Posts Tagged ‘miscarriage’

(mis)Adventures in Reproduction: Diagnosing Bad Luck

Surprise! I’m still not pregnant (nor have I been since the chemical pregnancy in April). Here’s what’s happened in the past three months:

RE or REally not impressed

My Obgyn broke up with me saying, “There’s nothing more I can do for you.” I’m not sure what she had really done for me to begin with so I only feel slightly rejected instead of broken-hearted. As a parting gift, she referred me to a reproductive endocrinologist (RE) otherwise known as a fertility specialist. I went back and forth on whether I should actually go. What, exactly, could this RE do that my OB hadn’t already done (except charge me $50 per visit instead of $25)?

After talking about it with some online friends, I decided that a consultation couldn’t hurt and I had my, now rather large, medical file sent to the specialist’s office. I went to the first appointment with just a little glimmer of hope that maybe, just maybe I would be getting some answers soon.

At the first appointment, the doctor reviewed my history and bloodwork results from the OB. She refused to speculate on possible causes of the miscarriages until she had the results of about 22 blood panels and a saline ultrasound — all of which had to be done on very specific cycle days. I walked out of the office after that initial visit with lab orders (for myself and my husband), prescriptions, and directions about how to prepare for my ultrasound.

With each test, I grew more excited, sensing a discovery was just around the corner. “Today’s test is going to show something! I just know it.” I imagined sitting in the office, getting the results and exclaiming “Well that explains it! And you say all I have to do is take these magic pills and it will all be ok? Why didn’t I do this sooner?”

The follow-up appointment didn’t exactly go like that. Instead, it went like this. Doctor: Well, I’ve reviewed the results of every test and everything is well within normal range. I have no explanation for your multiple losses other than to say it’s simply bad luck.” Me: Did you just say my diagnosis is bad luck?” Doctor: Well, that’s not a diagnosis, but yes. There’s nothing wrong that we can see.” Me: “So that’s it? That’s how this ends?”  Doctor: “That’s up to you. I have a treatment plan.” Me: “You have a treatment plan for bad luck?” Doctor: “The plan is to get you pregnant as many times as possible and hope that one sticks.” Me: Stunned silence followed by tears and lots of nose blowing.

As a side note, my husband was with me for that appointment and he said the doctor looked truly shocked that was sobbing. Does this not happen frequently in this office? Hormonal women getting hopeless news on a nearly daily basis and the doctor is shocked that I am sobbing? Anyway…

I walked out of the office that day faced with choices that range from $400 per month to $4000 per month. Keep in mind that all of these choices are aimed at getting me pregnant as many times as possible and “hoping that one sticks.”

I’ve decided to not pursue any of the choices made available to me; not Clomid, not Femara, not IUI (inter-uterine insemination), not IVF (in-vitro fertilization). I’ve decided that reproducing really shouldn’t be this hard. And I have no idea where that leaves me or what’s left to do– except to write a break-up letter to my RE.

So that’s the update. I plan to finish out the summer with my own treatment plan: an endurance mud-run race this weekend, plenty of wine drinking on summer terraces, perhaps a cocktail of natural fertility boosting supplements, and reckless baby-dancing with my husband — you know — just in case one sticks.

Life After Miscarriage: Houston, We Have a Problem – Again

My ovaries are holding my eggs hostage.  That’s what the doctor called to tell me last week. She didn’t say those exact words – that’s just my spin. What she actually said was, “Based on your blood work, it doesn’t look as if you are ovulating. I’d like for you to come in to talk about taking Clomid.”

I said, “Yeah. I figured as much. Twenty dollars, twenty ovulation predictors sticks, and lots of squatting over a cup with no positive result led me to the same conclusion.” OK, OK, I didn’t say those exact words, but that’s what I was thinking.

I have a routine down for dealing with bad news. It’s just happened so often during the past few months that I realized it’s an established protocol.

First, I call my mom. This is usually because I want to be dramatic and download. I spill a crescendo of conclusions, she (as a nurse) points out all the flaws in my logic and my misinterpretations of clinical possibilities (or impossibilities). I cry and ask her why she can’t just listen and validate my feelings. And then I hang up and call a girlfriend.

The girlfriend is great for validating the emotion.  She will eventually get to logic and talk me off the ledge, but first, she wholeheartedly encourages the drama because she knows that to try to talk logic to a woman who is hormonal and unpredictable will do no good. She offers to come over and break dishes with me and knows that when I say, “No, don’t worry about it,” she can tread lightly on to the terrain of sense and sensibility.  By the time I hang up, I’m ready to call my husband.

These are usually very short conversations because to try to explain how my ovaries and other girly bits are not functioning without a diagram and hand motions is pointless. We agree to talk at home later and hang up to return to our normally scheduled work programming as if nothing has happened.

All up, this takes about 26 minutes of phone time and is entirely necessary for me to go on functioning. From connecting with people who have experienced what I have, I can confidently say that behind every woman coping with and healing from a pregnancy loss is a strong cast of characters. They are the people who answer the phone, endure verbal abuse, sympathize and empathize, and simply show up when it matters.

I am so grateful to my supporting cast because they have carried me.  To them, I say: Thank You for dancing in my ballet of grief and hope. You are the best in my worst of times.

Life After Miscarriage: One Step Forward and Two Steps Back

For as many steps as I’ve taken toward moving on, there are still days where I feel like I’m caught in quicksand.

No matter how much I work, or how many weekend trips I plan, or how many runs I do in the morning, no matter how much I fill my day planner, I cannot escape the miscarriage. I’ve tried my best to fill my life with work, and friends, and church, and books, and magazines, and exercise. I’ve tried not to leave any room for grief. But somehow, it keeps finding its way in.

If I’m quiet for one moment, I slip into a daydream where I imagine myself six months pregnant or decorating a nursery.  I catch myself imagining my husband rolling over in the morning and kissing my big belly, whispering to our son or daughter.

I fall into pockets of sadness in the mundane moments of my life – just today, in the simplest act of wiping down the sink after rinsing dishes.  I had to turn away from my husband because I didn’t want him to see the tears in my eyes.  I know he could sense something was wrong but there’s nothing I can say that will help him, or anyone understand.

Life After Miscarriage: A Frustrating Existence

This month,  we should have been buying nursery furniture. We should have been painting the bedroom, transforming it from gift wrapping room to soft, comfortable space with a crib, and a rocking chair and tiny hangers in the closet. Instead we’re wondering when, or even if, we’re going to be able to conceive again.

If I had to pick one word to sum up the past four months of my life it would be “frustration.”

  • On March 22, I was frustrated that my doctor couldn’t tell me anything more hopeful than there was a 50 percent chance that I would miscarry.
  • On March 29, I was frustrated that the child I dreamed about holding at Thanksgiving was gone.
  • On April 8, I was frustrated because my body continued to hold on to the remains of the baby.
  • On April 9, I was frustrated because the Misoprostal didn’t work and I had to take another dose.
  • On April 13, I was frustrated because I was caught off-guard at work with the brunt of the miscarriage.
  • On April 23, I was frustrated because it was supposed to be the end of my first trimester.
  • On April 27, I was frustrated because there was still a significant amount of HCG in my blood stream.
  • On May 16, I was frustrated that a month worth of days had passed and I still hadn’t had a period. (It finally arrived on June 16).
  • On July 16, I was frustrated because my second cycle had not yet arrived.
  • On July 20, I was frustrated because I had a negative pregnancy test but still no period.

And on July 22, I called my doctor. “Uhh. Hi Betty. It’s Emily. I’m on Cycle Day 38. I’m really frustrated. How am I supposed to conceive again if I’m not having regular periods?”

I have a doctor’s appointment in a few days.

Life After Miscarriage: Getting Ready to Try Again

It’s day 3 without caffeine. I’m getting a head start on cutting out the two cups of coffee. I’d rather have withdrawal symptoms now than when I’m pregnant.

I’ve been thinking about what I’ll do differently next time. Cutting out all caffeine is one thing. There are too many conflicting studies out there. Some say that less than 200 milligrams of caffeine is fine. Others say that any caffeine at all causes in increased risk for miscarriage. I’d rather not take any chances.

I’ve also started to take my prenatal vitamins like I was taking my birth control: religiously, not at the same time every day, and with a swig of beer occasionally.

Next time I’m pregnant, I won’t take any baths. Maybe the bath water was too hot. And I won’t go to spinning class. Maybe my heart rate was too high at one point.

Looking at this list, I should probably just start on bed rest the second I test positive. I can’t be too careful can I?

I’ll probably always wonder if I did something to cause the miscarriage. How could I not? Sure, I’ve read all the literature and I’ve heard my doctor say it too: “Most miscarriages that occur before 12 weeks are the result of a chromosomal abnormality and cannot be prevented.” Blah. Blah. Blah.

It would be so much easier to deal with if I could just pinpoint the cause. I’d know not to do “it” again and I’d feel so much better about my sense of control. It would be so much better to hear the doctor say: “Yeah. It was the coffee. Don’t do that again.” Then I would know! And I could control it. But how the heck can I control a chromosomal abnormality?

This pregnancy thing is such a crap shoot. And frankly, with what I know now, I can’t believe there are so many people in the world.

Life After Miscarriage: The First Period

It’s here! It’s here! It’s here! After a whopping 9.5 weeks, my period finally arrived. I haven’t been this thrilled about getting a period since I was 20 and forgot to use a back up method while I was on antibiotics (some antibiotics interfere with birth control pills).

Despite my best efforts to induce it weeks ago with parsley tea, red raspberry leaf tea, pomegranate juice, and a stint of wearing nothing but thongs, it took nine and half weeks.

I don’t think nine and a half weeks is average. From everything I read, and even from what my doctor said, four to six weeks is about average. Does that mean that I’m above average? Well, I’ve always tried to be a cut above the rest.

The minute Aunt Flo arrived, I texted my husband. “You might want to bring home a bottle of champagne. I finally got my period!” He was just as excited as I was though I think for different reasons. Getting my period meant that he didn’t have to make room in the refrigerator for the parsley bunches (parsley can supposedly bring on menstruation), or receive daily e-mail updates on possible signs of its impending arrival.

I think we both knew it was coming when I asked if it would be wrong to dip a spicy chicken wing in chocolate. Other than strange cravings and the worst breakout since I was about sixteen, I had no other warnings though and that’s what made the wait so frustrating.

Of course, now that it’s here there’s the little question of when we start trying again. One doctor told me to wait for three cycles and another told me to go for gold after one cycle. I guess the upside of waiting so long for a period was that we didn’t have to make any decisions about what we were going to do.

There’s a tremendous amount of energy that goes into thinking about these things. There’s logic on both sides of the coin. If we wait and I don’t conceive again right away, or worse, we have another miscarriage, I’m going to be angry that we waited. If we don’t wait, and I conceive, and we have another miscarriage, I’m going to be angry that we didn’t wait.

You’re probably thinking “Uh…isn’t it possible that you’ll conceive right away AND have a healthy full-term pregnancy?” Yes. It’s possible but so are the other scenarios.

Life After Miscarriage: Lessons Learned

I’ve been feeling much better lately. Really, I have.

I’ve been thinking about what I learned from this whole experience and I’ve come up with a few things:

Grief is like a tsunami. It comes suddenly and in huge waves. It completely drowns the heart and mind and then it recedes, slowly.  Eventually, things get back to normal but it takes time and you can’t rush it. And that takes me to my next learn.

Time really does heal. Yeah. It’s cliché and I wouldn’t have believed you two months ago if you would have said I would feel like myself in just eight short weeks.  But I do. I think the catch here is that you have to be willing to heal and, for me that meant finding out that you have to…

Trust the process. I’m still working on this one. Pregnancy is a forty-week process. Miscarriage is a process. The monthly menstrual cycle is a process. Grief is a process. Healing is a process. I’ve learned I can’t rush any of it. I’ve tried and it just leads to more anxiety.  Anxiety leads to suffering and here’s what I’ve learned about suffering…

Suffering is a choice. After this experience, I can distinguish between grief and suffering. Grief is what you feel when you lose something that meant a lot. Suffering is becoming a prisoner to grief. I can grieve my loss but I will not suffer from it or because of it because I deserve more.

If a woman in my life ever experiences a miscarriage, these are the things I would tell her. She wouldn’t believe me, of course, because it’s not something you can believe until you go through the process yourself. But I would tell her anyway because when you go through a miscarriage, you want to know that it will get better even when you simply can’t imagine anything but the pain of the loss.

While I’m sad I had to learn these lessons in this way, I’m grateful that I’ve been able to come away with something and I’m proud to say that I survived.

Life After Miscarriage: Eight Weeks Not Pregnant

Early June will mark 8 weeks since my miscarriage. Eight weeks was how long my baby lived inside of me. In eight weeks, nearly all the organs in my baby’s body had started forming.  Its eye lids were sealing shut. It had hands and arms, and legs. It had a beating heart. And then, it was gone.

So here I am, 8 weeks not-pregnant. It’s almost like a dream; something that I’m sure and certain seemed so real but there’s nothing that exists to prove it to me.  I would question whether it all happened, but the empty place in my heart tells me it did.

My best friend is well into the second trimester of her pregnancy. She is exactly where I would have been. She sent me a message the other day after hearing her baby’s heartbeat for the first time. When I opened the message I simultaneously had two reactions. The first was one of excitement for her; her first true sign that life exists inside. The other reaction was one of sheer shock.

Since the miscarriage, it hadn’t occurred to me that pregnancy ends in anything other than a miscarriage and here, in my life, written in a text message on my phone, was an example of how it does.  

That was a confronting moment and I spent a few seconds whimpering and trying to stop my face from contorting into the expression that ends with tears and gasping.

I couldn’t do it. I cried on my husband’s shoulder, soaking it with tears and begged him to help me understand why. “Why not us? Why not our baby’s heartbeat? Why did this happen?”

He didn’t have an answer. No one does and believe me I’ve asked: doctors, nurses, friends, and yes, God. The same thing I hear over, and over, and over again is “Everything happens for a reason.”

OK. I can buy it. I get it. It makes sense. But what’s the reason it happened to us? Answer me that and should I be fortunate enough to have a successful pregnancy, I’ll name my firstborn after you.

Exhibit 100E: Female Homosapien Post-Miscarriage

I never thought I’d be so anxious to get a period. Yes, you read it right: anxious, not eager.  I’m starting to get jumpy here. Before the pregnancy, I was regular to the hour. It was actually kind of creepy. Now, I’m on day 35 of Period Watch. Yep – it’s an official event with official lingo.

I’ve adopted some of the National Weather Center’s lingo to help liven up the waiting. “Watch” actually means, conditions are favorable though no actual signs have been spotted. “Warning” means that there’s been an actual sighting.

Indeed, conditions are favorable. It’s been more than 20 days without bleeding and my last ultrasound showed no remaining products of conception. Plus, I really, really, want to get it. What’s not favorable about that?

Getting old Aunt Flo will be the first sign that my body is back in business. The second sign will be getting another one within a reasonable time frame.

I feel a bit like I’ve become my own science experiment. Watching, waiting, observing; adding variables like vitamins and folic acid: “Let’s see what happens if I take these.” And then, subtracting other variables: “If I don’t wear a pad, and I wear white pants, will karmic forces intercede?”

Soon I’ll be sampling my own cervical mucus and comparing it to pictures on the internet. But hey, it’s in the name of science! Exhibit 100E: Female Homosapien post-miscarriage.

Come to think of it though, when you’re trying to have a baby, conception is really more science than it is romance. If you look for information on trying to conceive, then you’ll probably come across three of the most popular topics:

Temping: the process of monitoring your basal body temperature to detect the subtle rise indicating ovulation is imminent or occurring. A decline in temperature after a slight elevation usually indicates the egg was released and not fertilized. If the temperature stays elevated, it could indicate implantation of a fertilized egg.\

Cervical mucus: I wasn’t kidding when I said I was going to start sampling it. Otherwise known as CM, cervical mucus morphs throughout the month from sticky to creamy to slippery and thin like egg-whites. It’s the slippery thin stuff that helps sperm swim and when you see it, it’s time to get it on if you know what I mean.

Charting: the process of recording temperature and cervical mucus among other signs throughout your monthly cycle. There’s a whole system of checks, and circles, and squares and letters and morse code involved with charting (just kidding on the morse code part – but it’s almost as complex)

All of that is well beyond my reach at this time though. I’m still waiting for my monthly cycle to make an appearance for the first time since January.  I’ll give it two more weeks until I start to panic. In the meantime, I think I’ll go buy some white pants and see if I can tempt the universe.

After Miscarriage: The Big Follow Up

I’m convinced that the universe is conspiring against me. The day I first found there was a problem with my pregnancy my doctor was delivering babies. The day I didn’t see a heartbeat on the ultrasound screen, my doctor was on vacation and my husband was en route to San Francisco for a business event. The day I actually had the miscarriage, my hubby was in Washington, DC.  When the nurse called to schedule my two-week follow up appointment, it made sense that she said, ‘Ohhh. Gosh. The week we need to get you in is the week the doctor is scheduled for jury duty.” Come on universe! Really?

I digress, however. Today, I want to share my follow-up appointment saga.

Because my doctor was out fulfilling her civic responsibilities (and for the record, “I have to deliver babies” is not a valid reason to be excused from jury duty in the great State of Ohio), I had to select, from among more than a dozen, another doctor in the practice. “Do you have a preference?” the scheduling nurse asked.

I requested the doctor a friend recommended and didn’t hold my breath for anything special. That’s why I was pleasantly surprised by the women who walked in the room and said, “It’s hard coming to our offices and seeing so many pregnant women and babies, isn’t it?”  

Let me be really honest here. Her compassion wasn’t unprovoked. The nurse who called me in from the waiting room had the gall to ask “How are you?”

Well, after sitting in a waiting room full of glowing women in various stages of pregnancy, I was undeniably not OK. Through gritted teeth, I basically told the nurse about how sucky my life is right now.  She was lucky to walk away without bruised shins.

I guess my reaction was a bit startling because she led me to a room right away and the doctor was knocking on my door within a matter of seconds. I can only imagine what the nurse must have said. Probably something along the lines of “We’ve got a situation in Room 2. Take your tranq gun.”

Wiping my eyes with the back of my hand and uncurling my lower lip, I nodded in acknowledgement of the doctor’s question and thought about apologizing for my emotional behavior. I decided against it and let her make the next move.

The doctor was blessedly calm. She’s what my friend would call ‘granola.’ You know. The type of person to wear Birkenstocks with socks and play an acoustic guitar after dinner and before reading Organic Gardening on her soy sheet set.  In other words, exactly what I needed. (By the way, I have no idea if this doctor wears Birkenstocks or gardens organically but I would be willing to bet yes.)

We chatted for a bit and she jotted down notes as I recounted the events that landed me in that room on that day. She answered all of my questions, did an internal exam, ordered blood work and said, “There’s no reason to wait if you want to try again. You can start with your next cycle.”

“Let me clarify,” I said. “You mean, as soon as I get my period, I can stop using protection?”

Nodding, she said, “Yes. Your next cycle.”

For the first time in weeks I smiled. I was overjoyed. “Thank you. Thank you for your time and your patience.” I hurried out of the room nearly knocking over the nurse I initially almost knocked out. I went to the lab to have my HCG (the pregnancy hormone) draw and then made the good news call to my husband.

The excitement of that visit lasted just over 24 hours. I got a call the next day from my doctor’s nurse. “Your HCG is still at 13. We need to make sure it gets to zero. Can you come back for more blood work in two weeks?”

I was devastated. I am devastated. How can this be? I’m not pregnant but the pregnancy hormone is still in my blood?

“It can take some women a long time to drop to zero,” the nurse explained over the phone.

“Well, what if it doesn’t drop?” I asked.

“We have no reason to believe it won’t,” she said. “We just like to make sure it gets to zero.”

Through more probing I was able to find out that some women require an “intervention” if the numbers don’t continue to fall. The nurse didn’t care to elaborate on what exactly an intervention entails. Left to my own imagination, I pictured a cold hospital room and machines that beep. I hope I don’t have to find out.