $1,449

Plan Allowance: $0 (that's right - nothing, zero, zilch, nada, big fat goose egg)

You Owe Provider: $1,449

What on earth could be the basis of the denial, you ask?

"Benefits are not provided for services, drugs, or supplies that are not medically necessary or related to ABORTIONS.  You are responsible for these charges even if the services, drugs, or supplies were ordered by a provider."

Yep, that's right people, my miscarriage has been equated to an elective termination of my pregnancy.  I know that this is probably just a coding error on someone's part, but we really don't need to be dealing with this absolutely insensitive mistake right now.  Thanks for rubbing salt in the wounds.


Opening Up About Our Fertility Struggles

Before our most recent miscarriage, only a handful of people in our life knew about our fertility problems including a few close immediate family members, my best friend and a couple of co-workers I gave some limited information to when I needed people to cover for me at work so I could go to appointments that were never easy to predict.  Back in August, after reading this article published in Self magazine, we drafted an e-mail we considered sending to family and friends.  At that time, we were approaching our tenth anniversary and seemed to be fielding lots of questions about if and when we were planning to have kids.  Also, I had sent a letter to the editor of Self to tell them that I was happy to see that they addressed this important issue, but was disappointed that the article wasn't highlighted, or even mentioned, on the cover (especially since the whole point of it was to break the silence of infertility).  I was asked to provide my full name and place of residence because Self was considering my comments for publication.  I have an uncommon last name and, if my comments would have been published, I was concerned that people in our lives would learn about our fertility problems in a very impersonal way if they somehow happened to see my name in the magazine.  As it turns out, Self never published my comments.  If they would have, we were going to send the e-mail we drafted to a wider circle of relatives and close friends as soon as we saw my name and comments in black and white.  But we returned from a wonderful vacation to celebrate our anniversary and found out I was pregnant shortly thereafter.  With this new pregnancy, we decided to hold off on sending the e-mail and keeping our struggles private a little longer. 

After we lost this second pregnancy, we decided to switch clinics.  We continued to keep our struggles private while we attempted three more IUIs with the new clinic.  IUI#5 (the second one with the new clinic) resulted in another pregnancy and our most recent loss.  After this loss, my husband and I decided it was time to share our problems and losses with others.  It is just getting too hard to keep it a secret anymore.  I'm tired of dodging the questions about kids and starting a family.  So I pulled out the e-mail we wrote in August, revised it a bit to include more updated information and hit the send button about 48 hours after our last miscarriage.

I'm so glad that we sent it. Sending the e-mail felt liberating.  It felt like the right time to finally "out" ourselves.  I felt like I got rid of a huge weight I had been carrying around.  We sent the e-mail to about 30 people and have been overwhelmed by the responses we received.  No one has made any insensitive comments even though I actually expected to receive some.  We've received amazing responses from handwritten cards to two completely unexpected and generous offers from friends who said they would be willing to explore the option of surrogacy with us if that is the path we decide choose.  I don't know why, but I have been stunned by the love and support we have received.  I really shouldn't have expected anything less.  After all, these are all people who love and care about us.  We are truly blessed to have such an amazing support system and I am glad that we will be able to confide in, and rely on, these relatives and friends from this point forward if and when necessary.

I wasn't quite brave enough to post something on Facebook yet, but with National Infertility Awareness Week approaching, I think I will muster up enough courage to "go public" with some type of message.

While I don't want to post the e-mail we sent in its entirety here, I am more than happy to share it with anyone who is contemplating coming out to family and friends and would like to see how we finally did it.  Just e-mail me or leave me a comment with your e-mail address and I will forward the message to you.


"You're right, I don't have any idea."

I returned to work on Monday after our loss on Friday.  The loss that my RE described as a "dramatic miscarriage" because of all the blood I lost and the large clotting that went along with it.  I spent most of Friday, Saturday and Sunday just lounging around the house.  My husband and I watched the first two seasons of Weeds with Net.flix on demand.  I could have called in sick and stayed home, but I wanted to go to work so I could think about something else, to concentrate on something other than our third miscarriage.

I fielded a call from someone that morning who was calling to inquire about the status of a certain case.  I'm not particularly fond of this person in general, but I am always professional and cordial when I speak with him.  He started the conversation with the standard, "how are you?" I responded, "I'm okay, how about yourself?"  You know this type of conversation -- asking about a person's well-being as a formality even though you don't really give a crap, but you feel obligated to do so before proceeding onto the real reason for the call/conversation.  He could have just said "fine thanks" and moved on, but of course that is not what happened.  Instead, he said, "It's a little crazy over here.  My wife is out of town this week and I have a lot going on."  I replied, "I guess that could make things a little more hectic than usual."  And then he said, "With an eighteen month old, you have absolutely no idea."  I couldn't resist and my next statement was, "Unfortunately, you're right, I don't have any idea." That was greeted with a noticeable few seconds of complete silence on the other end of the line which was then followed with "so the reason I'm calling is . . . " 

I hope my response made him uncomfortable.  I'm proud of myself for actually saying what went through my head out loud for once.  I'm not sure where my courage to say it came from.  Maybe it had something to do with my general dislike of this person and his comment rubbing me the wrong way on my first day back to the office after my third miscarriage.  Maybe it is because I'm tired of keeping our fertility struggles and pregnancy losses private/secret any longer.  Or maybe I felt more confident being pretty direct about it because my husband and I finally "outted" ourselves to our extended family and close friends this weekend.  I'll write about the way we shared our struggles and losses and the incredibly supportive responses we've received this week in my next post.


Just a Quick Post . . .

. . . to thank all of you for your support and leaving me such thoughtful comments.  I have some other thoughts and updates to share, but honestly I am not too motivated to write it all down at the moment.  I just wanted to make sure you all knew that I've read and appreciated all of your messages. 


No More Baby

***Warning!  May not be for the faint of heart.***

My third beta was scheduled for today.  I woke up early this morning to take my mom and sister to the airport by 7:00 a.m. and then headed to the lab.  Right before I left my house, I inserted my morning MVP and noticed a slight amount of red blood on the applicator after I removed it.  Given my bleeding experience last week which still resulted in more than doubling HCG levels, I tried not to be too concerned especially since I was going to be at the clinic in less than an hour for bloodwork anyway.  I dropped mom and sis off at the airport and made my way to the clinic.  The clinic is located downtown in the midst of a large medical and university campus and it is a bit of a walk from the closest parking garage to the office itself.  While I was walking there, I felt a substantial warm gush and just knew I was bleeding.  I made it to the clinic receptionist to check-in for the bloodwork, but asked to see a nurse first since I had started bleeding again.  My favorite nurse greeted me with empathy, suggested I have the bloodwork done first and that they would call me as soon as it came in.  She gave me the standard instructions ("if you start bleeding heavily or feel sharp pains, yadda yadda, call us right away").  I had my blood drawn and was heading back home by 7:30 a.m.  (extremely thankful that today was my day off and I would be able to come home and just lay on the couch without having to call in sick).

I was home by 8:00 a.m.  I changed into my comfy sweats and went to the bathroom (warning, TMI ahead) and that is when I felt the first chunk of something pass.  I couldn't bear to flush the toilet full of blood.  I called my husband, who was already at work, in a panic and he immediately came home.  I never felt large clots passing with my other two miscarriages - they were both just like longer and heavier periods with lots of cramping and dark red blood.  So then I thought, maybe it was the MVP I had just inserted less than 2 hours before that came out.  But about an hour later, I went to the bathroom again and felt two large clots pass that time.  I was still bleeding bright red, but otherwise felt okay.  No cramping, no nausea, not dizzy.  My husband wanted me to call the clinic back, but I, probably foolishly, said no and that I would wait until the nurse called with my beta results and then let her know what had been going on since I was home.  Well, that wasn't a good plan.  Next thing I know it, I bled to the point where it soaked through my thick maxi-pad, through my underwear and favorite sweatpants and right onto our couch.   I ran up to the bathroom, sat on the toilet and passed 3-4 more large clots.  I thought for sure the baby was in the toilet.  Heeding my husband's earlier suggestion, I yelled to him to call the RE's office.  He did and they told us to come right away.  I put a new thick, maxi-pad and a pair of old jeans on and we were on our way. 

The walk from the garage to the office was not fun.  Half way there I could feel another large clot coming out.  They were expecting us when we got there.  I told them I needed to use the bathroom and then the nurse's had a quiet conversation on whether or not they would want/need to see whatever I deposited in the toilet.  The consensus was no, because it was early, 5w5d, and they suspected that whatever it was apparently wouldn't be worth viewing.  In the bathroom, I passed another large clot and discovered that I had bled through the maxi-pad I had put on less than 30 minutes earlier.  After I used the bathroom, I was taken to an exam/ultrasound room.  My vitals were taken and the doctor quickly came in.  He seemed to be shocked by the amount of my bleeding and the clots.  He said that he was glad that we came in and that if I had waited much longer, I would have probably needed an ambulance.  To my surprise, the vag cam revealed that the sac was still there, but it was not attached to the uterine wall any more and was making its way down and out.  Because the bleeding was significant, we were given two options: (1) transfer me for surgery under anesthesia, which could take 1-2 hours before it would begin, with the possibility of passing the sac on my own before we got there; or (2) do a suction curettage, an outpatient procedure, right there in the office which should stop the bleeding within 15-20 minutes assuming no other complications.  We opted for the second choice.  I wanted it to be over sooner and I knew the sac was still there and if they got it all out then they might be able to test the tissue.

Of course, the RE had to discuss the risks with us and I had to sign a consent form (although I know this is standard procedure, I wonder if the RE was also remembering that my husband and I are both attorneys).  Two nurses and a medical fellow came in to assist the RE.  They numbed my cervix, waited a few minutes and then inserted a small vacuum to remove the sac.  The fellow was controlling the abdominal ultrasound to help the RE guide the vacuum.  There was some cramping, but it wasn't as bad as the HSG I had done.  And just when I thought it was over, I heard the RE say something about still being concerned by the bleeding and that he needed to make "a second pass" to make sure most of the tissue was gone.  I think that part of the reason he did that was in the hopes of retrieving more tissue so that there would be enough for pathology to try to test.  Before the procedure started, he never mentioned the possibility of needing to make a second pass.  I cried and I laughed throughout the procedure.  I wasn't really in control of my emotional reactions.  It all seemed to happen so fast.  Somewhere in the midst of all this, I heard them reviewing my HCG levels.  They were at 10,956 today.

After the procedure was done, I stayed in the room to rest for a bit with my husband.  I was given wash cloths to clean myself up.  After awhile, I got dressed.  The RE came in to talk with us for a bit and gave me a prescription for an antibiotic and explained the risk of a potential infection.  Unless I experience anything out of the ordinary, I go back in two weeks for bloodwork again to make sure my HCG is dropping.  The pathology and genetic tests may or may not work and we won't get results for at least a month.  We are now back home, possibly in need of a new couch.  Just flipped the cushion over for now.

This is miscarriage #3 so I can officially be diagnosed with recurrent pregnancy loss (RPL).  It's completely boggling to me how RPL is not a diagnosis after two pregnancy losses with no live births ever, but who am I to say?

What I do know is, I have an absolutley AMAZING husband.  This is so hard for him, too, in so many ways.  He's grieving our losses and was very scared for my well-being today.  But through everything today, he remained strong and calm and loving and supportive . . . like he always is.  He's shared the news with our family members because I just couldn't do it.  He called our friend to cancel the plans we had with him tonight.  He bought me a big ass Diet Coke from Mickey D's (something I have been denying myself from the moment we found out I was pregnant).  I truly have no idea what I would do without him.  And I truly hope that one day I will be able to give him the family we both desperately want.


Trying to Relax and Remain Calm . . .

. . . but it isn't easy and doesn't come naturally after experiencing prior pregnancy losses.  Today is 5w1d.  Still SO early.  I'm tense every time I go to the bathroom, holding my breath until I inspect the toilet paper and make sure the bleeding hasn't started again.  I'm also wondering if the results of my second beta were just some fluke and because of the early bleeding I had I may no longer be pregnant.  I don't want to POAS for fear of seeing the line getting fainter and disappearing.  I should have insisted on getting another beta before Friday, just to make me feel better.

I also have a love/hate relationship with my progesterone - I have started calling it my MVP (for "magical vaginal pill").  I'm hoping that this pregnancy will progress without much difficulty because I'm using the MVP this time around.  My first pregnancy happened about 9 months after we started TTC and before we started seeking fertility treatments.  It was before we really knew we had any issues to be concerned about so I didn't even know progesterone supplements existed.  My second pregnancy occurred naturally, two years after our first miscarriage, while we were on a break from medical interventions.  Now two years wiser and more experienced with IF, I asked for the progesterone suppositories once I discovered I was pregnant this time.  However, the RE I was seeing at the time was out of town and unavailable and the RE who was covering for him didn't think it was necessary.  That pregnancy didn't make it beyond 8 weeks either.  My biggest complaint about my MVP is the mess it creates and (sorry TMI ahead) the warm gushy flow it creates that always makes me think I've started bleeding.

I wish I was experiencing more of the typical symptoms everyone seems to associate with pregnancy.  My boobs really aren't sore or hurt at all.  I have had to pee more often, but I think that is partially because I have been drinking more water than I normally do.  I have been somewhat queasy, but no major nausea or vomiting.  I was pretty exhausted on Saturday and fell asleep on the couch by 6:30 p.m.  I slept until about 1:30 a.m. and then was wide awake until about 11:00 am.  This is very unusual for me.  But other than that, I'm feeling pretty good which then makes me second guess whether everything is really okay.

I'm trying to take it easy as much as possible.  Although logically I know there really isn't anything that I can do to cause or prevent a miscarriage, I just can't help but wonder whether I'm doing things "right."  Most people think I have a stressful job.  I do work about 10 hours per day on average and often bring home work to do on the evenings and weekends.  But I'm trying to not be all consumed by work as much.  Truth is, I actually like and enjoy my job and it keeps me occupied.  If I'm busy, the time goes by faster and it helps me keep my mind off the IF roller coaster. 

I know every pregnant woman is likely apprehensive, gets nervous and worries throughout her pregnancy.  I just envy those fertiles out there who don't have to add "I wonder if I'll lose this pregnancy, too?" or "I wonder if I'll make it past the first trimester this time?" to their list of concerns.


Utter disbelief!!!

I went for my second beta this morning.  The nurse just called with the results about 30 minutes ago and by the tone of her voice I could tell that I was going to get news that I wasn't expecting and hadn't been preparing myself to hear.  72 hours after my first beta which was 109, my level today was 560!!!!! OMG!!  I still don't know how this could be??  I'm still bleeding somewhat although it has slowed down over the past 24 hours.  Still more than spotting in my unprofessional opinion.  But 560??  That is higher than I have ever been at CD34.  I told the nurse that I was truly shocked because I'm still bleeding and she said some people continue to have what seem to be light periods throughout their pregnancies.  Great, just what a woman who has been TTC for over 3 years and has had 2 miscarriages to show for it needs to hear!  My RE is, of course, out of town this week, but I asked the nurse if one of the other REs was available to talk to me about the bleeding because it is not reassuring despite the strong hcg results today.  Makes me wonder what it could be.  Nothing to worry about??  Vanishing twin syndrome?? Subchorionic hematoma??  I've researched them all with Dr. Google of course.  They want me to wait until next Friday to come in for a third beta and then will schedule a first u/s for the following Thursday or Friday.  The waiting may kill me.  Has anyone else out there experienced anything similar to this?