Tuesday, December 30, 2008

Spoke Too Soon (Or, Why My Girl Parts Deserve a Caribbean Vacation)

You know how in my last post I made it sound like the miso*prostol was not as bad as you might think? How it seemed like the process was more or less over and I was feeling relatively fine physically?

When am I going to learn to keep my mouth shut?

Miscarriage is definitely one of those things that you really can't go into detail about in any kind of social situation. Some might call it bathroom talk. So, despite knowing that readers of this blog would have a higher threshold for hearing about it (at this point, it takes a lot to gross me out), I will spare you the specifics. Suffice it to say I've been up all night with some of the worst pain I've ever experienced. I don't even think you can call what I had "cramps" -- I think what I felt was in some sort of new category. And I sincerely feared bleeding to death in my sleep.

I think my reproductive organs have decided to go on strike. They can't take it anymore. And I don't blame them. They deserve a break, and so do I. My husband and I were considering booking a last-minute (warm weather) vacation later this week, but the way things are going it's now out of the question. I feel like crap and I don't want to be far away from doctors and medical facilities that I know and trust.

It's not fair. Such a juvenile, simple-minded protest, but I keep going back to it. It's not fair that my body is doing all of this work to get rid of something dead instead of bringing something to life. It's not fair that this miscarriage is happening in two parts -- the failed pregnancy with no end in sight. It's not fair that my husband and I have this rare and much-needed opportunity to get away and recuperate, but the miscarriage won't let us.

It's not fair. The girl parts and I, we need a break.

Sunday, December 28, 2008

In with the New

Christmas always seems to me a time of renewal. Of course the purest symbolism of the holiday is about hope and better things to come. And I think there's something about bringing in new things that always makes me want to clean out my closets, recycle old magazines, make bags of donations to charity and start fresh. This Christmas, with all of its complication and sadness and upheaval, is no exception. I long for a clean slate, to say goodbye to what's been and look forward to possibilities ahead.

It's been quite a journey from the shock of my first "bad" ultrasound to here. First, I had to endure a second ultrasound to confirm what we already knew. Unfortunately, through this experience I also learned what my due date would have been -- knowledge I had been trying desperately to avoid. I have no need for such a specific trigger for suffering. But now I know, and rather than share it here I am just going to try to commit it to that part of the brain where old algebra equations and what you ate for dinner last Monday go to disappear. Try.

Once we had this confirmation, I realized how ready I was for this process to be over. There was something so deeply sad about feeling pregnancy symptoms because my body still had not clued into the failure of this pregnancy -- and I wanted to release it from its duty as soon as possible. So I called my clinic and asked for the medication they use to enduce miscarriage. I thought they would just call in the prescription to the pharmacy. Not sure why I thought this would be this simple when nothing in this process ever is, but once again I was wrong.

Apparently because the drug is also used for voluntary termination of pregnancy, I had to go in and see a doctor to get it. And because there were no doctors that day at the local clinic where I'm usually seen, I had to go to the big hospital downtown. This created a few problems. One, I had no idea where I was going within the endless halls of that place, since the only other times I've been there were for my retrieval and transfer, in a different wing. So my husband and I proceeded to get very lost. That, combined with my alarm over taking this medication and my empty stomach (note to self: eat lunch before dealing with major life events), led to a massive anxiety attack. I was sure that I would become the first patient to require care in both the IF clinic and the cardiac care unit on the same day. But I recovered with some Sun Chips and deep breaths outside, and after a few minutes felt ready to go back in. When we finally found the right elevator for the clinic, the security guard stopped us. The floors above were on "lockdown," and I overheard his security guard friend on the radio say that someone had a nurse pinned against the wall. Perfect.

Once we were allowed upstairs, after an hour wait we saw a 12-year-old doctor (husband's assessment) for the prescription. I asked a ton of questions, and then waited some more while she went and got another doctor and the printed prescriptions. Apparently, because my doctor wasn't in, one of her senior colleagues was supposed to come in and make sure I wasn't overly depressed or confused or something. Unfortunately, the doctor available to do this was the one in the practice who missed bedside manner training day, and he proceeded to tell me that I still might need a d&c after taking this medicine. Thanks, buddy. That's great news, because clearly I'm looking for all the torture I can get, and more to worry about until then.

The next morning, Christmas Eve, I woke up and, hands shaking, took the miso*prostol, anti-nausea medicine and 800 mg of Motrin and settled in on the couch, prepared for the worst. What started happening six hours later was not pretty or painless, and I definitely wouldn't recommend this drug for recreational use or anything, but for me it turned out to be a very good alternative to surgery (note to anyone considering taking it: DO NOT read the horror stories available out there via Dr. Google). It was more or less over by Christmas morning, and an ultrasound on Friday showed that I'm now clear to just wait for my period to come (I have been assured it will once the hcg drops to zero) or the follow-up visit with my doctor scheduled for Jan. 12, whichever comes first.

There is so much I could say about a Christmas Eve spent on the couch having a medically induced miscarriage while my incredible husband baked pies (yes, you read that right) in the kitchen for my family get-togethers. About the exhausting effort of wearing a brave smile on Christmas so I wouldn't dissolve into a tearful heap over what might have been that day. It was deeply sad and painful in all the ways you can imagine.

But it happened -- for whatever reason, this miscarriage on Christmas has become part of my story -- and somehow, I survived. Crying more tears and feeling more anger over the unfairness of it all will not change this, and though the tears and the anger will still continue to come (they did today with surprising force), my overwhelming desire now is to move forward, out of this time and place. I want to feel hopeful once again that what's ahead is better than what I've left behind. I have to believe that. It's the only way I can keep going.

Thursday, December 18, 2008

A Big Misconception

I got an email from Joe Biden today. Well, me and millions of other people. I was sitting at my desk (Yes, you read that right: my desk. Somehow, for the past two days, I have hauled my sadsack self to the office. I don't know if the effort has been worth it, to be honest. I'm exhausted.) when I noticed the flashing red light of my BlackBerry signaling a new message to my webmail account. Since Monday, whenever that happens it feels like a beam from my own personal lighthouse. A lifeline, a message of comfort from a friend who knows what's going on. Something to hold onto. Something to help me breathe. But when I opened the message, it turned out to be from the VP-elect. The subject? "A Big Misconception."


This week has been like one of those disturbing, vivid dreams where people, places and events that shouldn't go together are suddenly intertwined, nothing makes sense and you can't wait to wake up. Except I can't. I feel doomed to spend the rest of my days in this time and place, mourning something too early to be a real baby but too late to be just another failed cycle. I am a zombie, a shell, a shadow that walks and talks and eats and types but doesn't really register feeling unless I'm crying or talking about my miscarriage.

And yet, it still hasn't really happened. One of the things you do not know until you go through this (because, really, they're not going to describe this to you when they tell you you're pregnant -- although, with miscarriage rates what they are, I'm thinking they'd be better off doing just that) is that the options you have when they discover that your fetus is not developing ("fetal demise" is what the report on the table in front of my doctor on Monday so delicately called it -- one of the many things I am sorry I saw that day) absolutely, horrifically suck. You can either stop your progesterone and wait for it to happen naturally, take a pill that essentially puts you into a violent form of labor to expel the pregnancy or have surgery in which they suck it out of you. Oh yeah, awesome choices. Just the kind of thing I wanted to be weighing this holiday season. Mistletoe, chestnuts roasting on an open fire and how to terminate a non-viable pregnancy.

The problem, I am learning, with conception is that it can end in misconception. And that feels so much heavier to bear, so much harder to ever get over, than no conception at all.

Monday, December 15, 2008

Too Good to Be True

I just knew that if I dared to think for even a second that this might work out, that this positive pregnancy test and good initial scan might lead to a second good ultrasound and -- imagine -- a real live baby, that something would happen to prove that hope foolish. That I would then be left not just with a broken heart, but with a broken heart and vivid images in my head of those moments of hope, doomed to play over and over and over until I feel like I can't breathe.

Today was going to be either one of the best days of my life, or one of the worst. As the ultrasound tech started the scan that would seal the fate of this day and this pregnancy, my heart hammered in my chest and I struggled to catch my breath. I yearned for her to turn the screen toward me, to reassure me that there was a live baby growing in there. But she didn't. I looked at my husband, who raised his eyebrows and looked hopefully at the screen. I thought it was a good sign -- he looked positive -- but I later learned it was because he wasn't sure what he was looking at and thought the sighting of the sac was good news. Nothing -- nothing -- could have prepared me for what I heard next: that there was still a gestational sac, but nothing inside. No heartbeat. No baby. Nothing. Turns out, today was going to be one of the worst days of my life.

I wish there was something someone could do or say to take this searing pain away. Some medication they could give me to let me leave this head and the raw sadness for just a while. I want to box up all of these feelings and send it away somewhere so I never have to know them again. I don't even want to write this post, these words, because someday when it doesn't hurt so much I don't even want to remember how it feels to be me at this particular moment. I'm afraid of muscle memory, afraid this sorrow is leaving some indelible mark on me that might never fully disappear.

I was handled well today -- they did everything right and my amazing doctor said all the right things. She just couldn't say the words I most wanted to hear. No one can. And I literally don't know how to live with this kind of pain.

Tuesday, December 09, 2008

All in

On Friday, we upped the ante. My favorite ultrasound technician (never an unsolicited comment, always the right amount of small talk) called my name in the waiting room at my clinic, and this time my husband went in with me. Because instead of looking at ovaries and follicles, we were looking for a developing baby. And before I even had time to get nervous, she found one: there, on the fuzzy black and white ultrasound screen, was the loveliest black blob I've ever seen in my life. I found out later, when the nurse called, that everything about this splotch/blob/black hole (as my husband so delicately called it) was 100% normal for this stage. Which means I should be able to relax a little, right? Wrong. So wrong.

That ultrasound raised the stakes. We're no longer talking about the success or failure of a cycle. We're talking about a real pregnancy. A real developing baby, albeit a sesame-seed sized one, that I saw with my own eyes on a fuzzy screen. And all the hope and the early plans that go along with it, that I've dared to make mentally for this developing being in my rare moments of sheer optimism.

I'm all in on this. And there's nothing left to do but wait and see what the next hand looks like next Monday, when we peer at that screen again, this time hoping, praying that we see a heartbeat.

Tuesday, December 02, 2008

Bye-Bye Betas

Today's result: 1,236. I've crossed the finish line on betas, and the bruise on my hand from the first one has finally, finally healed. Thank you, God. And goodbye to all that.

Next up: a 3-D form of terror. First ultrasound scheduled for Friday morning. I'm bracing myself, though I'm also trying to exhale a bit since the next two days will be free from any kind of check on whether I'm still pregnant, and becoming more so. I need to seize the opportunity to stop being in a constant state of alarm, if only for 48 hours.

So far, pregnancy doesn't feel like pregnancy at all -- or at least not what I anticipated it would feel like when I thought about it the thousands of times that I did. The symptoms I've had so far have been subtle and not at all pointing undeniably to a bun in the oven. So the only proof I have are these numbers which mercifully have done exactly what they're supposed to do. Here's hoping the ultrasounds follow suit, and that I can start to feel something more tangible about this pregnancy, something to hold on to, something that makes it feel more real. Something that gives me permission to believe in it and -- imagine this -- enjoy it. (Just please let this something not be violent morning sickness as I loathe, and actually deeply fear, throwing up.)

Monday, December 01, 2008

Test. Worry. Repeat.

Some early pregnancies go like this: blood test, yay! we're pregnant, let's start planning the nursery. Mine, so far, has gone like this: blood test, euphoria, anxiety. Repeat. Repeat. Repeat.

Still, I am encouraged by yesterday's result: 622, again nearly doubling from two days before. Apparently I need to keep going in until I reach a beta of over 1,000, at which point we can do an early ultrasound. So hopefully, hopefully with tomorrow's beta I can officially be done with this every-other-day blood draw exercise. Fingers crossed.