How I'm faring..

I truly have the most amazing family. My mom is coming here on the 31st, and she will stay till the 12th. I leave the country just a few days after that, my ticket is booked.  I didn't go anywhere yesterday. Not to work, not to the birthday celebration of a friend, not to Philly to be with the friend who came down for the ultrasound (she really wanted me to be around people). Instead, I stayed home, holed up, read books, watched endless episodes of White Collar.  I did not even cry once, nor was I particularly sad. I was just  numb-- anybody familiar with that feeling where all of life comes at you in slow motion, like you are underwater? Today has been more of the same, though there was a bit of  a crying jag in the morning.  I am going to make myself to go out later, wear pretty clothes instead of ratty pajamas and hang out with actual people. I'm also in limbo.  I'm waiting to be rid of the physical presence of this pregnancy, and I'm eager to get karyotyping reports and the bloodwork, and then I just want to move on. Enjoy the silly, stupid things that make life colorful and fun.

I'm really looking forward to India. I'm looking forward to vegging out with family, I'm looking forward to not working,  I'm looking forward to getting seriously cute (and hot) outfits for my brothers wedding. Looking/feeling cute while you are knocked up is really not an option (since people would have looked at the unwed, visibly pregnant sister of the groom like they would a whore at church), and while I'd MUCH rather have been pregnant and scandalizing all and sundry and being the ultimate social rebel (I was planning to be open about the SMC route), I'm going to bloody enjoy the alternative since its been force-fed to me.

In my post titled 'Why does Miscarriage hurt so much' I'd expressed the desire to be more matter of fact and less attached during any particular pregnancy, so, if I had to go the distance and do this many, many times to have one healthy child, I would have the emotional where-withdrawal  be able to do so. I wanted a miscarriage "to be a stumble instead of a giant fall". The ghost of a silver lining is, I think my psyche has managed it. My first pregnancy loss hurt like crazy, the sheer unexpectedness of it knocked me for a six. I thought my second loss would finish me off, but surprisingly, the recovery was faster, which I attributed to being around family. This time, I'm actually recovering faster than even the second time--I'm getting desensitized to early pregnancy loss, for whatever that is worth.

The only things that are really bothering me:
a) The minor one: Feeling like such a screw-up. Other people have babies so easily and I've failed time and again. Its what has kept me from telling many people who I care about, but who manage to reproduce easily. I'm both proud and competitive. These are utterly pointless, foolish qualities, that keep one from truly evolving as a human being, and are utterly ridiculous applied to the area of biology, where none of us have any control about how we turn out and what issues we face. In this regard, what I'm going through may actually end up teaching me a valuable lesson, which might leave me a better person. That lesson is most definitely still a work-in-progress though- Being sad is fine, but I'm also pissed off and mainly, embarrassed that I keep screwing this up. Ugh. Stupid me.
b) The major one: I'm so, so very scared about what I might have to do, and how far and how difficult this road might be. I don't know what I'd do, if I could not have a child. I honestly just can't imagine it.

But for now-emotionally, I'm truly ok. Physically, I've started cramping a little though, no spotting yet. My mom is coming in Tuesday morning, I hope I can hang on and manage not to start miscarrying till that point.

Over

The 3rd time, is not the charm apparently. The baby measured 6w5d, with no heartbeat. I am so very thankful my friend from Philly was there, she literally held my hand through that and the staff of OB clinic was very kind. They immediately whisked me off for the full RPL panel, an eye popping 22 tubes.

I'm too chicken for a natural miscarriage, and it also makes it harder to collect the fetal material for karyotyping. So a D&C will be scheduled at the earliest, latest by next Thursday. I don;t want to wait too long, just in case they cannot make the fetal cells grow. Its imperative that I get that karyotype done. I really want a chromosomally abnormal verdict, the alternative points to a much harder to deal with scenario. 

Somebody called me resilient, and I most definitely am that. I will get through this, and I'm pretty determined to not let it bury me under a shadow for too long. I really, really want my mother, especially for the day of the D&C though, and for after. As I told my friend- its better to have people around you, but they have to be the right people, only the ones you love and trust to that degree, who you can allow to see you break down, temporarily. And my mother heads up that short list. But she is in India, she has a medical practice that she just can't abandon. We'll see, I'm really dreading telling them tonight.

And of course- what is going on as a refrain in my head- WTF is wrong with me? Why does this keep happening? And..the hardest one to face- can it EVER be fixed?

I'm don't have the problem of declining egg quality and I thought my *maybe* PCOS was tackled, or so I believed. Very boggy, scary ground indeed, but in a while, everything may be hopefully clearer than it is now.

95%

I'm sure some of you reading are wondering why I freak out when there seems to be no cause to freak out- my pregnancy so far looks pretty routine, with everything checking out, even the little lag in growth seems like no cause for alarm at this point.

I've seen my way through 2 textbook 'perfect' pregnancies so far. Great HCG rises, great progesterone. They say, after you see a heartbeat, your chances of success are 95 %. I had perfect ultrasounds at the 6-7 week point for both pregnancies, with strong heartbeats in both.   In the first pregnancy, by the end of the 7th week the baby was almost 6 days behind, and that was a red flag, but nobody was concerned, because hey, the bad stuff happens to other people. My second pregnancy was perfect almost to the end of the 9th week. With a predicted 95 % chance for sucess in both cases,  I miscarried twice.

I'm just trying to explain why I cannot relax, or trust the excellent odds I've been given. Augusta bought up a terrific point, that we just keep expecting the past to repeat itself, its human nature. But I also remind myself that each pregnancy is like a snowflake- truely unique. The problems that ended the first pregnancy were nothing like what ended my second pregnancy, and if I can be reasonably certain of anything, it is that this pregnancy is likely to be nothing like my first two. That is not any sort of guarentee that it will continue, only that it is likely different.

About how I'm feeling- OMG, do I have a baby bump now. There is no weight or mass gain, its just that internally, everything is redistributed and my belly is significantly distended. It probably is more apparent because I am super petite.  I think that old wives tale is true- you do show faster in subsequent pregnancies. Overall, I've lost a couple of pounds- I'm not even eating that much, just having small things throughout the day. I've also been feeling vaguely ill the past couple of days, its *almost* a queasy feeling, further limiting quantity of food consumed. I've also been feeling twingy & crampy in the uterus region today, which is new for this pregnancy.

Mildly twingy & crampy is ok, but around the time that my second pregnancy ended (on the day the heartbeat stopped), I had seriously strong, painful cramps that night. I was out with friends, we were playing boardgames, I remember this rush of adrenalin around the time the cramps began, my heart was almost trying to beat its way out of my chest, I was so very unsettled and did not know why. The timing of that with the stoppage of the heartbeat was an interesting coincidence, sometimes, you have to wonder whether your body registers it at a subconscious level. For now, there is none of that. Just mild twinges. Yay. One day at a time.

I wrote this post for one reason--Lots of new pregnancies everywhere, I see the excitement caused by good news at the early ultrasounds, the optimism, the hope. And that is what the people who come reading are comfortable with, I don't think most people know how to react to the darker, more pessimistic tone of the posts I'm putting out-- its like- why is she so afraid?  I hope this one goes towards explaining that.

But with the fear, intermingled in that, is beautiful, amazing hope. Right now she is kept tethered to my subconscious, with my conscious taking up a wait-and-see approach, but she is still there.

Ramblings from pregnancy brain

I've now entered that zone where time moves like molasses, and I'm far too preoccupied with the million dollar question: What is the Fate of this Pregnancy?

Although some my earlier posts sounded alarmist, for the most time, I was actually able to not obsess on this subject and life was fairly comfortable.But each ultrasound produces such upheaval.  Its literally like waiting for the Sword of Damocles to drop.

For the first 24 hours after the last one, it was awful, I could barely think of anything else. That night, I went out to a Broadway play (Newsies---review, its decent, not fabulous). This question was running in the background all the bloody way. I've done so many google queries on delayed growth, I'm now sick of the subject. The verdict is (drumroll please) it can go either way. DOH. Thank all of you who chimed in with stories. They really, really helped. I absolutely know that this can end well, its just that I also remain painfully aware of the alternate scenario.  But anyway, as predicted, I've calmed down now and am just going with the flow. Still time is moving by a bit too slowly. Should have a post on possible distractions.


This pregnancy remains completely abstract to me. I cannot possibly bring myself even to put up the pregnancy countdown widget, and find out what is developing in my baby at this very minute. I dug up some photos of how an embryo is supposed to look at this point, and compared it to my 2nd ultrasound pic, which is sharply defined, and its slightly reassuring when I play the utterly pointless game of comparing it to pregnancy #1, which was chromosomal normal, but with rapidly slowing growth between week 6-8 and looked entirely formless at both ultrasounds (yes, I am nuts and this is entirely illogical and ultrasounds are effected by the angle implanted, yada yada, but whatever makes me sleep better at night, right?). Is'nt it also amazing how different each pregnancy looks? I have not found 2 ultrasounds on the internet that look the same,even at the very same point.

I occasionally talk to my uterus, doing my best to let this baby know how much I love him/her and how I'd give anything for him/her to be ok, and how there is a world of people waiting to take care of him or her, but  that is it. I am utterly unable to process the likely miraculous potential of what is happening in me at all. I guess its an innate defense mechanism.

There is a part of me that is sadly envious of anybody who can get excited about a beating heart. I never even got excited and squealy like most people get on seeing that heartbeat, it was more been more like, been here, seen that, what is the next part?? It is painful (and sad) to lose that joy, to instead obsess about this process from the perspective of how many bloody millimeters the fetal pole has grown, and where you will be 2 weeks later.  I hope that this with this round, I get the privilege of reclaiming that simple wonder somewhere along the way. I think it can come back partly with new milestones crossed, lets see if I get to cross any of them.

This pregnancy is different in another way, this time, I have a friend with me always. Next week, the person who has been coming with me (love ya, V) is out of town. Another friend (instrumental in shoring up my sanity through this process) is traveling from Philadelphia for the day, just to be there for me. Words fail me as to how amazing that gesture and this person is. I hope we get good news, for her sake as well as mine. People other than me are going to be genuinely hurt if this one does not work out. I don't even want to think about how this might hurt my family.

Anyway, if I don't post again (like I can hold out that long), the ultrasound will be next Thursday, when I'll be 8 weeks and 2 days along. I'm not going to my RE (since he can see me only in the mornings), but I found an OB, which works better for my friend who will get here by afternoon. This practice sounds fancy, I'm excited!

On a side note: I had people email me that they were having issues commenting to discus- If you have problems, could you let me know?  If its a widespread problem, I'll have to look into deleting it. 

6w6d U/S

Well, the good news is the baby has clearly grown, and is still alive. Heartbeat was 110. Just on seeing it on the screen, I felt better. The part where everything in  me just sank was when the RE did a CRL- the fetal pole measured 6w2d. I'm 6w6d today, or rather, I'm at the start of the 6th day of the 6th week, since this was around 9:30 am. By that token, it is measuring at least 3 days behind, if not 4.  If I compare this to my 2nd pregnancy, by 6w6d, my baby was measuring 6w5d and the heartbeat was 130.  So its looking crappier than the last time, which looked almost perfect at this point.

Current pregnancy 6w2d,
 apparently measuring 6w1d(really?) by CRL

The good news is  that it visually appears like there has been growth. Its highly likely that the first measurement (of 6w1d at 6w2d) was rubbish given we could barely see anything. In the second ultrasound, the embryo looks a little curved to the right of the yolk sac (do you see it?) and I wonder if that could mess up the CRL too. Impossible to say, but please, throw in your inputs.

 Current pregnancy, 6w6d, 
apparently measuring 6w2d by CRL

I did some googling for delayed growth at similar timepoints. The results are very mixed- I found  a couple of instances where miscarriage occurred within a few weeks, and quite a few instances where things turned out to be just fine. Its really impossible to say, all options remain on the table, with a probably slightly raised risk for a unfavorable outcome within the next few weeks. Apparently, trisomies are supposed to show delayed growths. I've been mostly relaxed (or so I thought) before my first ultrasound and in the gap between this one and the last.  But when I came home and burst into tears, and cried for a good half hour, I realized the stress I'm under. Its insane. Nobody should have to go through this.

I'll be fine by tomorrow and will probably remain comfortably numb (with that tantalizing, beautiful flicker of hope still thrown in) for the most part, till the next terrifying ultrasound rolls around, which should be in the middle of the next week. It will be with my RE again- no graduation to OB yet. After realizing that it was behind, he called me in for round 3, mostly I think to reassure me. This scared me a little though because the nurse had said that if the RE deemed it was a good U/S, I'd be released to the OB at that point.

I know this can go south, in any number of ways. I know this could end well. If any of you have any anecdotal stories to share about being behind at this point ending well, then please, share. I really could use the momentary reassurance.

Like something the cat dragged in

Remember how I said I felt no symptoms of pregnancy? Well, I jinxed it, and I had had definite queasiness when I woke up 3 days in a row too. 2 days later (the evening of my 6w2d ultrasound), I ended up throwing up in a restroom in JFK when I went to pick up my cousin.  Then, the next day, it kind of faded away and its been gone 3 days, but I refuse to get worried by this. On balance, I'd rather I did not have nausea as a symptom to deal with. Despite the reassurance, you cannot possibly enjoy it (though I did feel a little happy while throwing up), and when it stops, you only get far more alarmed.  Women in my family often go through their entire pregnancy without feeling nausea, so its not even like its a requisite for a healthy pregnancy.

I've been exploring Manhattan like a fiend with my cousin. Both Friday and Saturday, we spent about 6-7 hours walking around the city. Saturday morning, I woke up with a sore throat, but I really did not let that stop me. Today, I woke up feeling like dog shit. My entire body hurts, it feels just awful. I've spent the day staying in with my poor cousin. This is my second infection in like 4 weeks since getting pregnant, I am most certainly immune-compromised. Gah.

So basically, between throwing up, feeling sick, feeling breathless, having what occasionally feels like hot flashes, I feel most definitely pregnant. My baby had better be hanging on, or its just another reason (like I would'nt have enough) to shake my fist at the universe. Ultrasound tomorrow morning, this is all effin terrifying.

6w2d U/S

It was most decidedly underwhelming, and not altogether reassuring, but nor was it a cause for alarm either. The gestational sac was visible, in the uterus, immediately and looked to be a decent size and was the prettiest part of the picture. It was really hard to see the fetal pole, but I definitely got glimpses of what could be the fetal pole as he kept moving the wand around, but it kept disappearing a second later. It was difficult to visualize because it was completely tucked into a corner of the gestational sac.

My heart stopped in the first few minutes, where we could not see the fetal pole. After we found it (he had to press down on my uterus to see anything), it was hard to see a heartbeat, I thought I could at times, but what do I know?  My RE said he saw a heartbeat too, but it was faint.  I asked him to do a CRL (difficult as we could barely see the thing) and it measured 6w1d, but the measurements were crude at best. The RE said he could see the yolk sac, but it was hardly the clear round thing of my previous pregnancy. The picture we got was god-awful. I don't have access to a scanner right now, but I took an iphone picture of the ultrasound.
 
I asked him if he thought things looked fine for this stage, and he said yes. He asked me to go back on Monday, which is what I will do.

I marvel at the change in myself. In the first ultrasounds in previous pregnancies (which were 2-3 days later in the 6th week), I saw better and more reassuring images, but I was still unsatisfied that things were not *perfect*, with the CRL lagging behind by like 2 days or something like that. Now, I just listened to the doctor, with a fetal pole I could barely see and a heartbeat that looked barely apparent, and left things to rest. I think the best way to describe me now is 'impassive'. The fate of this little one remains utterly unpredictable, and shrouded in fog, but que sera sera. I can get through this weekend, run around town with my cousin and have fun. That is the bottom line right now.  When I go back on Monday I have 2 people (my cousin and my friend) coming with me, can't ask for more.

I also spoke to my boss and told him I want to stop working by the middle of August. That conversation went surprisingly well. PIs (Primary Investigators, the nomenclature for professor at the head of a research lab in academia) can be unpredictable creatures, and there was a strong possibility that he would make life difficult for me after. But, so far, so good.