Monday, April 28, 2014

The calendar is mocking me

Well. my HCG is negative.  In the grand scheme of things this is incredibly good news.  No retained products.  No follow-up surgery.  A smooth clean miscarriage if there ever was one.
Husband and I are not ttc this month, my cycle appears to be a little wonky....I never did get a positive line on any OPK, although I did get the ovary pains that usually arrive with ovulating.  Aside from not having the lovefests that are usually engaged in our bedroom mid-cycle, we did nothing to prevent pregnancy per se.  I will say with confidence that the odds are highly unlikely that I will be pregnant from just that one time.  Yeah, I know, I sound like a teen in a pregnancy prevention PSA here from the 80s, or something out of the mouth of your high school friend who totally found herself with child, right?  Just remember, I do not have the ovaries of a 16 year old.

Now comes the obligatory wait for my period, so I can stress about the calendar some more.  Because that's pretty much what I do for maybe, 43% of my day.  I stare - not glance - at a giant "At a glance" book on my desk.  If my period arrives on schedule, I will be traveling for work during my most fertile time.  Because OF COURSE I WILL.  Which has led to conversations in our home about whether Husband flies out to see me for a quickie.  Yeah, you read that right.  I'm 40, I just miscarried, and I can't afford to waste a cycle.  I am getting a headache just thinking about how we would accomplish this, given, you know, niblet.  It's not exactly an ask you want to make of your kind, but somewhat prudish in-laws.  I can just see the poor guy now, "umm yeah, could you watch niblet for a night so I can try to get her mom knocked up?"

Oh, also complicating the quickie?  My employer requires staff to double-up and share rooms during work conferences.  Yeah, you read that right too.  I will be sharing a room with my Research Director on this trip.  Could you just imagine THAT conversation?  "So Research Director, do you mind if I could get the room to myself for about, say, twenty minutes?" Face palm.  So we're looking not only at a round-trip flight for husband to visit, but at the prospect of him ponying up for a room as well.  Ow.  My head really hurts now.

But hey, who knows, maybe my luck will hold!   I mean, the timing of the miscarriage worked out after all.  Maybe I'll be late this month - or extra early.  Even just a day or two would help immensely.  I'll take all that timing energy again universe, so here goes:  I REALLY cannot make a baby between 5:30am on May 20th and  8pm May 23rd.  Is that doable? Thanks!

Thursday, April 24, 2014


I am fairly certain I am about to start ovulating.  My body blares it loud and clear without needing OPKs.  If I count Day 1 of my miscarriage as Day 1 of my cycle I would be on CD 12 today - and I generally ovulate on CD 13 or 14.  Now comes the conflicted feelings.  Do I use protection this week?  Do we wait the one natural cycle for my lining to build up?  Or do I say fuck it, I'm out of town for a good portion of next month and will be away from Husband when I need him, so what the hell.  There are stories of women giving birth to healthy babies conceived immediately after miscarriage, but there are also stories of additional losses due to implantation problems... you just can't win.  The next egg could be the one healthy one I have or another doomed shot.

All of this insecurity is heightened by not having a plan.  Dr. Cuddles is pretty convinced my next step is IVF with PGD.  While this may be true, it is an unattainable goal for us financially.  Personally, I would love to try a few cycles of timed intercourse with femara or injectables.  Or at least use up the clomid pack I have on my dresser.  And I know in my heart I have to start the search for another RE who will be willing to work with me (they are supposed to work with you after all).

One good thing is that I have gone full throttle on my new fertility diet.  I am slamming almonds and sunflower seeds like they're nobody's business.  I am starting each day with a smoothie that includes almond milk, blueberries, flaxseed and kale.  I've lost two pounds and it's not even been a full week of this. 

TLC is on the agenda this weekend.  In addition to teaching a zumba class and spring cleaning my house this weekend, I plan to re-read a few of my comfort books on RPL and infertility.  These include:

Inconceivable, by Julia Indichova


Coming to Term, by Jon Cohen. 

More on these later, but I'll suggest that if you're in the middle of some serious baby blues, these titles could help.


Monday, April 21, 2014

A new beginning

Passover.  Easter.  Spring.  We're in the season of new beginnings.  I have returned from a cross-country trip with niblet and while I'm not quite rested (actually I'm a a whole-lot jet-lagged), I'm thankful that this third miscarriage came and went pretty uneventfully.  Some cramping, some bleeding and then it was done.  My HCG is being tracked to zero and the odds are slim that there are any remains I need to worry about. 

Speaking of which, last night I had a total meltdown.  You see, I had passed what I believe to be the gestational sac right before I left last week, and it sat on my dresser (hidden from view) decomposing in a sterile container marked BIOHAZARD. Like something out of a horror or sci-fi movie.  And late last night, I made a decision that I hope I won't later regret:  I said a prayer and flushed it down the toilet.  Because you see, the thought of taking it in to the hospital for testing, which could in turn send me in for more testing, was just too much to bear.  I am sure the embryo (if there was even one in there) was doomed with run of the mill chromosomal issues, my last two losses were.  And well, lets just say I'm not in a place where "answers" are very helpful.  I no longer need answers.  I need some luck.

Upon learning of my third loss, my LA-based cousin - bless her heart  - said,  "Oh my god, can the doctors figure out what is going wrong?"  Bless her heart, because you see, in LA, women have babies in their late-thirties and forties easy-peasy (and as it happens, ART is hardly unusual in our extended  family).  It just never occurred to her that my older eggs would be to blame.

For the first time in two years I am operating without a real plan.  Husband and I just don't want to throw the dice at IVF without PGD, and we can't afford the PGD.  The thought of a return to doctor Cuddles for another IUI gives me a headache.  I want to wait until I get a normal cycle  to start TTC again, and then I change my mind a say fuck it, why bother even timing anything any more.  I need to stop and breathe.

Monday, April 14, 2014

return to the new normal?

I am sitting at my desk at work on my lunch break and realizing that the smallest glimmers of good news will greatly lift your spirits when you're in a hole.  In my case, the good news is marked by blood. Yes, I started bleeding last night.  With copious amounts of Chinese herbs,  a session of acupuncture that involved "release energy" and an outpouring of prayers and support from virtual and real-life friends, my body is actually doing what it is supposed to be doing when carrying a baby that is doomed.  It will be a with a huge sigh of relief when I am able to tell Doctor Cuddles, thanks but no thanks to another D&C.

IVF isn't as "on the table" as my last post suggested.  The deal-killer is the PGD, or Preimplantation Genetic Diagnosis that is not covered by our insurance.  PGD is thousands of dollars a pop, as much as six in some labs.  On top of the couple of thousand in out-of-pocket costs we would have for IVF, it's just too much.  We just don't have this money.  And IVF without the genetic screening is frankly, pretty worthless and risky.  I can clearly get pregnant (with a little help from ovary-stimulating drugs).  I am just not getting pregnant with any chromosomally normal eggs.

So I sit here, cramping, and staring at my desk calendar, wondering when my next cycle will start.  In four weeks?  Six?  I have cried many my tears on this loss already. I need to move forward, to plan ahead.  And I need to find some sign out there that I can still do this.  That I can still keep trying.  And that I can continue to weather more losses if I must.  Welcome to my new normal.

Thursday, April 10, 2014

And so this too shall pass

I am officially miscarrying.  Thankfully,
1.  A gestational sac is present in my uterus, I don't have to worry about one of my tubes rupturing at any inopportune moment, and
2. My HCG has started to drop.

I will take all prayers, chants, mantras, positive energy and good vibrations that are out in the world right now.  But what I would love, would be to actually miscarry naturally, preferably in the next 4 days, but even more ideally, before Tuesday the 22nd.  I have another D&E scheduled for that date in the event my body doesn't cooperate, because Doc Cuddles is concerned with the "products getting sticky" (her words). 

We also had another IVF conversation, where she raised what I must admit is a good point:  Continuing to go through miscarriages is making me lose not only what's left of my mind, but precious time.  Three chromosomally abnormal babies in a row points in the direction.  I have just learned that our insurance DOES in fact cover it (at least up to 90%). "What I really want to do is extract a ton of eggs from you and have them tested so you wouldn't have to go through this," she said, as I thought "what you really want is me undergoing a $15K procedure.

Nevertheless, it's back on the table.  It has to be considered.  I have been so unhinged from my post-partum drop this week that I swear I was a danger to the world around me.  Yesterday I got pulled over for expired tags - which in fact weren't expired, it's just that the sticker was in my glove compartment (of course it was).  I am quite sure the nice female officer was following me to make sure I didn't drive my car over a bridge or something, after tearfully blurting out "I am miscarrying my third baby."  I could see her behind me as I started bawling behind my steering wheel. 

And so today I am back home taking a much needed mental health day, spring cleaning my house, impatiently waiting for this baby to pass...

Friday, April 4, 2014

Smack my head.

So my latest labs are in and my HCG only rose slightly from two days ago.  I am officially panicked that this is ectopic, though I am clinging to every hope I can muster that with my super high progesterone (over 40) it's not.  If the universe ever wanted to bum me out even more than possible, it would force me into a situation where I needed a methotrexate shot.  And would, thus, be prevented from jumping on the horse for 3 months. 

Welcome to my world friends - AGAIN - where falling HCG is actually a cause for celebration.


I'll have a plate of limbo with a side of grim foreboding

I'm back again in the worst zone of RPL, which in itself I wouldn't wish upon my worst enemy.  My betas are rising but not doubling normally.  I have felt ill-at-ease this whole week, emotional and unstable and not in a happy hormone "wow, I'm pregnant crying at a hallmark commercial" kind of way.

On the worst possible scenario side:  the pregnancy is ectopic.  The best miscarriage outcome I could hope for is a quick acknowledgment that it will not stick.  I have never miscarried "normally" so hold out little hope for this turn of events.  Miscarriages are awful in every form, but after going through undiagnosed miscarriages that last as long as 6 weeks, why can't my body just bleed and be done with it?

On the other end of the spectrum is a very unlikely scenario that I began with a twin pregnancy.  Unlikely because my numbers weren't terribly high to begin with.  But the faintest glimmer of possibility because I did have three large follicles on the morning of my IUI.

With my track record the outcome of all of this is pretty much written in the stars.  My stress is compounded because I am supposed to travel across the country with niblet to visit family. The tickets were gifted to us by a family member.  I feel obligated to go, but it will be trigger city, as my cousin just had her first baby.  I'm honestly at a loss for what to do.  I want to be selfish and just tell everyone, "Sorry, no can do, I am sick and can't fly across the country now with my 5 year old."  But not to self-aggrandize, I have never done anything like that before.  Want me to contort myself into a pretzel for your needs and wishes?  Want me to be in two places at once so everyone can be happy at work/home?  I'm usually your gal.  It's fucking exhausting, but I'm good at it.  Right now, all I feel is useless.