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Monday, October 27, 2014

Faith is Going to the Office Without Wearing a Pad

Alternate title: Inside the Mind of an Otherwise Easygoing Woman Gone Completely Mad

Tuesday marked the last of my progesterone suppositories. I had been so looking forward to that day because I was so over the experience! For eight weeks I had been inserting them twice a day, putting on a pad, and then feeling it as it dissolved back out of me, drying into a chalky substance that would stick to my body and my clothes. Miserable! At least this time it felt like a worthy investment since I was actually pregnant. The four cycles that I was doing them for a week and a half before finding out I wasn’t even pregnant created a little more bitterness.

But what I hadn’t anticipated was the anxiety about whether my body was really making enough progesterone now. I know I was never that low (though I wasn’t given a starting number, just the very high number after starting the medication) so I tried to trust that there was no reason my placenta wouldn’t be taking over progesterone production. Both my fertility doctor and my OB had stated that if my placenta did NOT take over, then it just isn’t a viable pregnancy. So coming off the suppositories was like holding my breath, waiting to see if my body would hold onto my baby without medical support. 

But wait a second – my sister was still not producing enough progesterone at this point and was on shots until 37 weeks. So how can two different doctors both just shrug their shoulders that the pregnancy isn’t meant to be if the placenta isn’t taking over? My beautiful niece Felicity would not be here today if my sister’s doctor had had that reaction. Maybe it’s because my levels were high enough that it would be a true medical anomaly for me not to produce enough to support a pregnancy, whereas my sister struggled with dangerously low levels even on supplements? But why wouldn’t they just check my blood to make sure? How could they not take this more seriously?

The fertility clinic is overly cautious because so much is at stake in trying to achieve pregnancy for their clients, so my “just slightly low” levels may not have been levels that would even concern a regular doctor. Maybe I would have been just fine pregnant on my own. But now that I had been relying on the supplements, they had become like a crutch, and I was so afraid of what would happen when I had to go without them. I toyed with the idea of just finishing the box (another week and a half or so) but then worried about going against doctor’s orders and what might happen if I had too much progesterone in my system.

I have also been worried about the bleeding, because they keep assuming it’s just irritation from the suppositories. That could be hopeful in that it means it would now stop…but it also gave me reason to be nervous if it didn’t stop, because then that would mean it’s from something else.

So I’ve been anxious about if I bleed again, and also anxious about an impending miscarriage now that I was testing out my placenta. After about two or three days, I felt my fear turning into panic. I knew it took less than two days to get my period after coming off the progesterone during the failed cycles. I kept thinking I was feeling slight lower back pain or slight discomfort that could mean impending miscarriage. I don’t cramp during my periods, but I do get lower back pain and like a discomfort or mild awareness in my uterine area. That’s what I kept feeling like I was experiencing, but it was mild enough that I wasn’t sure if I was imagining it or if it was a normal part of pregnancy.

I started researching when the placenta takes over, and got nervous when I saw posts by women saying their doctors told them to take the supplements until 12 or 13 weeks. I came so close to taking another one just in case, and wondered if it would be in time to save my pregnancy and if I should then just take one every couple of days to have a little boost of extra progesterone in case my body just needs a little help. Then I called my fertility clinic and left a voicemail with the PA asking what my initial levels of progesterone were, hoping that the number would be high enough that I would be reassured that I really shouldn’t be concerned.


I fretted over those things but didn’t do anything, and soon it was Saturday and I was still pregnant. I realized that if it had been four days and I was still okay, that probably meant everything was fine and my placenta was doing the job. I also hadn’t had any bleeding yet. So Sunday I braved it by going to my friend’s son’s christening without a pad. I had to stop wearing one at SOME point! And isn’t that supposed to be a benefit of being pregnant, that you don’t have to mess with that stuff anymore? I told myself that everything seemed okay, and I couldn’t just live in a state of anxiety, and that wearing a pad 24/7 was proof that I was not trusting my body to take care of my baby.

Just that one act feels like a leap of faith, because if I were to bleed like I did less than a week ago, it could cause quite the embarrassing situation. And maybe that will happen, but I can't tell you how empowered I feel just by dropping the crutch and stepping out on my own. We will be okay.

Wednesday, October 22, 2014

Be Careful What You Wish For!

I’ve been antsy about not having another sonogram until 12.5 weeks because I had one at 5.5, 7.5, and 8.5. They have been reassuring, and it’s also so nice to see how much growth has happened in such short periods of time. I was a little sad that I wouldn’t get to witness different stages of growth between weeks 8 and 12.

But I didn’t want it this way!

Yesterday around noon I saw a tint of red in my underwear, and when I wiped, dark, bright red bloody tissue was on the toilet paper. It looked like something that should not be coming out of me unless I’m on my period, and I immediately panicked. I ran straight back to my office and called the OB. For some reason I’m much less hesitant to call them for every little thing than I was with the fertility clinic. Maybe because I know they’ll be with me for the long haul so I feel they are responsible for me and this is just going to be part of our journey! The nurse asked if I was cramping or having lower back pain, and I said no. She said then that “it’s probably nothing” but they could schedule me for a sonogram if I was concerned. Yes, please! I told them I work in the Bronx and would need time to get there, so they gave me a 3:15 appointment.

I immediately ran to my supervisor’s office and burst into tears and said, “There’s more blood, and it’s like a clump, I have to go to the doctor right now!” She hugged me and said to let her know how it goes. I’m so, so fortunate in this area. I couldn’t be in a more supportive work environment.

I got there early and they didn’t see me until 4:15. I didn’t mind the wait because I was grateful that they fit me in, but I was just so nervous and wanted to know what was happening! I also kept wondering if there was more blood. Just after 4:00, I finally asked to use the bathroom and checked. There was nothing further. That reassured me quite a bit, because if a miscarriage was impending, I don’t think it would take a break for a few hours. But what do I know? And also it was my last day of the progesterone suppositories, so I feel like the extra hormones could always trick my body into holding on longer than it otherwise would if I wasn’t on supplements.

As soon as I came out, they called me back. A new doctor saw me since mine wasn’t available. I know this can be a downside of choosing a large (4) OB practice, but it had been more important to me to find a practice with great reviews for bedside manner, skills, knowledge, and respect for my wishes. I’m glad I saw her because I loved her also, and it let me know that at least one of the other doctors I now feel comfortable with attending my delivery if mine isn’t available. I would love to meet all of them at some point!

While the doctor was out of the room, I took a peek at the laptop that was sitting out with all my information on the screen. There was a note for my call Friday that said, “Patient called RE some small amount of vaginal spotting when she wipes. She denies back pain or cramping. She was reassured and will call back if the bleeding continues or increases, cramping starts or back pain, or if she has any further questions or concerns.” (I took a picture of the screen so I have the exact words. Does that make me crazy?) This immediately looked like liability coverage to me; it’s noted that I was reassured and that I agreed to call back with any changes or concerns. So I guess now that I DID actually call back to say it was worse, they had to respond by offering a sonogram even though they weren’t concerned about it from my description. The note for today said, “Pt with episode of red staining with ‘clump’. To office for evaluation.” I was amused that they quoted me on “clump”.

The doctor first used a speculum to check my cervix and said everything looks fine, that there was no cervical bleeding. She then did a transvaginal sonogram and checked for uterine bleeding, which was not there, and showed me the heartbeat.

I couldn’t believe what I was seeing on the screen. It was an actual BABY! Gone was my seahorse. The baby was laying on its back, and I could see where the kidney-bean-shaped sac dipped down in the middle to connect to its stomach. The placenta and umbilical cord, I’m guessing. Seeing a head and a body, and something that looks like an eye, just froze me. I was in shock. And then I was flooded by emotions. They just ransacked my body and I started crying as soon as the doctor left the room. And talking to my baby, just holding my abdomen and saying, “THERE you are, you’re really there, I love you so much, stay put and stay safe!”

It’s an odd thing. The sonograms make me feel so connected that I can barely hold myself together for awe of it all. And then within a day, it already ceases to feel real again because I don’t feel or see anything except my growing sore breasts. I want to just stare at it on the screen all day so I know what it’s doing and that it’s okay! Everything is just happening in there without my control, and I’m just waiting for periodic check-ins to make it real again. My baby is more within my control now than it ever will be once it’s born. I don’t have to figure out how to meet its needs; my body’s just doing it. I don’t ever have to be separated from it. I can protect it better than I ever will be able to again. And yet I still struggle with feeling distant and disconnected at times, like it isn’t really happening. I actually MISS my baby – and it’s right here with me all the time!

In my outpouring of relief and love that the sonogram triggered, I said, “I’ll give up anything and everything to keep you safe and have you here with us. Just join us when you’re ready and stay safe til then!” I’ve had my anxieties about the realities of the ways in which our lives will soon change. I’ve thought about how reluctant I am to give up my solitude and freedom, my ability to just watch Netflix if I want all day, or go out on a whim without a half hour of preparation. I think it’s normal to start processing some of that and the losses that will come with this wonderful change. But in that moment, with such relief that my baby was okay, I felt like I wanted my baby here tomorrow, no matter what that meant for changes to my life, just to know it made it and was safely in our family. I’ve never felt such strong, instinctual, and immediate love for something that is still really a stranger and more of an idea than a real person in my life. It was overpowering and still blows me away.

It's hard to make out the details here, but when I zoom in on my phone, I can see eyes, nose, open mouth, and even an arm bent and up by its head!!

Sunday, October 19, 2014

10 Week Update

I'm ten weeks today, and it's been quite a ride. I had a few weeks of queasiness, but now not in over a week. Only once, in the middle of the night, did I actually feel really sick, but I still never vomited. I just felt like my stomach was heaving, like I was really seasick, and it wracked me for about an hour until I just fell back asleep. Aside from that one incident, I would just feel bouts of queasiness throughout the day. I kept ginger candies on me for when it got bad, but "bad" was still never really that bad.

The worst thing was really the difficulty eating. I would be so hungry but the idea of most foods would just turn me off. I was always in the mood for pizza from the amazing pizzeria down the street (which I only indulged once over those several weeks) and could always eat carbs, but protein became more difficult to stomach. I would eat barely any dinner and then have a bowl of cereal when I got hungry later. I was so repulsed by leftover pesto chicken that I reheated for lunch one day (I ended up just eating the pasta and then was ravenous and snacking all afternoon because I'd had no protein) that I still can't eat chicken. It was such a curse, being so hungry but feeling sick at the idea of anything that would be good and filling!

All that has passed. Somehow, without my realizing it, it disappeared around or before nine weeks. I've felt so great the past week that I sometimes get nervous about whether everything is okay! I hadn't had any spotting in over a week, and told my wife Thursday night that I felt like one of those factories that have a sign up with like "7 Days Accident Free" where they update it every day. It was just so reassuring that the spotting could be over, and every consecutive day without it felt great. No sooner than I said that, on Friday morning I saw some red blood. Not the "normal" pink or brown, but red. I was at work and went back to my office and broke down in tears.

I had let my guard down. I'd begun to feel blissful again. And physically comfortable at that! I was just in such a happy and secure place. This was like a slap in the face, like a reminder that I was getting too comfortable and should still be anxious.

I ended up calling my OB because I was worried that it would get worse over the weekend and then I would feel bad about calling an on-call doctor after hours so I would be questioning myself about whether it was really a big deal or whether I was overreacting. I figured calling during work hours and just getting an answer would put me at ease, and it did. My nurse said not to be alarmed unless I have to change my pad because of it or unless I get a backache and cramping. So of course then I kept feeling like I was having a backache and then would run to the bathroom to check my pad, but there was nothing. There's been nothing since (it's been two days). And I'm starting to feel more secure again, and yet at the same time, carrying a little bit of dread in the back of my mind.

Two and a half weeks til we get our 12 week sonogram. I'm hoping that gives me a little more reassurance!

Tuesday, October 7, 2014

Choosing an OB

I have been going to my family doctor for GYN exams, so I didn't have an OB and now had to go about choosing one in order to be discharged there from the fertility clinic. Where to start?? I looked up places nearby before I was ever pregnant and had bookmarked the site of a practice with five female OBs called "Women for Women." I always like the idea of supporting women in "nontraditional" fields, and it has always come into play when choosing a doctor. When it came time to actually choose an OB, though, I looked up reviews for this practice and didn't really like what I saw. There were great reviews for two of the doctors, pretty unsettling reviews for another two, and radio silence on the fifth. Not great odds. But after reading reviews for other practices in the same area (a town extremely dense with hospitals and medical providers, all within ten to fifteen minutes from us), I didn't see anything better. They were all getting two or three stars out of five, with complaints about wait times, bedside manner, and rude and unprofessional receptionists.

I felt so defeated. I figured I'd better stick with my original choice and just hope that mostly unhappy people write reviews. I called them at 9:20 AM and was sent to a voicemail stating to call back between the business hours of 9 and 5. I called again at 9:40, same thing. I was immediately done. It was not a great first impression that no one was picking up the phone 40 minutes into the workday and I was having trouble just making a first appointment!

I started to look up OB/GYN practices near my town and found one in an affluent town about 18-20 minutes away that had wonderful reviews. People raved about both the doctors and the reception staff. I called and was immediately attended to by a friendly receptionist who helped me make an appointment that fit with my work schedule (availability at 6:30PM?? Yes, please!) and let me know where to go on their website to get anything I needed to prepare for the appointment. I had a good feeling right away! But because I was choosing my appointment based on who could work with my schedule and not based on a doctor I had any knowledge of, I was a little nervous about being randomly assigned to one.

Today put my fears at rest. The doctor had an emergency earlier in the day and was backed up, so I didn't see him til 7:30, but he still took his time with me and was very warm and professional. The woman who took me back to the room said to stay dressed because Dr. K had never met me before and would want to first before the exam. He came and introduced himself and asked me some basic questions. One of them was about spotting and bleeding, so I told him I'd had some bleeding right before my sonogram last week, and then the following night. He said, "You're on progesterone, right? How much longer did they say you need to take it?" And that was all he said. His lack of concern was very comforting. The nurse at the clinic had told me progesterone suppositories can be very hard on the cervix, so it made sense that that was his next question.

He then left so I could undress and came back and did a full gynecological exam. He was so quick and thorough, not quite as gentle and explanatory as I'm used to my female doctors being, but so damn efficient that I wasn't even self-conscious and just completely trusted him. He poked all around my abdomen and said, "Oh yeah, it's definitely there." What?? What did you feel? Can you tell my uterus has doubled in size, because I can't! I came home and poked myself all over hoping to feel what he felt but couldn't.

Then he smiled and said we were doing a sonogram. We weren't sure if they would so I was SO excited! Dr. K turned to my wife and asked if she had seen the last two sonograms. She said, "Yes, and they were so different in just two weeks!" Dr. K said, "Wait til you see what's changed in just one week." And there our baby was on the monitor, with actual SHAPE to it! Not the blob of last week, but an upright figure with a little head and a protruding chest with that sweet thumping heart. He said, "It's a little human now, right? That heartbeat is nice and strong." Oh I was soaring. I couldn't believe I could see a head and know what position my baby was in. It looked like a seahorse, just hanging out upright with a head and big chest and no limbs! Incredible.

It felt so surreal, like I froze and felt like, "This isn't really happening. I'm PREGNANT? How is there this little person in there, with a shape and a beating heart, and I barely feel affected by it and life feels normal?" It feels so disconnected to the idea that I'm going to be a MOTHER next year. God willing, there will be an actual baby crying in my arms and I will be somebody's mom so soon. I will be completely responsible for and enslaved by this sweet, helpless creature. And it's just in there growing and preparing to change my life forever, while I walk around and go to work and kick my feet up like nothing's happening, with just occasional mild queasiness and super sore, firm breasts to clue me in at all. Insane. Surreal.

He took us to his office afterward to talk (and had a mezuzah in the doorway!! I'm a happy girl!) and gave us photos that did not show the shape nearly as clearly as the actual live sonogram did, and we were told what to expect over the course of my pregnancy and what appointments I will have. I won't get nearly as many sonograms as I've been getting, and I'm going to miss that! Then I was given a flu shot and a bag full of goodies: eleven different prenatal vitamin samples and a ton of pregnancy and parenting magazines.

Oh also? My blood pressure is NORMAL for the first time in years! I've read that it can drop a little early in the pregnancy because blood is being diverted to so many new places, so I'm not assuming that it's just magically fixed. But any time with blood pressure of 120/78 instead of 138/86 is time I appreciate having.

My little seahorse! It's in profile facing left. The head is very small and then you can see the big chest. Whatcha doin' in there, little bug??

Wednesday, October 1, 2014

Heartbeat!

I've been so lucky during this pregnancy so far. I had one bout of rough sickness a week and a half ago, waking up at 2AM to seasick-like nausea that went on until I finally fell back asleep an hour later, and otherwise have just had passing periods of queasiness or sometimes just a "bleh" feeling. There are certain foods that I know I definitely do NOT want because I will feel a little sick thinking about it (tonight we had ground beef thawed to cook and I just couldn't), but that changes day to day. My breasts continue to be extremely sore and tender, and they developed a heaviness seemingly overnight about a week and a half ago. I'm a little more sensitive and emotional; things affect me that always would have, but my emotions are closer to the surface, harder to control, and take longer to recover from. I feel more tired than usual, but only had a few days where I just felt so exhausted I could barely do much. I feel like all of this is supposed to be much worse than it is!

Today was our appointment for the clinic to detect a heartbeat and discharge me to my OB as a "live pregnancy." It was huge for us because the chances of miscarriage go down to 2% after the heartbeat is detected, so I figured it would bring us some relief. My BabyCenter app told me at six and a half weeks (I'm seven and a half now) that the heart was now beating, and it just freaked me out! Because pregnancy is tracked from the first day of your last period, this means the heart is beating only FOUR and a half weeks after conception. How in that time does it go from ONE cell to something with a beating heart?? I'm just so amazed.

I went to empty my bladder before the sonogram as instructed, and saw bright red blood on my pad (which I have to wear because of the mess created by my progesterone suppositories). My heart just sank. I've had minor spotting, very faint pink or brown a couple of times a week, but nothing bright red since the last incident. I hated to tell my anxious wife but I had to. I told her I was just glad it happened immediately prior to the visit so that we could ask the doctor about it, instead of calling frantically later that night. The doctor didn't say much because, unlike the nurses, she won't just say something to provide comfort. She's very factual. So she just said, "well let's look," and commenced the sonogram. Immediately the gestational sac was visible, with two blobs inside, and she said that everything looked good. She explained that the upper blob was the yolk which would become the placenta, and that the bottom was our baby. Then she pointed to the rapid thumping right in the center and said, "there it is, the heart." I immediately started crying. She moved past it so quickly to check everything else out, and I wanted to ask her to find the heartbeat again and let us just watch for a while! Or record it with our phone to watch repeatedly later! But my inhibitions held me back and I just let myself feel happy that we had seen it and that we knew everything was okay.

The doctor said that bleeding is not uncommon in early pregnancy, and that since everything looks good, I shouldn't be alarmed unless it steadily increases, there are clots, or it's accompanied by cramping. And then she said, "If that's the case and you're miscarrying, there's nothing that could be done, but you should call your doctor just so they can help figure out what's going on." I appreciate her honesty! She told me that they will not officially discharge me until my OB appointment next week so that I still have someone to call or even see if anything happens between now and then.

She gave us a picture of our little bug and then the front desk staff congratulated me with big smiles as they collected my files for me to give to my OB.

Once in a while I have a moment of panic that something I can't even see is invading me and just growing and doing its own thing. It's so wild!!