To the women who bought our bassinet and crib

One of you

bought the fancy crib in which 

my babies never really slept

the other

a blue and tan bassinet

with a folding stand. 

*

Our relationships were brief 

born in each instance 

of a commercial transaction. 

And yet they fostered

the sort of candour 

among strangers 

that loss survivors sometimes share. 

*

You each told me about your losses. 

I empathized 

and shared some of mine. 

There were tears 

and fear

– so much fear –

and hope. 

*

I’ve thought of you 

since then

wondering

and quietly hoping

this time is different

this time 

your baby comes home 

in your arms. 

Thoughts on Redundancy 

I have often wondered in the past 12 months whether to officially park this blog or disable it as its purpose – bringing my spirit baby home – was achieved (thanks be to God, the Universe, my Obstetrician, my Reproductive Immunologist and my tenacity). 

And it’s tough not feeling guilty for throwing my success in the faces of my sisters who soldier on – I remember the anguish posts by those who had living children evoked in me before the MT and by those who had more than one while we endured failure after failure on the road to bringing home our spirit baby. 

But enough about me. This post is about the blog and what purpose I envision it serving going forward. The thought that maybe it could help others has fuelled my ambivalence and the hesitance to disable or abandon it with deliberation (as opposed to the inadvertent neglect born of a busy job and busier couple of boys that’s resulted from Life in the past 12 months and especially since I returned to work last December). 

You see, every so often I get an email from a stranger who has stumbled across my humble blog. I’m always surprised by this as I’ve never marketed or cross-posted on twit.ter or insta.gram to increase traffic or otherwise. Candidly I have always considered this space primarily self serving and at best entertaining. Now that I have little to no time in which to write and post here the space began to feel redundant. What was I adding tithe blogosphere that warranted keeping this site alive?

For better or worse I haven’t found time of lard to give that question prolonged thought. Admittedly it has always been my hope that if someone came here needing help or information or a friend in recurrent loss, she or he would feel welcome to contact me. Each time I am contacted I respond genuinely and as generously as life permits. 

Late last week someone from the company that maintains Dr. Braverman’s website contacted me. He said some things that surprised me and made me reflect anew on what this blog has to offer and how I could be part of expanding options for others struggling with recurrent pregnancy loss or unexplained infertility that may have immunological causes. 

In the end I accepted his invitation to post a link to Dr. Braverman’s website not to increase my doctor’s wealth. He needs no help in that department (a fact of which I’m regularly reminded as I continue to pay down the debt a year past our spirit baby’s first birthday). Rather, I wanted to make it easier for women and couples needing help – like I did – to find me and to find him and other available options. 

In short I wanted to make this space feel less redundant. Notwithstanding my neglect of it these days. To do that I’ve made a long overdue update to my profile page (see here) that now includes a direct link to Dr. B’s website. 

Meanwhile I’ve tried cutting myself some slack for the neglect. 

There are posts I’ve wanted to write and grief I’ve been processing that I’ve considered sharing here. But for now the order of the day is “Life rules”.

Vantage Points and Shame

Today I volunteered at the MT’s playschool.  It runs from 9 am to 3 pm which is a pretty long day for kids aged 19 months through 5 years.  It gave me some perspective on a few things. A vantage point.

First, the MT has some truly remarkable qualities of which I am deeply proud.  Among them is his empathy with others when they are suffering.  A new kid who just started with the program last month is very young and “cry-ey” in playschool teacher/parent vernacular. She was having one sob-fest after another before 10:30 am.

My eldest (living) son tried several times to console her. I watched as he offered her among other things both compassion and affection.  She rebuffed him every time.

The MT persisted. Not in an annoying or thoughtless “it’s all about me, you rescuer” way. Patiently. Softly. Using hushed and warm tones and gentle touch. Eventually I had to tell him that she only wanted to be held by an adult (and one particular teacher if not her mom, who wasn’t there) and that he would not be able to help even though he was doing the “right” things to comfort and acknowledge a friend’s suffering.

Other vantage point have presented themselves of late. For example? The MT adores his baby brother but in recent months has blurted out things like “Mommy can we have a baby girl?” or “Mom can me and [baby A] have a sister?” and “I want a baby girl Mommy.”

Yeah kid.  Me too.

These moments are not helping with my ambivalence and deep longing for a third child (which began as an ache for a daughter but has morphed into a more general longing for a child).  Yet they too offer a vantage point and challenge me to sort through my melee of feelings and thoughts on the subject.

In the past few weeks since first sharing my feelings about this topic I have swung like a pendulum between declaring the prospect absurd and out of the question to pining with an intensity that is hard to put into words. The LP and I have drafted pro and con lists and shared them with each other.

Mostly I’ve detached from my feelings and spent the majority of my time numb about it.  Somehow that seems easier than engaging my feelings.

I was thinking about all of this today while volunteering (I was looking at family photos on the “Family Tree wall” which made me want to interview every parent with more than two living young children).

Unexpectedly, I got a text from the LP’s only nephew’s wife. She is expecting.  My eyes burned and I had to bite my lip hard to stop from bursting into tears in the middle of the playschool Pirate Ship.

Almost immediately I wrote the perfunctory “Congratulations” and “Cute”tt about their pending announcement (which included a 12-week ultrasound photo. Because when we have not personally experienced loss those things make sense I guess?)

To be clear:  I don’t begrudge women or couples who celebrate their babies or who make early (or any social media) announcements. But. Still. They send me down a rabbit hole.  That hole is rife with pain and other feelings I don’t even know how to articulate and feel deeply ashamed even acknowledging now that I (finally) have two living children of my own.  How dare I have these feelings?

I did cry when I told the LP when he called to ask how things were going at the playschool.  I couldn’t help it.  I felt ashamed and confused by my emotions then too.

After my “shift” at the playschool I finally gathered my wits if not my feelings and texted again to thank her for telling me before announcing on social media (she’s pure lovely and one of my few Face.Book connections on my real-name account). I also admitted that I still find unexpected announcements on social media traumatizing for reasons I cannot explain (given the two living kids thing).

The weirdest part? I had a dream the other night that she and her husband were having another baby (they had number one last year on the MT’s third birthday). They got married on the due date of the baby we had longed for and lost in my first pregnancy.  I never forget their anniversary. Sometimes life’s timing serves ulterior purposes I guess.

Anyway, watching myself withhold my feelings in a space where it was not safe or responsible to acknowledge or feel them and reflecting upon it late compelled me to think about why I have so much shame in relation to something so “natural”. By way of example, it goes something like this:

Thought/feeling #1: Why can it be so easy for others and so hard for us? (Eyes burning.)

Thought/feeling #2: I will never make an announcement like this and I never have. (Chest aching, throat tightening.)

Thought/feeling #3: How heartbreaking is that? (Tears welling up.)

Thought/feeling #4: It’s your own fault for letting fear and recurrent loss run your life.

Thought/feeling #5: You have two healthy living children.  Even if you fought tooth and nail for them, they are here and you are pining for the grass you perceive as greener on the other side of some imaginary fence.  Shame on you! (Cold wind encasing my body. Feelings going numb.)

Though/feeling #6: I should reply so she doesn’t think I am traumatized or begrudging them for their good fortune and ease of successful conception. (Sending congratulatory text.)

And on it goes.

From the vantage point I now occupy I see that I’ve been stuffing down my feelings about my own longing for the last several  months.

Last Friday I wanted to cancel the telephone consult we scheduled quite a while ago.  It is scheduled to take place in a little over a week with a doctor at a Canadian facility where we might be able to cycle if he will work with Dr. Braverman and follow his protocol or if he will prescribe my past successful Braverman protocol even if he won’t support working in a consultative capacity with Dr. B. Friday was the deadline for cancelling and getting a refund on the charge for speaking with this doctor.

The LP didn’t want me to cancel. I don’t know why not but I didn’t cancel. Yet I’ve oscillated wildly – so wildly it’s kept me up at night on occasion and I’ve had to settle on numb rather than engage my feelings, whatever they might be, about it all – and had come to rest on the decision not to try again about a month ago.

For a variety of reasons I am not ready to share here I have been flip flopping since then. On the whole I get the sense that my heart simply is not in this. I think it is reluctant to face getting broken yet again.

I do not know how to explain it. I feel detached. Afraid. Ashamed. Uncertain. And exhausted by the indecision. A part of me just wants to shut this process down, grieve the sense of loss and move on. I want out of the limbo.

Which brings me back to shame. Damn that emotion. It is a destructive little devil. And immobilizing.

Is my ambivalence fueled in part by shame (and her evil cousin, guilt?)? I do not know but for the first time the question has presented itself to me and it feels hungry, in need of an answer.

I think I need to start journaling again. And therapy. I’ll add both to my to do list.

What if…

In the early months of this year a friend very close to our family – a friend who had intimately witnessed many of our miscarriages, IVF cycles, immune testing and finally our successful immune-treatment cycle that later resulted in the birth of baby Azulito – called me looking for advice. She was pregnant. 

Not planned, a severe endometriosis sufferer in a long-term relationship with a guy who had taken steps to insure he would not father any more children. Yet there she was, the morning after finding out and wanting advice about how to keep baby and herself healthy and safe. 

She did not want to terminate the pregnancy but her boyfriend did not want to raise another child. Her child. Their child. On top of that she had her own fears about becoming a mother and raising a child herself. 

I felt sick. I felt betrayed by things greater than myself. Again. I was sure she was asking herself many of the same questions I was. How could this be happening? Why is life so cruel? So unfair? Why me? Why now? Why, why, why, why?

For a time it seemed she would raise her child even if doing so meant becoming homeless, jobless and without the relationship that has brought her a whole new life complete with (his and his ex’s) children on a part-time schedule. 

I have been very close friends with another birth/first mom for many years. I knew adoption would be a devastating “choice” in these (in any) circumstances. I dreaded the lifetime of unimaginable grief, self-loathing, doubt and loss I knew would await our pregnant friend if she did what her boyfriend said from day one that he would do: place her baby with an adoptive family (while continuing to help raise his kids). 

As the months passed it became clear that an open adoption was The Plan. I promised myself I would support whatever path our friend chose. It has not been easy for us. It has been much harder for her. Infinitely harder. 

I/we offered everything we could to ensure our friend could raise baby if she chose to do so and we have offered what support we can since she chose to place her daughter with her adoptive family and leave her with them at the end of the revocation of consent period. I hope to be able to support her whenever she may need or want that. 

I cannot count the tears I have shed or the ways in which I’ve felt my heart shatter. I know their number and magnitude are dwarfed by our friend’s own loss to date and in the new life she forges in the open adoption relationship she ultimately chose. 

Why am I sharing this here? Now?

I love our friend like family. I admire her candour and the courage with which she is facing life after placing her daughter. I love her daughter even though I cry and grieve a little each time I look at her photos and think of her. She recently described her child as the one thing of which she is most proud. So she should be; she did the very best she could for that baby from day one.

At a personal level these events have given rise to a river of grief in me I could not have forecast. The river is vast and swift. I have felt myself drowning in it many a sleepless night for months on end. 

In my gut and heart I knew for months – even though the testing was inconclusive and even though she felt that the baby was a boy for most of her pregnancy – that our friend would give birth to a daughter. Surely for my grief to be complete the universe had to deal me this final blow. 

And so it was. 

What has happened for me in the process of witnessing our friend’s struggle with how to manage her unexpected pregnancy and make a plan that she could not only live with but try to thrive with in time is hard to explain. I could not explain it here even if I wished. My views on the adoption industry are not popular and I care too much about our friend to cheapen her experience by sharing what little I can truly know or understand about it given my own history and perspective. I hope I have not already said too much. 

In any event her pregnancy – which chugged along beside my own for many months – forms the impetus for this post and probably several to follow. It opened my heart to feelings and my mind to thoughts I have been unable to shake or put to bed. 

The short version is that I have wept and ached not only for her impossible choices and crushing loss but knowing I would never be able to have a daughter myself. Or another child irrespective of whether a boy or girl. I have cursed myself – for being such a late bloomer, for waiting so long, for buying the lies, for not following my gut and looking for a reproductive immunologist sooner – and fate, the universe, God or whatever you want to call it – for screwing me over so resolutely in the child-bearing department. I have raged against all the wrongs I perceived as a result. 

In short, I have drunk deeply and long from the well of grief. My visions blurs and head dizzies just thinking about it. 

And then it happened. I asked the ill-fated question I probably should have eliminated from my vocabulary long ago when it comes to my reproductive abilities. 

What if… 

What if we tried again? Would I hope for a girl? Yes. Would I be just as excited to have another boy? Absolutely. 

Yes we are too old. Yes this is utter madness. Yes it would cost another fortune we don’t have. Yes it would mean three kids in full-time child care because yes, it would mean me having to go back to work before I would like if it even worked. And the worst yes of all: it may not work and would cost nearly the same fortune to fail as to succeed. 

And yet. I have made inquiries. We are waiting for a consult to determine if a certain doctor in our own country would work with Dr. Braverman if we did a DE IVF cycle with him using a protocol designed by Dr. B and with him consulting (ka-ching x 2). I have grown simultaneously calmer and more restless since setting these balls in motion. 

The one thing I have not done is meditate to call on the spirit(s) of any child(ren) who may or may not be interested in us being his/her/their parents. It is too soon for that. 

I am wrought by an anxiety that this is another manifestation of my grieving and not a sustainable rational or reasonable thing to do. It would surely mean my never retiring. At least not before my 70th birthday. I also do not want to set myself up for an insatiable thirst that ca only ever be satisfied at the well of grief. My communication with any spirit baby or babies will be very different if I am reaching out to say goodbye for now rather than extending an invitation. 

And now for a caveat of sorts:

* I have wrestled with whether to password protect this post. In theend – at least for now – I have chosen not to in case anyone else has struggled or is struggling with similar feelings or circumstances. Whether it readsas such or not this is one of the most vulnerable entries I have ever posted. 

* In light of my deep sense of vulnerability I may delete this post or password it. I will certainly delete and block all troll comments as I have done in the past (you’ve been warned, a-holes). And I may not respond substantively in public to any comments though I may be more inclined to do so outside of this public forum. If this happens please don’t take it personally. I feel pretty raw fragile and pensive about all of “this” at the moment. 

 

I remember you

Little light, tiny boy, you were my first. You were supposed to be born in early August. You left us on New Year’s Day instead. I think about you often. As you know we have given our second living son your first name as his second. You are buried in a planter in our front yard. Remember when I dragged that heavy thing, weighing almost half as much as I do, from our old home to the one in which we now live? I remember you. And my love for you lives on always, not only on days like today dedicated to infant and pregnancy loss. 

Little spark, you were with us only briefly and some doctors said you didn’t count. But you did. I remember you. You were wanted. You too were loved.

Miracle Toddler, you broke the spell. Notwithstanding every complication my body threw in your way you triumphed. You have lived through the six losses that followed you. And the one who survived. Your little brother. You were my first miracle who lived. I will love you forever and in all ways. 

Tiny gift, you were welcomed with such hope. My heart broke with a newfound anguish when you disappeared. Too soon. Forever too soon. I remember you. 

Little bean, I was so excited to know you. I dreamed of holding you. I dreamed of you being my best holiday gift ever. But then you too were gone. Too soon. My heart died a little more with your passing. 

Oh, Mandy, then there was you. You were our holiday and special occasion baby. Conceived on vacation. We first saw your heart beating on my birthday. I watched you grow and knew you would be my beautiful baby girl. You were so brave. You fought hard. But it was not enough. I cried begging the doctor to let me see you one more time, fearing you too had slipped away. Knowing something was wrong. And something was. So dreadfully wrong. The Miracle Toddler cried with me as I mourned your passing. Time and time again. I am so sorry I lost you Mandy. I remember you. I always will. You will forever be the daughter I will never get to hold. 

Tiny button, you were our first IVF baby. Your time with us was brief but our love and longing for you deep and plentiful. I remember you.

Dearest whisp, you were with us for Valentine’s Day and the weeks that followed. And then you were gone. Just like that. I remember you. 

Wee Hope, you were my Mother’s Day baby. I traveled far, yearned long and worked hard for you. I did everything right. I thought it would be enough. How wrong I was. You taught us so much. You are missed. And I remember you. 

Little E, you landed in my womb alongside baby Azulito. Little Blue. He lived. You did not although you tried and for that I thank you and, little E, I remember you.

Baby Azulito, you are finally here. You beat every odd and overcame every obstacle my immune system erected in your path. I could not be more grateful. I will remember you in all ways and forever. 

Though my heart is heavy, my eyes burning and my cheeks stained as I write this, little loves of mine, I know I am fortunate and filled with gratitude for the two of you who fill my arms, day and night. I love each and every one of you. And I remember you even when and even if virtually everyone else has long forgotten most of you. 

October 15, 2015 is a day dedicated to pregnancy and infant loss remembrance and awareness where I live.  I typically have a hard time writing on days like this. My feelings are complicated and it is difficult not to feel guilty when I think of others still struggling and facing today and everyday with empty arms. Yet my lost loved ones deserve to be remembered. And so I write. To all of you reading this who are struggling with infertility and or  surviving pregnancy or infant loss please know my thoughts and compassion are with you. 

A very quick update

Azulito/a’s scheduled birth date is still June 9, 2015. 

The placenta has not moved at all from my last ultrasound three weeks ago. A cesarean delivery is mandatory. 
Thank you thank you thank you for your tremendous outpouring of support and kindness in response to my last post. 

I am going to try my best to mentally prepare myself for the possibility that I may need an emergency hysterectomy on June 9th if the risk of placenta accreta (placenta invading uterine wall, posing risk of mom bleeding to death if not medically resolved, the most extreme means of which is removal of the entire uterus) becomes reality. I am going to will that not to happen but want to stay as calm as possible if it does. So that will be my new project.

That and surviving this awful nausea for the next 13 days. 

I have to go back for one more ultrasound at the Perinatology (Maternal Fetal Medicine) Clinic on June 8th to make sure things remain on track. 

Today baby A was estimated to weigh 6 lbs 4 oz – only a couple of ounces less than what the Miracle Toddler weighed at birth. Of course that estimate can be off by up to one pound at this late stage so the little one could weigh 5 lbs or 7 lbs or anywhere in between! 

We are at T minus 13 days and counting, folks. Holy mackerel!

The Mystery Remains Unsolved

To you lovely friends who offered comforting words and condolences yesterday evening about the pain and sleep deprivation I’ve been experiencing lately: Thank you from the bottom of my heart. Your kind words, wishes and prayers meant so much. 

And they may have worked! I got some sleep last night. Still interrupted by pain jags but much more sleep overall than in many days.

At the hospital, we eliminated all serious conditions that could be causing the pain: pulmonary embolus, lung infection, enlarged or dysfunctional spleen, low platelets, signs of infection via blood test. Thankfully, all of those were ruled out. That’s the good news. 
The not-so-good news is that they cannot give me anything I can take for the pain. The only drugs they recommended at this late stage when the baby (whose liver is far more vulnerable than ours) would get it too are Tylenol and Tylenol 3 (with codeine). I am allergic to a filler or bonding component that’s used in codeine; drugs containing it make me throw up (a rather violent action I’ve been trying hard to avoid). So that’s not an option. Darn. 

The pain is likely a result of inflamed rib joints and surrounding tissue which has gotten worse rather than better – mysteriously – over the past couple of weeks since I injured them coughing my lungs clear. Because Azulito is a big-time mover and shaker, I suspect that the kicks and jabs to that area (which are very painful unlike the kicks to the same spot on my other side, which are just slightly uncomfortable) and the muscle spasms they bring on (man, those hurt! And take my breath away) are largely to blame. 

I also think that the LP’s insanely busy work schedule replete with long hours that mean I’ve been flying solo with the Miracle Toddler much more than usual for the past several weeks and the MT’s decision to become my Velcro-child recently (insisting I pick him up and carry him often or endure his sobs and anguished expressions) are not helping me heal the bruised ribs and surrounding tissue. There is no easy remedy for either of those at the moment, unfortunately. 
Last night I took two extra-strength Tylenol and 3 mg of Melatonin. The latter knocks me out when I’m not pregnant. I do not usually take it while pregnant because of the conflicting information about its safety to baby. Last night I was desperate. And I slept more than I have since Wednesday night of last week. Sorry, Azulito/a, if I made you drowsy or screwed you up in any other way last night. Your mommy needed some rest. 

I am truly hopeful that this is the last time I feel compelled to go to L&D on an emergent basis to rule out any serious issues that could impact the safety of baby or me in this pregnancy. Three visits like this are enough. Only three weeks and one day left for my placenta and baby A to hang in there. Thank goodness the end is near. 

And thank goodness for all of you. Thank you again for your love, kindness, support, prayers and sweet words – both when I was stuck in the hospital last night and always. 

Persistent Pain, I Hate You

I’m at the hospital. Labour and Delivery. Again. 

I am here to get this persistent and at times debilitating pain in my upper left abdomen, just below and behind my ribcage, checked out. I have not been able to sleep more than 30 to 60 minutes at a time the past several nights (and earlier today when I desperately tried napping) before the pain wakes me up. Tylenol does nothing for it. 

There is something about constant pain and sleep deprivation that ribs me of my emotional stability and repeatedly reduces me to tears or near-tears in a flash. I feel like a lousy parent because I can’t do much with the MT and have no energy or endurance when (understandably) he is frustrated and disappointed. He was so sweet today, playing by himself and picking me a gazillion dandelions to cheer me up (I am allergic to dandelions according to my last immunologist but whatever, these are still yellow and not spewing their pestilent pollen). I was looking forward to taking him out today. That did not happen. 

I’ve seen the Resident on duty (who is very kind and remembered me from my first of these three visits to L&D back at 20 weeks) and she has said she is not too sure what to do with me as the only risks from where this pain is are blood clot (not likely since I’m on Lovenox), lungs (they checked my oxygen saturation as step one to rule that out – it was 97% – and are waiting on ordering a chest X-ray as some radiation does pass to baby), spleen and otherwise musculature.  

In Chinese medicine the spleen channel is associated with excema around the eyes (the return of which about 5 weeks ago necessitated my going back on prednisone). I wonder if there is anything to that?

I have been poked and palpated (ouch!! on the left side), had blood drawn and expressed my reservation about the X-ray unless it’s strongly recommended. If platelets are low I will likely need an ultrasound to look at the spleen. The Resident said it is very unusual for a mom to develop a spleen issue during pregnancy, however. Not impossible but unlikely. May I not be the statistical minority once again (cholestasis, which led to the MT’s emergency induction, is also a rare occurrence). 

For now we wait and see. 
Being the mystery patient kind of sucks.  At the same time, I suppose it’s better than being told there is something seriously wrong. The Resident was reassuring as well, saying that since I’m almost 34 weeks now even if something requires that Azulito/a arrive earlier than scheduled, we may not even need steroids for baby’s lungs. 

The LP and MT have been waiting for me nearby but I can’t see them. I wish they were here in this sterile room with me. I miss them and I feel a little stupid for being here as the unexplained case (again).  

My nurse, while clearly skilled, is not pleasant.  I hate drawing the chilly nurse who leaves me feeling disbelieved, as though I am a hypochondriac of a pain-wimp (I’m neither). I don’t think people with that mindset or who exude they attitude should be in this profession (or at least should not work in L&D). If I were in charge…

Anyway.  Here I am.  In the hospital. Uncomfortable. Sleep deprived. And hating on this mystery pain in my upper left quadrant.  Curse you, pain. You suck. 

As I was about to sign off the Resident returned and said the OB on call (who did my lady D&C) said we need the chest X-ray to rule out a lung issue. The Resident gave me stats on the risk and I have signed the consent. Now I wait for that and the blood test results to come back. 

Meanwhile, Azulito/a has been busy busy busy. That is the good news in all of this. 

Fingers crossed that we get some answers and a way to let me sleep before this little person makes a long-awaited arrival. 

As the Baby Turns – 32w1d and Counting

The fun continues!

Baby Azulito/a has officially turned into head-down position. That may be mostly pointless considering that unless this placenta previa and risk of placenta accreta situation resolves itself, I will be having surgery to deliver this baby but I understand that in Chinese Medicine having baby aligned vertically is important regardless of the delivery method so I’m counting this as a blessing. At least until the baby turns again (which could happen, the little one hasn’t been the most compliant with plans to date).

At yesterday’s OB appointment I was reminded that I’m at risk of having an emergency hysterectomy following the baby’s delivery if my imperfect placenta does not release from the wall of my uterus (or has invaded it, which can be difficult to determine on ultrasound with certainty, I’m told). I know that my OB has to make sure that I understand that this is a risk but I could have lived without the reminder. It is much easier not to worry about something when the last time it was mentioned is more than 3 months ago. The risk of this happening is not great – which is awesome – but the fact that it is a risk at all brings me to my knees every time I think about it. Plan: Do not think about it. And no visits to Dr. Google.

I have been coughing so hard from the respiratory flu I contracted (thank you, LP) a few weeks ago that I’ve pulled muscles and am now experiencing the equivalent of bruised ribs on both sides (worse on the left). This was confirmed by my OB yesterday as being just that and not something more serious, thankfully. Still, the coughing gets me up every night and has worn me out most days. My kingdom for some cough syrup or a good sedative.

I’m now 32 weeks which means about 5 weeks to go. Yesterday I discovered that the scheduled caesarean was mis-scheduled for almost 39 weeks. I felt and heard the panic in my voice as I challenged the date at my OB appointment. I barely contained myself from bursting into tears with my OB. He immediately acknowledged this was not in accordance with his instructions (his instructions were 37 or 37.5 weeks), said he’d have the surgery rescheduled and left a note on my chart instructing the staff to call me with the correct date. The risk of going to 39 weeks is stillbirth, of course, and my anxiety over that has been at an all-time high this past month so I really did not need that emotional kick in the cajones yesterday. I have yet to receive a phone call and I will be calling tomorrow if I have not heard by then. Call me distinctly unhappy about this hiccup.

In other news, I have our next follow-up and first biophysical profile (BPP) ultrasound with the Perinatology (Maternal Fetal Medicine) Clinic at our local women’s hospital later this morning (very soon, in fact). I am praying that baby Azulito/a passes that test with flying colours because more worries is something I can live without. I am also scheduled to speak with the Pediatric Urologist about those enlarged kidneys, what they could mean, how any medical issue with them might get diagnosed after delivery and what treatments could be required if they are not simply “large normal” or don’t resolve on their own as everyone hopes.

The LP is in trial today so I’m going it alone at these two medical appointments (same with yesterday’s little chat about placenta accreta, hysterectomy and messed up delivery dates). This is probably better for him in the sense that he is able to stress and worry less when he is not face-to-face with these realities but I do wish things were otherwise and he could be with me. My nerves feel jangled.

On that note and how to unjangle: Later today, I will be seeing an energy healer whom I’ve never met before. She’s trained in Reiki, Yuen Method and Trilotherapy. If any of you have experience with the latter two practices, I’d love to hear from you! My long-time TCMD and acupuncturist recommended I see this woman after I admitted to being at a breaking point last week emotionally from being sick with the flu, sick with morning sickness that has debilitated me despite the drugs lately, and being scared of this baby not making it out of me alive. She suggested it did not seem to be something physical in origin but energetic or spiritual. I’ve been warned that this healer is “a little out there”. We shall see. It cannot hurt. I hope.

Finally, tonight the LP and I are going on a date (!?!) to celebrate our fifth wedding anniversary. When we got married, I wanted to go to Italy and be married with two witnesses and nothing else. The LP wanted a big wedding. We did the latter and the deal was that by our 5th anniversary we’d make that trip to Italy that I wanted (I really wanted to get married on the Amalfi coast. Cliché perhaps, I know, but call me romantic and in need of an exotic honeymoon). Well, that’s not going to happen. This is our fifth and we are so in debt as a result of the past two and a half years of trying to have a second living child that a trip to Europe is out of the question. Maybe for our tenth?

It’s weird to think about the fact that we’ve been together for over 8 years… almost 9 years though officially only eight and a half… we have been through so much, suffered so many heartaches and heartbreaks. We each wear many scars from our prior lives and from the wounds that came with forging a life and trying to build a family together. I started trying to get pregnant before we were even married… wow. It has been a rather lengthy and complicated journey. Ten pregnancies later, here I am… praying that baby Azulito/a comes home in our arms, safe and sound, in another 5-ish weeks and celebrating five years of marriage to my soul mate.

Excuse me whilst I wipe away the tears.

It will be a busy day. Wish us luck. Please.

Revelations

It has been a while since I have updated, in part because nothing really eventful has been happening with this pregnancy – a blessing for which I am tremendously grateful – and because a great deal has been happening in the rest of my life.

 

My most recent ultrasound was almost two weeks ago at 25 weeks.  Baby was measuring on track and was estimated to be weighing in at 2 lbs 2 oz (give or take 5 oz).  For 25 weeks that sounded pretty good to me.  The technician spent considerable time trying to show me why it was not possible our baby has Spina Bifida. I wanted to tell him that I’ve moved on and did not welcome an opportunity to relive the stress that the positive screen for SB caused but I kept my mouth shut, mostly because I could see that he meant well and was trying to be reassuring.  He cross-examined me about why I was being monitored, however, compelling me to reconsider my compassion for his supposed good intentions. 

 

Why do technicians feel the need to grill me about my medical history and my understanding of why I am having extra ultrasounds when they have my chart and invariably say “yes, I read that” when I say we have had many pregnancy losses (8 in total and I hope that ends the count)?   This has happened to me four times during this pregnancy so far, all with different technicians (so it’s not just one sadistic creature doing this).  The second time I actually asked if the tech had read my chart.  She said yes, but she wanted to know what I understood.  Next time, I am not going to play this charade.  If you want to know why I am there, ask the referring physician and stop making me recount my medical history, my loss history, my immune issues and the issues with my placenta. It’s in the chart.  Read it, shut up and do your job.  

 

Funny, I did not realize how bitter I am about the cross-examination routine until I started describing it here.  At least now I know that it upsets me and I will be drawing a very clear, firm boundary should it happen again.  You hear that Universe?  Harumph!

 

Back to the medical update: The placenta is still located both in an anterior and posterior position which means the Placenta Previa diagnosis remains.  The tech thought maybe the placenta had moved but when he showed me where it was in relation to the cervix, it looked exactly the same to me and he was really guessing from reading my chart rather than comparing images from the prior scan to the one he was doing.  He also said that blood flow to the placenta does not change once it’s measured around 20 weeks (which is not true) so I am not putting much stock in his thoughts about the Previa issue when the OB reported it to remain an issue.

 

I am still on Prednisone but have weaned down to 7.5 mg and on Thursday I will drop down to 5 mg and next week Thursday to 2.5 mg.  I will be entirely Prednisone-free in two and a half weeks.  Yay!  I may have a sip of wine to celebrate!  I have three more Intralipid IV treatments and after that the only medication on which I will remain is Lovenox (enoxaparin sodium).  Yay!  I may have a second sip of wine after the Intralipid treatments are done.  You pregnancy purists, pretend you didn’t read that.  

 

As I hover over the threshold into the third trimester, I must confess that I am ready for this pregnancy to end.  Not soon – please do not let this baby come before 34 weeks, Universe, please – but when it ends (which won’t be after 37 weeks in any event).   This has been the single most stressful and exhausting period of my entire life (more stressful than trying to work, complete law school and visit/care for my dying mother; more stressful than articling while escaping a violent partner and rebuilding my life, more stressful and exhausting than the various traumas I experienced living abroad).  I read some of my blogging sisters’ musings about missing their babies being in their wombs or not wanting their pregnancies to end on one level and I feel both sad (because I think it evidences something I am clearly missing out on) and totally unable to relate.  

 

I do not want to come across as ungrateful.  Yeesh, writing that sentence alone made my eyes flood with tears.  I am more grateful than words could ever convey to have carried this baby as far as this and to hopefully be birthing this baby in the next couple of months.  I *love* feeling Azulito(a) kick and wriggle and perform Jujitsu inside of me.  That said, I would trade the in-my-tummy gymnastics for a healthy baby in my arms and an opportunity to get my body back, try to figure out my immune system and get it back onto some kind of healthy plane of existence again, and be on leave from work spending time with the Miracle Toddler and our new addition free from the current daily anxieties about everything that my crappy placenta and my zealous immune system could cause to go wrong with either baby or me, the aching hips and back and neck and shoulders and head, the daily blood pressure checks and injections, the crazy pregnancy dreams, the anxiety of being completely underproductive at work for reasons beyond my control, etcetera, etcetera, etcetera.  

 

As deeply grateful as I am, I have had enough of this roller coaster ride.  I will happily disembark when that time comes (which hopefully is not for at least 7 more weeks!).

 

In other news, the LP and I are in counseling (brought about in large part by the stress and other side effects that the last 2 years have caused). I am glad we are getting help.  I am not ready to blog about it here and may never choose to do that, but I am feeling good about this move and grateful that the LP is taking part voluntarily despite the fact that the issues we are examining dig to really deep, very challenging places in him.  I see this baby as having been and being a catalyst for tremendous change not only in me but in my marriage and in the LP.  The Miracle Toddler will also be facing great big changes soon and I hope he can find it within himself to still say “I love your baby, Mommy” then as he does now (though I will forgive him if from time to time that’s simply too much to ask of a toddler).  I suppose when I envisioned Azulito(a) communicating that s/he chose us because of something to do with “education”, I did not imagine the learning would be so profound this early.  At least I know I was not wrong in interpreting the message that way.  This most certainly has been an education.  And then some.  I have a feeling there is plenty of learning yet to unfold.

 

On that note, I want to thank each of you who read this blog for your support, interest, encouragement, love, kindness and – to those of you who share them, your words.  I will be forever grateful and hope that whatever I may bring to you is some compensation for the time and energy you have shared with me.  I wish you all the best, always.

Curveball #47: I “failed” the first test for Gestational Diabetes

Because life and this pregnancy have not mounted enough hurdles in my path yet, today I found out that I “failed” the GDM (Gestational Diabetes Mellitus) test I took last week as requisitioned by my MFM (maternal fetal medicine specialist). The cut-off for “normal” is 7.7 mmol/l. Anything equal to or greater than 11.0 results in an automatic diagnosis of GDM. Mine was 10.7. Not great.

I was uncharacteristically upset about this all morning. I have taken the previa and even the risk of placenta accreta diagnoses more-or-less in stride, but this GDM news had me throwing a pity party and angry with the Universe and God (why me? why now? why this? can’t you cut me a break for a few weeks here?). Things may not be as bad as I feel right now, apparently. I asked Dr. Braverman if he thinks there is any chance this could change (assuming I fail the second test, the fasting 2-hour test, this Thursday, which my Ob considered somewhat likely given I’m still on 40 mg of Prednisone until at least next week) assuming I can get off the steroids or remain stable immunologically on a lower dose (say 20 mg). He said that he’s not a fan of testing and treating GDM before 24 weeks as a firm diagnosis because many patients no longer have blood sugar metabolism issues after they stop Prednisone (which he aims for by 24 weeks if possible).

We saw my ObGyn for the first time this pregnancy this morning. He was awesome at its finest, being supportive of the work we’ve done with Dr. Braverman, explaining what the MFM wrote in her report on last Wednesday’s ultrasound, and generally discussing in a calm, non-alarmist fashion the pros and cons of everything we are doing to keep this pregnancy going and my health risks and those to baby as low as possible. He is always non-alarmist and never condescends to the LP and I, which I appreciate. Today was no exception. He said he will be doing his job and is comfortable letting Braverman call the shots on the immune meds front and to work with the MFM in any further recommendations she may have as she monitors baby and me going forward.

Do you hear that, Azulito/a? We have a team in place for you!

Even though my GP has not yet transferred my care so my OB’s nurse had to look up some of my test results and reports, I decided immediately after our appointment this morning to cancel my last scheduled appointment with my GP and say so long to the stress that is having to wrestle with her disbelief and exasperating “not medically necessary” nonsensical comments at each appointment. Hasta luego o casi nunca, doctora! There is a headache I can live without.

It is such a relief to have a team of doctors taking us seriously and all aiming for a common goal – to support me and this baby to be as safe and healthy as possible until the optimal time for Azulito/a to make her/his entrance into the world outside my womb.

In closing out this wee update, I want to give the Miracle Toddler and the LP a big shout-out.

The LP has been very loving and kind and trying hard to parent as a team with the novel challenges the Miracle Toddler has been mounting of late. Despite having four trials (one lasting over two months) scheduled in March through June and a crazy busy practice generally, he has come with me to all of the scary appointments lately. For this I am deeply grateful. Even if he says almost nothing, his presence lends me strength and a calm I dearly need (the irony of this is lost on most of you but given that the LP is one of the most highly-strung humans I have ever met, trust me when I say there is some irony in this).

The Miracle Toddler has made generous and heartfelt offerings of his own. He has moved me to tears (only rarely of frustration). His newest thing is to tell me multiple times every day that (a) he loves me (and his daddy); and (b) he loves this baby. When I talked to him on the phone from New York yesterday he said “is baby still in your tummy?” and “I love your baby” when I confirmed that baby was still there. I think he likes it when I tell him that I believe he will be the best big brother ever (in case anyone wants to challenge me for using hierarchical language, please note that as the MT’s mother I own without shame or reservation that I will – without hesitation – award him first place even if your kid is a more capable or equally loving sibling. In case you’re wondering, I would expect no less of you.). It melts my heart every time he says “I love your baby” and “I love you, Mom.”

And that, my friends, is enough to keep me going, potential GDM diagnosis and all of the other hiccups and messy stuff being what they may.

Yet Another Rant About Western Medical and Canadian Public Health Care Bureaucracy

On Thursday afternoon we had a follow-up detailed anatomy (anomaly) scan to last Wednesday’s emergency ultrasound intended to assess whether Azulito/a had any visible anatomical abnormalities that would confirm (or refute) the positive test result for alpha-fetoprotein I received last week Tuesday, indicating elevated risk of Spina Bifida or Anencephaly (or other open neural tube defect).

Thursday’s ultrasound was performed by Mary Poppins. Her pleasant bubbly nature is the only kind thing I can say about the entire experience. She started by asking me if I knew why I was there. Suppressing an urge to plant a fist in her throat and rip out a handful of the hair carefully tousled and tied atop her head, I responded with “You have not read my chart, have you?” as I heard the LP shuffle his feet in the chair at the foot of the examination table on which I was lying.

She assured me she had viewed my last ultrasound but that she liked “to hear from patients”. Trying not to roll my eyes and pinning my fists beneath me so as to avoid risk of assault charges, I recited in 7 seconds or less why we were there on Thursday and why we’d been there the week before. I did not get into the fact that this was pregnancy number 10 for us and that the LP and I suffer from what would surely be diagnosed as some form of ultrasound- and pregnancy-loss-induced post-traumatic stress disorder and could be just get on with it already and let me see what the hell she was looking at (she refused to let me see the screen until the end when I got to see the cutesy baby stuff that people who only get one or two ultrasounds always want to see).

I was upset, scared and angry. In my gut I immediately knew things were not going to go well before she even began the ultrasound. Things ended much worse than I could have expected. She refused to let us talk to the doctor, saying he was busy and needed time to compare last week’s report and images to this week’s. She said we had to wait for him to do that, write up his report, send it to our doctor and make time to speak with my doctor once she received the report.

My doctor is still off work sick (this is two weeks now – did she have a bloody breakdown or catch an infectious disease? For heaven’s sake already!). We went to her office immediately after being rebuffed at the ultrasound clinic. First available appointment with my (about to be fired) doctor is February 12, 2015. Perfect. Universe, are you kidding me?

As a child, I loved Mary Poppins. On Thursday, I wanted to pummel her.

To keep what could otherwise be a long story very short, we learned…. Well…. Nothing. Not entirely true. We learned that Azulito/a has adorable hands and feet. How delightful. Is my outrage and anxiety projecting itself between the lines here? I ask because it is leaping up like bile from my gut and lapping at the back of my teeth as I type this.

Don’t get me wrong, Azulito/a. I love your feet. And your hands. And your little button nose. I love everything about you and am doing everything I can to bring you safely into this world. But what I really wanted to know – what the LP and I really needed to hear was that at 18 weeks the doctor – not Mary Poppins – still could not see any abnormalities consistent with a finding of Spina Bifida or other open neural tube defect.

Mary Poppins not only refused to get the doctor for us to speak with. She refused to tell us how big Azulito/a was measuring so we would be able to assess if the growth was on track from last week in a desperate measure to draw assurance from anything she had scanned in the follow-up that the doctor had recommended. Her secrecy triggered many prior ultrasound experiences in which technicians have either acted evasive and refused to tell me or, when the LP has been with me, to tell us anything or the times when the technicians have outright lied to me (the best one being “I just need a moment to find the heartbeat we saw last time”. Yeah, that never actually happened and I knew the baby had died all the while she kept telling me that lie.)

The LP said “if she’d seen something she would have gotten the doctor” at first but I pointed out that with all of the complications we had with the Miracle Toddler’s pregnancy, not once did the technician ever let on a single issue – we were always blind-sided by the report when my doctor would go over it with me or us later. Upon recalling that, his anxiety level shot up, too. This was very different than last week when they were eager to comply with our (in my view, completely reasonable) request to speak to the doctor and the doctor was candid and forthright in saying the scan was earlier than they’d like, technically difficult and not perfect but did not reveal any abnormalities.

I want to believe everything is going to be okay or at least not fatal or near-disastrous. I truly do. But nothing about what happened on Thursday or what’s been going on in my mind since then is making that easy.

I am no stranger to the bureaucracy of our public health care system. I defended doctors in this regime against litigation and complaints for several years. I have hired and worked with doctors, nurses, others in the Western medical field as experts. I get the CYA protocol that underscores every move every professional makes. And that only makes me more anxious. Because everyone likes to share good news. The lips get sealed when the news is less revelatory.

In short, I am scared. And deeply enraged by the inhumanity of the system in which we are forced – because there is no alternative to the public health system where we live – to accept “care”. If I did not need these people as much as I do right now, I would be writing a scathing letter of complaint to the Colleges of each of the medical professionals by whom I feel utterly and repeatedly let down right now. But for now, that is not in the cards. I hope in time good news will overshadow the bad and I will let go of this outrage, hurt, silence, terror and anxiety and those complaints will go by the wayside.

I know, making them might improve things for others. That’s what my mother would say were she still alive. But I don’t need to be a crusader here. I am barely making it through each day when the stress levels are as high as they have been lately. Besides, I am not convinced another complaint or two or twenty-seven would make one lick of difference in the long run. Experience has taught me that is just not how those complaints work. The doctors and others who get them suffer momentarily, but their Colleges do nothing or next to nothing. And systemically, nothing changes.

And on that sour note, I end the hostile portion of this post.

Now on to something a little sweeter. A note to you, our dear baby. We love you, Azulito/a. Please be okay.

What is next? We attend the Perinatology Clinic next Wednesday, February 4th, for a Level II Ultrasound and to speak with one of the perinatologists there (I will not leave until that happens) about the positive screen, elevated aFP and whether that ultrasound and the ones this and last week suggest any neural tube problems. If so they will offer us amniocentesis. If not I hope this ends our current foray into yet another experience I would not wish on any expectant parent.

Some Good News to Start a New Week

This will be brief but much more upbeat than my last couple of posts.

Today’s ultrasound brought some much needed relief. Azulito/a is measuring a full week ahead, looking like a teeny person (except in 3d when s/he appears rather alien), and had a heart rate of 176 this morning.

I know we are not out of the woods but for today I am both deeply grateful and viscerally relieved. I hope that measuring big is not a sign of something bad I don’t know about (since I’ve always measured behind even in our one ultimately successful pregnancy). I’ve asked Dr. B to avoid any more unnecessary surprises but I truly hope his answer is along the lines of “of course not” rather than “only if it when…”

Thank you all so very much for your warmth, friendship, support, love and company. You really do make a difference.

Bureaucracy and Unnecessary Stress – Updated with Ultrasound Results

On Tuesday morning I awoke from a bad dream in which this baby’s heart had stopped. It came out of the blue and shook me to my bones. I had been intending to cancel this Friday’s (today’s) upcoming ultrasound because it is so close to when I will see Dr. Braverman on Monday. The dream caused enough unrest for me not to follow through on the cancellation plan. I am going for ultrasound number three later today. The lump in my throat as I type those words is palpable.

On Wednesday morning I called my general practitioner’s office the second they opened to ask if I could pick up a copy of my ultrasound report from last Friday to send to Dr. Braverman (and to add to my binder of personal health records because that’s the kind of obsessive behaviour that turns my crank). After leaving a detailed message for my doctor’s amazing nurse/assistant and getting a clarifying phone call from a complete stranger who happens to be sitting at said nurse/assistant’s desk this week (hopefully because said nurse is on vacation), I spent the day waiting and waiting and waiting.

Mid-afternoon I left another message. Very late in the day I got an alarming call back. The stranger had spoken to my doctor who reportedly said:

* she didn’t think that weekly or biweekly ultrasounds were medically necessary (even though she never told me that when she requisitioned them for me on November 10, 2014);

* she remains concerned that our public health care provider may refuse to cover the costs of these ultrasounds and therefore they may not be insured services (presumably because they are not medically necessary in my doctor’s current opinion (?));

* she was not comfortable giving me any more of my personal health records without consulting the clinic’s medico-legal representatives; and

* I may have to complete some paperwork, wait and pay some money to obtain my records but my doctor and the stranger would not be able to tell me anything further until Thursday because the medico-legal people had left for the day.

To say I was upset and stressed out by this development is an understatement. To say the timing was terrible is trite. The tailspin and fury that followed ruined my evening and disrupted my sleep. Deep down, I felt abandoned by my doctor – the same doctor who has seen me through all but the very first of our eight pregnancy losses, the same doctor with whom I have shared both of my comprehensive immune diagnosis and monitoring reports from Dr. Braverman – and fearful that this is the kind of crap I will be facing throughout this pregnancy if we are fortunate enough to see it continue.

I raged against what I have come to behold as a hateful Canadian public health care system. The irony is not lost on me that the LP and I pay a disproportionately high amount for this abysmal system (clearly for others’ use of it since my own access to it has been thwarted at many turns and remains tenuous with respect to the current pregnancy apparently). Once again I found myself saying I would rather pay for private health insurance and have the option to truly choose my care providers and care than live here under this oppressive regime of sub-par care and doctors more concerned about getting paid for their services in a model that wants to refuse payment for anything that may not be “medically necessary” in their draconian view.

In case you fear l lost my mind and am now incarcerated because I brought an assault rifle to either my doctor’s or the public health provider’s office (because I contemplated it – do these people who mess with me at this point forget I am completely hormonal and jacked up on steroids?), there is – or may be, time will tell – a less unpleasant ending to this story than the above would suggest possible.

Yesterday the stranger from my doctor’s office called and said:

* I could pick up last Friday’s report;

* it was the last report my doctor would provide free of charge;

* my doctor had prepared a new requisition to replace the one she gave me on November 10, 2014 in which she instructed the sonography lab to fax a copy of all future reports to Dr. Braverman directly; and

* it is up to the labs whether they comply with this instruction. If they don’t I will have to call each time, pay a small fee for the reports and drive to pick up copies from my doctor’s office.

I don’t mind the small fee. I cannot erase from my memory and anxiety banks the comment that my doctor does not think these ultrasounds are medically necessary. I am still reeling from that and feeling very unsettled about the implications of this comment for my present and future care prospects here at home. I am left with a flurry of questions that – as evidenced by the time of this post – have woken and kept me up at night.

Has she put this in my chart? What else does she think is medically unnecessary? Did she even read the Braverman diagnostic and treatment reports? Does she even believe I have autoimmune conditions that have been responsible for much of our painful reproductive medical history? Will she be sharing her opinions with my ObGyn when she transfers my care to him if this pregnancy progresses?

Ugh.

Why can nothing – or seemingly little – on this journey for us be simple and free of unnecessary stress?

UPDATE: Today’s ultrasound went very well and offered some deeply appreciated reassurance. Baby was measuring ahead (8w4d) at 19.8 mm (I think – I was sneaking an unauthorized peek). That’s almost double from last Friday – the little one had a big growth spurt this past week! Her/his little heart was thumping along at 181 and 179 bpm. The little one also waved its itty bitty leg buds at me and showed off a big old cranium filled with a whole lot of invisible space at the moment.

My cervix is still long and closed (yay!) and I saw the very early stages of the placenta forming. The technician suspects it will be posterior (the Miracle Toddler had an anterior placenta) so that should be interesting if it comes to pass. I have no experience with this but I’ve read that one feels more and earlier movement and is less likely to suffer back labour with a posterior placenta. Sounds good to me!

7w1d: U minus 8.5 hours and counting

I have my second ultrasound in about 8.5 hours. My heart races when I think about it. I wish I could will myself not to think. About it or anything else related to fertility, babies, autoimmune or recurrent pregnancy loss.

Some part of me cannot imagine this scan being another catastrophe. How could we really be so cursed? But the reality is, even if Dr. Braverman’s immune protocol is still working, there is always the chromosomal component that could cause this baby to stop developing or developing normally. We could still have a missed miscarriage for reasons completely unrelated to my hopefully-suppressed and still-behaving immune system.

My best friend wrote me yesterday that she cannot imagine the energy it takes to face the worry every day after all that we have been through to get here. That strikes me as a poignant observation on a few fronts:

1. No wonder I’m exhausted. I’m making another human (I hope) and shouldering or at least trying to process and let go of *so much worry*.

2. My normal is not most expectant mothers’ normal. I am so immersed in my situation and the RPL experiences of several of you that I sometimes forget how rare my circumstances are. How many women have an immune system hell-bent on destroying new life? Thankfully not many in the grand scheme though I think it happens more than most doctors ever acknowledge or are prepared to consider.

3. Knowledge is a double-edged sword. I am so grateful to know why we have lost so many babies. I am also terrified knowing that aside from the chromosomal issue we cannot control there is always the possibility of my immune system developing an adaptive response and doing a 180 on us, especially during the first and early second trimester. This is of course why Dr. Braverman pushes monitoring and why I was so quick to drink that kool-aid. I have been working to accept that so far things look good and I am doing everything I can to make this work. This is as good as it gets. I pray and hope that it is enough.

4. Finally, maybe this will work. And maybe one day in this pregnancy I will wake up and be genuinely less afraid. Not entirely free from worry because motherhood is laced with worry from start to finish. But able to worry less and feel some shade of confident that we really will welcome another child into our lives and home.

For today, my wish is for peace. Peace of mind. A peaceful ultrasound this afternoon. A peaceful sleep tonight. A peaceful journey to December 25th (13 weeks) and beyond. A peaceful birth.

A girl can dream. This is mine.

Ultrasound #1 at 6 weeks 1 day

Yesterday I took yet another red-eye trip from Western Canada to New York City. I rented a car and drove to Woodbury, Long Island and met a friend and fellow Braverman patient for lunch. Lunch, my friend and her husband were delightful.

Then I drove to the bank to get cash to pay for my Intralipid infusion and went into Dr. Braverman’s office. By this point I had slept about 2.75 hours on a plane. I was beyond exhausted and my throat was hurting in the kind of way that left little doubt that I will be sick before long. In this fragile state I had decided not to ask for my ultrasound to be done a day early.

My nurse had other plans when she found out the LP could not come to the Saturday ultrasound today. Before I knew it she shuttled me into an exam room and said Dr. Braverman would be right in to do my ultrasound before the Intralipid infusion. I had no time to think or do much beyond strip from the waist down and fervently plead with powers greater than me for some good news.

Please let this time be different.

I was trembling something awful. Tears were leaking out of the corner of each of my eyes. I shook so much – despite every effort to lie still – that Dr. Braverman asked if he had hurt me and if I was okay apart from the obvious anxiety. He told me not to panic if he did not speak right away as he looked around. I cannot tell you how grateful I was for that caveat because it allowed me a moment to inhale and accept that it would be a few minutes before I has any conclusive news.

That is not what happened.

I looked over my right shoulder at the sonogram screen and the first thing I saw was a clearly visible gestational sac with a clearly visible yolk sac inside it. As I registered my first thought – there is only one – and felt a piercing sadness register in my heart, I saw that magical Rocky Mountain graphing line spread across the screen.

“There is the heartbeat. That is what you told me you wanted to see today, right?”

I think it took me several seconds to digest this. Then came tears and my brilliant and incredulous response: “That is BABY’S heartbeat?”

Next we got to hear it. That beautiful, melodic chuh-chuh chuh-chuh sound. I wiped away tears so I could see the screen. 122 beats per minute. At 6 weeks 1 day. Dr. Braverman said we were looking for 90-110 in the first part of 6 weeks so 122 was fantastic. On top of that, Azulito measured a day ahead – 5.4 mm or 6w2d.

In the other good news department, my uterine blood flow was perfect and my blood tests from 2 weeks ago indicate, in Dr. Braverman’s words, “a textbook perfect response” to the cocktail of immune medications I have been taking. Although he acknowledged that I have a long way to go and it is very early yet, all of my results read as a whole together with this first ultrasound are reassuring. He was very pleased.

He asked if I wanted to redo this performance and video tape it for the LP. Of course I did! After a moment of awkwardness while we navigated removing the dildo cam, me trying to discreetly cover my behind with the paper sheet as I leapt off the examining table, grabbed my phone, leapt back up and tried not to go through my knees (which had turned to rubber at some point in this process), the video recording was underway. Chuh-chuh chuh-chuh chuh-chuh is immortalized in video. Amen.

Azulito has become a film star before his or her second month birthday.

I have never in my life hugged a doctor or felt any inclination to do so. When we ended this visit, however, I told Dr. Braverman I was going to hug him instead when he extended his hand and said “congratulations”. To his credit he did not give me one of those awkward stranger hugs replete with uncomfortable pats on the back. It was a big, warm hug and he even rubbed my back when a sob involuntarily (but thankfully quietly) escaped. I suddenly felt very self conscious and promptly made it all business again (serves me right for hugging my doctor, that’s so unlike me!) and said thank you for getting us this far.

And so it is. Azulito lives. I hope this remains true for a very long time.

Thank you all for believing, hoping, supporting and awaiting anxiously alongside me. I am so very grateful.

Beta #2 at 8dp5dt (13 dpo)

I have been waiting with baited breath all day to get my report on this beta. I had to gamble and order refills of all of my meds except Neupogen (because I ordered lots of it the first time not realizing it was more than a 5-week supply) today without knowing if my betas have doubled otherwise I would have to delay my flight home on Friday.

My hands have been shaking much of the day and I have felt jittery and anxious. I have been waking up at night and unable to fall asleep, which is common for me when pregnant and on prednisone.

The email finally came this afternoon with beta #2. Progesterone results were still pending. Beta was 128. A doubling time of 45.9 hours from 62 on Monday. I immediately felt my heart leap into my throat and I have fought back the urge to vomit ever since.

My only measure of success in my various pregnancies to date (this being #10) is the one success story. My betas were really high and doubled very fast. So when this one did not measure up, I wanted to curl up and die or at least burst into tears and sob all over my desk at work.

I have not done that. I am going to go for a walk and try to calm down and pray that pregnancy #10 will be success story #2 somehow.

My next beta is Monday, October 27, 2014. In the meantime, I’m back in New York tomorrow and returning home Friday.

I’m sleep deprived and overwhelmed by fear. I hate this. I hate my anxiety and inability to tame it. I really, really do. I wish I could enter a coma for the next 8 weeks and awaken to news that the first trimester was over and everything looked great.

I will update Monday after the beta if I can’t find positive things to say before then.

3dp5dt: Holding Fast to Blissful Ignorance

This morning some fearful thoughts tried to sneak their way into my mind. I beat them back with a stick and sent them packing.

Up until that moment, I have enjoyed a very uncharacteristic confidence and sense of calm about this transfer. I never spend the two-week-wait (or the ART variation thereof) in a zen-like state of calm. I am never flooded with peaceful energy and thoughts of my life being pregnant for the coming 8-ish months. Never. Until now.

I feel rather chilled about the whole thing. Yesterday my acupunturist and TCMD asked if I felt optimistic. I could not say yes, not because I don’t have hope but because until I thought about how to answer that question I had been simply feeling comfortable. Comfortable and content. Comfortable that I have done everything possible for this cycle to be successful and odds are that I am pregnant. Content believing that even if it is a complete delusion.

I have discovered the experience of blissful ignorance. How completely fascinating.

I have never understood women saying they did not want to take a home pregnancy test before their beta because they wanted to savour the belief that they were “pregnant until proven otherwise” (an expression I feel quite loathsome toward, even now that I have clearly drank the kool-aid). I’ve always been a band-aid ripper-offer. I routinely and compulsively test early and test often. I have never not tested out my triggers, for example.

This time, I had no trigger. All of my low-dose hCG injections were complete well before transfer (Dr. Braverman prescribed them to help implantation, in lieu of Lupron since we did a protocol without that drug this time). I have no trigger to test out this time. I pulled out tests to stuff into the bathroom drawer last night on the basis that I would start testing Saturday because it is a special day for the LP and I. I knew that would be too early (4dp5dt) but I thought it could give me a baseline against which to measure any changes.

Today, I am reconsidering my decision. What if I feel completely anxious after testing and getting a negative, even though I know it will be negative? I will lose this moment of bliss. My zen-like, peaceful, “optimistic” state will be dashed and it is unlikely I will be able to recover or restore it. Or will it? Can I maintain my faith and find peace in all of this even if I start testing early?

As I think about it, I believe Sunday is the day to start testing. 5dp5dt or 10dpo is the earliest I have ever had a positive HPT before and often the second line is not really visible to anyone not suffering from line-eye until 6dp5dt or 11dpo. But that begs the question, doesn’t it? Should I test at all before my beta next Wednesday? Whether I should or not, I will. That much I know. I just don’t have it in me not to test early. I am who I am.

In the meantime, I am deeply committed to the blissful ignorance that is my unwavering faith that Azulito and maybe a companion are along for the ride and have chosen this cycle to make his/her/their way home at last. I love you, little babies. I know you are only embryos right now but I’m calling you babies anyway. Science be damned.

The last two mornings I have looked to my Animal Spirit Guide cards (I used the physical cards, not the online link or the app). I asked for a message from Spirit about our embryos, Gertrude and Alice. Each morning I drew the Unicorn:

FullSizeRender

Immediately after drawing the Unicorn this morning, I realized I had to indulge in some creative play. I took out my intuition journal (because I couldn’t find my art journal) and some oil pastels, picked up the pastel that my hand first gravitated toward (green – coincidentally the same colour as I had my toenails painted for this cycle), closed my eyes and put pastel to paper. Next my hand went to blue – Azulito’s colour – and I closed my eyes again. I continued until it occurred to me that when I’ve been visualizing the mind-body connection to my uterus lately it has been taking the form of a lotus flower. I felt strongly that oranges and reds belonged in the flower out of which the blue and green presences seem to have floated. Here is what resulted:

FullSizeRender

When I look at the finished product now, I see flames and our Gertrude and Alice rising out of the fiery lotus flower in phoenix-like resurrection. Gertrude (in green) looks a little rougher around the edges and Alice (in blue) a little more contained.

I do not know entirely what all of this means. But it feels right. And I like that.

I could get used to this blissful ignorance thing. It’s almost as good as Val.ium.

The Madness Continues and a Word of Thanks

The plan was hatched. The intentions were set. The flights and hotel accommodations were booked.  And then life came along and got in the way of my best laid plans.  Again.

The LP will not be joining me in New York for the transfer of (I hope and pray) our last two embryos, Gertrude and Alice, on Tuesday.  The transfer has been scheduled for the afternoon.  That was a small hiccup I did not anticipate and although Dr. Braverman told me that science says there would be no problem at all with me flying back home Tuesday night, his gut (and mine) say wait one more day.  I left home Thursday last week and today I accepted that I will  not be back – and I will not see the Miracle Toddler or the LP again – until Wednesday evening.  So it is.

The later-than-anticipated transfer time meant the LP would be travelling back solo (as would I) as he has a work commitment he cannot change further (he already changed it to be able to come to the transfer next Tuesday).  Oh well.

Then something much more serious happened.  The LP injured his back very severely.  Even on muscle relaxants and anti-inflammatory medications, he can barely move.  This has never happened before although he has been having muscle spasms in his back this year.  The suspected source to date has been stress and the strain of a desk job under high tension.  And possibly a lack of consistent exercise although the LP does curl and plays hockey nightly with the Miracle Toddler when not disabled (no hockey today or last night!).

The prospect of air travel and sitting in airport lounges for 8-9 hours on Monday and the same on Tuesday night with a severely injured back makes me wince.  The LP was determined to come notwithstanding this latest obstacle but today we both agreed that this was a bad long-term plan for his physical and mental health and not likely to make me feel very good about asking him to be at the transfer with me.

In other news, the Progesterone In Oil (PIO) is kicking my behind (literally, because you know that is how I roll).  Dr. Braverman’s nurse taught me a new trick about heating it immediately before drawing and administering it and so far this has meant no lumps or bumps because the oil is thinner and moves more easily as I inject it and after having done so.  I don’t so much mind the needles going in.  All of that I can manage and would not even blink or complain.  The pain I have for about 24 hours afterward at the injection site on the other hand… that is not pleasant.  I feel as though I walked into a sharp object and gave myself a mother of a bruise on each flank.  I will take the PIO over Prometrium any day of the week but I hope I find some better spots on those flanks soon or I will be a walking wincing wimp in short order.

On the eve of Canadian Thanksgiving, I am struck by how much I have for which to be thankful.

In the present moment, I have been truly moved by some phenomenal events so far on this week’s stint in NYC.  First, I met a friend and fellow RPL sufferer from Canada and her partner for whom I have developed a lasting affection.  Together we briefly met with another blogger who happened to be attending a conference in NYC this weekend.  That was intense.  I don’t think I could have attended that conference.  Yowza!

I have been awed by the kindness and generosity that some truly amazing women in New York have shown me these past few weeks.  I am humbled and choking up a little as I write to say how honoured I am to have met you.  These amazing women who I did not know a few short months ago have behaved as true, long-time friends do.  You have checked in on me, met me to do things and welcomed me into your homes.

Friends, you know who you are.  Please also know that you mean so much to me and I am so grateful for you helping me be and feel safe, comfortable, “normal” and less lonely in this totally abnormal, often lonely and anxiety-provoking process.  What you have done and are doing means so much to me.  Thank you.

And to everyone who has wished me well, followed along, worried beside me, shared this journey and hoped as I have hoped for you that things will one day work out as we long for them to do: thank you.  A toast to each and every one of you, my friends.  Please accept my heartfelt thanks.  We truly are an amazing group of female creatures.  Yay us.  Yay you.

Spirit Baby, I Choose You

I think for many of us, when we do IVF the first time notwithstanding the statistics saying it only works some – nowhere near 100% – of the time it’s inevitable that we believe in whole or in part that it will work, if not the first time then sometime soon afterward. When IVF does not make our dreams come true (cancelled cycles, BFN, loss), it is such a blow.

When one moves on to donor egg IVF and the same thing happens, it can shatter who you think you are. The blow is hard. In my case, much harder than the first blows with ART. In the LP’s case, the blows may have been more comparable.

When one gets a diagnosis saying you have so many immune and genetic obstacles it is unlikely you could ever stay pregnant and practically impossible for you to carry another child to term after doing so once, as I did, the devastation is complete. Or one is inclined to think it is. We want that to be the final blow.

I pray and hope that there is no next level or layer of obliteration of my sense of self and faith in God, myself, western medicine, traditional Chinese medicine and the contract I believe we have made with our spirit baby.

My fear is not gone even though I am choosing not to give her voice. The risks are real. I know that. I choose not to think about them. I know from experience that this means any negative outcome will be soul-shattering.

I know there is a decent chance the first time we do this immune protocol and use a frozen embryo that may not survive the thaw we run the risk that it will not work.

The risks are real.

I choose not to linger on them.

I choose faith.

I choose hope.

I choose life.

I choose my beautiful, powerful, heart and soul shattering spirit baby, Azulito.

Azulito, I choose you.

Intralipid Presentation by Jeffrey Braverman and Darren Ritsick

Last Friday while I was hanging out in Woodbury, Long Island (because that’s how I roll), I had a nice chat with Dr. Braverman about the cocktail of drugs he has prescribed for me, how they work, why I care, and why in his view “everything” on the Internet about reproductive immunology is “wrong” (because that’s how he rolls).

I harbour no illusions about the fact that if he were aware of my blog and he and/or his team read my attempts to understand and convey that understanding I would fall squarely into the “wrong” camp of misinformation on the world wide web. Since he has effectively admonished not only me but everybody with medical degrees and knowledge far more comprehensive than mine will ever be, I reckon I’m in good company. I also figure that there is no point in trying to perfect my lay-person (read “for Dummies”) posts if they are destined to be “all wrong” in any event. As I’ve said before, I am NOT an MD and I am NOT offering any medical advice here.

With those caveats out of the way, I offer an unsponsored invitation to those of you currently prescribed (or past users of) Intralipid to read the presentation slides to which Dr. Braverman referred me during our fireside chat. Okay, there was no fire. But there was music, thanks to the good doctor (seriously, he turned on the music). He mentioned having given a presentation at the American Society for Reproductive Immunology conference that he chaired (of course he did ;-)) this past June about Intralipid and that it was posted on his clinic’s website. I had not read it previously.

Other than the information I’ve read on medical research sites and compliments of Evil Dr. Google, my only prior experience with Intralipid was when my mother was hospitalized for colon cancer and received the treatment when she could not consume foods by mouth. They had a PICC line in her upper chest and my most vivid memory is her visible pain and distress while having that line installed (I spent every moment I wasn’t in law school at the hospital when my Mom was first diagnosed. I learned and saw things I wish I could erase from my memory. Life is cruel sometimes). When the PICC was inserted, I almost puked. As is true for most of us, it was much harder to watch someone I love suffer than it is to endure my own pain.

Skulking around, I found the presentation to which Dr. Braverman had referred. Apart from the above trip down memory lane, I am here now to share the wealth. I believe the article is written by Dr. Braverman and his Director of Research, Dr. Darren Ritsick (who is very nice and shared some research when I had neupogen questions previously – a shout out to him). The introduction recognizes both authors although the Power Point only includes Dr. Braverman’s name, as he was presenting (to my understanding, which could be “all wrong”).

Before I post the link, I want to add some editorial comments, per the it’s my blog and I’ll cry (or sing) if I want to principle.

First, I am very curious about the discussion at the end of future research directions, eincluding the interaction between Lovenox and IL and gender and IL. I hope by the time that research is reported my interest is a purely academic one and not one borne of personal necessity and a heart broken more times than I care to think about.

Second, I know some of you will not take the time to read the actual Power Point slides. I have worked with human beings in high-stakes ventures long enough to know that not everyone will do the heavy lifting even if they know it may be in their best interests. On that basis, I will also mention an important point I drew from the presentation. Intralipids are NOT a discount substitute for IVIg. Levels not believed at this time to be corrected by Intralipids, according to these authors, include:

* Elevated intracellular cytokines
* Elevated serum cytokines
* Elevated autoantibodies/alloantibodies

See slide 35 for more on the IVIg / IL discussion. Of course, if I could afford IVIg, I would be asking Dr. Braverman about that as an alternative for me given that I hit the first two of those three targets. Alas, money is a live issue and I have not done so. He did say it may be something to consider if attempt #1 with the Intralipid IV and the rest of the cocktail does not work. I am not going there right now.

The presentation also includes some interesting (to me, confessed nerd) discussion about using other oils in the emulsions, such as fish oil or even olive oils, which on the spectrum are less pro-inflammatory than the current/previous formulations that use soybean and safflower oil. See slide 36 for an illustration of this.

Even more fascinating (again, to me) is the possibility that Intralipid may have angiogenic (formation of new blood vessels from existing ones) effects. I’m no doctor but it seems to me that this could be a big deal for women whose placentas are not forming properly for immunological or other reasons.

In short, it seems to me that if Intralipid is an iceberg, reproductive immunology has only explored the tip at this point. How exciting (to me)! To me, it is also a little unfortunate in that I would love to be able to leapfrog ahead to the day when Dr. Braverman and his awesome team could offer a more certain outcome in my case (and yours, fellow immune-affected readers). Alas, the resources of Mr. Peabody and Sherman are not available to me (or you) yet, so onward I march.

Without further ado, the link to presentation can be found here. Further instructions for Dummies (present company included): Click on the blue line that reads “Click here to view Dr. Braverman’s Intralipid PowerPoint Presentation”.

Enjoy, friends and fellow RI and other science/medicine/reproductive health nerds!

Please Let These Needles and Other Things Do the Trick

This morning marked episode one of my current three-needles-per-day (Neupogen, Lovenox, Novarel (hCG)) and multiple pill (Prednisone, Estrace, Claritin, 81mg Aspirin) routine. I also am on a bunch of supplements to which I have had to add Calcium (to address the negative effects on bones caused by the Prednisone and Lovenox) and Magnesium (to avoid the constipation that will surely follow the high doses of Calcium and because it’s supposed to help balance things out more generally).

Only the Lovenox hurt and only a little. I have divided my supplements and drugs into 5 doses/times. This is the most regimented I have ever been entering a cycle. It feels obsessive and reassuring at the same time.

To be honest, I’m not entirely sure how I feel. The fear is hanging around like a bad penny but I’m trying to keep holding her hand and reminding her that we can get through this together. She needs me more than I need her; if I send her packing, she’s gone. She does not need to know I am likely unable to do that at this point.

I keep trying to remind myself that this may not work the first time and that is okay. I think I need to stop that and just tell myself I’m already pregnant, as I did with my last transfer (the one that ended badly in May). Although it ended badly, I was more confident than I have ever been and I felt better throughout the cycle as a result of that increased confidence.

Of course, my increased knowledge of how many obstacles stand between me and a healthy, full-term (or at least viable) pregnancy makes self-delusion a little trickier.

I return to New York to spend another date with Dr. Braverman’s nurses for my second Intralipid infusion and with the Almighty Oz himself on Friday for another ultrasound (to check my lining and other lady bits). I will also need blood tests done; Dr. B orders all kinds of hormone levels, not just estradiol. I hope to have the blood tests completed Thursday evening at home so I don’t have to pay for them in New York (since I don’t think I can get that reimbursed by our public health system or paid for by my private insurance).

I will be on weekly Intralipid infusions for three weeks and then every two weeks. In theory, our embryo transfer will happen between that third infusion and the switch to the bi-weekly plan. I hope I make it to the bi-weekly part of the plan.

I cannot even express how much I want this cycle to work. Please, forces greater than me, make this happen.

To Infinity and Beyond!

Today is officially Cycle Day 1 (CD1) of my FET cycle with Dr. Braverman. The intralipids infusion, ultrasound and three chats with Dr. Braverman yesterday all went well. The only hiccups were my uncooperative veins (I have two instead of one puncture sites but that’s typical for me with IV attempts), a taxi incident and my period being ambivalent about showing up yesterday morning.

Dr. Braverman cleared me to start all other meds on Day 3, which will be Monday. Unless his nurse fails to get me my meds calendar for Monday morning in which case she sad I will start on Day 4. I’m a little nervous about this and will be asking Dr. B if it is a cause for any concern today when I report today as CD1.

I am officially excited. And a little afraid of things going wrong. The balance is tipped toward excited. Thank goodness.

Intralipid Hiccup and Other News

Gratitude
I wish need to begin this post by thanking each and every one of you who reads my blog and supports me in my journey to have another living child.  I am more deeply grateful than I have words to express.  My eyes smart as I write these heartfelt words of appreciation.  Your kindness, compassion, support and love mean so much to me.  Thank you.

On the subject of gratitude, I would like to offer special thanks to Jasmine at Journey in the Woods – an infant loss and writing blog that speaks from and to the heart in the most intimate voice of a fiercely passionate yet deeply grieving mother – for nominating me for a Sisterhood of the World Blogger Award.  You can see her post here. I will write a post on the award, hopefully soon. Please stay tuned for that.

The Intralipids Hiccup

I will start this wee rant by saying that in the past eighteen-ish months I have developed and find no shortage of sources to fuel a thriving contempt for the public health care system in my country. I have been let down one time too many.

I got a rather unpleasant surprise yesterday when I visited my doctor’s office. I had booked this appointment in August. It was the first available appointment (and this is my family doctor, not a specialist). Of course it lands at the start of the week in which I finally expect to start my next (and prayerfully last) FET cycle.

I assumed that since my doctor is sympathetic (having seen me through 7 of my 8 miscarriages and our one successful pregnancy), she would make magic happen for me. She did just that on one hand (she gave me requisitions for blood and ultrasound that are for fertility treatments, which normally would cost me about $450 combined per monitoring appointment). I was anxious about whether she would do this (or be able to do it).

It never occurred to me that my doctor would not be licensed to prescribe the IV mayonnaise (intralipids or IL) that Dr. Braverman has recommended I have piped into my system weekly. Its ostensible purpose is to neutralize my unbelievably high Natural Killer cell activity and calm some of my systemic inflammation, both of which are believed to be contributing to my recurrent miscarriages and implantation issues.

Not only am I fully on-board with this recommendation (even if it ultimately turns out to be a variation of snake oil), I am terrified of not doing it (and doing it weekly) given that my NK activity levels are in the 98th and 99th percentiles in the 50:1 and 25:1 tests. I do not dare fail or refuse to pump liquid fat into my body to neutralize those NK cells given what has happened with my previous pregnancies. I will do whatever it takes to make this happen.

Which, as it turns out, means making weekly flights from the northwestern Canada to New York’s eastern seaboard (along with the related travel expenses and arrangements that invariably will include planes, trains, automobiles and possibly buses). Welcome to Plan B, version 37.0. I will have my first IL IV at Dr. Braverman’s Long Island clinic this Friday. He was gracious enough to walk through some alternatives for a Plan C on the phone and via e-mail yesterday but so far nothing is confirmed beyond me heading to his clinic every week for the next several weeks.

I should have bought shares in some of the U.S. airlines. Oh yeah, with what money?

Holiday season and winter are coming. I cannot continue Plan B through an entire trimester of pregnancy if I am blessed enough to get and stay pregnant during this cycle. So there will need to be a Plan C and I will need to implement it in October, after we figure out whether (a) our embryos or at least one of them survives the thaw; and (b) the transfer is successful. I should know that by roughly the third week of October (this is happening so fast all of a sudden. EEP!).

At the moment, Plan C options include:

1. Camping out in an Emergency Room at a nearby hospital and begging for mercy from a prescribing ER physician who will agree with Dr. Braverman’s recommendation for IL and approve me having them administered at said hospital’s IV Therapy Clinic. There are a few such clinics in my city, all seem to require a referral from a doctor with admitting privileges at the hospitals. My GP does not have those privileges, of course. My ObGyn has privileges at a hospital (the women’s hospital) at which there is no IV Therapy Clinic, of course.

2. A variation on item 1: Asking my GP to refer me to a doctor with admitting privileges at a hospital with a IV Therapy Clinic. I do not know if this is actually possible and the RN I spoke with yesterday at our healthcare referral service yesterday (who was remarkably sympathetic and put in 100% effort to try to help me) had no idea either and was unable to determine that from the records and databases available to her.

3. Travel to the U.S. or possibly a fertility clinic on the west coast in my own country where the owner/RE does IL treatments for his patients (which I am not). The travel cost of doing this is roughly equivalent and in some cases greater than me flying to the U.S. Dr. Braverman said his scripts/recommendations are “sometimes” followed by doctors at the Beer Center in northern California. There is also the possibilty of asking my former southern California RE to help out with this since he was willing to have me do one or two IL treatments during the FET cycle he proposed we do before I insisted I have immune testing completed before doing any more embryo transfers.

Yesterday I was stunned, scared and overwhelmed but relieved after Plan B fell into place. Today I am angry, bitter and resentful of the bureaucracy and delay and Kafka-esque absurdity that is navigating the Canadian public health care system for something as innocuous as intralipid infusions. I want to throat punch the public health care gods right now. You guys truly suck. If I were in control of your oxygen buttons, I’d be turning them off right about now.

On that positive note, let’s move on to item 3 on the agenda, shall we?

Hypnotherapy

Ah, zen. I cannot tell you what happened during my hypno appointment last night because I don’t remember anything after seeing the bright flashes of light and colour that mean Azulito (our spirit baby) had arrived. I will get the recording today sometime.

Apparently I did not speak this time although I was very animated and made a lot of facial expressions that convinced my hypnotherapist that I was in a good place and communicating with some one or ones. I believe that is true although I was a little disappointed to not remember this time, unlike last time. And because I did not speak aloud, the recording may not tell me much more about the communications I was having. I do feel quite certain I was communicating at least in part with Azulito and I am grateful that the feeling I was left with afterward was one of deep calm and reassurance.

I believe I have made the right choice. If I waver (and I will, because equivocation in this area is ingrained in me), I will remind myself of the Falcon’s guidance and I will listen to the hypno recording to soothe and reassure me. That way, I can befriend my fear rather than let it run the show.

Despite the IL hiccup and my general worry that this will not work, I am starting to get the tiniest bit excited about this FET cycle. EEP!

Keep Talking, Falcon

I have been suffering from bouts of raging anxiety since reality came home to roost.  The plan is to start our next FET (frozen embryo transfer) cycle later this week.

My heart is set on a protocol that excludes oral contraceptives and Lupron because both bring on negative side effects that leave me thinking my body is shouting “stop giving me that stuff!”  Not knowing what day this week will be cycle day one (i.e., not knowing on which day I will see red) is a source of anxiety, as are some of the existing commitments in my work calendar.  Combined, they have me concerned about whether I can make the timing of some of my monitoring appointments work.

If I am honest with myself, the deeper fear is the one about this (the entire shebang) not working.  It is about neither of our last two embryos surviving the thaw.  It is about me not getting pregnant and me getting pregnant and losing that baby, too.

I want pregnancy number 10 to be different. I want there to be a pregnancy number 10.  I am afraid that I am asking God and the Universe for the impossible.  And, objectively speaking, in some ways it looks to me as though I am.

I have never been more scared to fail.  I have never been more scared of another miscarriage, not because it will mean another lost baby but because it may foreshadow the ending to this journey that I have never wanted to face.

This is the most terrified I can remember being about anything. It is not a just-woke-from-a-nightmare type fear.  This fear is much deeper, much darker, more insidious and has a steadfast grip.  This fear is in in my bones and in my belly.  It is in every breath, every lump in my throat, every beat of my heart.

This fear is real.

I have an appointment with my hypnotherapist this evening.  I am going to need it to help me explore and address this fear before it eats me alive.

I also see my family doctor this morning.  I have already started taking Claritin on Dr. Braverman’s instructions.  I’m hoping that my family doctor will prescribe Intralipids for me so that I can start the first of my weekly IV treatments as soon as possible and that she will give me requisitions for all of the ultrasound and blood tests for my remote monitoring appointments.

I have fear about this, too.  If she says no, I will not be cycling in the coming month.  I just cannot see how I could make that work and I cannot afford to live in NYC for 3 weeks and be away from work all that time (which is what would be required).  Or at least I cannot imagine doing that right now.  Of course if I have to, we will make this work somehow.  I could ask my doctor for a medical leave from work.  Anything is possible if I have to make it happen.  But for once, it sure would be nice if things went my way on a few things.

On the topic of fear, I drew an Animal Spirit Guide card last that truly spoke to me.  When I tried to look  up a link to complete this post this morning, I found this one and drew *the same card*.  I got chills.

Meet the Falcon:

 

As you can see, the Falcon is telling me to act on the opportunity that is at hand and commit to it without equivocation.  As is likely true for so many of us RPL and IF sufferers, equivocating is something I do well especially about important issues over which I feel conflicted or fearful.  Interestingly, my question before drawing the Falcon was whether I am making the right choice in wishing to pursue the FET/reproductive immunological protocol I’ve selected and starting it  in a few short days.  Falcon has spoken and she has told me to stop equivocating.

I saw a falcon (I first thought it was a hawk but then realized it looked more like a falcon) yesterday when I was out with my niece.  We talked about falcons we have seen recently.  How serendipitous.

The Falcon, according to Dr. Steven D. Farmer, tells me that:

  • “Providence is on [my] side, and the opportunity that has been presented to [me] is congruent with [my] soul’s purpose.  Even if [I] don’t feel fully prepared or have doubts in [my] ability to manage the complexities that are inherent in tackling this venture, [I must] dive in anyway.  [I]’ll be pleasantly surprised by the support that will come to [me] in unexpected ways.  All it takes is the willingness on [my] part to continue on a steady course wholeheartedly, while at the same time being open to changes in the direction that the winds are blowing.”
  • “It’s very important to stay focused on the goal that’s ahead of [me], while also remaining mindful of the purpose of your mission.  Commit to your mission 100 percent, and fulfill that commitment to the best of your ability.” [Is this starting to sound like a Tom Cruise movie?]
  • “This isn’t a time for analysis, introspection, or retreat, but a time for action. As [I] respond to the opportunity that’s before [me], I [must] be willing to adjust [my] course of action as the need dictates, while at the same time moving steadily toward [my] goal.  [I] can deal with whatever concerns come up without being distracted by them and without straying from the path [I am] on.”

Wow.  Thank you, Falcon.  Please keep talking to me, Falcon.  I needed your advice and the reminder to carpe this diem, commit to my decision completely, stay the course, shift with the winds as necessary and – above all – not to equivocate.

And on that note, the final countdown begins.  I hope today’s doctor and hypnotherapy appointments bring assistance and tools to address the medical and spiritual/psychological/emotional aspects of my “mission”.

I am ready.  (I don’t feel ready but I am committing to this 100%. It is mind over matter time, folks!)  Hear me fake a roar.  Roar!

*Non-sequitur alert* I am reminded of Alex the Lion in the Madagascar movies.  (Mental note to self: Re-watch those movies during the two-week-wait.  They always make you laugh.)

Wishing all of you – and me – luck and other good things in the coming weeks.