Trying to Reason With Worry

Once again, I was totally nervous about today's ultrasound. And once again, everything was fine. Kiddo is still in there, heart is still beating, body is still growing. Or at least, it looks like it to me - since these are just reassurance ultrasounds, the tech didn't measure length the last couple of times.

I had no real reason to think things wouldn't be fine. I'd had low-grade nausea for a couple days, and I still felt the round ligament pains, although not as much the last couple of days.

And still, I get really stressed beforehand each time.

R tried to reassure me. In the past, when he's said "It will be fine", I've told him not to say that for fear of jinxing it. This time, I didn't scold him, I just let it go. I guess that's progress, at least.

But I still can't let go of the tissue box. When we had the first ultrasound last month, when I climbed up onto the table, I had R hand me the tissue box that was sitting on the counter. I wanted easy access to it in case it was bad news, plus it gave me something to hold and focus on. I still make him give it to me every single time.

I tried reasoning with myself this afternoon, after the appointment. Realistically, I'm doing everything I can do to encourage this pregnancy to continue. If something's going to happen despite that, then it's going to happen. If I spend all this time worrying and everything turns out fine in the end, I will have tarnished an incredible experience with worry. And if I spend all this time worrying and it ends badly, all that worrying wouldn't reduce the grief. So I'm trying to let the worry go. Not necessarily very successfully, but I'm hoping I'll get better at it with practice.

Whatever will be, will be. Maybe I should tattoo that on my forehead.

Pictures

Here they are, pictures as promised.

The first one is the most clear one from Friday's ultrasound. The head is on the right side, and the white triangle is the nose. I think the ultrasound tech said the straight right line below that is the upper mandible, and the white area below that is the jaw. The left foot is on the far left side of the image, and the right foot is the light white blob above the short bright white line. I'm not sure what that white line is or what the bright white line running along the bottom is - maybe the spine?

This next photo is not the most attractive, so I can't quite believe I'm sharing it with you. But it is what it is. At least I don't have to show my face... :-)

And let me just say, not all of that bump is baby, not by a long shot. Even when I weigh 40 pounds less than I do now, with a BMI that is in the "Healthy" range (i.e. below 25), if I were to wear something form-fitting, I'd still have the kind of stomach that makes people look and think "Hmm, is she or isn't she?" About 90% of my body fat tends to congregate in my belly, something that no amount of sit-ups or cardio seems to be able to change.

From yesterday (11w1d):

Nose!

There's a nose! I'm almost as excited about the nose as I was the toes.

It's late, so I'll leave it at that for now and post more this weekend, maybe even an ultrasound pic and the first belly shot, if I get myself organized enough to scan in the first and take the second.

I should have posted sooner, so I'm sorry if I worried anyone. Our appointment was toward the end of the day, and when we got home I took a long nap and then did something I haven't done in a couple months - cooked dinner.

My Body Is...Functioning??

RE's office began weaning me off the meds last week, and we made the second change to the dosages over the weekend. I had blood drawn on Friday and again today. And even though we cut the PIO down to 1/2 a cc per day from 1 per day, my progesterone level rose a few points.

I've been worried that my placenta wouldn't kick in, but apparently, my body is functioning. Correctly.

I honestly don't know how to wrap my head around that. I've had, literally, 8 1/2 years of bad news about how my body doesn't function like it's supposed to, many of the malfunctions being fertility-related, others not. So this is new.

I think the best way to explain how I feel is to say "Hopeful, but not yet trusting." The analogy that keeps coming to mind is having a relative who has an addiction and decides to check himself into rehab. You're hopeful, because he's taking a positive step in the right direction, but that doesn't mean that the day he walks out of there, you're going to be 100% trusting that he'll stay on the wagon permanently without the wheels falling off at some point. Building trust takes time.

On the bright side, the ultrasound tech said that today I looked more calm than I have in the past. Apparently I've had a pretty wide-eyed, freaked out look up to this point. (Big surprise, I know!)

And I was feeling pretty calm, until we were on the way over there and I realized it's 10w4d, and the only other ultrasound we've had during the 10th week was the one at 10w2d when we found out that Baby #5's heart had stopped.

I had a few moments of panic where I thought maybe we should just skip the mid-week ultrasound this week - somehow 11w0d (Friday) sounded safer to me. (I didn't say logical, just safer...) But I kept those thoughts to myself and let R drive on.

This time, the tech was able to see Kiddo well enough through an abdominal ultrasound that she didn't need to follow it up with the transvag approach. Heart still beating, still in the 160's, legs and arms had grown and were waving around a lot.

Kiddo is measuring 2 days ahead of schedule. I just wish I could call my dad and tell him that. Today is the 4-month anniversary of his passing.

Venturing Out

We didn't wind up going to the movies this weekend, mostly because the two movies I was most interested in are no longer in the theaters. But I did have R take me out to run a few errands.

I think I overdid it a little bit, but everything still seems to be fine. I got out of breath walking from a parking lot to the back of a store, and then when we got to the grocery store, I had to sit at a table by the coffee kiosk, because I knew there was no way I was going to be able to make it around the store.

I'm glad we're doing the twice-a-week appointments, because I seem to hit a point of concern around mid-day on Mondays. Today, I was concerned because I hadn't been feeling any stretchy/pulling feelings, which I've had pretty much every day. But thankfully, they're back again this evening.

They've been feeling a little different the last couple of days - somewhat higher up than the groin area, and more sharp/pinchy than achey. So of course that makes me nervous, too. :-) But I've been telling myself that it's probably because my uterus is moving into a different position and it's (hopefully) starting to rise up a bit. Plus, this is a couple weeks further than it's ever stretched before, so the change to sharp/pinchy makes sense.

I'm curious what all of you think about renting a doppler? I would have expected myself to already have ordered one, but I haven't. I think I'm worried about how I would react if I couldn't find the heartbeat. R thinks it will just cause me extra worry and stress.

And one last question. I just switched over to the new Blogger interface before the last post, and even though I'm still entering two returns after the end of each paragraph, now I'm having to put in line break tags to prevent the posts from being one giant paragraph. I never had to do that with the old interface. Am I doing something wrong, or are any of you having the same issue?

Double Digits

I'm beginning to feel like a broken record, but in a good way.

There's still a heartbeat. It was down to 167 or 168 today (from 182 a week ago), but I know it usually peaks at about 9 weeks and then starts to slow back down again, so I'm trying not to worry. Both the u/s tech and the peri said it was fine.

We are finally into the double digits! Kiddo measured at 10w1d today, so 1 day ahead of schedule and almost exactly 1.5 inches in length. My retroverted uterus has also started to move into the correct position, although the tech guessed it'll probably take another couple weeks to get completely straightened out.

Today, Kiddo was on his/her stomach, the head slightly lower than the body. We could see an arm waving and the body moving a lot, but we couldn't really see the legs/feet today. No toe viewings. :- (

Since I haven't had any bleeding in 15 days, the peri said I can start to do light activity around the house. No exericsing, no heavy housework (ha! Even when I'm not pregnant, heavy housework is not likely to happen), no returning to work yet. She said we can discuss returning to the office during next Friday's appointment, depending on how the week goes. I did get permission to go to a movie, though, so I'm looking forward to an out-of-the-house adventure that does not involve lab work or an ultrasound wand...

The Tuesday ultrasound really helped with the stress factor - I was more calm going into this ultrasound than any of the prior ones. Of course, the fact that I had to go to the bathroom about 15 times yesterday (literally) and felt nauseous this morning also helped, too.

But I'm still only scheduling appointments one week at a time. I'm happy, I'm thankful, but I'm still taking this in very small increments.

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.

Beta #5 Coming Up

I'm trying to stay hopeful, but for no reason in particular, I haven't been feeling very optimistic today.

Actually, that's not true. I think the reasons I'm feeling discouraged are because I've spent entirely too much time with Dr. Google today. Pretty much everything I found when I searched for "pink* gray* tissue miscarriage" pointed to being fetal tissue, so I'm pretty sure we lost at least one. And my cervix feels a lot wider and softer whenever I put the suppositories in, which also does not seem to be a good sign.

Also, the achiness is still coming and going, I don't have any morning sickness, and I'm not feeling any of the other stretchy, weird, one-side-or-the-other kinds of feelings I was feeling up until a few days ago, which I assume were implantation and/or my uterus stretching.

On top of all that, I also saw plenty of stories where women saw heartbeats at 8, 9, 10 weeks or made it to 15 or 20 or 25 or 35 weeks and still went on to lose their baby/babies for one reason or another. And that's already happened to us once. So that just underscored the reality that even if everything looks good during the first ultrasound, every day of this is still a new, uncertain day.

On the bright side, I'm only spotting now, and it's mostly brown or very light pink.

I had called and left a message with the reproductive immunologist's office yesterday to see if I should stop the aspirin/Lovenox. A nurse called me back today and said to stay on those since the spotting is brown at this point, but stop them if it turns red again.

She also said they want another beta, even though RE's office said they'd rather not. So I have another stat order for an HCG and progesterone tomorrow. We'll see what happens.

And Sue, weren't you the one who told me to back away from the HPTs? :-) But to answer your question, I stopped on the way home from Friday's beta and bought another box of 2. The one I took when I got home looked very similar to the one before that - the test line was much darker and wider than the control line.

I have one more left, but I figure my levels would have to be down somewhere near 300 before I'd be able to tell the difference, and even if my levels are dropping, they probably haven't dropped that fast. So I'll try to hold off on the last one, at least for now.

I have to go get a RhoGham shot tomorrow morning. My best bet is to go to the ob/gyn I've seen in the past, but I had decided to switch to a different doctor this time around - a perinatologist one of my friends recommended. My first appointment isn't scheduled until 8/11, but I think I'm going to call them in the morning to explain the situation and see if they'll help me out. I'd just really rather not go back to the other doctor's office if I can avoid it.

And even though I'd really prefer to do the ultrasound as close to the end of next week as possible so that we have the weekend to cope if it's not good news, I think I'm going to see if I can get it moved up to 8/8, assuming that it appears we still have a reason to go to the appointment at that point.

Have I Mentioned I'm Not a Big Fan of Rollercoasters?

And yet, here we are.

I've never been one to define strapping myself into a cart, racing around a metal (or, scarier yet, wooden) track, and praying we don't derail as "fun". But at least that's over in the span of about 4 minutes.

Clearly, this "what the heck is happening inside my uterus??" rollercoaster is promising to be a much longer ride.

As bedtime approached last night, the achiness and kind-of-but-not-really-cramping feelings started to get quite a bit stronger, and the bleeding increased a little, although it still wasn't anywhere near full flow. The last time I went to the bathroom before bed (warning: TMI ahead), there was still the bright pink/red bleeding, but also a small, almost teardrop-shaped, smooth, grayish/pinkish blob of some sort.

It was only about half an inch long, and I didn't poke at it. I don't think it was a clot, because those are usually dark red/purple and sponge-like, and this was neither of those things. Maybe it was a gestational sac? Although it didn't look transluscent, which is how I've seen gestational sacs described. Maybe it was part of the placenta?

Whatever it was, as soon as it passed, the achiness really started to ease up, and by morning it was completely gone. The bleeding seems to be slowing as well, and now it's a light pink/brown combination rather than bright pink/red. It hasn't quite slowed to the point that I would call it spotting, but I'm hoping it will get there soon.

In the meantime, I'm still laying here in bed, and poor R is running up and down the stairs bringing me food, doing laundry, etc.

All we can do is wait. And see what the next bend in the track brings.

Beta #4

Well. 2,091 - a doubling time of 44 hours. P4 and E2 in normal range, though I really would have preferred the P4 to be higher than 7.5.

So we wait. And I lay in bed. Or is it lie? I could never keep the rules around that one straight. The nurse said she'd rather i stay in bed than get up to get another beta, so another one isn' t on the schedule at this point. If the bleeding changes significantly, then a repeat beta may be ordered.

Today's beta means I'm still nursing a thread of hope. The continuing bleeding means it is a very frayed thread. Let's hope this is just an initial, isolated bump in the road and isn't indicative of what the next 8 months are going to be like...

Bleeding

There's bleeding.

Not full flow, but certainly more than spotting. Bright pink at first with no tissue, now bright pink mixed with brown and a little bit of tissue.

I had blood drawn this morning for P4 and E2, and it started a couple hours after that. I called the clinic and spoke with a nurse, so she called the lab to see if they could add an HCG. I'm assuming they could, since she hasn't called me back to tell me to go in and get drawn again.

I'm now officially on full bed rest, only supposed to get up if I have to go to the bathroom. And when you're constantly thinking about going to the bathroom, and what you're going to see when you do, it feels like you have to go every 20 minutes or so. (No, I'm not actually getting up that often.)

I know what everyone says about SCH, and the nurse said it's a possibility, but I'm not hanging my hat on that. My symptoms were less on Thursday (nausea, having to go to the bathroom frequently), and today they're non-existent except for the thinking-about-having-to-pee situation.

I just want to know, one way or another. I suppose if the beta is significantly below 664, we'll know. But the nurse also warned that the number might not tell us a lot - if it's higher than 664, we won't necessarily know if it's on its way up or down. She also mentioned the possibility of both of them starting to take and one not continuing on. So I may have to get blood drawn for a 5th time on Sunday.

And, since that isn't enough fun, I also have to arrange for a RhoGham shot within the next 72 hours.

Calmer...(For Now, Anyway)

You guys are awesome! I've been checking in on the comments all day, and they really do help make me feel better. I couldn't ask for better virtual hand-holders than all of you. :-)

The last time I saw any sort of spotting was that 4 a.m. trip to the restroom. There was a tiny little bit of staining around noon, but that looked like what I've been seeing for the past week, so I chalked it up to cervical/vaginal irritation.

I still haven't been quite as bloated today, and I haven't had some of the uterine sensations I've been having, but I keep trying to remind myself that I won't have every single symptom to the same degree every single day.

And, I think the morning sickness kicked in this morning. I felt a little bit of nausea yesterday morning, but I wasn't sure if it was the real thing or just nerves over beta #3. This morning, even though there was the spotting, I knew it wasn't nerves.

It was great - it lasted most of the day. Never have I been so thrilled to feel not well... :-) So I'm hoping for more of the same tomorrow morning.

I also keep trying to remind myself that in most of the other pregnancies where the end began with bleeding, the bleeding didn't stop once it started. There was only one other one (my first pregnancy) where I spotted on and off for about 5 days before it was clear that it wasn't just normal pregnancy spotting. So if the intermittent spotting continues, hopefully I'll become a little less uptight about it at some point.

On the other hand, I spoke last night with an IRL friend who has struggled with infertilty for longer than average and is now going to be delivering twins in a couple weeks. I'm changed things up this time and scheduled the appointment with her ob, who is a peri. (Apparently I'm hoping some of her luck rubs off...)

My friend told me that when it came time to get in the car and go to the first ultrasound, she told her husband she just couldn't do it - she was too afraid and anxious. He was able to coax her into the car, and then she said she stood there in the parking lot and couldn't bring herself to walk into the building. She eventually went inside, and then when she got on the u/s table, she cried and cried and cried - too hard for them to do the scan until she was able to calm down.

I said, "Oh, good, they've seen that before. So they won't be surprised if I do the exact same thing!"

The u/s is scheduled for Thursday, Aug. 11 - two weeks from tomorrow.

I made the appointment, I still have the appointment, but that is as far as I have allowed myself to come. The receptionist told me she would e-mail me a new patient packet that I need to fill out and that I also need to arrange to have records from RE and former OB sent over. I haven't received the e-mail, and I haven't called her to tell her that or called RE/former OB to get records sent over.

I'll get to the first part of next week and then see if I'm ready to take those steps. Just scheduling the appointment felt like a risk - I'm not yet up to anything more than that.

I could make it easier by going to the local RE who handles my monitoring. I'm already an established patient there, and I wouldn't have to get any records transferred. But somehow, I just don't want to.

When we walked out of the clinic after the transfer, I told myself that whichever way this goes, I am no longer an infertility patient for the foreseeable future. I won't totally rule out me doing another transfer at some point down the road, but not as our next step. So I guess I just don't want to hop back into the stirrups as an infertility patient with someone who was actually my very first RE in this whole process and has known me throughout the journey.

Apparently, I'd rather spread around to strangers the fun of dealing with the completely hysterical mess that tends to be me on ultrasound day...

Uh-Oh

Typing from Nook at 4 a.m., so this will be short.

Had dinner, fell asleep for a couple hours, came upstairs to go to bed. Felt a couple sharp pains right before bed. Didn't like them but decided not to worry.

Didn' t have to get up to go to the bathroom for 4.5 hours. Told myself not to worry (should have been only 3 hours) even though I had a lot to drink last night.

Got up to let the dogs out, went to the bathroom.

There is spotting again. But this time, it doesn't look like the staining type of spotting I've been seeing, it looks like the bad kind. And now there's a pain on the left side of my ute area that I don't like.

I got cocky yesterday and scheduled the first u/s after getting the beta results. Ha!

Now I'm worried.

Which Path Will It Be? (aka Beta #3)

664. A doubling time of 38.06 hours.

Huge sigh of relief.

So for now, we are still on this path and will see where it takes us.

I will post more later, but wanted to put up the result and say thank you again to all of you for your support. I will continue to need virtual hand-holding, I'm sure. :-)

Slowly Losing My Sanity

So, since it appears the HPT line has gotten as dark as it's going to get, do you think it's an unreasonable approach to start timing how quickly it gets dark as a measure of whether the beta is still rising or not?

I'm only half kidding.

I just did yet another HPT. (I believe this is #9.) Now I'm checking to make sure the line doesn't start to get more faint.

Once again, thank you for all of your supportive comments. You're what's keeping me still a semblance of sane right now.

Here's how the last 24 hours have gone:

I did some more research yesterday (surprise, I know!) and found a lot of places that said 48-72 hours is a normal doubling rate. I read, and re-read, and re-read all of your comments.

I start to feel better.

I get an email from my regular nurse this morning: "Congratulations!! So far, I think it looks fine..."

I feel better still.

I can't leave well enough alone.

I e-mail her back: "So you don't think it's a problem that it didn't double?" She responds: "Yes, if it had doubled it would be a better sign..." She went on to say it was still a "normal increase" and that the first beta was "very good".

I fixate on "if it had doubled, it would be a better sign".

Hope fades.

The day progresses. I don't have any spotting.

Hope starts to rise again.

Then I start to worry that perhaps the lack of spotting is a bad sign. (Only in my completely screwed up brain, I know...)

Hope fades.

I realize that I am having to go to the bathroom more than usual today. This is usually a good sign for me.

I start to feel more encouraged.

Reading an article online, I come across a reference to a book called 50 Ways to Soothe Yourself Without Food. It's written to help emotional eaters. I'm doing pretty well at not doing a lot of emotional eating, I lie to myself (as I'm eating a bowl of cookies n cream frozen yogurt). I check out the book on Amazon to see what kinds of reviews it gets.

Some achey, not quite crampy, feelings begin. I start to get the physical feelings I get when I'm about to start my period. I remind myself that I had those same feelings at the beginning of the last week, too.

I hope that this is a good sign. I worry that it's not.

I decide to check to see if there is any bleeding and do another HPT. (The last one I have in the house.)

There is no bleeding, no spotting.

The line comes up on the HPT faster than it ever has - a lot faster than the control line. (This is when the stopwatch test idea enters my mind.)

I look at the line. Ok, it's dark, but it's not quite as dark as the last one I did. I can't remember exactly when I did the last one. Maybe Saturday morning.

I think maybe not enough time has passed. After all, it's only been about 20 seconds.

I write this post.

I go back to check on the test. It turns out, the line can get even darker. But the control line on this one is a lot fainter than the control line on the last one. This one and the last one are out of the same box, shouldn't the control line be similar between the two?

Still, I can't help it - hope rises a little bit that maybe this darkest yet line means that everything is still on track.

Beta #3 (and a repeat progesterone, at my insistence, even though the last one was fine) will be tomorrow morning. (Silver - the first two draws were at 8:30 a.m. This one is scheduled for 8:15. But I appreciated the idea you had... :-) ) I will ask them not to call until the end of the day, because I have meetings all day.

I need to buy the 50 Ways book - I have to figure out a way to keep my sanity in check.

I hope R hasn't eaten the last of the fro yo.

Beta #2

Once again, there are tears. Lots and lots of tears. And they're not happy tears.

It's not horrible, but it's not great either. It only rose to 277, so it didn't double.

The nurse who called is one I've never spoken with before. She said it only rose by 53%, they were concerned, and I'd have to get a repeat beta on Tuesday. When I pointed out that 149 doubled equals 298, so 277 couldn't bethat far off, she argued with me at first but then finally relented and went to ask someone else.

It's actually a rise of 86%, a doubling time of 53.66 hours. And when I look in the Beta Base calculator, the average for a singleton at 16dpo is 206 overall, 202 for the 33-37 age range.

So why am I so darn upset? I don't know, but I am. R has put a tissue box on one side of me, and an adorable, fluffy cat on the other. Normally she's a grump, but she rises to the occasion when I have moments like this.

I have a 14-page paper due in 9 hours. I've barely started. I can write fast, but even so, I don't think it's going to happen...at least, not by the deadline.

Beta #1...

...is finally here.

149.

So, much, much better than the 11 we had last year. It's higher than average for a singleton on the Betabase chart (102 is average overall, 99 for my age range), but below average for twins (206, 209 for my age range). So who knows? But for now, at least one has started to take, so I'm going to just enjoy that.

I mentioned the bleeding to both the RI's nurse and the nurse who called with my beta, and both seemed to think it's the suppositories that are causing the bleeding. I've stayed in bed as much as possible today, and there hasn't been much bleeding, so I'm still calm.

The conversation with my boss went well; she was very understanding, so I'm just going to work from home next week.

Hopefully Sunday's number will double. For now I'm trying to decide if I should test again tonight or make myself wait all the way until tomorrow morning. :-) This morning's test looked pretty much the same as last night's, but then again there was only about 9 hours between the two.

I figure that at some point, the line just can't get any darker. But I may wind up with a countertop covered in tests while I check out that theory...

More Testing, More Spotting

Thank you for all of the encouragement and support. I didn't post again last night because I wound up waiting until this morning to retest. The line was significantly darker.

Hope rose.

Then before I left work this evening, I went to the bathroom. And there was a fair amount of reddish orange blood covering some of the surface of the pantyliner, and more when I wiped. (Sorry, I know, TMI.) And I'd been achy again.

I had an acupuncture appointment right after that, and as soon as I laid down, the achiness eased up.

I stopped on the way home and bought 4 more tests. Tonight's test is darker than this morning's, just barely lighter than the control line. (I haven't taken photos yet, but I will.)

I will be testing again tomorrow morning. :-) Beta draw is at 8:30 PT.

On the advice of an IRL IF friend, I'm going to get into bed and stay there as much as possible for the foreseeable future. I wasn't going to say anything to my boss (we're not in the same state, so we don't see each other, just communicate via e-mail and phone), but I think tomorrow I'm going to tell her what's going on and tell her I'm going to work from home indefinitely. (My phone number on caller ID and dogs barking in the background give away my location, so I can't just pretend I'm in the office and not tell her...) She doesn't know anything about our IF/adoption history. Let's hope that goes well.

Pictures, and Spotting

Here's the first picture from last night. It was difficult to get the line to show up in the photo. I don't know if you'll be able to see it or not, but it's definitely darker than it appears in this picture.



I did the EPT last night right before bed, and for the first time ever on an EPT, it said:



So, yea hurray. Last year, I still got a "not pregnant" on an EPT from the same box when my beta was at 45, so I'm assuming this means the hcg level was at least 50 last night.

Today was fine, but then on the way home from work I started feeling some achy pains. I wouldn't say they would qualify as crampy, but still, I think I'd prefer to feel nothing at all at this point.

When I got home, I put in another suppository, and there was a fair amount of light pink. I would like to think it's just because the suppositories (they're tablets, not the waxy kind of suppositories) are irritating my vaginal lining. However, it had been 10 hours since I'd put in the last one, so I don't think the bright pink could have been from that. And I'd be surprised if that much bleeding happened that quickly from the suppository I had just put in.

I laid down for a while after that, and the aching stopped. But then when I got up and went downstairs for dinner, it started back up again. It's still going on.

I had promised myself I wouldn't POAS again until tomorrow night, but now I think I'm going to be chugging some water and doing an "is it darker, is it not?" line comparison tonight.

I want some indication of which way this is going, but I'm not freaking out. I'm just resigned at this point - either it's going to work or it's not, and if it doesn't, it doesn't, and we move on.

Or at least, that's what I keep telling myself.

So, I Tested

During last year's FET, I tested at this point. It was a Monday night, and the first offical beta was on Thursday morning. There was no line on Monday night. Not even a hint of one. And it wasn't until Wednesday night - 12 hours before beta - that if I held that night's test literally right next to a lightbulb and squinted really, really hard, that I could barely see what had to be the faintest line ever.

Here we are again at that same point - Tuesday night, with the first beta scheduled for Friday. I was really, really tempted to test last night, but R talked me out of it.

Tonight, I decided to just rip the band-aid off. I told myself that I would stop looking at the test as "positive" or "negative" because, well, "negative" just has such a negative connotation to it, and making it so black-or-white was just adding to the stress.

So I told R I would look at it differently - the result will just be a road sign giving us an indication of our path, nothing more. Nothing super final. One line = the road sign is pointing toward adoption, two lines = the road sign is pointing toward seeing where my uterus takes us in this process.

I tested. I set it on the floor in the water closet. I opened the door to check on it twice within the first 30 seconds.

I didn't see a second line.

I decided to forget patience and just picked the thing up and stuck it on the sink counter. And then I looked again. A full minute hadn't even passed yet.

And there is a second line.

And I don't have to hold it directly next to a light bulb to see it. I don't even have to squint. It's there.

It was a FRED. I have a couple of EPTs, which have never, ever been kind to me. They always show up with "not" before "pregnant", even when I had a beta of 45.

So tonight (if my bladder is full enough) or tomorrow morning, I'm going to try an EPT and see what it says. And if the darn thing finally leaves off the word "not", I will take a picture and post it.

I took a picture of tonight's test with my cell phone, but it didn't turn out well enough. I'm going to go grab the regular digital camera; maybe that will work better. Because I think for once it's a line that might actually show up in a photo.

We're not overly excited. At all. In fact, we looked at the test, said "Okay," and then left to go grocery shopping.

But I am going to enjoy this (apparently in a very unexcited way) for every moment, regardless of how many (or how few) moments it lasts. And be a little, little bit happy that at least in one tiny part of the process, it seems I can actually count on my body to work correctly, at least for a little while - this is the 5th treatment cycle in a row where we've gotten a positive. Now if only we can get it to stick for another 8 months this time...

'You're Up and You're Down'

My mood - and degree of hope - is a bit like a Katy Perry song at this point. But thank you all for your words of encouragement and support. You're helping keep me sane. Well, I suppose that word is relative at this point, but you know what I mean... :-)

I've managed to make it this far without testing. I was tempted this morning, but I talked myself out of it.

Friday night, we were laying in bed watching TV, and I began to feel something kind of like a kitten very gently kneading inside my uterus. I refused to get up for fear of disturbing anything that might be happening, so I took off my contacts in bed and made R take them into the bathroom to clean them. (The things that man has done for me these last 9 years!)

There haven't been any other consistent sensations, just an occasional twinge here or there. When I feel one, hope surges. When the twinge doesn't continue, hope fades.

This afternoon, I was feeling really sleepy. I know the progesterone supps cause that, but still...like I said, up and down, up and down...

I need to stop at the store and stock up on some FREDs, so I'll probably do that on the way home from work tomorrow. My guess is that's about as long as my willpower will hold out.

Feeling...Nothing

Two days post-transfer, and there's no implantation spotting (the one time I want to see a little bit of bright pink on tp, and where the heck is it?!), no pinchy implantation cramping, nothing.

For the two FETs I did that made it to at least 6 weeks, I had a tiny bit of implantation spotting within 24 hours of transfer. For the 1 FET that was negative and for last year's FET that was pretty much over as soon as it began, there was no spotting.

I always have implantation pinching/cramping, always. Last year, it was less than I would have liked, which is probably related to the fact that it ended so early.

So I am bummed.

And then I had a dream last night - R and I were in a room somewhere (blank white walls, nothing to distinguish it), and then we got the call from the nurse: BFN. After that, I walked out into a hallway, and there was Kerry Vi.ncent (of the Food Network's "Challenge" show) saying in her signature disdainful tone, "I don't know what you were thinking..." and shaking her head at me. (As in, "I don't know what you were thinking by hoping this would work.")

But then again, we've done everything different this cycle - different supression protocol, different acupuncturist, different immune treatments, staying at a different hotel, different RE did the transfer (Sur. - he was very nice), different number of embryos, etc. And if this works, I'm going to use a different ob/gyn this time, too.

So maybe this is just one more thing that's different, and it'll lead us to a different outcome. Because as R pointed out: "You may have spotted, and you may have cramped, but look how that turned out in the end."

They're On Board

I'm officially incubating. We transferred two Day 5 blasts: both survived the thaw, both were 100% re-expanded without losing any cells, and both had hatched. It was a different RE than our regular one who did the transfer. He was very nice and said blasts couldn't get any more perfect than that. Hopefully "perfect" = "they'll stick around."

I was too stressed about this to sleep much last night - I tossed and turned for all but about 2 hours. Finally around 6 a.m. I decided I might as well do something helpful and productive, so I got up and went to the hotel fitness center to walk/run (mostly walk) on the treadmill. That helped calm me down and made me feel stronger. Note to self: Must exercise more often.

I teared up a couple of times while we were at the clinic, but surprisingly I don't actually cry. I was quite proud of myself for that. :-)

Of course, the valium might have had something to do with it. I don't remember it having much of an effect on me last time, but this time it almost put me to sleep. I'm still feeling very zen - we'll see how long that lasts.

So, do you think tomorrow is too soon to start testing?

It's a Go!

The repeat blood draw at the other lab came back at 0.2, so RE's office says the cycle is still on. I still had a small bit of doubt, because how do we know it's the first test and not the second that's wrong?

But then I called the place that ran the first test (it was a local RE's office), and they were great. They got someone on the phone with me right away, and she explained that their office uses a different assay than the other lab, so in their lab anything less than 6 is equivalent to 0.5. So she was also very confident that I hadn't ovulated and that it was fine to proceed.

Why their results sheet doesn't make that clear, I don't know. And she said that our RE's office should know the less-than-6 rule, because they do monitoring for a lot of our RE's patients. The nurse at RE's office said she had never heard of that, but as long as everyone is in agreement and there is a valid explanation, I'm not going to have any "what if's" lingering in my mind over this.

So that was great news. Then the IVIg infusion coordinator called and said "um, I just checked in with your insurance and there's been a change...call me back."

I was afraid she was going to say they reviewed the preauth again and denied it. If so, we'd be paying about $3,500 out of pocket.

Well, it's going to be $3,000, but for a different reason. When she originally got the authorization, it was in May. My company's benefit year runs from June 1-May 31, so this year's benefits took affect on June 1, which means a new, $3,000 out-of-pocket requirement before insurance will start covering anything.

Fortunately, last fall when we signed up for R's benefits (which run from Jan.-Dec.), we knew we'd be doing IVIg and figured it wouldn't be covered, so we did the maximum contribution to his FSA account. So while we'll have to pay out the $3,000 up front, we'll be able to get it back pretty quickly through that.

Now that we're sure we're going to the clinic, I've got to figure out a place for us to stay. We're both going to be working all week, so we were hoping to get a 1-bedroom suite for the separate spaces while we're both on calls.

However, something major must be going on in Denver next week, because we can't find even one hotel anywhere vaguely near the clinic that has anything other than a studio available. (Well, maybe we could if we were willing to spend $300-$400 a night, but that's just not in the budget.)

Wish me luck, in more ways than one. :-)

Possibly Canceled, and Another Surprise

So, it seems that every time I move an inch closer to the finish line, it moves an inch farther out. Or, in this case, possibly a month.

My progesterone level is never, ever, ever above 0.5 during CD21 tests in a natural cycle. Except during last year's transfer, when it was slightly above 1 and caused the transfer to be moved up a day.

And this morning, when it was above 2. It would figure - the two times my body works like it's supposed to is when we're trying to do a transfer.

RE's office thinks maybe there was just a lab error, so I had to get redrawn this afternoon. We'll find out tomorrow. If it wasn't, the cycle has to be canceled, because it's too high to know for sure when it started to rise, so they wouldn't know with confidence which day to do the transfer.

I'm scheduled to have IVIg on Saturday, and our flight is scheduled for Sunday night.

I was on a bcp/lupron overlap protocol. Both of those things are supposed to prevent ovulation, aren't they (indirectly in lupron's case)? So that's what makes RE's office think it was a lab error.

Still, not great news.

But I had plans to have dinner with a former co-worker, and I was looking forward to that. She's a couple years older than me and also has no kids due to fertility, so she can relate. Except, it turns out, now she's 13 weeks pregnant.

I tried my best to put on a happy, excited face for her. But I'm afraid it probably wound up looking more like a "Seriously, universe?? How many more I-can't-get-pregnant-but-oh-look-now-I-am announcements are you going to send my way?" face.

On the bright side, at least I managed not to cry.

An Honor (and Trying Not to Hyperventilate)

I was going to lead with a title like "We've Been Chosen", but given that you'd probably think it was related to adoption, I didn't want to be deceptive. Nor do I want to jinx us...

So, you're wondering, what is this honor? Well, we actually have been chosen (in a manner of speaking) by a couple who thinks we'd make good parents. R's best friend and his wife approached us a couple of months ago to ask us if we'd be willing to be legal guardians and take custody of their son if something (heaven forbid) should ever happen to both of them.

But they also mentioned that they were considering several other people as possible guardians, so when we didn't hear anything more about it, we assumed they'd chosen one of their other options. Then a few days ago they called to tell us that they'd made a decision, and it was us.

I have to admit, even though this is a situation where of course we hope we will never gain custody of the child involved, it still felt really nice that they chose us from among all of their options. We are truly honored.

We also have to figure out how to hang out with a 7-year-old. R hangs out with his best friend and their son frequently, so he's comfortable with R. We also spend time as a fivesome doing various things (including weekend trips), but his parents suggested that it would be good for the two of us to spend an afternoon with him (just the three of us) every once in a while. I have to admit, I had a fleeting moment of "What if he thinks we're boring/lame/hates us?" But he's a great kid, so I know it'll be fine.

That's actually not what's creating the hyperventilating. The transfer is in 10 days. Beta is in 19 days (or maybe 20, depending on how I feel about the 22nd at that time). In less than three weeks, we'll know the outcome of step 1. And then be plunged into the unknown of step 2, because either way, it's an unknown. Even if we get to step 2 of a pregnancy (meaning the day after beta), that doesn't guarantee the next day, or the day after that.

As I write this, it's just dawning on me what's causing the hyperventilating. I was thinking that coming face-to-face with the beta results - the answer to which path we'll be going down for step 2 - was what was causing it. But I think it's really the unknown of step 2, regardless of which path it is, that's bothering me.

Have I mentioned that I'm not a big fan of uncertainty and unknowns?

This Oughta Be Fun

The results of my first E2 level check for this FET cycle came in yesterday. It was supposed to be at least 50, but it was only 8.

So instead of stepping up to 2 estrogen patches, then 3, then 4, I'm going straight from 1 estrogen patch to 4 patches, plus oral estrace twice a day. R is already bracing for the hormonal moodiness that is bound to ensue. :-)

The blood draw was on Monday. It was kind of complicated, because I had one order from RE for the E2, another order from the PCP for a thyroid panel, and then vials for the communicables that needed to be drawn and spun but then shipped to RE rather than run by the lab. Plus, R was with me to contribute his 2 vials for the communicables as well.

I have to admit, I couldn't help but think "I hope this is the last time I have to do a draw for something other than one simple, straightforward order." I'm afraid to find out how the cycle turns out, but at the same time I'm also ready to move on.

Speaking of which, I held out for as long as I could, but I finally gave in today and called the adoption professional we're planning to work with if the cycle doesn't go well. I'm working on updating our profile. You know me - always a backup plan. I think I'm on Plan T at at this point...

T Minus 28

Assuming all goes well, I will be incubating four weeks from today. We booked our flights last night. Gulp.

I'm trying to be calm about this cycle, but it feels like there's so much riding on it. I looked at R last night and said, "You mean if this doesn't work, I'm just supposed to stop? Give up? Admit that I can't do this? That something 85% of the population has no problem doing (half of them without even trying or meaning to), I can't do it despite 9 years, 2 countries, half a dozen states, and who knows how many needles/cycles/procedures?"

Clearly I'm not good at accepting limitations.

R pointed out, though, that succeeding at incubating isn't the end goal and that we will still have other options to get to the end goal if that particular route doesn't work.

I saw my therapist today. Our next appointment will be exactly one week after transfer, assuming transfer occurs as scheduled. Even though that's a couple days before the first beta, I'm sure I will be peeing on a stick that morning, so I told her to be prepared.

She asked if I'd rather wait to see her until after the betas. Ha. I'm pretty much going to need to be camped out on her couch for about a week, so I scheduled another appointment for a couple days after the second beta.

I'm still not really letting myself process the grief about my dad yet. She pointed that out too, but surprisingly gave me a pass again this time.

But I can tell that it is slowly bubbling to the surface - after I left her office, I swung through a drive-thru to pick up dinner, and they were featuring a banana pudding milkshake. Banana pudding was my dad's favorite dessert (I made three huge pans of it - seriously underestimated how long it takes to cook 12 boxes of cook-and-serve pudding! - for the potluck reception after his services), so I ordered the shake. And then promptly burst into tears. But fortunately there were a couple of cars in front of me, so I managed to (mostly) pull myself together before I got to the cashier's window. Thank God for the trend of Jackie O-style sunglasses.

Stuff...and a New Cycle

I've started several posts in my head during the past couple of weeks but haven't gotten one into the computer until now.

Going through the services for my dad was tough, of course, but there was good in that week at the same time. R and I got to spend some time with my oldest sister and her family (including my niece, who volunteered last summer to be a gestational surrogate for us). Although I'd only met my nephews once before, all of her family was very welcoming to us.

It was really unexpected to me, but in a good way, how much we just felt like family. It was just natural, just there. I don't know how to explain it very well. I generally think of my parents as being my only blood family, and I had no idea how much I had been missing that connection in my life until after the reception following my dad's services, when we were in the car and R told me that I should organize a family reunion. I said, "Seriously? With everything else going on in our world, you think I need to take on organizing a family reunion?" And he said, "Yeah, I know, but you're happy when you're with them." "Happy" isn't the word you expect someone to use to describe you literally a couple hours after you've buried a parent - and honestly, it's probably not a word he has used to describe me in a very long time - but I realized that he was right. So I'm grateful for that connection.

I haven't really started to deal with my dad's death yet. Certainly I shed some tears in the moments after he passed and during the services, but mostly I just force them back and haven't let myself have a good cry yet. I saw my therapist a couple days after we got back home. She said I was reciting the events as if I was describing a movie that I was watching. She pushed and probed a little and ultimately decided to let me live in my little world of denial for the moment, but I don't think she'll let me get away with that during my next appointment in a couple weeks. :-)

We got some surprising news the week after my dad's services - it looks like one of my health insurances (I'm on both my employer's insurance and R's insurance policy through his employer) will cover IVIg! The home health company that will do the infusion let me know, but I wanted to hear it for myself so I called the insurance company to verify it. They confirmed it as well, although I have to say I still don't believe it 100%.

The cost of IVIg had apparently been weighing on me more than I realized, because as soon as we found that out, I was like "Ok, let's get this show on the road!" And, as R and I so often do, he ying'd when I yang'd. He's been so supportive and strong in all of this, but as soon as I was ready to move forward, suddenly he was feeling "Whoa!" and not quite wanting to face the prospect of our last attempt (with my uterus). But now he's on board.

We still don't have quite all of the pieces together, so the transfer could get derailed, but as of right now it's planned for two days after my birthday in July. The reproductive immunologist can order the IVIg itself, but since I don't live in the state where he practices, I have to find a local doctor who is willing to order the actual infusion of the IVIg, or else I need to find another home health company within my insurance's network in his state to do the infusion, and travel there to have it done. I have an appointment on Friday to ask my PCP if she'll order it - fingers crossed.

Also, my TSH level is better but still not where it needs to be. It was 7+ a couple weeks ago, so that's about half of the 15+ it had been, but it still needs to get down into the normal range before transfer. My PCP increased my Syn.throi.d dosage again from 100 mcg to 125 (I was on 75 when I got the 15+ result), so I'll re-test again in the end of June.

Thankfully, though, it does seem that the improved TSH has reversed my kidney issues. My eGFR is now back in the normal range instead of Stage 3 kidney failure, and my creatinine is much improved (still not quite back to normal yet). Granted, the eGFR technically still at the low end of the normal range, but I'm hoping if the TSH gets back to the normal range that the eGFR will move toward the upper end of normal. It still amazes me how all of our body's systems are so interconnected.

And now, after all that good news, here's how I came off the holiday weekend and launched into the cycle (bcp's start tonight): The co-worker who I began carpooling with a couple months ago, who I clicked with right away and was so happy to find someone else my age who doesn't have kids, who I have made it a point to not discuss the kid issue with at all because I just didn't want to go there, asked me point blank on the way home tonight whether R and I have thought about having kids. I tried to just laugh it off with a "Yeah, maybe someday" kind of response.

It turns out she's 14 weeks pregnant. From her first IVF cycle. I am trying hard not to feel sorry for myself, but I'm not sure I'm succeeding.

Dad Passed On

I was not looking forward to last week, but it turned out to be a much more painful week than even expected.

Wednesday was the 5th anniversary of miscarriage #2. Thursday was the 7th anniversary of miscarriage #1.

And then, on Friday morning, dad passed away with his wife and me by his side.

It was somewhat expected, although I don't think anyone - including the oncologist - thought it would be quite that soon.

Dad had seemed to be doing well (relatively speaking) when I spoke with him several times in April, but then test results the weekend after Easter showed that despite the transplant, leukemia cells had returned. So R and I drove out to be with him two days later, and then four days after that he was gone.

I'm thankful he's not suffering any more, and I'm glad his wife, who has literally been by his side pretty much every single moment of every single day since he was diagnosed two years ago this month, no longer has to be a full-time caregiver.

I don't know if it's relief that his ordeal is over or that I've dealt with so much loss that I'm an expert at coping or if I'm just flat-out avoiding dealing with it at all (ding ding ding, I think we have a winner, folks), but so far I haven't really cried. R keeps looking at me sideways, like he's trying to spot the warning signs of the big implosion he's anticipating.

I haven't been in the mood to talk much lately (obviously, since I haven't been posting or commenting). I think between all the infertility stuff and my dad's battle, I'm just tired of medical stuff in general.

We don't know yet when we're going to do our next transfer. A couple months back, tests showed my thyroid meds dosage was way too low (TSH was 15+) and that my kidneys were in stage 3 (the middle of 5 stages) of kidney failure.

My doctor increased my thyroid meds, and I think that has also improved my kidneys, but I need to get bloodwork done to confirm that before we can move forward with a cycle. I was going to get that drawn last week, but with everything going on, we won't be home until next week, so it will have to wait until then.

Fingers crossed that I manage to keep myself together through this week - services are at the end of the week.

Doggie Pictures

To everyone who commented on my last post, thank you for your words of kindness and comfort. I can't believe it's been almost two weeks since we lost him.

There's a major deadline coming up at work next week that involves an out-of-state trip, so I haven't really allowed myself to think about it, much less grieve yet - I've just been stuffing it in. (Not a good idea, I know! It comes out eventually, and the longer it's in there, the less pretty it is when it finally does happen...)

Anyway, I think I mentioned last fall that we had some professional photos taken after Indy was diagnosed, so I thought I'd share a few of those. However, this blog is anonymous, and while the chances of someone I know happening across it and recognizing the photos is small, it's still not a risk I'm willing to take. Since Blogger does not allow individual posts to be made private, I created another blog and posted them there. If you want to see them, send me an e-mail at momto 3dogs@ yahoo (dott) com, minus all of the spaces, and I'll give you access to it.

Horrendous guilt

Coming out of my cave to share some horrible news.

We had to say goodbye to our "baby boy" at 3:30 this morning. We were expecting that we would lose him to the rare nerve sheath tumor he was diagnosed with in the fall. Instead, we lost him to an intestinal obstruction.

I don't know what happened. I don't know what it was, what he possibly could have gotten in to. There aren't children's toys to get into around here (obviously), we don't leave clothes or other stuff on the floor, he wasn't a chewer or the type to get into things. All of his toys are present and accounted for.

I keep racking my brain trying to figure it out.

It's quite possible that it was something he got into while I was at work, when there's nothing I could have done to prevent it. It's even possible that it was another tumor that was compressing his intestines; the vet offered up that possibility, although it sounded like she thought it was less likely to be that and more likely to be a foreign object. Apparently right before we got there, she had just finished pulling a fully intact pair of boxer shorts out of another dog's intestines. She also mentioned something about having pulled batteries, magnets, bikini underwear and even a tampon out of other dogs.

We could have done surgery. And though it would have been $4,000-$8,000 and required a 3-5 day hospital stay, and though we knew we only had weeks to a few months left with him, I was tempted. I didn't want to let him go like that, for that reason. But then R pointed out that his legs would have been even weaker after all the time he would have to spend laying down during recovery, and I knew I'd only be doing the surgery for me, not for him.

The vet said it wasn't our fault, that dogs will be dogs. That her own dogs have gotten into things they shouldn't, and that I shouldn't blame myself. But I do. How could I not?

I was supposed to take care of him, not let him eat something that would kill him. Maybe this is why we don't have kids. If I can't even keep a dog alive, why on earth would God trust me with a kid?

I know that's extreme. And self-pitying. And on some level, ridiculous. But still, there it is. The thought that keeps playing again and again in my head.