The mw spoke with the OB.
He fussed at her for not flagging it as an emergency file, because his initial paper diagnoses was ectopic and he was concerned that he would be unable to see me before next week. She reassured him that she had seen me and talked to me this week and that I had no bleeding or pain that would indicate ectopic (and that I was well aware of the signs and symptoms), and that she personally did not think it was ectopic. He was reassured, but wants to see me first thing Monday.
He did say that it was not a normal pregnancy and would not develop into a normal pregnancy. While I've known this all along, my heart still twisted when she said that to me. The ironic thing here? I'll be seeing the doctor at 9w1d (according to ovulation), which is the same week/day that I learned that Chickadee was gone. Really, fate, it's terribly amusing. Except for the amusing part.
Of course, any signs of pain localized on one side, any sudden unexplained bleeding, any shoulder or upper back pain send me right to the ER and any other sort of abnormality or pain means I should call the mw and if the OB can see me before then he will. I'm cramping now, cramps that remind me of the miso cramps (dead center by the way, and tight. annoying, but still mild and no spotting), and am debating calling her now, but I think I will see what develops.
The biggest signs point towards a blighted ovum. Which, as I went back and did more research on it, makes a whole lot of sense. A blighted ovum is a one-off where the fertilized egg implants and a sac starts forming, but the embryo never develops. The body sustains the 'pregnancy' for awhile, but with no embryo, eventually, the body miscarries the remaining products of conception. A lot of b/o's are found around this point in pregnancy and can be characterized by exceedingly low levels of hcg and an u/s that shows an empty sac. No one knows for sure why they happen, and they can't be prevented. They are pretty well random. Not even really genetically based - it just doesn't form.
And in my particular case, it would make a LOT of sense. I've said before that I didn't think this pregnancy ever stood a chance because the lowering temps and the period indicated the corpus luteum had disintegrated. The continuing low temps support the idea that progesterone was gone, and that is usually necessary for a pregnancy to survive. But clearly something implanted - and stayed put - and a b/o would explain the abnormal but persistant rise in hcg and even the spotting (and the cramps I'm having now). It would also be easy to get rid of via misoprostol and we could start ttc immediately.
So that is what we are hoping for, since there is little point in hoping that we'll see a baby with a twinkling, flickering heart waving back at us.
I will meet the OB first thing, have an u/s and discuss treatment options from there. Hopefully it is just misoprostol again - though that is a sucky thing to hope for, it's still the best possible outcome right now.
The mw did warn me that the doctor was very blunt and that I should be prepared to hear him lecture me about my weight and say that I should lose 50-100 pounds before I consider ttc again. I'm glad of the warning, because I otherwise would have been furious. While I agree it is a doctor's solemn duty to point out things like that, I'm not stupid. I know I'm fat. I know the health risks that carries (I'm in pretty good general health, thanks) and the specific risks it carries for ttc (I have normal ovulatory function and cycles and there is no reason to think at this point that my weight has contributed to my m/c's). If someone is condescending or rude about my weight, then I get livid, and quickly. So the warning was appreciated. If it's done kindly, as my mw has addressed it, I appreciate it. If it's not, I lose it. And the mw warned me, because as she said, it's already an emotional enough situation.
So, answers soon, one way or another. Let's hope and pray it's the easier way that doesn't require a lot of time off work or time off ttc.