Monday, December 28, 2009
Saturday, December 26, 2009
Monday, December 14, 2009
Tuesday, December 1, 2009
Monday, November 23, 2009
Thursday, November 19, 2009
Thursday, November 12, 2009
Monday, October 26, 2009
Tuesday, October 20, 2009
Monday, October 12, 2009
Wednesday, October 7, 2009
Sunday, October 4, 2009
Wednesday, September 30, 2009
Wednesday, September 23, 2009
Monday, September 21, 2009
Friday, September 18, 2009
Tuesday, September 15, 2009
I can only assume that there is still a live baby inside of me, although this is mostly based on not thinking about it too much. At my last appointment, my OB cheerfully told me to come back in three weeks and I absolutely freaked out about waiting that long. Here I am, coming up on the weeks that led to the demise of my last pregnancy, and I couldn't imagine why she wouldn't want to monitor me more closely than before. My last ultrasound had been a week before this appointment, and I know that there are a lot of insurance regulations, blah blah blah, but I absolutely cannot wait a month between ultrasounds at this point.
She did agree to see me in two weeks instead of three, but I was hoping for week by week appointments, at least for a while. Maybe that's just not realistic, but I have begun to think about calling in with "pains" of some sort and see if I can get in earlier. The stress alone is bad enough that my insurance will have to pay for more acupuncture and chiropractic appointments if it won't approve extra ultrasounds. Grrr!
In other news, my daughter has started her new fancy private school. This is not the "school for geniuses" here in Los Angeles - that idea just seemed worse and worse the more we found out about it. Neither is it the "hyphenated exclusive prep" school here that was salivating over her test scores. The school we chose is more focused on developing the whole person than creating an academic superstar. Plus, it is close to our house as well as our philosophy. Which is part of our philosophy, actually, in that we didn't want our child on a bus for two hours a day. Part of me is just desperately hoping that I haven't made a giant mistake about this, but my gut feeling was that those other schools would have made us all miserable.
The work itself is just so different from what she's used to that the level of challenge is more about figuring out what the expectations are than just doing the assignments. The homework is posted online, along with the schedules for all of the extracurricular activities and any special events. She has to check rubrics for each assignment to make sure she isn't missing a crucial component. There are honors levels for most classes, and study halls with teachers who take smaller groups of kids and work past the assignments at advanced levels, so I do think she'll be fine as far as being challenged. Far better than last year. Plus, she has to figure out how to change for PE and still make it to science afterwards on the other side of the campus. I think that will be the real challenge, actually.
We're both still trying to figure out how to get to school an hour earlier than we used to. The good news for me is that I don't have to worry about making it to the office on time - now I can even stop at the farmer's market on my way to work. And I'm fine once I'm up and about - but getting out of bed so early is almost impossible. I miss coffee...
Friday, September 4, 2009
The nuchal fold is a translucent space in the tissues behind the neck, and if the area is expanded (larger) it can mean that fluid is accumulating in that space - not a good sign, since genetic anomalies can create that excess fluid. Checking for the presence of a nasal bone is also part of the screening. So, a thin neck fold and any kind of nose bone are the hoped-for findings. Which, luckily, is what we found today. And even though I know that it's not a definitive test, it is nice to see that things aren't suspect already.
Still, with my last pregnancy, the nuchal translucency scan was also fine. The first trimester blood screening was normal, growth was always right on target. It does weigh me down to think of how much can go wrong between now and birth, and as much as I want to be able to believe that these things are rare, that the odds are always in favor of "fine", it's hard to forget that I've been here before, not so long ago.
It's not that I'm all doom and gloom - I loved seeing the little somebody wiggle around, floating and bobbing like one of those giant balloons in a parade. It's amazing how human-ish the fuzzy combination of blobs and splotches can look. I'm so grateful for each reassurance: the placenta looks good, the organs look fine, we counted two arms with hands and two legs with feet. So, I am happy, but it's mixed with caution. I am relieved, but it's not complete. I suppose maybe I am pleased - a word that always seems more neutral than it ought to be, but I guess that helps it work here.
I think I am going to have to start "telling" - I'm too bellyish to be anything but pregnant, so it's mostly just obvious. Even a solid diet of pastries couldn't make anybody this particular shape, so the idea that I just got fat over the summer might not go over as well as I had planned. The traditional notion of waiting until the first trimester is over coincides with my girth fairly well - and if that means 13.3 weeks, then I will just have to carry strategically placed tote bags for another twelve days. I'll be like an inconveniently pregnant sitcom actress, always holding potted plants and shopping bags and giant manila folders over her midsection. Too bad it's about a million degrees here and I can't just wear an enormous poncho all the time!
Tuesday, September 1, 2009
Monday, August 24, 2009
Wednesday, August 12, 2009
Thursday, August 6, 2009
Friday, July 31, 2009
Things are still looking like they may actually work out. At 6w4d we saw an embryo measuring 6w5d, and a flicker of a heartbeat at 129 bpm. So far, so good. But it's a hollow kind of reassurance. I used to think that those of us who have gone through losses really had to get past the point of the loss before we could begin to relax and believe things might work out. But now I'm not sure even that will be enough for me - I can't imagine losing this feeling of "maybe" and "we'll see". My OB was so excited for me, hugging and kissing me and almost literally jumping up and down. It just seemed like too much, too soon.
The nurses offered me their pre-natal welcome package, which includes lots of samples of vitamins, a copy of WTEWYE, coupons for pregnancy yoga and massages and gift certificates to maternity stores. I got the same package last fall, so I still had most of the things in my big box of IVF leftovers. I just said thanks, I have everything I need. But I was shocked by how naive it seemed - not even 7 weeks and they are already assuming I'm going to need this stuff? Don't they of all people know that these things are not guaranteed?
I'm going to be out of the country for almost a month - my OB said I could come in the day after I get back, but the ultrasound lady suggested I wait just four more days and then we can do the nuchal translucency scan at the same time. So, okay - but my RE will be back by then, and you can bet I'm going to try to get in there for a scan as soon as my plane lands. I guess it's just going to be a tentative time for me, and I'll have to figure out how to be okay with that.
If anyone has a sister (cousin, friend-of-a-friend, etc.) who's an ultrasound tech in London, let me know!
Monday, July 27, 2009
At 6w0d, I feel tired. No nausea, no sore boobs. Maybe my boobs have been pregnant too many times (this is #7, including the probable early miscarriages before I knew enough to recognize that my period wasn't just oddly two weeks late). Maybe they've been plumped up and stretched out enough that it doesn't really matter any more? They seem a teensy bit firmer, but alas, not really anything more in terms of cleavage.
I think my daughter suspects. She hasn't said anything outright, and I'm not going to bring it up, but she has remarked, at separate times, that I'm not drinking coffee, that my clothes are all really floppy, that I'm going to a lot of acupuncture and doctors appointments. It was only five months ago that I was fully pregnant, that all those things were completely well-known to be related to that, and that she was asking a million questions about everything.
When we were in Yosemite in December and had to run from the bear (I know you're not supposed to run from a bear, but it's impossible not to) I had grabbed her hand and pulled her through the woods. Afterwards, she said it was fun and I told her that I wasn't supposed to run so fast, so haphazardly, because of the baby. (Yes, I've wondered if that could have been a factor in the demise - I wonder about everything.) And today when we were taking a walk in the hills, she started running down a grassy slope and calling for me to come after her. I told her that I can't run right now. She turned and looked me in the eye and said "Like that time with the bear?"
The problem with high-IQ kids is, well, they can figure things out for themselves. If it weren't summer, if my husband weren't out of town, if her camp hadn't ended last week, then maybe she wouldn't have noticed? But now, after only a few weeks, I know she knows. There is some unspoken agreement that we aren't really saying it out loud, but I think she's just waiting for me to say something first. I've been weighing the options - being openly truthful, ignoring the topic completely, waiting for her to bring it up - but I have no idea what to do. I know she probably just wants reassurance - I do too! - but I'm not sure I can give her much at this point. What would you do?
Friday, July 24, 2009
All I could think of was that if there were two I would have had a back-up. It is just such a measure of how much loss and failure and disappointment come into play with infertility treatments that I couldn't even muster up some genuine enthusiasm for what is actually normal. And the crazy thing is, I quite emphatically don't want twins. I can understand why it's so appealing after IVF - two for the price of one! - to get even more of what you were hoping for. But the possibility of added complications, especially at my "advanced" age, seriously frightens me.
Anyway, even though I never wanted two take-home babies, I did like the idea of a spare in there, just in case. Which is horrible, because it assumes that the odds are so bad that one by itself doesn't have much of a chance, that something drastic will happen. And I know (really, I do) that it's enough that there is one, that it seems to be doing well so far, that hoping for a back-up is ridiculous when there is still every reason to just go ahead and hope for one that's successful. As long as I'm just hoping, might as well hope for what I really want, right?
If I weren't so nervewracked by by infertility I would be amazed that I have seen my child at such an early stage. I wish I could blithely assume that this is my baby, that in March I'll get to meet this little whitish circle. Shouldn't it feel incredible to be able to watch these earliest moments of your own child's life, to see and know and verify such a teeny tiny existence?
Instead, I'm bracing myself for the next scan, hoping for a good heartbeat and the idea that this one might actually make it.
Monday, July 20, 2009
She reviewed my protein-S deficiencly results and thought we should retest and look at uterine blood-flow doppler before assuming that I need to switch to lovenox. My hematologist has me on low-dose aspirin until 9 weeks, then lovenox and monitoring. I know that he feels it's better to be on the lovenox just in case, and at this point I am leaning that way, too. So, I have a few weeks to think about it, and maybe the next round of bloodwork will reveal something new, but in general I am willing to err on the side of "don't #2@*% this up."
Other than that, I have nothing. I have no symptoms, no hunches, no news - just me waiting for that first ultrasound. The one good thing I found out from the MFM is that I can still go on my August trip, so at least I don't have to cancel our vacation. I do have to wear compression stockings on the plane, but I should probably do that anyway for my spider veins.
I have been tired, but I don't even have the sore progesterone boobs that I usually get regardless of the outcome of a cycle. I have no nausea, no headaches, no vivid dreams. No overwhelming sensitivity to smell, no cravings. My bras still fit, my pants aren't too tight. Although, to be honest, I'm only wearing the "IVF pants" now - regular pants have been at the far end of the closet rod for a loooooong time.
My OB wants to see me on Friday, but I think that will still be too early for any kind of scan. Done with betas and not ready for ultrasounds. Early limbo.
Thursday, July 16, 2009
So, who knows? But for now, things are good and I suddenly have a slew of appointments with a new MFM, my hematologist, my acupuncturist and - of course - a mani/pedi just to celebrate!
Believe me, I of all people KNOW that this is just the beginning. I'm not telling anyone but my husband (and you!) for a good long while. But it's something, and for now I'm so grateful.
Tuesday, July 14, 2009
And now, this email from her:
I’m not really supposed to give you the final call until we see your second beta level….which is why I’m emailing and not calling (things echo in here so much….).
I was excited for you though…your first beta is 329. So far, so good! Continue your medications and I will call you on Thursday to let you know how things are looking.
Congratulations and I’m sorry about being impersonal with the email!
Sweet, right? Waiting until Thursday would have been torture.
In any case, 329. Which is high, even taking into account the fact that I tested a day late since I was out of town. Not that I'm questioning my decision to transfer three embryos - yet, anyway. There are so many hurdles between now and the possibility of then that I'm not even going to think about any of it yet. First things first - or, in this case, second things (next beta) first.
Thanks for all of your lovely comments, too - it meant so, so much to me. Of course, after my laptop died my dad had offered the use of his computer, but I was too nervous to use it while everyone was around. I would wait until they were all asleep and sneak back into the family room to check my reader. It was so wonderful to feel cheered on and congratulated in the wee small hours!
Saturday, July 11, 2009
Monday, July 6, 2009
I'm also not sure how I feel about it - two lesser-quality embryos sitting there, waiting. If this cycle doesn't work, I would prefer to do another (pre-paid) fresh one than rely on two slow-poke leftovers. I'll have to go back and read my plan to see if I am required to use the frozens first. If so, I am screwed out of another fresh cycle, since my plan runs out in September.
But, at the same time, in researching CGH I learned all too well that the best-looking embryos are not always the normal ones. In fact, it seems more often than not that the normals are the medium=good ones. Of course, there are a million reasons that this is not statistically reliable outside of that particular testing. For one thing, many people who choose CGH already have a history of abnormalities.
I would have loved to know for sure that I had a genetically normal embryo. And if I go through this again, I may opt for the testing after all. But there seems to be a lot of stress attached to the process, in terms of the additional wait, the high instance of "no result" reports, surviving the thaw, worrying about mosaicism. We decided to just cross our fingers and hope for the best - not very scientific, but since I still have to worry about whatever it is that happened in my last second trimester, we figured we'd save the money for all the fancy specialists that our insurance won't completely cover.
For now I know that if I DO get pregnant, I am going to do amnio as soon as possible. Once upon a time I was so low-intervention that I didn't even take tylenol unless something drastic happened. Now, just get me as much information as possible. If things go awry, I want answers.
In the meanwhile, I'll be traveling at the end of the week, so I'll have to bring my pee-sticks with me. Do you think anyone has ever POAS in one of those little airplane bathrooms?
Saturday, July 4, 2009
100% of my embryos made it to day 5. When the doctor came in to talk about how many to put back he was so excited for the good quality that I actually felt a little zip of hope run through my veins. I asked him if he could surgically remove it, but he seemed to think it was a good thing.
We put back the 3 best ones. The whole time we were deliberating on the number to transfer, I was thinking of Sky and Wombded, the opposite ends of the transfer spectrum. Both made really well-considered choices about the number to transfer for their own circumstances, and I am just hoping that it works out as well for me. It's always scary to think about having a pile of babies, but it's also a matter of being realistic about the chances of even getting pregnant. The doctor and I talked a lot about success rates, twins, and SR. With three embryos, my chances of triplets are about 1.5% and my chances of just one are only about 30%.
Still, the fact is, embryo quality has a lot to do with success. Many clinics use an embryo-rating system of an overall number grade followed by two letters. The number describes the outer shell, cavitation and expansion. The letters describe the inner cell mass (the baby) and the outer cells (the placenta). Which makes it easy to see why a "A" baby cells and "D" placenta cells would be bad.
Of course, my clinic has their own special system which involves an overall number rating (1-6) and a 1-100 score that includes inner and outer cells, some kind of enzyme released into the culture medium and a lot of visual assessments by the embryologist. Anything under 70 doesn't really have a chance. We looked at the low-res images of the embryos and they showed me the blob of inner cells and the rings of outer cells. These weren't nice clear pictures like the ones from IVF websites - they were sort of like security-video images.
Anyway, we put back an 87, a 95 and - believe it or not, from these old-lady ovaries - a 100. Now, how am I supposed to keep from thinking this has a chance?
Hope - 0 to 100, just like that.
Thursday, July 2, 2009
In any case, I have been waiting all morning to find out the status of my six "beautifully fertilized" embryos. I know it's usually a numbers game, so I've been trying to calculate my odds of being mildly surprised or at least reasonably resigned to whatever news the lab has for me. I am still strangely removed from the process - I am very curious about the information in a science-project kind of way, but even when I try I cannot bring myself to be hopeful. Experimentally, I wondered how I would feel if it turned out that all six embryos were doing well and things looked great. But it's so hard to make yourself have a meaningful reaction to a theoretical possibility.
But then, I got this email:
You have some beautiful embryos! Even the embryologist says so. All 6 are still growing strong. We’ll see how they look on the day of your transfer and the doctor will discuss it with you then.
See you Saturday!
So, do you think I might break down soon and start to think, just maybe, there's a chance?
Tuesday, June 30, 2009
Not sure what that means, but the other 6 fertilized "beautifully", so I'm trying to just be glad that something in there seems to be working. I'll know more Thursday morning - in the meantime, I am still in the "whatever" mindset, so none of this is either getting my hopes up or bringing me down. I'm not even trying to be all zen about it, I just don't have that level of excitement that I used to think was so unavoidable.
I used to take each step as a cleared hurdle - yay, retrieval! yay, fertilization! etc. - but now I know that it's not about making it through each minor part of the process. Anything can happen, and all of those milestones don't really mean as much to me anymore. There are a million light years between where I am now and a sibling for my daughter, and I know that every journey starts with a single step, blah blah blah. But for now I'm looking at the big picture, not "futurizing" (as my daughter's ed. psych. says) and just focussing on the fact that I will be able to know in my heart that I did everything I could, that one way or the other I will be at peace with all of this.
Sunday, June 28, 2009
All of which meant that I had to hire a chauffeur to drive me to my retrieval this morning. Yep, I went in style, a big black town-car and a hunky wanna-be at the wheel. Considering how tender things can be "down there" after the procedure, I'm actually glad I wasn't going home in my husband's little gas-miser. There is something to be said for a giant leather back seat, after all.
I won't know much until tomorrow, of course. Of the thirteen, ten seemed mature. Because my husband couldn't be there they will have to use his frozen "specimen", which we have never done before. I've heard that it can actually be better in some cases since the thawing and washing process winnows out the bad ones - but "fresh is best" is the usual recommendation, so I am a little nervous about it. My clinic ICSIs everything, so as long as there are a few good ones in there somewhere it should be okay, but adding one more thing to the list of "what-if"s isn't ideal.
My doctor said something funny just as I was going into the OR. The embryologist grasps the sperm by the tail, which immobilizes it so it can be manipulated. I had a sudden image of some kind of Harry Potter scene, of embryologist-wizard students learning these secrets. Maybe it was the fentanyl, but there is a kind of strange-magic quality to the whole process.
In any case, thanks for the book recommendations. I managed to borrow almost all of them from friends, but I was so out of it for most of the day that I just watched Mad Men and dozed. If all goes well, transfer will be on Saturday - which is perfect for a long weekend of books, with my husband around to fetch me whatever I call for (until Monday, anyway).
Fert report tomorrow morning.
Thursday, June 25, 2009
I'm still relatively noncommittal about the whole thing. Follicles? Great. Retrieval? Sure. If I get to the point where I need a perinatologist, I'll start to think we may be onto something. Until then? Okay, fine, whatever.
As for bed-rest, my tivo is full of late-night shenannigans, Chelsea Lately and Craig Ferguson. I love that Craig - he's wry and sweet at the same time, which turns out to be charming. And Chelsea is lewd and smart, also a good combo. So, I hope they can amuse me for a few days. I have more or less given up on regular TV - it's not that I don't like anything, but I can't commit to keeping up with a plot line of any kind.
My emergency TV is My So-Called Life. I bought the whole thing on DVD a few years ago, but I never watched it. Somehow, I thought it would be best to save it in case I ever really needed to be distracted. I watched the first three discs earlier this year, after the baby died. It seems silly to rely on TV to help you through a crisis, but I have to say the time-wasting was just what I needed.
Other than that, I need to get a good book. A really good book. I loved The Time Traveler's Wife and there are rumors that the author has another book coming out soon - but not soon enough for any upcoming bed rest. So - any suggestions?
Wednesday, June 24, 2009
Thursday, June 18, 2009
But I'm beyond hope this time. It used to be that I was just too nervous to admit that I was hoping much, even secretly. It wasn't so much the genuine disappointment of a failed cycle that I was trying to protect myself from. I wanted to be able to be objective so that failure wouldn't feel personal. I wanted to be able to shrug off a bad cycle so I could gather myself together for the next one. I was trying to be strong and realistic and determined without letting myself care too much - but it doesn't matter how much you tell yourself that you won't hope if deep in your heart you know you're wishing as hard as you can.
I've been stuck for so long in the in-between phase, knowing that hope isn't going to help me but unable to keep it completely at bay. Hope, wish, want. How could I completely separate the process from the goal? Impossible, really - the goal is the only reason for the process. But this time, the goal has changed for me. I just don't want to leave this unfinished. I'm not expecting anything but closure.
And I can write all of that here and know that it makes sense - but you can bet that if I said it to most people the first thing I'd hear would be "It'll probably happen now that you've just relaxed and stopped worrying so much!"