Monday, January 25, 2010

Smile, White, and Blue

What a day. Today was the much anticipated ultrasound. Originally we were supposed to find out the sex today but an over-zealous tech told me at 13 weeks. We did get confirmation- it's a boy!

I had the first appointment of the day, at 7am, to make it convenient for my husband. The ultrasound was very successful. They checked his whole body (kidneys, spine, heart, brain, diaphragm, fingers, toes) and all looked normal. He is 11oz now. Tell that to my stomach. We got one 3-D image and it looks like he is smiling.

After the screening, my husband left for work. He had his performance review that morning. I had to meet with a doctor because at my check up last week my blood pressure was high. I typically get white coat syndrome where you blood pressure gets high because you are nervous about the doctor. So I assumed that was my issue.

I do have to say, I worked myself up into a tizzy during the week with nightmares of having pre-eclampsia and delivering at 24 weeks. The nurse brings me back and I asked for a few minutes to calm myself down. She didn't honor my request and it showed, my BP was 140/100. They highest it has ever been. Last week it was 140/80 and that had been the record to date. She said she would leave and the doctor would take my BP when she came in to see me.

Well this made matters worse, the doc is the last person I wanted checking it. When the doctor comes in, I thought I had calmed myself down. I was sadly mistaken. It was still 140/100. I explained I get nervous and this has happened to me before and if I just relax for a bit it will come down. She said she couldn't chance it and couldn't let me go home, and I needed to check into the hospital for observation. I was somewhat incredulous at this point. She wasn't kidding. I said if I do need medicine will she just give it to me and she said no, it has to come from my internist, they don't deal with medicating for blood pressure. I am sure my blood pressure rose even more at that point.

So ten minutes later, I am moving my car from the street (a huge coup in downtown Chicago) to the hospital parking lot. It was about 8:30am. I didn't want to tell my husband yet what was going on because he was already worried about the review and I didn't want to add to it.

Around 9:15 I get in a room. It was an actual delivery room on the labor and delivery floor. It was very nice, but word of advice, bring your own pillows. The bed was pretty uncomfortable and the pillows had a plastic case under the pillow case. But the floors were hardwood, had a large bathroom, and a flat screen TV. The nurse was incredibly kind and after asking about 100 questions about symptoms, she said I think your issue is you were nervous, you don't have any other symptoms.

The numbers started trending down. Meanwhile they ran labs on me. I was then introduced to a third year med student. I have lots of doctor friends and have the utmost respect for my doctors, but between this one and the ones I had during my fibroid surgery, it is hard to believe they will ever turn into confident doctors. She seriously took the exact same medical history the nurse did but with less confidence. Had she just looked at the computer screen in my room, she would have seen all the answers.

About an hour into my stay my numbers were completely normal and by the time a doctor from my OB's practice came in to check meI was down to 115/55, which is quite good.

The doctor said it looked like I had a classic case of white coat syndrome, but I need to figure out how to get it in check or I am going to end up in the hospital every week. For now, they want me to come in weekly to check it. And bonus- she doesn't want me exercising all week! Doctor's orders.

So all in all, day started out great with the baby's smile but the white coat syndrome left me a little freaked out and blue.

Wednesday, January 20, 2010

Old Scars Run Deep

I get asked a lot if now that I am pregnant, do the miscarriages still sting. There isn't a simple answer to this question.

In some ways, the majority of pain, or really hypersensitivity has passed in relation to my own situation. I believe the baby I am carrying now is the baby I was meant to raise.

On the other hand, certain aspects of going through the ordeal has stayed, and it isn't always about me.

For instance, this past weekend we were at a party and I saw a woman there who we have seen socially for years. I have known, from both her and others that they are having a hell of a time getting and staying pregnant. She told me before I was even trying that they were having problems.

Well she already knew I was pregnant, but at the party, another couple announced their pregnancy. She was so nice to both of us and had a big smile. But I know that smile. You are happy for these other people, but just wish you could join the team. It reminded me of how I would try to explain to my husband why these situations were hard. He never really got it and assumed I was being jealous and not happy for my friends. It wasn't that at all. I said it was like you tried out for varsity football and made the team and all your friends were on the team. And one day the coach cuts you from the team, with no warning and no reason. But every time you see your old teammates, they are wearing their jerseys and talking about practice or the big game. You just feel left out and wronged because you deserve to be on the team. People who want to be pregnant just want to be on the team and have incessant conversations about which bottles are the best and the merits of a $700 stroller.

So back to the party, I just felt awful and found myself saying, it was a really long road to get here and if it could happen to me it could happen to anyone. I was kind of a blubbering mess which must have only made things more awkward. But it showed me that I have such a deep compassion for anyone going through this. I don't want anyone to feel how I felt.

Another area that sticks with me is a feeling that the bottom could always fall out from under me. I know pregnancy is scary for anyone, but I don't think it is the same for someone who has gone through a loss. I feel there is a huge majority of people that get pregnant and just assume they will carry a healthy baby to term. Of course they might get nervous before a big test, but it isn't the same. For me, I crave constant reassurance- like pregnancy symptoms, ultrasounds, hearing the heart beat. I still get nervous I will see blood when I go to the bathroom. I know that's not normal.

I have also found that I am still a bit petty about people that have been married for 7 seconds and fall pregnant. Unless you are of "advanced maternal age" I don't get it and it offends me on behalf of all of those trying to get pregnant for eons.

After I got out of the first trimester, I have felt much more at ease. The geneticist at my 12.5 week NT screening said at that point only 3% of pregnancies end in miscarriage. This was a comforting stat. And it improves every week.

Looking at all these fertility experiences in aggregate, I am okay with it all. Quickly, living for the egg on my Clear Blue Easy Fertility Monitor, waiting for the coveted Fertility Friend crosshairs, and making it to test day at the end of my TWW seems very far away. But I will never forget what it was like. I think while you are in the thick of fertility problems, you only partially believe it will happen for me. My friends and family would tell me all the time that it will happen. I just wish I could have truly believed it and I wish even more that people who read this will believe it for themselves.

Tuesday, January 19, 2010

Guest Post!!! Ectopic Pregnancy

A friend of mine recently went through an ordeal. After months and months of trying to get pregnant, she went to see a fertility doctor. Before any treatment, she discovered she was pregnant. It became obvious fairly quickly that something wasn't right. Finally, the doctors determined it was etopic. It took an agonizingly long time for the pregnancy to end. I asked her to share her story with my readers.

Six weeks ago I was diagnosed with an ectopic pregnancy. I wasn’t surprised; I knew something was wrong. The day before they were finally able to see something growing in my right fallopian tube on ultrasound I fainted getting out of bed. Luckily, I was being monitored at the time by my fertility doctor; two weeks earlier, what should have been a routine day-3 blood test revealed slightly elevated HCG levels. The ectopic diagnosis was the culmination of two weeks of uncertainty, frustration, and the strange, strange sensation that I might have—finally, after all this time—actually gotten pregnant.
It turns out I had gotten pregnant naturally during my previous cycle--the cycle before I was due to begin fertility treatments. It came as a surprise that my HCG level was elevated because I got (what I thought was) my period right on time that month. In fact, that day-3 blood test was meant to determine my baseline numbers so that I could begin clomid that week. It was weird, though--with each subsequent visit, my doctor and nurses played it close to the vest; basically, my Beta was going up normally, yet my numbers were on the very low-end of the accepted spectrum. I was in and out of his office early mornings throughout those two weeks getting blood tests and ultrasounds, and each afternoon when the nurse would call with my results it would be a flat “we still don’t know what’s going on…why don’t you come back in a couple of days and maybe we’ll have a better idea then…” Looking back on it now, I realize that no one—not even I—ever called it a pregnancy.
I suspect that they monitored me so closely because they saw this coming—my very low (less than 1) progesterone levels, my weak Beta, the lack of anything visible on ultrasound. I think I probably owe them my thanks for not getting my hopes up in the first place, and I know I owe them my health (and, though it’s surreal to think of it this way, my life), but at the time all I felt was resolve. I didn’t want the reality of what was happening to be kept from me; I could handle it, so I thought. Following my doctor’s confirmation that it was, in fact, ectopic, things began to happen very quickly. Though even after being rushed to the hospital for a shot of methotrexate, sitting on a pink leather recliner—typically used by chemo patients (for that’s what methotrexate is, after all)—and waiting for someone to explain exactly what was going to be put in my body, what it would do to me and the thing in my fallopian tube, what would happen if it didn’t work, and what exactly “work” meant, I was fine fine fine. I could handle it.
Until I couldn’t. It hit me the next night—I think that first 36 hours was part relief that I finally knew exactly what had been brewing in my body for the last two weeks and part shock—when I was lying in bed with my husband watching TV. What had my friend told me months ago while she was in the throes of her own fertility issues and I had just begun to try? She said “talk to it—it doesn’t matter how early it is, talk to it, let it know it’s real. Let yourself believe it’s real.” And I had. I had talked to it every day, sometimes more than once a day. I told it to hold on. At the time I, of course, had no idea that it was holding on—just in the wrong spot. And as I lay there, I wondered if maybe it was listening to me. It was a baby, after all, not just a medical condition. And it had been listening to me—to its mom—and now I had to let it know it was okay to let go.
I know, I know. Cue the violins. Sorry. I just read that back and it sounds ridiculous. But if I’m being honest about this whole thing, that was exactly went through my mind.
When I said above that I probably owe my fertility doctor (and his support staff) my life, it’s not a sentiment that registers with me because I never considered that any of this could ever truly endanger my existence. My sanity—yes. My ability to have a healthy baby in the timeframe I’d hoped—yes. Even my marriage—sadly, yes. But did I ever really think about how dangerous the ectopic pregnancy could have been had it gone unnoticed? No. I’m too consumed with myself to consider the fact that I’m still here. I’m too aware of my new reality—the one that having an ectopic pregnancy has propelled me into. I see this situation more as a social responsibility than a personal health issue. I’m more concerned with how my moods affect my husband than with how they’re eating me up inside; I’m constantly battling the amount of bitterness I allow to seep into the “check-in” phone calls from my mom. I’m making sure that my friends and colleagues know I’m “okay”…after all, I want to be the strong post- trauma girl, not the mess walking around the produce section of Dominick’s with tears streaming down my face as Taylor Swift sings “Fifteen” on my Ipod.
I can only hope that the more days that go by (and believe me, they’re going by really slowly), the more okay I feel. And, of course, there’s saying I’m okay and actually being okay. I’d like to think that I’m somewhere between the two. I certainly have my setbacks—I tend to avoid Facebook these days. I also find myself gravitating towards friends, and even friends-of-friends, who have had fertility issues. It’s like being in a sorority you never wanted to join; it’s just easier to relate to these girls right now, I guess.
Someone told me once that you get the baby you’re supposed to get. Of course, at times I take more solace in her other words of wisdom: there’s nothing wrong with irrationally hating someone that gets pregnant on the first try. At least for now. I won’t always hate, and I won’t always be the girl dealing with an ectopic pregnancy. We all have our own stories, and this is just the beginning of mine.

Friday, January 8, 2010

Moms Into Fitness First Trimester: DVD Review

I am very excited to share this review because I found a DVD series that I think is great. I think Moms Into Fitness Pregnancy First Trimester is a solid workout. It is the first in 4 part DVD collection.

The host is Lindsay Brin, who actually was part of a big study on prenatal exercise. If you watch the extra features on the DVD, you can hear her talk about the findings and recommendations.

What you need:
yoga mat/towel

hand weights (she uses 2 sets:5 pounds and 8 pounds; the person doing modified exercises uses 3 and 5 pound weights, I just just 5 pound weights for all exercise)

What you get:

The DVD features a 30-minute aerobic section and a separate 30-minute yoga practice

What it is like:

I am not sure if it is being pregnant (and I pray it is), but at times I felt winded and I know 3 months ago, it wouldn't have phased me too much. The aerobics remind me a lot of a step class without the step (grapevines, knee-repeaters). But she sprinkles in some long sets of muscle work. We are talking squats, lunges, triceps, biceps, shoulders and more. So you will do some aerobic exercises and then some muscle conditioning. She finishes with a core workout including plank poses, crunches, downward dog and of course, kegels (which I still haven't mastered out of the bathroom since I am worried I am going to mess up and have an accident. How's that for full disclosure?).

The yoga section is good. It isn't a cake walk but you do end feeling refreshed.

Why I like it:

First off, I like Lindsay. She isn't pregnant, but she does have 2 women who are in the advertised trimester, in this case, the first. She seems really friendly and informed. Second, I was treating myself with kid gloves before this video. I didn't think I could do plank, crunches, and some of these weight exercises. It makes me feel confident to knowing she was part of this study and is recommending these exercise.

The videos are trimester specific. So she is aware of different concerns/pregnancy symptoms. For instance, in the first trimester, you are more tired and fatigued, so she discusses that. She alludes to the fact that in the second trimester, she doesn't do any exercises that has you flat on your back.

I also feel like I have accomplished something when I do the Moms Into Fitness Pregnancy First Trimester workout. It certainly isn't the hardest workout I have ever done, but for pregnancy, I think it taxes me an appropriate amount. It moves quickly, when you are sick of aerobic, you move to weights and when you feel tired, you are moving back to aerobics.

I personally bought a 4-pack from Amazon which has one video for each of the three trimesters, plus a Moms into Fitness Bootcamp DVD for post-delivery. Here is the link if you are interested and I have also included the link to just the 1st trimester DVD.

Sunday, January 3, 2010

The NT Screening

Between your 11 and 13 weeks, many doctors send their expecting patients for an NT screening. Essentially, a geneticist estimates the chances your baby will have either Down's Syndrome or a Trisomy Disease (there are a few and if the baby makes it to term, it won't live long).

They assess your risk based on three factors: maternal age at time of delivery, measurement of fluid behind baby's neck, and blood work from the mom, but it measures something that the fetus makes, not the mom. So two factors are from baby and one is from mom.

Typically after this test is when people feel confident announcing their population to the greater world.

A week before my test, at 11.5 weeks, I went to the geneticist's office. My doctor doesn't perform this screening in her office. I had to give some blood. Oddly enough, at this highly private moment, I ran into someone I know. He had told me previously that his wife was expecitng their second, but I hadn't told him about my pregnancy.

Some people give blood the same day as the ultrasound, but I opted to go a week early because I would be able to get results the same day as the U/S, and by now we all know I am a worrier about such things and didn't want to wait even longer.

The following week I returned with my husband and my mom who was in town. The place was packed. They called us in for the ultrasound, which was an external for those wondering. It is so amazing to see the progress of the baby on this ultrasound at 12.5 to the one at 9 weeks. My mom was floored because they didn't have ultrasounds when she had my sister and I and the ones on tv don't do the experience justice. The baby was turning and kicking and waving its little arms.

I had been such a wreck that they would go in and the baby wouldn't still be alive. I know that seems crazy, but it happened to my cousin and clearly I don't have the best luck in this department.

The ultrasound tech refused to take a guess at the gender. I know it is early but I know people who found out at this point. She also wouldn't comment on the baby's neck fluid which is one of the three factors they were screening.

After the picture show, we went to the lobby until my husband and I were called in to meet with the geneticist. Our results were as good as we could have hoped for. Despite being 32 at the time of delivery my baby's genetic probably of having one of these diseases was as good as a twenty year old. Essentially they say for my age the odds of the baby of having Down's is, let's say, 1 in 550 but when you combine the neck measurement and the blood test, it is reduced to less than 1 in 10,000. Same for trisomy. We were later tested for SMA, a musclar disease which came back normal. My husband asked so many questions that my mom in the waiting room was in a near panic because she saw other couples quickly going in and out and we were in there forever.

All in all, it is a scary experience but so reassuring to have it behind you. It also made me feel better about starting a family at a later age. While it is true every baby will be different, at least I know that if I wait a couple of years for number 2, it isn't predetermined that the baby's risk of a disease is so much higher, my age is only one factor.

After this test, I felt so much more at ease. To be honest, I am 16 weeks now and those doubts I had before the test have gone away.

Happy New Year

Happy New Year! I wish everyone still trying a very prosperous year and those pregnant a very healthy pregnancy and only 10 minutes of hard labor.

It dawned on me that this new year felt so much lighter than last years and the only reason is because I am pregnant. This is kind of sad. As a pretty optimistic person in general, it is startling how this one factor outweighed all other great things in my life. I don't think it helps that my birthday is in January, so the world's new year is my new year too, and adding another candle never makes you feel better about TTC troubles.

So if you are in the fertility rut, as I was, try to think optimstically about the new year as the year I am going to get pregnant. By next new year, it is extremely likely that you will have a baby or will be delivering soon.