The Start of a New Chapter?

Today's the day and I'm scared.

I met with Dr. M. on Monday and she solidified the idea in my head that this is an exploratory surgery. She still thinks there will be something to resect/fix, but she can't say that with certainty until she gets in there. So that means one of two things will happen:

1. If it ends up being just an arcuate uterus, there is nothing they can really do. In that case they'll take a ton of pictures and send me off to a Reproductive Endocrinologist armed with all of my pictures, blood work, chromosome analyses, etc.
2. If it's a septum, they'll resect it and insert a balloon catheter. The catheter would be in for 5-6 days and it would be taken out in office. I would also take estrogen for a month followed by 10 days of progesterone which would bring on a bleed. We would then need to wait 3 cycles to ensure the lining builds up enough before trying to conceive again.

I slept horribly last night and had some really, really screwed up dreams. Then this morning I had a minor cry when I was telling E how nervous and scared I am that they won't be able to do anything. It feels (and sounds) so wrong, but I've been praying that there is a septum in there and they'll be able to fix it. I just want there to be an identifiable problem and a solution, which takes place today. That's not too much to ask for, right?!

Grief, Strength, and Peace

Reminders for Finding Strength and Peace in Times of Grief

"So do not let the pain of a situation make you hopeless.  Do not let negativity wear off on you.  Do not let the bitterness steal your sweetness.  Even though others may disagree with you, take pride in the fact that you still know the world to be an amazing place.  Carry on accordingly."

I used to visit the site Marc and Angel Hack Life every now and then for a little inspiration, but until today it had probably been a good year or so since I had checked it out. I'm pretty glad that I did.

The above quote was my favorite from the post and it hit close to home. RPL really has taken its toll on me: emotionally, mentally, and physically. It's changed the way I view life and I'm certainly not nearly as naive as I used to be.

"Do not let the bitterness steal your sweetness"

That's one that I need to remember. I think I've wrote here before about all of the experiences and feelings that RPL has robbed me of and how much it's changed me. But I shouldn't let it.

I hope that soon I can find peace with everything that we've gone through and I can learn to steal back my sweetness. I may not be the same person as I was a year ago and that's okay. But I need to work to get the sweetness back because it's always been of my core characteristic and I want to steal back myself.

We have a date!

I received a call from Ellen (nurse) this morning to answer my questions from yesterday. First and foremost, she said because I'm heterozygous A1298C MTHFR, I don't have to worry about any issues with birth control. So for now, I'm sticking with it and after surgery I'll probably try to avoid it just to be on the safe side.

Ellen also mentioned that Dr. M. wants me to take extra folate (Woohoo! That was one of the questions I forgot to ask!). Unfortunately she didn't have the exact amount, so I'll have to wait for a call back on that.

THEN...the moment I've been waiting for. My MRI results were in! She read me the long version and this is what I got from it: "arcuate uterus" "not a definitive septum" "surgery". Yup, surgery is happening folks. I appreciated the fact that Ellen admitted that she had no idea what an arcuate uterus was and put me on hold for a few minutes to do some quick research. She explained that it's similar to a uterine septum but much smaller. She also mentioned that while they don't see a definitive septum in the images, it's still possible that they'll find one when they go in for surgery. She left me with the expectation of a phone call about next steps sometime tomorrow since Dr. M. wasn't in the office today.

Of course I then visited Dr. Google and found a couple of encouraging tidbits. While it seems rather unclear if an arcuate uterus increases the chance of miscarriage, most research seems to recommend resecting the arcuate uterus if reccurent pregnancy loss has already occured. I also found a number of women who were diagnosed with an arcuate uterus via MRI only to find during surgery that they had in fact had a septum.

SO, I see this as A. a possibility that we will find a septum to fix. B. if there isn't a septum, at least she can resect the arcuate uterus. C. the arcuate uterus could still be our issue if there isn't enough blood/nutrient flow to the area and the babies keep implanting there.

Much to my surprise, I received a call from the doctors office this afternoon to get surgery scheduled. The only downfall is I found out how expensive it's going to be. I assumed it would be around $1200 but man oh man was I WAY, WAY off. I scheduled it anyway and decided that I would talk to E tonight and if I needed to cancel then I would.

E definitely had the same case of sticker shock that I did when I told him how much it was going to cost. After 30 seconds of silent pondering he said, "So we're basically spending x amount on an exploratory surgery?". I certainly didn't think of it that way but, yeah, he's right. His response to my "yes" is one of the reasons that I love him so much. "I don't want you to have to live through another miscarriage. Between the emotional and physical pain, it's not worth it. Even if nothing gets fixed, it will be worth spending the money because at least we tried." He's so selfless. I had to remind him that it's not just me going through the miscarriages but him as well.

So, it's decided.

Pre-op appointment: May 11th (and a little less money in our pocket)
Surgery: May 13th (and a lot less money in our pocket)
Post-op appointment: May 26th (and hopefully a good report)

And I'll leave you with this. Our fourth, and hopefully final, bear came in the mail late last week. Thanks Project B.E.A.R! (Ignore all of the clothing. I have them on a shelf with old clothes so I see them every morning and night)

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!!

23 Things...

23 Things I Wish Someone Told Me About Pregnancy After Loss

A friend sent this blog post to me tonight. Perfection. I can't identify with all of them because I haven't reached all of the milestones, but there were so many that hit close to home. A couple of my favorites:


" 2. The excitement of getting a positive pregnancy test may turn to indifference. It might sound strange, but when the pee stick had two lines instead of one, I didn’t jump up and down for joy. I actually stared at it in disbelief. First, I didn’t believe that I actually was pregnant again. Second, when I did let the realization that I was pregnant again sink in, it was as if fear decided to barge through the door. Anxiety swells up and all I could think of is “Do I really have to do this again” and “Can I really do this again?” "

" 3. You might consistently check for blood on your panties. It might sound strange, but having to go pee is a terrifying experience. Every time you pull down your pants you mentally prepare yourself to see spots of blood in your panties. There is no way around this. It just is. "

" 5. Others might want you to be ‘okay’ now that you are pregnant again, but this is far from the case. Just because you are pregnant again doesn’t mean that you have forgotten or gotten over the loss of your other child. It just does not work that way. Don’t let others expectations impact how you feel about your pregnancy and the child that died. It’s okay to not be okay. Actually, it’s probably normal. "

" 9. Anxiety around doctor’s appointments happens. Going to the doctor can be reassuring but it can also be scary because the doctor is often time the one who delivers bad news. It’s normal to get anxious about appointments, even women who have not experienced a loss, experience anxiety during appointments during pregnancy. "

" 15. Bonding with this baby may be challenging, but worth it. It’s scary to create a relationship with the bean growing inside of you because your past experience says, “Hey don’t get too attached, remember what happened last time.” And it’s normal to want to protect yourself from getting hurt again. However, whenever I noticed myself doing this I always told myself, “It’s going to hurt no matter what. It won’t hurt any less if I’m not connected to this baby, actually it might hurt more because I didn’t take the time to enjoy baby while they were here.” "

"17. You might experience PTSD. If your loss happened during pregnancy then going through another pregnancy can be traumatic. For me it was like reliving my trauma every minute of every day. I could not escape it and the closer I got to the delivery day the more my anxiety and triggers of my past trauma intensified. What helped me was working with a therapist and practicing loving kindness and compassion towards myself. "



Couldn't have said it better myself. I try, but nowadays whenever I'm pregnant, my anxiety is through the roof.

1 Year Angelversary

Today marks one year since we lost our first little angel. The first signs of a problem (declining HCG and brown spotting) started on April 11th, but the actual miscarriage was on the 15th.

If I would have told one year ago self where I would be today I would have called myself crazy and laughed. I can honestly say that I never, ever expected to be in this position. I don't think anyone every does expect it, but I really never imagined that I would be able to feel and deal with this much heartache, but I've survived.

E has 100% been my rock throughout the past year. I can't imagine and would never want anyone else by my side. He's been supportive, strong, and extremely compassionate. He deals with my random teary moments and my full blown, snotty pillow, messy situations like a champ and always knows how to make me feel better.

It's been a tough day, especially this morning, but there's still hope! Let's hope when we're looking back on April 15, 2014 next year, we'll be in a very different place in our lives!

Slowly moving forward

Well, I got my MRI scheduled. I think I answered about 30 questions while scheduling the appointment about my medical history. The scheduler mentioned that they needed pre-authorization from my insurance company and my doctor's office hadn't taken care of that. She scheduled me (tentatively) anyway for this Friday at 3:45.

I called the doctor's office on Thursday and asked them to take care of that and finally heard back today. It's a go! Woohoo!

So now I get to wait some more.

In other news, I'm doing well with getting healthier. I started on March 30th but later that week I got a really bad cold. I ended up skipping my workouts for four days (I didn't think mixing working out with the inability to breath would be a good idea) and ate like crap. BUT I weighed myself and I'm still down 4.6 pounds since March 30th. Two weeks? Not terrible! I can't really see a difference when I look at myself, but I certainly feel better. It's really helping to keep me going.

Wednesday is, for a lack of a better term, a special day. April 15th marks the one year anniversary of our first loss. I can't believe it's already been a year and here we are with three more failed pregnancies and dwindling hope.

But I really am trying to stay positive! Hopefully this MRI will show what we need and we can move forward.