February 26, 2004
Methotrexate Update 2
I had my third post-Methotrexate bloodwork done today. My hcg level dropped dramatically to 13. How sad that this is now good news.
Dr. Vaughn wants me to have blood drawn again on Monday. Considering how much it's already dropped, he's pretty sure my hcg level will be under 5 by then. If it is, I'll be able to go on birth control pills for a month (oh, the irony), and then Dale and I will be able to try again after my next cycle ends.
It hasn't even begun yet, but I now want March to be over with as quickly as possible.
February 19, 2004
Methotrexate Update 1
I had blood drawn on Monday morning. Although it's not uncommon for hcg levels to go up after a Methotrexate dose, mine had dropped to 155.
I had blood drawn again this morning too. The nurse just informed me that my hcg level has dropped again to 115. That's good news, in that it means I won't need a second dose or surgery. I get my blood drawn again next Thursday.
One unpleasant side-effect of the Methotrexate is that I'm cramping and bleeding again. Instead of enjoying my pregnancy, it's like I get to miscarry twice.
February 13, 2004
"Ectopic or Non-Viable Intrauterine Pregnancy"
Thursday's (Feb. 12th) bloodwork showed that my hcg level had climbed to 221 from 177, which was not a good sign. Since my Tuesday exam had showed a clear uterus, it became more likely that I have an ectopic pregnancy. The nurse informed me that they were going to do some more tests on the blood from Tuesday, and they'd call me Friday to let me know what the next steps would be.
This morning, the nurse called to say that all my (additional) bloodwork looked fine, so Dr. Vaughn wanted me to go ahead and receive a dose of Methotrexate. Methotrexate is a chemotherapy drug most often used to treat cancer. In some ectopic/inviable pregnancy cases, an extremely low dose of it (1/10th of a chemotherapy dose) is administered as an alternative to surgery. Dr. Vaughn said the dose I would be getting is so low that very few side effects of any sort are ever reported.
At 1 pm, Dale and I went to the pharmacy, picked up the medicine, and went to the clinic for the injection. While we were waiting, the nurse popped in and informed us that following the injection, there would be a lot of bloodwork and monitoring and there was a mandatory $500 fee that would have to be paid up front. This took us by surprise. We didn't have that much loose change on us, nor were we carrying credit cards, so I ended up spending 15 minutes trying to get through to an insurance rep to find out if they'd cover the monitoring. While I was on the phone, the nurse came back and tried to get us to go back to the waiting room, but Dale refused, so they just shuffled us to a smaller exam room while they waited on our decision.
When I finally got to speak to a live person, she said it sounded like something they'd cover and we should only have a copay, but I'm not sure she knew what she was talking about. Dr. Vaughn came in and explained that we would NOT need to produce $500 in order for me to get the injection and do the monitoring. He said they'd file with the insurance and it would all most likely be covered, so we'd just have the copay. So Dale and I agreed to the injection.
The Methotrexate was administered in two injections in each hip. The injections themselves didn't hurt, but immediately afterwards I had a terrible ache in each hip that made me walk stiffly to the waiting room, then sit gingerly in a chair. We had to wait 20-25 minutes, then the nurse took my vitals again and we were cleared to leave. We left with a stack of lab slips and instructions on all the stuff I have to avoid until the Methotrexate is out of my system (through my next full cycle). Oh, and the ache was gone, so that's a plus.
Women who have had one ectopic pregnancy are more likely to have another, which is now a huge concern for me and Dale. Before the shot, while talking to Dr. Vaughn, we asked him what he thought about In Vitro Fertilization. He said that in a woman with normal tubes, it still has a higher success rate than other methods (regular intercourse and IUI). In a woman with abnormal tubes or a history of ectopic pregnancies, the chances of a good pregnancy through other means drops while the success rate of IVF is just as high. So we asked what his opinion was of us trying with IVF next, instead of doing more IUIs. He said, "I think everyone should do IVF from the start! It's just got the best success rate."
I called our insurance provider after we got home and confirmed that they'll cover IVF. (It actually falls under the same grouping as the IUI method we'd just tried.) So, Dale and I decided that when we're able to try again, we're going to go ahead and do IVF.
February 11, 2004
what happened
Saturday, Jan. 31st, I began some light spotting. It was intermittent and clearly old blood, so I wasn't too concerned. Spotting at that stage of a pregnancy isn't uncommon, especially shortly after the ovum has implanted itself. Monday, Feb. 2nd, my blood test showed that progesterone was ok and my hcg was up as well, so I still wasn't worried. Tuesday, I was still spotting and starting to cramp painfully. Wednesday morning I called Dr. Vaughn and expressed my concerns. He told me to go ahead and have my blood drawn again. Wednesday afternoon we learned that my hcg level had dropped from over 200 (Monday) to 180. I was miscarrying. I was told to stop the progesterone supplements and have my blood drawn again on the following Monday.
Dale and I were heartbroken. We still are. We cried, and held each other, and cried some more. All I could think about is that we were losing our baby. The baby we've struggled to create for two years. Aside from some breast tenderness, I hadn't even gotten to enjoy feeling pregnant. I know that's for the best, better than if we'd lost the baby later in the pregnancy, but that doesn't make it hurt any less.
I avoided it for a couple of days, but I finally looked up information on miscarriages. Friends and family who'd experienced miscarriages shared their stories. Dale's aunt and uncle sent a lovely tulip bouquet. I placed it on the table at the base of the stairs. I put the card that came with it into a drawer. I learned that maybe as many as 1/3 of all pregnancies end in miscarriage, sometimes without the woman even knowing she was pregnant. I learned that with the multitude of activity taking place in a developing embryo, any of a million things can go wrong, and if something does, it's the body's natural response to spontaneously abort. I learned that there was nothing I did wrong and nothing I could have done to prevent the miscarriage. But it still hurts so bad, so fucking bad, and I'd do anything to be able to go back and fix it.
Everyone reassured me that it wasn't my fault and I wasn't to blame, and at least we know now that I can get pregnant, but I didn't fucking care. I just wanted my baby back. OUR baby. I had to keep reminding myself that it was our baby, and Dale was hurting as much as I am.
This past Monday (Feb. 9th) I had blood drawn again. In the mean time, the bleeding increased drastically Sunday night and cramps had become almost unbearable. My hcg had only dropped from 180 to 177, so Dr. Vaughn wanted me to come in for an exam. I was scheduled for Tuesday afternoon. Dale wasn't able to accompany to the exam, which bothered him. And I wish he could have been with me.
Dr. Vaughn did an ultrasound. He said my uterus looked fine, my right ovary was fine, my left ovary had a huge cyst that took up half of it, but that didn't concern Dr. Vaughn very much. He didn't see any trace of the pregnancy, but he's concerned because my hcg level had dropped so little. There's a possibility that the pregnancy could be ectopic (in my fallopian tube), so he wants to retest my hcg tomorrow (Thursday). If it's dropped, he's content to let the miscarriage take its time. If it's plateaued, I may need medical intervention, which could be medication or a surgical procedure, likely a D&C.
A Dilation and Curettage basically involves dilating the cervix and then scraping out the contents of the uterus. A D&C is often utilized in miscarriages, but I am appalled at the thought of having to have a D&C. It's also a common abortion procedure. While I'm far from anti-abortion, I hate the idea that my baby, or what's left of it, will be taken from me in such a manner. I may not have a choice though.
Like many others have already, Dr. Vaughn assured me that the miscarriage wasn't my fault and was probably for the best. Then he reiterated that we now know I can get pregnant and just what it will take. I'm already scared that this will happen again though.
February 04, 2004
miscarriage
we lost the babyMaternity Shopping
I went out for a bit of shopping today and ended up checking out the maternity store at the mall. I had a lot of fun trying on different tops and using the fake belly supplied in the dressing room. :D
I figure several pairs of my pants will carry me a bit into my pregnancy, but since I'll be wearing them low (under my belly), I'll need longer tops to go with them. I ended up bringing home three shirts, two of which Dale even like.
February 03, 2004
What's in a name?
Dale just came across a somewhat amusing article about a man who named his new son version 2.0.
Fortunately, while Dale is a junior, he has no interest in naming a future son "Arthur Dale Hichens 3.0."
February 02, 2004
Progesterone Monitoring, 3rd test
I've been agitated all day, and finally, just before 6pm, the doctor's office called, with good news again!
My hcg level is up to 216 and progesterone is at 19.9. The rise in the hcg level is crucial as it indicates that my pregnancy is progressing. The nurse told me that the progesterone level may flucuate now, but as long as it's above 15, they're happy. Dr. Vaughn still wants to monitor me though. so I'll have more labwork done on Monday.
I feel a lot more comfortable about sharing the news now, so I'm going to publish some entries that I've written over the last week. :D
February 01, 2004
First symptoms!
Although it still doesn't quite feel real, something is definitly going on with my body. My already-small bladder seems to have shrunk to the size of an orange. On the trip home from Houston (about a 3 hr drive), I had to have Dale stop twice so I could pee, and I'd even gone right before we left the house.
The other big change is that my breasts have become really tender. I first noticed Friday night, that when I'd roll onto my side or stomach, it would hurt my breasts. Today, I can't even cross my arms over my chest, and my nipples are getting sore too. I guess some really is happening.
Yesterday, the family got together for dinner at Karen and Thor's (Dale's parents). Jill, his sister, and new mother to three month old Allison, brought me several baby books. I promptly sat down with one of them and learned the difference between gestational age and fetal age.
Apparently, doctors consider the date of your last period to be the start of your pregnancy. Ovulation (typically) takes place two weeks AFTER your last period, so a doctor will consider you pregnant before you even conceive! So, gestational age starts with your last period, and fetal age starts at conception. I'm just ending what I consider my third week of pregnancy, but I'm about to start my 6th gestational week. How whacked is that?
Although I haven't talked to a doctor about it yet, it looks like I'm going to be due in early October, around the 3rd. Once I mentioned that to Dale's mother, she got excited and said that her dad's birthday was the fourth. She was willing to be that the first thing her mother would do would be to asked me to have the baby on the 4th. That wasn't the first thing Grandmom mentioned, but she did mention that Grandad's birthday was the 4th. :D