Sunday, June 28, 2009

A Whole New World

The waiting area at my new obstetrician's office was just as I'd imagined. There was some comfort in the fact that I could've been just another girl who threw out the birth control and peed on a stick after a carefree night. Waiting at the RE's office always felt like wearing a "Reproductively Challenged" sign on my forehead (I routinely imagined turning to the woman sitting next to me and asking, "What are you in for?"). So it was oddly comforting, in a way, to feel like just another pregnant lady doing what pregnant ladies do as I sat in this new waiting room.

Still, I felt like somewhat of an imposter, like an actress playing a different version of myself. I felt that once I got back to the exam rooms, at any point they would find me out – they would find something wrong, take away my newly bestowed pregnant girl credentials and send me running back downstairs to the RE clinic.

That's not what happened. Instead, my husband and I got called back for an initial consult with a nurse. She went over our medical histories and answered some questions about the practice. They then took at least half my blood supply, had me pee in a cup (first complaint to the OB's office: Could you please buy cups that are appropriately sized for peeing into? While urinating in the direction of one's hand, one prefers to be holding something larger than a tiny toy tea-party sized cup in said hand) and sent me back to the waiting room to wait for the doctor.

By the time we got called back to an exam room, I was worried about a few things. First, the nurse had said that typically an ultrasound is not given at that point – most patients wait until the integrated screening (NT scan/bloodwork) at 12 weeks. This information seemed unfathomable. Most women just walk in and walk out, taking brochures on pregnancy and talking about due dates without confirming that the pregnancy is, in fact, still going? I didn't yet know how to do it, but I knew I had to somehow convince them to give me one. Second, I worried that I wouldn't like my doctor. How could anyone live up to the ridiculously high standards set by my RE? And third, I worried that she wouldn't like me. Could she handle the bundle of nerves and barrage of questions that are my trademark?

Turns out (as with most things), I could've saved all that nervous energy. The doctor came in and, though I could tell she was a bit frazzled (a patient was in labor and she had to take a page in the middle of our conversation), she never made me feel rushed while I peppered her with my questions, many of them aimed at taking her pulse and sussing out her general philosophy (she seems to be "middle of the road" – cautious but not alarmist). Then she said that she knew I wanted an ultrasound, but that the techs were already gone for the day. I thought it would end there, and was mentally formulating how we might get around the absence of the people who do ultrasounds and still have an ultrasound when she added, I may be able to do a quick scan if you're willing to wait. I told her I would wait all night.

As she squeezed goop on my belly (ps I hate that word. If anyone has a better word for belly, please let me know ASAP. To me it's as irritating as "panties" and I hate to think about using it for the next 7 months.), she told me that when her friends get pregnant, they beg her to sneak them in for a quick scan between their appointments, which made me feel less like someone who needed unusual hand-holding and more like just another worried mom. And then suddenly, there it was on the screen (which, in this ultrasound room, is very conveniently positioned on the wall so you can actually see what's going on): a tiny little baby shape with that telltale frantic flicker. As if on cue, s/he did a little wiggle. A tiny, developing baby that is inside of me can move.

All of the above was confirmed on Friday when I went back in. I noticed a lot of pressure and pain on my right side, where my RE's office had told me a residual cyst was lingering. Thoughts of that cyst suddenly bursting and harming the baby were enough to overcome my desire to stay quiet – to avoid being "that patient" for the next few weeks until my integrated screening at 12 weeks. It was far easier than I thought to get an invitation to come in for a look, and though I knew everything was probably fine, how could I pass it up? I was there for nearly two hours, but I got another look at the kiddo (this time I got pictures) and reassurance that my ovary was not going to explode. What could be better?

Something dawned on me as I drove home on Friday. I seem to be the only one still worried at this point. My RE is clearly not – she gave me a due date and sent me on my way. My new OB (who was even better on Friday) knew the baby's heart was still beating before she even looked. My husband – well, my husband has never been worried (he's not the type). Yet I soldier on, an army of one in these mental battles against unforeseen (and unrealized) threats and complications.

I'm the only one still worried, and it's beginning to feel like lonely work. Perhaps it's time to consider a sabbatical.

Monday, June 22, 2009

Leave Your Bags Behind

The thing about infertility is that the emotional baggage it brings with it doesn't get packed up and shipped off at the moment of a positive pregnancy test or a good ultrasound. It stays with you, keeping you from exhaling and believing that all will be well.

Today, I will be meeting with an obstetrician for the first time. When I walk into the waiting room – which I assume will be filled with pregnant women who, upon peeing on a stick and seeing two pink lines, began picking out names and crib bumpers – I will be just another pregnant person. Just another one, that is, until I begin telling my new doctor about my battle scars, warning her about my particular angst in a way that hopefully doesn't send her running for the door in favor of less neurotic patients. I am going to need some extra hand holding. I am used to getting it at the RE's office, and I'm not sure how to ask for it from someone who is used to dealing with women more busy blossoming and glowing than panicking and ruminating.

I want to unload this baggage. It's a difficult thing to do after carrying it for so many miles, so long a journey. But I'm trying to trust that I no longer need it.

Tuesday, June 16, 2009

Graduation Day

Yesterday, it finally happened. I had wondered if they would hand me a tasseled cap or play Pomp and Circumstance, but instead it came without fanfare. It was just me and my husband sitting across from my doctor hearing these words: you're all done with me.

Wait – what? No more ultrasounds? No more tests or procedures? No more trying and pushing and struggling and working to make it happen? It's happened – really happened – and now there's nothing more to do but sit back and occasionally visit a regular old OB?

Apparently so. The ultrasound yesterday showed a baby (I would like your permission to call it – inaccurately but much more simply – a baby at this point. I have too much on my mind to worry about whether it is still an embryo or has officially morphed into a fetus.) measuring exactly on target at 8 weeks, with a heartbeat of 162. It had little arm buds (!) and you could actually make out a little human-like shape on the screen. And just when we thought we were done hearing good news, she told us there was no longer a blood clot visible in the placenta. So that bleeding? May have been a one-time thing.

I think I floated down the hall to meet with our doctor. She asked me how I was feeling and told me how normal I was for every anxiety I might have. When she took out that beautiful due-date calculator wheel, I just about cried tears of joy. I thought I might never get to see that wheel.

My new OB, recommended highly by my RE, has some huge shoes to fill. This doctor has helped give us a pregnancy, not only by meeting egg and sperm but by giving me the courage and confidence to go to these lengths to try. She is, quite simply, heaven sent.

I'm no Pollyanna – I am all too painfully aware that I will be carrying a degree of doubt, holding my breath just slightly until I'm holding a baby. But we've graduated to the world of good old-fashioned obstetric care, and I'm going to try (try!) to jump in with both feet.

Thursday, June 11, 2009

The Coast is Clear

The bleeding, thank goodness, seems to have been left behind at the ER (knock wood). But I think until I give birth (here's hoping), going to the bathroom and looking down may require serious mental preparation and deep breathing. Also, it is not helpful that one of the few subtle symptoms I've had is absolutely insatiable thirst – which means I'm spending an awful lot of time in the bathroom bracing myself.

I am encouraged by the many similar stories I've now heard. More than one person has quoted that about half of IVF pregnancies experience bleeding. I wish someone would explain to me, then, why you are not told at some point in this lengthy process that bleeding can be normal. I'm just guessing but I'm thinking that could've saved me from a good amount of panic on Sunday. Certainly not all, but some.

When I spoke to my doctor on Monday, I asked her when I might be home free. When you're holding your baby, she said. Actually, she added, When your child gets accepted to college. It's a scary business, this world of pregnancy and parenthood. All we can do is hope and pray for the best (right now I'm hoping and praying that Monday's ultrasound and doctor's appointment are reassuring). The rest isn't up to us, which is a hard lesson that I'm still trying to swallow.

Monday, June 08, 2009

Fear Has a Name

...and it is early pregnancy bleeding.

I think seeing it last night may have been the shock of my life. It was so incongruous – like the last snowfall of the season when you've already unpacked all of your spring clothes. My husband was grilling dinner and I was about to start my laundry. I went to use the bathroom and there it was. And no, it wasn't the brown color that I'd heard is rarely anything menacing. It was bright red, like the clear start of a period. I yelled for my husband and together, two keystone cops, we fumbled for a phone and the number for the doctor on call.

I had two options, she said. Wait to come into the clinic tomorrow to see a doctor or go to the ER now. She did not recommend the ER, she said – so busy on a weekend night – but admitted that some women are not emotionally equipped to wait until the morning. Um, yes, I said – that would be me. She told me she would make a note that I was coming in.

We waited for about 45 minutes before being called back. I felt like I was bracing myself as I hurtled head-on toward a Mack truck at 80 mph. I was trying to prepare myself for what the impact would feel like, how I might survive the collision. My husband kept reminding me how sure I had been on Friday that we wouldn't see a heartbeat. You told me it was probably a 1 percent chance it would be good, he said. Well, I said, now I think there's about a half a percent chance. No one has ever accused me of being an optimist.

I finally got called back. They wanted to start with a pelvic exam, but the nurse questioned my husband being in the room: You really want him in here for this? Lady, I wanted to say, we have been through IVF and a miscarriage together. You really think there's anything he hasn't seen at this point? I verified with him that he wanted to be there and we both said yes. She began the exam, and told us two things: one, that the opening of my cervix was closed, which could be a good sign; and two, that she saw the bleeding and "some tissue." What kind of tissue? I asked. She didn't know. She would have to send it to the lab for analysis to know for sure. I wonder what the lab would've said about a big clump of Crinone, which is what the attending ob-gyn later told us she thought it was. Good going, nurse. Way to calm me down.

The next step was an abdominal ultrasound. She saw the sac and yolk sac in my uterus, but did not see a heartbeat. But don't worry, she said. These abdominal ultrasounds don't really tell us anything. You need a transvaginal ultrasound for conclusive information. Which means that clearly, that test wins the award for most useless exercise of the evening.

They took five vials of blood, had me pee in a cup and told me to wait for someone to come get me for the real ultrasound. When they finally did come and get me, relief and fear set in: in just a few minutes, we would know. On the other hand, we would know.

My heart hammered as the ultrasound tech and radiologist peered at the screen, which was turned away from us. The radiologist finally told us calmly, I do see a heartbeat – I will tell you more about it in a minute. Which I took to mean, there is something wrong with it. But when, after an eternity, the tech removed the probe, the doctor told us there was a heartbeat of 136 BPM. He mentioned a small ring of blood around the sac, but said that mine was measuring at 10 (whatever unit of measure they use), and they only worry if it's 25 or more. So no signs of impending miscarriage? I asked. Nope, he said. It was the same feeling I used to get when I studied all night for an exam, walked in thinking I knew nothing and got it back with a huge A planted on the top. They released me a while later after I spoke to the ob-gyn. And at that point, my bleeding had stopped.

This morning, my doctor was incredibly reassuring. She told me how often early pregnancy bleeding happens, and how the vast majority of women go on to carry to term. She told me that the fate of this pregnancy is already sealed – that we're just spectators, waiting to see what this embryo will do. That at this point, the signs are good. And – once again reading my mind – she repeated that there is nothing I have or have not, can or cannot do to influence the outcome. All we can do is watch and wait.

I've survived a lot of waits through this process. If anyone has any thoughts on how to make it through this one, they are most welcome. Also welcome: any happy stories on your friend so-and-so, who had bleeding and now has a gorgeous baby. I need all the optimism I can get while I wait.

Saturday, June 06, 2009

My Beating Heart

After a fitful night of sleep filled with vivid, unsettling dreams and losing everything in my stomach in the morning, we made our way to the clinic yesterday. My skin had about made way for me to jump out of it when the waiting room door opened and an ultrasound tech called my name. I'll give you two guesses which one it was, and the first one doesn't count. You got it – the one that did the fateful bad ultrasound back in December. I paused for a second, but then felt an instant, odd calm about it. I think an interesting phenomenon happens with a controlling and superstitious person like me. You work so hard to make everything line up the way you want it, uncluttered by bad juju, but then there comes a point when life is just too much for you to control. You have no choice but to go with it and hope that the coincidence of it all is too absurd – that lightning can't possibly strike twice. Also, she is my favorite tech: kind, patient, no unsolicited comments on how many fibroids I have.

She led us back (to the same exam room, no less) and got, according to my expressed wishes, my favorite nurse to come in with us. I told them, voice shaky and cracking, that I wanted a running commentary as it happened. The probe was in for about two seconds when she announced (with not a small amount of relief on her part, my husband and I both thought), "I see a flicker!" Which was very helpful to hear at that moment, given that mine was about to explode right there on the exam table. The sweetest relief ran through everything I could still feel. She focused in on the heartbeat and measured 120 beats per minute. It was a little tough for me to see the screen and I can hardly remember what it looked like, but it doesn't matter. It's there, and hopefully there will be many more opportunities to get a better look.

I am all too painfully aware that we are not yet out of the woods. There are weeks, and miles, to go, and I cannot from here imagine a point where I might exhale. I also can't imagine that I am the only person in the world who, upon seeing a beating heart inside of her, began to question every instinct she previously had that she might be somehow qualified to be responsible for another human being. But at 6w 3d, our embryo has a recognizable beating heart, and even with the fear, my own heart – and gratitude – can hardly be contained.

Wednesday, June 03, 2009


I'm in an odd place, this moment. I'm pregnant. I have proof in the form of a fuzzy black and white photo. And yet, there's something about these first tenuous weeks after a post-IVF positive beta that say "pregnant until further notice." I can't yet take any steps that might point to "definitely pregnant" – buy maternity clothes, look at nursery decor, think about names. Yet I can't do anything definitively non-pregnant either – buy normal clothes, drink wine, work out. I catch myself looking wistfully at couples pushing strollers, think "Why can't that be me?" and then realize with a start that it could be. I'm closer than ever.

I fell off the wagon a little bit from my determination not to pay attention to symptoms I may or may not have. Thanks to all who set me straight (though I can't promise I won't ever ask you to remind me again when you first felt like you were pregnant and not just suffering from the worst case of PMS ever). I just long for a sign that all is well. I crave reassurance. There ought to be a little porthole so we could see what's going on in there. If I could go in and demand an ultrasound every single day without fear that they would commit me? You bet I would.

I wouldn't trade this place I'm in. I'm so grateful to be here. I want it to keep going. I want to see hope in the form of a just barely distinguishable flicker of light.