Post-op

It's been almost three weeks since my surgery. The actual procedure went smoothly, no complications. When my doctor came to speak with me right before the actual surgery, she asked what I would want her to do if when she got in there, she found my right tube to be damaged as well. Did we want her to take that one too? I honestly had never even considered this, but reluctantly said yes, knowing full well it would completely alter our fertility plans for the future. Thankfully, that right tube ended up looking fine and the left tube is gone forever. Thank goodness.

The recovery has been okay. Just in the past couple of days, I have started feeling like myself again. One of my incisions is pretty much healed, the other two not so much yet. I surprisingly got my period this week and that was excruciatingly painful since I'm still healing. I knew I was getting ready to ovulate right before surgery, but really thought having the procedure would have told my body to put that on hold for now. Since I was all drugged up and in pain anyway, I clearly never felt the actual ovulation pain right after the surgery. But I must have because exactly two weeks later, there was my period. Silly body trying to act all "normal" despite so much trouble.

I had my follow-up appointment with my doctor this week. They had sent home some pictures from my surgery that my husband and mother had tried their best to explain to me based on what they had been told after the procedure. But my doctor carefully went through it all with me and gave me even more pictures and a copy of the operative and pathology reports too. She removed a little bit of endometriosis, but that didn't really seem to be an issue. She did find and remove two fibroids in my uterus. Not all that surprising either. But she did say when they sent these fibroids for testing, it showed abnormal thickening of the lining of my uterus. Not cancer, less that 1% chance of becoming cancerous, but still not ideal for a pregnancy. It's called simple hyperplasia and mine is the best type to have as it's nonatypical. So yet another diagnosis. And as frustrating as it is to have yet another thing wrong with me, it is also another reason to be thankful that I chose to go back to the fertility doctor and was able to have this surgery. We never would have known about this and could have simply tried again with just the same sad result.

No wonder I've had so many failed pregnancies. So many reasons that lead to losses, it's amazing I've never really had trouble getting pregnant despite all this.

So our next course of treatment is four months of progesterone therapy. She was going to simply put me on birth control for these four months, but it's nearly impossible for me to take an effective birth control pill with my Factor V Leiden since I can't have estrogen. So she opted for the progesterone pills. Each month, after I know I've ovulated, I will take the pills for 10-14 days. This should help thin out and improve the lining of my uterus without completely throwing off my cycle. We still want me to continue ovulating and having a period in the meantime, but not to try to get pregnant at all during these four months. After the four months, my doctor will do an endometrial biopsy (thankfully an in-office procedure rather than surgery again.) And then we'll know whether we can start trying again at that point.

Part of me was sad we can't start trying again right away. I mean, I'm not getting any younger and I never imagined wanting to have my children so many years apart. But then again, it's freeing to know that at least for the next four months, we can kind of relax and just enjoy our life as it is. No worrying about possible pregnancies or losses. We can appreciate our little family the way it is and be thankful in that.

Pre-op

I'm finally having surgery tomorrow to remove my left Fallopian tube. Finally. Nearly seven years have passed since my first pregnancy, the first ectopic that began this rollercoaster. I'd be lying if I said I wasn't nervous. It's actual surgery with full anesthesia that's going to leave me in pain, recovering and unable to work or really care for my daughter for at least a week. But truly, this is a good thing. Something I've hoped for and wanted for a long time. Maybe this can finally lead to a successful pregnancy. But even if not, I will be glad to be finished with this stupid tube once and for all. Glad to not have the almost daily pain. Glad to not feel like I'm carrying around this bad part of me that is such a reminder of dark times.

New plan

This past week was the week of doctors' appointments. I met with my endocrinologist and found out my TSH has dropped back down to 2.7. Not quite as good as it was several months ago, but at least headed back in the right direction. He upped my thyroid dosage and told me to come back in two months. He asked what's happening with trying to get pregnant. I told him I was waiting to find out my TSH level and to talk to my fertility doctor before trying again. He said we didn't need to wait and to go ahead and try now. I do like this doctor, but it's frustrating when they just jump to conclusions without taking the whole big picture into account. It's not "just trying" to me anymore. Five losses later, I need to be more careful about this.

Which takes us to our fertility doctor appointment the next day. Shannon agreed to go. Thank goodness he's willing to be involved even if this is not his first choice. This appointment was to find out the results of all the millions of tests they've done over the past several months and to hear the doctor's plan for going forward. The results were nothing new or shocking to me. I have Factor V Leiden (blood clotting disorder), but now I know that I only have one copy of the gene, making it less likely that this will ever be a problem for me, pregnant or not. They were not able to get any DNA information from the slides from the babies they should have had on file at the hospital, so we weren't able to find out anything about those babies (a disappointment, for sure.) My HSG showed significant blockage in my left tube. She called it a hydrosalpinx. The one piece of new information is how much this hydrosalpinx could be affecting my fertility. Not only does it make it more likely I'll have yet another ectopic pregnancy, it could also negatively affect a properly implanted fetus by leaking toxic fluid into my uterus. Toxic fluid?? She said these can be so serious that almost no doctor would agree to doing IVF if you have a hydrosalpinx because research shows it causes such a high rate of loss. Well, that's news to me. I'm trying not to feel frustrated that we never knew this before. I've had HSG's in the past where we saw the blockage. I've complained of pain in the area for the past six years. But no one was willing to do anything about it until now.

Now she wants to take the tube out. Hallelujah! I've wanted this awful, bad tube out of my body for years. I know my OBGYN was trying to do me a favor by saving it we he did surgery the first time, but I always wished he hadn't. It's caused me nothing but pain and trouble, probably more trouble than I'd even known, it turns out. So now we wait. Wait for me to get my period in a couple of weeks to make sure I'm not pregnant when she does the surgery. I hope I'm not. At one point, I thought this might be a good month to start trying again and we weren't 100% careful, so there's always a chance, but I hope not. I really only think we can handle one more pregnancy, whatever the outcome. And I want to make our last chance our best chance possible.

I know the recovery from surgery won't be pleasant. I remember how painful and difficult it was when I had essentially the same laparoscopic procedure done to remove the ectopic years ago. And I didn't have a four-year-old who wants so much of my attention. Thankfully, my mom just lives down the road and will help a great deal with her. Maybe even my in-laws will help. I'll have to ask for and accept help and that's just the way it will have to be, even when I'd rather be tough and independent and do it the right way myself. Learning when and how to ask for help is a huge skill. I tell this to my clients all the time. Time for me to take my own advice.

The day of our fertility appointment was October 15th, National Pregnancy and Infant Loss Remembrance Day. And yes, the irony was not lost on me.

Craziness

I feel like I'm going crazy. I was convinced in the middle of the night last night that I was pregnant. Absolutely convinced. My period was due yesterday and never came. I've been having cramping and pain, but still not period and this is always how it's been with all my pregnancies. I usually ovulate earlier than expected, but my period arrives like clockwork exactly 2 weeks after I feel ovulation pain which I know for sure was 2 Wednesdays ago. I really didn't sleep much at all in the night, waiting until what I felt was a reasonable time to finally test. I was absolutely sure it would say I was pregnant, so I was shocked when the test read "Not Pregnant". I actually had to look back at it several times to believe it.

I wasn't heartbroken. A little disappointed, but nothing big. This was just our first month semi-trying again and I never expected it to happen so quickly. I told Shannon. He said sorry and asked if I was okay. I am.

So I went on about my day. I've continued to have pain and cramping off and on, but still no period. I had a routine appointment with my endocrinologist where I found out that my TSH has jumped up to 4.7 (!) again. It was .3 two months ago and the only thing we changed was to have me only take half a pill one day a week to help lessen the hyperthyroid symptoms I had been experiencing. I am shocked and disappointed it has risen so high so quickly. So my first thought again is I must be pregnant and that's what is making it go up now. And if I'm pregnant, it's already not looking good. First of all, a negative pregnancy test would show that the HCG levels are pretty low and they should not be that low 15 days after ovulation. Secondly, my TSH is already dangerously high for a pregnancy. So I stopped at a store on the way home and bought more pregnancy tests. This time, I got the ones that say how pregnant you are, like 1-2 weeks or 3+ weeks past ovulation. I figured these would have a lower range for testing and I could trust that. Still "Not Pregnant".

What in the world is going on with my body? In the middle of the night, in my absolutely sureness that I was indeed pregnant, I went ahead a used a progesterone suppository that I had left over from my last pregnancy and does not expire until next year. I know this could have confused my body and could delay my period, but shouldn't that have cleared out by now?

Honestly, at this point, I really don't want to be pregnant after all the worrying this has already caused me today. Last night, in the middle of the night, I welcomed the idea and tried to surround myself in positive thoughts. Today, I can't see that positivity so well anymore. I'm just ready for my period to show up now so I can move on and really try again the right way when my body is more ready.

Trying again

We discussed it and decided to go ahead and try starting this month. Originally I was going to wait since we were just getting started at the fertility doctor and hadn't even had all the tests or officially gotten a plan from the doctor yet. But what are all those tests and plans going to change? I know that most likely they're going to recommend IVF and that we don't want to do that. I'll admit that maybe, just maybe, I would consider it if we didn't have to pay for it. But really, it just doesn't feel right for us. I just want the chance to get pregnant as naturally as possible for me.

I kept hearing in my head that the HSG could help us get and stay pregnant for the next few months. Then the doctor called the next morning to say they saw evidence of swelling/irritation in my tube when she reviewed my HSG results. (Duh, I've told everyone all these years that it hurts there almost daily. No shocker to me.) So they're putting me on a course of antibiotics. I know I've heard of research showing that antibiotics can help your chances of getting and staying pregnant too. So I just couldn't pass up this shot to go ahead and try now. I don't think it will happen right away, but we might as well start now. I never asked the doctor if we should try this month or wait. I didn't want to hear her answer. I've been through this enough now to know I need to trust myself most in this process.

On a semi-related note, Shannon has a much younger brother who got married this summer. They're in their early twenties and still living at home with her parents (in a far away state from us). When we were there for the wedding, people inevitably asked when they were going to have kids and they said they definitely wanted to wait. Fast forward about a month. Surprise, surprise, she's already pregnant (another one from their honeymoon, no less.) I wanted to be happy for them. But really I wasn't. I thought they should wait, etc. But really I was jealous. I cringed at their announcement on Facebook and pictures they were posting of her little belly.

We recently found out that the pregnancy is not going well. Today I was told details that tell me this is definitely ending in miscarriage. It sounds like the doctor is still giving them hope. But I know better. No heartbeat at 11 weeks? It's not happening. There's no way your dates are that off. But I couldn't say that to them. They've reached out to us because they know we've been through it all too many times before. All I could honestly tell her was to hope for the best and prepare for the worst. And keep talking about it with people they know and trust.

It's sad that anyone has to go through this. And sad how scared and alone it makes you feel when in reality, they are so many of us who have experienced the very same thing. I'm thinking I really don't want to stay quiet about it all anymore. I may even share more with my real life friends about my current fertility experience, which I've barely done before. What's the point of staying quiet about it? It didn't help before and definitely didn't help when I was struggling through losses.

HSG

Just got back from my HSG test. It was much less painful than I remember it being years ago when I had it done before. It probably helped that I took two Aleve before I got there... The xray tech woman was very kind and walked me through every step of the procedure, both before and during the test. She even turned the screen so I could see what was happening as it was happening and explained it all to me (which I know she's not really supposed to do, but I so appreciated.) My uterus looked "beautiful", my right tube filled and spilled just like it was supposed to, and the left tube filled a little then nothing. No spilling, even when she had me move in different positions and she put more contrast dye in. So it's still blocked. No surprise.

I wish I could go back to six years ago when I had the first ectopic and had surgery to remove it. I would insist that my doctor take that whole stupid tube out too. I know he was trying to do me a favor, but it's just been nothing but trouble.

The woman that did my HSG today was trying to be helpful and tell me all about how this test can sometimes help you get and stay pregnant for 2-4 months after the test. Then she was explaining to me how your body ovulates from alternating ovaries each month and how she never knew that when she was trying to get pregnant. I had to just stop her there and explain how I already know entirely too much about ovulation and pregnancies, but I appreciated her effort.

Since we're so early in this process now again, I'm not sure how to feel about it all this time around. I want to be excited and hopeful, but honestly I'm just feeling bitter right now. I'm pissed that I even have to go through all this. I'm still mad when I see other women announcing their easy pregnancies on Facebook. I'm angry that I have to go to these crazy lengths just to have the tiniest of hope that I might be able to one day give birth to a baby. I want to get passed all these negative feelings, but for now it just feels like I've opened a big can of bitterness.

Doctor, revisited

Just got back from the fertility doctor. I still have mixed feelings about it all, but it went fine. I spent most of the time actually meeting with the doctor, going over my history and what we plan to do from here. I told her from the beginning that I really don't want to do IVF and she said we would table that discussion for now, but it may in fact be my best shot. I'm going to have another HSG done tomorrow to check my tubes. I remember having this done years ago and it was very painful, especially where the ectopic was. Heck, even the ultrasound she did today hurt when she pushed on that area. So not looking forward to the pain, but I expected this and do want to have the test done again.

Then we'll do more bloodwork next month. The biggest, newest thing we're going to do is she is going to try to go back to the records from the hospital when I had my ectopic pregnancy removed and when I had my D&C to try to test the chromosomes of those two babies. She said this is very new technology to be able to go back to these slides and get this sort of information. It can be difficult to do and may take awhile for them to even track down what they need, but that's the plan. That both excites and terrifies me. I've always had details I imagined about each of the babies, but I've never known anything at all for sure. If we find chromosomal abnormalities in these babies, that indicates a very different plan that almost certainly includes IVF.

It almost felt like an out-of-body experience being there. I've so blocked out so many things from those pregnancies and losses, it was weird to talk about them again. Even when I was filling out the new patient paperwork last week, I felt almost annoyed to have to list the details of each pregnancy again. I wouldn't say I necessarily feel hopeful at this point, but it felt like a positive experience overall. At least not a negative one. I felt like I was heard and respected and I didn't always feel like that by the end of my last fertility experience, to say the least.

I feel like I need to talk about all this to process it. But I'm not sure where to turn at this point. So I'm thankful I still have this blog to help me wrap my brain around it all. Here we go again...

Now or never

I'm going to a fertility doctor this afternoon. It's actually the same doctor I saw a few years ago with pregnancy #4, but she now has an office in my small town so I don't have to go to the bigger city to see her. I'm nervous about it. I have already decided I want to try to get pregnant one more time. I don't want to do IVF, but I want to do whatever else we can to help ensure that this one could be successful.

I've been going to an endocrinologist for the past few months and that has been the most encouraging thing of all. The more I read about hypothyroidism, the more I realize that I have been having symptoms for years! I'm pretty positive that my first pregnancy triggered my hypothyroidism. That was the strongest of all my babies, the one that refused to give up, the one that could have made it if it had just been implanted in my uterus. No pregnancy since that has been so strong. Even the ones that we saw heartbeats for. Those ones always measured a little small, the heartbeat was a little slow, etc.

The endocrinologist did lots of bloodwork from the beginning and finally gave me some answers. I have Hashimoto's disease, which is an autoimmune disorder that causes the hypothyroidism. I had an extreme Vitamin B deficiency and also a Vitamin D deficiency. All of these are linked to recurrent miscarriages. My endocrinologist immediately upped my thyroid dosage and put me on major prescription vitamins. And I am feeling so much better. It's been so many years of this now that it's hard to say if I'm back to "normal", but definitely better. Not so tired all the time, much more energy, starting to lose weight and gain strength. Very encouraging.

So it feels like it's now or never if I'm going to try again. I turned 35 this year, so it would already be a "high risk" pregnancy even without all my other losses. My thyroid level is so low now that I have even been having hyperthyroid symptoms (heart racing, hot flashes, etc.) I can't even drink a Coke now without feeling jumpy for the rest of the day, but I guess that's a good thing since I've been trying to give up caffeine for years. From everything I've read, it's best for my TSH to be as close to zero as possible when trying to conceive and stay pregnant. My TSH was .3 at my last appointment. So now or never, right?

Decisions, Decisions

I had my appointment with my regular OB-GYN today to discuss my options for the future, both if I decide to try again or not. If I were to try again, he said he recommends IVF and gave me the name of a fertility doctor he's seen a lot of success with. I thought about it all day and was starting to warm to the idea of seeing this doctor. Then I looked through the folder of information on them and googled them too. Now I'm not so sure. All of their info and reviews just talk about IVF. And honestly, I've never liked the idea of IVF for me. The thought of spending thousands of dollars and investing so much time and energy in the process only to have yet another loss sounds awful to me. I understand there are some pros for me, especially considering my history. IVF would choose the strongest, healthiest embryos and ensure they're implanted in my uterus, eliminating the worry of another ectopic. That's great and all, but I've had babies seemingly implanted correctly only to lose them...

This will sound crazy, but this morning when we discussed my options for not ever getting pregnant again I was more excited about the idea of a hysterectomy than doing IVF. My doctor tried to suggest a tubal ligation at first, but this doesn't sound like what I want. If I'm *never* going to try to get pregnant again, why in the world would I want to continue having periods?? Very painful periods at that. He finally agreed and documented all kinds of symptoms in my chart in case I do decide to go down that road so we can make sure my insurance will cover it.

I still strongly feel that my thyroid is largely to blame for my miscarriages. The more I research about thyroid disorder, the more it just makes sense. And the more it makes me wonder about other things I'm experiencing that could very well be due to my poorly controlled hypothyroidism. I recently found a doctor nearby who specializes in thyroid disorder. Everything I've read on her website makes me feel that she really could help me, whether or not we ever try again. I've already been leaning towards making an appointment with her just to see if it felt right. So now do I still just do that and ignore my regular doctor's advice? Do I meet with the fertility doctor too just to make sure? Why isn't there someone out there who can help me make these difficult decisions??

Bitter irony

I'm having excruciating ovulation pain tonight. Oh, the cruelest of ironies. Less than one week after I *finally* stop bleeding from the never-ending non-pregnancy, I'm already ovulating again. Enough already! It just makes me feel more broken. The tease of imagining that I'm super fertile and that my body thinks it's already ready to try again is almost too much. I was nearly in tears driving home from work tonight, both from the physical pain but also the emotional drain as well. I know we can't even begin to think of trying again for a few months. It wouldn't even be safe to conceive so soon after four (!) Methotrexate injections. That would only lead to yet another loss again for sure. But my stupid body did not get the message. It's so frustrating. I had a ton of EWCM the other day. And that pissed me off too. Why does my body want to try to trick me like this? Why do I have super regular cycles when it never seems to help anything?? I remember being much younger and having cramps and telling myself it would all be worth it one day because that meant I would get to have a baby one day. What a big pile of crap. Now I have almost daily pain that gets nearly unbearable at times when I ovulate or get my period. And what has that gotten me?? Five pregnancy losses!? It's hard to not feel hopeless and bitter over it all. And alone. I know it's not true, but it feels like no one else has gone through this. It seems like everyone else I know who has had a loss or losses like mine still have had at least one successful pregnancy too. But I can't even make it past eight weeks or so. It feels so unfair that I want to scream. I know so much about fertility and pregnancy, but there's little chance I'll ever get to truly experience it. Most moms I know don't even have a clue, but they just blithely go through these perfect, easy pregnancies. It makes me wonder why I've still keep trying, why I would even consider putting myself through it all again. But I still want to join their club. I still want to have the experience of feeling a life inside of me, of seeing my belly grow, of fun positive ultrasounds for once. Of giving birth, of being able to breastfeed. I know that if I'm never able to do these things, it will be one of my greatest regrets in life. I know I wouldn't love a biological child any more than I love Payton. I know it wouldn't change the parenting struggles. But selfishly, I just want the experience. It's something I've dreamt of for a very long time and it's still hard to imagine finally giving up that dream forever.

Relief

I got the results of my lab work today. My level is 6. Such a relief. Now I can start letting myself feel "normal" again. I went back to my personal trainer at the gym today too. That felt good. Hard, but good. I'm definitely sore tonight, but glad to be achy from exercise rather than the pregnancy/loss. I went ahead and made an appointment with my doctor for next month to discuss all my options for the future. Whether we ever try again or not, this is the appointment I should have made months ago when I was questioning all this. So for now, I'm thankful to be putting this all behind me. Ready to move on. Grateful for all my little blessings. Payton was the sweetest, most well-behaved child tonight and I absolutely loved and appreciated our time together.

More waiting

I had more blood work done today, so now I'm just waiting for the call tomorrow morning with the results. When I went there today, my nurse asked me how I was feeling. I cautiously said I think I'm feeling better, but it's so hard to tell. That's one of the things that is so frustrating about all these pregnancies and losses: they make me feel like I just can't trust my body. I can't tell what symptoms mean what anymore. Just when I think I'm feeling better, I find out my levels still aren't dropping. Or then I start cramping and bleeding again and wonder when my body will just feel normal again. I passed a lot of tissue yesterday, so I'm really hoping to be near the end now. We're going to California in a week to visit my brother and his family and I really don't want to be dealing with this anymore there.

When I went back for my second round of Methotrexate injections last week, the nurse there seemed really shocked to see me again. She said they never get anyone back for a second time for that. Gee, don't I feel special? Now I've had two ectopics and two rounds of Methotrexate with each. Even my nurse today said I must be some sort of record for ectopics. It's like the longest non-pregnancy that just won't give up. But thinking good thoughts for tomorrow and hoping I can finally start moving on...

Mixed

I got the results of my blood work today. My HCG level went down, but only a little. It's still 317, which is basically where it was two weeks ago. I was definitely disappointed to hear that. And even more disappointed that I have to go back tomorrow morning to have another Methotrexate injection. Honestly, I'm ready to just have surgery and get it over with. I want to get rid of this bad tube once and for all. But that's not what my doctor thinks is best yet. Ugh. So another time to the hospital. Two more shots. More waiting to hope my level continues to drop. It's the waiting and unknown that's killing me. I just want it over already. I just want to feel like I can actually start healing again.

On a more positive note, I went to a Mom's Night In tonight with my mommy's group. It's the first time I'd been around any of them since I found out we were losing this pregnancy too. I'd only told one of them about the loss right after we found out and frankly, I'd felt hurt that she hadn't reached out to me. But tonight was good. I stayed until the very end where it was just me and two of the moms I know well and feel comfortable with (including the one who already knew.) So I got to talk to them about everything. And that felt really good. I've learned through my work and especially through all my losses that there is power and healing just in telling your story. Just in feeling heard. I'm thankful to my friends for listening and glad I finally let myself open up.

It was funny. Two of the moms from the group had approached me separately in the past year saying they've considered adoption and asking me about our experience with Payton. And tonight, both of those moms came to me (separately again) and said they are planning to attend information meetings at adoption agencies this week. It made me start to think that maybe we should just go that route again ourselves. I wish there was just one right answer or some way to know the future to know what works for our family. Either way, I know I'm ready now to grow our family. And I know, no matter what, we will be able to do that soon. And that is a good feeling.

Exhausted

Just feeling exhausted today. This loss dragging out endlessly is really wearing on me. I'm really trying to act positive and like it's not bothering me. But it is. A lot. I thought the bleeding was ending and we could just move on, but nope. It's back again and I'm just feeling drained. I thought this loss would be no big deal and we'd just skip past it. No such luck. Still not as bad as my other losses. Still more distractions now and more happiness in general in my life now. I'm not a weeping puddle on the floor this time. But just trying to do some cleaning around the house this afternoon left me out of breath and achy again. So here I am lying with a heating pad again. Gee, what a fun wife and mommy I am lately. Luckily, my mom insisted on taking Payton for the afternoon so I could rest. Shannon has been sweet, but just doesn't get it as a man. No offense to men, but every time I've had a pregnancy loss, Shannon has also had something wrong with him (an earache, a sprained ankle, etc) and he gets tired of me not feeling well and not taking care of him....

This loss, like all the others, is isolating for me again. I've been to work and home and the doctor, but really haven't had any social interaction. I know I tend to isolate myself. I hesitate to go to our regular playgroup and it's not like I'm going to post all this on Facebook. But somehow I thought it might be different this time. Like my few friends I did tell would jump up and help me somehow. But it's the same old thing again. It makes everyone uncomfortable so no one really says or does anything.

I go back to the doctor tomorrow for more blood work to see if my HCG level has gone down. So we'll see if I can finally start to move on and feel like myself again...

Unresolved

Yesterday was, without a doubt, a rough day. Last week when I got the results from my second set of blood work, we found out my HCG level had gone up. Not a lot, really like from 320 to 350. Still clearly not a viable pregnancy, but definitely concerning. So my doctor scheduled me for a repeat ultrasound yesterday morning, just to check. As expected, the results were still inconclusive at best. You still really couldn't see anything. So just to be safe, my doctor diagnosed ectopic pregnancy and sent me off for a shot of Methotrexate. I was clearly not excited about this after having it twice with my first pregnancy and it not working, but I trust my doctor's judgement. I agree it is the least invasive intervention and the best course for now. Otherwise, I end up having a D&C or laparoscopic surgery, or both. Which I guess could still happen, but I doubt it.

The shot experience wasn't too bad this time. I had almost blocked out the other two shots that were awful since I had one in the ER and the other they actually admitted me and put me in a hospital room just to give me the injection. No one knew what to do with me then and said all sorts of inappropriate and inadvertently hurtful things back then. Yesterday was much better. They did the injections (it was actually two shots at once this time) in the infusion clinic where they do IV treatments like chemo and who knows what else. I was the only patient in there most of the time and the staff there was nothing but professional. No one asked me why I was there (hello, it's on the order form) or babied me unnecessarily. They asked if I'd had this drug before, made appropriate jokes and left me alone. Bless them.

I held it together but was on the verge of tears the entire time. I just want the whole thing to be over, to be resolved already. But, as my mom wisely said, this baby is not ready to be forgotten quite so easily yet. I've been having a lot of cramping and bleeding since yesterday, which is good but just a painful reminder. My doctor won't prescribe real pain meds for this one just in case of the slight risk of rupturing if it actually is ectopic. They don't want the meds to mask the pain of cramping versus rupture.

Really, the worst thing yesterday is I felt so alone. Shannon and I had a fight over the weekend and still weren't speaking. My mom was taking care of Payton, who thank goodness still has no idea what is really going on with me. I could have asked a friend to go with me, but didn't. I really wanted Shannon or no one with me. So no one it was. And that hurt.

I went to work for a couple of hours yesterday and that felt good to have that distraction and to have everyone treat me normally since they have no clue what I am going through. But the 30+ minute drive back was entirely too much alone time without distraction. I cried the whole way home.

I pulled it together so I could be there for Payton when I got home. She has no real idea what I'm going through, but she definitely knows something is wrong. She is a smart, intuitive girl. She knows Mommy is not feeling well and is not fully present as much lately. She's acting out at times, but is really handling it well. I keep reminding myself she'll never really remember this difficult time and won't be traumatized by this. She really does make this all easier and help me see the big picture of it all, but it still doesn't erase the pain.

I finally broke down and talked to Shannon last night. So we're better again, which is a huge relief. It's always hard for me to understand what he's going through with all these losses. He acts tough and says he's fine. I almost never see him cry other than in those moments of sad ultrasounds. I think he sees me crying and hurting and tries to be strong for me. But he's hurting too, even if it doesn't look the same as me. We both want the other to just magically understand and to take care of the other one, but it doesn't always work that way. We end up hurting each other more just by struggling in our own pain. I'm not sure how to do it differently, but we're trying.

Today I'm trying to take care of myself. Payton is at preschool. I'm sitting on the couch with a heating pad and my feet up. I'll go to work later and that should be a good distraction and help me feel like myself again. But for now, I'll just try to be kind to myself.

Healing

I feel better today. I'm not saying I've definitely shed my last tear over this pregnancy, but I already feel like I'm coming to terms with it and able to see the big picture without getting swallowed by the darkness again like before.

I'll admit, it wasn't my finest morning as a mother. I woke up cranky and still wanting to just wallow on the couch. Payton was sweet at first, but then really wanted more attention than I was able to give. Our poor cat took the brunt of it as Payton chased her around and generally tormented her in hopes of getting a reaction out of me. As I got more and more frustrated with the situation, it finally dawned on me what was happening. So I gave in and called my mom in for backup.

Then I went to lunch with my sweet friend. The one who brought by the plant last night. The one who's listened to me whine and cry about all my previous losses. The one who's endured my ups and downs despite how hard it must be for her in her own situation. And as always, she listened and empathized. Just talking with her helped me see a new, better perspective. I am so thankful for that.

Then I went to work. I was a little worried about working today, especially since it was at the shelter where I counsel pregnant and parenting teen girls. I knew I would be working with two noticeably pregnant girls and wondered how I'd be able to handle it. Honestly, one of my biggest concerns with trying to get pregnant again was how it would affect my work. I really do love what I do and didn't want another pregnancy loss to cloud my ability to work with these girls.

And amazingly, today, it did not. I didn't cry or even feel especially emotional while I was there. I was able to be present with my clients despite my circumstances and that felt really good. I just felt like myself. What a relief. Actually, I feel more worried about going back to our playgroup. Just too many babies and pregnant bellies there. And thankfully, somehow my brain is able to separate those from the shelter with those of my peers who I compare myself to and, let's be honest, feel jealous of.

I heard from my sweet nurse today who said my pregnancy hormone level was very low, only around 300. So that's a relief too. That means there really isn't a concern of ectopic with this one. And that low number coupled with really not seeing anything on the ultrasound yesterday reassures me that this miscarriage really shouldn't be too bad physically. I'm expecting it to really just be like a heavy period. No fun, but nothing like the trauma of the last miscarriage. This one is much like pregnancy #3, the blighted ovum. Never saw a baby, never felt too attached. I'll go back for blood work again tomorrow, but then I imagine that will be it for this pregnancy. No need for another ultrasound or any other follow-up. Just a two-week blip on the radar and now we can get back to "normal".

Full circle

Today has been a rollercoaster of emotions. I woke up at 4am, already anticipating my appointment this afternoon. I got up and did my Lovenox and Progesterone (which feels strange to just be quitting now.) We had some freezing rain today that threatened to close down the town again for the second time in a week, which is unheard of here. I was afraid I wouldn't be able to go to work and would sit at home worrying all day. But thankfully, I did go to work and was able to take my mind off everything for a bit. My last client of the day decided to color a mandala in session, which meant I got to color too. I was feeling relaxed and focused, ready to face the rest of the day.

While I was working, I happened to write the date and it dawned on me. Today was the day of my ectopic surgery six years ago. Six years ago. It felt like coming full circle to be back at the same doctor again today.

In a lot of ways it feels like we haven't come very far in these past six years. We aren't any closer in any practical way to having a biological child. I've certainly learned a lot about myself and experienced so many ups and downs, but still there are no guarantees.

Then again, I am so different now. What makes me the most different? Today, after a quiet afternoon at home with Shannon where I cried and we talked about where we go from here (not all that different from other losses), my amazing daughter came home. My sweet girl came up to me, gave me a big hug and said "I'm sorry you're not feeling well Mommy." She was both a great distraction and a great reminder that life goes on. That I do have much to be thankful for.

I sent texts out to my few friends and family that I had told about the pregnancy. I just wasn't ready to say the news out loud yet. But eventually I heard from everyone and it was very touching to know they care. One of my best friends who has been there with me through all of this even stopped by with a plant and a card, saying it was in memory of our special baby lost too soon. Her friendship and that gesture means more to me than she'll ever know.

Even with the sadness, I am thankful. I'm glad we found this out today rather than weeks down the road. I never felt especially attached to this pregnancy. Of course, I had started to imagine what could be, but I've really learned to guard myself over the years. Sad, but necessary. In the big picture, this was just a quick two week event in my life and doesn't have to define my entire being. I don't have to go back to that dark place of losses past.

First thing when we got home, Shannon poured me a big glass of wine. I had a big hamburger and Coke and a milkshake for dinner (my ultimate comfort food.) I sat on the couch and let Shannon do most of the hands-on child care tonight. I took an entirely too hot bath. And I'm feeling a little sense of peace with the situation for now.

Sad

Ultrasound did not go well. There was really nothing to see. And there definitely should have been something. They did blood work today and I'll do more Thursday to determine if it's a miscarriage or ectopic. The only thing we could see was a cyst on my ovary, which can be completely normal in pregnancy. So hopefully I'll know something for sure by Friday. Or I'll just have a natural miscarriage in the meantime. If not we'll do another ultrasound next week to decide the best course of action.

Either way, my doctor and nurse were very kind and understanding. I'm thankful for them.

I thought I was prepared for this. But I'm sadder than I thought I'd be. How can I be sad about something I never had?

Anticipation

I have my first ultrasound for this pregnancy scheduled for tomorrow afternoon. I'm still not sure how I feel about all this. Not sure how I'm supposed to feel. Not sure I can allow myself to feel yet. I am really looking forward to the appointment though. I think I'll feel better once I know what we're dealing with. I should be 6 weeks tomorrow, so there should be a heartbeat. If there's no heartbeat or it's not a strong one, I'll be prepared for the inevitable. I know what to expect there. If there is a good, strong heartbeat, maybe I'll be able to let my guard down and enjoy this a bit more.

This pregnancy certainly seems to feel differently than my others. I had symptoms with the others, but sometimes they seem stronger this time around. I definitely feel nauseous, achy, tired, out of breath easily. I have some cramping every day, but that seems to be lessening a little. I've had no spotting since the day before my missed period, so that's reassuring. But who am I kidding? I can't trust my symptoms. They've definitely misled me before.

I know it sounds crazy for only 6 weeks, but my belly seems significantly bigger to me. I'm not skinny normally, but this is definitely more. Even my "fat pants" are getting tight. My mom even commented on it today and she's usually a good judge of me.

The medications are going well so far. The Lovenox injections are leaving less bruises than the Heparin did in my last pregnancy. The Progesterone suppositories are not fun, but do make me feel like I'm doing something to help. I keep reminding myself how the pharmacist said these are good to help "stabilize the pregnancy" and that feels reassuring. I've been on a good routine of waking up super early to do all these meds before Payton even wakes up. So, thankfully, she has no idea what's going on for now. I've been trying to pick her up less and not do every little thing for her. Which is a good thing, whether I'm pregnant or not. She is 3 &1/2 and I definitely tend to foster too much dependence on me.

I've already told myself I think I'll want to try again later this year if this one doesn't work out. I think I could handle one more before officially throwing in the towel. It feels like we've already gone back down the rabbit hole as it is, so we might as well give it our best shot.

I'm going in with a list of questions and requests at my appointment tomorrow. I definitely feel more educated and like I've learned to advocate for myself much better this time around. And luckily, my doctor has been both proactive and open to my suggestions so far.

Shannon tells me I should be more positive this time around. But I still feel like I need to guard my heart. I do so much want things to be different this time and can start to picture it at times, but I'm not ready to fully embrace it yet. Maybe tomorrow...

Gotcha

Tomorrow is Payton's gotcha day; three whole years since she came to our home and changed our lives forever. I will forever be grateful to those that loved and cared for my daughter before we had a chance to. And forever be thankful that I get to be her mommy.

Tonight before bed, Payton chose to read "Are You My Mother?" We always love this one together, but it was especially poignant tonight. I took the opportunity to try to expand on her understanding of adoption. I told her we were just like the book, looking for each other until we finally found one another.

I asked her if she knew what it means to be adopted. She said yes with a big smile on her face, but wasn't able to say more. I explained that she had another mother and father when she was born. She said "My birth mommy and daddy?" I said they tried their best to take care of her, but they weren't able to. I said she lived in a hospital and a foster home before coming here. I told her that when they brought her here and we saw her for the first time, we said "Oh, there she is. There is our daughter."

She smiled and seemed to understand. I told her I was sad I didn't get to know her when she was born, but I'm so lucky to get to be her mommy forever.

Positive

Oh my goodness. You are not going to believe my news.

I. Am. Pregnant.

This is completely unexpected and unplanned. After all our years of trying and struggling and now whoops, here we are. I'm still in complete shock.

If you remember, I stopped taking the Depo this summer after the doctor discovered bone loss. Since then, I've been weighing my options and trying to decide our best plan. I recently decided I would just go ahead and get on a birth control pill and wait until my annual exam in June to discuss it all with my doctor. I was thinking of maybe trying one more time to get pregnant, maybe starting in the fall after going to some sort of specialist to make sure everything was good. And even that was still a big maybe in my mind. Either way, I had called the doctor last week to get a new birth control prescription (which in and of itself was difficult since I was diagnosed with that blood clotting disorder and can't take anything with estrogen.) I picked up the prescription and waited for my period to come to start it. And it never came. Unbelievable.

I know that since I wasn't technically on birth control, there was always a slight chance I could get pregnant. But we were careful. I know when I ovulate and tried to avoid intercourse then. This month we did it one time anywhere near ovulation and it was the day after, so I figured we were good. Surprise!

I started to get suspicious earlier this week when my period was late and I'm never late. But I told myself I was crazy and ignored it. I had some slight spotting and cramping on Monday night, so I took an Aleve, put on a pad and assumed it would come while I was sleeping. But it didn't. By Wednesday I was really suspicious. I told Shannon and went to buy a test that night after Payton went to sleep (I just couldn't buy one at the store earlier that day because I had no idea how I would answer Payton's questions.) I bought a pack with two tests and impulsively took one immediately. I must have done it wrong in my nervousness because the control line never showed so I had to just throw that one away. I made myself calm down and wait until the next morning since I knew it's always better with first morning urine anyway. I slept until 3:30 and woke up very aware that my period still had not come. I tried to go back to sleep, but finally gave in at 4am and took the test. Slowly and faintly, that plus sign started to emerge. I could hardly believe it. I didn't sleep anymore that night, but waited until Shannon's alarm went off at 6 to tell him. In the meantime, I got online and read up on my conditions that may have affected my previous pregnancies and tried to determine my plan of action.

Even as unexpected and unplanned as this is, it is certainly welcome. It's like nature said don't worry about all that trying this time, we got it under control. This has been my dream. Well, actually my dream has been to suddenly find out I'm already 12+ weeks along and everything is fine. So we'll go with it and handle it in stride.

I called my OBGYN as soon as I dropped off Payton at school. I talked to my nurse there (who I love, by the way) and we laughed "So much for that birth control!" She looked at my chart, listened carefully to my history and asked about all the conditions we'd discovered at the fertility doctor (4 years ago!) She talked to my doctor (who I also love) and called me back with the plan. I'm starting Lovenox shots and Progesterone suppositories right away. By chance, I had my thyroid level checked at my family doctor last week and it was slightly elevated. That's a whole other story. I strongly believe my thyroid is to blame for my miscarriages. I've done a lot of researching and reading on the subject and doctors as a whole tend to dismiss thyroid issues. The supposed appropriate thyroid levels are entirely too high. I don't blame my doctor. He can't be a specialist in everything. But knowing what I know, I cannot ignore it. My TSH level last week was 3.5 and the recommendation now is for it to be under 2.5, actually closer to 1 when pregnant and trying to conceive. And just getting pregnant usually causes the level to go up so most women need a 30-50% increase in their medication. I even read in several places where they recommend women automatically increasing their medication themselves once they get a positive pregnancy test. So that's what I did. When I talked to my nurse, she said (as expected) that the doctor wasn't concerned about my thyroid level and didn't see a need for an increase. I respectfully disagreed and insisted on it. And so he increased it :) If I'm going to give myself painful daily injections and vaginal suppositories, I'm certainly going to do everything in my power to save this one.

I'll be referred to a perinatologist, but they have to wait until at least 6 weeks to determine if it is "a viable pregnancy". So I have an ultrasound scheduled with my OBGYN in less than 2 weeks. And I'm okay with that wait. In other pregnancies, I wanted a scan as soon as possible and as often as possible. But I know there would really be nothing to see at this point and nothing I can do anyway. I certainly don't want to lose this baby, but if that were to happen, I know I would live. It doesn't feel so desperate this time around. I know I have Payton and other options. But wouldn't it be amazing if it did work this time?

I went to pick up my new medications this morning. I had to go to a special, New pharmacy since they had to compound the Progesterone and order the Lovenox. I know they're trying to grow their new business, but they completely sold me. The pharmacist was so nice. He went through each medication carefully with me, saying he knew my nurse had said I'd taken some of these but he knew it was years ago. He told me about his wife's miscarriages and that she goes to my OBGYN and loves him too. He encouraged me to call with any questions and made sure I knew how to contact him after hours if I ever needed to.

Then I went to my OBGYN's office so my nurse could give me a refresher on the injections. She totally didn't have to go out of her way like this and I was touched by her kindness. She also gave me a ton of samples of prenatal vitamins since it's been years since I've been on them.

All in all, it's been a positive experience so far. I have to say I'm cautiously optimistic. Still in shock, but hopeful. Maybe this is how it was supposed to be all along.