No Tumor

Ok, so today I'm normal. Or at least within the range of normal. Who knows. They have no real answer for why the bloodwork would be different two days in a row, they just say that's why they send me to another lab. (In my opinion, I should now be going to a third lab as a tiebreaker. But they're the ones with the medical degree, so their opinion wins!)

So we've been cleared to start our IUI, however, my body isn't cooperating. We are going to be gone for a week around Christmas and that's (approximately) the week that I'd need to be having my baseline bloodwork and ultrasound as well as starting my medication. So we'll wait out the Dec/Jan cycle, one last try on our own, and then we hand ourselves over to the doctors for fixing.

Bloodwork Results

Since there's a rule written somewhere that doctors are forbidden to call me with happy news, I got a somewhat disconcerting phone call today. They wanted to re-do my bloodwork since I'm a year older (and quickly approaching advanced maternal age at my ripe old age of 32 and almost a half!) and now some of it is wonky. The one that is bothering me the most is a marker that something could be up with my pituitary gland. My mom has a hundred and one issues with hers, but as far as we know they're secondary to her tumor removal. But what if they're not? What if I inherited some kind of "your pituitary gland hates you" gene? Honestly, when she mentioned that tiny (so tiny they don't always show up on scans) tumor in my head could be causing this, I lost my ever loving mind. But then, I remembered everything I have learned at Brain Tumor Day! You see, I have driven my mom to Pituitary Patient Education Day at Hopkins for the last 3 years. The presentations are usually similar (see: PowerPoint slide with xray of Homer Simpson & a tiny brain) but I know big words like micro-adenoma. If that's what it is, I take a pill and my hormones go back to normal. Who knew that the tumor option could be the best case scenario?

I have to go back tomorrow to a different lab to get the bloodwork drawn again. No stress, none at all, right? Sigh.

P.S. I don't want a brain tumor. Even if a pill fixes it.

Back to Shady Grove

Last year around this time, we started our Shady Grove journey. Since then, we have been successful on our own and suffered a loss. After my miscarriage, it took about 6 weeks for my body to get back on cycle. Then they told us to wait 3 cycles for my body to normalize. That put us in late summer before we were even back in the game. We decided not to run right back to the doctor since we were successful on our own, but decided that if November came around and we were still waiting, we were going back.

We're back.

Dr. K. gave us the same speech as last year. Pill IUI, injectable IUI, or IVF. Since my insurance covers 2 IUIs and they are less invasive, that's what we are starting with. I know that Clomid is taken by zillions of people, but it scares the bejeezus out of me. (FYI, bejeezus is recognized by my computer as a real world because it's not underlined in red. Amazing.) I have such a bad history with reactions to medicine. I don't want to fill myself up with all these medicines and then have it cause some kind of issue with me later on. I worry sometimes that all the medicines I took when I was younger and in search of pain free living are what got me here to start with, so adding more medicine to the mix, particularly one that messes with my reproductive system, is scary. But parents of people my age have taken it, so I guess if it was causing lots of diseases or cancers, they would have taken it off the market by now.

Last Day Before Work

I have to go back to work tomorrow.  Everyone keeps saying they wouldn't fault me if I stayed out one more day and went back next Monday, but it'll be good to go back with only 1 day before the weekend I think.  The bleeding was almost gone yesterday, but came back overnight with a vengeance.  It's slowing now, thankfully.  I'm going out to lunch with my MIL and SIL today, so it'll give me a reason to be up and about.  Yesterday I took Mike's car in for some work which also gave me a reason to leave the house.  Today I spent a lot of time getting the cat litter clean because he'd been scooping it while I was pregnant and it needed a hard core cleaning. (And he needs some lessons about how "doing the litter" doesn't only mean scooping and running.) :)

Yesterday was the hardest emotionally so far.  Maybe because the physical symptoms are lessening and so the emotional can come through? I'm sure my hormones have to bottom out at some point, too. 

I'd like it to be months from now.  Just skip right there...

My Stupid Body

Friday evening, I felt physically ok.  I was grateful that physically it was going to be not so bad.

Saturday morning when I woke up, the pain was unbearable.  It was a combination of the sensation of getting kicked in the groin and an intense version of the monthly pain I've been dealing with for so long.  Not really cramping, just pain.  I gave in and started taking the codeine.  I even had Mike wake me up when he went to bed in the middle of the night so that I wouldn't miss a dose.

Sunday, it was bad enough to make me catch my breath many times.  I had to take the pain pills regularly to even be ok enough to not make my eyes water.  I paged the on-call doc and he gave me permission to alternate between advil & codeine.  For most of the day, it was at least bearable, but later in the evening it turned into extreme cramps and the bleeding increased a lot.

This morning, I started passing lots of clots and there is more blood.  I have to have an ultrasound in a few hours to see if anything is wrong or if they missed anything...

Things That Will Be Hard

We have friends that are due a month before we were.  It was hard to see her posting on facebook this morning about ticking over to another week in her pregnancy.  I felt like I got punched in the stomach.  I wasn't expecting it to be that bad.

Procedure

I had the d&c procedure today.  We spent several hours at the hospital, most of it in the pre-op department.  They called me to come around 12:45pm but they didn't take me back until 3pm.  I think we left around 4:30.

The nurses with the exception of one were all very nice.  The anesthesiologist gave me zofran so that I wouldn't get sick, and didn't argue with me like some other anesthesiologist have done in the past.  Now that I'm getting to the point that I know the drill with being put to sleep, I know what to ask for.

The one nurse that was not my favorite had an odd reaction to something I felt.  Mike rubbed my arm when he said goodbye, forgetting that I had an IV (protected under tape, but still, I hate the way they feel when they are in, even with the tape holding them down) and I yelped and said STOP!  The nurse said "Really? It hurts that bad just being touched?" But not in a questioning tone of voice, more of a "seriously? wimp much?" tone of voice.  I just said not to worry, I have fibroamyalgia & am just the princess & the pea when it comes to touch sensation.  But I was annoyed that I had to explain myself because seriously.  You're wheeling me into a surgery to take out my dead baby.  Give me a freakin break, lady.

After I got out, I was pretty drunk & loopy.  I was much better than with my bladder test last year when I drunk dialed & slurred my way through conversations with my mom and best friend, but I was still having the same conversations over and over.  I didn't realize it until Mike & his mom outright laughed at me when I asked about my glasses again.

Mike's mom got us some pizza for dinner (Thank you, Zofran, for making food possible!) and then his friends came over to watch TV while I laid on the couch.  It was nice to have some distractions.  I'm glad his friend called and offered to come over, because we wouldn't have asked anyone to do it but it helped.

It's Gone

I went to the bathroom on my way out of work today, and I was bleeding.  I immediately called Mike & told him to meet me at the hospital.  Then I called the Dr while I drove.  They told me to go home, put my feet up, and call them with a bleeding update soon.

I was a complete bitch to the person on the phone at the Dr's.  I'm usually fine deferring to Dr's because they have a lot of knowledge.  But it was bad.  I didn't want to go home.

It worked, because I had an appointment 45 minutes later.  Mike met me there, we met the u/s tech, and had a scan.

The tech wasn't legally allowed to say anything to us.  However, she was silent and not speaking.  Then she started tearing up.  Then she turned on the color on the ultrasound machine.  Last time, just 2 weeks ago, when they turned on the color, the baby lit up like fireworks and we could see the heart beating with the color changes.  Today, there was no color so we knew.  I asked for a picture.  She said a couple times that she wasn't allowed to say anything, so I just said, "I am sure there are more fun parts of your job."  She replied, "This is certainly the hardest part" and handed us the tissues.  So I appreciate that while she wasn't allowed to officially read us the ultrasound, she didn't pretend we were dumb.

Then we went upstairs and the doctor told us the official news.  I had the option of waiting for days or weeks until my body takes care of it on its own, or I can have a d&c to take care of it.  I opted for the surgery so we can start moving on, at least physically.

As horrible as this is, I am thankful for the following:
-I had driven alone to work today because I was supposed to have class, so I was able to speed down 95 right to the hospital as soon as I knew I was bleeding 
-The nurse at the office dealing with my bitchiness and getting me an appointment right then.  My bleeding stopped, so if I had gone home I would have gotten false hope.
-The tech was kind to us
-The doctor that I like just happened to be the one working late, and just happens to be the one on the schedule for tomorrow's surgery

It's a Jellybean!

Doesn't look like much, but its heart is beating at 145.  Keep in mind, this is also on a super-zoom camera. :)

Can I just say, it's cruel & unusual punishment to make a pregnant woman drink a liter of water and then push an ultrasound wand on her tummy!!!! :)

First Appointment

We did get to ask some questions tonight, but it was 99% paperwork. The intake nurse was very confused by the fact that we had testing at Shady Grove but didn't get actual help from Shady Grove.  She was also very confused by the fact that I had some testing done at my appointment the day after my positive test.  Luckily the midwife was a little less confused.

We have a choice moving forward to do doctors or midwives, and we're doing doctors.  It seems like a better idea with my other "quirks." :)

I have an u/s scheduled for Thursday - yay!  Then another one in April for some health screenings.  And another appointment for the end of March

Questions for the First Appointment

I'm hoping to get some real advice & seperate fact from fiction at my appointment on Monday.  Here are some questions on the list, as compiled from message boards, books, and things that I really want to know.


Logistics Category:
Who will I see at my appointments?  Nurses? Doctors? Midwives?

How often will I have appointments?

What will happen at the appointments?  Which ones do husbands usually attend?

When will the ultrasounds happen?  How many will there be? 

Do I pay a copay at each appointment, or is there a big fee that will cover all of them?


Food & Drink Category:
I already don't drink alcohol & caffeine.  Is there anything else food/drink wise that I have to avoid?  Is it ok to eat lunch meat?  

Can I subsitute fruits for veggies in my diet?  I'm currently eating lots of fruit, several varieties a day, but I just can't get the veggies down.  I thought when I was an adult & then when I was pregnant that I'd just magically be able to do it, but I can't.

I am trying to increase the dairy, making sure I eat cheese, etc.  I can't eat yogurt b/c of migraines, and I'm trying my best with the milk.  Is calcium OJ or "kids" vitamin filled OJ an Ok choice??


Lifestyle Category:

Is it true that I can't take hot baths?  How warm can I go?  I've been off fibro meds for almost 3 years and it's the only way I've been able to stop the leg pain.

What medicines can I take for headaches? Colds? Sinus infections?

What exercise should I do or not do?  Is swimming ok? Water aerobics? Can I work with my trainer if she knows I'm pregnant? Zumba? Yoga? Pilates? Do you know of places that have prenatal yoga or pilates nearby?

How long into the pregnancy can I travel by car or plane?  

Can I change the litter?  My cat has never been outside.

Can I garden as the weather gets better?  I've heard no on the basis of neighborhood cats could be using the flower beds as a litter box.

Are there restrictions to how much I can lift and or bend over?  I move large piles of heavy books on a regular basis.  I imagine that as long as I feel ok I can keep doing what I'm doing.

First Appointment Confusion

I got my phone call today confirming my appointment on Monday.  I was surprised to hear them say "appointment with (girl's name)" rather than "Dr. Whoever."  A friend/carpool mate of mine used the same office for both of her kids, so I know a little about it.  I know there are 2 options - midwives or doctors.  She did the midwives both times for her prenatal care, and gave birth in the hospital both times, but with the first kid the delivery got hard and the doctors intervened.  Even though I'm pretty sure the midwives are practically the same thing as doctors here since they all share a practice, I'm planning on going the Doctor route.  I thought that since I saw a dr in general that I'd see her for this first appointment.  Guess I was wrong.  I don't recognize the name as one my friend as mentioned as a midwife though, so maybe it's one of the NP's or something like that. 

A definite downside to this practice is that it has a thousand people.  Even for my annual checkups and the abdominal pain I've been dealing with for the past year and a half, I often see different people.  That frustrates me a little, however, the benefit is that I can usually get in pretty quickly as long as I don't care who I see.  I do know from my friend that they like you to see everyone during your 9 months so that you're almost guaranteed to know the people who are on call when you actually have the kid. 

The Whole Family Knows Now

Mike got a hold of his brother today, and I told Sarah.  So now everyone that is family knows.  And it's for real.  Sarah wins the "loudest scream" award.  I worked it into a random comment in a conversation, so it took her a second. :) 

Two Down, One To Go

Last year on Valentine's Day, we got to tell people that we were finally buying a house.  This year we're telling them that we're having a kid.  Crazy.

My mom told my brother last night, which is fine by me.  Mike called his sister & brother, but only got his brother's voice mail so he'll wait til tomorrow.

So, now that people know, it's actually happening.  Like, the pea sized thing will turn into a watermelon sized thing & actually have to get out of my body.  And then we have to raise it.  This lovely abstract idea is getting more and more real.

Telling The Parents

We told our parents today.  We were going out to lunch with his parents for Valentine's Day, so we decided to go for it.  I called mine & then we told his at lunch.  He's pretty funny - he couldn't even wait til we sat down, he blurted it out right there in the foyer of Duclaw.  While everyone was happy and excited, his mom's first words were "You guys are going to be such good parents."  I couldn't have told you that's what we wanted people to say, but it was a good thing to hear. 

Now we have to tell the siblings........

And Another One...

Today, I found out a coworker is expecting as well.  She's super ahead of me - mid/late August at the beginning of the school year.  She waited til 12/13 weeks to tell the general school population, which is what I'm planning on doing.  I'm going to have to tell my principal & coordinator sooner than that but I will figure out dates later after I have my first or second appointment.

Symptoms So Far

So now that I've been aware for a week, here's what I'm feeling

• mild cramps
• SUPER thirsty
• Going to the bathroom all the time, which is probably a result of drinking so much water to quench my thirst
• noticeably low blood sugar if I go more than a few hours without at least a few bites of food
• small moments of nausea, but currently controlled by crackers or pretzels, mostly later in the evening

Not The Only One

My husband's friend announced tonight at our super bowl party that he & his wife are expecting a baby in September.  She's several weeks ahead of me, but I still don't think we will tell as early as they did...

SURPRISE!

Soooooooooo.........

Turns out that appointment tomorrow may be for something other than an endometriosis scope.

I had a positive pregnancy test today.  The last week or so I've noticed that my whole body just felt different - not good, not bad, just different.  Since today was 4 weeks since my last period I tested on a whim.  Color me shocked.

Spit Test Results

I got the results of the "spit test" today.  I am not a carrier for anything in the "top 16."  That means my hubby doesn't have to do the test.

Hey! I passed a medical test! ;)  Some of the things that are in the "top 16" test were pretty much 1 in a million anyway, due to my ethnicity, but it's a package deal.  The big one they wanted to check on was CF, due to the locations in Europe my ancestors lived.  Genetics is a crazy business.

Beta Thalassemia
Bloom Syndrome
Canavan Disease
CF
Familial Dysautonomia
Fanconi Anemia Type C
Gaucher Disease
Mucolipidosis IV
Niemann Pick Disease Type A
Sickle Cell
Spinal Muscular Atrophy
Tay Sachs

Hurry Up And Wait

I couldn't get an appt with the OBGYN until Jan 31!  That's forever away.  I want to get this show on the road.

Moving Forward

We were supposed to have a follow up visit tomorrow to discuss all the test results (Even though we know them) and the plan moving forward.  However, it snowed today.  So when I got up and saw that the regular roads were fine for driving (helps to back to a real road in this case!) I called and asked if anyone had made a snow cancellation that we could have.  Luckily, they did, and luckily, my husband was able to move his hours off to today as well so it all worked out.  It helps that the Towson office is really close to his job.

So, we fall into that category of "Unexplained."  Surprise!  Actually, that's not completely true.  Now that we have ruled out everything else, my mysterious pain comes back into the picture.  Dr. K gave us two path options, but recommended we take the path that gets me scoped for endometriosis.  Since this is what another doctor recommended almost a year ago, we are going to go that route.  The reason that this now comes back into play is that the endo dx could help me "earn" more treatment in the fertility area.  

He spent 30-40 minutes explaining the path in detail.  I was trying to keep my mind on the scientific side, and look at it medically - but it's so damn depressing.  This isn't how it is supposed to be.  You're supposed to realize you're late & pee on a stick - not have everything on a calendar and worry about sick days and substitutes and sub plans and scientists!  I did however, learn a lot today and as usual, generic internet reading gave me some misconceptions that have now been cleared up.

So here's the plan - presented in "Board Game" fashion with little to no scientific stuff:

Step 1 - Go directly to your regular OBGYN.  Have her scope you for endometriosis.  If your test is (-), advance one space to step 2pills.  If your test is (+), advance to step 4.

Step 2 
Take out your calendar. In your cycle, mark off days:
3 (baseline ultrasound - make sure you don't have any regular ole cysts, etc.)
5-9(take a Clomid pill to beef up your eggs)
12-14(ultrasounds and blood work- they make sure you have the right amount of eggs beefed up - too many could cause dangerous multiples, and so they stop you here.  If you have the right amount and the bloodwork doesn't show ovulation, then you get a shot to make it happen.) 
16 (IUI - because bedrooms no longer have a place in creating life)
26-28(blood work to see if the whole thing worked - 12% success rate - The "I Did this 4 Times" success rate is about 35%.  From the successful pregnancies, only 5% are twins and only 1% are triplets.) 

Bonus: Make up something health related to tell your carpool mate, attendance secretary, and principal, or finally fess up about what is going on.

Step 3 - FSH (Injection version of 2) - Same calendar as above, but you get to shoot yourself instead of taking a pill.
Plus: Higher success rate of 18%
Minus: Successful pregancy multiple rate: 15% twins, 4-5% triplets. (That is uncomfortably high, in my opinion.)

Step 4 - IVF
This one starts off the same as the others - but instead of doing the IUI, they go in and take the eggs out of you.  The multple rate is lower because they have a choice of how many eggs to fertilize instead of worrying about how many eggs get beefed up from medication.  When we went into this, the line that made me feel most comfortable in the original literature was that very few people need this step.  But now that I've heard everything - this step isn't THAT much scarier than the others.  In our state (MD) you do not qualify for IVF without hitting one of 4 qualifiers - tube problems (don't have them!), problems on the guy's side (don't have those!), endometriosis (seeing the point of step 1 here now?), or you've been trying for 2 years. (We're not there yet.) 

Many people do step 2 about 4 times - My insurance covers it twice.  So there's the financial decision that plays into this as well.  My insurance also covers IVF twice.  It makes me angry that money plays a role, but it is what it is.  It feels like gambling.  If you win - you really really win!  But if you lose, you really really lose, and you don't have the money to spend on alternative options to winding up with a child.  Makes me want to punch something, actually...

Edit: Did some $$ research by lurking on some message boards, turns out that the lab work and the testing and all that is covered, it's just the actual IUI procedure that wouldn't be covered after two times, and that's just a few hundred bucks.  That makes me breathe much easier!!

No More Holes!

The advantage of the HSG test today was that they G did not have to make any holes that my body doesn't normally have.  I was happy to find out the contrast didn't have to go through an IV because I still have a little bruising from my colonoscopy IV in December.  Woohoo!  They just used a thin tube and shot it in through a catheter.  I found the test interesting, because it had almost a video xray.  When I laid down, I saw hips on the screen - so I shook my hips to see if the screen's image would move.  They did - video xray!  Super awesome. :)  They injected the contrast (Did you know your uterine cavity is a triangle? I did not. It looked like a glowing arrowhead. Crazy!) and everything was where it belonged.  It was not completely pleasant - definitely some cramping, but only for a few seconds.  Not as bad as I thought it might be from reading about it ahead of time.  Apparently if there is a problem and the dye can't get through, then it can really hurt.  So I'm good.

Bonus good thing of the day - the parking garage attendant was backed up so he let a bunch of us leave without paying, just saying "Have a pleasant day!" as we pulled up to the window. 

Spitting For Science

As part of our initial meeting, Dr. K talked about genetic testing.  It isn't a requirement that we do it, but it is a requirement that they mention it.  They start with me, then if I test as a carrier for something, they test him.  It's amazing what they can learn from a vial of spit!  We decided it would be silly to not know, if it's that easy to find out...so today, my spit test came.  I had to spit into a test tube, screw on the top which made some kind of solution mix into the spit, shake it 5 times (not 6, not 4! :) and send it back to to the company.

We had an exciting scavenger hunt through the courthouse area in town - the website said there was a FedEx box at that address with a late pick up time, but it was really well hidden down an exterior corridor and around a corner.  If anyone saw me darting around courthouse square before, I'm sure they were greatly amused at me! 

Baseline Testing

Today was test number 1!  Simple ultrasound and a quick blood stick.  I did get to meet the lady who is our primary nurse, the financial counselor, and the PA who does a lot of the testing.  They were both friendly, but there wasn't a lot of time for chit chat because the place was hopping this morning.  I guess lots of these tests must or can be done in the early morning, because there were droves of women hanging out in the waiting room this morning.  I have 9 follicles on one side and 10 on the other which makes 19 - much bigger than the 10 that they want you to have as a minimum.  Therefore, so far there is nothing wrong.  That's a good thing. :)  However, nothing showed on the ultrasound that could be the cause of the pain - AND the simple wanding ultrasound hurt like a giant spike inside.  What could be causing this?!?!  I do like that I was able to go at 7am, because it means no time off from school.  Plus, my carpool mate couldn't ride with me today so I didn't have to inconvenience anyone.  

This afternoon they called with my blood work numbers - 
E2: 31 (Should be under 50)
FSH: 9.8 (Should be under 12)
PRL: 25.8 (Should be onder 25, but that little bit over is ok)

So everything is all good there too so far.