Standing still, again

There was no heartbeat today. Appears that it probably stopped a few days ago.

As much as I was trying to prepare myself for this, the extreme 24-7 morning sickness gave me a little hope. I suppose it was just lingering hormones. Or maybe Halloween's ultimate trick.

The D&C is scheduled for tomorrow. I'm familiar with the process. I'll wear my yoga pants and favorite sweatshirt; the one where I can pull the sleeves down over my hands. I'll ask for extra blankets to bury myself in as I wait my turn. I'll cry as they put the IV in my arm and then even more as they fit the mask over my face. Although I'm prepared for it, I don't think this is something you ever get used to. If anything, the pain becomes even more intense.

8 weeks, 0 days

I'm exactly where I was when I lost my last pregnancy. The significance of this day is not lost on me. If I find out on Wednesday that we still have a heartbeat, this will officially be my longest pregnancy to date. Ironic that it is the unhealthy pregnancy that lasts the longest.

I'm not looking forward to this week. Actually, I have a feeling it's going to be an all time shit-fest.

• Wednesday: Followup u/s with Dr. D. As I see it, there are three possible outcomes: 1) No heartbeat and grieving escalates 2) Slowed heartbeat and prolonged waiting for the inevitable end or 3) Continued "normal" heartbeat and more agonizing over the 'what if's' and, of course, more waiting. Yeah, no good options in there. 
• Thursday AM: Appointment with the fetal development specialist (if we get that far). For some reason the idea of seeing this doctor scares me to death. I also hate going to new doctors- the fear of the unknown is daunting. What if their super-powered u/s machine shows me something I don't want to see? Though unlikely, this thought plagues me. 
• Thursday PM: Remember my friends that found out they were pregnant exactly as I lost my last pregnancy? (No? You can read about it HERE). They are flying across the country to stay with me for 4 days (the trip was planned 6 months ago). Since my last miscarriage our friendship has struggled quite a bit. There has been a distance that has never been there before and I don't know if it is my fault or theirs or a combination of the two. I'm just dreading the thought of seeing my friend's partner's swollen belly for days on end. In my home. I have weird fears about their visit too. Like, I'm worried that if she voices one little pregnancy complaint, I will be down her throat. Or, that she will unconsciously cradle her swollen belly with her hands. I don't even want to hug her at the airport because I don't want to touch it. It sounds crazy, but this is where I am at. If hotels in our area weren't $300/night, I might have asked them to stay elsewhere. But they are, and so I can't. I'm not going to be able to handle this gracefully. Truthfully, I don't want them here. It's the worst timing imaginable. But I'm stuck and have to get through it somehow.

I fired my therapist, Zsa Zsa. My appointment last Monday was the final straw: 

1. I was talking to Zsa-Zsa about how hard it has been for me to relate to the rest of the world. I used an example of a friend of mine who texted me a few days prior. She was venting about her horrible day. It turns out her three-year old twins were going through a "phase" and she was beyond frustrated and angry. I found it impossible to text back any kind of support because, the reality of it is, I would cut off both my arms to have her problems. When I finished, Zsa-Zsa turned and angrily scolded me: "Tutti, you have NO idea how hard it is to raise children. You have NO idea." I sat there shocked. I couldn't even manage a reply. And though it's not right of me to play the Pain-Olympics, it also wasn't right for her to reprimand me for voicing my struggles in therapy. I shut down for the rest of the session. 
2. I realized that though Zsa-Zsa has been a sympathetic ear for the last eight months, she hasn't helped me. I have asked her a number of times for ways to cope and strategies to deal with all this grief and pain. But there has been nothing except the advice that 'time will heal'. Gee, thanks. 
3. At the end of the appointment Zsa-Zsa said, "I know you said nothing is really helping you right now, so would you like to cancel your appointment for next week?" Way to support a girl in crisis. Talk about feeling abandoned. So I cancelled my appointment next week. And all future appointments. 

Now I have to find a new therapist. 

I realize what a horrible place this blog has been. Looking back, there are few (if any) upbeat posts over the last several months. This place has been consumed with sadness, fear, pain, grief, anger, and sadness (deserves to be mentioned twice). And truth be told, it is not chronically this bad in real life, this is just where I feel safe voicing these feelings. So it becomes a dumping ground. However, I hope that at some point there will be light and happiness too. Maybe even some hope (don't want to get too far ahead of myself though). I just want to thank each of you for sticking with me. I know it's not easy to read and I know how difficult it is to find the right words to say sometimes. But with each comment that is left, I feel the support and love. And it helps so, so much. I gather so much strength from you all, strength that is so badly needed right now.

7 weeks, 4 days

I find it difficult to post lately. Not because I don't want to, but because I don't know where to start. I guess I'll just start with the concrete stuff.

My u/s yesterday was everything I hoped it wouldn't be: it provided no answers and no end.

• We still have a heartbeat. It is on the lower end, but still within normal range at 109bpm. When Dr. D flipped on the sound, I was wholly unprepared. The sound of that little heartbeat made me cry big, rolling tears. It sounded so... strong. So alive. It made me feel insanely guilty that I had gone into the appointment wishing only for silence. 
• CRL almost doubled from Friday, although still measuring a few days behind. 
• Yolk sac size reduced only very slightly from 9mm to 8.5mm, which is still in the highly concerning range.

Dr. D recommended that we go see a fetal development specialist. It's never good when your specialist refers you to an even more specialized specialist. She doesn't think that they will be able to give us any additional answers since I'm still so early, but they have more powerful u/s machines so she wants us to at least try. She also wants me to ask them about the Materni T21 test if I make it to 10 weeks. This is the blood test for downs syndrome, trisomy 18, and 13. I scheduled this appointment for next Thursday but I fully expect to have to cancel. My next u/s with Dr. D is Wednesday. I just can't be optimistic enough that we'll make it that far.    

I (politely) forced Dr. D into giving me odds. She said that her best bet is a 75% likelihood of this not working. Which in many respects is much better odds than even last week. She must have read my mind because she quickly followed with, "Do not get excited Tutti, things are still weighted heavily against you". I appreciate her honesty. Even if this baby somehow makes it, what are the chances that it will be a healthy baby? I don't know what to do with that. My head tells me to continue grieving because there is no way this is going to work. But the what-ifs play on my heartstrings when I'm asleep at night. I just can't handle the back and forth. So I tell myself that it is only a matter of time until this pregnancy ends and try to manage this mind-fuck that way. I don't know any other way to do it.

To add insult to injury, my pregnancy symptoms are increasing. As they should, because I'm technically still pregnant. Queasiness, fatigue, vivid dreams, sore boobs, frequent peeing: all symptoms I'm familiar with from previous pregnancies. However the one I'm struggling with most is my sense of smell. It's like someone gave me a bonus super power. The scent of burning frankincense from the church 3 blocks down and through closed windows wakes me up each morning. The smell of the shampoo as my husband takes a shower is entirely overpowering. I smell the dirt when I walk outside and I live in the middle of the fucking city. It's insane really. I feel honored to experience these things, but resentful that it won't result in what I want more than anything in the entire world.

This whole thing is just really, really hard.

7 weeks, 1 day

Scene: A bright spotlight shines on Universe as he walks out from behind the curtains. He holds his hands up in the air and the audience quickly hushes. "Intermission is over. Please take your seats folks. There is a lot more to this show yet!" 

I'm exhausted. I don't want to write this post. I don't want to do anything really. But at the same time, I feel the need to update. So fair warning, this will be a dumping of events and that is all. It is all I am capable of right now.

Friday I went into the clinic for my last u/s so that we could finally schedule my D&C. For the most part, I was ok. I wasn't weepy or angry. I was just anxious to move forward. It was appropriately silent during the u/s. So needless to say I was wholly unprepared when Dr. D, very tentatively, said that she found a heartbeat. It was tiny, but it was most certainly there at 105 bpm. I swear at that moment I felt something snap in my head. I felt like I was going crazy. How was this possible? I'd already started grieving the loss of this pregnancy. How much more back and forth could I possibly take?

I measured a few days behind, but more concerning was that my yolk sac was still quite large. I had previously refrained from researching this because I figured it didn't matter- it wouldn't change the outcome. Confused and overwhelmed, I asked Dr. D to be honest with me: what were my chances? She said that she was quite worried and that when she had seen situations similar to mine, more often than not, they hadn't ended well. However, in my head that still left room for a tiny, tiny bit of hope.

When I got home I assaulted Google. To not, would have been naive. I needed to know what was going on. And this is what I learned: 1) A yolk sac measuring over 5mm was considered "enlarged". Mine was 9mm. 2) This was indicative of a chromosomal abnormality 3) This was bound to end in miscarriage. It wasn't really a matter of if, but when. I found two or three anecdotal stories from random 2006 chat rooms where women had slightly enlarged sacs (6mm) which ended in live births. However there were 100's of bad stories to counter each good one. Even more conclusive were the scientific papers. That is when my tiny, tiny bit of hope was snuffed out. Again.

This is no longer an anembryonic pregnancy. No, now there is a tiny baby with a tiny heartbeat. My pregnancy symptoms are growing stronger. The spotting (ironically) has stopped. All this, yet I know how this is going to end. I head back on Wednesday for a followup. I know that there is a good chance that the heartbeat will have stopped by then. And if it hasn't, I'll have to wait even longer. Can you imagine? Just hanging out waiting for your baby to die? I can't. And I'm living it.

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Note: I know there are some of you that are still hopeful. That some still believe in miracles. But I don't, not anymore. I'm not asking you to not be hopeful, just please don't voice it to me. I need to face the facts and grieve my third loss for the second time. I can't manage to get through this any other way.

Standing still, Day 4

I've been feeling very numb the last few days. It's not like I don't know what is going on. Diagnostically I know what happened. I know what the next steps are and that none of it is good. But it has all been processed from a distance. No tears. Just going through the motions. Because I knew once those floodgates opened, there was no going back. I just wanted to delay it for a bit. To not feel like such a disaster for once.

But standing in the shower yesterday morning, I felt it creep in. I curled up on the shower floor and wept. The water didn't wash away my tears, nor did it drowned out my sorrow.

I have my husband. I have my close friends. I have my mom, my family. Dr. D and my nurses. My therapist. The women in my Resolve group. I have you guys. I've shared my story with so many people. I've talked about my feeling ad nauseum. I've written about them at length. I think that I somehow rationalized that if I gave lots of different people tiny pieces of my pain, that it would lessen my own. I was trying to unburden myself. I attempted to spread it out. To thin it.

But I've finally realized that my grief and loss are mine alone. I can't deposit these feelings and then run from them. They shadow me wherever I go. And they are as thick as molasses.

Physically I can do this. I know what I have to do and what the process is. I will go through surgery. Listen to the test results. Sit in Dr. D's office and figure out our next move. I will continue to wait. I will force my body to go through the motions, and it will obey. But emotionally I don't know what the process is anymore. I keep following the same track and when I find myself in the place I started, I don't know what else to do except continue back around. I'm going in circles and it's not working. I can't keep doing this, it's eating me alive. How do you stop the loop? For the life of me I can't figure it out.

I couldn't bare the thought of waiting until Wednesday for my next u/s. And then even longer for the actual D&C. I broke down and called Dr. D yesterday. I was ready to beg and plead to be seen earlier but I didn't have to. She told me to come in this afternoon and that we could schedule the D&C for as early as possible next week. Which is good because I started spotting this morning. I need this horror show to end.

Standing still, Day 3

I'm writing about this in the hopes that: 1) I might find someone else who has suffered from this and 2) Perhaps I can help someone by writing about my experience. If not today, maybe someday in the future.

At around the age of 14 or 15, I started having these, episodes, for lack of a better word. My mom had them too, which made me feel less alone and more understood. For years neither of us had a name to put to it. All we knew was that about once every year or two, seemingly out of the blue, our bodies would fail us. One second you would be sitting there working at your desk, or cooking dinner, and the next you would be on the ground, experiencing the worst stomach cramps you could possibly imagine (my mom said the pain is worse and more intense than going through unmedicated child birth- which she did twice), and slipping out of consciousness. Which, is always welcomed relief from the pain. However, waking up drenched in sweat and unable to see/hear/speak is terrifying on a level I'm not able to put into words. Within a few minutes of regaining consciousness you feel like you were on the loosing end of a bar fight: your stomach left aching and your body devoid of all energy.

For years doctors shook their head at my mom and me. "General anxiety" was often thrown down on our charts as the culprit (it was *not* anxiety). Finally, after tapping my mom's medical books and much Googling, we found a possible diagnosis. To my surprise it didn't have the words "insurmountable amounts of pain" included its name. Rather it sounded quite innocuous: Vasovagal Response. Symptoms fit perfectly, except both our reactions were 1000x more severe. This thing is not supposed to be life threatening, but for both of us it seems to be. My mom has had episodes that have triggered grand-mal seizures and mine, at least once, landed me in the ER where they lost my pulse for a least a few moments. Thankfully it doesn't happen often, but I live in fear of this thing.

With all 3 pregnancies I noticed that, at times, I would get quite dizzy when I stood up. It never bothered me much because I've always had low blood pressure and though it seemed to be happening more frequently, I was no stranger to having to hold onto a wall to stop the room from spinning. Last week, I stood up from the couch and along with the intense dizziness, I lost my sight. I just, couldn't see. I quickly fell to all fours and waited it out. Though a bit more dramatic than most dizzy spells, I tried to chalk it up to not drinking enough water. However, I now think this is part of the Vesovagal response. Just a much, much more mild form.

Two nights ago, the same day I found out that #3 wasn't viable, it happened again. But on a level that far exceeded anything that I had experienced to date. It came on strong and fast. I just, I don't even know how to explain it, I collapsed on the bed with what sounded like blown speakers in my ears, drenched in sweat, finding it next to impossible to form a single thought, while feeling my heart bottom out on me. I felt intense pain but not from anywhere specific. It felt like, I was dying. Not figuratively, but literally. I felt like it was too close. Too real. For 15 minutes I laid there, too weak and disoriented to grab my phone that was just 2 feet away. And wishing I wasn't all alone.

This time was very different than the rest: no stomach cramps, no loss of consciousness, and lasting much, much longer with a reaction much more severe. Eventually I started coming out of it. I called my husband so that he could call 911 for me if I did pass out (not cognitively being with it enough to realize that if he called 911, it would be for a dispatch in the wrong state). After about 45 minutes, I felt stable enough to get off the phone. Despite being exhausted, I didn't dare close my eyes for the rest of the night.

All of these years I've never been able to pin point a trigger except for one time when I was about 30 years old and I had an endometrial biopsy (for what I now know is my luteal phase defect) which triggered my most severe reaction up to that time. But other than that, I don't know when it is coming or what provokes it. However, I do believe that the severe dizzy spells and this latest episode were caused by my pregnancies. Viable or not, I have the hormones in my system. And it's been too consistent with timing to blame it on coincidence. I also know that stress can be a trigger. I wasn't stressed when I was 14 years old or even when this thing landed me in the ER, but I am now- and I'm sure that doesn't help.

I will talk to Dr. D about it, but I'm not sure there is anything she can do. No doctors have ever offered any solutions, and quite honestly always seemed as if I was over reacting. I don't know what this is or what it means. For me. My future. And any future pregnancies, if there even are others. It just seems to be getting stronger. Or perhaps the triggers are stronger.

Reading this over it almost seems too fantastic to be true. But every word of it is real and honest. I'm terrified of this thing in me. My body is broken in so many different ways.

Standing still, again

I walked out of my RE's office with a box in my hands. A box I am all too familiar with, stamped with bold blue typeface: PRODUCTS OF CONCEPTION.

I don't even know what to write anymore. What new words can I find to describe what it feels like to go through yet another miscarriage? My third this year.

I don't think there are any.

The yolk sac had grown a little, which apparently isn't a good sign. But more importantly, there was no heartbeat. With tears in her eyes, Dr. D said she was 99% certain that this pregnancy would not go any further. I have an u/s next Wednesday to make 100% certain. Then, we'll schedule another D&C. Get more genetic testing. Mourn one more loss.

Cycle 19, CD 44 (26 DPO)

After my last beta, they scheduled me for my first ultrasound. Based on my LMP,  I should have been 6 weeks yesterday.

I was working on getting to a calmer place mentally but facing that first ultrasound gave me quite a bit of angst. First, because I still have those last u/s images swimming around my head. As crazy as it sounds, I felt like it was going to be a scene out of a horror movie where I saw a dead 9 week old fetus instead of the tiny blip of a 6 week old embie. Crazy, I know. But those are the tricks my mind plays on me. Secondly, Mike is out of town on business. So, I was going to have to this all by myself. Que panic.

But I didn't have any choice so yesterday I put my big girl pants on and marched myself into the clinic.

Dr. D and my favorite nurse S innately understood my anxiety. They were both holding their breath along with me. I was mostly ok until that probe was finally in. Those first few moments of silence when your doctor intently studies the monitor and you frantically study your doctor's face in attempts to figure out if it is good or bad news, is almost too much. It's probably only a few seconds, but I could hear the blood in my ears, my heart thumping out of my chest. It's a dreadful moment.

We did see a gestational sac. And a yolk sac. And what looked like a teeny grain of rice floating in the abyss. But no heartbeat. Dr. D was quick to say that it might just be too early. She didn't realize I knew when I ovulated (I only happened to pull out the OPKs because I wanted to be sure my miscarriage didn't totally fuck up my body) so based on this new information, I'm actually only 5w4d. With that recalculation, it is very unlikely we would see a heartbeat this early.

Dr. D then went on to say that when she was pregnant and did an u/s on herself (I couldn't help but laugh at that image- to which she smiled and said, "it's one of the perks that come with the job") she only saw a tiny grain of rice too. But I know it's a numbers game at this point. At my u/s next Tuesday we could see a heartbeat or... we could not. And there isn't a damn thing I can do about it in the meantime, except hope.

The good news is I made it through this ordeal by myself. I didn't do it willingly but I did feel a sense of empowerment. Like, maybe I'm not as weak as I thought. Mike will still be out of town on Tuesday so at least I know now that I can indeed do this without him. I just wish he could be there, you know, just in case it is good news.

Cycle 19, CD 40 (22 DPO)

Beta #3 came back with good doubling numbers. At 22dpo I'm sitting at 8712 which actually exceeds the high end of the hcg chart. 

Last week was really hard for me. The shock of finding out I was newly pregnant again brought up all the emotions from my last miscarriage. And they spilled out everywhere. It was something I was wholly unprepared for. But in these last few days I've heeded Cristy's advice and begun to feel things without fighting against them; allowing the pain of missing my last little one to mesh with the excitement of a possible brand new beginning. It has been rolling around together to where sometimes I can't tell where one starts and the other ends. But I think that's ok. 

More than anything I'm sitting here thankful. So thankful it makes my eyes well with tears and my heart scream with hope. 

Cycle 19, CD 36 (18 DPO)

Beta #2 came back with good doubling numbers.

I've been numb ever since I saw that second line. Numb, dotted with bit of fear. Then last night, out of nowhere, I broke down into uncontrollable sobs. In my desperation to start trying again, never once did it dawn on me that it would happen so fast. And in that line of thinking, if it did happen fast, that I could be faced with another miscarriage. The last one is still so fresh. I still think about her all the time.

It's like I just got pummeled by a wave, was barely able to stand up again, and am looking at another one headed right for me.

But there are things that keep me afloat too. On Sunday when I found myself in a state of total shock, I quickly dialed the emergency-Trisha-hotline. She talked me down and made me laugh. When she asked me what my RE said, it dawned on me that I hadn't even called my her yet. We laughed even harder at that. I'm more lost and scared and vulnerable than I have ever been in my life. I'm terrified that I'm going to drown in this wave. But knowing that you are all hoping for me, means the world. It's the support that I can't possibly give to myself right now. Not now, but hopefully eventually.

To my loves, thank you.

Cycle 19, CD 34 (16 DPO)

A lot has happened in the week since I last posted.

Let me start off by saying, everything went according to plan at the airport. As I thought, TSA was on top of their game and screamed out, "Excuse me ma'am, are you a diabetic?" as I waited for my carryon with Follistim to come through the scanner. I was like a tiger sitting in wait for my meal to arrive. My muscles were tight. I saw my prey. I jumped. Unfortunately I think all that anticipation made my voice squeak as I yelled back, "No, [voice rising several octaves] but I am infertile!". It wasn't the delivery I was hoping for, but I rolled around joyously in that uneasy quiet that came immediately afterward. Mission accomplished! 

I also had a birthday. I'm one of those girls that always had a full 60 day countdown until the big day. Lots of anticipation and merriment would abound. But not this year. This year I turned 36 and I'm officially over that 35 year old infertility mark. Scares the shit out of me. I was able to keep it together enough to share a quiet day with my husband, enjoy a few treats, and not think of the looming year ahead. Birthdays and anniversaries are so very tricky these days. 

While I was traveling, I bumped into an old work friend. I've always liked her and in my new normal fashion, I spilled my infertility-beans on her within the first 10 minutes. She was very sympathetic and all was good until she told me a story about her friend that struggled for 4 years to get pregnant, finally had twins through IVF and then found herself with an unexpected new pregnancy (sans any intervention) a tender 6 months later. I didn't want to come off as a total bitch so I said, "I'm so glad things worked out for her" but then quickly followup up with, "but I'm not that girl. I'll never get pregnant by having sex." 

Except... I am that girl. 

I'm pregnant again. 

Pregnant while benched from my most recent miscarriage. Pregnant by having sex. Pregnant without a single needle stick, ultrasound probe, pair of lucky socks, or visit to the doctor. I'm pregnant without any acupuncture, vaginal suppositories, tww angst, or spending a dime (barring the $300 of fertility meds sitting unopened in my refrigerator). This shit just doesn't happen. Especially not to me. 

I am very, very thankful but I am not happy or excited. I am not hopeful that this pregnancy will progress like it is supposed to. I've been here before. Twice actually. I know those double pinks don't equate a baby. I feel like I know better than to think that now. Right now I just feel really numb.

My first beta was yesterday and it was 735 at 15DPO. That's really high. So high, in fact, that I started convincing myself that this was a blighted ovum, a molar pregnancy, or something else. But my husband gently took my hand and said, "You need to let go." And I have. I've remained calm since and now all I can do is wait until beta #2 on Thursday.  

And yes, I am just as shocked as you are.