Toes!

It's amazing what a difference four days can make.

I did okay through the weekend, but then yesterday I started to really freak out again about my lack of symptoms. I was in tears. (Perhaps I should count being overly emotional as a symptom?)

So after talking with a friend who encouraged me to just go in and get scanned again for the peace of mind, I finally gave in, called the peri's office and told them I need to come in twice a week for a while. They were great, as usual, so I'll be doing Tuesday ultrasounds and Friday ultrasounds and appointments.

I was so incredibly nervous this morning. I haven't been tired or nauseous or had headaches since Friday, and the need to go to the bathroom isn't quite as strong anymore either, so I was really trying to prepare for bad news. But thankfully the heartbeat was immediately visible.

Kiddo is measuring on track - four days of growth since Friday. And instead of arm and leg stubs, there are now longer arms and legs, and even feet and toes! We could see where the bones are starting to form/harden in the head and in the toes.

Technically the toes looked more like a dog or cat paw at this point, and we could only see three or four of them on each foot, but hopefully they will all be there when they're supposed to be. :-)

I couldn't believe how much more human-like Kiddo looked today even compared with just a few days ago.

On Friday, I know I blogged that I was more terrified than happy after the ultrasound. But this time, there was just huge relief and the same kind of happiness I felt after the first few ultrasounds. Hopefully this will carry me through to Friday's appointment without too much of the crazy reappearing before then.

R is laughing at me - I just keep saying "Toes! There are toes!"

In New Territory

Heart rate 182 (up from 167), Kiddo measuring 8w6d, which the peri said is fine even though today is actually 9w0d.

So, this is a new milestone - the furthest we've ever gotten with a heartbeat before is 8w1d.

With the first three ultrasounds, I felt a huge relief as soon as we saw the heartbeat, and I was so incredibly happy for a few days after. (Well, 12 hours in the case of the first ultrasound, since I started bleeding a lot again the day after that one.)

The odd thing is, I don't feel that way this time.

Of course, there was relief as soon as the tech said there was a heartbeat. (I still refuse to look at the screen until the heartbeat is announced.) But now, I just feel mostly...terrified.

I don't know what to do in this place. I don't know what to expect from here, what it's supposed to feel like, how it's supposed to go.

With all of our other pregnancies that got to the point of ultrasound, there was always just an oddly shaped gestational sac, or in the case of pregnancy number four, something that looked like a large white grain of rice, with kind of a large end (the head) on the 8w1d u/s. The ob's office just had a regular-resolution ultrasound machine.

I've been thrilled that the peri's office has such a high-resolution machine that makes it easier to see things. And it is pretty cool.

But.

But - this week there was very clearly a head. There are little leg buds and little arm buds. And a torso. He/she wiggled.

Kiddo is not just a large white grain of rice anymore. This time, the ultrasound tech typed "Baby" on the screen where Kiddo is for the pictures she printed out for us. Up until this point, it's always been "Embryo".

I've been attached to and grieved every one of the seven babies we've lost. I've felt the loss, even of the second one, which I realized on a Sunday I was pregnant, we got the faintest of faint lines on Monday morning, the beta that morning turned out to be 5, and I was bleeding by 2 p.m., so I barely even had a chance to realize I was pregnant before it was over.

But this, this would be a whole other kind of loss, a whole other kind of grieving if it were to end badly. And each week, it becomes more so.

So, like I said, terrified.

But on the bright side, the peri really understands. She said if I need to come in more than once a week for reassurance, that's totally fine. She's had some patients who came in every day for ultrasounds for a while, until they got to a point where they started to feel more comfortable. R's head shot up when she said that - I think he was trying to figure out how on earth he'd shuffle work meetings every day if I decided to go that route. :-)

I think I'm going to try to stick with once a week appointments, because if there's bad news, I'd just rather get it at the end of the week than the beginning. But if I start to stress, I may take them up on extra ultrasounds.

I need to go get progesterone/estrogen drawn for RE, and his nurse mentioned that I'll probably start weaning based on those results. I'm going to ask her to let me wean a little slower than usual, because I can only imagine how freaked out that will make me.

I'm trying to be hopeful that my body can work correctly without the extra meds. The peri asked if I'd started getting headaches this week, and I have. She said that's usually a sign of the placenta's hormone production kicking in.

So add headaches to the list of things I hope to keep having, in addition to nausea and stretchy feelings...

Chant With Me

Thou shall not get thy hopes up too high.

Thou shall not get thy hopes up too high.

Thou shall not get thy hopes up too high.

A couple days ago, it was a constant repetition of "Please, please, please let there still be a heartbeat." I swing back and forth like that. Right now I've been feeling nauseous for several hours, so I'm back to "Thou shall not...", trying to keep hope in check.

If there is a heartbeat on Friday (9w0d), it will be a new milestone for us. The furthest along we've ever been when seeing a heartbeat was 8w1d, four years ago this month.

I did well for about 3 1/2 days after the last ultrasound. I didn't have a lot of symptoms on Sunday, but after being a constant shade of green on Friday and Saturday, I was kind of okay with that. But only for a day.

So when there were still no symptoms on Monday, I started to get nervous again. Then it occurred to me that during the pregnancy four years ago, the ob thought the baby likely died within a few days after that 8w1d ultrasound. I realized that I was at 8w3d - a few days after 8w1d - and the nervousness escalated to anxiety.

On top of that, I noticed vaginal discharge that was different than anything else I've experienced so far (I'll spare you the details) after all the fiber I'd been eating finally took effect.

I caved and called the peri's office.

I love that place. They are all so nice and understanding. The nurse called me back and reassured me that everything sounded perfectly normal.

Still not very many symptoms yesterday, still very nervous. Then this morning I started feeling nauseous about 15 minutes before a major phone presentation I was giving (from bed, involving about a dozen people from our largest client, with my mom huddled in her bedroom with the dogs, me praying they would stay quiet and not give away the fact that I'm at home). I figured it was just nerves about the call, though, especially since it went away after the call was over.

But then it came back again late this afternoon, and it's stuck with me. Which makes me slightly green again, but happy nonetheless.

And trying desperately to keep hope reigned in.

P.S. Thank you all for the comments and ideas on fighting the morning sickness on my last post. And a special thank you here (since I don't think you have a blog) to A for delurking. :-)

About That Lack of Symptoms...

Not so much a problem any more.

I woke up yesterday with a major case of morning sickness that lasted until falling asleep last night, and within an hour or so of getting up this morning, it was back again. There have been several times I thought I might actually throw up, but so far I haven't. I've had morning sickness with other pregnancies, but it's been more mild - never to the point of almost throwing up.

Don't get me wrong - I'm not complaining. I'll deal with it if it means all of this turns out okay.

I'm open to suggestions on what's worked to help minimize it. R is at the store shopping for ginger ale, gingersnaps, chicken noodle soup, pretzels, and an acupressure wrist band.

Right now I'm munching on saltines and 7 Up. I feel okay as long as I'm eating, but a few minutes after I stop, the nausea sets in again. And I figure eating my way through it for 16 hours straight is probably not going to be the best approach, at least not from a weight gain perspective...

There were also a lot of strechy/pulling feelings yesterday. Normally I feel them but they don't bother me per se, but yesterday it was enough that I was contemplating taking some tylenol. I think my pain threshold was just unusually low because I was already feeling not great from the nausea.

Overall, I'm thankful for the symptoms. I just keep trying to remind myself that having symptoms now does not necessarily equal the outcome we hope for down the road. It's still waaaaayy too soon to get our hopes up...

Emotionally Spent but Still Incubating

We wound up going in unexpectedly this afternoon. Heart rate is 167 (up from 130 last week), and Kiddo is measuring exactly on target - 7w6d.

I had been totally braced for bad news.

We weren't going to move up the appointment. But then this afternoon, there was bright red blood once again. I hadn't expected it - after 8 days of no bleeding or spotting, I thought we were over that. I was hoping that tomorrow I'd get permission to get up and start moving around. Instead, I am still on bed rest until further notice.

If the bleeding had been the only thing concerning me, I would have just crawled back in bed to see if it would slow down (there wasn't as much as some of the other times, and it is slowing down now) and waited until tomorrow.

But because of feeling normal, noticing that the stretching/pulling feelings had slowed down to pretty much non-existent by yesterday, and realizing at 5 a.m. today that I'd screwed up my estrace pill dosing for the last 4 days (more on that in a minute), I couldn't wait.

I called and texted R, but he wasn't responding. It comes in handy sometimes that he and his dad work in the same company, about 20 feet from each other, because I called his dad and asked him to track R down.

The only thing that kept me semi-calm was that I wasn't feeling much pain, and no cramping. Still, I was trying to prepare myself for bad news. Instead, the tech said "Everything couldn't look more perfect." She looked thoroughly to see what might be causing the bleeding, but still couldn't find anything.

One thing I was worried about was my estrogen level, but the peri doesn't think that would have been enough to cause a problem.

I woke up as usual in the middle of the night last night, but this time I realized I wasn't having the night sweats that I get every night. Then it dawned on me that I had forgotten to take the evening dose of my estrace.

And that led me to realize that I'd also been forgetting my morning dose for the last 4 days. I had filled my pill boxes for the week on Saturday, but I kept the estrace bottle on my nightstand to remind me of my evening dose, and I forgot to grab it when I was filling the boxes. Between two thyroid meds, Vitamin D, the extra folic acid pills, the aspirin, the dexamethasone, and the anti-depressant and probably a couple of others I'm forgetting, it's a pretty full, colorful box of pills, and I just didn't notice.

I am still doing four patches every other day, though, and I was only missing one dose of the pills a day, so I imagine my level dropped a little bit but hopefully not enough to really cause a problem.

RE's nurse wouldn't commit to saying "no" when I asked outright "This won't hurt the pregnancy, will it?" But the peri doesn't seem to think it would.

The next ultrasound is in 8 days (next Friday), although the peri said they will absolutely fit us in earlier if the need arises.

Can someone make it be spring already? Please? Anyone?

The Weekly Pre-Appointment Freakout Commences

I was doing so well. After last Friday's appointment, I had 4 days of being relatively calm and normal. I even started a draft post about how I am enjoying this pregnancy, really, even though it's also been stressful.

But zen only lasts so long.

I woke up in the middle of the night Monday night as usual when the dog wanted to be let out. Usually I'll lay there for a moment, trying to determine if she's really up and wanting to go out or if she's just readjusting her sleeping position and will go back to bed, and try to close my eyes and go back to sleep. But it's generally useless, because at that point my bladder has made itself known and there's no ignoring it.

Except when I woke up in the middle of Monday night, I felt like I could go back to sleep. I rolled over, closed my eyes again, then realized my bladder wasn't calling out to me and went pretty much straight into a full-blown anxiety attack.

I'm afraid my uterus is shrinking and not pressing on my bladder as much. I'm also not as bloated - I just feel more normal in general.

Also, the stretchy, pulling feelings I'd been having (I assume round ligament pains) had been occuring kind of all over, including on the sides of my pelvis. But now I'm only feeling them down low, so for some reason now I'm thinking that those feelings are really the reverse of stretching - that they're further signs of my uterus shrinking back down.

Plus, I'm getting a kind of mild burning feeling in my cervix that I get right before my period is about to start. And I had been crashing for a nap every day around 5 p.m., but last night I was fine - didn't need a nap at all.

This morning, I think my chest is shrinking back down as well. There was a tape measure involved, but I forgot to write down yesterday's measurement, so I can't be positive, but I'm about 99% sure I was bigger yesterday.

There's no bleeding. The last bright pink/red I saw was a week ago today. The only stuff I've seen this week seems to be a little bit of vaginal/cervical irritation since I restarted the aspirin/Lovenox on Saturday.

I know all of this sounds crazy. But during the other pregnancy where we saw a heart beat, we saw it at 8w1d, and around 9w1d I told R that I wasn't growing any more. My stomach wasn't getting any bigger (I popped really early that time) and my chest also stopped growing, but even more than those signs, I just had a feeling that something was wrong, and I started to physically feel normal (non-pregnant normal).

At the ultrasound the week after that, we learned that the baby had died a few days after the previous ultrasound. I had a D&C a few days later (about 2 weeks after the approximate day of death), and I never had any spotting or bleeding during those 2 weeks, so not having any bleeding now isn't reassuring me all that much. (Although obviously I'd rather have no bleeding than bleeding.)

I have work meetings for the next two days that I need to attend. I'm afraid to call and see if I can move up our next ultrasound appointment in case it's bad news, so I'm going to wait at least until tomorrow afternoon to call, but I'll probably try to make it all the way to Friday's appointment (54 hours at this point) if possible.

This calls for some heavy-duty self-soothing. Ice cream may be involved in breakfast. If I put it in a blender, I can call it a smoothie instead of a sundae, right?

Cabin Fever

Today is the 24th day of bed rest, and the scenery is starting to look a little monotonous. I can't really complain too much, though, because it's R who is getting the shortest end of the stick.

The poor guy is doing all the laundry, grocery shopping, and cooking by himself, not to mention running up and down the stairs to bring me food and take dirty dishes away.

Meanwhile, I lay here looking at the exercise room that is attached to our bedroom. Which, mind you, I never seem to be able to find the time to use under normal circumstances.

But sitting here with a treadmill, elliptical machine, stationary bike, and a large collection of weights within my peripheral vision, I wind up thinking about my fitness. Or rather, lack of it.

Which leads me to think about R's lack of fitness. And his super stressful job that just got more stressful a few weeks ago when his boss retired and he was given a lot of those responsibilities to take over (with no promotion/raise). And the fact that we're not 25 any more. And all the horror stories you hear about seemingly healthy if somewhat out of shape men in their early 40s with high levels of stress who keel over unexpectedly.

So I decided it was time for action. I wielded the primary tool available to me at the moment - my laptop.

R now has a shiny new schedule of cardio, strength training, and flexibility exercises to do. It works out to an average of about 35 minutes a day.

Did I mention he hates to exercise?

He's wondering how the heck we've landed in this alternate universe where he's climbing hills on the treadmill while I cheer him on from bed. I tell him it reduces my stress level to know that he's going to be taking better care of himself, and the lower my stress, the better for the Kiddo. No, I'm not above guilting him into it...

I'm not sure he's entirely buying it, but he's exercising. So far, anyway.

Today's Sign Said...

Continue to see where this path takes us.

The embryo measured 7w0d (today is 6w6d), and the heart rate increased from 102 last week to 130. The ultrasound tech, who was the same one as last week, said she could also see the beginning of something (I have no idea what, I was too busy trying to soak in the fact that there's still a heartbeat) that is the next thing that's supposed to develop, so that's a good sign.

She still couldn't see any sign of what might be causing the bleeding, but she said subchorionic hematomas can be difficult to spot, especially if they're small, and if I bled it out, it wouldn't be visible.

We met with the perinatologist for the first time. I liked her. She talked through each of my issues, and the entire appointment from start to finish took more than 2 hours.

She doesn't think the Lovenox and aspirin are necessarily related to the bleeding, so I need to talk with the RI's office about those. She does not appear to be a fan of IVIg, but she did say it was our choice whether to continue doing it. (We will.) I'm supposed to stay on bedrest for the forseeable future.

The medical assistant who went over the paperwork I filled out before the nurse came in mentioned that I'll have to get registered at the hospital at some point. I think she said 20 weeks. That's so far from my mind, I wasn't really paying attention.

As soon as she said it, I had a total reaction and kind of caught her off guard. I told her not to jinx things and that if I get to 30 weeks - if!! - then maybe we can discuss that kind of stuff. Apparently I would have to do it before then (again, if we make it that far, still not wanting to jinx it by thinking so far ahead) because they need me to be registered there in case something happens and I have to go in early. But seriously, did we need to talk about that now, when I'm still one day shy of 7 weeks??

And due dates. Okay, seriously people, they keep insisting on talking about this. Last week the ultrasound tech told us. (I refuse to say what it is, so just look at July 13 as 2w5d and count forward from there if you really want to know.) Today when the doctor finished examining me, she said it, but she posed it as a question for me to confirm.

I think my face blanched.

I explained that we made the mistake of calculating the due date on the very first pregnancy, and it just became a painful day, so we don't like to know anymore. I suppose it's no surprise, then, that later on in the conversation she asked if I have a therapist...

And then we got to the checkout desk and had to make appointments. Plural. The peri had told us to go ahead and book weekly appointments for the next month or so.

I couldn't do it. It just seems too audacious to assume I'm going to need that many appointments.

R finally talked me into making two appointments and suggested that starting next week, each week we'll just make one more appointment, so we'll always have two booked, we'll just be able to book them one at a time from this point on. He doesn't try to fight the crazy anymore - he knows it's just better to work with it. :-)

It seemed like a semi-decent compromise, so I took a deep breath, tried to relax, and told the lady working at the desk that we wanted to make appointments for the next two Fridays.

Her response (with a cheery smile): "Sure, no problem. What's your due date?"

Does anyone know how to selectively erase something (a date) from one's brain?

I Don't Have a Good Feeling About This

Everything has been very uneventful. No spotting since Sunday, nausea that started Sunday night and lasted (in a mild state) through Tuesday morning, which I was thrilled about.

I'd started to let myself relax a bit again. Even went crazy and discussed whether we would find out the gender if we got to that point, had a discussion with a friend who is due with twins next week about vaginal birth vs. c-section as if I will face that choice someday soon.

And then, there it is again. I was feeling a little bit of cramping, but nothing major. I just figured it was a good sign that things are happening in there. I didn't even take a deep breath before peeking at the tp - I just assumed it would be pink-free.

It was not.

I put in a suppository at 5 p.m. There was not a speck of blood on the tp or the inserter. At 8:45, there was pink bleeding. So of course I had to check, and it looks like bright red is on the way again.

The ultrasound is at 2:30 p.m. PT tomorrow. We'll see what happens through the night and in the morning.

This time, I can't think of any good explanation for it. The first time, I chalked it up to low progesterone. The second time, I chalked it up to being out and about for bloodwork and the Rhogham injection. The third time, I chalked it up to restarting the Lovenox.

But this time, my progesterone level is great, I haven't been out and about since Saturday, and I haven't restarted the Lovenox. And there wasn't any sign of an SCH during the ultrasound. And the nausea eased up yesterday and did not return at all today. I realize it can come and go, but right now I'd much rather be having it than not.

So I don't have any good explanation. Just a nervous, uneasy feeling.

Hanging In There

I think the Kiddo is still in place. My sanity is still relatively intact.

Apparently, I'm becoming more used to living with uncertainty and unpredictability. Either that, or R is secretly spiking my food with valium. (Just kidding, although I wouldn't necessarily mind that at this point.)

Once I got home and back into bed yesterday, the bleeding slowed. I was hoping it would completely stop overnight. Unfortunately there was still a little bit of red at that point, but it was darkish red rather than bright red, and by late morning today I think I'm pretty much back to the brown spotting point.

The next ultrasound is in about 98 hours - not that I'm counting or anything - so we'll see what that shows if something doesn't go very obviously wrong before then.

I'm on Lovenox 40 ml twice a day and a low-dose aspirin once a day for hetero Factor V Leiden and hetero MTHFR. I haven't taken any more of my doses since the bleeding started again yesterday.

I left a message for the reproductive immunologist who prescribed it, letting them know I had started bleeding again, was stopping the meds again and telling them to call me if I needed to do anything else. I haven't heard back yet, so I'm assuming there's nothing else for me to do from their perspective and they'll call me tomorrow. If I don't hear from them by late morning, I'll call them again. Based on Silver's comment on my last post (thank you, Silver!), I want to ask them about whether they think it might be best to hold off for now and restart if I make it to the second trimester.

In the meantime, I'm trying to resist the urge to ask R to bake me chocolate chip cookies. Do you think my life revolves way too much around food?? :-)

Here We Go, Yet Again

Have I mentioned that I am not a fan of 6w1d?

Pregnancy #1 ended that day. In pregnancy #3, we lost the first twin on that day. For pregnancy #4, I woke up that day and all my symptoms were gone. That one turned out to be okay, because we got to see the heartbeat for the first time that day.

I was hoping since we saw the heartbeat yesterday and since I hadn't had even any spotting since Wednesday, that maybe we could get through today uneventfully.

No such luck.

R and I had just sat down at a restaurant for lunch, and I decided to go to the bathroom. Since things have been okay the last few days, I totally wasn't expecting the bright red bleeding.

And yet, there it was. On the pad, in the toilet, when I wiped. It didn't soak a pad within an hour, but it's definitely a lot more than I've seen so far.

We had just ordered, so we asked the server to pack up our food, and we headed home. I'm back in bed.

I hate this. I'm trying to be calm. Part of what's helping is that I'm not feeling aching or cramping, just bleeding. And there was no clotting - this bleeding (like last week and earlier this week) is still different at this point from the bleeding I've had in any other pregnancy.

The ultrasound tech couldn't see any sign of a subchorionic hematoma yesterday, but then again she also didn't look for it very long at all. The other thing is, I restarted twice-a-day Lovenox last night per the immunologist's orders since it had been 3 days since any bright red bleeding, so maybe that triggered it. But if I need the Lovenox, what effect will there be from not being on it?

If this is not going to end well, I'd rather it end now than later...

We Celebrated Reason #...

1!

There's one "perfectly shaped" (as the ultrasound tech described it) gestational sac, and about half a second after she got the wand in place, we heard one of the best phrases ever: "There's a flicker!"

She started by doing an abdominal ultrasound. She pointed out the sac at that point, but she said my uterus was retroverted, so it was hard to see anything very well. From that angle, the sac looked like a weird, non-round shape to me.

And since we've heard "abnormally shaped gestational sac, this doesn't look viable" at the first ultrasound for several of the past pregnancies, the weird shape made me nervous. She switched pretty quickly to the transvaginal approach, and I couldn't bring myself to look - I just stared at the ceiling until she mentioned the flicker, at which point I popped up like a jack-in-the-box. (There was a screen mounted on the wall in front of me.)

The embryo measured 6w0d, which is exactly what today is. She said they want the heartbeat to be at least 100 bpm at this point, and it was 102 bpm. I would have rather it be a little higher, but I know it speeds up each week for the next several weeks, so we'll just wait and see what Thursday's appointment brings.

We're relieved to be over this hurdle. And I'm grateful that we get to experience seeing a flicker again. But at the same time, we're still being very, very cautious. One day at a time, though each day seems to feel like a week right now...

Anyway, thank you for encouraging me to get the ultrasound early and cheering us on. It's a great way to start a weekend.

I Took Your Advice

I called this morning and scheduled the early ultrasound. 4:30 p.m. tomorrow (Friday). I was so relieved when she named a time that was at the end of the day.

I was stressed about it all day, but I'm starting to relax a little. Of course, there's a very high probability that will change again by mid-day tomorrow. :-) I will post at some point tomorrow night, but we're 3 hours behind the East Coast, so don't worry if you don't see something from me before bedtime...

There hasn't been any bright red in a little more than 2 days, and no spotting of any sort for more than 24 hours. This afternoon, I started to feel some stretching feelings, so hopefully that is a good sign. That's part of what's making me feel a little more hopeful. Still terrified, but a little more hopeful.

I'm trying to approach this by saying we're going to go celebrate afterward. Either we'll be celebrating that it went well, or we'll be celebrating that we're starting the adoption search, or (if things are still inconclusive) we'll simply celebrate that R was actually able to get me out of the car, into the office, and onto that table for the appointment.

There's a Whi.te Cho.colate Grill down the street from the peri's office. Gotta love a place that starts by listing dessert at the top of the menu.

Do you think they'd look at me askance if I order one of each?

More Ups, More Downs, and Trying to Surrender

I know I can be melodramatic sometimes. Apparently, posting at 4 a.m. after looking at toilet paper covered in a color I don't want to see exacerbates that tendancy.

This pregnancy is continuing to be a total rollercoaster. I'm trying really hard to just surrender to it and accept that other than bedrest, injections, pills, suppositories, and patches, there's nothing more I can do - it's out of my control.

Of course, there are some times it's easier to accept that than others.

I honestly did not expect the bright red bleeding to stop. However, I decided I wouldn't stop any meds until told to do so. There was still bright red when I was going to put in this morning's suppository. I figured since my levels are low, putting in two couldn't hurt anything, so I did.

And the bleeding slowed way down and turned brown. And I stuck in another (basically, my whole day's dosage by 11 a.m.) since I wouldn't be able to get the PIO for another few hours.

And then even the brown almost completely stopped. And then R picked up the PIO and helped me with the first injection.

And then a couple hours later there was bright red again, although less than there was at 4 a.m. And now I'm back to brown.

Clearly I have no idea what the heck is going on. And, obviously, neither does my body.

I spoke to the RI's office this morning and explained that since I'm on suppositories, RE says anything above 5 is fine. They were very emphatic that they didn't agree with that, that I should have been put on PIO a week ago, and that they think the progesterone level may cost us an otherwise possibly viable pregnancy.

However, I'm not sure what to think. I know the three suppositories a day is the standard protocol RE uses, and clearly he has a lot of patients (including several of you, I realize) who are very successful with that.

I also know that all the PIO in the world won't save a pregnancy that is going to end for reasons other than low progesterone - I've lost pregnancies completely while still on full dosages of PIO and E2 injections.

RE's nurse still says she doesn't think this is out of the ordinary, and she isn't "overly concerned." Nevertheless, she still sent over orders to have progesterone and estrogen retested on Friday. I need to ask to have another beta added to that. She also sent over the ultrasound order (at my request), but I'm not sure I'm going to do it. I know it's too early to see a heartbeat, and I think I want to see what direction the HCG is going first.

Mostly, though, I'm just chicken, afraid to face that ultrasound screen.

I can't believe I'm only 5w4d today (Tuesday) and that we're still 9 days away from the first scheduled ultrasound. (Well, technically we should be 6 days away at this point since I could do it as early as next Monday if I wanted.) It feels like we've been dealing with this up-and-down pattern for a month already. At the same time, it feels like Aug. 11 is still an eternity away.

Assuming there are no bad-news betas between now and then.

More Bleeding

I don' t think this is going to work.

I think this is the beginning of the end.

I think I' m going to be sick. And not because of morning sickness.

There was a perfect lining, two perfect blasts.

Why won't my body work right?

How do I learn to live with not knowing the answer to that question?

A Mixed Bag of Results

Here's how I feel right about now:



I got today's results in a voice mail:

Progesterone: 5.8 (down from 11 on Tuesday and 7.5 on Friday)
Hcg: 3,672 (up from 2,091 on Friday, a doubling time of about 88 hours)

The reproductive immunologist's take: It's bad that the beta didn't double, it's bad that the progesterone is low, get an ultrasound now to see if it's ectopic or a missed miscarriage. (I don't think he realizes that the clinic's threshold for progesterone is 5 since they're suppositories, so maybe he'll feel differently when I have a chance to talk with the office tomorrow.)

The on-call nurse at RE's take: The progesterone is still technically in the normal range, they have to supplement sometimes, put in an extra suppository tonight and pick up PIO tomorrow morning. The HCG is rising, and at some point it's hard to tell whether it's a good indicator or not. E-mail my regular nurse tomorrow morning to see if I should get an early ultrasound. She said she isn't "overly concerned", but then again I also didn't go into my history of 6 prior 1st trimester losses with her, either. If I had shared all of that, she might have sung a very different tune.

Beta Base comparison: The Beta Base site has been down at least through Friday. (It was up when I had the test last Tuesday, so not sure what happened.) However, through the magic of Google, I found a thread someone had posted on a forum with average singleton numbers for 24dpo, which is what I am today. The most common range was 3,667-5,506, so we're right there at the bottom of the most common range. The thread was posted in 2008 so the numbers might have changed a bit since then, but that's all I've got to work with at this point.

The bleeding/spotting: Had pretty much stopped, but today I went out for labwork, came home, went back upstairs, took a shower, came down to go out for the RhoGham injection, and now there is bright red again. Not a lot, and I think it's already tapering off a little since I have my feet up again, but it's still very stressful any time I see it. Per RI's instructions, I'll be stopping the Lovenox and aspirin until it stops.

My take: The beta is still hopeful, particularly if I did lose a twin on Friday night. I think something in there is still growing since then, or the numbers wouldn't have gone up that much. The progesterone dropping from 11 to 5.8 in 6 days is more concerning to me at this point.

I'm honestly not sure what to make of the bleeding. It's most like pregnancy #1 - I spotted for the first time (bright red) on a Thursday at 4w6d, it continued on and off. Went for an ultrasound at 6w0d, and there was a lot of blood when I went to the bathroom right before the ultrasound started. At that point, it didn't stop. I lost the pregnancy the next day, and continued to bleed what looked like a full period for the next 4 or 5 days.

In the other ones, there wasn't this spotting in advance, and once the bleeding started, it just kept getting stronger until it was over.

So I guess we'll go in for an ultrasound and see if there's a sack. Other than the one pregnancy where we saw a heartbeat, in the other three that got to the point of an ultrasound, it was an abnormally shaped sac each time, and they couldn't necessarily see a definitive yolk sac or fetal pole.

I'm so tired. Of course, part of that is that I barely slept last night because I was stressing about today's tests, and I took Benadryl this afternoon for the IVIg. (The nurse had to try 3 different locations before she could get one this time. I almost passed out after the second one and had to put my head between my knees for a while before we could try again.)

Mostly, I'm just tired of the uncertainty of this process. I did tell R that if this doesn't work, I might want to try one more time in the far distant future (hopefully after a successful adoption), using the IV antibiotics again, since that's what's gotten us the farthest. (We didn't do it this time because we wanted to see what the IVIg would do, and because of the expense involved, and because apparently the IV antibiotics can cause an NK flare in some people, so we didn't want to conflict with the IVIg.)

But if this rollercoaster ends by going off the tracks, I think I'm ready to walk away from it for now. This has reached the point where it has become too hard. I'd like to think I've had a fair amount of fortitude for the past 9 years, but I have officially reached my limit.