Deja Vu and a New Wrinkle

Aside from many fewer tears, "deja vu" is the best way to describe yesterday's D&C.

It was on a Friday, scheduled for 10:30 a.m. The first one was also on a Friday, either at 10 or 10:30 a.m.

I wound up with the same pre-op intake nurse, although this time I was much more prepared for her. She remembered me, too. But every time she tried to get chatty, I cut her off and attempted to distract her.

Her: "So how many babies have you lost?" Me: "Six. What did my blood pressure read at?"

Her: "Have the doctors come up with any reason this keeps happening?" Me: "Well, clearly none that has solved the problem. You know, I've never had someone take my temperature before by running a device across my forehead. Is that new?"

Her: "Have you thought of adoption?" (as she's walking me to the changing room). Me: "Can my husband come back to the waiting area with me?" (Even though I already knew perfectly well that the answer was yes.)

At least it was better than sobbing through the whole interview, like I did last time.

We were taken to the exact same pre-op area, and then I was put in the exact same post-op recovery stall. And it's not like this is a small place - there must have been at least 20 post-op stalls. The only thing that was slightly different was that I think I was in the operating room adjacent to the one I was in last time. The walk didn't seem quite so far this time.

And also like last time, as soon as I set foot into the operating room, I lost it and started crying. But at least this time I didn't wake up into heaving, hysterical sobs like last time.

The wrinkle in all of this came while we were waiting in the pre-op area.

While I am usually pretty fond of Ob, I am extremely annoyed with both him and the ob rad right now. Ob stepped into our waiting area with one hand holding his cell phone to an ear and the other flipping through my chart. He said hello and then proceeded to read a couple of sentences to us from the ob rad's report that basically says I have a misshapen uterus.

I'm not clear on whether ob rad thinks the top of my uterus is just slightly sagging or if he thinks it's fully bicornate. All I know is that Ob looked very grave and said, "That definitely causes miscarriages." When I mentioned that I had an HSG in February that looked fine, he looked very surprised, said "This February?" and then when I nodded, followed up with, "Well, get the films, send them to the ob rad and follow up with him." And with the cell phone still stuck to his ear, proceeded to turn around and leave!

The next time we were in the same room together, I was unconscious. In post-op, I told the nurse I wanted to talk to Ob because I had some questions. But he had back-to-back procedures and was running almost an hour late to begin with, so we didn't see him again.

The HSG in February was my second one. My first one was 2 1/2 years ago, and that RE also said my uterus looked fine. So my guess is that it probably is fine, but I will get all the films and consult with ob rad to make sure.

What is really irritating me about ob rad at this point is that we saw him three times in a row for all of our ultrasounds during this pregnancy, and not once did he mention this! Yes, he said during the first one that he thought it looked like the baby might be in the corner of my uterus, but he didn't say, "And by the way, your uterus isn't supposed to be shaped like this..."

And then Ob just goes and dumps that on us right before I have to walk into an operating room to have him suction our 6th baby out of me. I realize what he actually said was along the lines of, "You *might* have a uterus structure problem." But translated through the filter of what we've experienced, what I heard was "You've gone through five years of hell and lost six babies, and a problem that should have been FULLY DISCOVERED before you even began any sort of treatment at all may be partially or completely to blame for all of that. And you may never be able carry a child to the point of survival. Gotta go now."

Ggrrrr. Doctors really irritate me sometimes. I'm annoyed enough about this that if I wind up talking with Ob himself about the tissue testing results, I will speak up and say something. Assuming that he even got tissue to test - since he never went out to the waiting room to let R know how it went, we don't even know that for sure.

Pregnancy #5, Baby #6, D&C #2

It was clear early on that there wasn't going to be good news from this ultrasound. We saw the gestational sac very clearly, but unfortunately there were also two bubbles in the sac that weren't there last week.

For one brief moment, I thought maybe a twin had suddenly appeared. But then I realized that we couldn't see a clear fetal pole, much less a heartbeat.

Thankfully, today's ultrasound tech didn't take quite as long. The doctor came in relatively quickly, spent about a minute flipping through the various images and then turned to us.

He knew that we already knew the outcome, so he didn't say much. For once, I didn't ask much either, so I have no idea what most things were measuring. All I know is that he was able to see the fetal pole, but it was only measuring 2mm, which is smaller than last week.

I asked him if he thought there would be any benefit to doing a D&C, if he thought there would be any chance of being able to recover tissue that could be tested. He said, "Yes, absolutely."

The D&C is scheduled for Friday morning, at the same place as the last one. I think it's at the same time, too. I'm just hoping it's not the same nurse - I have no desire to repeat last time's pre-procedure interview from hell.

Nervous About Today's Scan

Our next ultrasound is about 14.5 hours away, and I'm nervous. Even though at this point we are totally detatched from the idea of bringing a live baby home from the hospital, I still really want this to work.

The fatigue kicked up a notch this weekend. I went to sleep Friday night, got up around 9:30 on Saturday morning and then had to go back to bed by 6 p.m. because I was just too exhausted to stay up any longer. I got up for about an hour around 10 p.m., and then went back to bed until 8:30 the next morning. So I'm taking that as a good sign.

And since Thursday or Friday night, I've been having to get up in the middle of the night to go to the bathroom - another good sign. Tonight, I could definitely tell that my uterus has grown when I was looking in the mirror - I'm sticking out further than ever before.

I think all of those things are good signs, but I'm still nervous about tomorrow. God, I hope there is a heartbeat. And an appropriately growing baby. One that sticks around for another 7 months this time.

Here's hoping that for once, we fall on the good side of the 0.1% odds.

Still Not Good, Still Not Definitive

And yet, I still seem to have hope.

There was one bit of good news that was not accompanied by not-so-good news: The baby is definitely not in my tube, and it's not even as far up in the corner of my uterus as it seemed to be last week. It's still not totally front and center either, but the ob rad seemed totally relieved about the location, and it sounds like that wouldn't be much of an issue.

If the baby continues to develop normally. And that's a big if.

The gestational sac had grown 5mm in the past 7 days, which was good. There was no clear yolk sac last week; this week, there was. There was no visible fetal pole last week; this week, the fetal pole measured 5mm. The two small sacs near the baby that looked like they were hemorrhaging have disappeared. They probably reabsorbed, which makes sense, since I haven't spotted in the past three days.

There was still no heartbeat, but the ob rad said at 5mm it's a tossup whether it's visible or not, so he wasn't surprised that we couldn't see it. The tech did most of the ultrasound, and she and I both thought we saw a tiny little flicker at one point, but she couldn't pick up the sound. And ob rad didn't go back and look for it when he came into the room, he just took a couple of uterine volume measurements that she didn't take.

So most of that sounds really good, right? Here's the bad part: I'm measuring more than 1 week behind. Ob rad says if things are measuring 4 days behind, there's still a decent chance, but that's pushing the outer limit. I'm at least double that.

He said if I wasn't so sure of my dates, he would think everything was fine and progressing normally and that I was just further behind than I thought. But with the Clomid, follicle scan and trigger shot, I think the dates are pretty solid.

In that case, he gives it a 99.9% chance of not being viable. But because of the growth we saw, he's not willing to recommend a D&C yet. So we go back on Wednesday for another scan. He said we should definitely see a heartbeat by then, and if we don't, he'll call it over.

Somehow, through all of this, I continue to have hope. Like I said in my last post, hope is a stubborn, stubborn thing.

Emergency Surgery (But Not For Me)

This is turning out to be a really tough week for R.

The first round of the layoffs that his company announced in January took effect on Monday, which meant he had to say goodbye to one co-worker and console the very sad, stressed and overwhelmed co-worker who is still there (until her layoff takes effect in December.) Nothing like a very shy, quiet guy having to be the team leader of all these very expressive, emotional women!

He's also been stressted about me all week, hoping I don't suddenly have a tube rupture. And then, to cap it all off, his dad wound up going into the hospital last night for an irregular heartbeat, and he had an emergency procedure done today to put in a pacemaker.

Thankfully, while it's still a big deal, having a pacemaker put in isn't the ordeal that it used to be 20 years ago. Back then, when my grandfather had one put in, it was major surgery and you were in the hospital for two weeks. R's dad had the procedure at 5 p.m. today, and assuming he doesn't have any complications overnight, he'll be discharged tomorrow and can go back to work on Monday. Thank God for technology advances in medicine.

There's still not much of an update on me, but we'll know more tomorrow. I went in this afternoon to have my blood drawn, and I have a repeat ultrasound scheduled for tomorrow afternoon.

I started having some pains on my right side around midday that made me wonder if the kiddo is in a tube, but they weren't too intense, and they stopped. From everything I've read online, if you're experiencing major ectopic pain, you'll know it. And I'm still having the ligament stretching twinges and pain, which I think is a good sign. I also haven't had any spotting since Monday. So part of me is hopeful, but the protective side of my mind is trying to beat back the hope.

If it wasn't for Ob insisting that we do a scan this week, I think I would have tried to push it back another week. I think even if we don't see good news tomorrow, unless they can prove to me with 100% certainty that something needs to be done immediately, I will probably insist on at least one more scan a week to 10 days later, just to make sure.

Hope can be a very stubborn thing.

Still No Major News

I managed to make it through my first two days of work without a ruptured tube - yea! Although I am feeling some pains on that side that make me wonder a little bit.

I finally got last Thursday's beta results - 6,811 for 6w4d or 6w2d, depending on how you want to look at it. It's kind of on the lower end of the normal range from what I could find online, but still well within the normal range.

When Ob's nurse called to leave that number, she also left urgent instructions for me to get a repeat test and a repeat ultrasound this afternoon or tomorrow morning. She said it three times in a row, like it was a matter of life or death. I was in a meeting for the afternoon and couldn't call her back, so I asked R to give her a call and figure out why this suddenly became urgent after they've spent the last five days ignoring me.

R would up speaking with Ob directly. Of course, communication among guys tends to be limited to not much more than grunts or groans, so I didn't get a lot of detail. The gist of it seemed to be that while the radiologist who did last week's high-level ultrasound was more concerned about the baby's location, Ob is more concerned that they didn't see everything they wanted to see (i.e. a heartbeat). It sounded like Ob was surprised the beta number came back as normal as it did. So apparently he still thinks this has a shot of working out, although how much of a shot I don't know, because R didn't ask. And it's all irrelevant, anyway - he can think we have a great chance, like he did last time after seeing a heartbeat for three weeks in a row - and it still doesn't mean a damn thing in the end.

Work is going well so far. I think it will be a good team to be on. But there's been a lot of baby talk, so it's been a bit tough. My boss' wife is expecting their first soon, and another co-worker announced today that his wife is also expecting. They've already completely redone the room that is going to be the baby's nursery with a new ceiling, new floors, etc. - basically, everything they can do except the gender-related stuff, because they don't know that yet. It sounds like they did all of this a few weeks ago.

Guess how far along she is? About three weeks more than me. 10 freakin' weeks! Can you believe that?? I can't even IMAGINE decorating a nursery at this point in the process. They are living in that blissfully ignorant (part of my mind is screaming "stupid" instead of "ignorant," but I know that's just the jealousy speaking) world that passed us by soooo long ago that the idea of doing such a thing is just laughable at this point. I hate that. And damn - just when I thought I was starting to become so Zen about all of this.