A quick ending to pregnancy #8

Hello blog world. I am not really sure if anyone reads this anymore but I felt like writing today so here goes…

I found out I was pregnant for the 8th time while on vacation in Hawaii. I knew the test would be positive…that’s the beauty and the curse of having been pregnant so many times. I was also pretty darn sure that my betas would not be very good when I got home because I had absolutely no symptoms after I got that positive test. And I was right. My first beta came in at 152 at 5 weeks. Based on that number alone and that I was incredibly sure of my dates, I was pretty sure I was in chemical pregnancy land. The second number went up…to 168. Not viable. The third number came in at 134 and proceeded to stay there for the follow up draw, prompting panic that this was an ectopic pregnancy. The following draw dropped to 119 and then 26 (which was the day after I started bleeding), so we are pretty sure it’s just an early miscarriage. I will have my blood drawn on Wednesday to confirm this, but I am pretty confident it’ll be 0 at that point.

In general, I feel a bit numb to the feelings that should surround a positive pregnancy test. I’m sure this is a protective mechanism. I did not cry at all over the lost pregnancy, and that was a first. One of the feelings I was not expecting was relief. I was relieved that it was not ectopic, of course, but I was also relieved to not have to go into an ultrasound and be told I had another missed miscarriage, or, worse, another stillbirth.

My husband was also relieved. He just hates this process so much and would love to stop trying for a second kid. I am just not there yet, so as long as he’s still agreeing to try, I am going to press on. I do feel that this is one step closer to a resolution (which is such an obvious statement) but I do feel like I am approaching my limit for this TTC business, and as much as I would like it to end in the live birth of a child, I realize that my preferred outcome is actually not that likely. We are starting to explore the foster to adopt process, but we have plenty of time to do this in the future if we decide that having two children is really what we want.

I did find out that I am homozygous MTHFR C677T, which has been shown to contribute to blood clotting issues and recurrent pregnancy loss. But it has also been shown to not contribute, so who the heck knows if it has anything to do with anything. I already take baby aspirin, which is what is recommended once you find out about the mutation. I have officially cut out all processed foods that are fortified with folic acid and I have started taking a prenatal with methylfolate, which made me feel awful so I switched to one with whole food form of folate. I am going to try another prenatal that is formulated differently with folinic acid and methylfolate and does not make people feel as crappy (so we shall see).

My vacation and the miscarriage screwed up my diet in general, so I am finishing up my delicious Kona Coffee and then I will cut out coffee again. We have one more trip planned this weekend and then I’ll go back onto my full fledged no processed foods and no sweets. Taking a break from the restrictive eating has been nice, but the success of actually getting pregnant again has re-motivated me to get back on the wagon. I also started running again last week, and it has been so nice to do exercise that is not just walking. I plan to continue doing 30 minutes 3 times a week for now.

Lastly I am looking at getting one last consult with an outside RE to see if there is anything I’m missing. My insurance-covered RE’s are just not interested in my case since I am not interested in IVF. I’m willing to spend a little bit of money to have a monitored cycle and to get a saline sonogram to make sure my lining is ok after that D&C. Maybe it’ll give me the diagnosis that actually gets me my live birth…or convinces me to stop!

Here we go…again…

July marks the month where we start trying again. I literally cannot believe that I’m writing those words. After 5 years of TTC, we are still at it. It’s such a surreal feeling.

July 9th was the 5 year anniversary of my first positive pregnancy test. We got pregnant on the first try. Living the dream, right? WRONG! It is unbelievable that after getting pregnant so easily I have experienced 5 miscarriages, a stillbirth, a uterine anomaly diagnosis, DOR and the miracle birth of my daughter. The whole story sounds like it’s someone’s nightmare, but nope, it’s my real freaking life. And I am actively choosing to continue what I assume will add more depth to the nightmare. Sometimes I seriously wonder what is wrong with me and why do I have such a desire to experience pregnancy and a successful live birth again after all we’ve been though. But I’m just not ready to give up on my body. I want this journey to end on my terms instead of on the shitty terms I’ve been dealt.

I have thought a lot about how I wish I had a different (in)fertility diagnosis. For example, I wish I needed IVF to conceive but was able to carry pregnancies with no issues. Or I wish I had a uterine septum instead of a unicornuate uterus. Obviously I have no idea what another road would have been like so I cannot really speculate that I would have preferred another path, but it certainly seems like it would have been less painful. Although, as I’m learning, pain is relative, so it’s likely I would have experienced the same heartbreaking feelings on another journey.

I had my cycle day 3 labs and AMH redrawn and boy are they shitty. My AMH had cut in half in 11 months from 1.2 to 0.6. My FSH is 14 but my E2 is 84, which means my FSH is being artificially suppressed and is likely higher. So now I’m in the full blown DOR zone and not just the likely DOR gray area. It makes me so upset that Colton died and that he may have been my last shot at a normal embryo. I hate the uncertainty of this road and that I have no idea if I will even be able to get pregnant again. But then I think about how I made 2 normal embryos last year and it can’t be that bad yet, right? I’m only 35 and while that’s considered to be of geriatric age for getting pregnant, so many people get pregnant and have no problems at this age and above. There was also a study that came out in 2017 basically saying that having low AMH and/or high FSH showed no difference in the ability of a non-infertile woman to get pregnant naturally. So I’m hoping that since I have never had a problem getting pregnant I am considered “non-infertile” and  I will still be able to get pregnant. Hopefully I still have some good quality eggs left. Too bad my uterus sucks and I have to gamble that the normal embryo implants in the right spot. Lastly I really hope that D&C did not screw up my lining but only time will tell.

Since March I have been taking ubiquinol, prenatal vitamins, vitamin E, vitamin C, vitamin D, extra folic acid, and a B complex vitamin in hopes to improve my egg quality. I also re-read “It Starts with the Egg” by Rebecca Fett and have re-committed myself to eliminating toxins from my household items and food as much as I possibly can. I also plan to re-introduce baby aspirin next month (which I am a bit scared to do since I’ve been dealing with some pretty bad heartburn since Colton’s delivery, but it’s been a lot better recently). Since June I am also eating  no processed carbs, no dairy, no alcohol and no coffee. The no processed carbs and dairy are really easy for me. I had wine/beer on my vacation but that is actually easy for me to eliminate as well. I just wanted to enjoy my vacation and my 6 year wedding anniversary. But man do I love coffee. I did quit for a month, but started again this past week on vacation so now I have to eliminate it again.  There is something so magical about a cup of coffee in the morning. I sound like an addict…

And that’s where I’m at. Overall I am doing just fine considering my baby died 4.5 months ago. We’ve done a lot of fun things, and I am really enjoying my toddler a lot. She’s at such a fun age. I know I sound really negative in this post but I think a lot of it is apathy. It just seems like it’s a futile attempt so I just am finding it hard to really commit to putting my all into trying again. But then I really want to have another baby and there is always the underlying hope that maybe, just maybe, it will actually happen.

The “What Ifs” are Hard to Carry

First of all I want to thank you all for your comments on my last few blog posts. I have not made time, nor have I had the energy to respond. I feel like I’m just going through the motions with a lot of things in life right now, and I’m ok with that.

Now onto the point of this post. Last Tuesday I met with my MFM to go over his thoughts on what the heck happened. He is a fabulous doctor, and he answered about 98% of my questions without me having to ask them. I wonder if that’s because he’s extra awesome or if that’s pretty standard for most people. Of course we don’t really know what happened. However, his best guess is that something was wrong with the placenta given that the placenta was on the smaller side and I had growth restriction in my pregnancy with A. But even with him saying that, he reiterated that we don’t know if Colton was growth restricted based on his weight (2lb 1oz, which was on the lower side of normal for gestational age) since we did not have a growth scan scheduled until 30 weeks.

There were no signs of infection, no blood clotting issues, no maternal fetal hemorrhage, or signs of a cord accident (there was a loose nuchal cord noted when I delivered him but this is very unlikely to be the cause of his death according to my MFM). I honestly wish there was a concrete answer, even if it was that my uterus sucks, because that would make it a whole lot easier.

Then we moved into the (scary) realm of trying again. If this is our decision, we should wait at least six months from the delivery, which puts us at late August. Getting pregnant too quickly increases the risk for growth restriction and pre-term labor, both of which I’m at risk for in general with my unicornuate uterus. Then we talked about what kind of monitoring I would need, and he basically said he wanted to meet with me early in my next pregnancy to come up with a plan I’m comfortable with. He offered to manage my entire pregnancy if I want, or we can co-manage with my OB, or I can just be managed by my OB (HA, yeah right!!). His recommendation is a growth scan around 23-26 weeks at least, and if I feel I need more frequent monitoring then he is happy to do it. He also said he would be happy to meet up and talk again before I am actually pregnant to go over any other questions I may have.

I asked the ever so important question of what is our risk of having another stillbirth, and both my husband and I were pretty shocked by the answer. He did the statistics in his head based on his knowledge of studies and experience and came up with 5-10%, but likely closer to 5%. His reasoning is that I will be monitored much more closely in any future pregnancy. That does not necessarily mean that I will have a term baby, but a 95% chance to deliver a live baby (meaning it’s possible that I may be induced early and have a premature baby). We both were surprised that the recurrent stillbirth prediction is so low (not 1% low like most people who have an “unexplained” stillbirth, but still low). He also calculated that my risk is about 50% to have another growth restricted pregnancy. This is way lower than my husband and I would have thought. Another related thing I wanted to know is how many times he’s seen someone have two stillbirths in a row and he said once, and both of this person’s babies had genetic defects as the reason for stillbirth.

Overall, this makes me reassured that if we do decide to try again, I will be monitored much more closely than with both Colton and A.

Something I asked him is if he thinks I’m crazy for wanting to try again. He said based on my risk factors and his analysis, he does not think it’s crazy at all for me to try for another pregnancy. I just have to make sure I can cope with the worst happening again.

My last questions was about using lovenox in a subsequent pregnancy. He does not think it’ll do anything (and he also does not think the aspirin does anything) but if I want to try it and can’t find someone to prescribe it, he would be happy to prescribe it for me. My husband does not want me to use this medicine and says it’s a deal breaker for trying again. I would like to try it if we do try again so I’ll have to figure out if I can convince him to let me do it.

I just wanted to add that my D&C showed that I had an infection in my uterus (endometritis) and no retained placenta was noted. The mass my OB saw could be a small fibroid (which has never been noted on any ultrasound or other test I’ve had so I’m guessing it’s a recent growth). We will follow up on this later, especially if I have long periods or bleeding and cramping in between periods. I finished a 5 day course of doxycycline and I am taking a 2 week course of Augmentin to hopefully get rid of it. My MFM says that endometritis is something the pathologist writes when they don’t have anything else to put down so it’s possible I’m taking the antibiotics for nothing. Awesome…

I don’t think I’ve actually written much about the events surrounding us finding out that Colton died, but I only noticed reduced fetal movement about 2 days before he died, and I have major regrets that I did not go in on Friday night after noticing the reduced movement. I was super concerned that night and I will always wonder if I would have gotten checked out if he would be here today. I am well aware that a 28 week delivery would likely have had some bad outcomes (including him dying anyway) but it’s hard to not wonder if he would be coming home soon (since this past Saturday I would have been 37 weeks). Both my OB, MFM and husband all say to not beat myself up over this, and I’m not, but the what ifs are hard to carry. I’ll leave it at that.

Ask Me How I’m Doing

I went back to work last Monday. It was initially really hard walking in and getting the hugs and condolences, and then it was just normal. Normal is so nice, and I have been wanting to feel some sense of normalcy since Colton died. One of the doctors shared with me that she also suffered a stillbirth. She said no one at our workplace knows and she only shares when it happens to someone she knows. In some ways I think it would be easier to have no one know. But since they do know, I think it’s appropriate to ask me how I’m doing. It allows me to open up if I’m feeling up for it, and it shows that people care. Another doctor did this, saying welcome back and asking how I was both physically and emotionally (physically almost normal and emotionally is day by day in case you were curious). I was really grateful that he did this, as I wouldn’t have expected it from him.

In my personal life, only a few people have been asking me how I’m doing. To be fair, I sent an email when Colton died saying I needed time before discussing it, so maybe I need to open up. But it makes it so much easier if my friends and family would just ask me how I’m doing. It’s hard to bring it up but I want to talk about it. My sister in law sent an email saying she didn’t know how to act and asking how she should act. I told her I wanted her to ask me about him and still be in touch with pictures of her kids. She has been texting pictures of her kids like we normally do, but then this past weekend when she visited, she said nothing about Colton. I even tried to bring up the delivery in a conversation and she just changed the subject. It’s so frustrating.

I have a couple of friends who have been texting and calling frequently and I am so eternally grateful for their support. It’s eye opening when you suffer loss to see who really cares. I’m not surprised by who has been in touch, but there are a couple of people I would have expected to be more present that have been missing. That’s life I guess.

In other news, at my follow up doctor’s appointment I still had the retained placenta. My OB was able to get me in really quickly for a D&C, which I had yesterday. It’s really hard to feel done with the physical part of birth when you’re still bleeding and cramping everyday. I was so incredibly scared to have this procedure done that I insisted it be done in the OR where I could sleep through it. Luckily this was accommodated. The OB who did it was fabulous and I even continued to advocate for myself by asking that the resident did not perform the procedure. After everything I’ve been through, if this procedure screwed up my uterus I certainly want to know that it was messed up by someone very experienced and not someone still learning. What a weird thought to have, right?!

I was so relieved to have the procedure over and done with yesterday that I was in a fabulous mood (after I napped for 3 hours). I had to have general anesthesia and a breathing tube due to heartburn, which was not something I wanted but it went fine so I’m just going to be thankful there were no problems. I am also so thankful that I didn’t lose my uterus. Being in the medical field, I just know way too much and I was so freaked out this would happen even though the risk is incredibly low. I certainly hope there is no scar tissue either.

Today I have no cramping and just light pink spotting. It’s glorious! I feel normal and it’s just so incredible to have my body be getting back to normal. Now I have to lose the last 10lbs of baby weight, but I can at least squeeze into a good chunk of my pre-pregnancy clothes. I’ve been running, walking and doing exercise videos with my husband to slowly get back into shape. It makes me feel so good. My husband and I both have noticed how we are in such better moods when we exercise. The mind-body connection is incredible.

Not a day goes by where I don’t think of Colton but I am no longer crying everyday. I do randomly have tears well up in my eyes and I also cry sometimes, but it’s much less frequent. I know that grief ebbs and flows and I’m pretty sure hitting all the milestones like the due date and birthday will be hard for me, along with lots of other random things. This is a part of me finding my new normal. It sucks that I have to do this, and I hate that I have to do this. Life is just so unfair.

Next week I meet with maternal-fetal medicine to go over the results of the stillbirth and figure out where to go from here. I already know there is no obvious reason for his death based on all the tests that were performed. However, I’ve crafted a list of questions to ask and I’m hoping to get something new out of our conversation.

Another date with misoprostol

As if the universe hasn’t dealt me enough shit already…

I passed some half dollar sized clots at 3 weeks postpartum, and had an ultrasound to make sure nothing was amiss at that time. I did not see my regular OB. Nothing was noted except a heavy uterine lining, which was expected. Relief overwhelmed me, because the doctor had to manually extract my placenta during my delivery, and I was expecting bad news.

I had my 6 week postpartum appointment today. Based on the fact that my bleeding has not lightened much, and in fact has become heavier and redder, I knew something was up, but I was hoping I was just one of the unlucky ones who bleeds a long time after birth.

As I undressed, I managed to bleed all over my legs, socks, and the floor. Glorious. Apparently there was a huge clot just sitting in my vagina making a mess everywhere. She removed it and took a quick look. Everything looked normal, and my pelvic exam was normal as well. Then she followed up with my gazillionth vaginal ultrasound.

The ultrasound showed I have what looks like some retained placenta. I have no idea how that was missed 3 weeks ago, but my OB said she looked at the previous picture and agreed nothing looked amiss there. My options are D&C or try misoprostol in hopes that it’ll cause enough contractions to get everything else out. I opted for the misoprostol, since I am intimately familiar with the workings of my body with this medication. I do not want a D&C if I can avoid it. At this rate I’m willing to bet my left toe that at my follow up next Friday I’ll still have some placenta in my uterus and I will have to have one anyway.

I had a whole host of questions about my stillbirth but the exam took so much time that I elected to save them for my follow up next week. We scheduled a 30 min slot before lunch to do a recheck and chat about the results. She provided me with the full report today so I can read over it and re-formulate my questions based on what I read.

Basically, there is nothing obvious that caused Colton to be stillborn. Maybe a cord accident, maybe placenta problems or a fetal arrhythmia. I wish there was a better answer. The ambiguity makes the next steps much harder for me.

I’m giving a huge F-YOU to my uterus right now. Feels like it just can’t do anything right.

The Worst Experience of My Life

Dear blog friends,

I am so sad to tell you that our beautiful baby, Colton, passed away and was born still on 2/24/2019 at 6:09pm. He was so beautiful and tiny, perfect in every way. My husband and I are devastated. I never in a million years thought I would experience this, even though I am intimately familiar with the risks of pregnancy, especially with my history.

I will be writing much more about the experience, the postpartum period, and what the heck we are going to do next in the coming weeks. It will hopefully be a therapeutic experience for me, and also I hope it will keep his memory alive.

Lastly, I hope with all my heart that if you have gone through this traumatic experience you know that you are not alone and I am so sorry to share this bond with you. The isolation is one of the most difficult parts, as no one knows him except my husband and I, and no one will ever get to know him.

Love,

RJ

The big ”V”

Today marks 24 weeks (by my calendar) so I’ve officially hit viability. Not that I want this baby to come anytime soon but it’s a bit of a relief to know if something does happen and I have to deliver early he will actually have a chance.

I had my 24 week appointment yesterday and my fundal height is measuring right on track, so that’s good. I was supposed to do the gestational diabetes screening but I ate grapes so it could have been a bit risky to try. We also had cake at work to celebrate January birthdays (yum). So I’ll do it next week when I have a half day. Hopefully that will not be an issue.

My weight is slightly higher than it should be this time. I’m up 19lbs (12 of that was by 16 weeks…eek). My OB isn’t really worried about it, especially with the history of IUGR, but I am a bit concerned. I do not want to put on too much weight. If I want to stay at 35lbs total I can only gain 16lbs more. With A, I gained 37 or 38lbs so not too shabby. I ate so much at the end trying to get A to gain weight. I now know that doesn’t work, so I will not bother eating too much extra if it happens again.

Next step is the GD test, followed by 28 week appointment, and then the ever important growth scan. I wonder how my fundal height will be measuring in a month. Hopefully all will be perfect!

22 week ultrasound…

So my cervix measured longer at 3.8 to 4 this time! Thank goodness.

I’m beginning to realize my anxiety about appointments is contributing to my symptoms and seems to increase my Braxton Hicks contractions and cramping. Apparently I need to do a better job relaxing in general. I am ok until a few days before the appointment and then I start to let the anxiety take over. Any suggestions?

Next step is a another cervix check at 24 weeks and the gestational diabetes test. Yay! And the ever so exciting viability at 24 weeks (which I hope to goodness I don’t have anything close to a 24 weeker)!!

20 week ultrasound

So in my true blogging form I am late to the game once again. My 20 week ultrasound was a week and a half ago and I’m happy to report that everything looks within normal limits with the baby! He is measuring on track with dates so far, which is a huge relief. And we confirmed that he actually is a he.

My cervix is measuring 3.2cm which is still in the reassuring range, but of course I’m concerned that it’s been shortening every two weeks. I started in the 5cm range, down to 4cm and now closer to 3cm. I held steady around 4cm for my last pregnancy. Hopefully my cervix check this week will show no change and I can stop worrying about it (yeah right, I am a huge worrier).

Next up is my last cervix check at 22 weeks, and then I will have a growth scan around the 30 week mark. With baby A, the growth scan at 30 weeks was where the IUGR was diagnosed so I’m hoping that history doesn’t repeat itself.

I’ve been feeling movement since 15 weeks but over the last week it’s become very frequent and it’s getting stronger. I even saw a kick through my belly the other night. My husband has been able to feel him this past week as well, which has been great for bonding.

My Braxton hicks contractions have been increasing in frequency over the past week as well. I hate that I feel them so early. I’m always concerned they are going to turn into preterm labor. I’ve also had some period-like pain that I’ve been attributing to round ligament pain (this has been my norm for weeks). It’s been way worse this pregnancy but luckily it’s only severe for 10-15 mins before subsiding.

I finally started telling people at work, and it’s certainly time because I cannot hide I anymore. Hilariously enough I have a co-worker who is due 2 days before me! She also waited until the 20 week mark to say anything. I know she and her husband had a hard time conceiving (although I don’t know the details) so I am super ecstatic for her! Sadly, I have another co-worker who is currently experiencing her third miscarriage in a year. She had a late miscarriage at 18 weeks where her water just broke out of nowhere, followed by two first trimester miscarriages. I’m so sad for her and I did my best to offer her support yesterday when she told me (I disclosed my five miscarriages to her) but I’m still unsure how much support she wants from the pregnant girl so I’ll just keep checking in.

In other news, we are potty training A. She is still in diapers for naps and nights but she’s doing great otherwise. She still poops in her diaper but has also pooped in the potty several times as well. I initially didn’t want to bribe but my husband started giving her 3 chocolate chips if she poops in the potty and that has helped immensely. She doesn’t need any bribing for pee. We had one day this week where she peed herself FIVE times in an afternoon and I though we had completely regressed, but it’s now been almost 4 days and no accidents since then. She is also doing great at daycare using the potty. I hope it keeps going well.

Wishing everyone all the best in the new year!

18 week cervix check

I met with a different doctor to do my 18 week check last Thursday. Thank goodness it’s measuring an average of 4cm. Everything else looked good (strong heartbeat, fluid looks normal) but it was a quick surface ultrasound. My anatomy scan is next Thursday and I am really hoping that everything looks normal and that he is measuring on track.

I have been feeling movement off and on, but it’s getting more frequent which is super reassuring. My placenta is anterior again so it really is a miracle that I can feel anything this early. I feel really lucky!

I hope everyone enjoyed their holidays. We did!