Thursday, October 27, 2011

Sewn up like the Bayeux Tapestry, to quote my friend T

NT Scan yesterday:

Went well. Nasal bone very prominently and clearly present (looks like this little heffalump* was not as lucky as his/her brother in that department and may have inherited DH's family's more, erm, prominent nose). Nuchal fold measured at 1.6 each time. Brain, heart, stomach all present, no apparent gross open neural tube defects. I left feeling vastly relieved. This kiddo is very obliging, and was in perfect position and holding still for the initial and most important measurements, and then started dancing around for us. Also, hiccuping (interfered with the heart rate, because it would lurch with the hiccups. Cute.).

Actual results will be available in about a week, but given the clear u/s I'm not concerned and was in fact comfortable with proceeding with the cerclage. The tech did not give an official guess because she couldn't at this early stage, and I had the Jack and Jill fetal DNA test done, which would tell us, so . . . (sidenote, the test is offered for free as a courtesy to my OB's patients because she refers all her patients to this place, otherwise we would have declined). However, she did say aloud that she would lean towards a particular sex. Interested to see what comes back on the DNA test and of course on future u/s. We do think we will keep it to ourselves, though.


No eating after midnight, so I had a glass of milk at 11 and went to bed. Woke up about midnight with terrible diarrhea, but glad that was out of the way yesterday. Never did sleep well again, knowing I'd be up in about 4 hours.

Got up at 4:45 to take a shower. Then got dressed and was ready by 5:15. The cab was picking us up at 5:30, and I needed to be at the surgical center at 6:00. Timing worked out well. I got there about ten til. Too bad it didn't open until 6:00 on the nose - the mosquitos are awful right now.

I was scheduled second of the first five, so I completed my paperwork and paid relatively quickly and was back in prep by 6:30. Got changed, into bed and then they had anesthesia come talk to me (haha, jokes on me, it was under general in the end). The anesthesiologist was quick to reassure me that the drug they used has been used in pregnant patients for over 25 years and was safe for me and baby. That was honestly the first time it had ever crossed my mind to wonder about that. Mom fail?

The anesthetist had a very difficult time placing the IV. Three tries in the end and my left hand, wrist and arm are purple. Turns out they do better when they don't use a tourniquet. Go figure. I was told that I would not be sedated before being wheeled down because the sedation they normally use wasn't safe. Ok, shrug. They did an u/s to check position of the heffalump and I watched him/her roll around and stretch several times. That kiddo is just always, always active. And then DH was brought back and then Dr. K showed up and checked the u/s again (but oddly, I wasn't laying back, so he had trouble and his CRL measurement was a full week back of the first one today and the measurements yesterday . . . heh).

Then DH took my ring and my glasses and they wheeled me down and moved me onto the table and had me taking deep breaths of oxygen, and then they had me taking deep breaths of oxygen only my throat was very, very sore and I was coughing some and I couldn't open my eyes and then they said "Can't find it, um, should I get someone?" Followed by "Oh, sorry, no it's right there. Fetal heart tones look great via u/s." And then I tried to open my eyes and they said I was all done and did I want some juice? And my husband would join me soon.

I got some juice, and my throat hurt a lot. And there was a lot of pressure and I could feel the stitch which was weird. DH arrived and I was pretty in and out of it for awhile. I know I asked him a couple of times about what the doctor told him. My b/p was sort of high, though again at home, it's been ok. It was decreasing by the time I left. Got dressed and called the cab and then we came home.

I went to the bathroom. Mild spotting, nothing big, some cramping, but like light menstrual cramps, nothing scary. Again I could feel the stitch when I went to the bathroom, though now it's not really a big deal. I stretched out on the couch and have taken a few naps. Not the most comfy ever, but not terrible. I'm still feeling lazy and sloth-like. Some cramping that Tylenol has taken care of, spotting seems to be nearly gone.

We tried to get a doppler reading, but the kiddo was moving way to much. We'd catch it then whoosh- moved. If it's moving that much, I think we're good.

So yeah. It's going to be ok, maybe. For the first time I'm thinking there is a possibility of this working out. Never thought I would actually get this far. But here we are - second tri and sewn up tight.

The restrictions - which I've known about for a long time - are a little daunting, but they will become second nature I'm sure. Going to be a long few weeks, but I'm hopeful, I think. Just taking it easy right now - I am not looking at anything work related, just chilling on the couch. All. Weekend. Long.

*heffalump came after the NT scan when one of said jokingly, 'we've got a heffalump that jumps in there.' it's been sticking.

Tuesday, October 25, 2011

Deep breaths, deep breaths.

Inhale slowly through the nose, exhale slowly through the mouth. Oooooooooooo. Ahhhhhhhhhhhhh.

I've been repeating that a lot the last couple of days.

Last night, I woke up and was convinced that there was something in my vagina. It felt a lot like when I would pass a clot, actually. Only, there was no clot. Or anything, though I cried for about twenty minutes. I was finally distracted by horrible, horrible vomiting (to little effect, as I hadn't eaten in hours). I eventually realized that if my water hadn't broken with that vomiting, I was probably fine and tried to ignore the cramping and fell into an uneasy sleep.

This morning was better. But I'm scrambling to get everything done at work that needs to be done before the surgery. I feel constantly behind. The sole consolation is that I felt the same last year so maybe there is hope yet.

I got a call from the surgical center today, and when I gave them my height/weight suddenly they said I was too heavy to have the cerclage placed there. They said the anesthesiologist was uncomfortable giving me anesthesia because they'd have a harder time intubating me at my size, and I should be in hospital. Given that no intubation is required (the anesthesia is a spinal), I was really confused, and then really upset. The nurse at the peri's office straightened it all out though and we are back on for Thursday morning.

I am scheduled for the NT scan tomorrow and getting the first panicky twinges about it. I have no reason to think anything is wrong - baby's hit the milestones and had good heart-tones, movement, etc. Nevertheless - test. Big one. With results coming a week after they stitch me up. Nerve-wracking. Lip biting. Scary. I'm hopeful we see all the markers we are looking for, so I'm reassured. With Gabriel I remember being very concerned about anencephaly, and the presence of a brain was enormously reassuring. Let's keep our fingers crossed that all is equally well with this one.

At least I am not worried about it being dead when we arrive tomorrow - we had a great session with the doppler tonight. It's been very hit or miss, and I limit attempts to no more than every other day and usually stop once we get a heartbeat. Tonight though, it was as clear as it's ever been and the parasite (who clearly dislikes the doppler as much as its older brother did) obligingly stayed in relatively the same area, so we got great sounds. Good enough to make us stop and just listen for awhile. There was a flash of excitement and pride, a breakthrough from the usual detachment I have with this pregnancy.

Which is not to say that it's gone - far from it. The question of Gabriel's sex was a looming one throughout his pregnancy. Of course, I was convinced he was a girl, and quite afraid of having a boy and what on earth I would do. I was legitimately concerned about gender disappointment, having always wanted a girl first, but it didn't matter in the end. I loved him, and was so excited when it was finally official that he was male. I'm curious this time, but there is nothing like the fervor of last time. No long conversations or guesses or musings. Of course, nearly everyone thinks this parasite is a girl, and I sway back and forth. In many ways that would be easier, and bittersweet in others. But then I doubt that it will be any other way when the constant comparison is to my poor lost little boy. Having a baby - should we be so lucky - won't answer the questions we've always had about what our son would have been like and what raising him would be. If anything, they'll become more defined, more crystallized as we see more clearly what we've missed and the foggy dream images take shape into a living reality.

Detachment is the only way for me to cope. Yes, I know if we have another loss I will feel guilty about it. But I have to balance that against surviving each day and the only way for me is for the excitement and hope and joy to be compartmentalized and allowed out only in careful doses. So tonight, it was sweet to listen for a few moments, to send a thought to the baby thanking it for its cooperation, and simply have a normal moment of pregnancy and bonding.

A deep breath in the midst of the panic that seems to supersede the majority of the time, if you will.

I will post sometime after the cerclage is placed, if things have gone well. If you'd keep your fingers crossed or think good thoughts or whatever you send into the universe on Thursday, we would surely appreciate it.

Friday, October 21, 2011

Whoa there, buddy, let's just slow this down a bit here, yeah?

OMG, two posts within a week?! Did the Rapture happen after all? No. Just updating.

I had another appointment with the regular OB on Monday. To be 100% honest, I was pretty well wrecked going into it. One of the women on the birth month board I've been visiting was a day or two behind me and we both had appointments on Oct 7, both had healthy babies with healthy heart beats, and then suddenly she went back and it was a missed miscarriage. Scared the fuck out of me.

And also, Monday was a huge deadline for a funding request and it's the first one I've done for this special funding that makes up, oh, a quarter of that department's budget and after working on it the previous week and then for 8 solid hours on Sunday, I was still not done and a little panicky.

So when they called me back and we didn't start with the u/s that I was supposed to be getting, I started getting very anxious. Apparently, my blood pressure was through the roof, despite being perfectly normal at every other appointment. The nurse was concerned, and asked if I was stressed out, to which I responded with a terse YES. She said we could try to find the h/b with the doppler and then she'd take it again.

Yeah, she couldn't find the h/b with the doppler. She was definitely not taking the blood pressure again at that point. Now, logically, I know that it was 11 weeks exactly, that it was still early, that it isn't automatically bad news, but I was already so freaked out that there was no way to separate the terror and nod sagely about logic. They wheeled in the old portable u/s machine, which was great, but they insist the doctor do the u/s in case there is bad news. I had to wait, naked from the waist down, staring at the u/s machine (which looked a lot like movie robots from the 80's) for fifteen or twenty minutes, during which I nearly completely lost it and started crying.

Dr. B was calm and reassuring as ever, but I was such a wreck that it didn't matter. She slid the probe in and immediately said, "Oh, see, baby's just fine, dancing away, saying nothing to worry about here Mom." and she turned the monitor so I could watch while she quickly checked the cervical length, heartbeat and placenta. Everything looked fine, and I was (and am) relieved that they immediately did the u/s for reassurance, but that's why I am supposed to have an u/s at every visit to begin with, scheduling person who fucked that up.

Then I learned that Dr. B doesn't actually do cerclage, so the list of questions I had prepared and the dates/schedule I thought I was getting? Nope - had to call the peri back to get it scheduled, which made me sullen and teenagery inside because I want an adult to arrange things for me, damn it.

I am to monitor my blood pressure twice a day (er, not been great about that just yet) and keep a log to take back. So far, it's been low. Go figure. I need to make certain the monitor is calibrated correctly, but it is returning normal figures for DH, so I sort of think it is working ok. I also got referrals to several psychiatrists and need to find one who takes my insurance, because the point at which my blood pressure is rising precipitously like that is the point at which I say I need some fucking anti-anxiety medication, please. Dr. B was quick to get me her referral list, I might add, after I said calmly that I desperately needed help with this. She also gave me a referral to the genetic center she sends patients to for the first tri screen (also known at NT scan), and that is scheduled for next Wednesday morning.

I don't see Dr. B again for nearly a month, but that may have to move up, depending on how things with the cerclage and whether or not I will have a follow-up with the peri.

Ohbytheyway, that (the cerclage) is currently scheduled for next Thursday. They'd have done it sooner, but I said I wanted the NT scan done first. Um. When the nurse called me back today to tell me it had to be next week, I nearly flipped out. I made sure that they know I'll be 12 weeks and change next week and she very impatiently clucked and said yes, yes, she's aware, next week.

I was not prepared for next week. I thought closer to 14 weeks. Certainly sometime after 13 weeks. Like, maybe after the official end of first tri? Also, I wasn't preparing work for next fucking week and OMG, what?

So yeah, Thursday, early in the morning. Wow. It's good. Really. Things are going well (provided the NT scan doesn't identify a hideous anomaly, but we don't have much reason to expect that given what we've seen so far), and the sooner the better, especially given the 'short presentation' of my cervix in the vaginal canal. It took me all day to figure out why I was so surprised and why I felt so steam rolled by this all happening so fast (beyond the work implications). I mean, I've known for 2 years that I would likely have a cerclage, and I learned 2 weeks ago that I definitely would. I know it would be placed before 15 weeks. So . . . what is the issue?

I finally pinpointed it and explained to Dh on the drive home thusly:

"It's like, whoa, there. This is all moving a bit fast, don't you think? It's like we've just met. And we're already getting intimate. But more than that, it's sort of . . . permanent. I mean, obviously not permanent, because it's going to be removed eventually. But it's a pretty big step to take, when I have no idea how this pregnancy is going to go. Which I realize is completely stupid, because the whole point of the cerclage is to help the pregnancy go as far as possible. But it feels like an awfully big commitment, and I don't feel ready to make that commitment. I feel like holding my hands up and telling him to stop thinking about my vagina and maybe back off and see where this thing is going first, you know?"

That's right folks. I'm concerned that the thing designed to prolong my pregnancy is being put in too soon because I'm not convinced I'll still be pregnant in a month. That repetitive sound is the sensible portion of me bashing itself against the wall created by the lunatic portion of me to keep the sensible one out.

Can't talk about work with a fuckload of profanity and foaming at the mouth, but am reminding myself that I was pretty much at the same place a year ago, and we all (me and the departments) survived, so it'll probably work itself out again this time too.

And lastly - in case it's not been made clear - I am half in love with Noel Gallagher, and fully in love with his music. I was crushed when I realized that even though Noel Gallagher's High Flying Birds was released on 10-17 in the UK, that it's not available here until fucking November 8. Because I love The Death of You and Me in a wholly unhealthy way, and because If I Had A Gun has jumped onto my top 10 all time favorites list. Seriously, it's one of the most romantic, haunting songs I've ever heard. I got chills when I first listened to it, and still get chills. If you are big into Jesus you may not like chorus line "you're the only god that I will ever need" but if that won't upset you like it upset my intern at work (who audibly thanked the holy father for protecting her ears when I turned it off; I didn't think it was even loud enough for her to overhear), then dear god go listen to it on youtube. Fucking amazing.

Saturday, October 15, 2011

Pregnancy and Infant Loss Awareness Day

Remembering all the beautiful babies that have been lost far too soon, and all the grieving parents wishing they could hold them again. I hold you all in my heart and in my thoughts today.

This is something I've read and re-read lately, because since I got pregnant again, Gabriel has been more firmly on my mind. Reliving his pregnancy, reliving his birth, trying to remember the beautiful moments and not just the scary ones. Now that more people are learning of my pregnancy, people who don't know about Gabriel or understand the dangerous path I'm walking right now, I find myself reading this again and nodding along.

It is of course from my dear Elizabeth McCracken and her memoir An Exact Replica of a Figment of My Imagination and if you have never read it - do. A brilliant writer who carries you into her world of loss and grief in a beautiful, honest, funny way. She captured so brilliantly the things I wanted to explain to other people, and I will never forget buying it about two years ago and opening it while I waited for my to-go order and standing in that line simultaneously laughing and crying out loud because this was a kindred soul.

How she speaks of loss and her Pudding here, this is how I feel about Gabriel today:

"I want it, too, the impossible lighter-side book. I will always be a woman whose first child died, and I won't give up either that grievance or the bad jokes of everyday life. I will hold on to both forever. I want a book that acknowledges that life goes on but that death goes on, too, that a person who is dead is a long, long story. You move on from it, but the death will never disappear from view. Your friends may say, Time heals all wounds. No, it doesn't, but eventually you'll feel better. You'll be yourself again. Your child will still be dead. The frivolous parts of your personality, stubborner than you'd imagined, will grow up through the cracks in your soul. The sad lady at the Florida library meant: the lighter side is not that your child has died -- no lighter side to that -- but that the child lived and died in this human realm, with its breathtaking sadness and dumb punch lines and hungry seagulls. That was the good news. She wasn't going to pretend that he hadn't, no matter how the mention of him made people shift and look away.

A stillborn child is really only ever his death. He didn't live: that's how he's defined. Once he fades from memory, there's little evidence at all, nothing that could turn up, for instance, at a French flea market , or be handed down through family. Eventually we are all only our artifacts. I am writing this before our first child turns into the set of footprints the French midwives made for us at the hospital . . .

. . . I don't want those footprints framed on the wall, but I don't want to hide them beneath the false bottom of a trunk. I don't want to wear my heart on my sleeve or put it away in cold storage. I don't want to fetishize, I don't want to repress, I want his death to be what it is: a fact. Something that people know without me having to explain it. I don't feel the need to tell my story to everyone, but when people ask, Is this your first child? I can't bear any of the possible answers.

I am am not ready for my first child to fade into history."

Love to all of you mothers and all of your children, present with you or not.

Sunday, October 9, 2011

Back with another update

The short version so you can skip the rest of the shit if you like:

Still pregnant with a viable fetus. Saw the perinatologist Dr. K on Friday and my little parasite (the most affectionate name we've come up with) was measuring ahead a bit with a good steady heartrate and good placement. My cervix measured 3 cm, but on manual exam showed a 'short presentation' - based on this and on my history, Dr. K has agreed completely with Dr. B's assessment and I will have a cerclage placed in 3-4 weeks and start 17p shots weekly at 16w. He said that of course there are no guarantees, which I know, but that he felt pleased and thinks I have a good shot at this.

And now the rest of the crap:

I honestly meant to write more between visits. But I found that every time I opened it up and stared at the blank white box, the fear would rise up again and I quietly closed it and went on my way. Or I'd come here and pour out a very long piece which was either a long rant about work and how buried and unhappy I am (which, once redacted to remove identifying details is confused in the extreme) or a long rambling on how convinced I am that the pregnancy is over or will be soon and god, I am tired of thinking it, how boring to read such things over and over and over.

In truth, I'm coping. Probably not very well, and dear lord do I stare longingly at that gorgeous unopened bottle of Mt. Gay Eclipse, but for the most part (long panicky and repetitive emails and chats with my dear T aside, who patiently listens and soothes though she's probably ready to do herself in to get it to stop already), I plod through each day.

Now that I'm nearly 10 weeks (and oh, yes, after measuring ahead, I went back and changed all my tickers back to where they were before the last u/s because I like Monday ticker-change better than Wednesday, because it's two days ahead my precious), and we've seen a good heartbeat, the risks have dropped to under 3%. We've also heard the heartbeat on the home doppler, which may drop us down to 2%. Not that I'm holding my breath over statistics - they've never been kind in the past. It's more like, ok. Maybe the tension can unwind a click now.

The hardest part was the in-between of the u/s. Just around 7 weeks and not another until 9.5, because of scheduling (and yes, I know how 'lucky' I am to get all this monitoring, I've been told on my birth month board, to which I snapped back that I'd much rather have a healthy normal pregnancy and forgo all the extra u/s ...). That particular time was difficult because it was too early to use the doppler (who am I kidding, we started trying at the end of 8 weeks/beginning of 9), far too early to feel movement, my uterus is still pretty far down in my pelvis (I can find it easily now though!) and the prime time for missed miscarriages. Symptoms are changing as well, as we approach the end of first tri, as the placenta moves towards taking over hormone production, etc.

I went from constant boob soreness to mild achiness in the evening. I went from all-day nausea and food aversions to hunger, interest in certain foods (I can eat tomatoes! and onions! and pickles!), and only some really bad near-vomiting after eating and in the evenings. Fatigue - well, hell, I'm so stressed out that ones particularly hard, and frequent urination? I have been drinking water like I'm a camel embarking on a desert journey, so who can say? Take all of that, through in paranoia, and some cramping, and a massive dose of stressed-out crazy and you get, well, me. It was difficult to function. All my free thoughts pulled together to say AFRAID AFRAID AFRAID AFRAID. I had horrible nightmares about the pregnancy ending in gruesome ways, about my family members dying or murdering others, and finally the past week saw me awake every night between 3 and 4, and be unable to return to sleep because of the things running through my head.

And let's not forget that work is a godawful disaster right now that brings its own high stress levels. I can't even get into all of it, but there is no sense that things are getting better or that that will ever get better (though that is a bit dramatic, really). No light at the end of that tunnel, really. I told a couple of people that I thought I would be coping better overall if I only had work to deal with or if I only had the pregnancy to deal with. The combination, instead of distracting me from the pregnancy or increasing my focus at work, has left me one big mess of a person who feels like she is failing at every thing she touches.

The anxiety levels are through the roof, in other words.

Things will get easier though. I hope. At least now, we're into fetus-hood. We're into the point where the doppler is working (and oh, obliging baby, how grateful I am that you are so kind - placed right at the top of the uterus, my parasite moves right near the probe and obligingly swims back and forth at that spot - no real searching or following, not like with Gabe. The technobeat freight train fades in and out and we let out a breath we'd been holding and there it is). We have a plan in place for my treatment. The pregnancy has been so different from Gabriel's - no bleeding, no worries, no scares except in my head. The baby will get bigger, the heartbeat easier to hear and measure. The trimester will end, and a cerclage will be placed. The monitoring every other week will continue, movement will start. As each of these things happens, another click of unwinding, of ability to move or to breathe. Not relax - ever relax? I doubt it. But easier, I hope.

I am able to do a little more - my family has been told now. I think we'd have liked to wait to make any announcements until after the cerclage (that certainly is the general plan for the rest of work or Jason's family, make sure that goes without disaster), but alas, my brother's wedding the week after placement makes it difficult, as everyone else is going and we are not. Everyone seems excited and hopeful though and my brother was really nice about the announcement. I bought canvas to make letters for the name for this one - Oliver or Vivienne (I'm starting with Vivienne, as nearly everyone believes it to be a girl). Cream letters, with sage green trim for Oliver or mauve trim for Vivienne. The colors were so clear. I didn't shake like a leaf this time. I had a few moments of doubt, but not the paralyzing fear of even a week before.

This is as positive as I can be, I fear. I feel an uncomfortable duty to pretend to happiness and delight, to be grateful for the symptoms that were dragging me down, and I can't do it. I feel terribly for those who would love to be in my position, but I can't manufacture emotion. Abstractly, I am happy, and hopeful. Emotionally, I am numb and want it to stay that way. The fear is hard enough when I am numb. Attached and hopeful and stupid? I don't think I could get out of bed again. So we go about every day, breathing in and out, trying to do one day at a time. Some days it works better than others. That, really, is the essence of life, I guess.

Oh, and as an odd post-script? At nearly 10 weeks pregnant, for a lark, I took one of the internet cheapie tests that are still laying around here (can't pass them off on anyone, not just quite yet, not really) - these tests that were the bane of my ttc existence with their faint lines and squinting, that gave me the first unbelievable positive at 9 dpo? 10 weeks pregnant, and the test line is still not darker than the control line. Wow.