Tuesday, December 31, 2013

To positivity!

Today I'm on Day 2 of Clomid.  If it works, booyah!  If it doesn't, onwards and upwards! 

With that I am pulling myself out of this funk right now to remind myself that I have much to be grateful for as we head in to 2014.  Husband. Niblet. Stable employment. Many loved ones in good health. 

A joyous New Year to all!

Monday, December 30, 2013

A Clomiphene New Year

After a ridiculously stressful four day period of not getting a period, testing negative on HPTs and all-around freaking the fuck out that my Asherman's had reared its ugly head, I finally got my period yesterday.

Day 1 was marked by my complete inability to deal with my emotions. I was a basket-case yesterday, which began bright and early in the am, with my attempting to work out to a zumba DVD and learning that my knee is totally not healed. In fact, it's a mess and all of the movement that I used to rock so hard, all of my ability to dance and shake and jump that I took for granted is still elusive. So I moved on to a gentler ballet class video, finished it and sat down to cry for the loss of my former self. When I say cried I mean cried. It just hit me so hard that the molar pregnancy, the Asherman's, the second miscarriage, all of these events were survivable so long as I could get my endorphins up and dance.  But now that I can't, I am losing it.  Just falling apart physically and emotionally. 

Today, Day 2 was marked with the start of my first course of Clomid.

Clomid.  Wow.  In the world of fertility this is  no big deal.  While the follicle-stimulating drug has done wonders for many women, at my age it hardly produces miraculous results.  As per my usual reasoning, I wonder whether I will be in the fractional percentage for whom the drug produces some nasty side-effects.  Perhaps it won't impact me at all.  Alternatively, I could become a member of the small percentage who become impregnated with twins.  Frankly, it's all too much for my mind to wrap around. 

I also anticipate beginning an IUI cycle next week, and we are awaiting the results of Husband's semen analysis.  Statistics put the success rate of IUI for a woman my age at around 10%.  So I have nothing to warrant getting my hopes up.  We have some money tucked away for a few IUIs, but for the near future that will be the end of our road in the world of assisted reproduction. 

In 2013 I was a part-time dance teacher who could bounce around to latin dance music to shake the blues away.  I am entering 2014 a little pudgier, more stressed out, and on a course of fertility drugs. I feel like a poor facsimile of my former self.

Wednesday, December 25, 2013

Hanging in there on the Holidays

To all of my readers, I wish you happy holidays.  And to my readers who deal with repeat pregnancy loss and infertility, I am truly sending you all of the positive energy I have.

Tis the season of exhaustion. 

It's lovely to be grateful for all that we have - hopefully, good health, kind supportive family.... but this is also the time of year where things get dangerously reflective for some. 

For those of us struggling to have a healthy baby, it's just.... difficult. 

I am Jewish, but I LOVE Christmas.  Maybe it's my fondness for  Dickens.  The lights.  The food (god, yes, the food - don't read this Dr. Cuddles, World's Sternest Reproductive Endocrinologist, I promise, I am getting around to dropping ten pounds for you).  But since losing pregnancies, this time of year is hard.  Niblet's grandparents are downstairs right now as I write this.  She is one lucky niblet to have so much love in her life.  But anyone in my position will attest that the forced cheer and smiles suck the life out of you.  I just spent a good hour in the upstairs bathroom, taking the longest shower I could get away with.  My period is due tomorrow and by all evidence it's coming.  Another cycle to get one's hopes up.  Another year.

To my readers who have suffered losses and are struggling this time of year, I wish you gentler days ahead.  Treat yourself to those stolen moments away - in your shower, on a brisk walk away from the family that you don't want to break down in front of,  maybe "grabbing something you left in your car" if you're desparate - do whatever it is you gotta do.  It's a season that signifies love and peace, and I wish you most of all, peace.

Wednesday, December 18, 2013

Good morning brain. You can shut down now.

Information has been thrown my way today that is incredibly calming, I LOVE days like this.

To start: this morning I learned that an old friend is pregnant with her first, and my knee-jerk reaction was pure unadulterated joy for her.  Instead of the jealousy that usually creeps in.  For the first time in a while, I just smiled at a beautiful facebook picture.  Guys, this is a new experience for me.  It doesn't hurt that she is roughly my age, a source of hope for an AMA chick like myself.

Than later this morning I got a call from the nice nurse coordinator who deals with scheduling and insurance in Dr. Cuddles' office.  It turns out that my husband's insurance will probably not cover ANYTHING related to fertility treatments because I am technically not infertile.  My two miscarriages don't count, and I need two years of never getting pregnant for their coverage to kick in on anything, IUI or IVF.

Here comes the crazy part:  I am THRILLED about this!

Last night I tossed and turned about IVF.  I had been considering dropping my excellent primary insurance coverage to go on my husband's plan.... but this would have a domino effect of eliminating other benefits I enjoy from the plan (including a childcare benefit I get for niblet).  Not to mention I was torn about embarking on a very difficult physical and emotional set of procedures that kinda/maybe could get me successfully impregnated  - some stats put my success rate as low as 20%.

Well, thanks to this new info - that my husband's plan wouldn't cover IVF even if we wanted it - I don't have to think about this anymore. It's one less thing to wrack my brain over. Yay!  We don't have $15K lying around, period.  We do have some savings we carved aside for IUIs, but that's it, that's as far as we can go without tapping into retirement savings (and we consider ourselves lucky to have that).   I no longer have to envision a future where the best possible scenario includes our children taking care of their elderly-assed parents, who foolishly took a penalty on the 401K to bring them into this world!

Monday, December 16, 2013

What the world needs now...

An incredible video came my way that I must share.  It is about empathy.  And how different empathy is from sympathy. I am always thinking about this sisterhood I am now a member of... and I was just gob-smacked at how amazing this video is.  Short and sweet, it hits the message out of the park. 


To every person who crosses my path, may empathy be the response that is offered when you are in that deep dark hole.

Thursday, December 12, 2013

a bitter dose of reality

So I tend to live in blissful ignorance of most reality tv.  It's not that I'm "above it" (though I confess as much of a snobbish Downton Abbey obsession as anyone).  We don't have cable - not so much because it's an entertainment wasteland, but frankly because it costs a lot of fucking money and is the ultimate time suck. 

I am vaguely aware of The Little Couple, actually I have heard some good things about it.  Well, now the show is providing an interesting conversation starter for us molar survivors, as this came across the babycenter molar pregnancy support board the other day: http://www.dailymail.co.uk/news/article-2521967/Little-Couple-star-Jen-Arnold-reveals-cancer-uterus-caused-nonviable-pregnancy.html

In case you didn't read the link, Jen, the intrepid star of the show fell pregnant and miscarried.  With a molar pregnancy.  Which quickly turned cancerous, failed to respond to chemo, spread to her lungs, and ultimately sacrificed her uterus.

Oh my god, if this isn't the worst case of the worst case scenarios, I don't know what is.  Molar pregnancies are incredibly rare.  Developing choriocarcinoma - and ultimately requiring a hysterectomy - is like, the pinnacle of rarity, and some kind of cruel joke of the universe.  This is without a question, the worst fucking thing I have read all week.  I am wracking my brain to try to comprehend how this poor woman had to suffer even more than the "mere" devastation of a miscarriage with cancer, but it's a pointless exercise.  Fucking molar pregnancies.

I would love to reach out to her with the women on the bbc board.  Of all of my reproductive "mishaps" I found my Partial Molar Pregnancy to be the most isolating experience imaginable.  "It's a baby.... Noooo.....It's a "cancer baby"....It's out of fucking science fiction, that's what it is.  Medically speaking it's damn difficult to describe, and the combination of grief and fear that pervades is unreal.  Maybe a message from some other women who survived would be helpful. 

Saturday, December 7, 2013


In the past few days I have had the uncomfortable feeling that hits you when you realize that there is a world of knowledge and experience trapped in your brain that is impossible to translate to most of your friends, family, or that cool chick you like to talk to in the office lunch room.  And it's not like the knowledge possessed by that boring guy who can ring off baseball stats, or the history buff with encyclopedic knowledge of the battle of Gettysburg.

Instead, your "expertise" is kinda depressing.

Hitting my various support boards to chat about OBs vs REs, IVF vs IUI, Day 3 tests, Day 21 tests, RPL, PCOS, FSH, AMH, estradiol, follicular counts, luteal phase defects, clomid, femara, GonalF, blastocysts, PGS, PGD, hysteroscopies, HSGs, SHGs, progesterone suppositories, shots and pills, lovenox, temping, cervical mucus, estrace, betas, dpo, hcg, CMPs, PMPs, cytotec, D&Cs/D&Es, blighted ova, trisomies, triploidies,  translocations, karyotyping, spotting, septums, uterine adhesions, fibroids, polyps, corpeus luteum cysts, sub-chronic hematomas, red leaf teas, Vitamin E, Vitex, Maca, CoQ10, castor oil packs, musinex and the supreme importance of wearing slipper socks when your feet are cold.... well, I sometimes wonder if I could have completely rocked at something like trigonometry if I used half the energy I have spent in the goal of becoming a fertility expert.

Friday, December 6, 2013

Stagnant Chi no more.

So here is the moment in our regularly scheduled programming where I become a complete shill for acupuncture and the entire eastern medicine industry.  Because for the first time since April of 2012 - yes, 2012 - I had a normal period.  A period that had no spotting prior to its arrival and was heavy and normal when it arrived.  It's a freaking miracle, and the only changes in the mix are the weekly acupuncture sessions I have gone to for the past 2 months or so.  Yes, my recent hysteroscopy allowed a normal bloodflow (thanks for clearing my cervix Dr. Cuddles!) but would not have addressed the mysterious spotting, and having plenty of FLO in the old "aunt flo" is a pretty new development too.  My rockstar acupuncturist is convinced that my Chi was stagnant, and blood wasn't flowing properly to my uterus.  Well, the traffic jam of my chi has been cleared ya'll, we're back in the game. 

And since my period came a day early, husband and I also have an extra shot this cycle.  I won't get my hopes up at all, given the fact that I just don't get knocked up as easily as I did when I was younger.  I fully expect to have a long hard talk on Monday with Dr. Cuddles about my medicated options, but this month is improving radically.

Saturday, November 30, 2013

a post of wishes and hockey and rhymes

So my period is arriving.... ugh, right as I type this.  For the past few months this the arrival of AF ("aunt flo" to those who don't spend countless hours in fertility conversations) has been marked by a feeling of utter despondency.  However, today it  arrives with more of a sigh, and mostly crossed fingers, toes and eyes, hopes that my Asherman's isn't returning.  You know what I want for Hanukkah? FLO.  I want to get a normal looking period, that's what I want.  I want to have to wear the mother of all maxi pads.  Enjoy that visual.

Meanwhile, this December Husband and I will have precisely one shot at rendering me knocked up because he will be traveling for work during the exact days that I will likely ovulate.  And I mean one shot, right at the crack of dawn before he leaves - the goal of all goals for the month.  I've even asked the dude to practice some visualization exercises.  Given this circumstance of unfortunate timing working against us I am not really holding out any hope for us to conceive in 2013.  December will also mark my sixth cycle in a row of trying to conceive since my last miscarriage, an ominous milestone.  So I am excited to have my monthly visit with Dr. Cuddles in two weeks.  We can have our usual warm and fuzzy conversation, where I can beg her to probe my cervix with a pipelle, because this is what you do when you have a problem with scar tissue growing over it.  We can also discuss clomid and the nuts and bolts of intra-uterine insemination.  Ahhh yes, I forsee fun times.

Yes, I am strangely calm about all of this tonight.  My new mantra is "Right now I am thirty-nine... my egg reserve's not in complete decline...."  Catchy right?

Monday, November 25, 2013


Sore boobs: Check. 
Headaches:  Check.
Vivid, gory dreams:  Check.
Home pregnancy test this morning:  Big Fat Negative.

I swear, if this is my new normal in PMS, I will absolutely go insane.

Sunday, November 24, 2013


This morning I am up at 8 DPO (eight days post ovulation in my two-week-wait, for the uninitiated), and a new lab popped into my account through the hospital lab report system.  Actually, it is an old lab, my AMH result - anti-mullerian hormone - another indicator of ovarian reserve.  While my FSH was a respectable number for a late-39 year old, my AMH is just "okay" - literally, the word used by Dr. Cuddles in the lab report.  I am not someone approaching 40 with the egg reserve of a 32 year old.  I am approaching 40 with the normal diminishing egg reserve of a near 40 year old.  Could I get pregnant? Sure, though with a high likelihood of using eggs with diminishing quality and a high potential for miscarriage.  Could a stroke of good fortune after some of the fertility nightmares I've experienced render this whole conversation moot?  Sure, though I am wise enough now not to bet on miracles anymore, not when I am already so blessed with what I have.

In the middle of the night last night, I awoke with a startling headache and sensation of dizziness, following some pretty wretched -and gory - dreams.  The old me would be all "oooh, maybe it's a pregnancy symptom."  The new me believes this is my body's new normal for PMS symptoms.

And with that, I told Husband this morning I would agree to my RE's suggestion to try to beat this clock a little.  I will agree to a cycle or two of Clomid, and assuming that doesn't work (and also assuming we can find the money for it) will consider moving to injectables, perhaps with IUI.  These drugs will stimulate my ovaries to produce more eggs a cycle, increasing the likelihood of getting a good one.  Is there a risk of multiples?  Gah, yes.  But it is a risk I think I am willing to take.

IVF remains a path I just can't consider.  Never say never they say, and god knows, when I thought we were carriers of a balanced translocation I was all, "sign me up!"  However, our insurance (actually husband's insurance) will only pay for IVF after two years of infertility - I hope to learn in my follow-up appointment with Dr. Cuddles whether she could code two chromosomally related miscarriages as infertility.  If those miscarriages are viewed by the insurance company as "you're not infertile" - then IVF will easily be ruled out for us, because we don't have $30K to pop for it (we barely have savings for IUI).

There's also this:  I know too many women who have suffered the depression of failed IVFs.  I can only imagine it to be a hypermagified sense of loss.  All of the struggle, the timing, the hormones, the literal physical pain you endure - and it comes with a very low statistical success rate for women in my age bracket.  No, I don't think I can do it.  I admire the women with the resolve to push there, but I am not one of them.  My beautiful - albeit small - family of 3 will be enough (I think).

Another thing struck me this weekend:  I think I do need to put a time limit on this endeavor.  I have been trying to have another baby since 2012.  We are on the cusp of 2014.  Two years of miscarriages, surgeries, complications have been exhausting, now that I am emerging from it.  I can't put an age - say, 42, - or a year  - say, 2016 - on this, but I have to come to terms with the reality that I don't have an infinite amount of energy.  I can't make baby-making a mission.  I can make it the subject of a blog, and spend many hours talking to virtual friends about it, and I may end up in therapy over it, but I have to find a way to balance this pure longing with the ability to function in my daily life.  And I suspect the only way to do that is to let it go.

I see now that this is a pretty eastern way of viewing the world.  Hell, maybe all of this acupuncture is working.

Monday, November 18, 2013

It really WAS too much halloween candy

My glucose is 79.  Take that and your atkins diet too Dr. Cuddles.  I'm not pre-diabetic.   Jeesh.

Wednesday, November 13, 2013

Back in the game?

Operative hysteroscopies are a barrel of laughs, I tell ya. 

So, I'll confess, I had some doubts going into this one...but hey, turns out my Asherman's adhesions were reforming around my cervix (pesky fuckers) and she cleared those away.  Not enough to completely seal it off like the last time, but they were visible to me on the beautiful picture I got of my hoo-ha, so it's to not have to worry about that now!

Dr. Cuddles (yes, THIS is how I shall refer to my RE from here on in) was far more concerned with the results from my pre-op bloodwork though.  "Are you or anyone in your family diabetic?" she asked sternly.  Umm, no.  I didn't even develop gestational diabetes when pregnant with niblet.  Turns out my glucose, when tested a week ago, was 173.  "Normal" should be in the 70-99 range.  Gulp.  Was it the Halloween candy I stash in my desk?  I have been strictly ordered to lay off of bread, pasta and potatoes (thanks Dr. Cuddles), and retest this asap, as the glucose levels could be affecting my cycle and causing my premenstrual spotting.  Interesting.  And of course, worrying. 

On the happy front: My estradiol levels are normal.  In fact, my FSH is "normal" for a gal my age as well (say yeah for the one hearty ovary!) And again, my uterus is clear, huzzah!

On the less happy front, Dr. Cuddles has officially suggested that I go down the rabbit hole. Seeing as how this is her bread and butter, I'm not terribly surprised. She believes some rounds of Clomid would be in order, to get me to pop out more potentially healthy eggs to work with.  She also mentioned IVF with pre-genetic screening, in the event my body wouldn't find that one good egg on its own ("You are 39 after all").....however, I am not quite ready to go there.  Lord knows, I've never wanted to go there, having been able to get pregnant three times the old-fashioned way.  My insurance covers zip in the way of fertility treatments, and husbands only begins to cover IVF after a year of infertility (we are officially entering the 6 month mark).  I suppose if I'm not pregnant in another 6 months I will entertain the thought.  Sigh.

In the meantime, I will just continue to down my Co-Q 10 supplements like there's no tomorrow and convince myself that acupuncture is re-aligning my chi properly, or whatever it's supposed to do. 

Tuesday, November 5, 2013

The universe is talking to me (and I'm not completely batsh*t crazy).

So, a common theme I have seen on the repeat pregnancy loss boards is the idea of signs, guideposts from the universe giving us strength to keep on keepin' on.

It's a no-brainer for me to continue trying to conceive until I take home a "rainbow" baby.  But recently I realized that not everyone viewed my situation as so cut and dry.  One friend gently questioned whether I would consider adoption or fostering... Another asked whether I was giving myself a cut-off date to give up....my parents recently questioned why I was continuing to put myself through the physical ringer with batteries of tests and blood draws... couldn't I cut my losses and accept life as a family of three with just Husband and the adorable niblet I already have?

Encountering these kinds of responses to your narrative certainly makes one pause.

Besides just providing my stock answer here, that "I will only be done when the risks of grief outweighs the joy of  success," I am compelled to describe two recent instances of clarity.  Two experiences that tell me I am on the only path I can be on right now.

A few weeks ago, after an exhausting business-trip, I encountered a stunningly beautiful woman on my Amtrak ride home, we became seatmates.  She had a shit-ton of luggage and I, being on crutches at the time, needed a place to rest my leg.  Her luggage was comfy and she was just....lovely.  In all ways.  I mean, I had never seen anyone exude such an aura of grace.  A mother of 3 who lived in France and was visiting one of her kids in college.  A former dancer and macrobiotic chef (who shared some healthy snacks with me).  And somehow, in our ramblings riding along the east coast, she came to share with me that she had lost a baby at 42.  And I started to cry.  And she held my hand.  And didn't offer platitudes.  But as we talked she offered me strength and I swear, a level of comfort that no one could replicate.  And during our talk my resolve strengthened, my inexplicable desire to have a baby firmed.  And it was cray-cray-craaaaazy, because for the first time in my life I wondered whether God really existed.  No, for reals.  I am agnostic, "spiritual" if you will, but have always been kind of skittish on the question of a true "higher power" - but putting this woman in my path, on that night.... I can't process it in any other way.  I needed her and she appeared before me like a freaking angel.

And then yesterday, the universe plastered a very different sign in front of my face.  I was sitting in my RE's office waiting-area when a young, 20-ish woman walked in with a baby stroller, holding an adorable little cherub of an infant boy.  And at first I thought she was a new mother....but then I wondered if she was a nanny or babysitter.  And I watched her give the baby a bottle while staring at her phone and doing some impressive nearly one-handed texting.... and he fussed and she kept texting.  And he drank that bottle up and started getting that uncomfortable look I recognized, the same "hey, lady, please fucking burp me" face that niblet would make after eating every meal.  And she started rocking his stroller back and forth, not looking up from her VERY IMPORTANT TEXT, and then he started to cry.  And he started to wave his little arms frantically, as if to say, "Please, unstrap me, this totally sucks, for the love of all that's holy, pick me up!"  And she never looked up from the phone.  And I sat there squirming, trying not to watch, trying not to judge, and trying even harder not to jump up, unstrap the poor kid and give him the burp he desperately wanted.  So I was sitting there, trying to formulate a way to offer unsolicited advice or help to her, in a way that wouldn't come off as obnoxious and judge-y, when she got up and (at this point, the baby is screaming) and told the receptionist she was bringing the baby to his father in the restaurant in the lobby, and then left the office.

And I only then realized I was holding my breath the entire time. 

At that moment I saw clearly that for some inexplicable reason, I want - no, I need to be responsible for another baby.  I need to hug and feed and burp and soothe a baby.  Me, of all people, with MY particular baby experience -- Niblet had COLIC (capitalized for effect) and it was like something out of a gross-out comedy (seriously, I was always covered in refluxed milk).  But I can't help it, God help me, I want to do it all over again.

And to anyone who says, "Justonemorebaby, you're crazy, come on, at your age? After what you've been through?"  My response right now: I think I'd manage just fine.

Monday, November 4, 2013

And..... surgery.

Nothing like gearing yourself up for a test (in my case, a saline sonogram) only to learn, "you know what?  I really need to look inside your uterus with a hysteroscope."

My hormones appear to be normal, yet my period is spotty and on the fritz, my lining appears mysteriously thin, and there is some unidentifiable thing in my uterus (Blood pocket?  Polyp? Who the fuck knows). 

And so next week I go in for some fun out-patient surgery.  At least I'm not waiting too long for my lack of answers.

Wednesday, October 30, 2013

Tests. And more tests. Yay!

So, my progesterone is normal, and I have to say, I'm a little surprised. 

Let me backtrack:  I visited my RE a few weeks ago, complaining of a very spotty, light period.  Of course the return of my AS was a primary concern, but then my RE took a look at my ovaries via ultrasound and of course gets me completely freaked the fuck out about how one of them is "puny," perhaps I am facing Diminished Ovarian Reserve (DOR) and I could be in a "fertility crisis" (note to RE:  please, I implore you, never use the word CRISIS with me.  Ever).  She sent me home with a fair degree of nail-biting paranoia, insomnia and scripts for more blood tests, a Progesterone check on calendar day (CD) 21 of my Cycle and the FSH/Estradiol/AMH combo on CD 3 (which will fall next week) - this one to assess just how many good eggs I could have left in me.

Low progesterone is common cause of premenstrual spotting in women my age, so I was sure that I would get a call saying I needed to go on a hormone supplement.  Instead, I got a call saying my progesterone is fine, asking that I come in for a sonohysterogram to take another look-see at my uterus.

First, the sonohysterogram: This is a test where a catheter is inserted into your uterus, which is also being monitored by ultrasound.  The catheter is hooked to a line of saline, which then fills your uterus, so that a doctor can get a visual image on any potential abnormalities, such as polyps, or fibroids, or other anatomical issues. This test is reportedly painful as all fuck.

And yet, as is par for the course for me, I am THRILLED to be getting this done next week.  My guess is that my RE is looking for a polyp or fibroid near my ovary causing spotting.  But I have had a nagging fear that my cervical scar tissue has returned, so if a catheter can get in there, it means that there is at least some passage way.  Likewise, the catheter could break away any tissue present.  Or, alternatively, if the catheter doesn't get in, I at least know to hop a plane to Boston for a fun in-office hysteroscopy with my miracle doctor.

And pain, well, I figure if I could have scar tissue cut from my cervix without anesthesia I can get through this right?  And I don't have to fly into Logan (yet).

What my current RE lacks in the warm and fuzzies, she more than makes up for in competence, I think. 

Friday, October 18, 2013

What a difference an injury makes

Wow, can I just note really quickly that I can honestly go more than two hours straight without thinking of babies, or fertility, or scarring, or miscarriages or diminished ovarian reserve now that I am hobbling around on crutches and my leg is in a considerable amount of pain?  AWESOME!

Monday, October 14, 2013

Down the Rabbit Hole

Today I saw my RE to discuss my wonky periods.  Needless to say, I'm headed down an incredibly dreary path that will be recognizable to other women my age.  The good news:  a "beautiful" uterus (not something us AS gals hear too often) and one decent ovary that likely has an appropriate number of eggs for a gal my age. 

The bad news:  one "puny" ovary that is very likely putting me on the path of Diminished Ovarian Reserve (DOR).  I get to look forward to progesterone testing in exactly 2 weeks, and then more detailed hormonal testing two weeks after that to determine just how realistic is for my aging ovaries to knock a healthy egg out.  Depending on the outcomes of that testing, there could be some highly uncomfortable conversations in my future about what lengths I want to take medically to conceive.

I never imagined I would be in this position, hell, few women do.  About 18 months ago we formally started down the road to giving niblet a much wanted sibling.  While I certainly rationalized that a miscarriage could result from a pregnancy, I never imagined that I would lose over a year of my fertility in the process.  I certainly could never envision two medically complicated miscarriages, one with an instruction to stall trying to conceive for over 6 months of time.  That time I lost could have well turned out to be crucial. 

And it's hitting me that both internally and out, I have a very different body from the one I started out with those 18 months ago.  My obsessive exercising has done little to shed the weight of my last pregnancy, and it's not lost on me that I am walking on crutches right now, without any clear idea of how long my recovery will be.

Whoa.  This is a total bummer.

With that, I am off to my first acupuncture session.

Friday, October 11, 2013

Another PSA

Well, things are looking up.  Sure, I'm on crutches, and I'll need physical therapy, and it's raining so hard that we're all walking around looking like pathetic drenched kittens, but it's a torn muscle behind my knee, not a ligament, and I won't need surgery, so I'll take it! 

But the better news is that my RE can actually squeeze me in this coming Monday to start investigating my wonky period, including setting me up with progesterone tests.  What a difference a new doctor makes.

So here's my public service announcement for the week, the one I will never stop repeating:  PLEASE, press your doctors if you feel that something is wrong.  YOU know your body better than anyone (and if you don't, YOU have the power to learn it's rhythms and cycles).  If your doctor is dismissive of your concerns, seek out a second opinion. 

Every day I check the support boards and read the post of some poor soul who is spotting, or whose period is lighter or maybe she has a weird cramp, and her doctor is all "ehhh, you're worrying too much, a woman's body isn't always like a clock, sometimes things are a little out of whack, it's probably nothing."  Ughhhh, this is often times a seriously wrong answer.  Because how many of us just know our bodies tweaks and quirks when something appears or feels off?  I bet a whole lot of us. 

Good god, it's hard enough for so many of us to get pregnant, or maintain a healthy pregnancy once we get that BFP.  Adding on the weight of a doctor who won't listen or help when we believe something is wrong is time and energy that none of us have to waste.

Thursday, October 10, 2013

A brief interruption from our usually scheduled fertility thoughts

So you know how I do all of that dancing to keep my spirits up and my head together and boost endorphins to stave off depression?

Yeah, well, I am waiting on an MRI today because friends, I cannot walk, and I am fairly sure I popped a ligament in my knee last night during what was an otherwise tremendously fun and challenging ballet class.

Which is kind of funny, because I was all depressed about my wonky period this week, and wanted to dance in order focus my thoughts on something that didn't involve my uterus.

And now I get to wonder whether I need arthroscopic knee surgery. 

YOU WIN UNIVERSE.  You fucking win.

Saturday, October 5, 2013

Thinking about Postpartum Depression

When niblet was born I was sad.  Very sad.

My OB, in hindsight, didn't ask me many questions about how I was feeling.  I am fairly sure I filled out some sort of standardized questionnaire about my feelings at my 6 week visit, but I am pretty confident I would have checked off all of the boxes that said "nothing to see here, kids, all's honky-dory."

Niblet's pediatrician showed a few signs of concern at her early well-baby visits, given that I was a quivering teary-mess.  She had colic, you see, and cried for about 8 hours straight every day, from about 3-11pm  (no, really, I promise you, I am not exaggerating.  I wish I was).  He explained the "baby blues" and noted that once niblet started adjusting to the world better, in a few weeks I would feel better too, my hormones would regulate, things would look up.

Unfortunately, they didn't.  I was still pretty fucking sad well after the normal two-week period of baby-blues had passed.  And with the sadness came guilt.  How could I be depressed?  What kind of ingrate was I?  I had given birth to this incredibly beautiful, stunning life.  Relatives came to stay, friends came to visit, we were literally immersed in love, we were truly a lucky little family.  But it didn't matter, I just felt awful and powerless.  And very afraid.

It's difficult for me to conjure the memories of the many months that I felt on the verge of breaking during niblet's infancy.  But while many friends expressed concerns about my well-being and stability, I never actually sought additional medical help.

My hormones started regulating - or at least, my depression abated -  after about 5 months of what I consider "phoning in" my mothering.  Don't get me wrong, Niblet was nursed and hugged and carried and cooed at and given all of the attention plus some during those early months, but I often felt like I was having an out of body experience while devoting that attention.  Anyone looking at me would see an ordinary mom enjoying her newborn, and not the reality of a scared mother who spent many hours feeling disconnected and dead inside. 

I was obviously driven to write this post by the recent capitol hill shooting.  It got me thinking about my own circumstances, how even with great access to medical care and an extensive support network of friends and family (including a husband who is incredibly "hands-on" about fathering), my less-than-picture perfect reaction to childbirth was incredibly frightening.  It also got me thinking about the only other times I ever felt this deep, dark weight - after my two miscarriages (though more acutely with the first one, characterized by through the roof HCG levels, when I had carried my doomed cancer baby for nearly three months).

Women who suffer miscarriage are often told to just go home, rest a day, stay out of swimming pools and warm baths if they've had a D&C, and refrain from sex for a few weeks. My own OB actually told me I would be physically "just fine" one day after my first D&C.  I don't know about you, but no one ever explained to me that I would feel awful, not just from existential grief, but from the rapid hormone drop I would experience.  In a way, I was lucky to know my body so well from my past experience, I could anticipate what I knew would also be a dreadfully painful physical reaction to my miscarriage, let alone the emotional one.  And lo and behold I anticipated correctly, because the depression that came on was a doozy. 

I wonder how many women out there are suffering very real physical hormonal after-effects of miscarriage and told to basically suck it up and get on with their day?  How many women who carry babies and lose them in their second and third trimester are being monitored?  Yes, some people expect them to be sad, but how many doctors are really watching for the potential after-effects of very real chemical crashes they are experiencing?

Wednesday, October 2, 2013

Beating back the doldrums

As I head down the final stretch of yet another two-week-wait I am really trying to do a better job of keeping my wits about me.  Last month's emotional meltdowns were, well, really fucking exhausting. 

Also, as many babycenter lurkers know, October 15th is National Infant Loss Awareness Day.  Many virtual friends will be wearing ribbons, lighting candles, attending walks and vigils.... I just learned that I will be getting my yearly employee evaluation that day.  Nice timing universe, the last thing that will be on my mind will be my fertility.  So really (!) nice timing universe.  I now acutely understand the mixed emotions that come with a day of recognition.  On the one hand, I am heartened that people have a public forum to acknowledge the real losses they have experienced.  On the other hand, my miscarriages are carried with me on a daily basis. 

This month I am trying to be physically proactive about beating back the depression that will inevitably creep in when I pee on sticks and get big fat negatives (BFNs for any random readers unfamiliar with fertility speak).  I'm taking a ballet class this week, because you can't possibly think about your shriveling old eggs and the weight of your own mortality when you're trying to execute pirouettes, I promise you.

And next week I have an interesting new addition to the justonemorebaby wellness regime, acupuncture.  There's reams of (virtual) literature out there about the benefits of needles directing blood flow to your uterus, unblock your chi, stimulating hidden superpowers (can mine involve vacuuming?) and whatever the fuck else they do.*  I mean, it can't hurt, and I am one of the lucky few in the US whose employer covers it, so cost isn't an excuse.  Why the hell not, right?  I have heard that quite simply, it makes you feel good, and that's as good a reason as any for anything in my book.

For those who are wondering, other elements of the justonemorebaby wellness plan include a daily dose of (VERY EXPESNIVE) Co-Q 10 supplements and prenatals.  Co-Q 10, for the uninitiated, is like, the magical wonder vitamin, so if Co-Q 10 can't help me, nothing can.  Oh, and I have also significantly scaled back my caffeine intake.  I haven't completely eliminated it, mind you, because I would like to have a few friends and family members want to take care of me in my old age.  I'm sort of like the Hulk while operating sans tasty stimulant (albeit shorter and not green) in this respect - "Please don't make me angry.  You wouldn't like me when I'm angry."

*I say this will all due respect to practitioners and believers in Eastern Medicine.  No really, I'm not being facetious here, my Dad is - no shit - a tai chi master - and I will take the advice of an experienced acupuncturist, over the advice of dipwads who couldn't figure out that my cervix was sealed shut, ANY day.

Wednesday, September 25, 2013

Becoming your own best advocate, Asherman's and beyond

So perusing CNN during my lunch today, I came across this article, "5 questions to ask before surgery".  Needless to say, WTF, they have left off the most important questions anyone should ask of ANY doctor before any SURGICAL procedure! Drumroll:

How many of these (insert surgery here) have you performed?  What were the outcomes for these patients?

One of the most unpleasant things I discovered when my uterus was unceremoniously sealed shut from a D&C (why did the ark of the covenant just flash before my brain?) was that my doctors - the same ones who stated outright that this wasn't a common side-effect of a D&C*  - also turned right around and said they would fix me in the OR. 

So please stop and think about this for a moment: I'm a supposedly rare case (which is debatable and merits own blog post), yet I should let someone who hasn't seen this kind of case before put me under anesthesia and try to undo the damage.

That doesn't sound right, does it? 

Ladies, this is your uterus we're talking about.  Or your ovaries, or your hormone levels, or anything else you can think of that is kinda crucial to your well-being.  I am not being hyperbolic when I say that your fertility - and all of the hopes and dreams that go along with it - is on the line here with your decisions. 

The Asherman's website has incredible tools for women who are concerned about AS and are wading into these conversations with their doctors, and one of the best is the "Questions to ask your doctor"  http://www.ashermans.org/information/what-to-ask-your-doctor/

I know from talking to scores of women with fertility and reproductive issues that it can be really uncomfortable to put your doctor on the spot.  They have a degree.  They have training.  They are "Board Certified."  They may be in a "Top Doctor" issue of your local magazine.  Who am I to question their skill-sets, you wonder when you're sitting there, vulnerable and gobsmacked by their diagnoses and jargon?

I have laid my own experiences out before the world on this blog because I am on a mission to IMPLORE women to understand that the certificate on the office wall is not the be all and end all of expertise.  Yes, it can be uncomfortable to have these conversations, but they are necessary and you are worth it.  My RE was absolutely incredulous that I would fly off to another fucking state to see a doctor to unseal my cervix - this despite the fact that I later learned he had another patient in my boat who did exactly the same thing!  (BTW, that makes me not-quite-so-rare, doesn't it?)  His physician assistant, the kind lady who attempted to ram a catheter into my uterus, suggested I see a "top local doctor" who specializes in uterine surgery.  I was the one who informed her that this doctor uses laser surgery to treat AS, which can actually make it worse.  She specializes in fertility, yet had no idea. 

Look, we are all walking a fine line when it comes to taking "control" of our health, and obsessively lying awake in front of WebMD or Dr. Google at 2am can be detrimental as well.  But we often have so much more power than we know.

*My own OB claimed that she had NEVER performed a D&C resulting in uterine adhesions before. 

Friday, September 20, 2013

And they say romance is dead

Amazing how when you are trying to be among the ranks of the knocked up, at nearly any point in the month you can exclaim "it's that time of the month again!"  Between your period, pre-ovulation, ovulation, Mittelschmertz  (the Germans have such a lovely turn of phrase for those among us with mid-cycle cramps, don't they?), and the two week wait, well, it's ALWAYS some time of the month, isn't it?

Last month every bodily twinge, every trip to the bathroom, every morning headache and tingly boob was a predictor of something.  Now in reality, that something was actually the creeping crawl of obsession and insanity.  But it's a New Year Yo, Happy 5774! Let's get a fresh start, one characterized by some mental stability!

At Casa de Justonemore we are peeing on sticks again, this time ovulation predictor kits.   Nothing like suggestively waving around a double-lined stick to get one's husband in the mood.  In some bedrooms I imagine softly lit candles on the nightstands, perhaps some fresh flowers (yes, I read a lot of trash romance novels), maybe some Barry White is playing in the background?  Our boudoir is lined by OPKs  and pre-seed, the mood only enhanced by the occasional chirps of niblet singing to herself two doors down the hall.

Ahhh, bring on the sexy times.

Thursday, September 12, 2013

What not to say

I seriously wish I wrote this so I could lay claim to its wisdom.  Someone posted an excellent (snarky) piece that showed up on my FB feed today.*  There's lots of variations on the whole "What not to say to someone who's grieving" to be found all over the internet, but I heartily endorse this one, which includes sage advice like the following:

"If you find yourself starting a sentence to a grieving person with the words “Well at least”, just stop.  Don’t finish it.  Close your mouth and step away."  WORD. Or, likewise,

God has a plan.”  Never.  Never, ever, ever say this.  Seriously.  Never.  If you want to have a theological discussion about the role of God in suffering and pain, fine; but wait until grief has stopped beating the shit out of the person.   When people say this to me I have to fight the urge to punch them in the throat and reply, “You’re right.  He does.”  I couldn't have better it said.

Yesterday, I tried to offer some kind comments to someone on the interwebs who had gotten into a fight with a relative. Her relative, probably intending to be helpful, told this grieving young woman who just lost her baby, "Lot's of women have miscarried before you."  Now, this could possibly have been some poorly thought out sort of "buck up little soldier" pep talk, had it not been immediately followed by, "You are acting really selfish by not getting over your miscarriage."

Who else heard the sound of that record screeching (yes, I am aging myself with this comment).

Yo, would you tell the person who lost her grandmother that "Lots of women have lost their grandmas, so stop yer crying?"  No?  Didn't think so.  Jeesh. 

*Just a word of warning:  if you're feeling even remotely sad, hopeless or infertile based upon your reproductive history, STEP AWAY from the facebooks.  They're a fucking minefield.  Between the pregnancy announcements, ultrasound pictures, baby bump and actual new baby pics, facebook will send you into therapy if you're not careful.

Friday, September 6, 2013

A Grief Primer

This was great.  Seriously, I have been feeling more than a little unhinged as of late, and after reading this, well, I feel a little less like I am going to be sent over to crazy-town.


Thursday, September 5, 2013

How about some renewal and rebirth?

It is Rosh Hashana, the Jewish New Year, and a time of the year that I truly love.  On the Jewish calendar, the New Year actually falls in fall, as opposed to winter.  The idea of renewal, of rebirth in the autumn has always instinctively felt right to me.  The crisp air, the leaves starting to fall off the trees, the seeds burrowing into in the earth,  it's all very tangible and invigorating. 

This is now the second year in a row that I am emerging from a miscarriage in the fall, around the Jewish High Holidays.  I've noted it before, I'm not particularly religious, but I think the traditions of my faith will bring me comfort and perhaps, some sanity and grounding. 

I am not sure that lots of folks are getting up in the middle of the night to pen two week wait haikus.  This whole week I have felt incredibly nervous, twitchy almost, and at a risk of having some reader out there attempting to track my identity down and have me committed, I have felt ill-at-ease with my ability to function the way I like.  Sleep has been elusive.  I can't think of one day where I haven't regretted saying something to someone around me, it's as if my brain is on a strange malfunctioning auto-pilot.  Walking around in a constant state of distraction, well, it really makes you question your place in the world and your abilities.  To hold down your job.  To make a lunch your niblet will eat.  To be someone that people would genuinely like to be around.  And it certainly makes me question my abilities as a mother, a wife, a friend, an employee.  To sum this week up, I am just getting life wrong

It's a cop-out to pin this on lingering miscarriage sadness, and I really didn't sit down to write intending to post a pity party.  So it's with some real hope that I welcome the high holidays.  I want a new beginning.  I don't believe you can or should ever wipe a slate clean, we are the sums of our experiences, after all - our joys, our traumas, our loves, our sadness and our mistakes.  But I am looking forward to this new year, I am really looking forward to the heavy day of atonement and repentance that's coming next week, the Jewish big cahuna, Yom Kippur.  Last Yom Kippur I said a mourner's prayer for my lost little cluster of molar cells, my cancer baby.  This year I will do the same, but the timeliness of it all is hitting me harder.

I hope to emerge from all of this in a better place, renewed and reborn.  A place where I'm not twitchy and antsy and afraid and mucking things up.  Where I'm a better and more thoughtful person.  Where I'm less impulsive and more considerate.  Where I show more empathy.  A place where I'm comfortable and at peace with the idea of being responsible for a new, living, breathing little human.

Monday, September 2, 2013

The Two-Week Wait. A Haiku.

Once again, time slows.
Hark!  Too soon to crush a dream?
Don't pee on that stick.

Friday, August 30, 2013


I just returned home from a memorial service for a friend's mother, who died too young, was lost too soon.

I never met her but she was remarkable, nine of her children were in attendance.  The room was filled with sisters, grandchildren, cousins, neighbors, loved ones.  Her DNA was in bloom in the room, along with music.  As was her spirit.  She was a poet, an activist, a mother.  The memories of this woman were tangible, the room was thick with love, warmth and humor.  Those memories, along with the many words she penned, ensured that she really is still with her family, her friends and the many people she touched.  There were many tears, but she was - she is - eternal.

The miscarriage of a baby - particularly one early in utero - is wrapped in complication.  Many friends and strangers, intending to be kind, tell you that this really wasn't a baby at all, but a cluster of cells.  And  a cluster with chromosomal problems at that, deeply flawed and never meant to breathe on this earthly realm.  This truly isn't helpful.

When you lose a pregnancy, at any stage, you lose a dream.  It could be a vision of yourself as a mother.  It could be a sibling for your living child.  It could be the dream of a family picture that you envisioned.  For some women, the dream is borne with two lines on stick.  For others, the dream begins at an ultrasound. 

I think I've mentioned before that I am an only child.  I was - am - a very happy one, with more love than I can express for my parents, and a rapport with them that I think is unique. But I always imagined niblet with a little sister or brother.  Not because I have any belief that she needs them to be a stable human being.  Not because I believe that siblings are always there for one another.  Not because I think that onlies are spoiled, or at risk of some social disease.  Just because, well, because this was my dream.  Some people dream of acquiring a boat.  Some people dream of a trip to Hawaii.  I dream of raising two children.

Every baby I have lost is a loss of that dream.  But to explain to people my miscarriages in those terms, in the parlance of dreams, well, that doesn't really do the trick either.  It's not quite right.  Some people dream of going to grad school, but they blow their MCATS/LSATS/GMATS.  They've lost something too, right?  Visions of their careers, or the futures they would have?  I was a dancer, a ballerina, and dreamed of being on stage as a full-time career.  It didn't happen for me.  I found fulfillment elsewhere, while I still mourned the loss of a vision of myself.  But just trust me when I say that the losses of my babies feels very different from the loss of my dance dreams.  Mourning them simply cannot be the same.

And please, just throw your rationality to the wind when I say, with the utmost determination, that they were my babies.  Not my clusters of cells, not my fertilized eggs, not my zygotes.  They were my babies.

So what are the words to describe the gaping hole that is felt for babies that could never live?  For babies that were mere clusters of cells for those who did not know them?  For babies that could never create poetry, or leave a room full of attendants with memories, and music and stories?  For babies that perhaps only live on in a medical record or a blurry ultrasound picture? 

Words hurt, words sting, words express, words heal.  But sometimes they're really difficult to find.

Tuesday, August 20, 2013

Seven words.

"Your husband has no abnormalities.  Keep trying."

The message sent to me by my RE, via the hospital's online lab report portal for patients. 

Saturday, August 17, 2013


The next few weeks following the news that my recent pregnancy was lost due to a rare Trisomy were a fog.  As you've figured by now, reproduction for me is like an old movie set, in Victorian-era London, with the copious use of a smoke machine.  We learned that there would be one of two outcomes: a) this is a random "de novo" event, and my recent loss is the result of some more unfortunate luck, or b)  There is an "explanation" to my problems:  my husband is a carrier of an inherited chromosomal abnormality called a Balanced Translocation and I will continue to lose babies because of it.

So what does a girl facing a potentially rare chromosomal defect that causes miscarriages do?  Join a support group of course!

The Balanced Translocation (BT) support group is one smart group of ladies (and a few rare gents who like to discuss their feelings with the virtual world).  Some are women who have survived as many as 8 miscarriages.  Others are women who have discovered -  after having one completely normal pregnancy -  that they can't conceive a healthy baby the second time around. All of the group's participants have been through a special ring of hell called Repeat Pregnancy Loss (RPL). 

BT is a game-changer.  Some couples turn to IVF with genetic screening to try and cull out only healthy eggs - this may or may not be covered by insurance (more than likely not). Others stick it out and brace themselves for multiple miscarriages - three, four, five, ten(!) -  in pursuit of a healthy baby.  Because BT turns out to be a game of reproductive roulette. 

I learned a lot about statistics the next few weeks.  The best explanation of BT, and the potential translocation my husband carried, was found here:

Another awesome attempt at genetics comes from this blogger, who helpfully uses playdough to illustrate her husband's BT.

The bottom line is that when you or your partner carry a genetic translocation, you have at least a 50% chance of conceiving a baby that is "unbalanced" - this means severe disability, often so severe that the baby won't survive the pregnancy, let alone the outside world.  This is what accounts for the high miscarriage rate in its carriers.  You then have something along the lines of a 25% chance of conceiving a baby who carries the chromosomal defect but is otherwise perfectly healthy (though prone to their own miscarriages when they later reproduce).  And then there's something like a 25% chance of having a baby that is "perfect" a non-carrier.  All of these numbers are rough estimates and the outcomes hinge on the specific kind of BT carried, along with too many other factors for me to wrap my humanities-driven brain around.

Carriers of BT have to face horrifying and calculating decisions on a daily basis.  Do I keep ttc naturally?    Do I turn to IVF to try to cull more healthy eggs?  Do I undergo CVS and amnio despite their miscarriage risks?  Do I terminate a baby who is unbalanced? What are my parameters for stress and grief?  At what physical and emotional price to I continue to push my body's limits?

These decisions consume me for the next few weeks as we wait for Husband's lab work to come in.  All I can do is hope that our baby's T-14 was "de novo" - a one-off defect that wasn't inherited.  I am no longer hoping for an explanation on my pregnancy loss because the explanation is terrifying.  Wow. I am actually hoping for more bad luck.

Waiting. Again.

Having had a miscarriage already once, complicated by, well, the specter of cancer, this new loss was actually more terrifying.  Was it another molar pregnancy?  Something even worse?

This go-around, I am registered on my fancy hospital's web-portal, and can access all of my lab results as soon as they're in.  I was at a work-related function when I made the mistake of checking the site.  Kids, put the phone down, or you'll learn the hard way that nearly bursting into tears in front of your colleagues isn't optimal.

Karyotyping results:  Trisomy 14, Trisomy 22.

Wait, what?  My poor baby had not just one chromosomal abnormality, but two????  Sweet jesus.

That night I get home and of course research the fuck out of these trisomies.  For starters, is it beyond bad to see a DOUBLE trisomy? 

T-22, turns out it pretty common, often associated with advanced maternal age. 

T-14, however, throws me for a loop.  The only hits I really get on it are related to something called a "Robertsonian Translocation" which appears to be an inherited genetic defect.  Good god, are we inherently flawed on top of old?

The next day, new RE calls.  "Your karyotype results are very interesting," she says, with the fascination in her voice that I am becoming accustomed to.  "I had to talk to a genetic counselor to understand them!" 

I love being a walking statistical anomaly. 

Let me guess, Doc, do you suspect we have a balanced translocation?  It turns out my withering old egg contributed the T-22, however, the T-14 came from Husband's DNA.  He would have to get karyotyped himself now to determine whether or not he was a carrier.  For once, I wasn't the one who would be donating vials of blood for the cause.

Friday, August 9, 2013

Dr. Feelgood

My new RE is something of an intimidating woman.  She's just not warm and fuzzy.  Her reviews on Healthgrades have many a complaint about her telling patients to lose weight.  I was actually nervous about this factoid, seeing as I was a bloated pregnant lady.

And when I brought Husband in with me that Monday to see her, she did in fact tell me to lay off the refined sugars should I attempt ttc again - and told my poor husband he could follow the same advice for good measure.  At least she was equitable about it.

We finally got to talk, and I got the distinct impression my case fascinated her, I could see the wheels spinning in her head as I described my history.  Partial Molar Pregnancy.  Asherman's.  Repeat Pregnancy Loss.  But for the first time in a while, a doctor managed to make me feel a little less shitty about my circumstances. 

"You didn't need chemo after the molar? Good."
"Your scar tissue was all localized in your cervix?  Removed in one procedure?  Great."
"You were getting regular cycles?  You had a healthy pregnancy?  You're clearly fertile."

When we got to the part about how I was going to remove my dead baby, she threw me for a loop:

"I don't like to prescribe cytotec to women like you.  If you'd popped out a bunch of kids, maybe.  But it's traumatizing.  And frankly, I want to test the fetus to see whether there were chromosomal issues.  I suspect this is a chromosomal problem, which is normal at your age.  Ideally, this is a situation where you dropped a bad egg.  We should really do a D&C."

But Doctor, what about scarring?  "I won't use force," she says.  "It will be a gentle suction D&C.  There's some curettage, but it shouldn't cause harm."

I look at Husband.  I think about my worst case scenario, another flight to Boston.  I imagine no longer enduring labor pains in my tiny bathroom while Husband tries to hide Niblet away. Take a breath.  OK, a D&C it will be. 

She performs an exam, we chit chat in that awkward way you do when someone will be inserting objects up your vagina, I focus on her teal green toes.  They match her mani. She's really put together.  I, on the other hand, in my current mental state, look like someone who wandered in off the set of a disaster movie.  We talk progesterone.  "You're taking the pills orally?!?!  Oh, I never prescribe them that way.  They act like a sedativeNext time you will take them as suppositories."  I like both the confirmation that my fog and exhaustion was over the top, and of course, I like the words, "next time."

She performs another ultrasound ("hard to get a really good picture with that tilted uterus") confirms that my baby has no discernible movement or heartbeat and we schedule my D&C for the following morning.

Scenes from a miscarriage. Week 3.

Wednesday June 5.  Pregnancy Week 6, Day 4.  Whoa.  I am exhausted. And queasy.  And last night I polished off a jar of pickle juice.  Yes, I said juice.  With a straw.

Thursday June 6, 10am.  Arrive at Maternal Fetal Medicine for ultrasound.

Thursday, 10:30am.  Lying on table squinting at ultrasound monitor.  Tech leaves room to bring in doctor.  The gestational sac is not measuring properly.  A kind doctor comes in.  We talk about my partial molar pregnancy.  I am likely miscarrying again.

Thursday, 11am.  Drive home crying.

Thursday 3pm.  My OB calls, she orders more lab-work.  She repeats what I am still processing, that there is a likely possibility I am miscarrying.  I do not remember the details of this conversation. 

Thursday 4pm.  Arrive at lab for blood-work that will confirm I am once again carrying another dead or dying baby.  Sitting in the chair, choosing which arm to lay forth for more blood, I cry. The phlebotomist asks if I would like to go behind a privacy curtain.

Friday, June 7, 10am.  I emailed Dr. Isaacson the night before asking his advice on miscarriage management.  He advises I either take drugs to induce the miscarriage, or opt for a "gentle suction D&C."  He warns that the drugs don't always work, and in some cases an AS patient ends up in the ER, under the case of a doctor who isn't careful to avoid scarring. He assures me that if my period doesn't return 8 weeks after a D&C, I can revisit him in Boston and he will perform another hysteroscopy.

Friday, 3pm. My doctor calls, she is going on vacation (again).  She suggests that I should see a new Reproductive Endocrinologist to manage my miscarriage because my case history is so complicated.  I am somewhat happy to learn it is a doctor familiar from the Asherman's forum.  She is reportedly competent.  We discuss whether I should take misoprostol (cytotec) to induce miscarriage.  I am given a promise that her office will call new RE, and this RE will fit me in her schedule next week on Monday.

Saturday June 8.  Cancel my zumba class.  Cry.

Sunday June 9, 2pm.  Seven weeks pregnant.  How did I get here?  Accompanied Husband and Niblet to her daycare classmate's birthday party at an enormous bowling alley.  Wonder in a haze, is anyone else here losing a baby, amongst the sound of clanging balls, falling (duck)pins, the sticky floors, the children screaming and skittering around, hopped up on sugar, breathlessly anticipating pizza and fruit punch. 

Sunday, 9pm.  I read every story I can find about cytotec, specifically the intense pain involved.  "I can do this.  I can do this. I can do this," I repeat to myself like a demented little engine that could.  I don't want another D&C.  I don't want my Asherman's to return.  I will gird myself for laboring this tiny sac at home. 

Scenes from a miscarriage. Week 2.

Wednesday May 29.  Week 5 Day 4 of pregnancy.  I'm really fucking tired.  Arrive at hospital Advanced Radiology lab for first ultrasound.  Warned by doctor that the most I will see is a gestational sac, perhaps a fetal pole.

Wednesday, 2:30pm.  Youngish ultrasound tech is baffled by request for ultrasound this early in pregnancy.  Engenders no confidence.  Loudly exclaims "I don't see anything in there.....maybe... yeah, I don't know.... I can't say I am seeing a sac..... I don't know."  I am told my doctor will get an official report the next day.

Wednesday, 2:50pm.  Drive home crying.

Wednesday 6pm.  Start feeling mysterious cramp around right ovary.  Between the pain and the words of ultrasound tech I am now convinced my pregnancy is ectopic.

Wednesday 6:15pm.  Join "ectopic pregnancy" support group on babycenter.com.  Pose symptoms and questions to group.  Read horror stories about ruptured fallopian tubes and near-death experiences.

Wednesday, 9pm.  Warn husband of potential trip to ER.

Thursday May 30, 1am.  Is my cramping getting worse.  Is my baby trapped in my right tube?  Am I going to survive an ectopic pregnancy?

Thursday May 30, 10am.  Call doctor for Advanced Radiology ultrasound report.  Speak to kind assistant who says report isn't in yet, the doctor will call me as soon as she gets the result. 

Thursday 10:15am.  Imagine senior ultrasound technician staring at the images of my uterus in confusion.  I know from years of this shit, it's very tilted.

Friday May 31, 8am.  Call doctor back for lab report, kind assistant is pissed off at Advanced Radiology, my ultrasound report still isn't in yet.

Friday, 9am.  Fuck it.  Call in sick from work.  I'm exhausted.  Take niblet to pool in act of desperation to give her the attentive, loving, non-panicked mother who won't scar her for life, the mother that she deserves. 

Friday, 3pm.  Doctor calls me while I am buying Niblet a grilled cheese at the pool snack bar.  Her report says there is a gestational sac in my uterus.  IN MY UTERUS.  And I have a benign corpeus luteum cyst on my right ovary.  I should return to a lab next week for another ultrasound. 

Friday, 3:10pm.  Who is that crazy grinning lady with the kid in the pool snack bar?

Friday, 3:15pm.  Schedule radiology appointment for the following week with the hospital's department of Maternal Fetal Medicine.  In other words I will see a doctor who can actually read ultrasounds. 

Scenes from a miscarriage. Week 1.

Tuesday May 21. First blood-work, 4 weeks 3 days pregnant. 

Wednesday May 22.  Learn HCG = 668, Progesterone = 18.8.  Remain calm.

Thursday May 23. Second blood-work, 4 weeks 5 days.

Friday May 24, 2pm. Learn HCG rose to 1254.  This is an almost but not quite a 50% increase. Call doctor in panic.  She has left the office at 2.

Friday, 6pm.  New doctor returns my call, this is our first conversation, the first time she hears my voice.  I explain my Asherman's connection to one of her former patients.  She immediately warns that my age is a risk factor.  But my Hcg is fine, she just wants one more HCG and progesterone check. I then take the opportunity to summarize my reproductive history for her, as she does not have the benefit of my chart.  Healthy vaginal birth in 2009.  Partial Molar Pregnancy in 2012.  Asherman's Syndrome.  Concerns about incompetent cervix post-AS treatment in Boston.  She literally says "Oy," when I ask if I can teach my zumba class. (As long as I am not bleeding).  And then warns that she will be away for the holiday weekend.

Saturday May 25.  4 weeks 7 days, head to lab for betas.

Sunday May 26.  5 weeks pregnant.  Anxiously await call for doctor, who said she would receive my betas electronically and inform me of my progress.

Monday May 27, 8pm.  Finally receive call from Doctor.  HCG = 2439, which is good, but progesterone is low, only 10.9, which is bad.  Panic ensues. Dr. Google says it should be at least 15 - 20 is better - for a baby to survive.  Doctor will email in a prescription for oral progesterone to my local pharmacy, tells me not to worry, "I put more stake in rising HCG numbers than progesterone, yours are good," she says, clearly hearing my panic.

Monday, 9pm.  Scouring the internet for literature about the role of progesterone in a healthy pregnancy, imagine my body as a giant hormonally deficient vise crushing my baby to death.

Monday, 2 am.  Up awake imagining my baby fighting for its very survival because, have I mentioned I am hormonally deficient?

Tuesday May 28, 9am.  Arrive at Pharmacy and beg kind woman who looks at me like I am demented to rush my order, which has come through their email.

Tuesday 10am.  Take first dose of Progesterone.  Attempt to "will" myself to a zen-like calm through visualization exercises.  Imagine the cluster of cells in my uterus cheering at the added hormones now coursing through my veins.

Tuesday, 6pm.  Wow.  I am really freaking tired.

Wednesday, August 7, 2013

The Indignities of Advanced Maternal Age

"Supervision of high-risk pregnancy of elderly multigravida."  This is the shit you have to put up with when you're pregnant over 35.

('Pregnancy with other poor reproductive history" is sadly, a test code that doesn't discriminate).

Pregnancy after a miscarriage feels like....

Dumbfounded silence.  The sound of air. 

And then it feels like "Wheeeeeeee!"

Until then it doesn't.

Let me backtrack.  I knew I was pregnant in May, before I even took a test. BAM.  When I finally peed on a stick and saw matching lines I was strangely calm.  I am pretty sure I was quite blasé with my husband like, "Well, I'm pregnant.  O.K.  Cool.  Let's see if it sticks."  This is not the stuff that Clear Blue Easy Ads are made of.

First, I needed a new OB because, well, hell, I couldn't go back to the irritating lady who cracked jokes with a nurse in front of me before she scraped my uterus up and rendered me infertile, let alone the practice that instructed me to arrive for my D&C at the wrong time.

Luckily a member of my AS group saved the day, she told me of a great local obstetrician who delivered her first daughter after AS treatment, a doctor who took her concerns seriously. I would need to change hospitals, and become a patient at the hospital I had previously shunned as it was known in my town as C-Section central.  Of course, the more educated me now understood that this was because the women seeking obstetrics at this hospital were more high-risk.  Like it or not, I was now high-risk too --between my age and my sad little over-dilated cervix, I needed all the extra monitoring I could get. 

(I would like to slap the "old me" now, the one who self-righteously viewed the hospital's publically available C-Section statistics as indicative of servicing well-heeled ladies who lunch, ladies who wouldn't want those lunches upset by something so common as labor.  PLEASE CAN I SMACK ME?) 

So I called this nice OB's office at 4 weeks 2 days pregnant. They set me up with blood tests to monitor my HCG and progesterone, even though the doctor wasn't actually available to see me.  Not an ideal situation, but I took it.

Tuesday, August 6, 2013

Have I mentioned that I really hated my first RE?

I returned to Dr. X for my follow-up as prescribed by Dr. Isaacson, and wouldn't you know it, the guy managed to eff that up too.  No, seriously.  Remember that pipelle he was supposed to use to clear my cervix of scar tissue?  Yeah, well, he went ahead and painfully dilated my cervix instead.  And me, being in a sort of vulnerable position (seeing as I was lying prone and stirrups were involved), I was just like, "were you supposed to do that?"  Dr. X responded, "Oh, well, this is taking your doctor's suggestion one step further."  Are you trying to SHOW OFF Dr. X?  Because that is UNBELIEVABLY wrong.  AS patients are already at risk of incompetent cervix should they fall pregnant, you just made me even more vulnerable.  Jesus. Thanks doc.

THEN  - after he has already performed the completely unnecessary procedure - Dr. X gets all anxious and asks me if I could be pregnant, because dilating one's cervix could you know, cause a pregnancy to fail.  NOW YOU ASK ME?  No, I am still being monitored for my partial molar pregnancy, and I have to wait another month to pull the goalie.  No, I'm not on the pill, we use condoms and I am not about to get on the pill at my age, I am cranky enough. 

The next month my HCG remains negative.  Finally, we're back in business.

Sunday, August 4, 2013

You know your doctor is great when....

You've flown a few hundred miles and they manage to see you on time. 

When you are called from the waiting room you are escorted into a nice private room with good magazines and soon after a student/resident with a friendly smile comes in.  She explains she is here to listen to your story and take you case history.  And she listens.  REALLY listens.  For like, at least a half hour.

When about 10 minutes after the resident leaves, your new RE walks in the room, looks you straight in the eye and says, "It's a pleasure to meet you.  I am pretty confident about what is going on here."  And it becomes clear that this doctor listened to the description from his student.

When your new RE proceeds to whip out a handy plastic model uterus, placing it before you.  And says, "I believe that the majority of your scar tissue is here (pointing to cervical canal).  I am also pretty sure that your cramps are actually a good sign, there is healthy endometrium in your uterus that is shedding each month.  Your upper uterus could well be scar-free"

When you note aloud that no one has believed you up to this point, he says, "I believe a patient knows best about what's going on in her body."  And for a moment you would bear this guy's children you're so happy.

When he continues on, saying, "After I review you via ultrasound, I will take you in an operating room and cut away the scar tissue.  I am going to use scissors.  If you're in pain I will stop.  In a case like yours I will not be using any kind of estrogen treatment because it doesn't make an impact on cervical scarring."  Guys, he's explaining what he's going to do.  He's treating me like an adult!  And he's respecting my potential pain!

When he makes no promises.  "Cervical scarring is often prone to returning and requires some follow-up, a few visits every two weeks to your local doctor will be fine, all he or she needs to do is probe your cervical canal with a pipelle to clear the cavity of any filmy tissue that could return.  And if it returns after that you will come back to me and I will remove it again."

When he sees the aghast look on your face because you believe quite strongly your local doctor is an incompetent asshole.  "Any doctor, even your gynecologist can do this," he says kindly.  "Here, let me show you a pipelle, so you can see what I'm talking about." (proceeds to grab what looks like a really long q-tip).

When he takes you in for a plain old ultrasound and points to the screen and says, "Yes, see here?  Those are some adhesions."  And you're really fucking impressed because you have learned that most doctors will never be able to identify Asherman's on an ultrasound, yours sure didn't.

When you're lying on an operating table, staring up at a helpfully calming picture of a beach, and squeezing your eyes shut after about maybe, 5 minutes, because you know that he's applied betadine to your ladyparts, and then you can feel something really fucking uncomfortable (that would be the scope going in and up, and probably the micro-scissors), but then he says, "Open your eyes, do you want to see?  I've just cleared your cavity.  Here, look at this monitor."

When you look at the monitor, as instructed by a doctor who wants you informed and understanding of your surgery, in real-time, you are amazed because he is moving the camera around inside of you and showing you the cervical canal he's just cleared, as well as your fallopian tubes, which he sees are beautifully clear (his words).  You realize, he really does want you to take ownership of your body and your health.

When he finishes up, he asks how much ibuprofen you took and then jokes, "your stomach will feel worse than my surgery did from 800mg."

When after you've finished changing your clothes he prints out beautiful color pictures of your clear and healthy uterus, a lovely keepsake from Boston, along with a full description of diagnosis, treatment and follow-up instructions about that pipelle.

When you rush back to the waiting room to greet your husband, with tears in your eyes and you say, "I'm fixed."  And he looks confused, and you say, "He did it. It's done. He cleared all of the scarring.  I'm not infertile anymore." 

When you and your husband can sit in Doyle's Pub in Jamaica Plain about an hour after your surgery, eating clam chowder, drinking a beer, marveling at your color picture-vajayay-keepsake, and truly know with every fiber of your being that you just spent the best $500 dollars of your life on flights and a hotel room.* 

When you state that Keith would make a lovely first name for a baby boy.

*Dr. Isaacson is in your PPO network, so you're crossing your fingers that you don't wind up with out-of-pocket costs on your surgery.

Saturday, August 3, 2013

Pilgrimage to Boston.

By the time December 2012 rolled around, I was tired.  I was tired of this infertility that was so rudely foisted on me, tired of cramps that felt like monthly labor pains, I was tired of blood draws to monitor my HCG, and frankly, I was tired of mourning the loss of a future sibling for my niblet.  Because yes, let me say that a top of all else, I was sad.  The complications of my miscarriage forced me to go into overdrive to heal myself and find answers, see lots of doctors and get lots of tests, work-out like a crazy woman to lose the baby weight (THIS is a whole other post) and try to mother the child I already had in a way that wouldn't send her into therapy.  And through all of this, I didn't realize how sad I was.  Earlier that summer I was carrying a baby.  Until I wasn't.

By mid-November, even before what might have been the pokiest failed HSG test in history, I had concluded that I was not going to find treatment for my AS locally.  I didn't trust Dr. X at all.  Now, there are currently three doctors in the UNITED STATES who are considered "A-list" experts in surgically treating AS.  Dr. March, in California, Dr. Olive in Wisconsin (who isn't as well known as he should be, based on the number of Midwestern AS sufferers on the boards who never heard of him), and Dr. Isaacson in Boston.   All three have treated thousands of women like me, women who were told their uterus was obliterated, women who were told to give up ever thinking of carrying a baby on their own. *

Dr. Isaacson, besides being the closest to me geographically (though still a plane ride away), performed most of his surgeries in-office, using a device called a flexible hysteroscope.  No HSG bullshit for him, he would insert a scope into my uterus (while I was awake and on copious amounts of ibuprofen) and he would start cutting away - then and there - any scarring he saw using micro-scissors.  Yes, I said micro-scissors (because as I learned from the AS group ladies, lasers or use of heat in the wrong hands could make scarring worse).  So like hundreds of women before me, I called the offices of Dr. Keith Isaacson at Newtown-Wellesley Hospital in Boston.  Doesn't he look nice? 

You guys, my conversation with the Bahston-accented receptionist at the front desk was more productive than four months of conversations I had been having with my own doctors.  When would I like an appointment?  No, I wouldn't need films of an HSG, Dr. Isaacson will just evaluate your uterus in-office and treat you that day.  Yes, it's ideal for him to see you during certain days of your cycle, but you haven't had a period in months?  No problem.  You need to catch a flight back home that day?  No problem.  It was like the goddamn Brigadoon of doctor's offices.  I felt so comfortable that by the end of our conversation I slipped into a yicky habit I am often accused of by friends, I started talking like her.  Thank god a coworker let me use her private office to make the phone call, so no one around me would be wondering "Why is she talking like that?  What happened to her vowels?"

My hysteroscopy was scheduled for December 12th and I received so many emails of encouragement in my inbox.  Every single woman who assured me that I would love this man and he would absolutely "fix me."  I procured cheap flights, a hotel room and a rental car for myself and dear husband.  He lived in Boston for a while, so he was gonna drive.  My ability to deal with stress has a limit after all.

 *Post-script:  I neglected to mention other A-list doctors in NY:  Dr. Palter, in Long Island who is reportedly amazing, and Dr. Copperman in NYC.  Dr. Copperman is a controversial doctor on the Asherman's site, because he actually uses laser surgery to remove adhesions.  Nevertheless, he has many glowing reviews and a track record that shows his abilities.


When you're experiencing medical problems - particularly ones that bring pain along with anxiety - often, just getting an official diagnosis is a step forward.

By the time I began regularly seeing a Reproductive Endocrinologist at "BABIES GUARANTEED FERTILITY CLINIC" I had already started a new relationship with the amazing women on the Asherman's Syndrome (AS) Support Group.  The more I read about the diagnosis and treatment of AS, the more I felt in my gut two problems:  1) He wasn't experienced in treating Asherman's yet he seemed to brush the surgery off as if it was easy-peasy, a 2) He was dicking me around in even coming up with a diagnostic plan quickly.  "You're not one of our usual kinds of patients," said a nice nurse at the clinic, meaning that I didn't need their assistance to start a normal ovulation cycle, to join an egg with sperm, or to implant an embryo.  Dr. X, to his credit, did realize after some blood work that even more blood work would probably get us nowhere, but couldn't decide whether to schedule me for an HSG at the hospital or a sonohysterogram (same thing basically, but in office and using saline solution). 

Finally, an HSG was scheduled.  Despite the fact that this test is reportedly painful as all fuck, I was excited.  I messaged women in my new AS support group with lame but important, anxiety-easing questions, like "Will I be able to teach a zumba class the same day?" Because after being told that it was my Svengali-like anxiety and neuroses keeping my period away, maybe I would get a more "medical" kind of answer.

Around Thanksgiving, about 4 months after the D&C that caused me so much pain, I show up at the hospital, take 800 mg of ibuprofen to steel myself to the prospect of a giant catheter filling my uterus up with fluid, and eventually lie on a cold table. And a nice woman tries to ram a tube up my cervix.  And I mean RAM.  I mean, the painful part of the procedure hasn't even begun yet!  And after a few more pushes, the kind woman stops and looks at me:  "I can't get the catheter in at all," she says, "it's like a brick wall is completely blocking me."  And she couldn't believe it when instead of bursting into tears, I actually managed a slight smile at her words.

And THAT, friends, is what I call the glory of vindication.  Because for FOUR MONTHS I have been saying I am getting a period, really, only it's trapped inside of me, building up each month and my body is literally contracting with LABOR PAINS to eliminate it.  And now a doctor will FINALLY believe me.


Tuesday, July 30, 2013

Test Please.

The weeks following my provera challenge blur together in a clump best described by the word ARGH.

There's some positivity:  I continue to get regular blood draws to monitor my HCG as per molar pregnancy protocols (and totally imagine an office pool betting on my mortality every time I show up with the bandages on my arm), but I catch a break and my HCG, which dropped to zero in less than 8 weeks, seems to be staying at zero.  Having read many a post on the molar support boards about women needing chemo, I am truly thankful.

But my period is nowhere to be seen, and I am pretty much doubled over in pain each month on the exact day I expect it to show.  I mean pain, like labor pain pain.  My OB write me a prescription for a sonohsyterogram, but says, "I have never had a patient with scarring after a D&C in my years of practice.  It would be like getting struck by lightening."  Seeing as the whole fucking partial molar pregnancy - you know, the kind of pregnancy that brings with it a cancer scare - is like a fucking lightening strike, these words aren't comforting.

And then I can't find a doctor to actually perform the test.  My insurance requires it at an Advanced Radiology Lab, but the doctor is only there once a week, and we can't seem to schedule it properly around what I believe my cycle to be, blah blah blah....it's just beyond irritating.  So I ask for a referral to a Reproductive Endocrinologist (otherwise known as an RE) because these tests are what they do.  Maybe an RE can take a look-see at my uterus. 

So at this point of my journey, I am sent to the offices of "BABIES GUARANTEED" Fertility Clinic.  Look, full-disclosure:  I personally know many women who have landed in this clinic for reproductive assistance.  And from some of my research, if you need IVF or IUI, they're the absolute bomb.  But at this point in my journey, I didn't need to even consider reproductive assistance, I just want someone to take a good look inside my uterus and see what's goin' on in there.

My first visit with Dr. X at the clinic does not get off to an auspicious start.  He asks for my history and his face lights up at my advanced maternal age, because I am old, but not too old (cha-ching).  The lights shut off a little when I explain my recent pregnancy, and the existence of niblet, an easy unassisted pregnancy. Clearly I can get knocked up.  And when I take it upon myself to describe how my period has been MIA, and perhaps maybe I am a walking case of Asherman's Syndrome, he hits me with the words that ruin our doctor-patient relationship forever:  "You should really stop reading things on the internet.  You're not a doctor."

OK, folks, I have known and loved many an actual hypochondriac, and I assure you, I am not one.  No, I am not a doctor (though if I wanted to be a complete douche about it I could technically say that I am a Juris Doctor).  I understand all too well the perils of WebMD.  Like, I know from firsthand experience that if you make the mistake of typing in your cold and headache symptoms into Web MD, you will be told that you are either suffering from a) Allergies or b) SARS.  Not to mention I research shit for a living.  Trust me, I know the importance of a peer reviewed study.  So when I suggest to Dr. X that perhaps my symptoms indicate Asherman's Syndrome, I would appreciate not being pat on the head and told to be a nice little girl and stop reading big words.

Jeesh, this was proving to be a long road.  Even longer when Dr. X said a few more irritating words: "I want to do some blood work and see whether your hormones are at issue."  Two steps forward, three steps back.

If you google it (or, Finding my people, Part II)

So, I'll make a confession, I started googling "(insert number) weeks after a D&C and no period" way before I hit 10 weeks.  It was probably after 6.  I got many hits, most of them on various pregnancy support boards.  I read post after post, and saw most women suggesting to each other some variation of  my OBs theme, "Patience, it will come."  But a few posts caught my eye, ones where women questioned whether they could be suffering from something mysterious sounding called "Asherman's Syndrome."

I perform all kinds of research for a living.  By the time I embarked on my provera challenge around 10 weeks post-D&C, I was already pretty well versed in Asherman's.  A wiki page described the ailment as follows:  "Asherman's Syndrome is a condition characterized by adhesions and/or fibrosis of the endometrium most often associated with dilation and curettage of the intrauterine cavity." Basically, the gist is that your uterus forms scar tissue after surgery.  This doesn't sound pleasant.

Strangely, when I investigate further I come across the following website:  www.ashermans.org, the home of the "International Asherman's Association."  Great!  This problem doesn't just have a name, it has a whole association backing it up.  Who introduce themselves in the following friendly fashion:  "Welcome to our site. If you are looking for information and support for Asherman's Syndrome, intrauterine adhesions/scarring, or related problems, you've found the right place."

And under the heading "Symptoms" I read:  "Most patients with Asherman's Syndrome have scanty or absent periods (amenorrhea) but some have normal periods. Some patients have no periods but feel pain at the time that their period would normally arrive each month. This pain may indicate that menstruation is occurring but the blood cannot exit the uterus because the cervix is blocked by adhesions."  Fuck yeah!  That sure sounds like me.

But as I continue to read the extremely well-presented information on the site, I start to get a bit of a sinking feeling.  Say, from this statement:  "Asherman's Syndrome is thought to be under-diagnosed because it is usually undetectable by routine diagnostic procedures such as an ultrasound scan."  Pristine lining my ass, I think to myself.

Reading the information provided by these kind people empowers me, but also frightens me.  I read about diagnostic tests that I could well need, yet barely pronounce, like sonohysterography, hysterosalpingogram, hysteroscopy.  But all of this is sort of like putting together a puzzle, and I like the idea of approaching the issues in my uterus in a Sherlock Holmesian fashion.  I read that missed miscarriage cases that require D&Cs could increase the risk of Asherman's, as well as studies that show that a woman's uterus can be vulnerable to scar tissue forming there if "retained products of conception" are left in there too long.  And I morbidly realize that I was carrying a dead baby in mine for nearly 6 weeks.

All of this is fascinating, and I am thrilled to see that the Asherman's peeps have a yahoo group that one can join, and with that membership, you get even more information, as well as the ability to talk with other women who are suffering with you.  So even though I realize am nowhere near an official diagnosis of this  malady by a medical professional, I make the decision to join this group.

Readers, this will prove to be one of the smartest decisions I have ever made in my life.