Confusion

I'm officially confused and don't know where to go from here. For real.

First things first. I had my MRI on Friday and it was easy peezy compared to when I had one on my head. The only thing that threw me off was needing to get an IV. I didn't realize Dr. M. wanted a few images with contrast so it was unexpected. Thankfully she only had to poke me once. Unfortunately she had to dig around and I now have an awesome bruise.

The picture was taken Saturday morning but its much darker now. Yikes! But with that being my only battle wound, I really can't complain.

Onto the more interesting news. Dr. M. called this Saturday afternoon (I was shocked, too. Why is she calling on a Saturday?!). She said that all of my blood work was looking good so far. I asked about the Antithrombin III that the nurse told me was slightly elevated. Dr. M said it's nothing to worry about as it's usually an issue if you have decreased numbers. We'll just re-draw in 6 weeks.

She did, however, let me know that I am heterozygous for MTHFR. She quickly went on to let me know that it's nothing to be worried about because traditionally it was thought that both heterozygous and homozygous forms caused losses but now it's more commonly believed that it's only the homozygous mutation that causes losses. She said that I could continue the baby aspirin, but she doesn't believe this to be our problem. She also said that my homocysteine levels were "perfect". *More on this in a minute*

I also let her know that I had my MRI and asked when she expects to receive the images, which she believes should be this week. I asked if she thinks that surgery is still in the near future and she responded with an immediate "Yes". She said that she could feel something while doing the D&C and while the images during the diagnostic hysteroscopy weren't the best (because of all of the blood) she believes that she saw something as well. She, apparently, was ready to do the surgery after the ultrasound but had me do the MRI so that we can try to avoid a laparoscopic procedure. She wants the best view possible so that we will, hopefully, only have to do the hysteroscopy. But it sounds like maybe it will be in the next month or so.

Now, swinging back around to the MTHFR. I was actually the one who suggested that we test for it the day that we found out that nugget's heartbeat had died. I remember Dr. M. saying that MTHFR usually caused second trimester losses, but if it was something that I wanted to check, she was willing to. The reason I wanted to check? Because of my friend, A.

A had 7 losses, all in the first trimester. She finally found out that she had MTHFR and saw a hematologist who said that because she was heterozygous, there was no reason for her to be on a blood thinner. She was grasping at straws and a blood thinner was really her last resort, so her OB prescribed it for her throughout her next pregnancy. She ended up with a little boy who is now 1.

I texted her after speaking with Dr. M. and she thought it was crazy that Dr. M. didn't think this was an issue. We chatted a bit and then she asked if the doctor told me to stop my birth control pill immediately as it's very dangerous with MTHFR. Um, no. Apparently her doctor told her that he will never ever prescribe a birth control pill for her (and her IUD is hormone free) because it can cause even more clotting issues for those with MTHFR. I promised to call and ask Dr. M. about that on Monday.

Right now, I'm not 100% sure which route to follow but here's the thinking that E and I are going to run with (for the moment at least).

• Call Dr. M. on Monday to ask about birth control and ask if folate supplements are needed.
• Continue with the surgery route. The way I see it, if she goes in and does surgery and doesn't find anything, she's not going to scrape anything so I won't have any scaring. I would be out a couple hundreds of dollars and know one way or another. If she does find something, it gets fixed.
• Once surgery is done, I'll discuss with Dr. M. her beliefs on blood thinners, such as lovenox, for someone like me with heterozygous MTHFR. The limited research that I've done has shown mixed views. If I'm unhappy with her answer, I'll get a second opinion from a specialist and go from there. 

Both E and I feel so overwhelmed with all of this. I know there's a very good chance that we may never get a concrete answer, but limbo stinks and this maybe, maybe, maybe pattern that we're stuck in is making it all that much more difficult.

Fingers crossed Dr. M. gets the MRI images early this week and it actually SHOWS something!!

2!

I got my beta results today: 2! I asked the nurse if I was low enough to get all of the blood work taken care of next week but she didn't know. Hopefully I'll hear back tomorrow because I'd love to get it done Monday or Tuesday.

I also asked about the pathology results and they were still listed as "pending". Now I'm concerned. She said that she was going to have their medical records member call the hospital to try to get it figured out. If they're able to get any answers I'll hear back tomorrow. If not, I have a feeling that we're in trouble.

I really dislike waiting.

Waiting is the worst 2.0

Sometimes I really don't understand how life can be so cruel.  I had come to terms with the fact that our precious little nugget had probably already passed and knew that E and I would make it through another loss together. We just had to get through the ultrasound. Hang on to your bootstraps ladies and gents, this is going to be a long one!

We waited for what seemed like F.O.R.E.V.E.R to get called back and when we did I was slightly disappointed that it wasn't the same tech as last week. In a confusing and challenging situation, consistency makes my life a heck of a lot easier.
When we got in the room she started by asking if the doctor had told us what we would probably see based on the low heart rate and small sac last week. I replied that I hadn't spoken with my doctor but spoke with the head nurse and had done research on my own so I knew we probably wouldn't see much. Now, I'm all for honesty and not giving false hope thanks to what we've been through, but you should still ensure that you deliver the news with some tact. She did not and it put a sour taste in my mouth.

We started with an abdominal ultrasound and she pushed really, really hard. I couldn't help but think that if the baby was still alive, she might kill it with her force. We didn't see anything and I looked to E and said "This can't be good" and the oh-so-wonderful tech muttered "Yeah, probably not." Thanks. We did the vaginal ultrasound and I'm truly surprised that she didn't tear any tissue out. Once she left the room, E even commented about her really digging in there. If only he knew how it felt!

Thankfully we saw baby again but I knew right away it was worse. Nugget's heart rate was a strong 133bpm and he/she measured 7w1d (10.1mm). The sac, on the other hand, didn't look so great. It measured 5w6d or 9.2mm (if I remember correctly). There was barely any fluid. Like almost none. See?

We left the ultrasound shocked and confused. We spoke with Ellen and Michelle at the doctor's office and they urged us to go back for an ultrasound in one week, rather than two. Ellen was our cheerleader. She came into the waiting room saying "I TOLD YOU IT WAS GOING TO BE GOOD NEWS" and gave me a big hug. It was funny to see the looks that we got ;) She is definitely being our optimist and it is certainly welcomed. She also admitted that she had called over for the results before coming to get us and expressed her dislike for the tech. Glad it wasn't just me!

Then around lunch time my doctor called. Boy was I happy to hear from her. We haven't spoken since my last post-miscarriage appointment and while Ellen has been very attentive and helpful, the doctor has (understandably) been quieter. Here's what she said:

1. She is going to treat this as a viable pregnancy because there is a fetus and a strong heartbeat. Her philosophy is to not be so concerned with the sac size once the fetus is present and she's sticking with that. I agree with her, however, later in pregnancy doctors are concerned with the amount of amniotic fluid surrounding the baby, so why wouldn't they be concerned about it now, you know?  Anyway, I'm not a doctor.


2. She reminded me that not all pregnancies go exactly as spelled out in the textbooks, and that could just be the case with ours.


3. I asked if she thinks the progesterone is the only thing sustaining the pregnancy and she gave me an immediate "NO". She believes that if the pregnancy wasn't meant to survive, the progesterone wouldn't be enough to allow it to progress.


4. She suggested that we consider early pregnancy genetic counseling a little earlier than most. Based on my track record and the fact that we're not really following the textbook, she believes it would be best. I, of course, got nervous and shaky but she tried multiple times to reassure me that she doesn't think our baby has a higher chance than any other baby of having any issues. I didn't ask for specifics and because we've never been at this point before I don't know specific names of the tests, so bear with me. One test wouldn't happen until 10-12 (I think) weeks because it requires ultrasounds to look at specific body parts. The test that we could do right now is the progenity blood test which looks for the chances of the baby having trisomy 13, 18, and 21.

So that's where we're at. E and I discussed testing and I'll be honest, it was really scary thinking about it all and I got really overwhelmed. I know all parents have to decide if they'll do the testing but the fact that she brought it up makes me think that a small part of her believes that's the issue. E's initial response was no to testing, but after he heard my side, he changed his mind. The results wouldn't change our view in any way; it's still our baby, one that we've worked so hard for, and we would love him or her all the same. BUT, I would want to be able to prepare myself. If I only get to hold my baby in my arms for a few hours I want to know that our time is limited and drink up every last moment of it. BUT THAT'S NOT GOING TO HAPPEN. EVERYTHING WILL BE OKAY. Right?

It's been such a long day and I'm sure this post is such a jumbled mess but it just goes along with how I'm feeling today!

Waiting is the worst

It feels like we had our last ultrasound a lifetime ago and Thursday feels like it is still two lifetimes away! I don't feel pregnant anymore. Granted, I didn't feel overly pregnant last week either. Last week I randomly got my sore boobs, slight morning sickness, and tiredness back on Tuesday and it lasted through Thursday. But since waking up Friday morning, I haven't had much of anything. Today I had slight morning sickness for a few hours but that's it.

The waiting and uncertainty is almost unbearable. I'm having a very difficult time trying to go about my daily business not knowing if my baby is alive or dead.

I really hope we get some definitive answers on Thursday. Of course I'm still praying and hoping that we will see that a miracle has taken place and that the sac is now right on track, but I know the chances of that happening are extremely slim. It's so sad knowing that our little baby is so squished in his/her home.

Here's hoping today and tomorrow speed by!

Limbo

I've been having a tough time deciding if I should write this post now or wait. I've obviously decided to. We are 100% in limbo right now and it's an awful, agonizing experience.

We had our ultrasound Thursday morning. Right when the tech came in I started to get teary eyed and then the tears started to fall. She asked if I was okay and thankfully, Eric replied for me by saying that it's a scary experience for us because we haven't had much luck in the past. She started with an abdominal ultrasound and I knew right away there was nothing there. She asked how far along we were and then decided to do a vaginal ultrasound. When she walked out of the room, I turned to Eric and said "Game over." and started crying again.

I finally composed myself and the tech came back in to get started. It all happened fast, but right when she began, I saw a sac and I saw something in it. Then I looked closer and I could see flickering on the screen. WE HAVE A BABY WITH A HEARTBEAT. She mentioned that she saw the sac, yolk sac, fetal pole, and heartbeat. I asked if we would hear the heartbeat and she said of course. She didn't seem overly happy, though, so I asked if everything looked all right. This was the same tech that we had during the last pregnancy so she said she wanted to be completely honest so that we wouldn't have any surprises. She gave us a 50-50 chance of this pregnancy being viable because the gestational sac looked very small. I asked if the heartbeat was okay and she said yes, it was 109bpm so it had probably just recently begun beating.
We have to go back next Thursday. Hopefully the sac will have caught up but if it not, we'll see one of two things: either the sac will not have grown substantially and the pregnancy will not be viable or the heart will have stopped beating.

No one has been able to give us a whole lot of information other than the baby was measuring 6w3d (6.4mm) and the sac measured 5w2d (7mm). Of course I started researching once I got home and I really wish that I hadn't. Based on the limited research of small sac syndrome, we have a 80-94% chance of losing this baby because the difference between the sac and CRL is less than 5mm.

We're crushed. It was our first time hearing any of our babies heartbeats and it was a game changer. Of course we loved all three of our previous babies, but it almost felt like we met this baby for the first time on Thursday. We're going to be devastated if we lose him/her. We've decided to try to not dwell too much on the negative but still be realistic. As Ellen said, "Prepare for the worst but hope and pray for the best". That's what we're doing. I'm also trying to focus on showing this little one as much love as possible so that's all that he/she will have known if something bad does happen.

Now, I'll leave you with a picture of our sweet little one who we pray stays with us.

Preparing for the worst

At 1:00 on Friday, I decided that if Ellen called me back I wasn't going to answer and I wasn't going to listen to her voicemail until Sunday night. We were leaving for Vegas with our friends and I didn't want to ruin my weekend if there was bad news.

Ellen never called and I tried to put my bad thoughts out of my mind for the weekend. We told our friends about the pregnancy and just asked that they keep it to themselves and not get too excited  yet. We had a great time! E and I both won money, plus, I saw Britney Spears in concert. YES.

I called the doctor's office this morning and then waited around for the call back. Michelle, who I've only spoken with once or twice, called to let me know that my HCG last Thursday was 1410. 1410.

 

It's a little blurry, but clearly shows that we're fast approaching the danger zone. This is EXACTLY what happened with our last pregnancy. My numbers started off low, but they were doubling at an amazing rate (20-30 hours) and then slowly started to slow down until they drastically slowed.

I'm trying not to give up completely yet, but deep down inside I know this is the end of the road. This is more than likely not a viable pregnancy. I'm waiting for a call from the office that does ultrasounds. Hopefully they call this afternoon and I can get it set up for this week. I'm praying that it is a viable pregnancy and also that it is not ectopic.

Sigh.

2-3

I took another one of those stupid Clear Blue Weeks Estimator tests and it still says 2-3. I should be well over 2,000 by now so I know the news that I receive in a few hours about my blood work from yesterday won't be good. Sigh. We really just can't catch a break.

I'm hoping that I'll get to speak with Ellen. When I spoke with her yesterday, we had planned to set up my ultrasound for next Thursday (7 weeks) but now I have a few things that I want to discuss.

1. Do I even need to do that ultrasound?
2. Should I continue to take the progesterone? We're going away this weekend so I'll keep taking it through Saturday night either way because I don't want something to happen while we're gone, but is it really worth continuing?
3. Why us?
4. If we can help it, I'd much rather have a D&C this time. I wanted one last time, but God and nature didn't allow for it. This time I would really prefer to have it done if possible. But that also gives me mixed feelings. Then I feel like I'm intentionally aborting a baby. I know that technically it isn't if the pregnancy isn't viable and I would miscarry eventually anyway, but part of me feels that way.

Vegas should be really fun this weekend.

Progression

Below is my progression so far on Wondfo tests. The top is my test from yesterday, 23dpo. I'm glad to see some change.

My last blood draw was on Monday (2/16) which was 21dpo. I was supposed to go back on Friday (2/20) for my last draw but I asked to go in today instead. Ellen (my favorite nurse at the office) was very accomodating when I explained that I unexpectedly have the day off today so it would be easier to come in today.

I'm nervous. Really, really nervous. I'm afraid that my levels will have slowed tremendously just like the last time. I'm also really nervous for the ultrasound. I explained that my mom is in town until next Thursday and it would be easiest to have the ultrasound while she is still here so that she can watch my nephew. Theoretically, my levels should be WAY over 1500-3000 at that point and we should see something.

I'll have my latest draw results tomorrow and will update then.

#4

While waiting for my clotting results to come back, I got a crazy surprise. I'm currently pregnant for the fourth time since March 2014. As I told E, there aren't many women who can say they've been pregnant four times in a year! My sister gave me the nickname "Fertile Myrtle" when we told her. Sigh.

Now we can't do any of the clotting tests again until I am not pregnant. Obviously, I hope that means that we have a LONG time until we can do that testing but only time will tell!

So far, things are going okay. Dr. M wanted to put me on vaginal progesterone suppositories but unfortunately our insurance wasn't on board. Instead, I've been taking 100mg orally every night.  I had one episode of spotting at 4w2d or 3w5d (assuming I ovulated on CD 19 like normal; we weren't trying or tracking this cycle) but it was only when I wiped and I haven't had anymore since. I'm really scared that the progesterone might be giving me false hope.

Ellen, my favorite nurse, asked how I wanted to approach this pregnancy and I decided that I wanted to do the same as the last pregnancy. Ensure that betas are doubling properly and then an early ultrasound once I hit 1,500. Here's where we're at:

2/4 (9dpo, the day I found out) at 10:45am = 10
2/6 (11dpo) at 10:00am = 34 (27.19 hours)
2/9 (14dpo) at 2:00pm = 93 (52.35 hours)
2/16 (21dpo) at 10:00 = 994 (47.98 hours)

Personally, I think they're low BUT with the exception of the 11 to 14dpo draw, they're doubling within 48 hours. My next draw will be this Friday but I won't get the results until next Monday. I feel like I'm in HELL.

I was telling my mom today that my biggest issue right now is control. I'm not a controlling person. In fact, I am extremely indecisive and would rather that everyone else make decisions for me. With that said, the last pregnancy and this one, I'm realizing that pregnancy tests are the only way for me to feel somewhat in control of what is happening. I promised E that I wouldn't test everyday like I did the last time. I've kept that promise because I'm not testing daily, but I'm certainly testing every other day and I am OBSESSING. It's so difficult when there is absolutely nothing that you can do.

When I got the call with my results this morning, I was hoping for at least 1,000 but knew that a proper double from last Monday would have been 1,116. When the nurse said 994, I was glad that we were at least close to 1,000.

We're remaining cautiously optimistic right now, but to be honest, I'm really trying not to get too attached. It's so difficult.

As for this blog, I'm hoping to continue documenting this pregnancy. After our last loss I threw out all of my pregnancy tests and deleted all of my beta levels and now I regret that. This time, I'm keeping it all right here!