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Monthly Archives: March 2018

In the uterus, however briefly

Well, the “a little bit pregnant” saga continues. Yesterday, I went in for blood work, and got a call late morning with my updated HCG levels. 1200. That’s a 77% rise in 48 hours, which again is within normal limits. The overall number is generally lower than expected for being 5 weeks 3 days (my RE said she’d like to see numbers “2 or 3 times higher than that”).

Given this rise (and probably just the fact that it went over 1000), they wanted me to come in right away for an ultrasound to rule out an ectopic pregnancy. I ended up literally rushing over to their office immediately, because it was 11:15 and I had patients scheduled all afternoon (1-4:30). It’s such a hassle to cancel/reschedule patients, so I’m glad they were able to see me right away, but it also definitely got my blood pressure up for the whole situation.

They did an ultrasound – both abdominal and transvaginal. My RE was in the room for the ultrasound, which was good (no waiting around for results). They pretty immediately saw that there was a “small sac” in the uterus, and were able to confirm that it was not an ectopic pregnancy (thank goodness). And there was indeed a pregnancy to be seen in my uterus – right in the center. At 5 weeks 3 days, they saw a sac and a faint yolk, and mentioned a couple of times that it was small. At the end I asked the actual size of the sac, and the ultrasound tech said she thought around 3mm, though she didn’t have the numbers in front of her. (I’ve read that 5mm or greater would be “normal”)

Before we even started, my RE said that she wasn’t going to “do anything until nature decides what’s what.” I took that to mean she would recommend a chemical abortion or D&E unless it was a clearly nonviable pregnancy. At that point, she felt like it was likely not viable, but that I was “still in the ballgame.” So honestly, at this point, I was feeling about the same as I was previously. I knew that it wasn’t ectopic and really wasn’t worried about that, because I hadn’t had a single twinge of anything on one side or another that would indicate a possible ectopic. My RE also mentioned that she was worried it could have possibly implanted in my C-section scar and been just as bad, which was something I hadn’t considered at all.

My sense after leaving the ultrasound was that I’m still likely to be having a non-viable pregnancy, but that there’s a tiny chance it’ll pull through. The follow up plan was to return for another ultrasound in 2 weeks. My RE said that she could have me back in 1 week, but that we would possibly see a fetal pole and low heartbeat, and then return a week later to have no heartbeat, which she feels is probably more devastating. I think it’s weird that she shared that, but also tend to agree.

Within about 15 minutes of leaving the ultrasound, I felt a gush. I assumed it was the ultrasound goo, but after feeling 1 or 2 more gushes I hit the restroom as soon as I got back to work. Turns out I was bleeding – bright red blood and at a pretty good clip. I put a pad on and ate my lunch while feeling a couple more gushes. By the end of lunch, I had confided the whole sordid tale to 3 of my colleagues/friends. I went to the bathroom again and felt myself pass what felt like a large clot (my only comparison for this sensation was the clots I passed post-birth in the first handful of days). I came back into the office we were eating in and said, “I think it might have just happened?” Of course this is all happening at 10 minutes to 1, and my 1:00 patient (a new evaluation) was already in the waiting room. One of my colleagues was so wonderful and offered to take that patient for me as she had the early afternoon spot open for writing, and they all encouraged me to go home. I was able to quickly cancel the rest of my day and head home. I got home around 1:30 or so, and when I went to the bathroom again had the same “clot passing” feeling. Oddly, after that the bleeding totally stopped. I had minimal spotting for a couple of hours but only when I wiped. I think I probably bled for a total of 1.5-2 hours? And there was minimal mild cramping.

Soooo I am guessing that that was the miscarriage I’ve been kind of waiting to happen. To be honest, if it was, I’m pretty relieved that it means I won’t have to make a decision about a D&E or Methotrexate. I know that there’s always the chance that the bleeding (and even clots) were just the result of the ultrasound kind of “shaking loose” blood that was pooling somewhere up there. But given all of the information, I’m thinking that’s not too likely. I messaged my RE because there’s no way in hell I’m waiting 2 weeks to find out if that was “it,” and they put in orders for me to have blood work again tomorrow to see if my HCG starts to drop. After all of that, we’re still in a very “wait and see” place. I’ll be back tomorrow to report what happened to my HCG.

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678 …

Well, the uncertainty continues. I’m trying to get used to the anxious/everything-is-up-in-the-air feeling that pretty much permanently resides in my brain.

To recap: I got (very) positive home pregnancy tests on Friday 3/16 and Saturday 3/17. I started spotting on Saturday, and light-medium flow on Sunday. The bleeding was red and by Monday was very heavy. I had 2 days of heavy flow, then another light/medium day, and then 2 more days of spotting. Overall, it felt like a “normal” period to me (my periods have been super heavy since they returned after having Riley), but with a couple of extra days of spotting. I’ve had no cramping or pain, but the bleeding was red, heavy, and clot-y (sorry for the TMI but also this whole blog is TMI so …). I had a bit of spotting on Saturday and nothing on Sunday or today.

Blood HCG levels have been low and rising, though slowly.

  • Monday 3/19 – 127
  • Wednesday 3/21 – 199
  • Friday 3/23 – 271.42
  • Monday 3/26 – 678

This most recent rise was closer to normal – I think that’s a 52 hour doubling time. BUT, the numbers are still too low to be able to see anything on an ultrasound. And obviously the overall picture continues to be abnormal. So, I get to go back in for blood work again on Wednesday. They’ll check my HCG but also look at other things (they did not tell me what the other things were, just that I don’t have to fast). And I am now scheduled for an ultrasound on Friday morning (3/30). That was originally supposed to be on Thursday, but my doctor is apparently on IVF/surgical duty that day so can’t be in for the ultrasound. Even though I want answers sooner, Friday is better for me all around because I work on Thursday but am off on Friday.

I asked the nurse what the possible paths at this juncture are. She said:

  • If they don’t see/can’t find a pregnancy in the uterus, they’ll likely recommend a Methotrexate injection (chemical abortion)
  • If they can confirm an ectopic pregnancy, they’ll recommend Methotrexate as well
  • If they can see a pregnancy in the uterus but can confirm that it is abnormal/not viable, we’ll discuss options including a D&E
  • If they can see a pregnancy in the uterus and it could be normal, we’ll do more waiting and seeing

I also asked whether a normal pregnancy progression is a possibility here. She said “never say never” and that she has seen it happen. She gave it maybe a 10% chance (this is just a nurse totally guessing here, not based on any evidence or data … kind of thought it was weird that she put a number on it but also 10% was higher than I expected so I’ll take it).

Sigh. So that’s the continued state of my uterus. I’d love to hear from anyone who has had slow rising HCG (and/or full-on bleeding in early pregnancy), regardless of what the result was. I don’t really have anyone in my life who has experienced this (to my knowledge), and I try not to google too much …

I’ll catch y’all back here again on Wednesday I suppose!

Slow climb

HCG came back 271.42 today. To recap:

  • Monday 3/19 – 127
  • Wednesday 3/21 – 199
  • Friday 3/23 – 271.42

Obviously not good doubling times, obviously most likely indicative of a miscarriage/non-viable pregnancy, but annoyingly still trending upwards. My RE ran some additional blood work as well, though I’m not even sure what – I think a complete blood count and liver function maybe? Anyway all of that came back normal. The plan is still to wait it out. More blood work Monday, ultrasound Thursday. Sigh.

53%

I went in for my second beta this morning, and fully expected the numbers to be dropping given how much heavy bleeding I’ve been experiencing. In fact, the number increased, albeit slower than is typical for a normal pregnancy (which makes sense, given how unlikely a normal pregnancy is at this point). They reminded me that my Monday beta was 127. Today’s was 199. That’s a 53% increase in 48 hours. I’m pretty sure the guideline is for doubling every 48-72 hours, with at least a 60% increase over 48 hours. Basically it’s more uncertainty (with a healthy dose of nope). In the meantime, I’ve been bleeding since Saturday, and bleeding heavily since Monday. Today is less heavy, but Monday and Tuesday were VERY heavy, and it’s been dark red bleeding with clots the whole time (sorry for the TMI). All of that said, I am still getting the fun early pregnancy side effects like heightened sense of smell, very minor nausea (the thought of beef made me retch today), and major exhaustion.

So I’m just hanging out, continuing to consider this a miscarriage/chemical pregnancy, and waiting for the numbers to drop so that I can move onto the next. I’m not doing anything to sabotage the outside chance that things may turn around and this may become a viable pregnancy, though the chances are so so low. I’m honestly not feeling as awful about this as I thought I would. Disappointed perhaps, but in the same vein of the disappointment I felt each time an IUI or that first IVF didn’t work. I haven’t cried. I AM frustrated at the not knowing, and anxious to be able to get to the next steps (which I can’t do until my HCG is below 5).

Blah! OK to end on a positive note – Riley started a new daycare on Monday and seems to really like it. At her old daycare, she came home every single day with a rash and “allergy shiners.” So far this week she has looked awesome, which just reinforces my perception that she was just a little allergic to her old daycare (detergent, pets, mold … something like that). Our doggo came through surgery well, though we are waiting to hear on the biopsy still. But she’s finally seeming more like her self (barking at the mailman and all those good things). Also, I love my kid so much I can’t even handle it sometimes. The biggest difference between TTC the first time vs. this time around is that I have my beautiful bundle of awesome that I can go home and snuggle. It makes it easier to not fixate on all of this and keeps the bigger picture in perspective. I know that I couldn’t have had that perspective the first time around, and am grateful to have it now.

“Positive”

The spotting and light bleeding I posted about on Saturday turned into a medium flow Sunday and a very heavy flow today. I went in for my beta as planned and got a call today from the nurse congratulating me on my pregnancy. I honestly don’t even remember the number – it was 107 or 127 or 157? Technically positive (though at this time in my pregnancy with Riley my numbers were in the 300s, and my pregnancy tests with her were much lighter than this weekend’s). I was pretty pissed that they didn’t read the note from the on call RE this weekend to at least note my bleeding. I had to rehash it, and confirm that the amount of bleeding I was experiencing was most likely not consistent with a viable pregnancy. Things being as they are, I apparently have to keep taking the Crinone at least through Wednesday (not that it’s staying in there long enough to absorb …), and will get a repeat beta on Wednesday to see how the numbers are trending. Once I get back to 0, they can submit to insurance for a frozen transfer. Most likely, I’m looking at a transfer in early May if all goes to plan.

Today was the Monday of all Mondays. My daughter started a new daycare (her old one asked us to leave because they weren’t comfortable with her allergies), which was nerve wracking. Also, our beloved 10 year old dog had surgery to remove a very large fatty deposit that was starting to affect her gait, which resulted in them finding and biopsy-ing a lump under her tongue (more uncertainty). She’s doing ok tonight but occasionally starts whining and it’s very sad to hear. Also, Riley has been sick and we took her to the pedi after daycare only to find out she has an ear infection. Em and I both woke up with sore throats, probably with whatever virus Riley has/had. Add to all of that my insanely heavy period/miscarriage … Just in general … an epic Monday.

For now, I had a lovely glass of wine tonight and am partaking in a little retail therapy. I know this post is super blah negative – I’ll pick myself back up tomorrow but tonight I’m wallowing.

Uncertainty sucks

So, it’s exactly 2 weeks since egg retrieval (9dp5dt), and I woke up this morning with a bit of brownish red spotting, so took another pregnancy test just to see. I knew it would probably still be positive given that my HCG was high enough yesterday, but it felt like something concrete I could do. Anyway, it was definitely positive. I know the darkness of the line doesn’t mean much, but it was way darker than yesterday’s, and almost as dark as the control line. Even so, my spotting turned into some red bleeding. Nothing needing more than a liner, but definitely beyond spotting. I called my RE’s office and spoke to the on call RE, who basically confirmed what I already knew – could be a chemical pregnancy, could be a non-viable pregnancy, could be normal bleeding, and there’s nothing I can do but watch and see what happens. I’ll keep taking the Crinone and go in for my blood test on Monday morning as planned. Those numbers will give us more info.

For now, it sucks to have the uncertainty. But I suppose it was uncertain anyway! I’m trying to stay positive. I know red blood is not a good thing, but I also know that it could just be a little bleeding that doesn’t progress. I also know I have 3 frozen embryos in the wings.

Just to make things extra fun, we are on a family trip in DC (doing a 5k in memory of my aunt who passed away from colon cancer). Traveling, especially on a plane, with a 16 month old is stressful. Throw in that she has a full blown cold … and you can see how things are feeling in my life right now.

Here’s today’s pregnancy test just for shits. Any and all good vibes appreciated. Happy St. Paddy’s Day!

Well damn

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