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The journey gets harder…

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We tried with medicated IUIs in November and December with no success. In January, near the end of my TWW, I started spotting and was expecting my period to start any day. The spotting stopped, and my period didn’t come. So I took a test, and there they were, those two little pink lines telling us that we were pregnant. I called the RE’s office the following Monday. They had me go to the lab for a betaHCG (beta) blood test.

The nurse called that afternoon, and I could hear in her voice immediately that it wasn’t great news. My beta came back at 26. By that point in pregnancy (around 15 days post ovulation), they like to see a value of 100 or higher. She told me that I could’ve just implanted late, and we’d have to see how quickly my numbers doubled to know more. So, two days later I went back for another blood test. This time, my result was 65. That still wasn’t the 100 they were hoping for, but my numbers more than doubled in the 48 hour window, and the nurse was much more upbeat when she called. The call ended with a “Congratulations!”.

Still, I felt like something was wrong. My wife kept reassuring me that it was just my normal worrying nature. We were scheduled for a first ultrasound at 7 weeks to see the heartbeat for the first time. Unfortunately, my gut feeling was right. We wouldn’t make it that far.

During my sixth week of pregnancy, I started having cramps. I kept hearing that cramping in the first trimester was normal, but I knew deep down that this was not normal. It couldn’t be. This was as bad if not worse than my period cramps. Every time I went to the bathroom, I expected blood. Then, one afternoon during the last week of January, the cramps were so bad that I had to go to the ER. We had Little Man in tow, because we didn’t have anyone to leave him with on such short notice. With it being flu season, he and Mommy waited in the car until I got a private room in the ER. Then, we were informed that during flu season, children aren’t allowed in the ER at all unless they are the patient. So, everything that follows we went through with nothing but text messages between us.

In the ER, they did another beta and an ultrasound. The tech doing the ultrasound and the radiologist who reviewed it could not visualize anything in the uterus. During the ultrasound, the tech had warned me that it might just be too early to see anything, but I knew that this was the end. Back in the ER, my beta results were back. In over a week, my beta had less than doubled or had doubled and had already started to drop. I was given IV pain meds and admitted for observation. Not only was this pregnancy not viable, but also they were worried it was ectopic.

My wife called a friend to keep Little Man so that she could be with me during transfer and until I got settled in my room.  As they transferred me from the ER to my hospital room, I began to bleed. Even though I knew it was coming, the sight of blood was what finally reduced me to a sobbing heap… After a couple of hours, Mommy left to pick up Little Man, and they went home for the night. Being separated was so hard, and being there in the hospital alone wasn’t easy, but I knew that I wanted Little Man to be at home in his own bed for the night.

The next 36 hours or so are a complete blur. I was allowed no food and even worse, no water in case emergency surgery was necessary. Every 4 hours, my blood was drawn to make sure my hemoglobin levels were stable and that I wasn’t bleeding internally. The OBs on call determined that my severe pain was from a complex (meaning blood or fluid filled) ovarian cyst. After 24+ hours of my hemoglobin levels being stable, I was released with instructions for follow-up betas and an office visit with the OBs that had been on call during my stay. I went home and I cried and slept and cried some more.

The next couple weeks were filled with the ever constant reminder that I was losing the pregnancy, the bleeding. I dreaded going to the bathroom, because it meant looking at all that blood. I was off work for the rest of the week until we got my pain under control. Then, I had to go back to work and pretend like my heart wasn’t breaking. None of these people even knew that we were TTC, let alone that I had been pregnant the last time they’d seen me. Even though I’d felt like something was wrong all along, and even though we’d never even gotten to the point of seeing our bean on an ultrasound, we still felt this loss and still needed to grieve. I had let myself imagine a 2013 Christmas with two little ones in the house. I had started to think about all the things that would be our last as a family of three. Now, that was no longer going to be our reality.

I bled for weeks. It stopped the day of my follow-up with the OB. I had another beta level drawn at that appointment. My levels had returned to pre-pregnancy numbers. This meant that my body was ready to TTC again once my period returned. Because my beta numbers had dropped all the way without intervention, and my pain had ended, the doctor finally said conclusively that the pregnancy was not ectopic.

That’s all I can write for now. I’ll continue in future posts.

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“Invisible Family”

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Wanted to share…

http://www.brainchildmag.com/2013/03/invisible-family/

Back to the present for a moment

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I sometimes (often) struggle with just how much to share here. This blog is public and searchable, but this struggle has been very personal and painful. I decided to share the entries in my previous post that I made during the time I was struggling, because I think it’s time that we are more open about depression, anxiety, and the medications used to treat them. I decided to share our latest TTC journey, partially because I need to “talk” about it, but also because I think it’s about time we talk more about infertility and pregnancy loss as well. So, I’m trying to be as open as possible even when it’s a bit uncomfortable.

I’m going to fast forward for a minute from my recent posts to the present.

Our IVF intake appointment was yesterday. It was much more detailed and thorough than I expected. I was thinking this would be a “here’s how we do it, call us back when you’re ready for all of your testing” kind of appointment. It was much more than that. We’re to the point where we just have to call on the cycle before we’re ready to start birth control (BCP) to give them a heads up so they will put us in the schedule and then call back on CD1 of the following cycle to start the BCP. In the meantime, I have to have some (a lot of) bloodwork done. We already did antral follicle counts and mock transfer yesterday. We’ve decided to wait for my July period which should be mid-month and get in on that clinic schedule. That gives me 14 weeks to drop some more weight which will help optimize our outcomes and get all the insurance pre-approvals. I spent an hour and fifteen minutes on the phone yesterday afternoon just trying to find out what medications are and are not covered by my medical plan and which ones are covered under my pharmacy plan. It was slow and frustrating, but I think I got all the answers I need for that part of the process. I’ll also have this wait time to get all of the required bloodwork out of the way. They’re still trying to decide which, if any, blood tests Mommy will also need. Mid-July seems like forever but not at the same time. If we’re lucky enough for our fresh transfer to stick, our kids will have close birthdays which is something we considered trying to avoid when we were doing IUIs around the same time last year, but at this point, we’re just ready to be pregnant!

So that’s where we are now. I’ll get back to telling you how we ended up here in my future posts.

Posts from the Withdrawal Period

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Here are two entries I made on a private page of this blog during the time talked about in the “Withdrawal” entry. As you can see, I was in denial that my anxiety was anything other than a reaction to the medication taper. I also talk about one of my other big concerns about getting pregnant – how it could affect my job. OPK = Ovulation Predictor Kit; CD3 = Cycle Day 3; RE = Reproductive Endocrinologist (fertility doctor)

Early July 2012

“Today and the past couple of days have been hard. I’m weaning off the Cymba1ta that I take for my Fibromyalgia. This means that I’m dizzy, disoriented, foggy, and raw. I’m irritable and anxious. I’m in hell. Even something as simple as getting my blood pressure taken at the doctor this morning is terribly painful. I just keep telling myself that this will all be worth it. I’m currently in the middle of a “test cycle” with the RE. That means that this cycle we’re doing bloodwork and ultrasounds but skipping the insemination. I should ovulate any day now and go in for a blood draw next week some time. My CD3 ultrasound and bloodwork all came back normal. Hopefully, we’ll get the same news from the post-ovulation bloodwork and will be ready to do our first insemination in early August. I’m so ready to get this show on the road, and for this Cymba1ta to be out of my system so that I can feel human again.”

Seven days later

“I woke up yesterday to a positive OPK and a huge leap forward in getting through the Cymba1ta withdrawal. For the first time in weeks, I am dizzy less often than I am not, and I actually feel like it’s completely safe for me to drive. I called the RE yesterday after getting that smiley on the OPK. I’m scheduled for bloodwork a week from yesterday. As long as that comes back showing nothing unexpected, we will proceed with an unmedicated IUI the next time I ovulate. I have suddenly gotten very nervous and excited and nervous. 😉 One of my lingering concerns about getting pregnant is linked to the fact that my reliability at work already suffers due to my Fibromyalgia. I don’t have a lot of leave built up, because I have to use it, and I have to call in unexpectedly way more than I would prefer. I’m worried that because I’m in the kind of relationship that requires significant planning for pregnancy, my getting pregnant will be frowned upon by my supervisor. He has been nothing but supportive as I’ve struggled with my Fibromyalgia, but how is it going to go over when I’ve purposely added another “complication” to the mix? I wouldn’t blame someone for questioning that. It’s been one of my concerns all along, but I (along with my wife) decided that this is something we are ready to do now. I shouldn’t have to put off such a huge life decision because I have a chronic illness. I will not sacrifice an attempt to carry a child simply because we have another uterus in the house. If I was building a family with a cis male, there would be no option for him to carry, and I wouldn’t have this worry. I just don’t want to be seen as irresponsible. I take pride in the fact that I’m (we’re) anything but…”

Withdrawal

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I decided that it would probably be best to get through Little Man’s first birthday festivities before starting to taper my medications. I didn’t know exactly what to expect, and I wanted to be present and involved in that milestone and not be in so much pain or be so fatigued that I was just trying to survive it. So we waited, and in June, I started the taper.

I’d been on Cymba1ta for a couple years for my Fibromyalgia. Coming off it was hell, and that’s no exaggeration. I was constantly dizzy and nauseous among other things. As my dose was reduced more and more, anxiety started to overtake my life. I thought that if I could just make it through the taper that things would level out in the end. I felt like the anxiety was just one of the withdrawal symptoms. I was wrong. Not only had the Cymba1ta been helping with Fibro pain, it had been masking my Generalized Anxiety Disorder (GAD).

A few weeks after finishing my taper and being completely med free for the first time in more than a decade, we had our first IUI. I was barely functioning on an hour to hour basis at that time, and going through with that IUI was probably one of the dumbest decisions I’ve ever made. I just felt like if I gave it a couple more weeks, the anxiety would fade, and if I got pregnant, my Fibro would get better. It was really irrational thinking. During that two week wait (TWW), it hit me hard that I was in no shape to be pregnant. I couldn’t even take care of myself let alone nurture a fetus. Every time I took a pregnancy test during that last half of my TWW, I prayed that it would be negative, and I was so relieved when I started my period. That was so odd considering how long we’d planned and prepared to start trying again and how much money we’d spent. These are the exact opposite of the feelings I should’ve had.

We took a break from trying to conceive (TTC), and I started go back to weekly therapy sessions with the psychologist I’d seen after my dad’s death, and I scheduled an appointment with my psychiatrist to discuss the safest options for controlling my GAD while still TTC and during pregnancy. We had realized that the benefits of medication far outweighed the risks in my case. I could not function, let alone have a healthy pregnancy without some sort of help. I’d lost 30lbs in less than 3 months. I wasn’t eating. I either couldn’t sleep or wanted to sleep all day. I was missing a lot of work, and I felt like I was missing out on life with the family I already had. I had completely withdrawn from my life. Both of my mental healthcare providers agreed that medication was necessary. We chose the one that my psychiatrist recommended as the most well-studied and safest possible option to use while TTC and pregnant. I started on a low dose and increased slowly so that we’d know the lowest possible dose to get me somewhere resembling normal. Finding that place took a couple of months.

Once we were sure my GAD was well-controlled, we decided to start trying again. This time felt completely different from the first. I wanted to be pregnant, and I felt confident that I was ready. That was so unlike the first try. This brings us to near the end of 2012, almost exactly 6 months ago.

A Change in Plans

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After Little Man was born, we asked Mommy’s OB when it would be safe for her to get pregnant again. We had assumed she would carry all of our children, and we knew that age wasn’t on our side. The OB recommended starting trying again in 9 months. As we began to approach that 9 month mark (early 2012), something started gnawing at me, and so this twist in our plans began…

Deciding to carry a child was not easy for me. There were a lot of reasons I felt like I shouldn’t – that I should just be happy to be a mother and not complicate things. The problem with that was this feeling I couldn’t shake that I would regret that decision some day when it was too late if I didn’t at least try. I don’t have a need for biological relation to my child, but I do have the “need” to gestate, to grow and nurture a child inside my womb. So, when I finally admitted to myself and then to Mommy that this was something so important to me, we started to look into all those things I felt should/would/could keep me from becoming pregnant.

I had always worried that I inherited my mom’s fertility issues long before we were actually planning for children. This was before I knew that I’d been conceived using donor sperm. When my mom told me that her doctor during the time she was trying to get pregnant had attributed much of the struggle to my father’s issues stemming from Agent Orange exposure, that worry became less intense. I felt like maybe I wasn’t doomed to a decade of struggling and multiple miscarriages before I could carry a baby to term. That was my mom’s reality, but maybe, I wasn’t doomed to repeat it.

One thing always at the front of my mind is my Fibromyalgia. I was afraid to put any more “burden” on my body. I also knew that I was not comfortable taking any of the daily medications I had been prescribed just to help me function, while pregnant or even while trying to conceive (TTC). Lastly but certainly a big one for me, I didn’t want to pass this on to my child. My mom has it, I have it, and I didn’t want our child to have it. That is the worry that led us to speak to the RE about reciprocal IVF (in vitro fertilization).

For those of you less versed in reproductive assistance, reciprocal IVF is when one partner’s eggs are retrieved and fertilized with the intent to place the embryos into the other partner’s uterus. We wanted to use Mommy’s eggs to make embryos that I would carry. We had a long meeting with the RE about this. I honestly wasn’t even sure he would go for it since Mommy is already considered to be advanced maternal age (AMA). He did though. He said that he would do that if we wanted to, but these were his concerns. There’s no data on how likely it is that our child born using my eggs would have Fibromyalgia, but there is plenty of data that shows how much age affects egg quality and the possibility of fetal abnormalities. We would be taking eggs seven years older than my own to make embryos. He said that he would be more concerned about that than the chance that a child may inherit Fibro. That discussion along with some other information led us to start looking into regular IUI (intra-uterine insemination) using my eggs and donor sperm.

So, after many long discussions and lots of reading, we decided that we would move ahead along the path of considering IUI with me carrying. Now, it was time to address the rest of my concerns. My other concerns about Fibro and pregnancy were greatly reduced by a visit with my rheumatologist. She said that in her experience, women with Fibro who get pregnant do really well. Something about the pregnancy hormones helps alleviate the symptoms of Fibromyalgia in the majority of cases she’d seen. I also have anecdotal evidence of this from e-friends I’ve made over the past few years. (This makes me wonder why they aren’t researching some sort of hormone therapy to treat Fibro, but I digress) The rheumatologist and I made a plan to wean me off several medications, and I set up an appointment with my general practitioner to discuss the others. All of my care providers were very supportive of our decision which certainly helped me to feel more secure in it.

By the time I was finished with my GP, we had a plan and a timeline. We were moving forward and started to look at donors. This was the same month as Little Man’s first birthday.

…to be continued

Silence Broken…

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I haven’t written about this here, because there are people who read this blog who know our “real life” identities, and we haven’t shared this news with any of them yet. For almost a year now, we’ve been trying to give Little Man a sibling. This time, I’ve been trying to get pregnant. It’s been a long hard road, and we still don’t have any good news to report on that front. In the coming weeks, I’m going to write some about our story here. I need a place to talk through it for myself, and maybe there’s someone else out there who will stumble across it and find comfort in the fact that (s)he is not alone in facing infertility, anxiety disorder, and miscarriage. It’s been hard for me to be quiet all this time, but now you know why I haven’t really been writing. If you’re still here, thanks for hanging around.