Tag Archives: D&C

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.