SIXTEEN.

I keep meaning to start up the weekly posts again. And every week I chicken out. We’re now three weeks past our last loss milestone, but I still haven’t been able to shake the fear. I put on a smile for other people (mostly because I’ve found my fears tend to make other people uncomfortable or cause them to try to convince ME to feel okay) — but deep down I’m still scared. And so is D. Probably even more than I am. I guess that’s just the hand we’ve been dealt and I wouldn’t expect anyone who hasn’t been through what we have to understand. That said, I’m definitely clearly pregnant now. And I do find myself looking back at my weekly updates with T and wishing I were taking the time to document this pregnancy, so I guess now is as good of a time as any to start. (deep breath) Here we go…

Baby: is about 4 and a half inches; about the size of an avocado (or a grenade, according to one website!). His ears and hearing are becoming more developed and he should be able to hear what’s happening on the outside now. This means he will start to recognize mine and D’s voices so he’ll be familiar with us once he’s on the outside. He’s also growing hair, lashes and eyebrows. (I wonder if he’ll be born with a mohawk like T!) Baby is also forming taste buds and should begin to develop preferences for certain things I’m eating.

Mama: is feeling pretty good, aside from some sciatic pain. That came on around 20ish weeks last time, and this time around it started around 13 weeks. I’m finding that everything seems to be happening sooner this time, really. Last week I started feeling him kick and roll a few times a day. I’ve been feeling what I thought might be flutters for a couple weeks now, but as of last week, it’s suddenly become much more obvious. I didn’t start feeling clear movement until about 19 weeks with Theo – but I also had an anterior placenta with him and it’s posterior this time. I’m also showing much faster this time. Granted, I’m starting pregnancy about 5 lbs heavier than I started with Theo, so that may contribute some to the tummy, but there’s a definite bump there now, and it’s about the size it was closer to 20 weeks last time. I’m working out more this pregnancy than I did with T and I’m hoping that will keep the weight in check, despite my higher starting weight.

Total weight gain thus far: 6 lbs.

Cravings: jalapenos, Girl Scout cookies.

IMG_0649

So far, so good.

13 weeks, 3 days. I have officially passed our last loss milestone. Things are looking good and we are pretty much “out” with our news (slowly telling more and more people — still undecided on whether we’ll do any sort of “big” announcement on social media).

As I mentioned in a previous post, we’ve run a litany of tests, on D, me and the baby. We’ve also had nearly weekly ultrasounds, which has been good for our sanity. We got the results of the NIPT back about a week ago and we have a healthy baby BOY! Still feels so surreal to think I’ll be a mom of two boys.

Since we aren’t hiding this any more, I figured I’d go ahead and publish the posts I’ve been drafting throughout. You may notice, I haven’t been doing weekly posts this time around. Maybe I’ll resume those next week, starting at 14 weeks.

It still doesn’t feel real, and I still have this fear that everything could be taken away from me at any minute. But, today I am pregnant.

Here’s a progression of baby through the first trimester (we didn’t get a printout from our 13 week visit):

5 weeks 1 day

5 weeks 1 day

7 weeks

7 weeks

8 weeks 2 days

8 weeks 2 days

9 weeks

9 weeks

11 weeks

11 weeks

12 weeks

12 weeks

…And a bonus video from 12 weeks. We have another active baby! The jiggling at the end is because I laughed.

Motherf*cker.

So, I got the results back from my repeat loss bloodwork. Diagnosis: heterozygous C677T MTHFR (which I can’t help but read as motherf*cker every time), high TPO levels (which are most likely related to the thyroid problem I already knew I had,  but could also be indicative of an autoimmune disease) and borderline ANA levels (which could also indicate an autoimmune disease).

Motherf*cker.

The good news is, the RE feels good about the course of care we’re on. The MTHFR gene mutation inhibits  folic acid absorption and he had already proactively put me on an extra dose of folic acid. So we’ll continue that. I’m taking Synthroid already to deal with the hypothyroidism. And the heparin shots I’ve been taking could help the autoimmune disease – if that’s what I have. The doctor wants to run a few more blood tests that may tell us more about the autoimmune possibility, and could also will look at both mine and D’s kareotyping, which could show whether one of us could be genetically predisposed to passing along chromosomal abnormalities (which are the most common cause of miscarriage). The tests are expensive and not fully covered by insurance – and the doctor said we didn’t need to them if we just want to stay the course of treatment and hope for the best. But to me, it was a no-brainer: we’re running the tests. We’ve come this far already – I just want to feel like we’ve checked every box.

So, we go back again on Monday (10 weeks!) for another ultrasound and the blood tests. Then the following Monday (at 11 weeks) we have our first OB appointment. I’m planning to do the NIPT testing with my OB, which will look at the chromosomes of the baby to rule out the major chromosomal defects and hopefully put our mind further at ease (and as an added bonus, we’ll get to find out the sex of the baby at that time too). Depending on the results of the kareotype testing, the RE said he might also recommend an amniocentesis, which I have mixed feelings about. An amnio looks at ALL the chromosomes (whereas the NIPT just looks for the most common chromosomal disorders), and is considered a diagnostic test (NIPT is still just considered “screening” even though it’s about 99% accurate). Problem with an amnio is that it comes with a small risk of causing a miscarriage. It’s only about 1%, but it’s still enough to make me nervous, which is why I’m leaning toward just doing the NIPT unless the RE strongly recommends otherwise. I mean, we’re doing all these tests to figure out why we’ve had miscarriages, and hopefully prevent another one. I’d never forgive myself if during that course of testing we unnecessarily caused another one.

I guess we’ll cross that bridge when we come to it. Onward.

Heavily medicated.

I’m starting to feel like the Collette Reardon character from Saturday Night Live with how many times I’ve been to the pharmacy in the last couple weeks.

SNL_1070_07_Update_3_Collette_Reardon

As I mentioned in my last post, my doctor has recently started me on a few medications to help my body do a better job at keeping this baby. I’m on so many meds right now — many of which need to be taken at different times — that it’s getting hard to keep track of everything. I actually had to go buy one of those “days of the week” old lady pill cases and set alarms for myself just to keep everything straight. Here’s what a typical day looks like now:

6:00 a.m. – alarm goes off, take Synthroid (for low thyroid; must be taken an hour before eating)

7:00 a.m. – inject myself in the stomach with Heparin just before leaving for work (to prevent blood clots)

10:00 a.m. – phone alarm goes off, take Prometrium (for low progesterone; 12 hours before bedtime dose)

6:00 p.m. – eat dinner, take prenatal vitamin, DHA, extra folic acid (4 pills), B6 and B12 (for fetal health and pregnancy support; must be taken with food)

7:00 p.m. – second Heparin injection (12 hours after the first)

10:00 p.m. – second dose of Prometrium, just before bed

For anyone counting, that’s 11 pills plus two injections every single day. After the first trimester I should be able to stop the Prometrium, and I may be able to drop the Heparin at some point, depending on the results of my blood clotting disorder tests.

Speaking of tests. I had betas drawn again today. I’m happy to say my betas are at 315.3 (up from 91.4), so they’re still more than doubling. The doctor wants me back for one more draw on Wednesday, after which they’ll schedule me for my first ultrasound if my numbers are high enough. Also today, I had all my repeat loss testing done. 16 vials of blood in total. I was surprised I had any blood left and didn’t pass out walking out of the building. My poor arms look like those of a heroin addict from all the blood draws, not to mention the all the bruises that will soon be covering my stomach from the Heparin injections.

It’s a lot to handle, but I just keep saying – whatever it takes to bring this baby home. I’m reminded of a powerful image I saw recently of a sleeping baby surrounded by hundreds of syringes and vials, illustrating the journey through in-vitro fertilization. And while I know what we’re going through pales in comparison to IVF, I can certainly relate to the great lengths, pain, discomfort and money many couples go through in order to do what so many people take for granted.

syringe10n-1-web

Here we go again.

I’m pregnant.

I’m not sure how to feel right now. I wanted this. I want this. We did this on purpose. But I’m scared out of my mind and the fear is overshadowing all other emotions at this point.

I found out last Wednesday. I took a test at 9 days past ovulation, thinking surely it would be too early to tell (the earliest I’ve ever gotten even the faintest line was 10 DPO). I hopped in the shower after taking the test, fully expecting a stark negative by the time I got out. Imagine my surprise when I discovered a faint, but very obvious second line staring back at me. I immediately started crying. Not out of joy this time, but out of terror.

A faint second line... but a line, nonetheless.

A faint second line… but a line, nonetheless.

Of course this would happen now. Just one week prior, I actually had my first appointment with a reproductive endocrinologist to look into our miscarriage history. I just wasn’t comfortable with the way my OB had essentially diagnosed me as having nothing wrong before even running any tests. Her reasoning was that most things that would cause repeat miscarriages would have affected our pregnancy with Theo. She did end up running a few tests, and everything came back clear, but I figured it couldn’t hurt to get a second opinion from someone whose specialty is getting — and keeping — people pregnant, versus an OBGYN whose focus is general women’s health issues.

The RE was very thorough in his assessment of our situation. He did agree that the fact we’ve carried a successful pregnancy to term was a very positive sign. But he didn’t agree with my OB’s assumption that a prior successful pregnancy meant there was nothing wrong. He was especially uneasy with our most recent loss since it was so late – he wasn’t ready to just blindly blame it on chromosomal abnormalities, which is the most common reason for miscarriage, and what my OB had assumed was the cause. There were also numerous tests outside the few my OB had run that he recommended looking into. He suggested we take a cycle off from trying and use the month of December to run a more thorough workup on both of us to see if they could pinpoint a reason for the losses. I explained to him that there was a chance I was already pregnant, and that I’d know in about a week. He said if that were the case, he’d monitor me closely throughout my first trimester and would run as many tests as he still could (not all the tests can be done if you’re pregnant already). I left the appointment feeling good. We had a plan. I was to call the second I either got a positive pregnancy test or started my period, as the timing of next steps was critical in both scenarios. In the meantime, I was given a prescription for a different kind of prenatal vitamin, another for extra folic acid, and I was instructed to take vitamins B6 and B12.

So on Thursday, after getting a positive home pregnancy test, I went in for my first blood draw. They were checking both my HCG and progesterone levels. HCG came back at 33, which is low, but I knew it would be low since I was only 10 days past ovulation at that point (i.e., 5 days before normal people who aren’t obsessed with peeing on tests so early would even know they were pregnant). The starting number isn’t important – but it’s supposed to double every 48 hours so the next draw would prove more critical. My progesterone was a little on the low side — 16.8, and they prefer it to be over 20. So they started me on progesterone supplements as well.

I had my second blood draw on Saturday (yesterday) and I’m happy to say my HCG was 91.4, so it’s more than doubled! I go back again on Monday for a third draw.

Also on Monday, I’ll be getting a comprehensive repeat loss panel done. I’m also going to be getting my first shot of Heparin. Even though my OB ran bloodwork for two of the most common blood clotting disorders, the RE wants to test for others, as a blood clotting disorder would both explain a later loss (a blood clot in the umbilical cord can be fatal to the baby), and could also explain why we escaped one healthy pregnancy unscathed (no blood clot during those 9 months = no problems). The RE said the tests can take 2-3 weeks to come back, and since those 2-3 weeks are some of the highest risk for miscarriage,  they’d rather put me on the Heparin injections now, and then take me off if all the bloodwork comes back clear. I’m not particularly looking forward to giving myself injections twice a day in the stomach, but if it means we get to take this baby home, I’ll do whatever it takes.

13 weeks pregnant — an unexpected loss.

Yesterday at 13 weeks, we went in for a routine checkup, and found out our baby was gone. The irony is that I think I was finally at the point where I was feeling confident. We had told most of our family and friends last week since we had reached the “magical” 12-week mark, and I had found the heartbeat via home doppler several times. I’m still processing everything and I’m kind of in shock. I mean, who loses a baby at 13 weeks for no apparent reason?

Our appointment started out very normal. It was our first meeting with our new OB (last appointment had been with the nurse practitioner), and she went over our history, talked about both our previous loss and our successful pregnancy, and talked about our plans for this pregnancy as far as any testing, delivery plans, etc. At the end of the appointment she pulled out the doppler to check for the heartbeat. When she didn’t find it right away, none of us were terribly worried at first. I know it can be tricky to find. But the longer she searched, the more concerned I started getting. She kept yapping away about something and I honestly have no idea what she was saying — I just kept listening for that unmistakable galloping sound. A few times I glanced over at D and I could see he was starting to worry too. Finally she said she was going to grab the ultrasound machine. I had this overwhelming feeling of dread, but kept trying to tell myself it would all be okay — and hey, on the plus side I’d get to see my baby again, right? We weren’t due for another ultrasound until 20 weeks, so I kept trying to convince myself this would be a nice surprise.

But as soon as I saw the baby on the screen, I knew. Just 4 weeks earlier at our 9-week ultrasound, baby was dancing around on the screen, waving its arms and legs. This time the baby was very still. And there was no flicker in the middle where we should have seen the heart beating. The doctor didn’t say anything for a few minutes, while she got different angles and measurements, but I knew it was over long before she said anything. She finally confirmed there was no heartbeat and that’s when I broke down. She pointed out that the baby was measuring right on track — 13 weeks and 1 day, so it had to have happened in the last couple days. I already knew this, since I had just found the heartbeat via home doppler three days prior. She kept talking, pointing out other things — like how the shape and position of the baby meant that the death was recent, yada, yada… I honestly wasn’t listening. I just wanted to run out of the building. My baby was gone. What else mattered?

As it turns out, losing a baby at 13 weeks is more complicated than losing a baby at 7 weeks. Whereas before I was given three options: wait to miscarry naturally, induce with medicine, or a surgical D&C, this time the doctor said our only safe option was a D&C, due to the size of the baby and the amount of bleeding that would come with losing a second trimester pregnancy. I really hate the idea of another D&C, especially after all the complications we experienced last time. But my doctor assured me my experience was rare. Then again, so is miscarrying in the second trimester, water breaking before labor starts and too much lipase in your breastmilk. I seem to end up on the wrong side of statistics a lot. Unfortunately, with the long holiday weekend, we can’t even talk to the scheduler until Monday. I was instructed to head to the ER if I start bleeding over the weekend.

So here we are, in a state of limbo. Still carrying my baby, and still feeling pregnant. Still looking pregnant too. Mostly all that fits me right now are maternity clothes, but they’re just too painful to wear when I know my baby is gone. So I spent most of the afternoon yesterday cleaning out my closet and packing all my maternity clothes away again (I had just unpacked everything last weekend and put most of my regular clothes in storage, so I got to spend a few hours swapping everything out once again). Everything I own either feels tight and uncomfortable or shows off my belly, which I can’t stand to look at right now.

It just sucks. Who loses a baby at 13 weeks? And why? The doctor had no explanation. She said it was most likely a chromosomal abnormality, but everything I’ve read online says most chromosomal abnormalities are more likely to cause first trimester miscarriages. Why did baby develop this long? The doctor will do some testing on me after my D&C and see if she can find anything like an autoimmune or blood clotting disorder, which can sometimes be the culprit of late miscarriages. She also said we have the option of having the baby tested for chromosomal abnormalities after the D&C, but that it’s expensive and  usually not covered by insurance. I’m not sure what we’ll do, but I’m leaning toward not doing it. What would it tell us, really? Either the baby had an abnormality and there’s nothing we can do to prevent that from happening again, or the baby was healthy and its death was just senseless.

It was really hard to have to break the news to everyone yesterday, but the support and love we’ve received has been overwhelming (in a good way). I guess that’s the silver lining to having told so many people. Interestingly, a lot of people have offered to watch Theo for us, but to be honest, he has proved to be a beacon of light in this dark time for us. His innocence, silliness and even his tantrums have been a reminder that life goes on, and he’s provided some much-needed distraction. Although he had just learned the concept that there was a baby in mommy’s tummy, and loved to pat my belly and say “baby” and then kiss it. He did that this morning and it was like a knife through the heart. I’m glad he’s young enough that he’ll probably forget soon enough. My 9 year-old niece, on the other hand, was excited about a new cousin and I can’t imagine the job my sister-in-law had trying to explain this to her.

I had been keeping weekly entries for this pregnancy in secret and I’ve debated whether I should publish them. I think I am going to. As hard as it is to look back on, it’s still an important part of our journey. So if you’re interested, you can scroll back as far as April 30 for my first update about this pregnancy.

12 weeks pregnant.

12 weeks – a big milestone and it still doesn’t really feel real. Our next appointment is on Thursday at 13 weeks. Normally this is when I’d be getting the NT scan, but like last time, we’ve opted out. On the one hand, I’d love to have the extra ultrasound and get another look at baby, but I don’t like that the testing only gives you your chance of chromosomal abnormalities and not an actual diagnosis. In other words, you could be told you have a 1 in 10,000 or a 1 in 40 chance of having a baby with Down Syndrome or one of the other trisomies. I feel like any odds they could give me, I’d just worry over. So like last time, we’re moving forward on the optimistic assumption that everything is okay. We’ll find out more at our anatomy scan on August 20, anyway. I guess I’d rather just live in ignorant bliss unless/until I’m given reason otherwise.

In other news, I’ve decided to tell work after our appointment this week. Originally I was going to wait until after I figured out what was happening with my job — I’m currently on a 1-year contract but a permanent role opened up on my team and my boss is encouraging me to apply — but I’ve heard the hiring process can sometimes take months. Hiding it for a few more weeks until I have an offer in-hand would be one thing, but there’s no way I can hide it for much longer. I already have to be careful about my wardrobe. Case in point? I thought this wrap dress was loose enough, and black is slimming, right? Then I caught a glimpse of myself in the mirror…

 

IMG_5946Yeah… :/

Baby: This week baby is the size of a plum, about 2.1 inches. Most critical systems are formed, and he/she is about to enter the growth and maturation stage. Baby now has reflexes and will move if you poke him/her. In fact, today I was wearing some pants that were a bit tight in the waist and I was sitting, which means they were digging in a bit, and I could have sworn I felt a bit of fluttering against the pressure of my waistband. I think it’s probably too early and it was just gas or something, but it really felt identical to baby flutters and it got me excited.

Mama: Other than feeling fat, I’m feeling pretty good. Still peeing multiple times per night, and my boobs have gotten sore over the last few days, but all things considered, I think I got lucky that the first trimester is almost over and I never really got morning sickness that bad this time. My biggest complaint these days is that my legs are so itchy!! I honestly have no idea whether that’s a pregnancy symptom, a thyroid symptom or completely unrelated, though.

Weight: Up 1.2 lbs this week for a total gain now of 3 lbs. I feel like I look more than 3 lbs. heavier, though.

Cravings: Nothing specific or consistent, but I’ve come to realize I’m just easily influenced in pregnancy. Like someone mentions something and I just HAVE to have it. Sometimes it’s ice cream. Sometimes it’s cheese. Sometimes it’s pickles. But it’s always urgent!

 

11 weeks pregnant.

Just days away from the 12 week milestone, and time definitely feels like it’s going more quickly this time. I think we’ve pretty much just started telling whomever at this point. I know 12 weeks is the “safe point,” but I doubt a few days makes a difference. Still won’t be telling work for a little while since there are a few things up in the air with my job, and not telling work means we won’t be doing a Facebook announcement anytime soon either. Really hate keeping secrets and it’s getting harder to hide physically. Which brings me to…

Mama is looking pregnant. I know most of it is still bloat and guts being displaced, but I definitely have a small bump on my lower abdomen. Still getting occasional waves of nausea, but nothing major. Looks like I may have lucked out this time around in that department. Boobs are a little more sore now and I’m still tired, but maybe not quite as tired as I was before.

Weight: Up 0.6 lbs. this week for a total weight gain now of 1.8 lbs.

Cravings: Nothing specific, though sweets of all kinds sound good.

Baby is the size of a lime this week. Or a strawberry, depending on what app/website you’re looking at. Or about 2 inches if you’re looking to get more specific. Toothbuds and genitals are on the agenda this week. Really looking forward to finding out what we’re having. Even though this pregnancy feels totally different, my gut still says another boy. But my gut was wrong last time, so who knows. Honestly, I’d be happy with either. I’d love to have the chance to experience being a girl mom, but boys are pretty awesome and I know Theo would love having a little brother. Honestly, the biggest downfall to having another boy will be picking another boy name. I felt like we exhausted every boy name last time. But if that’s the biggest of my worries, I’ll count myself pretty blessed.

10 weeks pregnant.

Double digits, crazy! Time definitely seems to be going by faster this time. It’s weird to think we’re only about a week and a half away from officially letting the cat out of the bag. Last time, I felt like that day couldn’t come soon enough. This time, I’m not feeling quite ready yet. Maybe it’s because so much is up in the air with work right now. Our department is re-orging and I’m not sure what that will mean for my job. So regardless of who we tell at 12 weeks, I may wait longer to tell work so I can see how things shake out here first.

Baby is the size of a prune this week, and has working arm joints. His/her cartilage and bones are forming, while vital organs are already fully developed and starting to function. New this week: baby is growing fingernails and hair!

Mama: Got some not-so-great news last week as a result of my blood draw the week before. Turns out my thyroid is low, which is common in pregnancy, and easily treatable, but does have potential serious repercussions if left untreated. So they started me on a low dose of synthyroid daily, and they’ll recheck my levels as the pregnancy progresses and up the dosage, if necessary. Other than that, I’m feeling some nausea but very little actual puking, fatigue, moodiness, the usual. I’ve also been ridiculously itchy for the last month – mostly my legs and at night. Also strange, was that yesterday and today I started having pain in my Achilles tendon, which has made it hard to walk. Fun stuff! I’m having such a hard time finding stuff to wear. I’m already wearing maternity pants or doing the rubber band trick with my regular pants.

Cravings: None at the moment.

Weight: Up 0.6 lbs this week for a total gain now of 1.6 lbs.

9 weeks pregnant.

We had our first prenatal appointment yesterday at exactly 9 weeks, and we got to see our baby again! This time, he/she looked much more like a baby… or at least like a gummy bear. He/she was wiggling arms and legs, and the heart was beating like crazy. It actually made me tear up, seeing the baby move – the first time I’ve actually gotten emotional this pregnancy. I think it’s finally starting to feel real, and now that we’ve had two scans and I’ve reached 9 weeks, I’m starting to think we may actually get to take this baby home. We’re still not in the clear for about 3 more weeks — and really, even then there are no guarantees — but like I said, it’s definitely feeling more real. D even said he’ll probably tell his mom, so I know he’s finally getting excited too.

IMG_5829

Baby: We have officially reached fetus status, as baby is no longer an embryo! Baby is about the size of a green olive (is it bad I’m craving green olives?), and is developing more distinct facial features this week.

Mama: Same old, same old. This pregnancy really is quite a bit easier than Theo’s, although I did almost throw up in the car this morning. I coughed and it triggered a gag reflex and I heaved a few times before I got it under control. Good thing I did, because I had nowhere to pull over and I was already on my way to work. Close one. But aside from one-off episodes like that (usually when brushing my teeth), I feel mostly fine with the occasional wave of ickiness that lasts an hour or so, then fades away again. Other than that I’m just super hungry all the time, and still pretty tired. Oh, and bloated. So bloated. I already look pregnant so I’ve had to plan my outfits carefully. I’m getting my first maternity Stitch Fix on the 15th and am hoping that helps me with my wardrobe options. I’ve been doing Stitch Fix for almost two years now and am super excited they’re now offering maternity!

Cravings: Green olives.

Weight: Minus 0.6 lbs. this week, bringing total weight gain to 1 lb. so far.