Thursday, August 23, 2012

First Trimester Screening

Yesterday was an emotionally draining day, it's amazing how sometimes highs and lows can coincide and occur simultaneously, it's hard to process everything at one time.  First and foremost, we had our first trimester screening yesterday.  We were referred to a popular MFM practice that many ob/gyn's refer to in the DC metro area.  I had the bloodwork portion of the test done last week, so that the results would be in yesterday, and we could discuss them with a genetic counselor.  We arrived for our 10:15am appointment at 10:00am, and weren't taken back until 10:45.  I had been drinking water all morning to make sure my bladder would be full for the ultrasound, so by the time we were taken back I thought my bladder was going to burst.  I asked if we could do the ultrasound first, because otherwise the genetic counselor was going to have a puddle all over her floor before long.  Luckily they were able to accommodate us and make that happen.  I was taken to a room and we got started pretty quickly.  I was holding my breath while the sonographer found the baby, and said a little prayer that that heart was still beating...and sure enough, the heart was beating beautifully, and the baby was moving around like a champ.  She started taking measurements quickly, knowing that my bladder was super full, and showed us how well the baby is developing.  The nuchal fold was measured, and it was a great measurement for the size of the baby, which enabled R and I to breathe a sigh of relief.  We got to see the blood flow in the spinal chord, which was so amazing, and we learned that the baby is measuring 5 days ahead of schedule.  We were feeling great.

We sat down with the genetic counselor and she told us that the screening was very positive.  Just the fact that the age of the egg was 28 vs my age of 36, brought the risk for major chromosomal abnormalities down drastically.  The results of the bloodwork and ultrasound were consistent with the statistics, everything is looking great.  We left the office feeling so hopeful and lucky, we decided that were going to begin sharing the news with our extended families and friends.  Of course, we had to tell our beautiful Smiley that she's going to be a big sister :)

The rest of the day was a bit of a blur, both of us went our separate ways back to work, I started sharing the news with some of my co-workers, everyone was so excited and supportive.  My boss most of all, she has exceeded all of my expectations in so many ways.  Sharing the news with friends has been amazing, we decided we would tell our close friends about using a donor egg, but limit it to that, and ask that they keep that detail to themselves.  The people that are closest to us know our history, have shared our journey with us, and are our biggest cheerleaders, even if they don't understand everything there is to know about using a donor egg, they know that it's a wonderful option in building a family.  One thing we do want to avoid, is someone in our lives who may not completely understand, opening their mouth later on and making a comment around our child about him/her being a donor egg baby...so for now, the closest of the close will know, and others, don't need to know.

So the wonderful news about the first trimester screening should have been enough for the day, but unfortunately, as things have tended to go for us, there has to bee some bad with the good.  My dad has been unhappy in his job for quite awhile, I knew that his boss was having some financial issues and couldn't afford to have my dad work a full week, but I learned yesterday that things for my dad are worse than I thought.  He himself, is having financial troubles (which is not a new thing for him) and he is asking for us to give him some money that we were holding for him (very long story that involves him avoiding debt collectors from his previous business failings).  He e mailed R asking for the money yesterday morning, and R sent him an e mail back letting him know how much he'd have remaining, and that we would not be able to lend him any money beyond that amount, given the expenses we are going to have ahead of us.  My dad was hurt, and sent me an e mail saying he was glad that R "warned him" - this all took place before the screening! Did I need that??  I completely understood where R was coming from.  When my dad's business was failing several years ago, my dad borrowed a lot of money from us, and we did not see any of it back.  We were lucky that we were able to help him a the time, but we swore that we would never do that again, especially since now we have our own family to support.  My dad understands that, and he holds onto a lot of guilt for having put us through that...but it doesn't change the fact that it did happen.

My dad has been sinking into a depression the last couple of months, he revealed to me tonight that things have been going on in his office that he hasn't shared with us, and he's spent many days unable to get out of bed.  It's so painful knowing that my dad is suffering, he's had such a terrible time since my mother died.  He's not in great physical health to begin with, but to be so depressed is not going to help matters at all.  He needs to find another job...but he's paralyzed.  He's convinced he's too old, and has no real skills that an upstanding organization would find useful.  My dad used to be a successful, confident business man, and to see him deteriorate these last 10 years has been heartbreaking.  He said that he made an appointment with a therapist, that is a HUGE step for him, given that he's shared in the past that he didn't believe in therapy.  I guess he realizes that he has to do something, or he's going to be in real trouble. 

I am trying to not allow my dad's issues to spill over into my life like they used to, but it's easier said than done.  I guess his issues and our issues need to coexist right now, but I know that I need to focus on my own health, and making sure the baby is getting what he/she needs.

The best part of our day, yesterday, was telling Smiley that she's going to be a big sister.  We picked her up from school, and as we were driving in the car, we told her.  She started laughing and clapping, and repeating, "I'm going to be a big sister!"  She has a couple of friends with baby siblings in the infant class at her school, so she has some concept of "baby sister and baby brother" but we don't think she really gets it...yet :) 

Thursday, August 16, 2012

UTI and LBI

Things have been pretty status quo since my Ob appointment last week, I continue to navigate through the nausea by eating constantly, it usually does the trick, but sometimes it backfires and I end up feeling worse than I did before I ate.  I'm just trying to go with the flow and do what I need to do to get through it all.  I find that the toughest times for me are when I am with people for a lengthy amount of time and I have to figure out my meal and snack situation.  Last night I attended a focus group hosted by my health system's marketing team, we sat through 2 focus groups from 6 - 10pm, observing people answer questions about where they'd go for cardiac care, and their reactions to our advertising campaigns.  The market research company that held the focus groups fed us pretty well, and if anyone from my team was watching, they would have noticed me eating throughout most of the evening.

Monday I received a call from one of the nurses from my Ob practice, she said the results from my urine culture came back, and I have a UTI.  She said it's nothing to worry about, it's very common, and they were going to put me on amoxycillin for a week.  I was not surprised to learn of the infection, I had been having minor symptoms for awhile, but I just chalked it up to pregnancy and all of the things going on in that vicinity.  I'm a bit nervous, however, because in the past, regular amoxycillin has not gotten rid of my uti's, I've needed to move to macrobid to knock them out.  I am hoping things go differently this time, I will be back there in a couple of weeks for an appointment, and they will be able to re-check me.

I have my 1st trimester screening next Wednesday, I was able to go to the MFM's office (where I will have the screening done) to do the blood work portion of the test.  The results will be in by our appointment, so we'll meet with the genetic counselor first, then have the ultrasound.  I vacillate between being really anxious about the test, and thinking everything will be fine.  I guess I will just have to cross my fingers just take it as it comes.  Not as easy as it sounds, but I will just have to do it.  Luckily, we have a nice distraction coming up, we are headed out this afternoon to Long Beach Island, NJ.  R's best friend and his wife and daughter rented a house for 2 weeks, and invited us to join them for part of their trip.  We made these plans months ago, before we had even undergone the IVF.  It turns out they are pregnant with their second child, so when R's friend told him the news, R told him about our news too.  I was fine with it, I knew that it would be too stressful trying to hide it for 4 days, this way if I have issues with nausea, it won't be a big deal.  I'm a bit nervous about the car ride, it's going to be a good 4-5 hours, depending on traffic, and I told R that given my UTI, I will definitely need to stop to pee multiple times during the ride.  Hopefully Smiley will cooperate and nap/watch DVD's the whole trip, and will not get too antsy.

I am looking forward to getting away and being distracted from my nerves of the upcoming screening.  It will be nice to spend some time on the beach, and to visit with our friends whom we haven't seen in awhile, they live in New York and we're lucky if we see them once or twice a year.  Their daughter is about a year younger than Smiley, I'm sure they will have a lot of fun together.  My bathing suit situation is pretty ugly, I barely fit into 2 of my suits, I refuse to put on my maternity bathing suits, it's too soon, and they would be too big anyway. When I wore them during my pregnancy with Smiley, I was much farther along than I am now.  I will just make them work, and when all else fails, keep the cover up on :)

So I am really in the home stretch of my 1st trimester, it's hard to believe.  On July 2nd when I received my beta results, I could not imagine that I would make it this far.  I sometimes beat myself up for looking farther ahead, thinking about baby furniture and accessories...bringing out the high chair again and activity mat, do I buy a breast pump or rent one again? I think that I am jinxing myself and need to keep those thoughts at bay.  I realize that sometimes it's o.k. to let those thoughts in, it would be unnatural if I didn't, and in reality, thoughts don't "jinx" people.  This is all out of our control, whatever will be will be.  I can only continue to be cautiously optimistic, and before long, we will have a clearer picture (literally!) of what will likely be. 

Tuesday, August 7, 2012

Moving Right Along

The last couple of weeks went by faster than I expected they would.  I really believe that the energy healing work that I've been doing has helped keep me more balanced and calm.  I still have had some freak out moments, but for the most part, I'm just taking things one day at a time.  The nausea is still there in full force, but I'm managing it as best as I can, mainly by eating. Constantly.  And by eating I don't mean having a few crackers, I mean meals. I am someone who is normally very health conscious.  I typically watch my calories and exercise regularly.  I learned when I was pregnant with Smiley that I am very different as a pregnant woman, the nausea creates a whole different person.  I find myself pulling into McDonald's for an Egg McMuffin, because I must have it.  And oddly enough, it calms the nausea...for about an hour and a half.  Then I'm trying to figure out what I can eat next that won't make me ill and will calm the nausea simultaneously.  It's a balancing act, when I'm meeting with physicians and co-workers every day.  Thursday I have a dinner meeting with a Neurosurgeon we are trying to recruit, I am hoping and praying I can keep myself together for the evening.

Today we had our first appointment with our new OB practice.  I went in early yesterday morning for an ultrasound, as they didn't have two appointments together in one day.  I actually enjoyed going in early, I had time with the sonographer to ask some questions about the practice, and learn a bit about how they work.  She was so sweet, I got great vibes right off the bat.  And of course, it was wonderful to be able to see that little heart beat, and see him/her moving around! Today we met with one of the OB's, we really liked him a lot.  We went through our crazy history with him, discussed his opinion on a VBAC vs. scheduled C-section - he looked at me and said, "you've been through a lot.  Let's not risk anything, I recommend a planned C-section"  O.k. that's set then!  We discussed the first trimester screening, I was able to get an appointment in 2 weeks, so I'm glad to have that on the calendar.  We also talked about having BRCA gene testing, given my mother's passing from breast cancer.  It's something I've thought a lot about, and I do plan on having that done, but I feel like I can only handle one thing at a time right now.  I am nowhere prepared to make decisions about radical mastectomies or hysterectomies while I'm trying to nurture a life.  I have pretty much come to terms with the fact that I likely carry the gene, given that my mother was of Ashkenazi Jewish descent, and was diagnosed so young (two big risk factors for me), but I have been told by a breast surgeon that I still have time, and I've been very proactive in my screenings so far, so let's just get through this pregnancy, G_d willing.

R and I came away from the appointment feeling like we made the right decision about switching practices.  Forget the fact that they have an office right around the corner from our home (although our appointment was at the other office about 15 minutes away, but still much better than 45 minutes away, which is what we were doing before!) but we got the sense that they are going to take good care of us.  The nurse that worked with us today, treated me like I was her only patient of the day.  She's young and sweet, she told me that if I ever feel anxiety between appointments, I can call her any time and come in to hear the heart beat.  I wanted to hug her.  She also mentioned that her brother is a coach with the new Penn State coaching staff.  Again, wanted to hug her...told her I am a PSU alum, it warmed my heart to hear that her brother loves the coaching staff and that the team is so happy with the support they have.  The icing on the cake was my doctor telling me that I get to come back a week after my first trimester screening, so really I have to just get through the next 2 weeks until that, and then I get to be seen again, a week later.  That will get me into (knock on wood) my 13th week.  But like I find myself saying 50 times a day, I must take things one step at a time.

Time to go have my evening snack and crawl into bed, if I'm lucky I'll make it part way through a DVR'd show!

Monday, July 23, 2012

Fast Forward to U/S #2

I started a post a few days ago that I thought I saved, but sadly it's lost in the blogosphere somewhere.  We had our first ultrasound on 7/17 and we were thrilled to see a little tiny heart beat.  We were in awe, even though I had started feeling the nausea set in, until you see that beating heart, it's anyone's guess how the 1st ultrasound will go.  We were asked to come back a week later - which was today, where if everything went well, we would "graduate" to our OB.  One week later, here we are, graduated and onto our OB.  R and I made a very decision over the last couple of weeks, we decided to change OB practices so that we could deliver in the community hospital that is a mile and a half from our home, vs. staying with the OB whom we love at GW.  As much as we wanted to stay with her, and that practice, the practicality of delivering a few minutes from home vs. an hour away just won out.  I want things to be easy for R, who will be juggling Smiley, our dog, our families, if G_d willing we make it to our March due date.  So I did some research and asked my RE about the practices who refer to them, and picked a group that has a great reputation.  I go in on Monday 8/6 for an ultrasound, and the next day we go in for our initial appointment.  Another beloved 2ww :)

The nausea has really set in at this point, I struggle with talking too much about how difficult it is, because I don't want to complain about something that so many people would give their left arm to have - and I know that feeling of want!  I just want to be able to function without always feeling so sick.  I was able to get some Zofran today from my RE's office, and I'm hoping that that will do the trick, I took it when I was pregnant with Smiley, I had horrible nausea for 16 weeks with her, I imagine I may be in for a similar ride. 

So we're still in the game, I'm so grateful for having made it this far.  Keeping hope alive that this little bundle will stick around for the long haul :)

Monday, July 9, 2012

Milestones

I have made it through 3 betas relatively unscathed.  It's hard to believe that it's been a week since my first beta, I never thought I would make it to that date, and now I have survived a 5 day vacation with R's mom, aunt and uncle, and a sneaky trip to Labcorp to have my second beta drawn in the middle of it all.  R's mom knows what's going on, but his aunt and uncle do not, and we were at their beach house.  I fabricated a story that I needed to have some routine bloodwork drawn for a physical that I have this week, so I scheduled a 7:30am appointment at the labcorp 3 miles from their house, near Atlantic City.  Aside from needing to wait 24 hours for the results (even though they were written as "stat"), when I learned the result of 1669, I was able to take a breath and enjoy the rest of our trip.  We had some great time on the beach, saw friends, had some wonderful meals, and were able to get some relaxation in there, despite the oppressive heat that everyone was dealing with along the east coast. I have to admit that I was looking forward to getting home and back to my routine, and to my 3rd beta which was drawn today.  The result was good, it was around 4600, which the nurse said was right where it needed to be.  For some reason I was thinking it would be higher, but she said that it's rising appropriately, and they want me to come in for an ultrasound next Tuesday, 7/17.

I am doing my best to not let my anxiety take over my being.  I am extremely grateful to have made it this far, and the fact that I am even pregnant at this moment in time, gives me hope that if it doesn't work this time around, it CAN work.  But of course, the fear creeps in from time to time, as different twinges and twitches come up.  I know we have a very long way to go, and we have had way too many losses to start celebrating this early in the game.  I keep repeating "one day at a time" when I start to feel the panic set in, but I often feel that I need to be prepared for the worst. 

In the mean time, I have a busy week of work, and coming up at the end of the week, is a very big anniversary. July 13th would have been my mom's 65th birthday, the 14th will be the 10 year anniversary of her passing.  I just can't believe that so much time has gone by, so much has happened these last 10 years.  I still wish I could pick up the phone and tell my mom about my day, gush about her beautiful grand daughter, cry over the losses I've experienced before and after Smiley.  I just miss her.  Plain and simple. We have some things planned for the weekend to honor my mother's memory; for the first time in years, I am not dreading these 2 days that are normally looming over me like an annual gray cloud.  I am actually looking forward to celebrating my mom, rather than mourning her.  I'm going to take Smiley to the cemetary on Friday, I'll have her draw a couple of pictures and we'll slip them under her stone.  We'll talk to her, sing some songs, and leave some rocks, in the traditional Jewish fashion. Friday night I plan to make my mom's lasagna recipe in her honor, and on Sunday, we'll go back to the cemetary, along with R, my dad and brother, and then we'll go out for brunch and celebrate her some more.  I know she'll be happy with our plans for remembering her on such an important anniversary. After all, she's always on our minds, 365 days a year, but this weekend, I know her presence will truly be felt.

Monday, July 2, 2012

Beta #1

I am in the midst of packing for a 6 day vacation to Margate, NJ with my husband's family - it was always dicey in my mind thinking of what this vacation could look like given how my beta was to turn out today.  I kept thinking about how miserable I would be on the trip if my beta was negative, and how anxious I would be if my beta was positive, and having to sneak away for a blood draw at a Labcorp on Thursday, and all around just keeping the news to ourselves.   Well, it turns out that I get to enjoy an anxious week at the beach with additional del estrogen and progesterone shots, and a 7:30 blood draw on Thursday...my beta came back positive today, I still can't believe it.  The number was 488, and I am 13dp5dt.  We are very excited, but after enduring many many miscarriages, I need to keep a level head and take this one step at a time.  If I can get through this vacation in one piece, that will bea step in the right direction :)

Hoping to have a good result from Thursday's beta, and then I'll go back to my RE's office on Monday for a 3rd.  Continuing to cross all fingers, toes, and anything else crossable :)

Thursday, June 21, 2012

DE: Not Always the Magic Bullet

How in the world did it go from the middle of April to the 3rd week in June? I swore that I would be blogging more frequently, sharing the details of our DE journey, and tracking our progress.  Somehow, the time got away from me, and here it is, June 21, and I am 2dp5dt. 

Things did move pretty quickly once we selected a donor.  We originally thought we were going to end up waiting for more donors who were eligible for a 1:3 transfer to show up in the database before we made a decision, for some reason I wasn't falling head over heels for any of the ones that were listed.  I had this vision that I would find someone who resembled me to a tee - dark complexion, dark eyes and hair, 5'7 or taller.  R and I talked about what traits were truly important to us, and it turned out that it became less important that a donor be my long lost twin..because if we waited for her to show up in the database, we risked a very long wait. I also thought about how Smiley does not resemble me completely, she doesn't have my coloring, so why did it matter if the donor had my coloring? We ended up really liking one of the women who had some of the physical features we were looking for, but not all, and a very strong profile otherwise.  We had found our donor.

Fast forward through cycle synchronization with the donor and the 2 other recipients - that entailed a month and a half of the BCP, which turned me into a raging bitch who gained weight and began suffering from migraines...reminded me of why I never did well on the pill when I was trying to PREVENT pregnancy, all of those years ago.  Then the lupron began, another fun portion of the synchronization process, and then I began the Del Estrogen shots every 3 days, to start preparing my lining. Before I knew it, I was getting updates from my nurse about the donor's response to her ovarian stimulation, she seemed to be producing the numbers that would support 3 donors, which really was exciting.  I knew there was always a possibility that upon retrieval, there wouldn't be enough eggs for all 3 of us.  We were slotted for the 3rd position, so we had to prepare ourselves for the possibility of a cancelled cycle, but everything was always looking good for us, even upon retrieval.  On 6/13, our donor went in for her retrieval. 18 eggs were retrieved, and we received 6.  It turned out of those 6 eggs, 4 were mature, and all 4 of those fertilized.  The next day, my nurse called to share that all 4 were fertilizing properly, so we were encouraged by the news.  In the back of my mind, I still assumed we would have a day 3 transfer, because in our past IVF's with my eggs, we were lucky to even make it to day 3 before the embryos died out.  On the 2nd day, my RE called and said the embryos were really doing well, and we would schedule a day 5 transfer.  I was speechless.

I ended up having a 9:15am transfer on Tuesday.  We had one blast that was doing well, and 3 other embryos who were compacting, but hadn't yet reached the blast stage.  Our RE encouraged us to transfer the blast, and only the blast, in order to avoid having multiples.  R and I discussed this before; my heart was really leaning toward transferring 2, because, really, what were the chances that we would conceive multiples??  After really thinking it through during the cycle, we felt that our course of action would have been different if Smiley wasn't in the picture, if we weren't already blessed with one child.  We would have absolutely gone with transferring two - but with already having a very active and precocious 2 and a half year old, we didn't want to risk having multiples...a higher risk to an already high risk pregnancy.  So we transferred the beautiful blast that we had, and hoped we'd have at least one to freeze.

For the first time since my first IVF cycle, (when I was naive to how poor our embryos really were), I truly embraced my 24 hour "bed rest." I watched bad TV, read my Kindle, napped, let R wait on me, and snuggled with Smiley in bed.  I even took more rest time than needed, my transfer was at 9:15 am so technically, I could have resumed normal activity yesterday morning; I could have gone to work.  I decided to F that and stay home another day; I took a long warm shower and moved from the bed to the sofa. 

I went back to work today and tried to keep my mind busy.  I knew that today I would find out if the 3 remaining embryos were still viable and ready to freeze.  By 3:30 I was getting antsy, and even R was surprised we hadn't heard anything.  I called my nurse and got her vm immediately, not even a ring.  I called the main number and asked to speak with another nurse in the donor program, was transferred to someone and of course, got vm.  She called me back on my way home from work, she said that my nurse was out of the office today but I was on her list for calling tomorrow.  Unfortunately, this nurse didn't have good news for me....none of the 3 remaining embryos made it to freeze.  I had to have her repeat what she said, because I didn't understand what she was saying.  I thought with DE, embryos thrived, and bloomed like flowers.  Everyone I know that has done DE has had embryos left over, why the hell don't we? What is it with us and embryos? I just don't get it.  The nurse assured me that just because those embryos didn't make it, it doesn't mean the embryo we transferred isn't going to make it...it had made it to blast and it's now where it needs to be.  But now, I feel like a dark cloud of doubt has shifted over the cycle a bit, where as this morning, I was so very positive that this was going to be our magic bullet.  R reminded me that we made it farther than we ever had, we used to dream of day 5 transfers (I think in our very last cycle we actually did a day 2, our embryos were so bad) and we just had one.  I had to keep remembering that, and also remember that we have 6 attempts at this if we need it.

Yes, I understand that by being in the Shared Risk program we have the opportunity to have 6 fresh cycles.  That means selecting a donor 6 times, synchronizing cycles 6 times - getting on the roller coaster 6 times.  I know that we'll never reach 6, I don't have it in me.  I haven't decided how far I'm willing to take it, and hopefully it will be a moot point, because this cycle will have worked and our clinic would have made money off of us, with a first time success.  I guess I have a hard time believing we are that lucky.  Then I think about all we went through in TTC the first time, and how hopeless I felt, so much so that we had given up on my eggs and were moving toward DE...and then Smiley was conceived, and despite many losses before her, I carried her to term. I guess we are that lucky after all.

Beta day is Monday July 2.  We are supposed to go to the beach with R's family the next day.  I have to say I am nervous about the trip, no matter what news we get - we get a negative I will be a mess (although I'll be able to drink my sorrows away).  We get a positive, and then I will worry about not spilling the beans, and also, somehow sneaking away to get a second beta done at a labcorp in Margate, NJ.  With R's family, it's very difficult keeping things private.  I have to keep telling myself that these are premature worries, and we need to take things as they come.  Not so easy for me but thankfully work is busy next week, and the weekends always fly by. 

I do want to talk to my RE about why he thinks we had no embryos to freeze. I am also curious to see if I can learn if the other recipients had any left to freeze. In the mean time, I can only take care of the one and only embryo that truly matters, the one who is hopefully making him/herself comfortable, and finding a nice home inside my uterus. Fingers and toes crossed.